ABA Therapy Alternatives, Applied Behavior Analysis Alternative Treatments for Autism

ABA Therapy Alternatives

Does your child with autism spectrum disorder (ASD) struggle to engage with other people? Do they have language development challenges, behavioral struggles, or frequent tantrums? Applied behavior analysis (ABA) may be an effective treatment option.

ABA is commonly used to treat children with ASD. The therapy is tailored to each person’s needs and focuses on building skills in specific areas. These areas include learning, socialization, and more. The goal of ABA is to help children with autism function independently and thrive in their daily lives.

This article will describe how ABA treatment works and what it might look like. It will also explain how ABA should be used alongside treatments that address the impaired metabolic processes behind autism symptoms.

About Applied Behavior Analysis

What Is ABA Treatment?

Applied behavior analysis is a behavioral therapy for children with autism. The therapy was developed in the 1960s by Ole Ivar Lovaas.

The Norwegian-American clinical psychologist spent almost 50 years studying strategies to improve the lives of children with autism. After decades of research, he created ABA.

Applied behavior analysis is a form of positive reinforcement. The treatment involves rewarding children for certain behaviors, with the idea that this will encourage patients to repeat those behaviors.

In other words, when you reward a child for making eye contact or saying thank you, those behaviors may increase. Alternatively, when you don’t reinforce those behaviors, those behaviors may decrease.

Applied behavior analysis can help children with autism:

• Decrease negative behaviors like self-harm
• Increase positive behaviors like self-regulation
• Apply learned behaviors in new environments
• Strengthen communication, language processing, and social interactions

Research shows that ABA delivers significant benefits in helping children communicate and socialize (Gitimoghaddam et al., 2022). Clinicians believe it is most effective in younger children who engage in ABA for at least 20 hours per week (Linstead et al, 2017). 

Is ABA Therapy Harmful?

Applied behavior analysis is not harmful.

In the past, some communities found it controversial. Positive reinforcement is also used in animal training, and initially, not everyone approved of the parallels. A tailored intervention, however, recognizes the patient’s humanity. ABA isn’t “drilled” into children with ASD. Instead, it acknowledges that all individuals have their own needs, emotions, and preferences.

It’s also important to note the distinction between positive reinforcement and bribery. Bribery involves telling the child about the reward they’ll receive in advance—before the child has completed the task.

Positive reinforcement allows the child to engage in positive behaviors independently. Only then will they be rewarded. This makes them more likely to repeat those behaviors naturally, without prompting, over time. Eventually, the positive reinforcement will evolve into more subtle encouragement.

What Therapy Techniques Does ABA Use?

These are some of the therapy techniques families may experience in applied behavior analysis:

• Discrete trial training (DTT)

In the early days, ABA focused exclusively on DTT. This technique involves guiding the child through a series of tasks and then offering positive reinforcement.

For example, a child may be asked to make a specific sound or identify a specific pattern. When they follow the facilitator’s instructions, they may be praised or rewarded with a sticker.

In DTT, each task is presented in isolation. Children follow clear instructions and practice new skills repeatedly until they master them.

• Pivotal response training (PRT)

PRT is less rigid than DTT. The therapy combines play and other activities to guide the child’s learning. Typically, the therapist lets the child take the lead here.

For example, the therapist may find a set of blocks for the child to arrange. Instead of instructing them to get started, they’ll let the child take the lead.

With PRT, reinforcement should be closely related to the task at hand. In our example with the blocks, the child should be rewarded with the option to tear down the blocks after they complete the activity. Alternatively, they may instead choose to keep playing with the blocks.

• Verbal behavior intervention (VBI)

VBI focuses on communication and language. It encourages children with autism to improve their language skills by connecting words with unique purposes.

For example, VBI teaches those with ASD why people use specific words. The therapy also reveals how different words can be used to make requests or express ideas.

The benefits of VBI are expansive. They include helping children recognize behavioral patterns, respond to verbal cues, and participate in meaningful discussions.

