What is the Behaviour Analysis of Child Development?

Introduction

The behavioural analysis of child development originates from John B. Watson’s behaviourism.

Brief History

In 1948, Sidney Bijou took a position as associate professor of psychology at the University of Washington and served as director of the university’s Institute of Child Development. Under his leadership, the Institute added a child development clinic and nursery school classrooms where they conducted research that would later accumulate into the are that would be called “Behaviour Analysis of Child Development”. Skinner’s behavioural approach and Kantor’s interbehavioural approach were adopted in Bijou and Baer’s model. They created a three-stage model of development (basic, foundational, and societal). Bijou and Baer looked at these socially determined stages, as opposed to organising behaviour into change points or cusps (behavioural cusp). In the behavioural model, development is considered a behavioural change. It is dependent on the kind of stimulus and the person’s behavioural and learning function. Behaviour analysis in child development takes a mechanistic, contextual, and pragmatic approach.

From its inception, the behavioural model has focused on prediction and control of the developmental process. The model focuses on the analysis of a behaviour and then synthesizes the action to support the original behaviour. The model was changed after Richard J. Herrnstein studied the matching law of choice behaviour developed by studying of reinforcement in the natural environment. More recently, the model has focused more on behaviour over time and the way that behavioural responses become repetitive. it has become concerned with how behaviour is selected over time and forms into stable patterns of responding. A detailed history of this model was written by Pelaez. In 1995, Henry D. Schlinger, Jr. provided the first behaviour analytic text since Bijou and Baer comprehensively showed how behaviour analysis – a natural science approach to human behaviour – could be used to understand existing research in child development. In addition, the quantitative behavioural developmental model by Commons and Miller is the first behavioural theory and research to address notion similar to stage.

Research Methods

The methods used to analyse behaviour in child development are based on several types of measurements. Single-subject research with a longitudinal study follow-up is a commonly-used approach. Current research is focused on integrating single-subject designs through meta-analysis to determine the effect sizes of behavioural factors in development. Lag sequential analysis has become popular for tracking the stream of behaviour during observations. Group designs are increasingly being used. Model construction research involves latent growth modelling to determine developmental trajectories and structural equation modelling. Rasch analysis is now widely used to show sequentially within a developmental trajectory.

A recent methodological change in the behavioural analytic theory is the use of observational methods combined with lag sequential analysis can determine reinforcement in the natural setting.

Quantitative Behavioural Development

The model of hierarchical complexity is a quantitative analytic theory of development. This model offers an explanation for why certain tasks are acquired earlier than others through developmental sequences and gives an explanation of the biological, cultural, organisational, and individual principles of performance. It quantifies the order of hierarchical complexity of a task based on explicit and mathematical measurements of behaviour.

Research

Contingencies, Uncertainty, and Attachment

The behavioural model of attachment recognises the role of uncertainty in an infant and the child’s limited communication abilities. Contingent relationships are instrumental in the behaviour analytic theory, because much emphasis is put on those actions that produce parents’ responses.

The importance of contingency appears to be highlighted in other developmental theories, but the behavioural model recognises that contingency must be determined by two factors:

  • The efficiency of the action; and
  • That efficiency compared to other tasks that the infant might perform at that point.

Both infants and adults function in their environments by understanding these contingent relationships. Research has shown that contingent relationships lead to emotionally satisfying relationships.

Since 1961, behavioural research has shown that there is relationship between the parents’ responses to separation from the infant and outcomes of a “stranger situation.”. In a study done in 2000, six infants participated in a classic reversal design (refer to single-subject research) study that assessed infant approach rate to a stranger. If attention was based on stranger avoidance, the infant avoided the stranger. If attention was placed on infant approach, the infant approached the stranger.

Recent meta-analytic studies of this model of attachment based on contingency found a moderate effect of contingency on attachment, which increased to a large effect size when the quality of reinforcement was considered. Other research on contingency highlights its effect on the development of both pro-social and anti-social behaviour. These effects can also be furthered by training parents to become more sensitive to children’s behaviours, Meta-analytic research supports the notion that attachment is operant-based learning.

An infant’s sensitivity to contingencies can be affected by biological factors and environment changes. Studies show that being placed in erratic environments with few contingencies may cause a child to have conduct problems and may lead to depression (see Behavioural Development and Depression below). Research continues to look at the effects of learning-based attachment on moral development. Some studies have shown that erratic use of contingencies by parents early in life can produce devastating long-term effects for the child.

Motor Development

Since Watson developed the theory of behaviourism, behaviour analysts have held that motor development represents a conditioning process. This holds that crawling, climbing, and walking displayed by infants represents conditioning of biologically innate reflexes. In this case, the reflex of stepping is the respondent behaviour and these reflexes are environmentally conditioned through experience and practice. This position was criticised by maturation theorists. They believed that the stepping reflex for infants actually disappeared over time and was not “continuous”. By working with a slightly different theoretical model, while still using operant conditioning, Esther Thelen was able to show that children’s stepping reflex disappears as a function of increased physical weight. However, when infants were placed in water, that same stepping reflex returned. This offered a model for the continuity of the stepping reflex and the progressive stimulation model for behaviour analysts.

Infants deprived of physical stimulation or the opportunity to respond were found to have delayed motor development. Under conditions of extra stimulation, the motor behaviour of these children rapidly improved. Some research has shown that the use of a treadmill can be beneficial to children with motor delays including Down syndrome and cerebral palsy. Research on opportunity to respond and the building of motor development continues today.

The behavioural development model of motor activity has produced a number of techniques, including operant-based biofeedback to facilitate development with success. Some of the stimulation methods such as operant-based biofeedback have been applied as treatment to children with cerebral palsy and even spinal injury successfully. Brucker’s group demonstrated that specific operant conditioning-based biofeedback procedures can be effective in establishing more efficient use of remaining and surviving central nervous system cells after injury or after birth complications (like cerebral palsy). While such methods are not a cure and gains tend to be in the moderate range, they do show ability to enhance functioning.

Imitation and Verbal Behavior

Behaviourists have studied verbal behaviour since the 1920s. E.A. Esper (1920) studied associative models of language, which has evolved into the current language interventions of matrix training and recombinative generalisation. Skinner (1957) created a comprehensive taxonomy of language for speakers. Baer, along with Zettle and Haynes (1989), provided a developmental analysis of rule-governed behaviour for the listener. and for the listener Zettle and Hayes (1989) with Don Baer providing a developmental analysis of rule-governed behaviour. According to Skinner, language learning depends on environmental variables, which can be mastered by a child through imitation, practice, and selective reinforcement including automatic reinforcement.

B.F. Skinner was one of the first psychologists to take the role of imitation in verbal behaviour as a serious mechanism for acquisition. He identified echoic behaviour as one of his basic verbal operants, postulating that verbal behaviour was learned by an infant from a verbal community. Skinner’s account takes verbal behaviour beyond an intra-individual process to an inter-individual process. He defined verbal behaviour as “behaviour reinforced through the mediation of others”. Noam Chomsky refuted Skinner’s assumptions.

In the behavioural model, the child is prepared to contact the contingencies to “join” the listener and speaker. At the very core, verbal episodes involve the rotation of the roles as speaker and listener. These kinds of exchanges are called conversational units and have been the focus of research at Columbia’s communication disorders department.

Conversational units is a measure of socialisation because they consist of verbal interactions in which the exchange is reinforced by both the speaker and the listener. H.C. Chu (1998) demonstrated contextual conditions for inducing and expanding conversational units between children with autism and non-handicapped siblings in two separate experiments. The acquisition of conversational units and the expansion of verbal behaviour decrease incidences of physical “aggression” in the Chu study and several other reviews suggest similar effects. The joining of the listener and speaker progresses from listener speaker rotations with others as a likely precedent for the three major components of speaker-as-own listener – say so correspondence, self-talk conversational units, and naming.

Development of Self

Robert Kohelenberg and Mavis Tsai (1991) created a behaviour analytic model accounting for the development of one’s “self”. Their model proposes that verbal processes can be used to form a stable sense of who we are through behavioural processes such as stimulus control. Kohlenberg and Tsai developed functional analytic psychotherapy to treat psychopathological disorders arising from the frequent invalidations of a child’s statements such that “I” does not emerge. Other behaviour analytic models for personality disorders exist. They trace out the complex biological-environmental interaction for the development of avoidant and borderline personality disorders. They focus on Reinforcement sensitivity theory, which states that some individuals are more or less sensitive to reinforcement than others. Nelson-Grey views problematic response classes as being maintained by reinforcing consequences or through rule governance.

Socialisation

Over the last few decades, studies have supported the idea that contingent use of reinforcement and punishment over extended periods of time lead to the development of both pro-social and anti-social behaviours. However research has shown that reinforcement is more effective than punishment when teaching behaviour to a child. It has also been shown that modelling is more effective than “preaching” in developing pro-social behaviour in children. Rewards have also been closely studied in relation to the development of social behaviours in children. The building of self-control, empathy, and cooperation has all implicated rewards as a successful tactic, while sharing has been strongly linked with reinforcement.

The development of social skills in children is largely affected in that classroom setting by both teachers and peers. Reinforcement and punishment play major roles here as well. Peers frequently reinforce each other’s behaviour. One of the major areas that teachers and peers influence is sex-typed behaviour, while peers also largely influence modes of initiating interaction, and aggression. Peers are more likely to punish cross-gender play while at the same time reinforcing play specific to gender. Some studies found that teachers were more likely to reinforce dependent behaviour in females.

Behavioural principles have also been researched in emerging peer groups, focusing on status. Research shows that it takes different social skills to enter groups than it does to maintain or build one’s status in groups. Research also suggests that neglected children are the least interactive and aversive, yet remain relatively unknown in groups. Children suffering from social problems do see an improvement in social skills after behaviour therapy and behaviour modification (refer to applied behaviour analysis). Modelling has been successfully used to increase participation by shy and withdrawn children. Shaping of socially desirable behaviour through positive reinforcement seems to have some of the most positive effects in children experiencing social problems.

Anti-Social Behaviour

In the development of anti-social behaviour, aetiological models for anti-social behaviour show considerable correlation with negative reinforcement and response matching (refer to matching law). Escape conditioning, through the use of coercive behaviour, has a powerful effect on the development and use of future anti-social tactics. The use of anti-social tactics during conflicts can be negatively reinforced and eventually seen as functional for the child in moment to moment interactions. Anti-social behaviours will also develop in children when imitation is reinforced by social approval. If approval is not given by teachers or parents, it can often be given by peers. An example of this is swearing. Imitating a parent, brother, peer, or a character on TV, a child may engage in the anti-social behaviour of swearing. Upon saying it they may be reinforced by those around them which will lead to an increase in the anti-social behaviour. The role of stimulus control has also been extensively explored in the development of anti-social behaviour. Recent behavioural focus in the study of anti-social behaviour has been a focus on rule-governed behaviour. While correspondence for saying and doing has long been an interest for behaviour analysts in normal development and typical socialisation, recent conceptualisations have been built around families that actively train children in anti-social rules, as well as children who fail to develop rule control.

Developmental Depression with Origins in Childhood

Behavioural theory of depression was outlined by Charles Ferster. A later revision was provided by Peter Lewisohn and Hyman Hops. Hops continued the work on the role of negative reinforcement in maintaining depression with Anthony Biglan. Additional factors such as the role of loss of contingent relations through extinction and punishment were taken from early work of Martin Seligman. The most recent summary and conceptual revisions of the behavioural model was provided by Johnathan Kanter. The standard model is that depression has multiple paths to develop. It can be generated by five basic processes, including: lack or loss of positive reinforcement, direct positive or negative reinforcement for depressive behaviour, lack of rule-governed behaviour or too much rule-governed behaviour, and/or too much environmental punishment. For children, some of these variables could set the pattern for lifelong problems. For example, a child whose depressive behaviour functions for negative reinforcement by stopping fighting between parents could develop a lifelong pattern of depressive behaviour in the case of conflicts. Two paths that are particularly important are:

  1. Lack or loss of reinforcement because of missing necessary skills at a developmental cusp point; or
  2. The failure to develop adequate rule-governed behaviour.

For the latter, the child could develop a pattern of always choosing the short-term small immediate reward (i.e. escaping studying for a test) at the expense of the long-term larger reward (passing courses in middle school). The treatment approach that emerged from this research is called behavioural activation.

In addition, use of positive reinforcement has been shown to improve symptoms of depression in children. Reinforcement has also been shown to improve the self-concept in children with depression comorbid with learning difficulties. Rawson and Tabb (1993) used reinforcement with 99 students (90 males and 9 females) aged from 8 to 12 with behaviour disorders in a residential treatment program and showed significant reduction in depression symptoms compared to the control group.

Cognitive Behaviour

As children get older, direct control of contingencies is modified by the presence of rule-governed behaviour. Rules serve as an establishing operation and set a motivational stage as well as a discrimintative stage for behaviour. While the size of the effects on intellectual development are less clear, it appears that stimulation does have a facilitative effect on intellectual ability. However, it is important to be sure not to confuse the enhancing effect with the initial causal effect. Some data exists to show that children with developmental delays take more learning trials to acquire in material.

Learned Units and Developmental Retardation

Behaviour analysts have spent considerable time measuring learning in both the classroom and at home. In these settings, the role of a lack of stimulation has often been evidenced in the development of mild and moderate mental retardation. Recent work has focused on a model of “developmental retardation,”. an area that emphasizes cumulative environmental effects and their role in developmental delays. To measure these developmental delays, subjects are given the opportunity to respond, defined as the instructional antecedent, and success is signified by the appropriate response and/or fluency in responses. Consequently, the learned unit is identified by the opportunity to respond in addition to given reinforcement.

One study employed this model by comparing students’ time of instruction was in affluent schools to time of instruction in lower income schools. Results showed that lower income schools displayed approximately 15 minutes less instruction than more affluent schools due to disruptions in classroom management and behaviour management. Altogether, these disruptions culminated into two years worth of lost instructional time by grade 10. The goal of behaviour analytic research is to provide methods for reducing the overall number of children who fall into the retardation range of development by behavioural engineering.

Hart and Risely (1995, 1999) have completed extensive research on this topic as well. These researchers measured the rates of parent communication with children of the ages of 2-4 years and correlated this information with the IQ scores of the children at age 9. Their analyses revealed that higher parental communication with younger children was positively correlated with higher IQ in older children, even after controlling for race, class, and socio-economic status. Additionally, they concluded a significant change in IQ scores required intervention with at-risk children for approximately 40 hours per week.

Class Formation

The formation of class-like behaviour has also been a significant aspect in the behavioural analysis of development. This research has provided multiple explanations to the development and formation of class-like behaviour, including primary stimulus generalisation, an analysis of abstraction, relational frame theory, stimulus class analysis (sometimes referred to as recombinative generalisation), stimulus equivalence, and response class analysis. Multiple processes for class-like formation provide behaviour analysts with relatively pragmatic explanations for common issues of novelty and generalisation.

Responses are organised based upon the particular form needed to fit the current environmental challenges as well as the functional consequences. An example of large response classes lies in contingency adduction, which is an area that needs much further research, especially with a focus on how large classes of concepts shift. For example, as Piaget observed, individuals have a tendency at the pre-operational stage to have limits in their ability to preserve information. While children’s training in the development of conservation skills has been generally successful, complications have been noted. Behaviour analysts argue that this is largely due to the number of tool skills that need to be developed and integrated. Contingency adduction offers a process by which such skills can be synthesized and which shows why it deserves further attention, particularly by early childhood interventionists.

