What Should Families Know Before Starting ABA Services for Their Child?

Most parents seem to think that finding a good ABA provider is simply a matter of finding providers who are qualified to deliver ABA, and who can work around your schedule. While those are important criteria, the fact is that the quality of ABA services can vary dramatically from provider to provider. How you start your search is perhaps the most important thing.

Before your child and family embark on the journey of receiving ABA services, you should have a general idea of the large time, emotional, and financial commitment required for effective treatment.

What ABA Services Actually Include

For most people, the term ABA conjures up images of a child sitting on the floor with an ABA Board Certified Behavior Analyst/Therapist (BCBA) or Assistant (BCaBA) delivering structured instruction in the form of 25-40 minute ‘lessons’. While organized instructional sessions such as these are a part of a comprehensive ABA-based package for individuals with Autism Spectrum Disorders, another critical component that precedes such instruction is a thorough assessment of a child’s current developmental levels and skilled behaviors. In order to program effectively, a comprehensive Functional Behavior Assessment (FBA) and Developmental & Skill-Based Assessment must first be conducted in order to develop an individualized Program and Plan that describes the child’s current skills and behaviors and how they interact with his/her environment. This Program and Plan identifies areas where the child needs support and lists specific goals and objective measures for skill acquisition.

Our programs are most strongly supported through direct therapy sessions (one on one or small groups). We also support skill acquisition and reduction of problem behaviors through parent training, school collaboration, and frequent progress monitoring across all programs. —- Most programs are supported through direct therapy sessions (one on one or small groups). We also support skill acquisition and reduction of problem behaviors through parent training, school collaboration, and frequent progress monitoring across all programs. —- One on one and small group instruction in acquisition of new skills, supports reduction of problem behaviors, and aids in generalization of skills across all settings. Parent training and support to the school are also provided in order to create a supportive and cohesive intervention plan across all environments.

We individualize each child’s program based on unique developmental needs. Every child is different and some will need more hours than others. Some children do 10-15 hours and others 25-40 hours per week. This depends on a child’s age, the severity of their symptoms, a family’s schedule and goals for their child. As the child grows and learns the program will grow and learn with them.

Evaluating Potential Providers

Note that not all ABA providers are alike. As a parent, you should consider the provider’s philosophy as well as the standards that they use to determine best practice. First, find out the name of the supervising clinician that will oversee your child’s programming. Find out if that person is a Board Certified Behavior Analyst (BCBA) or certified behavior specialist (CBS). Having a BCBA is a good starting point, but it does not ensure that they will have a philosophy and standards that you support.

Please ask about recent turnover rates of our staff. Center staff orientation can be for several days. We are not just a daycare center with great programs. We also track youth engagement in healthy eating and exercise activities and a variety of other metrics that go beyond just reducing negative behavior.

What is the philosophy behind the treatment approach (e.g. is it compliance based, play based, child choice etc.)? Visit the centres and observe as much as possible. Get a feel for the children and the staff. Ask questions such as: What does a typical day look like for the children? How do the staff members interact with the children?

There are probably many different factors that go into your decision as to which provider you choose to work with as well as how you choose to use your services. Just as with Boston ABA services, there are two different ways in which you can use your services- center based or in-home- and every family is different. Some families find that children are able to generalize their skills to other settings and places whereas other families have found that their child needs to build on the skills that they have already learned in order to further develop, and that in home services can be helpful to do this.

The Assessment Process

Clients and families typically participate in an evaluation of 2-4 weeks prior to beginning services. The Board Certified Behavior Analyst (BCBA) will use a number of different tools to establish a base line of behaviors for which the child currently exhibits mastery as well as those skills from which they are deficient. However, the successful evaluation of a child for application of Applied Behavior Analysis (ABA) involves more than simply the standardized measures listed above.

Quality providers complete naturalistic observations in multiple settings (i.e. home, other community-based settings, school) as well as parent interviews in order to gain insight into the child’s strengths, challenges, typical routines, preferences and the values and goals of the family. The more the provider knows about the child and family, the more individualized the treatment plan will be.

Setting Realistic Expectations

No program is a straight line. There is great progress for several months and then a levelling off. Or just the opposite, lots of progress and then a step back in order to learn a new skill. This kind of back and forth is typical for most programs.

Some skills are more universal and applicable to other places and people than others. Some skills will need to be specifically taught and others your child will learn in therapy and then later apply them at home (with a little time and practice to adapt them to home settings).

Be wary of those quick fix claims and note that so many variables are involved in weight loss that it is never guaranteed to take place on a particular time frame. Instead look for a data-driven approach and an on going and changing programme.

Insurance and Financial Considerations

Most states now require insurance companies to cover ABA, and many have established evidence-based definitions of ABA that families and doctors can reference to facilitate reimbursement.Almost every state now requires insurance to cover ABA in some form, however each state requires different levels of coverage and each insurance plan may have different annual maximums, copays and prior authorizations required for different services. It is important to note that laws and insurance requirements change so it is always best to contact your insurance provider or a lawyer familiar with the insurance laws in your state for the most up-to-date information.

Instead of receiving Authorization for services within a few days to a week or so, as has been the norm, it is now taking weeks or even months. Some insurance companies are requiring pre-authorization for each specific service goal, while others are requiring pre-authorization for blocks of hours. Regardless of the process, it is the therapist’s responsibility to keep accurate documentation and records of all communication with the insurance company, as well as any resulting disputes that may need an appeal.

Questions to Ask Before Committing

BCBA observes all sessions at child’s home and makes program changes as needed. When a family builds a custom home, they may start with young children, but by the time construction finishes, the children often grow older and their needs change.

When selecting a translation provider for your project, it is helpful to know the level of communication that will take place between you and the provider regarding the status of your translation project. Quality translation providers are able to maintain ongoing communication with clients, in various formats, throughout the translation process.

When shopping around for providers, be sure to ask them about their weaning process, or transition plan. An effective ABA program weans its clients off of services as it progresses. That means by the time the insurance isn’t able to pay for as much service, you and your child should be functioning just fine.

For many children and families with autism, the right ABA provider can be more than just a therapist- they can be a developmental partner, guiding your child, family and care team toward long-lasting results. We will explore the qualifications of key ABA providers, as well as what to expect along the journey to find the best fit for your family.