ABA Therapy Age Limits & Age Range Based on Evidence

Applied Behavior Analysis (ABA) is an effective form of treatment for autism spectrum disorder. While Autism can be detected in children as young as 12 months old, a reliable diagnosis cannot be made until 2 years old. Most children are officially diagnosed by age 3, however, some are not diagnosed until their teen years or adulthood.

ABA is most beneficial for children with Autism when initiated early. However, its principles can be adapted and applied to individuals of varying ages. The key is to tailor the interventions to the specific needs of each person and to continually assess and adjust the ABA program to promote ongoing success.

This article will evaluate the effectiveness of ABA therapy on individuals of various age ranges.

What is the Age Range for ABA Therapy?

The optimal age for receiving ABA therapy is often considered to be during the early developmental years, ideally before the age of four with most children entering ABA treatment between the ages of 2 and 6.

Early intervention in children with Autism has shown significant positive outcomes. ABA therapy during this critical period can target core deficits associated with Autism, such as communication challenges, social skills deficits, and repetitive behaviors.

The earlier intervention begins, the smaller the delay in development which sets the child up for greater success and a better chance to catch up to same-age peers at a quicker rate. Research suggests that initiating ABA interventions in the preschool years can lead to substantial improvements in language development, adaptive behaviors, and overall social and daily living skills. In addition, longitudinal studies suggest that the benefits gained from early ABA intervention are maintained and sustained up to 18 years later.

Furthermore, early intervention is often emphasized in the context of Applied Behavior Analysis therapy, as it provides an opportunity to address and modify behaviors before they become more ingrained and challenging to change. French and Kennedy (2017) showed that the length of time that a child engages in a behavior is directly related to the length of time to modify or address the behavior. This means, the longer a child engages in a particular behavior, the longer it takes to change or eliminate that behavior.

What is the Minimum Age for ABA Therapy?

Many experts have been examining ways to detect Autism in children at earlier ages to be able to enroll them in therapy as early as possible. Researchers at the University of California, Davis MIND Institute were able to identify infants ages 6 to 15 months old, based on the number and severity of their symptoms who were at high risk for developing Autism later in childhood.

Early ASD Diagnosis with ESDM

The Early Start Denver Model (ESDM), which is rooted in ABA, can be used with infants. ESDM is a form of naturalistic developmental behavioral intervention designed to address social communication that parents can learn to administer to their babies. Social communication refers to the way we interact with others. For infants, that means eye contact, babbling or making noises to gain attention, and using gestures such as waving or pointing.

ESDM results in a more intentional form of playtime, mealtime, and other everyday activities rather than a clinical regimen. For example, if a baby has difficulty with repetitive hand movements, the parents can be taught to give the baby a toy to occupy that hand’s activity and to be more stimulating to the baby than observing their finger movements.

One sign of high risk for developing Autism is rarely providing eye contact or making noises to get adult attention. ABA therapists can teach parents how to find opportunities to be front and center in their baby’s field of vision. Another early sign of Autism is repetitive actions with toys. To address this behavior, parents are taught to use a similar object to show the infant a different way to interact with it.

The goal of ESDM and ABA therapy with infants is for parents to establish new habits in their interaction with their babies. The results of the study by the MIND Institute showed that by age 2, many of the children did not need or qualify for additional behavioral intervention. Furthermore, this approach allows for more effective and less intensive ABA treatment.

This approach is not used in infants younger than 6 months of age because the developmental milestones being addressed in the program are not present in typically developing babies from birth to 6 months.

What is the Age Limit for ABA Therapy?

It is important to note that the benefits of ABA therapy are not limited to a specific age. The principles of ABA can be adapted for older individuals, and therapy can be beneficial at any age to address specific behavioral challenges and enhance overall quality of life. The key lies in individualized assessment and intervention planning, ensuring that the therapy is tailored to the unique needs and characteristics of each person, regardless of age.

In 2015, two behavior analysts worked with Nancy, who is a 36-year-old with Autism who engaged in challenging behaviors such as head-banging, physical and verbal aggression, and attempting to eat inedible objects. Previous interventions such as medication, time-out in a locked padded room, and removal of personal items were unsuccessful. The science of ABA guides intervention protocols to decrease challenging behavior while increasing adaptive responses.