Families may consider different types of ABA depending on the situation or their therapist’s recommendation.

Is ABA the Only Treatment for Autism?

Applied behavior analysis is one of many treatment options for children with autism spectrum disorder.

Youth with ASD may also consider:

• Occupational therapy

This treatment helps children learn daily living skills like feeding, bathing, or getting dressed. The goal is to help them build independence in going about essential tasks.

• Sensory integration therapy

Some children with ASD are easily agitated in high-sensory environments. Bright lights and loud noises may feel overwhelming. This treatment helps patients manage sensory information.

• Nutritional therapy

All children benefit from good nutrition. A well-balanced diet—or supplementation—is even more important in young people with autism. We will discuss this in detail shortly.

Some families also rely on medication or social skills training to address the symptoms of children with autism.

What Is an Example of an ABA Treatment Plan?

An ABA treatment plan should offer important insights into the patient’s needs, progress, and goals.

A typical applied behavior analysis treatment plan should include:

Patient information

• Name
• Age
• Gender
• Diagnosis (including any concurrent diagnoses)
• Medications (if relevant)

Assessment information

• Presenting symptoms of ASD
• Strengths and weaknesses
• Types of interventions and assessments completed
• Results of those treatments
• Clinical responses to treatments

An ABA treatment plan may also include training instructions for parents, treatment goals, and a list of approved facilitators.

Should I Consider ABA Therapy for Autism?

While ABA can improve children with ASD’s quality of life, it should not be used as a standalone treatment.

The intervention is most effective when families combine it with other treatments such as speech therapy and clinically-backed supplementation.

This brings us to the next section of this article, which talks about combining ABA with treatments like nutritional therapy. Supplementation can target the impaired metabolic processes that cause symptoms of autism.

How to Improve Metabolic Processes in Children with Autism

What Causes the Behavioral Symptoms of Autism?

Children with autism often struggle to regulate their metabolism. This can lead to external behavioral symptoms, including:

• Anxiety
• Hand flapping
• Repetitive behaviors
• Obsessions and fixations
• Sleep difficulties
• Social isolation
• Tantrums
• Difficulty making eye contact

Selective eating is another common symptom. Many children with ASD prefer to eat limited foods, with a focus on simple carbohydrates and sugars. As a result, they may have a difficult time absorbing nutrients. This is one of the reasons why metabolic issues are so common in people with autism.

Low levels of the neurotransmitter serotonin (also known as 5-hydroxytryptamine, or 5-HT) are linked to certain nutritional deficiencies (Adamsen et al., 2014). These deficiencies similarly contribute to the behavioral symptoms of autism, including spinning, jumping in place, and running back and forth. Hand movements and a lack of social awareness are equally common.

Families navigating ASD should note that serotonin is involved in cognition, motor function, and emotion. It also plays an essential role in appetite regulation. This reinforces the treatment potential of nutritional therapy in children with autism spectrum disorder.

Detecting the impaired metabolic processes in patients with autism—and treating them with customized vitamin, mineral, and amino acid supplements—can significantly reduce symptoms of ASD. Yet patients should only supplement their nutrition with approval from a trusted provider. A licensed professional will make recommendations based on clinical research and laboratory test results.

High Oxygen Load in Children with ASD

Many children with autism experience cognitive issues, fatigue, and lack of energy. These symptoms are often the result of a process known as high oxygen load.

High oxygen load occurs when a person breathes oxygen at a higher partial pressure than normal. It is usually caused by poor mitochondrial function following exposure to radiation, toxins, or chronic gastrointestinal inflammation. It may also be linked to the consumption of high-sugar foods.

The mitochondria transforms the calories we eat into energy that our bodies can use as needed. Several chemical processes are responsible for this, along with free radicals.

Free radicals are ions that oxidize the cells. With a healthy metabolism, the body’s enzymes automatically neutralize them.

Without adequate nutrition, children may instead experience high oxygen load. In such cases, physicians recommend supplementing with omega-3 fatty acids—along with minerals like manganese, copper, zinc, and selenium. These nutrients help to form the mitochondria and can mitigate high oxygen load.