Autism

Ferster (1961) was the first researcher to posit a behaviour analytic theory for autism. Ferster’s model saw autism as a by-product of social interactions between parent and child. Ferster presented an analysis of how a variety of contingencies of reinforcement between parent and child during early childhood might establish and strengthen a repertoire of behaviours typically seen in children diagnosed with autism. A similar model was proposed by Drash and Tutor (1993), who developed the contingency-shaped or behavioural incompatibility theory of autism. They identified at least six reinforcement paradigms that may contribute to significant deficiencies in verbal behaviour typically characteristic of children diagnosed as autistic. They proposed that each of these paradigms may also create a repertoire of avoidance responses that could contribute to the establishment of a repertoire of behaviour that would be incompatible with the acquisition of age-appropriate verbal behaviour. More recent models attribute autism to neurological and sensory models that are overly worked and subsequently produce the autistic repertoire. Lovaas and Smith (1989) proposed that children with autism have a mismatch between their nervous systems and the environment, while Bijou and Ghezzi (1999) proposed a behavioural interference theory. However, both the environmental mismatch model and the inference model were recently reviewed, and new evidence shows support for the notion that the development of autistic behaviours are due to escape and avoidance of certain types of sensory stimuli. However, most behavioural models of autism remain largely speculative due to limited research efforts.

Role in Education

One of the largest impacts of behaviour analysis of child development is its role in the field of education. In 1968, Siegfried Englemann used operant conditioning techniques in a combination with rule learning to produce the direct instruction curriculum. In addition, Fred S. Keller used similar techniques to develop programmed instruction. B.F. Skinner developed a programmed instruction curriculum for teaching handwriting. One of Skinner’s students, Ogden Lindsley, developed a standardized semilogrithmic chart, the “Standard Behaviour Chart,” now “Standard Celeration Chart,” used to record frequencies of behaviour, and to allow direct visual comparisons of both frequencies and changes in those frequencies (termed “celeration”). The use of this charting tool for analysis of instructional effects or other environmental variables through the direct measurement of learner performance has become known as precision teaching.

Behaviour analysts with a focus on behavioural development form the basis of a movement called positive behaviour support (PBS). PBS has focused on building safe schools.

In education, there are many different kinds of learning that are implemented to improve skills needed for interactions later in life. Examples of this differential learning include social and language skills. According to the NWREL (Northwest Regional Educational Laboratory), too much interaction with technology will hinder a child’s social interactions with others due to its potential to become an addiction and subsequently lead to anti-social behaviour. In terms of language development, children will start to learn and know about 5-20 different words by 18 months old.

Critiques of Behavioural Approach and New Developments

Behaviour analytic theories have been criticized for their focus on the explanation of the acquisition of relatively simple behaviour (i.e. the behaviour of nonhuman species, of infants, and of individuals who are intellectually disabled or autistic) rather than of complex behaviour. Michael Commons continued behaviour analysis’s rejection of mentalism and the substitution of a task analysis of the particular skills to be learned. In his new model, Commons has created a behaviour analytic model of more complex behaviour in line with more contemporary quantitative behaviour analytic models called the model of hierarchical complexity. Commons constructed the model of hierarchical complexity of tasks and their corresponding stages of performance using just three main axioms.

In the study of development, recent work has been generated regarding the combination of behaviour analytic views with dynamical systems theory. The added benefit of this approach is its portrayal of how small patterns of changes in behaviour in terms of principles and mechanisms over time can produce substantial changes in development.

Current research in behaviour analysis attempts to extend the patterns learned in childhood and to determine their impact on adult development.

Professional Organisations

The Association for Behaviour Analysis International has a special interest group for the behaviour analysis of child development.

Doctoral level behaviour analysts who are psychologists belong to American Psychological Association’s division 25: behaviour analysis.

The World Association for Behaviour Analysis has a certification in behaviour therapy. The exam draws questions on behavioural theories of child development as well as behavioural theories of child psychopathology.

What is Single-Subject Research?

Introduction

Single-subject research is a group of research methods that are used extensively in the experimental analysis of behaviour and applied behaviour analysis with both human and non-human participants. Principal methods in this type of research are: A-B-A-B designs, Multi-element designs, Multiple Baseline designs, Repeated acquisition designs, Brief experimental designs and Combined designs.

These methods form the heart of the data collection and analytic code of behaviour analysis. Behaviour analysis is data driven, inductive, and disinclined to hypothetico-deductive methods.

Experimental Questions

Experimental questions are decisive in determining the nature of the experimental design to be selected. There are four basic types of experimental questions: demonstration, comparison, parametric, and component. A demonstration is “Does A cause or influence B?”. A comparison is “Does A1 or A2 cause or influence B more?”. A parametric question is “How much of A will cause how much change or influence on B?”. A component question is “Which part of A{1,2,3} – A1 or A2 or A3… – causes or influences B?” where A is composed of parts that can be separated and tested.

The A-B-A-B design is useful for demonstration questions.

A-B-A-B

A-B

An AB design is a two-part or phase design composed of a baseline (“A” phase) with no changes and a treatment or intervention (“B”) phase. If there is a change then the treatment may be said to have had an effect. However, it is subject to many possible competing hypotheses, making strong conclusions difficult. Variants on the AB design introduce ways to control for the competing hypotheses to allow for stronger conclusions.

Reversal or A-B-A

The reversal design is the most powerful of the single-subject research designs showing a strong reversal from baseline (“A”) to treatment (“B”) and back again. If the variable returns to baseline measure without a treatment then resumes its effects when reapplied, the researcher can have greater confidence in the efficacy of that treatment. However, many interventions cannot be reversed, some for ethical reasons (e.g. involving self-injurious behaviour, smoking) and some for practical reasons (they cannot be unlearned, like a skill).

Further ethics notes: It may be unethical to end an experiment on a baseline measure if the treatment is self-sustaining and highly beneficial and/or related to health. Control condition participants may also deserve the benefits of research once all data has been collected. It is a researcher’s ethical duty to maximise benefits and to ensure that all participants have access to those benefits when possible.

A-B-C

The A-B-C design is a variant that allows for the extension of research questions around component, parametric and comparative questions.

Multi-element

Multi-element designs sometimes referred to as alternating-treatment designs are used in order to ascertain the comparative effect of two treatments. Two treatments are alternated in rapid succession and correlated changes are plotted on a graph to facilitate comparison.

Multiple Baseline

The multiple baseline design was first reported in 1960 as used in basic operant research. It was applied in the late 1960s to human experiments in response to practical and ethical issues that arose in withdrawing apparently successful treatments from human subjects. In it two or more (often three) behaviours, people or settings are plotted in a staggered graph where a change is made to one, but not the other two, and then to the second, but not the third behaviour, person or setting. Differential changes that occur to each behaviour, person or in each setting help to strengthen what is essentially an AB design with its problematic competing hypotheses.

Repeated Acquisition

In addition to multiple baseline designs, a way to deal with problematic reversibility is the use of repeated acquisitions.

Brief

A designed favoured by applied settings researchers where logistical challenges, time and other limits make research difficult are variants of multi-element and A-B-A-B type designs.

Combined

The combined design has arisen from a need to obtain answers to more complex research questions. Combining two or more single-case designs, such as A-B-A-B and multiple baseline, may produce such answers.

Multiple-Probe

Popular in Verbal Behaviour research, the multiple-probe research design has elements of the other research designs.

Changing-Criterion

In a changing-criterion research design a criterion for reinforcement is changed across the experiment to demonstrate a functional relation between the reinforcement and the behaviour.

What is the Society for the Experimental Analysis of Behaviour?

Introduction

The Society for the Experimental Analysis of Behaviour was founded in 1957 by a group of researchers in the field of behaviourism.

Background

It publishes the Journal of the Experimental Analysis of Behaviour and the Journal of Applied Behaviour Analysis.

The Certificate of Incorporation (dated 29 October 1957) of the society states that:

The purpose and objects of this corporation shall be to encourage, foster, and promote the advancement of the science of experimental analysis of behavior; the promotion of research in the said science and the increase and diffusion of knowledge of the said science by the conduct of a program of education by meetings, conferences and symposia, and by the publication of journals, papers, periodicals and reports.

The Journal of the Experimental Analysis of Behaviour was established to meet the needs of those who were attracted to the behaviour-analytic approach but were unhappy with the lack of a journal specialising in that rapidly growing area. As described on its inside front page ever since, the journal is “primarily for the original publication of experiments relevant to the behaviour of individual organisms.” It started as a quarterly in 1958 but has appeared bimonthly since 1964. The initial Board of Editors also served as the first Board of Directors of the society.

Journal

In 1968, the society established the Journal of Applied Behaviour Analysis for “the original publication of reports of experimental research involving applications of the experimental analysis of behaviour to problems of social importance.”

It appears quarterly.

What is the Association for Behaviour Analysis International?

Introduction

The Association for Behaviour Analysis International (ABAI) is a professional association of psychologists, educators, and practitioners whose scholarship and practice derive from the work of B.F. Skinner.

ABAI organises conferences in the US and abroad, publishes journals, and offers accreditation programs for behaviour analysis training programmes. As of March 2021, ABAI has 97 regional associate chapters both in the United States and abroad, many of which offer their own annual conferences. As of 2019, ABAI had over 9,000 members and membership in its affiliate chapters was greater than 28,000.

Refer to Clinical Behaviour Analysis, Applied Behaviour Analysis, and Licensed Behaviour Analyst.

Brief History

The Association for Behaviour Analysis International (ABAI) was founded in 1974 as the MidWestern Association for Behaviour Analysis (MABA) to serve as an interdisciplinary group of professionals, paraprofessionals, and students. Behaviour analysis was well-represented in the Midwest of the US, but many behaviour analysts were disappointed with the level of support their relatively new field received at the existing psychology conferences. Gerald Mertens and Israel Goldiamond organised the first two-day conference, which was held at the University of Chicago, and speakers included, Sidney Bijou, James Dinsmoor, Roger Ulrich and Goldiamond.

MABA’s first headquarters were located on the campus of Western Michigan University (WMU) in Kalamazoo, Michigan. By 1977, the annual conference was extended four days and included 550 events, and MABA had grown to 1,190 members from 42 states and five foreign countries.

In 1978, MABA began publishing its first journal, The Behaviour Analyst (renamed Perspectives in Behavioural Science in 2018), and in 1979, the organisation changed its name to the Association for Behaviour Analysis (ABA), subsequently adopting the name Association for Behaviour Analysis International (ABAI). In 2001, it sponsored its first international meeting in Venice, Italy.

Association for Behaviour Analysis (ABA) began offering APA credits for the first time in 1994, at their 20th Annual Convention in Atlanta, GA. While the BACB solidified itself in the field, ABA offered its first BACB credits in 2000 at their 26th Annual Convention in Washington, DC.

Activities

Conferences

ABAI organises conferences related to the theory and practice of behaviour analysis. In addition to the annual conference, which is held at a location in the US or Canada, every other year, ABAI hosts an international conference. The association also holds an annual autism conference and has hosted several single-track conferences on topics of special interest to behaviour analysts, such as theory and philosophy, climate change, behavioural economics, and education.

Many conference sessions offer approved continuing education credits (CEUs) for practitioners who wish to maintain their professional certification. Among the organisations that approve ABAI presentations for CEU credit are the American Psychological Association, the National Association of School Psychologists, and the Behaviour Analyst Certification Board.

Accreditation Programme

ABAI operates an accreditation programme for universities offering master’s and doctoral degrees in behaviour analysis. Degree programs that achieve ABAI accreditation meet the organization’s standards of training and will satisfy the Behaviour Analyst Certification Board requirements to achieve certification as a behaviour analyst.

Society for the Advancement of Behaviour Analysis

ABAI is supported by the Society for the Advancement of Behaviour Analysis (SABA), a 501(c)(3) organisation that accepts tax-exempt charitable contributions. SABA maintains a number of funds to support research in child development, international development, public awareness of behavioural science, and diversity, equity, and inclusion. SABA also provides grants to support student research, student travel to the annual ABAI conference, and graduate research focused on issues of diversity, equity, and inclusion.

Position Statements

As of 2021, ABAI had released six policy statements on: right to effective behavioural treatment (1989), student’s right to effective education (1990), facilitated communication (1995), restraint and seclusion (2010), sexual harassment (2019), and commitment to equity (2020).

Awards

SABA administers an awards programme at the annual convention of ABAI that recognises distinguished service to behaviour analysis, scientific translation, international dissemination of behaviour analysis, effective presentation of behaviour analysis in the mass media, and enduring programmatic contributions to behaviour analysis. Past recipients of the award for distinguished service to behaviour analysis include Sidney Bijou, James Dinsmoor, A. Charles Catania, Jack Michael and Murray Sidman.

Journals

The Association of Applied Behaviour Analysis International publishes six peer-reviewed journals.

  • Perspectives on Behaviour Science, is ABAI’s first journal, published from 1978-2017 as The Behaviour Analyst. It is a semiannual journal publishing articles on theoretical, experimental, and applied topics in behaviour analysis, including literature reviews, re-interpretations of published data, and articles on behaviourism as a philosophy.
  • The Analysis of Verbal Behaviour is a collection of experiments and theoretical papers regarding verbal behaviour and applied behaviour analysis.
  • Behaviour Analysis in Practice is a peer-reviewed journal that includes articles on how to efficiently practice applied behaviour analysis.
  • The Psychological Record includes articles concerning behavioural analysis, behavioural science, and behaviour theory. It was founded in 1937 by Jacob Robert Kantor. Its first experimental area editor was B.F. Skinner. After being published most recently at Southern Illinois University at Carbondale, the journal was adopted as an official publication of ABAI. The Psychological Record publishes empirical and conceptual articles related to the field of behaviour analysis, behaviour science, and behaviour theory.
  • Behaviour and Social Issues, is an interdisciplinary journal publishing articles analysing human social behaviour, particularly with regard to understanding and influencing significant social problems such as social justice, human rights, and sustainability.
  • Education and Treatment of Children.

What is Imitation?

Introduction

Imitation (from Latin imitatio, “a copying, imitation”) is a behaviour whereby an individual observes and replicates another’s behaviour.

Imitation is also a form of social learning that leads to the “development of traditions, and ultimately our culture. It allows for the transfer of information (behaviours, customs, etc.) between individuals and down generations without the need for genetic inheritance.” The word imitation can be applied in many contexts, ranging from animal training to politics. The term generally refers to conscious behaviour; subconscious imitation is termed mirroring.

A toddler imitates his father.

Anthropology and Social Sciences

In anthropology, some theories hold that all cultures imitate ideas from one of a few original cultures or several cultures whose influence overlaps geographically. Evolutionary diffusion theory holds that cultures influence one another, but that similar ideas can be developed in isolation.

Scholars, as well as popular authors, have argued that the role of imitation in humans is unique among animals. However, this claim has been recently challenged by scientific research which observed social learning and imitative abilities in animals.

Psychologist Kenneth Kaye showed that infants’ ability to match the sounds or gestures of an adult depends on an interactive process of turn-taking over many successive trials, in which adults’ instinctive behaviour plays as great a role as that of the infant. These writers assume that evolution would have selected imitative abilities as fit because those who were good at it had a wider arsenal of learned behaviour at their disposal, including tool-making and language.

However, research also suggests that imitative behaviours and other social learning processes are only selected for when outnumbered or accompanied by asocial learning processes: an over-saturation of imitation and imitating individuals leads humans to collectively copy inefficient strategies and evolutionarily maladaptive behaviours, thereby reduce flexibility to new environmental contexts that require adaptation. Research suggests imitative social learning hinders the acquisition of knowledge in novel environments and in situations where asocial learning is faster and more advantageous.

