What Is EIBI?
EIBI stands for Early Intensive Behavioural Intervention and is based on the principles of Applied Behaviour Analysis (ABA).
An EIBI program aims to increase a child’s ability to learn, which in turn leads to the development of skills.
- What Is EIBI?
- EIBI vs ABA What Is the Difference?
- What Are the Components of EIBI?
- What Is Reinforcement?
- How Are New Behaviours Introduced Through EIBI?
- How Long Do the EIBI Results Last?
An EIBI program also aims decrease any challenging behaviour that may present as a barrier to learning, be impacting the child’s ability to positively engage with their environment, or that may be negatively impacting the child and the people around them.
Keeping children successful is an important component of an EIBI program, to achieve this, tasks are broken down into small, achievable steps, which are then gradually built up to the more complex skill. Skills targeted throughout an EIBI program aim to be generalised to the child’s natural environment.
Due to the increase in the prevalence and early diagnosis of Autism Spectrum Disorder (ASD), the demand for EIBI has increased.
This trend was noted by Smith, Hayward, Gale, Eikeseth & Klintwall (2019): “the rising prevalence of autism spectrum disorders (ASD) increases the need for evidence-based behavioral treatments to lessen the impact of symptoms on children’s functioning”. [1]
There is over 75 year’s worth of literature to support the effectiveness of ABA and EIBI programs for children with ASD and learning difficulties. It is an evidenced based practice and research has shown that children who receive access to an EIBI program in the early years and with the recommended intensity make more positive gains compared to their peers who do not receive access to an effective EIBI program.
“We found that children receiving the EIBI treatment performed better than children in the comparison groups after about two years of treatment on tests of adaptive behaviour (behaviours that increase independence and the ability to adapt to one’s environment), intelligence, social skills, communication and language, autism symptoms, and quality of life “. [2]
EIBI vs ABA What Is the Difference?
Early Intensive Behavioural Intervention (EIBI) refers to a type of therapy that is offered to children with autism which adheres to the principles of Applied Behavioural Analysis (ABA).
ABA is an approach to understanding which environmental factors influence the child’s behaviour.
Typically, EIBI is implemented under the supervision of personnel trained in ABA such as a Board Certified Behaviour Analyst (BCBA) or Certified Behaviour Analyst (CBA) through the Association of Behaviour Analysis Australia (Lovaas 1981; Maurice 1996).
EIBI “Programs typically address various domains of skills that are challenging for children on the autism spectrum (e.g., language, motor, imitation). Interventions are individualised and supervised by trained professionals, with positive reinforcement used to promote new skills and reduce problem behaviours”. [3]
What Are the Components of EIBI?
- An initial skills assessment to identify the child’s current skills set, any gaps in their development as well as any challenging behaviours that may be negatively impact the child or presenting as barriers to them learning from others and their environment
- An individualised program targeting several different skills for acquisition (the skills should range across all developmental domains to ensure all domains are improving at a similar and balanced rate)
- Behaviour intervention plan to address any challenging behaviours that are negatively impacting the child
- Specific teaching procedures that will likely differ across skills. The teaching procedure that is most effective to teach that child the specific skill should be identified and prescribed.
- It should be noted that with frequent and effective supervision, if a teaching procedure is not effective and resulting in the child making progress towards that skill, another teaching procedure will be identified and prescribed
- Implementation of the program across the child’s settings (e.g., home, preschool and the community).
- Data collection to track the child’s progress
- Implementation of an intensive program (e.g., 20-40 hours per week)
- Ideally, programs should commence from the age of 12-24 months.
An EIBI program is based on the principles of Applied Behaviour Analysis. At all times skills/behaviours should be:
- Clearly Defined – what behaviour it is we want to meet
- Measurable – How is the behaviour right now? What does the behaviour look like? Clearly defining the behaviour is important to ensure it can be measured (this is how we can tell if the child is making progress)
This helps us determine if we are moving in the right direction. If we are not moving in the right direction, other strategies or teaching procedures may be prescribed. Or the skill will be broken down into a smaller achievable skill which we can then build from. - Spotting Patterns and Trends Data – by recording the behaviours over time, we are able to identify patterns and trends in the child’s learning.
In contrast to traditional psychology, ABA has developed procedures specifically geared to measuring individual differences in behaviour. This has led to behaviour analysts becoming experts in tailoring individualised treatment programs. [4]
What Is Reinforcement?
Reinforcement involves the process of a consequence occurring that will increase the likelihood of the behaviour happening again. The consequence will strengthen the behaviour.
In an EIBI program, “behaviours that are reinforced are those that are important for the child and that they will help increase his social, emotional, and intellectual development and well-being”. [4]
There are two types of reinforcement, positive and negative and both will strengthen a behaviour.
Positive reinforcement involves providing or adding something following the behaviour that will increase the likelihood of the behaviour occurring again (e.g., providing access to a highly preferred toy following a behaviour targeted for increase)
Negative reinforcement involves removing something following the behaviour that will increase the likelihood of the behaviour occurring again (e.g., removing a less preferred activity such as schoolwork following a behaviour targeted for increase)
Reinforcers vary across people (e.g., something reinforcing for one person may not be reinforcing for another), and they may change across the day. Identifying reinforcers is a key component to an effective EIBI program and to ensure the learner is successful and making progress. Behaviour analysts implement a number of procedures to effectively identify reinforcers for each learner.
How Are New Behaviours Introduced Through EIBI?
Following the initial assessment stage, the behaviour consultant will develop the child’s individualised program which will include a range of skill acquisition procedures, teaching procedures and if required a behaviour intervention plan to support the child’s development. It is important to teach the new behaviours in small, achievable steps. This ensures the learner is successful.
Once the child’s program has been developed, the behaviour consultant will work closely with the parents, educators and therapists on the child’s team to ensure everyone in the child’s life is aware of their goals and how they can implement them and support the child. During the initial few weeks, it is likely the behaviour consultant will spend more time with the child and the people on the child’s team.
New behaviours will be taught in all of the child’s environments. However, usually they will be introduced in a more structured setting, such as the treatment provider’s clinic, or at the child’s home. This minimalises distractions, allowing the focus of the therapists to be on the child and increasing the child’s success with learning new skills. As soon as they are ready, the new skills will be generalised to the child’s other environments.
How Long Do the EIBI Results Last?
Studies have shown that the results last for years to come and these are skills that the child will have for the rest of their life. The skills targeted in an EIBI program aim to increase the child’s overall ability to learn from others and their natural environment.
Smith, Hayward, Gale, Eikeseth & Klintwall (2019) found:
“Results showed the participants significantly increased their cognitive and adaptive standard scores during the first two years of EIBI, and that these gains were maintained at follow-up,10 years after the EIBI had ended. Participants also showed a significant reduction in autism symptoms between intake and follow-up”. [1]
Early Intensive Behavioural Intervention or EIBI is an effective and scientifically proven method to support children with autism. EIBI can help kids overcome behaviours of concern and gives them the tools to learn so that they can catch up and keep up with their same aged peers.
Sources:
1. Treatment Gains from Early and Intensive Behavioral Intervention (EIBI) are Maintained 10 Years Later
2. Early Intensive Behavioral Intervention (EIBI) for Young Children with Autism Spectrum Disorders (ASD): A Systematic Review
3. Adapting the preschool environment to the needs of children on the autism spectrum in Sweden: A quasi-experimental study
4. Parents’ Education as Autism Therapists, Applied Behaviour Analysis in Context