Here are just some of the benefits of supplementing with omega-3 fatty acids:

• Better listening and concentration skills
• Reduced hyperactivity, dyslexia, and aggressive behavior
• Improved mood and emotional regulation

The benefits also extend to inflammation, blood sugar, and visual function.

Fatty fish like salmon, mackerel, and sardines are rich in omega-3 fatty acids. So are flax and chia seeds, along with spinach and walnuts. Omega-3 fatty acids are available in supplement form as well.

Ascorbic Acid Deficiency in Children with ASD

Common in children with autism, ascorbic acid deficiency is associated with picky eating. Young people who do not consume enough produce are more likely to experience this deficiency.

Ascorbic acid is also known as vitamin C. It boosts the production of cells and antibodies, and facilitates neurotransmitter production. Ascorbic acid also elevates serotonin levels, leading to improvements in mood, focus, and relaxation.

This is just one of the reasons why adequate ascorbic acid consumption is so critical. Families should encourage children with autism to consume foods rich in vitamin C, including bell peppers, berries, and cauliflower.

Citrus fruit like oranges and grapefruit also contain high quantities of vitamin C. Children with autism should aim to eat the whole fruit (rather than only drinking the juice) for the greatest nutritional benefits.

Families may rely on daily ascorbic acid supplementation if they don’t get enough vitamin C through diet alone. This option should only be considered if the child’s physician has confirmed an ascorbic acid deficiency. 

Lack of Eye Contact in Children with ASD

Many children with autism spectrum disorder struggle to make eye contact. Some people with ASD even have a difficult time making eye contact with family in their own homes.

While sensory overload is a common factor in this, there could be a biochemical cause too. Some children with autism refrain from making eye contact because of a G protein disorder.

G protein oversees the cellular signal, which is integral to healthy visual processing. A G protein disorder may be the result of insufficient vitamin A intake.

Vitamin A deficiency is associated with visual processing problems in the brain. Supplementation, however, can reconnect the retinoid receptors responsible for vision, sensory processing, and focus. This will repair the body’s G protein and improve visual processing.

In short, children with autism can work toward making eye contact by increasing their vitamin A intake. Leafy green vegetables, sweet potatoes, and carrots include high quantities of vitamin A. Vitamin A can also be found in cheese and eggs.

Supplements are always an option as well (when taken under the guidance of a trained provider). 

Biomedical Therapy for Children with ASD

Biomedical therapy is complex and involves multiple phases of laboratory testing. It is also a popular nutritional intervention in children with autism. The treatment examines the biochemical imbalances involved in autism and addresses them with proper nutrition.

The therapy acknowledges that metabolic impairments and immune issues can intensify the behavioral symptoms of autism. The idea is that by addressing these deficiencies, children with autism can reduce or completely overcome symptoms such as:

• Hyperactivity
• Depression
• Communication issues
• Social challenges
• Cognitive difficulties
• Insomnia
• Sand, clay, and fecal ingestion
• Walking in circles
• Sensitivity to light or sound

Common supplements used in the biomedical treatment of autism include omega-3 fatty acids, ascorbic acid, vitamin D, magnesium, and glutathione.

Methyl-B12 Therapy for Children with ASD

Methyl-B12 therapy can support children with autism in overcoming certain symptoms.

Methyl-B12 is a member of the B12 family of vitamins. It promotes a biochemical process known as methylation, which is critical to brain function and cellular health. Impaired methylation is associated with symptoms of ASD—including speech delays and developmental challenges.

Methyl-B12 assists with methylation by encouraging detoxification, regulating the immune system, and repairing genetic material. It also produces the cell’s membranes, maintains active forms of vitamins C and E, and creates the body’s main antioxidant (glutathione). Methyl-B12 is anti-inflammatory too.

The benefits of Methyl-B12 don’t end there. The vitamin converts folic acid from the diet into active folates that support healthy neurotransmitter production. Here again, adequate levels of serotonin and dopamine are associated with high spatial awareness, language processing, and social skills.