In the mid-20th century, social scientists began to study how and why people imitate ideas. Everett Rogers pioneered innovation diffusion studies, identifying factors in adoption and profiles of adopters of ideas. Imitation mechanisms play a central role in both analytical and empirical models of collective human behaviour.

Neuroscience

We are capable of imitating movements, actions, skills, behaviours, gestures, pantomimes, mimics, vocalizations, sounds, speech, etc. and that we have particular “imitation systems” in the brain is old neurological knowledge dating back to Hugo Karl Liepmann. Liepmann’s model 1908 “Das hierarchische Modell der Handlungsplanung” (the hierarchical model of action planning) is still valid. On studying the cerebral localisation of function, Liepmann postulated that planned or commanded actions were prepared in the parietal lobe of the brain’s dominant hemisphere, and also frontally. His most important pioneering work is when extensively studying patients with lesions in these brain areas, he discovered that the patients lost (among other things) the ability to imitate. He was the one who coined the term “apraxia” and differentiated between ideational and ideomotor apraxia. It is in this basic and wider frame of classical neurological knowledge that the discovery of the mirror neuron has to be seen. Though mirror neurons were first discovered in macaques, their discovery also relates to humans.

Human brain studies using FMRI (Functional magnetic resonance imaging) revealed a network of regions in the inferior frontal cortex and inferior parietal cortex which are typically activated during imitation tasks. It has been suggested that these regions contain mirror neurons similar to the mirror neurons recorded in the macaque monkey. However, it is not clear if macaques spontaneously imitate each other in the wild.

Neurologist V.S. Ramachandran argues that the evolution of mirror neurons were important in the human acquisition of complex skills such as language and believes the discovery of mirror neurons to be a most important advance in neuroscience. However, little evidence directly supports the theory that mirror neuron activity is involved in cognitive functions such as empathy or learning by imitation.

Evidence is accumulating that bottlenose dolphins employ imitation to learn hunting and other skills from other dolphins.

Japanese monkeys have been seen to spontaneously begin washing potatoes after seeing humans washing them.

Mirror Neuron System

Research has been conducted to locate where in the brain specific parts and neurological systems are activated when humans imitate behaviours and actions of others, discovering a mirror neuron system. This neuron system allows a person to observe and then recreate the actions of others. Mirror neurons are premotor and parietal cells in the macaque brain that fire when the animal performs a goal directed action and when it sees others performing the same action.” Evidence suggests that the mirror neuron system also allows people to comprehend and understand the intentions and emotions of others. Problems of the mirror neuron system may be correlated with the social inadequacies of autism. There have been many studies done showing that children with autism, compared with typically developing children, demonstrate reduced activity in the frontal mirror neuron system area when observing or imitating facial emotional expressions. Of course, the higher the severity of the disease, the lower the activity in the mirror neuron system is.

Animal Behaviour

Scientists debate whether animals can consciously imitate the unconscious incitement from sentinel animals, whether imitation is uniquely human, or whether humans do a complex version of what other animals do. The current controversy is partly definitional. Thorndike uses “learning to do an act from seeing it done.” It has two major shortcomings: first, by using “seeing” it restricts imitation to the visual domain and excludes, e.g. vocal imitation and, second, it would also include mechanisms such as priming, contagious behaviour and social facilitation, which most scientist distinguish as separate forms of observational learning. Thorpe suggested defining imitation as “the copying of a novel or otherwise improbable act or utterance, or some act for which there is clearly no instinctive tendency.” This definition is favoured by many scholars, though questions have been raised how strictly the term “novel” has to be interpreted and how exactly a performed act has to match the demonstration to count as a copy.

In 1952 Hayes & Hayes used the “do-as-I-do” procedure to demonstrate the imitative abilities of their trained chimpanzee “Viki.” Their study was repeatedly criticised for its subjective interpretations of their subjects’ responses. Replications of this study found much lower matching degrees between subjects and models. However, imitation research focusing on the copying fidelity got new momentum from a study by Voelkl and Huber. They analysed the motion trajectories of both model and observer monkeys and found a high matching degree in their movement patterns.

Paralleling these studies, comparative psychologists provided tools or apparatuses that could be handled in different ways. Heyes and co-workers reported evidence for imitation in rats that pushed a lever in the same direction as their models, though later on they withdrew their claims due to methodological problems in their original setup. By trying to design a testing paradigm that is less arbitrary than pushing a lever to the left or to the right, Custance and co-workers introduced the “artificial fruit” paradigm, where a small object could be opened in different ways to retrieve food placed inside – not unlike a hard-shelled fruit. Using this paradigm, scientists reported evidence for imitation in monkeys and apes. There remains a problem with such tool (or apparatus) use studies: what animals might learn in such studies need not be the actual behaviour patterns (i.e. the actions) that were observed. Instead they might learn about some effects in the environment (i.e. how the tool moves, or how the apparatus works). This type of observational learning, which focuses on results, not actions, has been dubbed emulation (refer to Emulation (observational learning)).

An article was written by Carl Zimmer, he looked into a study being done by Derek lyons, he was focusing on human evolution, so he started to study a chimpanzee. He first started with showing the chimp how to retrieve food from a box, So they had the scientist go in a demonstrate how to retrieve the food from the box. The chimp soon caught on and did exactly what the scientist just did. They wanted to see if the chimpanzees brain functioned just like humans brain so they related this same exact study to 16 children and they did the same procedure and once the children seen how it was done, they followed the same steps.

Imitation in Animals

Imitation in animals is a study in the field of social learning where learning behaviour is observed in animals specifically how animals learn and adapt through imitation. Ethologists can classify imitation in animals by the learning of certain behaviours from conspecifics. More specifically, these behaviours are usually unique to the species and can be complex in nature and can benefit the individuals survival.

Some scientists believe true imitation is only produced by humans, arguing that simple learning though sight is not enough to sustain as a being who can truly imitate. Thorpe defines true imitation as “the copying of a novel or otherwise improbable act or utterance, or some act for which there is clearly no instinctive tendency,” which is highly debated for its portrayal of imitation as a mindless repeating act. True imitation is produced when behavioural, visual and vocal imitation is achieved, not just the simple reproduction of exclusive behaviours. Imitation is not a simple reproduction of what one sees; rather it incorporates intention and purpose. Animal imitation can range from survival purpose; imitating as a function of surviving or adapting, to unknown possible curiosity, which vary between different animals and produce different results depending on the measured intelligence of the animal.

There is considerable evidence to support true imitation in animals. Experiments performed on apes, birds and more specifically the Japanese quail have provided positive results to imitating behaviour, demonstrating imitation of opaque behaviour. However the problem that lies is in the discrepancies between what is considered true imitation in behaviour. Birds have demonstrated visual imitation, where the animal simply does as it sees. Studies on apes however have proven more advanced results in imitation, being able to remember and learn from what they imitate. Studies have demonstrated far more positive results with behavioural imitation in primates and birds than any other type of animal. Imitation in non primate mammals and other animals have been proven difficult to conclude solid positive results for and poses a difficult question to scientists on why that is so.

Theories

There are two types of theories of imitation, transformational and associative. Transformational theories suggest that the information that is required to display certain behaviour is created internally through cognitive processes and observing these behaviours provides incentive to duplicate them. Meaning we already have the codes to recreate any behaviour and observing it results in its replication. Bandura’s “social cognitive theory” is one example of a transformational theory. Associative, or sometimes referred to as “contiguity”, theories suggest that the information required to display certain behaviours does not come from within ourselves but solely from our surroundings and experiences. Unfortunately these theories have not yet provided testable predictions in the field of social learning in animals and have yet to conclude strong results.

New Developments

There have been three major developments in the field of animal imitation. The first, behavioural ecologists and experimental psychologists found there to be adaptive patterns in behaviours in different vertebrate species in biologically important situations. The second, primatologists and comparative psychologists have found imperative evidence that suggest true learning through imitation in animals. The third, population biologists and behavioural ecologists created experiments that demand animals to depend on social learning in certain manipulated environments.

Child Development

Developmental psychologist Jean Piaget noted that children in a developmental phase he called the sensorimotor stage (a period which lasts up to the first two years of a child) begin to imitate observed actions. This is an important stage in the development of a child because the child is beginning to think symbolically, associating behaviours with actions, thus setting the child up for the development of further symbolic thinking. Imitative learning also plays a crucial role in the development of cognitive and social communication behaviours, such as language, play, and joint attention. Imitation serves as both a learning and a social function because new skills and knowledge are acquired, and communication skills are improved by interacting in social and emotional exchanges. It is shown, however, that “children with autism exhibit significant deficits in imitation that are associated with impairments in other social communication skills.” To help children with autism, reciprocal imitation training (RIT) is used. It is a naturalistic imitation intervention that helps teach the social benefits of imitation during play by increasing child responsiveness and by increasing imitative language.

Reinforcement learning, both positive and negative, and punishment, are used by people that children imitate to either promote or discontinue behaviour. If a child imitates a certain type of behaviour or action and the consequences are rewarding, the child is very likely to continue performing the same behaviour or action. The behaviour “has been reinforced (i.e. strengthened)”. However, if the imitation is not accepted and approved by others, then the behaviour will be weakened.

Naturally, children are surrounded by many different types of people that influence their actions and behaviours, including parents, family members, teachers, peers, and even characters on television programs. These different types of individuals that are observed are called models. According to Saul McLeod, “these models provide examples of masculine and feminine behaviour to observe and imitate.” Children imitate the behaviour they have observed from others, regardless of the gender of the person and whether or not the behaviour is gender appropriate. However, it has been proven that children will reproduce the behaviour that “its society deems appropriate for its sex.”

Infants

Infants have the ability to reveal an understanding of certain outcomes before they occur, therefore in this sense they can somewhat imitate what they have perceived. Andrew N. Meltzoff, ran a series of tasks involving 14-month-old infants to imitate actions they perceived from adults. In this gathering he had concluded that the infants, before trying to reproduce the actions they wish to imitate, some how revealed an understanding of the intended goal even though they failed to replicate the result wished to be imitated. These task implicated that the infants knew the goal intended. Gergely, Bekkering, and Király (2002) figured that infants not only understand the intended goal but also the intentions of the person they were trying to imitate engaging in “rational imitation”, as described by Tomasello, Carpenter and others.

It has long been claimed that newborn humans imitate bodily gestures and facial expressions as soon as their first few days of life. For example, in a study conducted at the Mailman Centre for Child Development at the University of Miami Medical School, 74 newborn babies (with a mean age of 36 hours) were tested to see if they were able to imitate a smile, a frown and a pout, and a wide-open mouth and eyes. An observer stood behind the experimenter (so he/she couldn’t see what facial expressions were being made by the experimenter) and watched only the babies’ facial expressions, recording their results. Just by looking only at the babies’ faces, the observer was more often able to correctly guess what facial expression was being presented to the child by the experimenter. After the results were calculated, “the researchers concluded that…babies have an innate ability to compare an expression they see with their own sense of muscular feedback from making the movements to match that expression.”

However, the idea that imitation is an inborn ability has been recently challenged. A research group from the University of Queensland in Australia carried out the largest-ever longitudinal study of neonatal imitation in humans. One hundred and nine newborns were shown a variety of gestures including tongue protrusion, mouth opening, happy and sad facial expressions, at four time points between one week and 9 weeks of age. The results failed to reveal compelling evidence that newborns imitate: Infants were just as likely to produce matching and non-matching gestures in response to what they saw.

At around eight months, infants will start to copy their child care providers’ movements when playing pat-a-cake and peek-a-boo, as well as imitating familiar gestures, such as clapping hands together or patting a doll’s back. At around 18 months, infants will then begin to imitate simple actions they observe adults doing, such as taking a toy phone out of a purse and saying “hello”, pretending to sweep with a child-sized broom, as well as imitating using a toy hammer.

Toddlers

At around 30-36 months, toddlers will start to imitate their parents by pretending to get ready for work and school and saying the last word(s) of what an adult just said. For example, toddlers may say “bowl” or “a bowl” after they hear someone say, “That’s a bowl.” They may also imitate the way family members communicate by using the same gestures and words. For example, a toddler will say, “Mommy bye-bye” after the father says, “Mommy went bye-bye.”

Toddlers love to imitate their parents and help when they can; imitation helps toddlers learn, and through their experiences lasting impressions are made. 12 to 36-month-olds learn by doing, not by watching, and so it is often recommended to be a good role model and caretaker by showing them simple tasks like putting on socks or holding a spoon.

Duke developmental psychologist Carol Eckerman did a study on toddlers imitating toddlers and found that at the age of 2 children involve themselves in imitation play to communicate with one another. This can be seen within a culture or across different cultures. 3 common imitative patterns Eckerman found were reciprocal imitation, follow-the-leader and lead-follow.

Kenneth Kaye’s “apprenticeship” theory of imitation rejected assumptions that other authors had made about its development. His research showed that there is no one simple imitation skill with its own course of development. What changes is the type of behaviour imitated.

An important agenda for infancy is the progressive imitation of higher levels of use of signs, until the ultimate achievement of symbols. The principal role played by parents in this process is their provision of salient models within the facilitating frames that channel the infant’s attention and organise his imitative efforts.

Gender and Age Differences

Imitation and imitative behaviours do not manifest ubiquitously and evenly in all human individuals, some individuals rely more on imitated information than others. Although imitation is very useful when it comes to cognitive learning with toddlers, research has shown that there are some gender and age differences when it comes to imitation. Research done to judge imitation in toddlers 2-3 years old shows that when faced with certain conditions “2-year-olds displayed more motor imitation than 3-year-olds, and 3-year-olds displayed more verbal-reality imitation than 2-year-olds. Boys displayed more motor imitation than girls.”

No other research is more controversial pertaining gender differences in toddler imitation than renowned psychologist, Bandura’s, bobo doll experiments. The goal of the experiment was to see what happens to toddlers when exposed to aggressive and non aggressive adults, would the toddlers imitate the behaviour of the adults and if so, which gender is more likely to imitate the aggressive adult. In the beginning of the experiment Bandura had several predictions that actually came true. Children exposed to violent adults will imitate the actions of that adult when the adult is not present, boys who had observed an adult of the opposite sex act aggressively are less likely to act violently than those who witnessed a male adult act violently. In fact ‘boys who observed an adult male behaving violently were more influenced than those who had observed a female model behaviour aggressively’. One fascinating observation was that while boys are likely to imitate physical acts of violence, girls are likely to imitate verbal acts of violence.

Negative Imitation

Imitation plays such a major role on how a toddler interprets the world. So much of a child’s understanding is derived from imitation, due to lack of verbal skill imitation is a toddlers way of communication with the world. It is what connects them to the communicating world, as they continue to grow they begin to learn more and more. That is why it is crucial for parents to be cautious as to how they act and behave around their toddlers. Imitation is the toddlers way of confirming and dis-conforming socially acceptable actions in our society. Actions like washing dishes, cleaning up the house and doing chores are actions you want your toddlers to imitate. Imitating negative things is something that is never beyond young toddlers. If they are exposed to cursing and violence, it is going to be what the child views as the norm of his or her world, remember imitation is the ‘mental activity that helps to formulate the conceptions of the world for toddlers’ Hay et al. (1991), when a toddler sees something so often he or she will form his or her reality around that action. So it is important for parents to be careful what they say or do in front of their children.

