What Is Priming in ABA Therapy?

Elemy
Updated: January 4, 2021

Priming is a cognitive therapy concept in which one idea, event, person, or object is linked to another.

We all experience priming even when we do not realize it. Media and marketing rely on priming us to associate their information or brand with certain feelings or experiences. We may also develop associations around negative experiences, like nearly being hit by a car with a certain intersection.

For therapists using applied behavior analysis (ABA) techniques, priming can help prepare a client for a future event, which reduces stress. Then, associating lower stress with that specific change, and eventually change in general, can help the client to ease into transitions. This is particularly helpful for children with autism, who often struggle with any change, large or small, in their routine.

Priming Supports Transitions in Applied Behavior Analysis (ABA) Therapy

Autism is a developmental disorder with symptoms that primarily impact socializing, communication, learning and cognition, and some motor coordination.

Currently, applied behavior analysis (ABA) therapy is the best approach to treating symptoms of autism and supporting positive behavioral change. This form of therapy is evidence-based, tailoring treatment plans to individual clients, such as children who have been diagnosed with autism, and gathering objective information to understand if the treatment program is helping.

People with autism, especially children with autism, have difficulty with minor changes in their lives. A break in routine, unclear instructions, unplanned time, differences in foods at meals, and other seemingly small differences in a daily routine or expected outcome can lead to intense emotional distress. Children with autism can react in several different ways to these changes, often leading to disruptions and upset that is difficult to calm.

One way for teachers, parents, therapists, and caregivers to manage this reaction is through priming. This is a behavioral technique to ease anxiety about unexpected changes or transitions, providing a sense of stability so that transitions are easier for both children with autism and their caregivers.

Cognitive psychology defines priming as the effect of one stimulus on processing a related stimulus. The stimuli are typically related through words, images, or concepts.

What Is Priming?

Priming affects everyone, every day. Few of us realize we are primed for certain things, but our memories and experiences can change how we respond to all types of stimuli.

A classic example involves walking past a billboard with an image of food on it, like a cake or hamburger, and feeling hungry. Even if you did not stare directly at the billboard, when the images of something delicious make their way into your subconscious, your mind reacts to that priming by feeling hungry. Similarly, if you see someone talking on their cellphone, it might remind you to call your parents later that day.

Another example involves word association. For example, if you read the word doctor, you will recognize the word nurse faster than the word cat if these words are shown to you later. This is because your mind is primed to think about jobs or people in the medical field. Essentially, your brain activates when exposed to a concept, making related concepts easier to access.

The concept of priming is based on understanding information stored as units, or schemas, in your long-term memory. When a schema is activated, it becomes easier to access by entering your consciousness, and this makes it more likely to show up in your behavior.

When a behavior therapist uses priming, they intentionally link these units together so they create a network in the mind, which can be used to trigger specific behaviors and emotions. This network helps to prepare the individual for a certain sequence of events.

Children with autism often struggle with restrictive or repetitive behaviors, which includes a rigid insistence on many parts of their lives staying the same. People with autism may develop rituals and routines so they can keep a sense of sameness. When these are disrupted, they often struggle and have trouble controlling their emotions and behaviors. Priming can help to ease these transitions so children with autism can feel more secure with less structure and routine.

Types of Priming

There are a few different types of priming.

Repetition priming: Once a schema has been activated, it takes less energy to activate it again at a later time. If the schema is frequently activated, it becomes hyperaccessible, so the rate of activation decreases too. This keeps schemas that are frequently activated accessible for much longer.
Associative priming: This type of priming is most familiar with word association, like reading the word cat which might bring up the word dog. A subtype of this form of priming is semantic priming, in which a stimulus is processed better when a related stimulus is introduced.
Negative priming: In some cases, priming can decrease the activation of related schemas by triggering inhibition rather than activation. This typically occurs when units compete for the mind’s attention, like making tea might prime you to think about milk and sugar, but both milk and sugar cannot appear simultaneously in your behavior.

Effective priming will feature several characteristics:

The work will take place in a calm, relaxing environment in order to protect against outside stress.
The therapist will introduce techniques in a calm, patient, and encouraging manner.
Priming lessons should be short.
Materials should be introduced.

Priming is not the same as testing, correcting, or teaching.

Priming in ABA Therapy for Children With Autism

Priming is typically used by ABA therapists, teachers, parents, and other caregivers to support children with autism who struggle with changes to routine, whether large or small. The purposes of priming for children with autism include to:

Familiarize the child with the change before it happens.
Introduce predictability into new information or a new activity.
Reduce stress and anxiety around change of any kind.
Increase the child’s success in adaptive behavioral change.

Supporting transitions through priming can help a child with autism picture alternative future events and become comfortable with these concepts. Stepping through the potential future activity, before requiring the child’s participation, can help the child manage their feelings about a change in their routine. Sometimes, ABA therapists even set up “rehearsals” for these events as part of a priming exercise, even if these rehearsals occur in a different environment, like a therapy office.

For example, in classrooms where teachers work with children who have autism, priming can work to smooth transitions between lessons. The teacher may show their students with autism the materials that will be part of the afternoon lesson in the morning before the lesson occurs.

Priming may also occur before the activity, giving an overview of what will happen. For example, the teacher may discuss a new mathematical concept that the children will work on soon and then begin teaching the actual lesson.

Priming Is Useful When Applied Correctly

Introducing the concept of change to a child with autism during a therapy session can help them manage their emotions around changes later in life. It lays the foundation to deal with change in the short term, and that prepares them for bigger changes that are inevitable throughout life.

As a therapist works with a child on the autism spectrum to introduce priming and prepare them for potential changes, it is important that the therapy environment be calming and encouraging. Oftentimes, this therapy takes place in the client’s home to ensure the most comfortable and safe environment. Since the individual is going to resist change, the idea is to introduce that change in the best environment possible.

It may also be important for the therapist to work with parents or teachers to teach them how to use priming to support the child’s needs. Like most techniques in ABA therapy, it’s helpful if parents and caregivers reinforce the approaches used in ABA therapy sessions in their daily interactions with the child. This helps lessons to take hold, as they can be applied in many different situations.