A Guide to ABA Therapy
Having your child recently diagnosed with Autism can be overwhelming. There is a lot of information being directed your way and you’re probably finding yourself having to do a lot of research regarding Autism and ways you can help your child.
Receiving this diagnosis usually will come with a recommendation for treatment options. This is where you will hear the mention of ABA therapy. What is ABA therapy? Is it really an effective way to help your child? How exactly does it cater to your child’s specific needs?
In our Guide to ABA Therapy, we will get you up to speed on what ABA Therapy is, why it works, and how our integrated approach can be beneficial for your child’s development.
What is ABA therapy?
ABA stands for Applied Behavior Analysis. It’s a science focused on improving behaviors that are important to your child and family and teaching new skills to help your child reach their maximum potential. ABA therapy is used to target challenging behaviors that may be getting in the way of your child’s development and improving those areas. Ultimately, we want to increase desired behaviors and decrease challenging or undesired behaviors.
Whether you realize it or not, you and everyone around you are using the basic science of ABA. Because we are all connected to and influenced by our environment, we all experience our behaviors changing based on the reinforcement and/or consequences that are happening around us. In other words, the context of our environment shapes our behavior by the positive and negative reactions in which we come into contact with.
The science of ABA therapy is an efficient and effective way to improve upon the behaviors of your child. This is all done in a safe, ethical way and it’s all supported by decades of thorough research.
Benefits of ABA Therapy
The benefits of ABA therapy are well documented. The ways we have improved upon and adapted different strategies within the realm of ABA has only served to increase the success of its methods. Specifically for parents, being familiar with the strategies and techniques of ABA allows you to be more confident in teaching your children new skills, meaning you are able to become more involved in their development.
Also, you will increasingly become more effective in handling any problem behaviors your child may exhibit, opening up more avenues to integrate your child into different environments. For example, if your child has a tendency to display problem behaviors in crowds of people or out in the community, being able to recognize the precursor behaviors, and how to deescalate those behaviors, will help you to ease your child into these situations more effectively. Having the knowledge of ABA as a parent will increase your confidence, decrease stress, and lessen some of the obstacles to the healthy development of your child.
Further along in this guide we will discuss more specifics on different ABA therapeutic teaching strategies. By being familiar with these ABA practices that your child’s technicians or Registered Behavior Technicians (RBT’s) are using within sessions, you will be able to take those same principles and bring them into your home environment. This will keep the learning journey consistent across settings and help you to optimize your child’s motivation to learn. This can increase compliance, create more natural opportunities for learning, and greatly improve the likelihood that your child will appropriately interact with family and peers.
The biggest takeaway you can have as an ABA parent is that your child’s learning will become more interactive, fun, and engaging. Having even a basic understanding of ABA therapy and its principles will allow you to have a more involved role in this learning and you will be right in the thick of things with the therapists in terms of seeing the improvements your child makes.
Eventually, as your child progresses through therapy, you will be able to see the benefits of the strategies being used. When your child starts developing the various skills they will be working on, you will see the increased confidence they have to behave independently in situations they otherwise would have held back on. The use of reinforcement gives you a way to naturally teach your child that certain behaviors will be less “valuable” to them, meaning they don’t gain access to the things that they want in that moment if they exhibit that specific behavior. Or, behaviors will become more “valuable”, meaning they will gain access to those reinforcing items based on appropriate behaviors.
Is ABA Therapy only for Autism?
In your research of ABA therapy, you’ve probably noticed that it is primarily used to teach and help the development of children with Autism. ABA is actually used to help with more than just an Autism diagnosis. The behavioral interventions used within ABA therapy can be utilized to treat any type of mental or behavioral disorder. The strength of ABA comes in its ability to shape human behavior. It is also easily adaptable to individuals and can be tailored to fit the needs of that individual, meaning there isn’t just one specific situation or diagnoses that can benefit from ABA.
At its core, ABA therapy uses techniques in order to assess, analyze, and treat any behavioral excess or behavioral deficit. This pertains to all ages and levels of development as well. It’s the science of teaching and learning and its principles can be used to help children, as well as adults, with any skills they may be lacking in order to help them be better integrated into their environments. The variety ABA therapy provides makes it a great option for any behavioral needs.
What does an ABA therapist do?
Ultimately, an ABA therapist is there to help your child with development and learning. But in order to do this effectively, the therapist needs to make the environment positive, fun, and reinforcing. One of the first things an ABA therapist does with any child is “pair.” Pairing is a technique used to really get to know your child, finding out what they enjoy and what they don’t enjoy. This allows the therapist to not only make the experience fun for your child, but also figure out what motivates your child and how strong that motivating factor can be during the learning process.
The goal is to “pair” a learning objective, an action, or even just the therapists themselves, with a reinforcing item or action. The process of pairing is critical to creating that connection and trust between the therapist and your child. It’s not uncommon for a therapist to spend a good portion of the first few sessions just playing with your child. Knowing that therapy involves more than just completing tasks and objectives allows your child to be more comfortable and willing during a session.