Autism

Children with autism exhibit significant impairment in imitation skills. Imitation deficits have been reported on a variety of tasks including symbolic and non-symbolic body movements, symbolic and functional object use, vocalisations, and facial expressions. In contrast, typically-developing children can copy a broad range of novel (as well as familiar) rules from a very early age. Problems with imitation discriminate children with autism from those with other developmental disorders as early as age 2 and continue into adulthood.

However, recent research suggests that people affected with forms of High Functioning Autism easily interact with one another by using a more analytically-centred communication approach rather than an imitative cue-based approach, suggesting that reduced imitative capabilities don’t affect abilities for expressive social behaviour but only the understanding of said social behaviour: Social communication is not negatively affected when said communication involves less or no imitation. Children with Autism may have significant problems understanding typical social communication not because of inherent social deficits, but because of differences in communication style which affect reciprocal understanding.

Individuals with Autism are also shown to possess increased analytical, cognitive and visual processing, suggesting people with autism have no true impairments in observing the actions of others but may decide not to imitate them because they do not analytically understand them.

Imitation plays a crucial role in the development of cognitive and social communication behaviours, such as language, play, and joint attention. Children with autism exhibit significant deficits in imitation that are associated with impairments in other social communication skills. It is unclear whether imitation is mediating these relationships directly, or whether they are due to some other developmental variable that is also reflected in the measurement of imitation skills.

Automatic Imitation

The automatic imitation comes very fast when a stimulus is given to replicate. The imitation can match the commands with the visual stimulus (compatible) or it cannot match the commands with the visual stimulus (incompatible). For example: ‘Simon Says’, a game played with children where they are told to follow the commands given by the adult. In this game, the adult gives the commands and shows the actions; the commands given can either match the action to be done or it will not match the action. The children who imitate the adult who has given the command with the correct action will stay in the game. The children who imitate the command with the wrong action will go out of the game, and this is where the child’s automatic imitation comes into play. Psychologically, the visual stimulus being looked upon by the child is being imitated faster than the imitation of the command. In addition, the response times were faster in compatible scenarios than in incompatible scenarios.

Children are surrounded by many different people, day by day. Their parents make a big impact on them, and usually what the children do is what they have seen their parent do. In this article they found that a child, simply watching its mother sweep the floor, right after soon picks up on it and starts to imitate the mother by sweeping the floor. By the children imitating, they are really teaching themselves how to do things without instruction from the parent or guardian. Toddlers love to play the game of house. They picked up on this game of house by television, school or at home; they play the game how they see it. The kids imitate their parents or anybody in their family. In the article it says it is so easy for them to pick up on the things they see on an everyday basis.

Over-Imitation

Over-imitation is “the tendency of young children to copy all of an adult model’s actions, even components that are irrelevant for the task at hand.” According to this human and cross-cultural phenomenon, a child has a strong tendency to automatically encode the deliberate action of an adult as causally meaningful even when the child observes evidence that proves that its performance is unnecessary. It is suggested that over-imitation “may be critical to the transmission of human culture.”

However, another study suggests that children don’t just “blindly follow the crowd” since they can also be just as discriminating as adults in choosing whether an unnecessary action should be copied or not. They may imitate additional but unnecessary steps to a novel process if the adult demonstrations are all the same. However, in cases where one out of four adults showed a better technique, only 40% actually copied the extra step, as described by Evans, Carpenter and others.

Deferred Imitation

Piaget coined the term deferred imitation and suggested that it arises out of the child’s increasing ability to “form mental representations of behaviour performed by others.” Deferred imitation is also “the ability to reproduce a previously witnessed action or sequence of actions in the absence of current perceptual support for the action.” Instead of copying what is currently occurring, individuals repeat the action or behaviour later on. It appears that infants show an improving ability for deferred imitation as they get older, especially by 24 months. By 24 months, infants are able to imitate action sequences after a delay of up to three months, meaning that “they’re able to generalise knowledge they have gained from one test environment to another and from one test object to another.”

A child’s deferred imitation ability “to form mental representations of actions occurring in everyday life and their knowledge of communicative gestures” has also been linked to earlier productive language development. Between 9 (preverbal period) and 16 months (verbal period), deferred imitation performance on a standard actions-on-objects task was consistent in one longitudinal study testing participants’ ability to complete a target action, with high achievers at 9 months remaining so at 16 months. Gestural development at 9 months was also linked to productive language at 16 months. Researchers now believe that early deferred imitation ability is indicative of early declarative memory, also considered a predictor of productive language development.

What is Applied Behaviour Analysis?

Introduction

Applied behaviour analysis (ABA), also called behavioural engineering, is a scientific technique concerned with applying empirical approaches based upon the principles of respondent and operant conditioning to change behaviour of social significance. It is the applied form of behaviour analysis; the other two forms are radical behaviourism (or the philosophy of the science) and the experimental analysis of behaviour (or basic experimental research).

The name applied behaviour analysis has replaced behaviour modification because the latter approach suggested attempting to change behaviour without clarifying the relevant behaviour-environment interactions. In contrast, ABA changes behaviour by first assessing the functional relationship between a targeted behaviour and the environment. Further, the approach often seeks to develop socially acceptable alternatives for aberrant behaviours.

ABA has been utilised in a range of areas, including applied animal behaviour, schoolwide positive behaviour support, classroom instruction, structured and naturalistic early behavioural interventions for autism, paediatric feeding therapy, rehabilitation of brain injury, dementia, fitness training, substance abuse, phobias, tics, and organisational behaviour management.

ABA is considered to be controversial by some within the autism rights movement due to a perception that it emphasizes indistinguishability instead of acceptance and a history of, in some embodiments of ABA and its predecessors, the use of aversives such as electric shocks.

Definition

ABA is an applied science devoted to developing procedures which will produce observable changes in behaviour. It is to be distinguished from the experimental analysis of behaviour, which focuses on basic experimental research, but it uses principles developed by such research, in particular operant conditioning and classical conditioning. Behaviour analysis adopts the viewpoint of radical behaviourism, treating thoughts, emotions, and other covert activity as behaviour that is subject to the same rules as overt responses. This represents a shift away from methodological behaviourism, which restricts behaviour-change procedures to behaviours that are overt, and was the conceptual underpinning of behaviour modification.

Behaviour analysts also emphasize that the science of behaviour must be a natural science as opposed to a social science. As such, behaviour analysts focus on the observable relationship of behaviour with the environment, including antecedents and consequences, without resort to “hypothetical constructs”.

Brief History

The beginnings of ABA can be traced back to Teodoro Ayllon and Jack Michael’s study “The psychiatric nurse as a behavioural engineer” (1959) that they published in the Journal of the Experimental Analysis of Behaviour (JEAB). Ayllon and Michael were training the staff and nurses at a psychiatric hospital how to use a token economy based on the principles of operant conditioning for patients with schizophrenia and intellectual disability, which led to researchers at the University of Kansas to start the Journal of Applied Behaviour Analysis (JABA) in 1968.

A group of faculty and researchers at the University of Washington, including Donald Baer, Sidney W. Bijou, Bill Hopkins, Jay Birnbrauer, Todd Risley, and Montrose Wolf, applied the principles of behaviour analysis to instruct developmentally disabled children, manage the behaviour of children and adolescents in juvenile detention centres, and organise employees who required proper structure and management in businesses, among other situations. In 1968, Baer, Bijou, Risley, Birnbrauer, Wolf, and James Sherman joined the Department of Human Development and Family Life at the University of Kansas, where they founded the Journal of Applied Behaviour Analysis.

Notable graduate students from the University of Washington include Robert Wahler, James Sherman, and Ivar Lovaas. Lovaas established the UCLA Young Autism Project while teaching at the University of California, Los Angeles. In 1965, Lovaas published a series of articles that outlined his system for coding observed behaviours, described a pioneering investigation of the antecedents and consequences that maintained a problem behaviour, and relied upon the methods of errorless learning that was initially devised by Charles Ferster to teach nonverbal children to speak. Lovaas also described how to use social (secondary) reinforcers, teach children to imitate, and what interventions (including electric shocks) may be used to reduce aggression and life-threatening self-injury.

In 1987, Lovaas published the study, “Behavioural treatment and normal educational and intellectual functioning in young autistic children”. The experimental group in this study received an average of 40 hours per week in a 1:1 teaching setting at a table using errorless discrete trial training (DTT). The treatment is done at home with parents involved in every aspect of treatment, and the curriculum is highly individualised with a heavy emphasis on teaching eye contact, fine and gross motor imitation, and language. The use of aversives and reinforcement, were used to motivate learning and reduce non-desired behaviours. The outcome of this study indicated 47% of the experimental group (9/19) went on to lose their autism diagnosis and were described as indistinguishable from their typical adolescent peers. This included passing regular education without assistance and making and maintaining friends. These gains were maintained as reported in the 1993 study, “Long-term outcome for children with autism who received early intensive behavioural treatment”. Lovaas’ work went on to be recognised by the US Surgeon General in 1999, and his research were replicated in university and private settings. The “Lovaas Method” went on to become known as early intensive behavioural intervention (EIBI), or 30 to 40 hours per week of DTT.

The original Lovaas method focused heavily on the use of aversives; utilising shocks, beating children, ignoring children, withholding food, etc. Using shocks, ignoring children, withholding food and toys, and spraying children with water are still used today and considered ethical by the Behaviour Analyst Certification Board (BACB). Another criticism of the Lovaas Method is Lovaas’s connection with gay conversion therapy, using his own behaviour modification techniques seen in ABA in The Feminine Boy project. Similarities in gay conversion therapy to making boys indistinguishable from their heterosexual peers have been drawn with Lovaas’ belief that ABA makes “autistic children indistinguishable from their normal friends.” He infamously said “‘[Y]ou start pretty much from scratch when you work with an autistic child…they are not people in the psychological sense”.

Over the years, “behaviour analysis” gradually superseded “behaviour modification”; that is, from simply trying to alter problematic behaviour, behaviour analysts sought to understand the function of that behaviour, what antecedents promote and maintain it, and how it can be replaced by successful behaviour. This analysis is based on careful initial assessment of a behaviour’s function and a testing of methods that produce changes in behaviour.

While ABA seems to be intrinsically linked to autism intervention, it is also used in a broad range of other situations. Recent notable areas of research in JABA include autism, classroom instruction with typically developing students, paediatric feeding therapy, and substance-use disorders. Other applications of ABA include applied animal behaviour, consumer behaviour analysis, behavioural medicine, behavioural neuroscience, clinical behaviour analysis, forensic behaviour analysis, increasing job safety and performance, schoolwide positive behaviour support, and contact desensitisation for phobias.

Characteristics

Baer, Wolf, and Risley’s 1968 article is still used as the standard description of ABA. It lists the following seven characteristics of ABA.

  • Applied: ABA focuses on the social significance of the behaviour studied. For example, a non-applied researcher may study eating behaviour because this research helps to clarify metabolic processes, whereas the applied researcher may study eating behaviour in individuals who eat too little or too much, trying to change such behaviour so that it is more acceptable to the persons involved.
  • Behavioural: ABA is pragmatic; it asks how it is possible to get an individual to do something effectively. To answer this question, the behaviour itself must be objectively measured. Verbal descriptions are treated as behaviour in themselves, and not as substitutes for the behaviour described.
  • Analytic: Behaviour analysis is successful when the analyst understands and can manipulate the events that control a target behaviour. This may be relatively easy to do in the lab, where a researcher is able to arrange the relevant events, but it is not always easy, or ethical, in an applied situation. Baer et al. outline two methods that may be used in applied settings to demonstrate control while maintaining ethical standards. These are the reversal design and the multiple baseline design. In the reversal design, the experimenter first measures the behaviour of choice, introduces an intervention, and then measures the behaviour again. Then, the intervention is removed, or reduced, and the behaviour is measured yet again. The intervention is effective to the extent that the behaviour changes and then changes back in response to these manipulations. The multiple baseline method may be used for behaviours that seem irreversible. Here, several behaviours are measured and then the intervention is applied to each in turn. The effectiveness of the intervention is revealed by changes in just the behaviour to which the intervention is being applied.
  • Technological: The description of analytic research must be clear and detailed, so that any competent researcher can repeat it accurately. Cooper et al. describe a good way to check this: Have a person trained in applied behaviour analysis read the description and then act out the procedure in detail. If the person makes any mistakes or has to ask any questions then the description needs improvement.
  • Conceptually Systematic: Behaviour analysis should not simply produce a list of effective interventions. Rather, to the extent possible, these methods should be grounded in behavioural principles. This is aided by the use of theoretically meaningful terms, such as “secondary reinforcement” or “errorless discrimination” where appropriate.
  • Effective: Though analytic methods should be theoretically grounded, they must be effective. If an intervention does not produce a large enough effect for practical use, then the analysis has failed
  • Generality: Behaviour analysts should aim for interventions that are generally applicable; the methods should work in different environments, apply to more than one specific behaviour, and have long-lasting effects.

Other proposed Characteristics

In 2005, Heward et al. suggested that the following five characteristics should be added:

  • Accountable: To be accountable means that ABA must be able to demonstrate that its methods are effective. This requires the repeatedly measuring the effect of interventions (success, failure or no effect at all), and, if necessary, making changes that improve their effectiveness.
  • Public: The methods, results, and theoretical analyses of ABA must be published and open to scrutiny. There are no hidden treatments or mystical, metaphysical explanations.
  • Doable: To be generally useful, interventions should be available to a variety of individuals, who might be teachers, parents, therapists, or even those who wish to modify their own behaviour. With proper planning and training, many interventions can be applied by almost anyone willing to invest the effort.
  • Empowering: ABA provides tools that give the practitioner feedback on the results of interventions. These allow clinicians to assess their skill level and build confidence in their effectiveness.
  • Optimistic: According to several leading authors, behaviour analysts have cause to be optimistic that their efforts are socially worthwhile, for the following reasons:
    • The behaviours impacted by behaviour analysis are largely determined by learning and controlled by manipulable aspects of the environment.
    • Practitioners can improve performance by direct and continuous measurements.
    • As a practitioner uses behavioural techniques with positive outcomes, they become more confident of future success.
    • The literature provides many examples of success in teaching individuals considered previously unteachable.

Concepts

Behaviour

Behaviour refers to the movement of some part of an organism that changes some aspect of the environment. Often, the term behaviour refers to a class of responses that share physical dimensions or functions, and in that case a response is a single instance of that behaviour. If a group of responses have the same function, this group may be called a response class. Repertoire refers to the various responses available to an individual; the term may refer to responses that are relevant to a particular situation, or it may refer to everything a person can do.

Operant Conditioning

Operant behaviour is the so-called “voluntary” behaviour that is sensitive to, or controlled by its consequences. Specifically, operant conditioning refers to the three-term contingency that uses stimulus control, in particular an antecedent contingency called the discriminative stimulus (SD) that influences the strengthening or weakening of behaviour through such consequences as reinforcement or punishment. The term is used quite generally, from reaching for a candy bar, to turning up the heat to escape an aversive chill, to studying for an exam to get good grades.

Respondent (Classical) Conditioning

Respondent (classical) conditioning is based on innate stimulus-response relationships called reflexes. In his famous experiments with dogs, Pavlov usually used the salivary reflex, namely salivation (unconditioned response) following the taste of food (unconditioned stimulus). Pairing a neutral stimulus, for example a bell (conditioned stimulus) with food caused the dog to elicit salivation (conditioned response). Thus, in classical conditioning, the conditioned stimulus becomes a signal for a biologically significant consequence. Note that in respondent conditioning, unlike operant conditioning, the response does not produce a reinforcer or punisher (e.g. the dog does not get food because it salivates).

