ABA & Behavioural Therapy

What is ABA therapy, in plain words?

Applied Behaviour Analysis (ABA) is a way of teaching that looks closely at what happens immediately before a behaviour, the behaviour itself, and what happens straight afterwards. Once that pattern is clear, a therapist can teach and reward a more useful skill and gently ease off the behaviour that was getting in the way.

Therapists call that chain the A-B-C, and once you know it you can watch for it at home:

• Antecedent — what happened just before. A demand, a sudden noise, a change of plan.
• Behaviour — what your child actually did, described plainly enough that two people would describe it the same way.
• Consequence — what happened straight after. The demand stopped, an adult came running, the toy came back.
• The consequence is usually the clue. A child who screams and is then left alone has learned something very efficient about screaming — that is learning working exactly as it should, not naughtiness.

How do we work out why a behaviour keeps happening?

Before any plan is written we watch your child and ask you a great many questions, because you hold far more information than we do. This step is a functional behaviour assessment: working out the job the behaviour is doing. Broadly, it will be doing one of four:

• Getting something — a toy, food, a turn, or your attention.
• Escaping something — a demand, a task that is too hard, a room that is too loud.
• Meeting a body need — movement, deep pressure, mouthing, when a child is under- or over-stimulated.
• Saying something your child has no words for yet — pain, hunger, tiredness, fear of what comes next.

Why did the advice that worked for someone else’s child do nothing for mine?

Because two children who both hit can need opposite plans. One is asking for attention and needs a faster, easier way to get it. The other is escaping a task and needs the task made reachable — extra attention will not help him, and may make things worse. The behaviour looked the same; the function underneath it was not. That is why we start with an assessment rather than a technique.

What happens when you bring your child to us in Multan?

We are on MPS Road in Block A, Model Town, near Bloomfield Hall School, open Monday to Saturday. Sessions and parent coaching run in Urdu or English — whichever language your child hears most at home.

• A first conversation about what is happening, when, and what you have already tried
• An assessment of what the behaviour is achieving, not just what it looks like
• A written plan in plain words, with goals specific enough to measure
• Teaching communication early, so your child has a better way to be heard
• Hands-on parent coaching, so the same response happens at home too
• Joined-up work with speech, sensory and special-education support where it is needed

What changes first, and what takes longer?

The first thing that usually changes is not the behaviour itself — it is how quickly your child recovers from it. Meltdowns get shorter before they get rarer. After that, most parents notice their child asking for something instead of grabbing it. Behaviour practised for years is generally the last thing to shift.

Expect a wobble early on. When a child who has always been heard by screaming is taught a new way to ask, the screaming often gets briefly louder first, because the old strategy is being tested one last time. We warn you before that happens rather than explaining it afterwards, and if the plan is not working we say so and change it.

What can you start doing at home tomorrow morning?

Behaviour changes where it happens, and that is mostly your house rather than our room. None of this needs a shop-bought chart or an hour you do not have.

• Catch the behaviour you want. Praise the ten quiet seconds, not only the shouting — for most children the hard thing is what gets attention fastest.
• Say what to do, not what to stop. “Feet on the floor” lands better than “stop climbing”.
• Give one instruction, then wait five full seconds. Repeating it three times teaches your child the first two did not count.
• Warn before every change. “Two more turns, then shoes” prevents more meltdowns than any consequence afterwards.
• Teach one reliable way to say “help” and “finished” — a word, a sign or a picture — and honour it every time.
• Keep the same response across everyone in the house, grandparents included. Consistency beats cleverness.

Is this behaviour, or is it something else?

Not every hard behaviour is a behaviour problem, and starting in the wrong place can cost you months. Part of the assessment is working out which of these you are looking at.

• A child who covers her ears, avoids textures or crashes into furniture may be meeting a sensory need rather than testing you.
• A child who cannot follow a two-step instruction may not be refusing — he may not have understood it.
• Worry, low mood and fear can look almost exactly like defiance in a young child.
• A sudden change in a settled child — new aggression, lost skills, badly disturbed sleep — should be checked with a doctor first, not managed as behaviour.

Bacha baat nahi manta — talking this through in Urdu

Say it however it comes out. Bacha baat nahi manta. Aik jagah nahi baithta. Ghusse mein maarta hai. Behavioural therapy here sits alongside our work for آٹزم (autism) and اے ڈی ایچ ڈی (ADHD); where the difficulty is really about feelings, a بچوں کا ماہر نفسیات (child psychologist) is often the better place to begin. And because families in Multan are so often told the opposite: a child who behaves differently has not been spoiled, and nobody here will tell you to shout more.