Journal of Psychological Science and Research

Applied Behaviour Analysis (ABA) is an evidence-based treatment for autistic spectrum disorder (ASD).¹ Licensure of ABA practitioners is now compulsory in most states in the U.S. and this year, the UK, and Canada also followed suit by further regulating and standardizing the practice of ABA. Many other countries (e.g., Australia, and Sri Lanka) have recently formed professional bodies, which certify professionals in the field of ABA.

One of the hallmarks of ABA is to identify the function of the behaviour prior to treatment.² This is performed through a Functional Behaviour Assessment (FBA). In England, The National Institute for Health and Care Excellence (NICE) (2021) issues guidelines for the treatment of certain conditions, which are considered gold standards throughout the world. As part of treatment, NICE recommends that practitioners working with children with ASD conduct a Functional Behaviour Assessment (FBA) to address challenging behaviours.³

Typically, four functions accounting for the problem behaviour are identified through the completion of an FBA: tangible, attention, escape, and sensory.⁴ Some behaviours occur because the child wants something, which is called ‘tangible.’ For example, a child may throw a tantrum, shout, hit, or headbang to get a specific item he or she wants. According to the FBA, the topography of the behaviour is irrelevant because they all serve the same function: tangible (i.e., the child wants something). Similarly, a child may exhibit a wide range of problem behaviours to gain ‘attention’ from others or to ‘escape’ from a task demand. In ABA children are taught replacement behaviours as alternatives to problem behaviours. For example, in order to ‘escape’ from a demand presented to a child, he or she may throw the books/pens, get up from their seat and start walking in the class. In ABA, the teacher would block the child from throwing books/pens, make sure the child does not ‘escape’ the demand, and give socially appropriate alternative behaviours, such as asking for a break in order to escape.

The ABA approach to treating the behaviour based on functions provides an effective framework for working with children with challenging behaviours related to ASD. However, when the function of the behaviour is sensory, ABA professionals are traditionally not trained on how to address those sensory behaviours or how to find alternative behaviours. For example, if a child takes off clothes in public, it may be due to tactile defensiveness. Addressing tactile defensiveness falls outside of the scope of ABA and within sensory integration. Sensory integration is taught in the curriculum for occupational therapists, physiotherapists and sometimes speech therapists, depending on the locality.

There are fundamental differences in worldview between the professionals who practice ABA and sensory integration. For example, occupational therapists generally do not accept the principles of ABA, even though ABA is an evidence-based treatment, along with sensory integration.5 Some scholars recognise this and call for greater collaboration between ABA professionals and professionals who practice sensory integration.^5,6

Currently, the need for sensory integration is becoming more recognised and some universities are beginning to teach sensory integration as separate degree coursework outside of occupational therapy, physiotherapy, or speech therapy. Even though collaboration between professionals who specialise in sensory integration and ABA may be helpful for individuals with ASD, training professionals in a separate field that integrates sensory integration and ABA - ‘Sensory Behaviour Therapy’- will produce professionals who are specifically trained to treat individuals with ASD. To some degree, this also closes the gap in service delivery for people with ASD between occupational therapists and ABA consultants. Within the context of increasing prevalence and identification of ASD in the general population, the creation of a new and unique division of psychology, ‘sensory behaviour integration’ is warranted.

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The Authors declare that there are no conflicts of interest.

1. 1. Centre for Disease Control and Prevention. Treatment and Intervention Services for Autism Spectrum Disorder. 2023.
2. 2. Dixon DR, Vogel T, Tarbox J. A Brief History of Functional Analysis and Applied Behavior Analysis. In: Matson, J. (eds) Functional Assessment for Challenging Behaviors. Springer. NY. Autism and Child Psychopathology Series. 2012.
3. 3. National Institute for Health and Care Excellence. Autism spectrum disorder in adults: diagnosis and management. National Institute for Health Care Excellence. 2021.
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6. 6. Gasiewski K, Weiss MJ, Leaf JB, et al. Collaboration between Behavior Analysts and Occupational Therapists in Autism Service Provision: Bridging the Gap. Behav Anal Pract. 2021;14(4):1209-1222.