Reinforcement

Reinforcement is the key element in operant conditioning and in most behaviour change programmes. It is the process by which behaviour is strengthened. If a behaviour is followed closely in time by a stimulus and this results in an increase in the future frequency of that behaviour, then the stimulus is a positive reinforcer. If the removal of an event serves as a reinforcer, this is termed negative reinforcement. There are multiple schedules of reinforcement that affect the future probability of behaviour.

Punishment

Punishment is a process by which a consequence immediately follows a behaviour which decreases the future frequency of that behaviour. As with reinforcement, a stimulus can be added (positive punishment) or removed (negative punishment). Broadly, there are three types of punishment: presentation of aversive stimuli (e.g. pain), response cost (removal of desirable stimuli as in monetary fines), and restriction of freedom (as in a ‘time out’). Punishment in practice can often result in unwanted side effects. Some other potential unwanted effects include resentment over being punished, attempts to escape the punishment, expression of pain and negative emotions associated with it, and recognition by the punished individual between the punishment and the person delivering it.

Extinction

Extinction is the technical term to describe the procedure of withholding/discontinuing reinforcement of a previously reinforced behaviour, resulting in the decrease of that behaviour. The behaviour is then set to be extinguished (Cooper et al.). Extinction procedures are often preferred over punishment procedures, as many punishment procedures are deemed unethical and in many states prohibited. Nonetheless, extinction procedures must be implemented with utmost care by professionals, as they are generally associated with extinction bursts. An extinction burst is the temporary increase in the frequency, intensity, and/or duration of the behaviour targeted for extinction. Other characteristics of an extinction burst include an extinction-produced aggression – the occurrence of an emotional response to an extinction procedure often manifested as aggression; and b) extinction-induced response variability – the occurrence of novel behaviours that did not typically occur prior to the extinction procedure. These novel behaviours are a core component of shaping procedures.

Discriminated Operant and Three-Term Contingency

In addition to a relation being made between behaviour and its consequences, operant conditioning also establishes relations between antecedent conditions and behaviours. This differs from the S-R formulations (If-A-then-B), and replaces it with an AB-because-of-C formulation. In other words, the relation between a behaviour (B) and its context (A) is because of consequences (C), more specifically, this relationship between AB because of C indicates that the relationship is established by prior consequences that have occurred in similar contexts. This antecedent-behaviour-consequence contingency is termed the three-term contingency. A behaviour which occurs more frequently in the presence of an antecedent condition than in its absence is called a discriminated operant. The antecedent stimulus is called a discriminative stimulus (SD). The fact that the discriminated operant occurs only in the presence of the discriminative stimulus is an illustration of stimulus control. More recently behaviour analysts have been focusing on conditions that occur prior to the circumstances for the current behaviour of concern that increased the likelihood of the behaviour occurring or not occurring. These conditions have been referred to variously as “Setting Event”, “Establishing Operations”, and “Motivating Operations” by various researchers in their publications.

Verbal Behaviour

B.F. Skinner’s classification system of behaviour analysis has been applied to treatment of a host of communication disorders. Skinner’s system includes:

  • Tact: A verbal response evoked by a non-verbal antecedent and maintained by generalised conditioned reinforcement.
  • Mand: Behaviour under control of motivating operations maintained by a characteristic reinforcer.
  • Intraverbals: Verbal behaviour for which the relevant antecedent stimulus was other verbal behaviour, but which does not share the response topography of that prior verbal stimulus (e.g. responding to another speaker’s question).
  • Autoclitic: Secondary verbal behaviour which alters the effect of primary verbal behaviour on the listener. Examples involve quantification, grammar, and qualifying statements (e.g. the differential effects of “I think…” vs. “I know…”)

Skinner’s use of behavioural techniques was famously critiqued by the linguist Noam Chomsky through an extensive breakdown of how Skinner’s view of language as behavioural simply can not explain the complexity of human language. This suggests that while behaviourist techniques can teach language, it is a very poor measure to explain language fundamentals. Considering Chomsky’s critiques, it may be more appropriate to teach language through a Speech language pathologist instead of a behaviourist.

For an assessment of verbal behaviour from Skinner’s system, refer to Assessment of Basic Language and Learning Skills.

Measuring Behaviour

When measuring behaviour, there are both dimensions of behaviour and quantifiable measures of behaviour. In applied behaviour analysis, the quantifiable measures are a derivative of the dimensions. These dimensions are repeatability, temporal extent, and temporal locus.

Repeatability

Response classes occur repeatedly throughout time – i.e. how many times the behaviour occurs.

  • Count is the number of occurrences in behaviour.
  • Rate/frequency is the number of instances of behaviour per unit of time.
  • Celeration is the measure of how the rate changes over time.

Temporal Extent

This dimension indicates that each instance of behaviour occupies some amount of time – i.e. how long the behaviour occurs.

  • Duration is the period of time over which the behaviour occurs.

Temporal Locus

Each instance of behaviour occurs at a specific point in time – i.e. when the behaviour occurs.

  • Response latency is the measure of elapsed time between the onset of a stimulus and the initiation of the response.
  • Inter-response time is the amount of time that occurs between two consecutive instances of a response class.

Derivative Measures

Derivative measures are unrelated to specific dimensions:

  • Percentage is the ratio formed by combining the same dimensional quantities.
  • Trials-to-criterion are the number of response opportunities needed to achieve a predetermined level of performance.

Analysing Behaviour Change

Experimental Control

In applied behaviour analysis, all experiments should include the following:

  • At least one participant.
  • At least one behaviour (dependent variable).
  • At least one setting.
  • A system for measuring the behaviour and ongoing visual analysis of data.
  • At least one treatment or intervention condition.
  • Manipulations of the independent variable so that its effects on the dependent variable may be quantitatively or qualitatively analysed.
  • An intervention that will benefit the participant in some way.

Methodologies Developed through ABA Research

Task Analysis

Task analysis is a process in which a task is analysed into its component parts so that those parts can be taught through the use of chaining: forward chaining, backward chaining and total task presentation. Task analysis has been used in organizational behaviour management, a behaviour analytic approach to changing the behaviours of members of an organization (e.g. factories, offices, or hospitals). Behavioural scripts often emerge from a task analysis. Bergan conducted a task analysis of the behavioural consultation relationship and Thomas Kratochwill developed a training program based on teaching Bergan’s skills. A similar approach was used for the development of microskills training for counsellors. Ivey would later call this “behaviourist” phase a very productive one and the skills-based approach came to dominate counselor training during 1970-1990. Task analysis was also used in determining the skills needed to access a career. In education, Englemann (1968) used task analysis as part of the methods to design the Direct Instruction curriculum.

Chaining

The skill to be learned is broken down into small units for easy learning. For example, a person learning to brush teeth independently may start with learning to unscrew the toothpaste cap. Once they have learned this, the next step may be squeezing the tube, etc.

For problem behaviour, chains can also be analysed and the chain can be disrupted to prevent the problem behaviour. Some behaviour therapies, such as dialectical behaviour therapy, make extensive use of behaviour chain analysis, but is not philosophically behaviour analytic.

Prompting

A prompt is a cue that is used to encourage a desired response from an individual. Prompts are often categorised into a prompt hierarchy from most intrusive to least intrusive, although there is some controversy about what is considered most intrusive, those that are physically intrusive or those that are hardest prompt to fade (e.g. verbal). In order to minimise errors and ensure a high level of success during learning, prompts are given in a most-to-least sequence and faded systematically. During this process, prompts are faded as quickly as possible so that the learner does not come to depend on them and eventually behaves appropriately without prompting.

Types of prompts Prompters might use any or all of the following to suggest the desired response:

  • Vocal prompts: Words or other vocalisations.
  • Visual prompts: A visual cue or picture.
  • Gestural prompts: A physical gesture.
  • Positional prompt: e.g. the target item is placed close to the individual.
  • Modelling: Modelling the desired response. This type of prompt is best suited for individuals who learn through imitation and can attend to a model.
  • Physical prompts: Physically manipulating the individual to produce the desired response. There are many degrees of physical prompts, from quite intrusive (e.g. the teacher places a hand on the learner’s hand) to minimally intrusive (e.g. a slight tap).

This is not an exhaustive list of prompts; the nature, number, and order of prompts are chosen to be the most effective for a particular individual.

Fading

The overall goal is for an individual to eventually not need prompts. As an individual gains mastery of a skill at a particular prompt level, the prompt is faded to a less intrusive prompt. This ensures that the individual does not become overly dependent on a particular prompt when learning a new behaviour or skill.

Thinning a Reinforcement Schedule

Thinning is often confused with fading. Fading refers to a prompt being removed, where thinning refers to an increase in the time or number of responses required between reinforcements. Periodic thinning that produces a 30% decrease in reinforcement has been suggested as an efficient way to thin. Schedule thinning is often an important and neglected issue in contingency management and token economy systems, especially when these are developed by unqualified practitioners (refer to professional practice of behaviour analysis).

Generalisation

Generalisation is the expansion of a student’s performance ability beyond the initial conditions set for acquisition of a skill. Generalisation can occur across people, places, and materials used for teaching. For example, once a skill is learned in one setting, with a particular instructor, and with specific materials, the skill is taught in more general settings with more variation from the initial acquisition phase. For example, if a student has successfully mastered learning colours at the table, the teacher may take the student around the house or school and generalise the skill in these more natural environments with other materials. Behaviour analysts have spent considerable amount of time studying factors that lead to generalisation.

Shaping

Shaping involves gradually modifying the existing behaviour into the desired behaviour. If the student engages with a dog by hitting it, then they could have their behaviour shaped by reinforcing interactions in which they touch the dog more gently. Over many interactions, successful shaping would replace the hitting behaviour with patting or other gentler behaviour. Shaping is based on a behaviour analyst’s thorough knowledge of operant conditioning principles and extinction. Recent efforts to teach shaping have used simulated computer tasks.

One teaching technique found to be effective with some students, particularly children, is the use of video modelling (the use of taped sequences as exemplars of behaviour). It can be used by therapists to assist in the acquisition of both verbal and motor responses, in some cases for long chains of behaviour.

Interventions Based on an FBA

Critical to behaviour analytic interventions is the concept of a systematic behavioural case formulation with a functional behavioural assessment or analysis at the core. This approach should apply a behaviour analytic theory of change (see Behavioural change theories). This formulation should include a thorough functional assessment, a skills assessment, a sequential analysis (behaviour chain analysis), an ecological assessment, a look at existing evidenced-based behavioural models for the problem behaviour (such as Fordyce’s model of chronic pain) and then a treatment plan based on how environmental factors influence behaviour. Some argue that behaviour analytic case formulation can be improved with an assessment of rules and rule-governed behaviour. Some of the interventions that result from this type of conceptualisation involve training specific communication skills to replace the problem behaviours as well as specific setting, antecedent, behaviour, and consequence strategies.

Use in the Treatment of Autism Spectrum Disorders

ABA-based techniques are often used to teach adaptive behaviours or to diminish behaviours associated with autism, so much that ABA itself is often mistakenly considered to be synonymous with therapy for autism. According to a paper from 2007, it was considered to be an effective “intervention for challenging behaviours” by the American Academy of Paediatrics. A 2018 Cochrane review of five studies that compared treatment vs. control showed that ABA may be effective for some autistic children. However, the quality of the evidence was weak; the number of subjects in the studies was small, and only one study randomised subjects into control and treatment groups. ABA for autism may be limited by diagnostic severity and IQ.

Efficacy

Recent reviews of the efficacy of ABA-based techniques in autism include:

  • A 2007 clinical report of the American Academy of Paediatrics concluded that the benefit of ABA-based interventions in autism spectrum disorders (ASDs) “has been well documented” and that “children who receive early intensive behavioural treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behaviour as well as some measures of social behaviour”.
  • Researchers from the MIND Institute published an evidence-based review of comprehensive treatment approaches in 2008. On the basis of “the strength of the findings from the four best-designed, controlled studies”, they were of the opinion that one ABA-based approach (the Lovaas technique created by Ole Ivar Løvaas) is “well-established” for improving intellectual performance of young children with ASD.
  • A 2009 review of psycho-educational interventions for children with autism whose mean age was six years or less at intake found that five high-quality (“Level 1” or “Level 2”) studies assessed ABA-based treatments. On the basis of these and other studies, the author concluded that ABA is “well-established” and is “demonstrated effective in enhancing global functioning in pre-school children with autism when treatment is intensive and carried out by trained therapists”. However, the review committee also concluded that “there is a great need for more knowledge about which interventions are most effective”.
  • A 2009 paper included a descriptive analysis, an effect size analysis, and a meta-analysis of 13 reports published from 1987 to 2007 of early intensive behavioural intervention (EIBI, a form of ABA-based treatment with origins in the Lovaas technique) for autism. It determined that EIBI’s effect sizes were “generally positive” for IQ, adaptive behaviour, expressive language, and receptive language. The paper did note limitations of its findings including the lack of published comparisons between EIBI and other “empirically validated treatment programmes”.
  • In a 2009 systematic review of 11 studies published from 1987 to 2007, the researchers wrote “there is strong evidence that EIBI is effective for some, but not all, children with autism spectrum disorders, and there is wide variability in response to treatment”. Furthermore, any improvements are likely to be greatest in the first year of intervention.
  • A 2009 meta-analysis of nine studies published from 1987 to 2007 concluded that EIBI has a “large” effect on full-scale intelligence and a “moderate” effect on adaptive behaviour in autistic children.
  • A 2009 systematic review and meta-analysis by Spreckley and Boyd of four small-n 2000-2007 studies (involving a total of 76 children) came to different conclusions than the aforementioned reviews. Spreckley and Boyd reported that applied behaviour intervention (ABI), another name for EIBI, did not significantly improve outcomes compared with standard care of preschool children with ASD in the areas of cognitive outcome, expressive language, receptive language, and adaptive behaviour. In a letter to the editor, however, authors of the four studies meta-analysed claimed that Spreckley and Boyd had misinterpreted one study comparing two forms of ABI with each other as a comparison of ABI with standard care, which erroneously decreased the observed efficacy of ABI. Furthermore, the four studies’ authors raised the possibility that Spreckley and Boyd had excluded some other studies unnecessarily, and that including such studies could have led to a more favourable evaluation of ABI. Spreckley, Boyd, and the four studies’ authors did agree that large multi-site randomised trials are needed to improve the understanding of ABA’s efficacy in autism.
  • In 2011, investigators from Vanderbilt University under contract with the Agency for Healthcare Research and Quality performed a comprehensive review of the scientific literature on ABA-based and other therapies for autism spectrum disorders; the ABA-based therapies included the UCLA/Lovaas method and the Early Start Denver Model (the latter developed by Sally Rogers and Geraldine Dawson). They concluded that “both approaches were associated with … improvements in cognitive performance, language skills, and adaptive behaviour skills”. However, they also concluded that “the strength of evidence … is low”, “many children continue to display prominent areas of impairment”, “subgroups may account for a majority of the change”, there is “little evidence of practical effectiveness or feasibility beyond research studies”, and the published studies “used small samples, different treatment approaches and duration, and different outcome measurements”.
  • A 2019 review article concluded ABA proponents have utilised predominantly non-verbal and neurologically different, children who are not recognised under this paradigm to have their own thought processes, basic needs, preferences, style of learning, and psychological and emotional needs, for their experiment. This also indicates a missing voice of children and nonverbal people who cannot express their view on ABA.
  • A preliminary study indicates that there might be a publication bias against single-subject research studies that show that ABA is ineffective. Publication bias could lead to exaggerated estimates of intervention effects observed by single-subject studies.