This is where Methyl-B12 therapy may come in. The treatment typically includes supplements or injections that ensure healthy methylation.

Methyl-B12 therapy can alleviate the following symptoms in children with ASD:

• Focus and attention issues
• Social struggles
• Spatial awareness challenges
• Speech and language difficulties
• Poor sensory integration
• Low emotional expression
• Violent or self-stimulatory behaviors

 The benefits of Methyl-B12 therapy usually begin in the first six weeks of treatment. However, this intervention should take place over several months or years for the most notable results.

Common sources of B12 include meat, fish, and dairy products.

What Are the Most Beneficial Supplements for Autism?

Children with ASD can alleviate symptoms of autism with a customized vitamin, mineral, and amino acid supplementation plan (Adams et al., 2021).

All patients are unique—so each person’s nutritional recommendations may vary based on their personalized laboratory test results.

Generally speaking, however, children with autism should consider the following supplements:

• Omega-3 fatty acids and fish oil
• Vitamin B6 and magnesium
• Vitamin B12 (specifically, Methyl-B12)
• Ascorbic acid (vitamin C)
• Vitamin D
• Probiotics
• Melatonin

You can learn more about the specific benefits of each supplement here. Just like with any therapy, families should speak with a doctor before adding a supplement to their child’s treatment protocol.

Can Nutritional Therapy Treat Autism Alongside ABA?

Nutritional therapy should be used alongside applied behavior analysis in children with autism.

Amino acids, vitamins, and minerals are important factors in biochemical processes—including neurotransmitter production. Since many children with ASD have lower levels of the neurotransmitter serotonin, laboratory testing-based supplementation can serve as an effective treatment option.

Meanwhile, ABA can teach children on the spectrum to learn new behaviors, improve their language and social skills, and exhibit more positive behaviors.

Families who consider both approaches experience a significant reduction in the symptoms of autism, from sleep challenges to repetitive motions. A long-term protocol that blends ABA and proper nutrition can improve the impaired metabolic processes that contribute to autism symptoms. This allows each patient to grow, self-soothe, and navigate common challenges.

The outcome, under the guidance of a trusted facilitator, is overwhelmingly positive. Here at C.A.T. Center, we tailor our treatment protocols to each child’s unique metabolic map.

Contact the C.A.T. Center to Treat Children with Autism Today

Do you have questions or comments about combining applied behavior analysis with nutritional supplementation to treat autism in children? Please contact us with questions or for more information on our treatment methods.

References

Adams, J. B., Bhargava, A., Coleman, D. M., Frye, R. E., & Rossignol, D. A. (2021). Ratings of the Effectiveness of Nutraceuticals for Autism Spectrum Disorders: Results of a National Survey. Journal of personalized medicine, 11(9), 878. https://doi.org/10.3390/jpm11090878

Adamsen, D., Ramaekers, V., Ho, H.T., Britschgi, C., Rüfenacht, V., Meili, D., Bobrowski, E., Philippe, P., Nava, C., Van Maldergem, L., Bruggmann, R., Walitza, S., Wang, J., Grünblatt, E., Thöny, B. (2014). Autism spectrum disorder associated with low serotonin in CSF and mutations in the SLC29A4 plasma membrane monoamine transporter (PMAT) gene. Molecular Autism 5, 43. https://doi.org/10.1186/2040-2392-5-43

Gitimoghaddam, M., Chichkine, N., McArthur, L., Sangha, S. S., & Symington, V. (2022). Applied Behavior Analysis in Children and Youth with Autism Spectrum Disorders: A Scoping Review. Perspectives on behavior science, 45(3), 521–557. https://doi.org/10.1007/s40614-022-00338-x

Linstead, E., Dixon, D. R., Hong, E., Burns, C. O., French, R., Novack, M. N., & Granpeesheh, D. (2017). An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder. Translational psychiatry, 7(9), e1234. https://doi.org/10.1038/tp.2017.207