Last week, we discussed the basics of applied behavior analysis (ABA) and what is involved in an ABA program. As mentioned in that post, ABA is "considered a safe and effective treatment for autism and ‘has been endorsed by a number of state and federal agencies, including the U.S. Surgeon General and the New York State Department of Health.’"  In recent years, ABA has become a popular treatment program, even so, there are some disadvantages.
ABA has been around for decades, although it has not always been considered a treatment for autism. A paper written in 1959 describes how techniques based on the principles of behavior were used to improve the functioning of chronic mentally ill patients [Allyon & Michael, 1959]. ABA became well known as a treatment for autism after a study by Ivar Lovaas was published in 1987. The study involved 19 children who were autistic. Many did not speak and had previously been diagnosed as mentally retarded. All of the children received intensive ABA treatment for 40 hours per week. A few years later, nine of the participants tested average or above average in intelligence and had moved into mainstream classrooms. Lovaas said these children had recovered from autism. Since then, ABA has increased in popularity and is used throughout the country.
PRO - Research Supports ABA as an Effective Treatment
ABA has been well researched and continues to be found to be an effective treatment for autism. Over the years, thousands of studies have been published about ABA. As early as 1972, a review of over 400 studies relating to ABA and autism concluded that these types of interventions showed the most consistent results [Hingtgen & Bryson, 1972]. Another review of over 250 studies was completed in 1996 and again found ABA to be effective in treating autism [Baglio, Benavidz, Compton, Matson & Paclawskyj, 1996].
CON - Time and Cost Can Be Prohibitive
In Lovaas’s study in 1987, children received 40 hours of ABA each week. This amount of therapy is and can be prohibitive because of both the cost and time involved. Many school districts, even those who provide ABA services, don’t have the resources available to provide ABA for that many hours. Therefore, many children with autism who do receive ABA services only receive them for a portion of the time suggested. Each insurance company has different procedures and policies concerning ABA and the remaining cost of providing therapy is not affordable for many families. However, a child doesn’t need 40 hours of therapy to be effective. Programs of 20 hours per week, or less, can and are implemented with good results - although results may not be as immediate.
PRO - Well Trained Professionals
ABA therapists have received extensive, formal training in behavioral analysis. They usually have a masters degree or higher. Most ABA programs are well supervised and therapists follow clear treatment guidelines and thoroughly document progress.
CON - Qualified Therapists May Be Hard to Find
Although the amount of training most therapists receive is a definite positive, on the other side is that many states and localities do not have laws and regulations regarding licensing of ABA professionals. Therefore, anyone can claim to be an ABA therapists. It is up to parents to be aware and to question a therapist’s qualifications. There is a Behavior Analyst Certification Board parents can check with to see if a therapist has gone through the certification process.
PRO - Customization and Personalization of ABA Programs
There is not "typical" ABA program. After thorough observation and evaluation, your child’s therapist will tailor a program to fit your child’s individual needs. While social skills is a big part of ABA, therapists work through a variety of skills, including academic, and focus on areas where your child needs specific help.
CON - Robotic Results
One of the concerns of critics of ABA is that children tend to have robotic behaviors and are not taught to think independently. This criticism comes because part of ABA treatment is to complete drills of appropriate behaviors over and over. Proponents of ABA don’t believe this is true and research studies have not found this to be true. Because children with autism are learning social skills, which may not be natural skills, they first learn to do so through rote and practice, much as you would learn a new language. Children can sound "canned" at first but as they learn to integrate their new skills into their life, the robotic element tends to disappear.
Because each child with autism is different, parents need to look at the different types of therapy available and determine which one is best based on their lifestyle, their child’s needs and their finances.
"About Applied Behaviour Analysis," 2012, Alexandra Rothstein, AlexandraRothstein.com
 "Applied Behavior Analysis (ABA)," Date Unknown, Staff Writer, Autism Speaks
"Applied Behaviour Analysis," 2007, Lara Pullen, Ph.D., Autism Canada Foundation
"Families Cling to Hope of Autism ‘Recovery’" 2011, Dec. 15, Alan Zarembo, Los Angeles Times
"Introduction to Applied Behavior Analysis," Date Unkown, Barry K. Morris, Autism -Help.org:Autism Spectrum Disorder Fact Sheets
Eileen Bailey is a freelance health writer. She is the author of What Went Right: Reframe Your Thinking for a Happier Now, Idiot’s Guide to Adult ADHD, Idiot’s Guide to Cognitive Behavioral Therapy, Essential Guide to Overcoming Obsessive Love, and Essential Guide to Asperger’s Syndrome. She can be found on Twitter @eileenmbailey and on Facebook at eileenmbailey.