Opposition to the Use in Treatment of Autism Spectrum Disorder

The Autistic Community

The value of eliminating autistic behaviours is disputed by proponents of neurodiversity, who claim that it forces autistics to mask their true personalities on behalf of a narrow conception of normality. Autism advocates contend that it is cruel to try to make autistic people “normal” without consideration for how this may affect their well-being. Instead, these critics advocate for increased social acceptance of harmless autistic traits and therapies focused on improving quality of life. Julia Bascom of the Autistic Self Advocacy Network (ASAN) has said, “ASAN’s objection is fundamentally an ethical one. The stated end goal of ABA is an autistic child who is ‘indistinguishable from their peers’ – an autistic child who can pass as neurotypical. We don’t think that’s an acceptable goal. The end goal of all services, supports, interventions, and therapies an autistic child receives should be to support them in growing up into an autistic adult who is happy, healthy, and living a self-determined life.” A recent study examined perspectives of autistic adults that received ABA as children and found that the overwhelming majority reported that “behaviourist methods create painful lived experiences”, that ABA led to the “erosion of the true actualising self”, and that they felt they had a “lack of self-agency within interpersonal experiences.”

Professional Concerns

Professionals against ABA have voiced concerns over it’s evolution from Radical behaviourism. Radical behaviourism when applied views the individual as nothing more than a stimulus-response, that all of their experience can be reduced to a set of behavioural functions and manipulated through operant conditioning which only addresses “the surface level” and may only temporarily subdue aggressive behaviour under the guise that it is addressed because the subject appears content. Other concerns have focused on the “ideological zealotry” surrounding it, where ABA journals and websites have claimed that it “cures” autism and is “the only evidence based autism therapy” which has restricted access to other therapies that are also evidence based like TEACCH. The rhetoric surrounding the virtues of ABA has concerning effects including parents and professionals that claim that ABA “cured” their child’s autism, like one parent who “…claims that ABA had saved her children’s lives, likening it to chemotherapy as a treatment for cancer.”

Researchers have critiqued the leniency of the ABA ethical code, discussing how it does not restrict or clarify the “appropriate use of aversives”, it does not require competency so ABA therapists are “not required to take even a single class on autism, brain function or child development” , and its view of the client as the parent so requiring “client consent” only requires parental consent, not the person receiving services. Similarly, because the parent is seen as the client, the goals that are set under the ethical code are according to the client’s needs, which means focusing on changing autistic behaviours for the benefit of the parent and not the child is considered ethical.

Besides ethics, scientists also have concerns over the methodological issues rampant through the evidence that ABA claims supports the therapy. Early ABA research regularly employed poor methodology, including the initial study by Lovaas that supposedly supported the use of the therapy. The study by Lovaas used a self-selected sample of autistic children with high IQ and many early and present studies also employed this poor sampling with a lack of randomization, researcher-selected samples, samples pulled from researchers’ own clinics, and funding by ABA organizations with a clear conflict of interest for proving ABA is effective. Another concern is that ABA research only measures behaviour as a means of success, which has led to a lack of qualitative research about autistic experiences of ABA, a lack of research examining the internal effects of ABA and a lack of research for autistic children who are non-speaking or have comorbid intellectual disabilities (which is concerning considering this is one of the major populations that intensive ABA focuses on). Research is also lacking about whether ABA is effective long-term and very little longitudinal outcomes have been studied.

Use of Aversives

Some embodiments of applied behaviour analysis as devised by Ole Ivar Lovaas used aversives such as electric shocks to modify undesirable behaviour in their initial use in the 1970s, as well as slapping and shouting in the landmark 1987 study. Over time the use of aversives lessened and in 2012 their use was described as being inconsistent with contemporary practice. However, aversives have continued to be used in some ABA programs. In comments made in 2014 to the US Food and Drug Administration (FDA), a clinician who previously worked at the Judge Rotenberg Educational Centre claimed that “all textbooks used for thorough training of applied behaviour analysts include an overview of the principles of punishment, including the use of electrical stimulation.” In 2020, the FDA banned the use of electrical stimulation devices used for self-injurious or aggressive behaviour and asserted that “Evidence indicates a number of significant psychological and physical risks are associated with the use of these devices, including worsening of underlying symptoms, depression, anxiety, posttraumatic stress disorder, pain, burns and tissue damage.”

Major Journals

Applied behaviour analysts publish in many journals. Some examples of “core” behaviour analytic journals are:

  • Journal of Applied Behaviour Analysis.
  • Journal of the Experimental Analysis of Behaviour.
  • Behaviour Analysis: Research and Practice.
  • The Behaviour Analyst Today.
  • Perspectives on Behaviour Science (formerly The Behaviour Analyst until 2018).
  • The Psychological Record.
  • The Journal of Speech-Language Pathology and Applied Behaviour Analysis.
  • Journal of Early and Intensive Behaviour Interventions.
  • The International Journal of Behavioural Consultation and Therapy.
  • The Journal of Behavioural Assessment and Intervention in Children.
  • The Behavioural Development Bulletin.
  • Behaviour and Social Issues.
  • Journal of Behaviour Analysis of Sports, Health, Fitness, and Behavioural Medicine.
  • Journal of Behaviour Analysis of Offender and Victim: Treatment and Prevention.
  • Behavioural Health and Medicine.
  • Applied Animal Behaviour Science.
  • Behaviour Therapy.
  • Behaviour and Philosophy.

What is Inhibitory Control?

Introduction

Inhibitory control, also known as response inhibition, is a cognitive process – and more specifically an executive function – that permits an individual to inhibit their impulses and natural, habitual, or dominant behavioural responses to stimuli (e.g. prepotent responses) in order to select a more appropriate behaviour that is consistent with completing their goals.

Self-control is an important aspect of inhibitory control. For example, successfully suppressing the natural behavioural response to eat cake when one is craving it while dieting requires the use of inhibitory control.

The prefrontal cortex, caudate nucleus, and subthalamic nucleus are known to regulate inhibitory control cognition. Inhibitory control is impaired in both addiction and attention deficit hyperactivity disorder. In healthy adults and ADHD individuals, inhibitory control improves over the short term with low (therapeutic) doses of methylphenidate or amphetamine. Inhibitory control may also be improved over the long-term via consistent aerobic exercise.

Tests

An inhibitory control test is a neuropsychological test that measures an individual’s ability to override their natural, habitual, or dominant behavioural response to a stimulus in order to implement more adaptive goal-oriented behaviours. Some of the neuropsychological tests that measure inhibitory control include the Stroop task, go/no-go task, Simon task, Flanker task, anti-saccade tasks, delay of gratification tasks, and stop-signal tasks.

Gender Differences

Females tend to have a greater basal capacity to exert inhibitory control over undesired or habitual behaviours and respond differently to modulatory environmental contextual factors relative to males. For example, listening to music tends to significantly improve the rate of response inhibition in females, but reduces the rate of response inhibition in males.

What is Gray’s Biopsychological Theory of Personality?

Introduction

The biopsychological theory of personality is a model of the general biological processes relevant for human psychology, behaviour, and personality. The model, proposed by research psychologist Jeffrey Alan Gray in 1970, is well-supported by subsequent research and has general acceptance among professionals.

Gray hypothesized the existence of two brain-based systems for controlling a person’s interactions with their environment: the behavioural inhibition system (BIS) and the behavioural activation system (BAS). BIS is related to sensitivity to punishment and avoidance motivation. BAS is associated with sensitivity to reward and approach motivation. Psychological scales have been designed to measure these hypothesized systems and study individual differences in personality. Neuroticism, a widely studied personality dimension related to emotional functioning, is positively correlated with BIS scales and negatively correlated with BAS scales.

Brief History

The biopsychological theory of personality is similar to another one of Gray’s theories, reinforcement sensitivity theory. The Biopsychological Theory of Personality was created after Gray disagreed with Hans Eysenck’s arousal theory that dealt with biological personality traits. Eysenck looked at the ascending reticular activating system (ARAS) for answering questions about personality. The ARAS is part of the brain structure and has been proposed to deal with cortical arousal, hence the term arousal theory. Eysenck compared levels of arousal to a scale of introversion versus extraversion. The comparison of these two scales was then used to describe individual personalities and their corresponding behavioural patterns. Gray disagreed with Eysenck’s theory because Gray believed that things such as personality traits could not be explained by just classical conditioning. Instead, Gray developed his theory which is based more heavily on physiological responses than Eysenck’s theory.

Gray had a lot of support for his theories and experimented with animals to test his hypotheses. Using animal subjects allows researchers to test whether different areas of the brain are responsible for different learning mechanisms. Specifically, Gray’s theory concentrated on understanding how reward or punishment related to anxiety and impulsivity measures. His research and further studies have found that reward and punishment are under the control of separate systems and as a result people can have different sensitivities to such rewarding or punishing stimuli.

Behavioural Inhibition System

The behavioural inhibition system (BIS), as proposed by Gray, is a neuropsychological system that predicts an individual’s response to anxiety-relevant cues in a given environment. This system is activated in times of punishment, boring things, or negative events. By responding to cues such as negative stimuli or events that involve punishment or frustration, this system ultimately results in avoidance of such negative and unpleasant events. According to Gray’s Theory, the BIS is related to sensitivity to punishment as well as avoidance motivation. It has also been proposed that the BIS is the causal basis of anxiety. High activity of the BIS means a heightened sensitivity to non-reward, punishment, and novel experience. This higher level of sensitivity to these cues results in a natural avoidance of such environments in order to prevent negative experiences such as fear, anxiety, frustration, and sadness. People who are highly sensitive to punishment perceive punishments as more aversive and are more likely to be distracted by punishments.

The physiological mechanism behind the BIS is believed to be the septohippocampal system and its monoaminergic afferents from the brainstem. Using a voxel-based morphometry analysis, the volume of the regions mentioned was assessed to view individual differences. Findings may suggest a correlation between the volume and anxiety-related personality traits. Results were found in the orbitofrontal cortex, the precuneus, the amygdala, and the prefrontal cortex.

Behavioural Activation System

The behavioural activation system (BAS), in contrast to the BIS, is based on a model of appetitive motivation – in this case, an individual’s disposition to pursue and achieve goals. The BAS is aroused when it receives cues corresponding to rewards and controls actions that are not related to punishment, rather actions regulating approachment type behaviours. This system has an association with hope. According to Gray’s theory, the BAS is sensitive to conditioned appealing stimuli, and is associated with impulsivity. It is also thought to be related to sensitivity to reward as well as approach motivation. The BAS is sensitive to non-punishment and reward. Individuals with a highly active BAS show higher levels of positive emotions such as elation, happiness, and hope in response to environmental cues consistent with non-punishment and reward, along with goal-achievement. In terms of personality, these individuals are also more likely to engage in goal-directed efforts and experience these positive emotions when exposed to impending reward. The physiological mechanism for BAS is not known as well as BIS, but is believed to be related to catecholaminergic and dopaminergic pathways in the brain. Dopamine is a neurotransmitter commonly linked with positive emotions, which could explain the susceptibility to elation and happiness upon achieving goals which has been observed. People with a highly active BAS have been shown to learn better by reward than by punishment, inverse to BIS as mentioned above. BAS is considered to include trait impulsivity that is also related to psychopathological disorders such as ADHD, substance use disorder, and alcohol use disorder. The higher the BAS score, or the higher the impulsive, the more it is likely to be related to psycho-pathological or dis-inhibitory disorders. Certain aspects of the dopaminergic reward system activate when reward cues and reinforcers are presented, including biological rewards such as food and sex. These brain areas, which were highlighted during multiple fMRI studies, are the same areas associated with BAS.

Compare and Contrast

Together, the two systems work in an inverse relationship. In other words, when a specific situation occurs, an organism can approach the situation with one of the two systems. The systems will not be stimulated at the same time and which system is dominant depends on the situation in terms of punishment versus reward. This phenomenon of the differentiation between the two systems is thought to occur because of the distinct areas in the brain that becomes activated in response to different stimuli. This difference was noted years ago through electrical stimulation of the brain.

The behavioural activation system and behavioural inhibition system differ in their physiological pathways in the brain. The inhibition system has been shown to be linked to the septo-hippocampal system which appears to have a close correlation to a serotonergic pathway, with similarities in their innervations and stress responses. On the other hand, the activation, or reward system, is thought to be associated more with a mesolimbic dopaminergic system as opposed to the serotonergic system.

The two systems proposed by Gray differ in their motivations and physiological responses. Gray also proposed that individuals can vary widely in their responsiveness of the behavioural inhibition system and the behavioural activation system. It has been found that someone who is sensitive to their BIS will be more receptive to the negative cues as compared to someone who is sensitive to their BAS and therefore responds more to cues in the environment that relate to that system, specifically positive or rewarding cues. Researchers besides Gray have shown interest in this theory and have created questionnaires that measure BIS and BAS sensitivity. Carver and White have been the primary researchers responsible for the questionnaire. Carver and White created a scale that has been shown to validly measure levels of individual scores of BIS and BAS. This measure focuses on the differences in incentive motivations and aversive motivations. As previously mentioned these motivations correlate to impulsivity and anxiety respectively.

Applications

Since the development of the BAS and BIS, tests have been created to see how individuals rate in each area. The questionnaire is called the Behavioural Inhibition System and Behavioural Activation System Questionnaire.

People can be tested based on their activation of either systems by using an EEG. These tests will conclude whether a person has a more active BIS or BAS. The two systems are independent of each other.

These tests can determine different things about a person’s personality. They can determine if a person has more positive or negative moods. Using psychological test scales designed to correlate with the attributes of these hypothesized systems, neuroticism has been found to be positively correlated with the BIS scale, and negatively correlated with the BAS scale.

According to Richard Depue’s BAS dysregulation theory of bipolar disorders, now doctors and other professionals can determine if a person with bipolar disorder is on the brink of a manic or depressive episode based on how they rate on a scale of BAS and BIS sensitivity. Essentially, this dysregulation theory proposes that people with BAS dysregulation have an extraordinarily sensitive behavioural activation system and their BAS is hyper-responsive to behavioural approach system cues. If a person with bipolar disorder self-reports high sensitivity to BAS, it means that a manic episode could occur faster. Also, if a person with bipolar disorder reports high sensitivity to BIS it could indicate a depressive phase. A better understanding of BAS dysregulation theory can inform psychosocial intervention (e.g. cognitive behavioural therapy, psychoeducation, interpersonal and social rhythm therapy, etc.).

The BAS/BIS Questionnaire can also be used in the cases of criminal profiling. Previous research as reported by researchers MacAndrew and Steele in 1991 compared two groups on opposite spectrum levels of fear and the response of a variety of questions. The two groups in the study varied on levels of BIS, either high or low, and were selected by the researchers. One group was composed of women who had experienced anxiety attacks and together made up the high BIS group. The low BIS group was composed of convicted prostitutes who had been found to take part in illegal behaviour. Main findings showed that the responses to the questionnaires were distinctly different between the high BIS group and the low BIS group, with the convicted women scoring lower. Results from this study demonstrate that questionnaires can be used as a valid measurement to show differences in the behavioural inhibition systems of different types of people. Gray also introduced his SPSRQ questionnaire to measure sensitivity to reward (SR) and sensitivity to punishment (SP) in anxiety (2012). It is a specifically designed questionnaire linking to Gray’s theory referencing the SR to the BAS and the SP to the BIS.