Experienced therapists will use reinforcers, like your child’s favorite toy or their favorite game, to show that they are more than just an instructor. The goal of the therapist will be to establish the fact that they are an avenue for fun and that your child’s reinforcing items or actions are more enjoyable with the therapist involved, rather than without them. If a therapist is successful in creating this relationship, it makes the teaching of your child that much easier.
Another way therapists will work off of reinforcers is to expand those interests into more of a variety of items and activities. This is important because it creates more opportunity for your child to interact with peers. The more activities and toys your child enjoys means more connections that can be made with those around them.
Within a session, the therapist is working off of a comprehensive and individualized treatment plan that is designed to address the specific needs of your child. The plan is developed by a team made up of one or more Board Certified Behavior Analysts (BCBAs). Goals will be developed directly based on assessment results. The BCBA will pull the goals that directly meet the deficits that are displayed in the assessment. It will also include a behavior intervention plan for any challenging behaviors that may need to be targeted.
Throughout the session with your child, the ABA therapist will be collecting data. The data includes correct and incorrect responses during programs, frequency and duration of behaviors, instances of communication, prompts needed to complete the skill, among other things. This data is then graphed, allowing the BCBA(s) to analyze the progress or lack of progress made by your child. Having this data readily available allows for any modifications to be made if/when necessary to increase progress with your child.
Communication is key within ABA therapy. A therapist will be in regular contact with the BCBA overseeing the treatment plan. This includes any significant changes or needs during the session or new behaviors that arise. Communication also comes into play when discussing sessions with you as the parent. An ABA therapist knows the importance of keeping you in the loop, and will give you updates at the end of each session.
A Typical Session Structure of ABA Therapy
Before each session, the therapist will have an idea of what programs they will work on that day.
Each therapy session will typically start with the therapist going through a pairing phase with the child. This includes pairing themselves with reinforcers so that the child sees them as a “giver of fun things.” Also, it’s important for the therapist to find out what the child will be motivated by during that particular session. It’s not always the same reinforcers that are motivating from session to session, so it’s important to figure this out each and every time.
Another big part of this pairing process is to demonstrate for the child that their session isn’t all about work with no play. Therapy should be fun for the child and the therapist, that’s when the most meaningful learning takes place. This phase of the session is when the all-important rapport building takes place. Trust is developed during this time and a connection is made between the child and the therapist.
During the session, the therapist will intertwine play with teaching. It’s important to keep learning engaging for the child, so introducing moments of play and interaction is key to a successful session. A good therapist will always be looking for reasons to praise and reinforce the child. Even if the child is having an off day, displaying more problem behaviors than usual, or just not quite grasping programs as well as they normally would, there are still small victories to celebrate. These small victories can help get the learning momentum back on track and also keep your child comfortable, happy and motivated. This is where that rapport building in the beginning of the session comes into play. Good rapport between the therapist and the child can help the session through some of the tougher times.
Because therapy sessions should never be all work with no play, we make sure to incorporate reinforcer leisure/break time between programs. However, even during these times there are learning opportunities to be had. Keeping the child engaged and interacting with those around them throughout the session is important, even during these leisure times. An example of this is when two children are playing together during a break. Maybe they both want access to the same toy. The therapist can take this opportunity to teach sharing or even collaborative play. This is also a great opportunity to work on social skills with peers as well.
ABA therapy is all about taking teaching moments and making them practical, relevant, and enjoyable for the child.
An Example of a Day at Ally Pediatric Therapy
Finding the right ABA program for your child is an important decision. We want you to feel confident that Ally Pediatric Therapy is the right partner for your child and your family.
- 8:00am: Johnny’s first ABA session focuses on sharing while playing, which often leads him to challenging behaviors. He loves cars, so he and a behavior technician head to the gym to play with cars on a racetrack. One of Johnny’s peers is also there working on a similar skill, allowing the behavior technicians to model the desired behaviors before Johnny and his friend practice them.
- 10:00am: Mom and Dad have difficulty getting Johnny ready in the mornings, so his OT sessions focus on teaching him to dress himself and tolerate new types of textures and fabrics.
- 11:00am: Johnny stutters, so speech and feeding sessions focus on improving speech skills to reduce stuttering and learning to eat new fruits and vegetables. He was motivated by playing with his favorite car in the morning so that is used for reinforcement in speech too.
- 12:00pm: At lunch, Johnny practices social skills with other similarly functioning children his age while eating foods he’s being introduced to in feeding sessions. Johnny’s behavior technician notices Johnny’s interest in a peer’s snack, and steps in to reinforce the sharing practice Johnny did in the morning.
- 12:30pm: Johnny’s after lunch session focuses on asking for what he wants, which is a critical skill to avoid tantrums. Johnny wants to play trains and practices asking his technician for each toy before using them.
- 2:30pm: The afternoon session will focus on applying skills learned earlier in the day with a new team member, which teaches a child how to apply skills more broadly in different environments.
