If your child was recently diagnosed with autism, your pediatrician may have mentioned applied behavior analysis, or ABA therapy, as a treatment to help your child improve social, communication and learning skills while decreasing the frequency of problem behaviors. As your family works together to navigate an autism diagnosis and provide your child the best tools to succeed, ABA therapy can be an important component to their treatment plan.
ABA therapy is a flexible therapy that is adapted for each child. ABA stands for “applied behavior analysis” and teaches skills that are necessary and useful in everyday life. ABA therapy helps an individual become more independent over time and be as successful as possible in school and at home. It is designed based on each child’s individual needs and preferences to provide positive reinforcement in activities they do on a daily basis. It helps strengthen positive behaviors and decrease negative behaviors.
This guide based on the most commonly asked questions from parents will outline what is involved in ABA therapy and what to expect if you are considering it as a treatment option for your child.
What Are the ABCs in ABA therapy?
Positive reinforcement is an important component in ABA therapy, which can be described with the ABCs of ABA therapy:
A stands for Antecedent, which is what happens before the behavior of interest occurs
B stands for Behavior, which is a description of what the person is doing
C stands for Consequence, which is what happens after the behavior of interest occurs.
The typical lay person considers “consequence” to mean a punishment, but in ABA, it is viewed differently. Instead, what happens after the behavior either reinforces or addresses it. A consequence would remove something from the environment, but should not be considered a punishment in a traditional sense.
What Should We Expect During an ABA Therapy Consultation?
Once your child is qualified by Acorn Health admissions to receive ABA therapy services, we will contact your family within 48 hours to schedule a virtual online consultation. During the consultation, one of our BCBAs and clinical experts will seek to learn more about your child by asking questions about their strengths, communication, social/play skills, behaviors, and adaptive living skills.
We’ll also ask some additional background questions on previous or current services received and provide an overview of ABA and what services look like at Acorn Health. Additionally, we’ll discuss the treatment plans we typically offer and provide information regarding commitment to hours, family training adherence, and other information pertaining to the child’s treatment. We also discuss the assessment process.
If your child is going to begin services with us, we will schedule two assessment appointments: an initial assessment appointment and a treatment plan review meeting. These will be scheduled to take place within 10 business days of your consultation.
The assessment process and treatment plan authorization process through insurance can take several weeks, so we inform families that it can take about a month to begin receiving ABA therapy services.Taking those timelines into consideration, during your consultation we will project out a start date of direct therapy or family training.
How Are ABA Plans Developed?
Once your child begins ABA therapy at Acorn Health, your family will work with a board-certified behavior analyst (BCBA) to schedule your child’s assessment. This assessment will review your child’s current skills and abilities, including:
Language and communication skills
Social behavior and interaction
Self-help abilities and daily living skills
Attention/Duration of engagement
Rate of skill acquisition
Play and leisure skills
Challenging behavior repertoires
The outcome of the assessment will inform the goals and structure of your child’s ABA therapy program at Acorn Health, and will allow the ABA team to develop a robust and personalized plan for your child. The plan will be specific to your child’s skill level and goals that will allow your child to be successful, both at home and at school. Your child’s individualized plan will include strategies and goals regarding communication, tolerating non-preferred items, building flexibility, decreasing challenging behaviors, building social play repertoires, increasing engagement with toys/activities and daily living skills.
While your child is undergoing ABA therapy at Acorn Health, there will ongoing reviews and assessments to measure your child’s progress. This is also a time when goals and objectives are reviewed and updated. These are created in partnership between parents and clinicians based on assessments, interviews and observations.
Goals will include targeting behavior that we want to see happen more often. Additionally, if a child engages in challenging behavior, goals will be created to teach appropriate responses that will replace the challenging behavior. Goals within your child’s plan are always focused on teaching skills that can be seen and measured, and include criteria for mastery to ensure that the behavioral repertoires are occurring under multiple conditions.
It’s common for a child’s plan to be comprehensive of a variety of behavior goals. However, if a child only needs support in minimal areas (toilet training only/social skills only), we will create a focused treatment plan.
Who Provides ABA Services?
At Acorn Health, there is a team of behavior analytics professionals that provide the latest advances in the science of ABA. These highly skilled professionals regularly evaluate plans, develop your child’s therapy experiences, conduct regular observations and refine your child’s plan in collaboration with you as parents. At Acorn Health, we are honored to be entrusted with the care of your child, and believe that a collaborative approach between parents, caregivers, teachers, doctors and other providers can set the stage for the best outcome for your child.
How Long Does ABA Therapy Last?
Typically, children with autism need intensive therapy. This typically means between 10 and 40 hours of therapy per week. Additionally, in order to have the best outcomes, parents should dedicate between 30 minutes to one hour each week to spend with their BCBA for caregiver collaboration/family training. Therapy is recommended until all goals are met, but many individuals with autism benefit from ABA therapy for an extended period of time.
What Are the Best Techniques for Changing Behavior?
Changing behavior requires a process that recognizes positive behaviors and addresses problem behaviors. Your ABA therapists and team work to create an environment where reinforcement is occurring frequently. Positive reinforcement can be described as something occurring after a response that makes it more likely for that response to occur in the future.
When it comes to reinforcers, these will be decided by the child, they pick what they like, and we have found this approach is the most impactful. We will always work to expand someone’s interests, but ultimately we use the items that a child enjoys.
Does ABA Therapy Work?
ABA therapy effectiveness for individual clients can be measured in many different ways. Most importantly, each child is assessed using a skills assessment and families are interviewed to help design a treatment plan that’s clinically appropriate for predetermined goals.
Once your treatment plan is designed and therapy begins, your registered behavior technician will collect data on responses from your child. Your BCBA comes to review the data and progress frequently. While the BCBA is present, they make decisions based on data on how goals will continue to be targeted, making modifications as necessary.
If parents are researching whether or not ABA therapy is effective in general, there are multiple studies and organizations that have endorsed its effectiveness and importance. Renowned organizations including the American Psychiatric Association, the American Psychological Association, U.S. Surgeon General, American Academy of Pediatrics, American Speech-Hearing Association, American Academy of Family Pediatrics, and the American Academy of Occupational Therapy Association have all endorsed ABA therapy as a valid evidence-based treatment for individuals with autism.
Several research studies have examined the effectiveness of ABA therapy including the research study of 1987 by O. Ivar Lovass, Ph.D., which found that through intensive ABA therapy, 90% of individuals substantially improved and 47% of the children in the study developed skill levels equal to peers. A 2005 Sallows and Graupner study indicated that approximately 50% of individuals with autism who receive ABA services before the age of four show a significant increase in IQ, verbal skills, and social functioning, and some are able to attend normal schools.