Future Research or Implications

As mentioned previously, psychological disorders have been analysed in terms of the behavioural inhibition and activation systems. Understanding the differences between the systems may relate to an understanding of different types of disorders that involve anxiety and impulsivity. To date, there are many types of anxiety disorders that deal with avoidance theories and future research could show that the behavioural activation system plays a large role in such disorders and may have future implications for treatment of patients.

What is Conduct Disorder?

Introduction

Conduct disorder (CD) is a mental disorder diagnosed in childhood or adolescence that presents itself through a repetitive and persistent pattern of behaviour that includes theft, lies, physical violence that may lead to destruction and wanton breaking of rules, in which the basic rights of others or major age-appropriate norms are violated.

These behaviours are often referred to as “antisocial behaviours.” It is often seen as the precursor to antisocial personality disorder, which is per definition not diagnosed until the individual is 18 years old. Conduct disorder may result from parental rejection and neglect and can be treated with family therapy, as well as behavioural modifications and pharmacotherapy. Conduct disorder is estimated to affect 51.1 million people globally as of 2013.

Signs and Symptoms

One of the symptoms of conduct disorder is a lower level of fear. Research performed on the impact of toddlers exposed to fear and distress shows that negative emotionality (fear) predicts toddlers’ empathy-related response to distress. The findings support that if a caregiver is able to respond to infant cues, the toddler has a better ability to respond to fear and distress. If a child does not learn how to handle fear or distress the child will be more likely to lash out at other children. If the caregiver is able to provide therapeutic intervention teaching children at risk better empathy skills, the child will have a lower incident level of conduct disorder.

Increased instances of violent and antisocial behaviour are also associated with the condition; examples may range from pushing, hitting and biting when the child is young, progressing towards beating and inflicted cruelty as the child becomes older.

Conduct disorder can present with limited prosocial emotions, lack of remorse or guilt, lack of empathy, lack of concern for performance, and shallow or deficient affect. Symptoms vary by individual, but the four main groups of symptoms are described below.

Aggression to People and Animals

  • Often bullies, threatens or intimidates others.
  • Often initiates physical fights.
  • Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun).
  • Has been physically cruel to people.
  • Has been physically cruel to animals.
  • Has stolen while confronting a victim (e.g. mugging, purse snatching, extortion, armed robbery).
  • Has forced someone into sexual activity (rape or molestation).
  • Feels no remorse or empathy towards the harm, fear, or pain they may have inflicted on others.

Destruction of Property

  • Has deliberately engaged in fire setting with the intention of causing serious damage.
  • Has deliberately destroyed others’ property (other than by fire setting).

Deceitfulness or Theft

  • Has broken into someone else’s house, building, or car.
  • Often lies to obtain goods or favours or to avoid obligations (i.e. “cons” others).
  • Has stolen items of nontrivial value without confronting a victim (e.g. shoplifting, but without breaking and entering; forgery).

Serious Violations of Rules

  • Often stays out at night despite parental prohibitions, beginning before age 13 years.
  • Has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period).
  • Is often truant from school, beginning before age 13 years.

The lack of empathy these individuals have and the aggression that accompanies this carelessness for the consequences is dangerous – not only for the individual but for those around them.

Developmental Course

Currently, two possible developmental courses are thought to lead to conduct disorder. The first is known as the “childhood-onset type” and occurs when conduct disorder symptoms are present before the age of 10 years. This course is often linked to a more persistent life course and more pervasive behaviours. Specifically, children in this group have greater levels of ADHD symptoms, neuropsychological deficits, more academic problems, increased family dysfunction and higher likelihood of aggression and violence.

There is debate among professionals regarding the validity and appropriateness of diagnosing young children with conduct disorder. The characteristics of the diagnosis are commonly seen in young children who are referred to mental health professionals. A premature diagnosis made in young children, and thus labelling and stigmatising an individual, may be inappropriate. It is also argued that some children may not in fact have conduct disorder, but are engaging in developmentally appropriate disruptive behaviour.

The second developmental course is known as the “adolescent-onset type” and occurs when conduct disorder symptoms are present after the age of 10 years. Individuals with adolescent-onset conduct disorder exhibit less impairment than those with the childhood-onset type and are not characterised by similar psychopathology. At times, these individuals will remit in their deviant patterns before adulthood. Research has shown that there is a greater number of children with adolescent-onset conduct disorder than those with childhood-onset, suggesting that adolescent-onset conduct disorder is an exaggeration of developmental behaviours that are typically seen in adolescence, such as rebellion against authority figures and rejection of conventional values. However, this argument is not established and empirical research suggests that these subgroups are not as valid as once thought.

In addition to these two courses that are recognised by the DSM, there appears to be a relationship among oppositional defiant disorder, conduct disorder, and antisocial personality disorder. Specifically, research has demonstrated continuity in the disorders such that conduct disorder is often diagnosed in children who have been previously diagnosed with oppositional defiant disorder, and most adults with antisocial personality disorder were previously diagnosed with conduct disorder. For example, some research has shown that 90% of children diagnosed with conduct disorder had a previous diagnosis of oppositional defiant disorder. Moreover, both disorders share relevant risk factors and disruptive behaviours, suggesting that oppositional defiant disorder (ODD) is a developmental precursor and milder variant of conduct disorder. However, this is not to say that this trajectory occurs in all individuals. In fact, only about 25% of children with oppositional defiant disorder will receive a later diagnosis of conduct disorder. Correspondingly, there is an established link between conduct disorder and the diagnosis of antisocial personality disorder as an adult. In fact, the current diagnostic criteria for antisocial personality disorder require a conduct disorder diagnosis before the age of 15. However, again, only 25-40% of youths with conduct disorder will develop an antisocial personality disorder. Nonetheless, many of the individuals who do not meet full criteria for antisocial personality disorder still exhibit a pattern of social and personal impairments or antisocial behaviours. These developmental trajectories suggest the existence of antisocial pathways in certain individuals, which have important implications for both research and treatment.

Associated Conditions

Children with conduct disorder have a high risk of developing other adjustment problems. Specifically, risk factors associated with conduct disorder and the effects of conduct disorder symptomatology on a child’s psychosocial context have been linked to overlapping with other psychological disorders. In this way, there seems to be reciprocal effects of comorbidity with certain disorders, leading to increased overall risk for these youth.

Attention Deficit Hyperactivity Disorder

ADHD is the condition most commonly associated with conduct disorders, with approximately 25-30% of boys and 50-55% of girls with conduct disorder having a comorbid ADHD diagnosis. While it is unlikely that ADHD alone is a risk factor for developing conduct disorder, children who exhibit hyperactivity and impulsivity along with aggression is associated with the early onset of conduct problems. Moreover, children with comorbid conduct disorder and ADHD show more severe aggression.

Substance Use Disorders

Conduct disorder is also highly associated with both substance use and abuse. Children with conduct disorder have an earlier onset of substance use, as compared to their peers, and also tend to use multiple substances. However, substance use disorders themselves can directly or indirectly cause conduct disorder like traits in about half of adolescents who have a substance use disorder. As mentioned above, it seems that there is a transactional relationship between substance use and conduct problems, such that aggressive behaviours increase substance use, which leads to increased aggressive behaviour.

Substance use in conduct disorder can lead to antisocial behaviour in adulthood.

Schizophrenia

Conduct disorder is a precursor to schizophrenia in a minority of cases, with about 40% of men and 31% of women with schizophrenia meeting criteria for childhood conduct disorder.

Cause

While the cause of conduct disorder is complicated by an intricate interplay of biological and environmental factors, identifying underlying mechanisms is crucial for obtaining accurate assessment and implementing effective treatment. These mechanisms serve as the fundamental building blocks on which evidence-based treatments are developed. Despite the complexities, several domains have been implicated in the development of conduct disorder including cognitive variables, neurological factors, intraindividual factors, familial and peer influences, and wider contextual factors. These factors may also vary based on the age of onset, with different variables related to early (e.g. neurodevelopmental basis) and adolescent (e.g. social/peer relationships) onset.

Risks

The development of conduct disorder is not immutable or predetermined. A number of interactive risk and protective factors exist that can influence and change outcomes, and in most cases conduct disorder develops due to an interaction and gradual accumulation of risk factors. In addition to the risk factors identified under cause, several other variables place youth at increased risk for developing the disorder, including child physical abuse, in-utero alcohol exposure, and maternal smoking during pregnancy. Protective factors have also been identified, and most notably include high IQ, being female, positive social orientations, good coping skills, and supportive family and community relationships.

However, a correlation between a particular risk factor and a later developmental outcome (such as conduct disorder) cannot be taken as definitive evidence for a causal link. Co-variation between two variables can arise, for instance, if they represent age-specific expressions of similar underlying genetic factors. For example, the tendency to smoke during pregnancy (SDP) is subject to substantial genetic influence, as is conduct disorder. Thus, the genes that dispose the mother to SDP may also dispose the child to CD following mitotic transmission. Indeed, Rice et al. (2009) found that in mother-fetus pairs that were not genetically related (by virtue of in-vitro fertilisation), no link between SDP and later conduct problems arose. Thus, the distinction between causality and correlation is an important consideration.

Learning Disabilities

While language impairments are most common, approximately 20-25% of youth with conduct disorder have some type of learning disability. Although the relationship between the disorders is complex, it seems as if learning disabilities result from a combination of ADHD, a history of academic difficulty and failure, and long-standing socialisation difficulties with family and peers. However, confounding variables, such as language deficits, SES disadvantage, or neurodevelopmental delay also need to be considered in this relationship, as they could help explain some of the association between conduct disorder and learning problems.

Cognitive Factors

In terms of cognitive function, intelligence and cognitive deficits are common amongst youths with conduct disorder, particularly those with early-onset and have intelligence quotients (IQ) one standard deviation below the mean and severe deficits in verbal reasoning and executive function. Executive function difficulties may manifest in terms of one’s ability to shift between tasks, plan as well as organise, and also inhibit a prepotent response. These findings hold true even after taking into account other variables such as socioeconomic status (SES), and education. However, IQ and executive function deficits are only one piece of the puzzle, and the magnitude of their influence is increased during transactional processes with environmental factors.

Brain Differences

Beyond difficulties in executive function, neurological research on youth with conduct disorder also demonstrate differences in brain anatomy and function that reflect the behaviours and mental anomalies associated in conduct disorder. Compared to normal controls, youths with early and adolescent onset of conduct disorder displayed reduced responses in brain regions associated with social behaviour (i.e. amygdala, ventromedial prefrontal cortex, insula, and orbitofrontal cortex). In addition, youths with conduct disorder also demonstrated less responsiveness in the orbitofrontal regions of the brain during a stimulus-reinforcement and reward task. This provides a neural explanation for why youths with conduct disorder may be more likely to repeat poor decision making patterns. Lastly, youths with conduct disorder display a reduction in grey matter volume in the amygdala, which may account for the fear conditioning deficits. This reduction has been linked to difficulty processing social emotional stimuli, regardless of the age of onset. Aside from the differences in neuroanatomy and activation patterns between youth with conduct disorder and controls, neurochemical profiles also vary between groups. Individuals with conduct disorder are characterised as having reduced serotonin and cortisol levels (e.g. reduced hypothalamic-pituitary-adrenal (HPA) axis), as well as reduced autonomic nervous system (ANS) functioning. These reductions are associated with the inability to regulate mood and impulsive behaviours, weakened signals of anxiety and fear, and decreased self-esteem. Taken together, these findings may account for some of the variance in the psychological and behavioural patterns of youth with conduct disorder.

Intra-Individual Factors

Aside from findings related to neurological and neurochemical profiles of youth with conduct disorder, intraindividual factors such as genetics may also be relevant. Having a sibling or parent with conduct disorder increases the likelihood of having the disorder, with a heritability rate of .53. There also tends to be a stronger genetic link for individuals with childhood-onset compared to adolescent onset. In addition, youth with conduct disorder also exhibit polymorphism in the monoamine oxidase A gene, low resting heart rates, and increased testosterone.

Family and Peer Influences

Elements of the family and social environment may also play a role in the development and maintenance of conduct disorder. For instance, antisocial behaviour suggestive of conduct disorder is associated with single parent status, parental divorce, large family size, and the young age of mothers. However, these factors are difficult to tease apart from other demographic variables that are known to be linked with conduct disorder, including poverty and low socioeconomic status. Family functioning and parent-child interactions also play a substantial role in childhood aggression and conduct disorder, with low levels of parental involvement, inadequate supervision, and unpredictable discipline practices reinforcing youth’s defiant behaviours. Peer influences have also been related to the development of antisocial behaviour in youth, particularly peer rejection in childhood and association with deviant peers. Peer rejection is not only a marker of a number of externalizing disorders, but also a contributing factor for the continuity of the disorders over time. Hinshaw and Lee (2003) also explain that association with deviant peers has been thought to influence the development of conduct disorder in two ways: 1) a “selection” process whereby youth with aggressive characteristics choose deviant friends, and 2) a “facilitation” process whereby deviant peer networks bolster patterns of antisocial behaviour. In a separate study by Bonin and colleagues, parenting programmes were shown to positively affect child behaviour and reduce costs to the public sector.

Wider Contextual Factors

In addition to the individual and social factors associated with conduct disorder, research has highlighted the importance of environment and context in youth with antisocial behaviour. However, it is important to note that these are not static factors, but rather transactional in nature (e.g. individuals are influenced by and also influence their environment). For instance, neighbourhood safety and exposure to violence have been studied in conjunction with conduct disorder, but it is not simply the case that youth with aggressive tendencies reside in violent neighbourhoods. Transactional models propose that youth may resort to violence more often as a result of exposure to community violence, but their predisposition towards violence also contributes to neighbourhood climate.

Diagnosis

Conduct disorder is classified in the fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM). It is diagnosed based on a prolonged pattern of antisocial behaviour such as serious violation of laws and social norms and rules in people younger than the age of 18. Similar criteria are used in those over the age of 18 for the diagnosis of antisocial personality disorder. No proposed revisions for the main criteria of conduct disorder exist in the DSM-5; there is a recommendation by the work group to add an additional specifier for callous and unemotional traits. According to DSM-5 criteria for conduct disorder, there are four categories that could be present in the child’s behaviour: aggression to people and animals, destruction of property, deceitfulness or theft, and serious violation of rules.

Almost all adolescents who have a substance use disorder have conduct disorder-like traits, but after successful treatment of the substance use disorder, about half of these adolescents no longer display conduct disorder-like symptoms. Therefore, it is important to exclude a substance-induced cause and instead address the substance use disorder prior to making a psychiatric diagnosis of conduct disorder.

Treatment

First-line treatment is psychotherapy based on behaviour modification and problem-solving skills. This treatment seeks to integrate individual, school, and family settings. Parent-management training can also be helpful. No medications have been FDA approved for Conduct Disorder, but Risperidone (a second-generation antipsychotic) has the most evidence to support its use for aggression in children who have not responded to behavioural and psychosocial interventions. Selective Serotonin Reuptake Inhibitors (SSRIs) are also sometimes used to treat irritability in these patients.

Prognosis

About 25-40% of youths diagnosed with conduct disorder qualify for a diagnosis of antisocial personality disorder when they reach adulthood. For those that do not develop ASPD, most still exhibit social dysfunction in adult life.

Epidemiology

Conduct disorder is estimated to affect 51.1 million people globally as of 2013. The percentage of children affected by conduct disorder is estimated to range from 1-10%. However, among incarcerated youth or youth in juvenile detention facilities, rates of conduct disorder are between 23% and 87%.

