Applied Behavioral Analysis (“ABA”) focuses on the principles that explain how learning takes place. Positive reinforcement is one such principle. When a behavior is followed by some sort of reward, the behavior is more likely to be repeated. ABA is the use of these techniques and principles to bring about meaningful and positive change in behavior.
In practice, ABA uses positive reinforcement to encourage positive behaviors and reduce negative or harmful behaviors. ABA is derived from classic principles of learning theory. The first proponent who published research was Dr. Ivar Lovaas who used principles of behavior modification to design an effective educational approach to teaching children with autism. In ABA, there is an ongoing analysis of the steps learned and mastered, along with additional skills in the hierarchy that need to be learned and the order in which they should be learned. ABA requires extensive, meticulous data collection to determine when learning takes place, and overlearning with intermittent reinforcement to achieve mastery.
Prior to the passage of the Affordable Care Act (“ACA”), autism was a pre-existing condition sufficient to merit complete disqualification from coverage. Under the Obama Administration, the ACA prohibited denials for pre-existing conditions.
After seven years of effort, Congress has not repealed and replaced the Affordable Care Act. However, House Speaker Paul Ryan has stated that the party is “going to keep getting at this thing” and Trump tweeted on April 23, 2017 that “ObamaCare is in serious trouble. The Dems need big money to keep it going—otherwise it die far sooner than anyone would have thought.”
Accordingly, at this time, much uncertainty surrounds the planned repeal of the ACA. If the ACA is repealed, children and adults with autism may not be entitled to receive ABA. At a minimum, any debate about the pre-existing conditions and the extension of coverage to dependents up to age 26 should be included in any national health care law discussion.