- 4:30pm: Mom arrives for pickup and is provided a summary of the day’s sessions by Johnny’s team.
As you prepare for your child’s therapy, you probably have some questions for us. Here are a few questions that we most often hear and answers to help you prepare:
What is my child going to do all day? Will he/she be bored?
No! Your child will direct much of their day, and Ally Pediatric Therapy staff will work learning opportunities into wherever a child’s interests lead. By switching rooms and interacting with different staff throughout the day, your child is constantly engaged in opportunities to learn and improve social and communication skills.
Will my child learn skills needed to be successful at school?
Yes! Our center-based model incorporates many benefits of a school environment, including frequent social interaction, while providing one-to-one support throughout the day to maximize learning. We teach foundational skills like attending (sitting still and paying attention), coping, and self-management, which are necessary prerequisites to be successful in school.
Will my child’s progress at Ally help improve challenges we have at home?
Absolutely! Ensuring that our work translates outside our center is a fundamental part of our program. All programs include parent education, to teach you what we do with your child, and to help you develop new skills. A child’s family is part of our team, and we work collectively to help your child learn, speak, and grow.
This seems like a long day for my young child, will they be okay?
Of course! Our treatment approach is play-based, which combines learning and fun for your child. Play is crucial for development, offering myriad opportunities for communication and speech, while teaching children to make choices. We move around throughout the day to keep your child engaged and make eating fun with our social skills lunch bunch! If your child naps we accommodate that too.
My child doesn’t have speech problems, why is an integrated program relevant for me?
Even if your child speaks, some types of communication, such as pragmatic speech (knowing how to communicate appropriately in a given social situation), can be challenging to grasp. Speech pathologists teach skills and rules that make communication more natural. This complements and builds upon skills learned in ABA, enabling the child to feel more comfortable navigating social situations.
Why is your center a better fit for my child than school / pre-school?
We understand parents’ desire to send their kids to school, in fact, it’s a goal for many families we support. However, schools are often not equipped to meet the needs of children with autism and fail to provide them adequate support. This causes kids to fall further behind and have trouble fitting in with their peers. Our program provides 1:1 support to help children develop the skills needed to learn in the classroom while developing friendships with their peers.
What is the Location for the Ally Pediatric Therapy Model?
Ally Pediatric Therapy uses a multi-location approach blending in-home and clinic based sessions. This can be done in a variety of ways depending on what is most appropriate for your family and child’s needs. Therapy may start in the home and move to the clinic to assist in the generalization of skills learned. If your child has some severe challenging behaviors, the BCBA may also elect to begin therapy in-home to make sure that we are able to get the challenging behaviors under control and then move the therapy sessions to the clinic.
Another option is to begin services in the clinic and move to an in-home setting towards the discharge of services. This will ensure that the skills your child has learned have generalized to the home setting and control has transferred to you as the parent. As mentioned in a section above, generalization is a key factor in any ABA program.
A third option is to have locations staggered throughout the week, if the BCBA determines that both locations are clinically appropriate from the outset of services. Your child would immediately have exposure to learning sessions in both environments and you would have that direct model during the week of how you should continue the interactions with your child when the RBT is not present.
Your child’s treatment plan will have the same goals regardless of the setting, however, one environment may yield more opportunities to practice one skill over the other. For example, the home environment will yield more opportunities for daily living skills like, food prep or laundry and chores while the clinic setting would be more appropriate for social opportunities.
Ultimately, location will directly be driven by what is best for your child and most appropriate for your family.
How long does ABA therapy last?
How long your child’s ABA therapy lasts is completely dependent on several different factors. Each child is different and it’s impossible to give a concrete timetable on how long treatment will take. Some factors to take into consideration are the complexity and severity of your child’s problem behaviors, the scope of skill deficits, the age of your child, your child’s learning history, and parental involvement.
In some cases, ABA therapy is a temporary intervention for your child’s development process. In other cases, the child may need to have long-term therapy to ensure the continuation of progress in certain areas, as well as reducing the chance of regression. Again, this will totally depend on the specific child and situation.
However, it’s important to remember that your child will be progressing, even if the changes are more subtle. Because ABA has so much evidence pointing to its effectiveness, it’s important to be patient and trust the process involved. Also, don’t be afraid to ask as many questions as you can think of so that you fully understand how your child is developing.
ABA Therapy and Insurance
Over the last decade or so, huge strides have been made in the awareness and development of ABA therapy. Because of this, over 200 million people have insurance coverage for ABA therapy and all 50 states now have mandated coverage for ABA. The details of your insurance plan will dictate what coverage you have.
We understand that this can be a stressful process to set in motion, and because of this, we will be there every step of the way. Our team at Ally Pediatric Therapy will answer any questions you have and will take some of that burden off of your plate. We want to help you get set up with your coverage as quickly and seamlessly as possible so we can start helping your child. Different plans cover ABA in a variety of capacities and we are happy to check to see what that looks like.