Sex Differences

The majority of research on conduct disorder suggests that there are a significantly greater number of males than females with the diagnosis, with some reports demonstrating a threefold to fourfold difference in prevalence. However, this difference may be somewhat biased by the diagnostic criteria which focus on more overt behaviours, such as aggression and fighting, which are more often exhibited by males. Females are more likely to be characterised by covert behaviours, such as stealing or running away. Moreover, conduct disorder in females is linked to several negative outcomes, such as antisocial personality disorder and early pregnancy, suggesting that sex differences in disruptive behaviours need to be more fully understood.

Females are more responsive to peer pressure including feelings of guilt than males.

Racial Differences

Research on racial or cultural differences on the prevalence or presentation of conduct disorder is limited. However, according to studies on American youth, it appears that African-American youth are more often diagnosed with conduct disorder, while Asian-American youth are about one-third as likely to develop conduct disorder when compared to White American youth. It has been widely theorised for decades that this disparity is due to unconscious bias in those who give the diagnosis.

What is Neuropsychology?

Introduction

Neuropsychology is a branch of psychology that is concerned with how a person’s cognition and behaviour are related to the brain and the rest of the nervous system. Professionals in this branch of psychology often focus on how injuries or illnesses of the brain affect cognitive and behavioural functions.

It is both an experimental and clinical field of psychology, thus aiming to understand how behaviour and cognition are influenced by brain function and concerned with the diagnosis and treatment of behavioural and cognitive effects of neurological disorders. Whereas classical neurology focuses on the pathology of the nervous system and classical psychology is largely divorced from it, neuropsychology seeks to discover how the brain correlates with the mind through the study of neurological patients. It thus shares concepts and concerns with neuropsychiatry and with behavioural neurology in general. The term neuropsychology has been applied to lesion studies in humans and animals. It has also been applied in efforts to record electrical activity from individual cells (or groups of cells) in higher primates (including some studies of human patients).

In practice, neuropsychologists tend to work in research settings (universities, laboratories or research institutions), clinical settings (medical hospitals or rehabilitation settings, often involved in assessing or treating patients with neuropsychological problems), or forensic settings or industry (often as clinical-trial consultants where CNS function is a concern).

Brief History

Neuropsychology is a relatively new discipline within the field of psychology. The first textbook defining the field, Fundamentals of Human Neuropsychology, was initially published by Kolb and Whishaw in 1980. However, the history of its development can be traced back to the Third Dynasty in ancient Egypt, perhaps even earlier. There is much debate as to when societies started considering the functions of different organs. For many centuries, the brain was thought useless and was often discarded during burial processes and autopsies. As the field of medicine developed its understanding of human anatomy and physiology, different theories were developed as to why the body functioned the way it did. Many times, bodily functions were approached from a religious point of view and abnormalities were blamed on bad spirits and the gods. The brain has not always been considered the centre of the functioning body. It has taken hundreds of years to develop our understanding of the brain and how it affects our behaviours.

Ancient Egypt

In ancient Egypt, writings on medicine date from the time of the priest Imhotep. They took a more scientific approach to medicine and disease, describing the brain, trauma, abnormalities, and remedies for reference for future physicians. Despite this, Egyptians saw the heart, not the brain, as the seat of the soul.

Aristotle

Aristotle reinforced this focus on the heart which originated in Egypt. He believed the heart to be in control of mental processes, and looked on the brain, due to its inert nature, as a mechanism for cooling the heat generated by the heart. He drew his conclusions based on the empirical study of animals. He found that while their brains were cold to the touch and that such contact did not trigger any movements, the heart was warm and active, accelerating and slowing dependent on mood. Such beliefs were upheld by many for years to come, persisting through the Middle Ages and the Renaissance period until they began to falter in the 17th century due to further research. The influence of Aristotle in the development of neuropsychology is evident within language used in modern day, since we “follow our hearts” and “learn by the heart.”

Hippocrates

Hippocrates viewed the brain as the seat of the soul. He drew a connection between the brain and behaviours of the body, writing: “The brain exercises the greatest power in the man.” Apart from moving the focus from the heart as the “seat of the soul” to the brain, Hippocrates did not go into much detail about its actual functioning. However, by switching the attention of the medical community to the brain, his theory led to more scientific discovery of the organ responsible for our behaviours. For years to come, scientists were inspired to explore the functions of the body and to find concrete explanations for both normal and abnormal behaviours. Scientific discovery led them to believe that there were natural and organically occurring reasons to explain various functions of the body, and it could all be traced back to the brain. Hippocrates introduced the concept of the mind – which was widely seen as a separate function apart from the actual brain organ.

René Descartes

Philosopher René Descartes expanded upon this idea and is most widely known for his work on the mind-body problem. Often Descartes’s ideas were looked upon as overly philosophical and lacking in sufficient scientific foundation. Descartes focused much of his anatomical experimentation on the brain, paying special attention to the pineal gland – which he argued was the actual “seat of the soul.” Still deeply rooted in a spiritual outlook towards the scientific world, the body was said to be mortal, and the soul immortal. The pineal gland was then thought to be the very place at which the mind would interact with the mortal and machine-like body. At the time, Descartes was convinced the mind had control over the behaviours of the body (controlling the person) – but also that the body could have influence over the mind, which is referred to as dualism. This idea that the mind essentially had control over the body, but the body could resist or even influence other behaviours, was a major turning point in the way many physiologists would look at the brain. The capabilities of the mind were observed to do much more than simply react, but also to be rational and function in organised, thoughtful ways – much more complex than he thought the animal world to be. These ideas, although disregarded by many and cast aside for years led the medical community to expand their own ideas of the brain and begin to understand in new ways just how intricate the workings of the brain really were, and the complete effects it had on daily life, as well as which treatments would be the most beneficial to helping those people living with a dysfunctional mind. The mind-body problem, spurred by René Descartes, continues to this day with many philosophical arguments both for and against his ideas. However controversial they were and remain today, the fresh and well-thought-out perspective Descartes presented has had long-lasting effects on the various disciplines of medicine, psychology and much more, especially in putting an emphasis on separating the mind from the body in order to explain observable behaviours.

Thomas Willis

It was in the mid-17th century that another major contributor to the field of neuropsychology emerged. Thomas Willis studied at Oxford University and took a physiological approach to the brain and behaviour. It was Willis who coined the words ‘hemisphere’ and ‘lobe’ when referring to the brain. He was one of the earliest to use the words ‘neurology’ and ‘psychology’. Rejecting the idea that humans were the only beings capable of rational thought, Willis looked at specialised structures of the brain. He theorised that higher structures accounted for complex functions, whereas lower structures were responsible for functions similar to those seen in other animals, consisting mostly of reactions and automatic responses. He was particularly interested in people who suffered from manic disorders and hysteria. His research constituted some of the first times that psychiatry and neurology came together to study individuals. Through his in-depth study of the brain and behaviour, Willis concluded that automated responses such as breathing, heartbeats and other various motor activities were carried out within the lower region of the brain. Although much of his work has been made obsolete, his ideas presented the brain as more complex than previously imagined, and led the way for future pioneers to understand and build upon his theories, especially when it came to looking at disorders and dysfunctions in the brain.

Franz Joseph Gall

Neuroanatomist and physiologist Franz Joseph Gall made major progress in understanding the brain. He theorized that personality was directly related to features and structures within the brain. However, Gall’s major contribution within the field of neuroscience is his invention of phrenology. This new discipline looked at the brain as an organ of the mind, where the shape of the skull could ultimately determine one’s intelligence and personality. This theory was like many circulating at the time, as many scientists were taking into account physical features of the face and body, head size, anatomical structure, and levels of intelligence; only Gall looked primarily at the brain. There was much debate over the validity of Gall’s claims however, because he was often found to be wrong in his predictions. He was once sent a cast of René Descartes’ skull, and through his method of phrenology claimed the subject must have had a limited capacity for reasoning and higher cognition. As controversial and false as many of Gall’s claims were, his contributions to understanding cortical regions of the brain and localised activity continued to advance understanding of the brain, personality, and behaviour. His work is considered crucial to having laid a firm foundation in the field of neuropsychology, which would flourish over the next few decades.

Jean-Baptiste Bouillaud

Towards the late 19th century, the belief that the size of ones skull could determine their level of intelligence was discarded as science and medicine moved forward. A physician by the name of Jean-Baptiste Bouillaud expanded upon the ideas of Gall and took a closer look at the idea of distinct cortical regions of the brain each having their own independent function. Bouillaud was specifically interested in speech and wrote many publications on the anterior region of the brain being responsible for carrying out the act of ones speech, a discovery that had stemmed from the research of Gall. He was also one of the first to use larger samples for research although it took many years for that method to be accepted. By looking at over a hundred different case studies, Bouillaud came to discover that it was through different areas of the brain that speech is completed and understood. By observing people with brain damage, his theory was made more concrete. Bouillaud, along with many other pioneers of the time made great advances within the field of neurology, especially when it came to localisation of function. There are many arguable debates as to who deserves the most credit for such discoveries, and often, people remain unmentioned, but Paul Broca is perhaps one of the most famous and well known contributors to neuropsychology – often referred to as “the father” of the discipline.

Paul Broca

Inspired by the advances being made in the area of localised function within the brain, Paul Broca committed much of his study to the phenomena of how speech is understood and produced. Through his study, it was discovered and expanded upon that we articulate via the left hemisphere. Broca’s observations and methods are widely considered to be where neuropsychology really takes form as a recognisable and respected discipline. Armed with the understanding that specific, independent areas of the brain are responsible for articulation and understanding of speech, the brains abilities were finally being acknowledged as the complex and highly intricate organ that it is. Broca was essentially the first to fully break away from the ideas of phrenology and delve deeper into a more scientific and psychological view of the brain.

Karl Spencer Lashley

Lashley’s works and theories that follow are summarised in his book Brain Mechanisms and Intelligence. Lashley’s theory of the Engram was the driving force for much of his research. An engram was believed to be a part of the brain where a specific memory was stored. He continued to use the training/ablation method that Franz had taught him. He would train a rat to learn a maze and then use systematic lesions and removed sections of cortical tissue to see if the rat forgot what it had learned.

Through his research with the rats, he learned that forgetting was dependent on the amount of tissue removed and not where it was removed from. He called this mass action and he believed that it was a general rule that governed how brain tissue would respond, independent of the type of learning. But we know now that mass action was a misinterpretation of his empirical results, because in order to run a maze the rats required multiple cortical areas. Cutting into small individual parts alone will not impair the rats’ brains much, but taking large sections removes multiple cortical areas at one time, affecting various functions such as sight, motor coordination and memory, making the animal unable to run a maze properly.

Lashley also proposed that a portion of a functional area could carry out the role of the entire area, even when the rest of the area has been removed. He called this phenomenon equipotentiality. We know now that he was seeing evidence of plasticity in the brain: within certain constraints the brain has the ability for certain areas to take over the functions of other areas if those areas should fail or be removed – although not to the extent initially argued by Lashley.

Approaches

Experimental neuropsychology is an approach that uses methods from experimental psychology to uncover the relationship between the nervous system and cognitive function. The majority of work involves studying healthy humans in a laboratory setting, although a minority of researchers may conduct animal experiments. Human work in this area often takes advantage of specific features of our nervous system (for example that visual information presented to a specific visual field is preferentially processed by the cortical hemisphere on the opposite side) to make links between neuroanatomy and psychological function.

Clinical neuropsychology is the application of neuropsychological knowledge to the assessment (see neuropsychological test and neuropsychological assessment), management, and rehabilitation of people who have suffered illness or injury (particularly to the brain) which has caused neurocognitive problems. In particular they bring a psychological viewpoint to treatment, to understand how such illness and injury may affect and be affected by psychological factors. They also can offer an opinion as to whether a person is demonstrating difficulties due to brain pathology or as a consequence of an emotional or another (potentially) reversible cause or both. For example, a test might show that both patients X and Y are unable to name items that they have been previously exposed to within the past 20 minutes (indicating possible dementia). If patient Y can name some of them with further prompting (e.g. given a categorical clue such as being told that the item they could not name is a fruit), this allows a more specific diagnosis than simply dementia (Y appears to have the vascular type which is due to brain pathology but is usually at least somewhat reversible). Clinical neuropsychologists often work in hospital settings in an interdisciplinary medical team; others work in private practice and may provide expert input into medico-legal proceedings.

Cognitive neuropsychology is a relatively new development and has emerged as a distillation of the complementary approaches of both experimental and clinical neuropsychology. It seeks to understand the mind and brain by studying people who have suffered brain injury or neurological illness. One model of neuropsychological functioning is known as functional localisation. This is based on the principle that if a specific cognitive problem can be found after an injury to a specific area of the brain, it is possible that this part of the brain is in some way involved. However, there may be reason to believe that the link between mental functions and neural regions is not so simple. An alternative model of the link between mind and brain, such as parallel processing, may have more explanatory power for the workings and dysfunction of the human brain. Yet another approach investigates how the pattern of errors produced by brain-damaged individuals can constrain our understanding of mental representations and processes without reference to the underlying neural structure. A more recent but related approach is cognitive neuropsychiatry which seeks to understand the normal function of mind and brain by studying psychiatric or mental illness.

Connectionism is the use of artificial neural networks to model specific cognitive processes using what are considered to be simplified but plausible models of how neurons operate. Once trained to perform a specific cognitive task these networks are often damaged or ‘lesioned’ to simulate brain injury or impairment in an attempt to understand and compare the results to the effects of brain injury in humans.

Functional neuroimaging uses specific neuroimaging technologies to take readings from the brain, usually when a person is doing a particular task, in an attempt to understand how the activation of particular brain areas is related to the task. In particular, the growth of methodologies to employ cognitive testing within established functional magnetic resonance imaging (fMRI) techniques to study brain-behaviour relations is having a notable influence on neuropsychological research.

In practice these approaches are not mutually exclusive and most neuropsychologists select the best approach or approaches for the task to be completed.

Methods and Tools

Standardised Neuropsychological Tests

These tasks have been designed so the performance on the task can be linked to specific neurocognitive processes. These tests are typically standardised, meaning that they have been administered to a specific group (or groups) of individuals before being used in individual clinical cases. The data resulting from standardisation are known as normative data. After these data have been collected and analysed, they are used as the comparative standard against which individual performances can be compared. Examples of neuropsychological tests include: the Wechsler Memory Scale (WMS), the Wechsler Adult Intelligence Scale (WAIS), Boston Naming Test, the Wisconsin Card Sorting Test, the Benton Visual Retention Test, and the Controlled Oral Word Association.

Brain Scans

The use of brain scans to investigate the structure or function of the brain is common, either as simply a way of better assessing brain injury with high resolution pictures, or by examining the relative activations of different brain areas. Such technologies may include fMRI (functional magnetic resonance imaging) and positron emission tomography (PET), which yields data related to functioning, as well as MRI (magnetic resonance imaging) and computed axial tomography (CAT or CT), which yields structural data.

Global Brain Project

Brain models based on mouse and monkey have been developed based on theoretical neuroscience involving working memory and attention, while mapping brain activity based on time constants validated by measurements of neuronal activity in various layers of the brain. These methods also map to decision states of behaviour in simple tasks that involve binary outcomes.

Electrophysiology

The use of electrophysiological measures designed to measure the activation of the brain by measuring the electrical or magnetic field produced by the nervous system. This may include electroencephalography (EEG) or magneto-encephalography (MEG).

Experimental Tasks

The use of designed experimental tasks, often controlled by computer and typically measuring reaction time and accuracy on a particular tasks thought to be related to a specific neurocognitive process. An example of this is the Cambridge Neuropsychological Test Automated Battery (CANTAB) or CNS Vital Signs (CNSVS).