The first thing the behavior analysts did was to assess Nancy to determine the function of her challenging behavior. It was determined that she engaged in the behaviors to gain attention from others. A behavior intervention plan was developed which entailed high-quality attention such as going out in the community resulted in an almost immediate decrease in challenging behavior. The decrease opened up new opportunities for Nancy, who has hopes of living together with her boyfriend one day.

ABA can be utilized to address a variety of behavioral challenges in various contexts, including schools, workplaces, and community settings. For example, ABA principles can be used to improve social skills, reduce maladaptive behaviors, and enhance communication in all people with developmental disabilities such as Autism.

Ages for In-Home ABA vs At a Center ABA?

The choice between in-home ABA intervention and center-based ABA intervention often depends on various factors, including the individual’s needs, preferences, and goals of the therapy. There is no strict age limit for either setting, but certain considerations may influence the decision-making process.

In-home ABA intervention is more often used with infants and toddlers up to preschool ages. It allows ABA interventions to occur in the child’s natural environment, thus facilitating the generalization of skills to daily life. In addition, it also allows parents to be more involved and to learn techniques that they could apply at every opportunity or interaction.  

Center-based ABA programs offer a more structured and controlled setting for instructing children in skills like paying attention, turn-taking, and following directions. These programs can reinforce these skills while acquainting the child with the routine and environment associated with specific tasks.  For example, ABA therapists can contrive a classroom setting with a small group of children to teach them to raise their hands and wait their turn. As a result, center-based intervention is typically used for children ages 4 years and older.

Conclusion

While ABA therapy is effective for individuals with Autism across the lifespan and in various settings, the ideal time to intervene is in the home, at the first sign of symptoms. Early intervention can greatly reduce the length of time a child will require behavioral intervention. ABA intervention between 6 months and 15 months can result in children not receiving an Autism diagnosis by the age of 2 years. Furthermore, early intervention in the home increases the benefits because parents and caregivers are involved and can develop new, habitual ways of interacting with their children that are in line with ABA principles.

Other therapy options may be more effective for teens and young adults. For example, occupational Therapy will focus on daily life skills, sensory processing, self-regulation, and motor skills. Social skills training can help individuals with Autism improve their social skills, understand social cues, and enhance communication skills in various settings. Cognitive Behavior Therapy can be used to help manage anxiety and depression in individuals with Autism. Some individuals and families explore alternative or complementary therapies such as music therapy, art therapy, or animal-assisted therapy. While these approaches may not have the same level of empirical support, some find them beneficial.

References

Bradshaw, J., Steiner, A.M., Genqoux, G., & Koegel, L.K. (2015). Feasibility and effectiveness of very early intervention for infants at-risk for autism spectrum disorder: A systematic review. Journal of Autism and Developmental Disorders. 45, 778–794.

Bukszpan, A., Duva, A., & Attanasio, V. (July 21, 2015). Two case studies of success using ABA to increase independence for adults with developmental disabilities. Autism Spectrum News.

Dawson, G., et.al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics. 125, e17–e23.

Estes, A., Munson, J., Rogers, S.J., Greenson, J., Winter, J., &Dawson, G. (2015). Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry. 54: 580–587.

French, L., & Kennedy, E.M.M. (2017). Annual research review: Early intervention for infants and young children with, or at-risk of, autism spectrum disorder: A systematic review. The Journal of Child Psychology and Psychiatry. 59 (4): 444-456.

Kasari, C., Gulsrud, A., Freeman, S., Paparella, T., & Helle-mann, G. (2012). Longitudinal follow-up of children with autism receiving targeted interventions on joint attention and play targeted interventions on joint attention and play. Journal of the American Academy of Child and Adolescent Psychiatry. 51: 487–495.

Rogers, S. (2021). Intervention with 6-month-olds with autism eliminates symptoms and developmental delay. Journal of Autism and Developmental Disorders.

Wallace, K.S., & Rogers, S.J. (2010). Intervening in infancy: Implications for autism spectrum disorders. Journal of Child Psychology and Psychiatry. 51: 1200–1320.