Applied Behavior Analysis (ABA) Therapy: A Comprehensive Guide

Applied Behavior Analysis (ABA) is an evidence-based therapeutic approach commonly used with children with autism and other neurodivergences. This approach to care is based on the science of learning and behavior. As a highly individualized and flexible approach, ABA can be utilized with children and adults with diverse needs. 

The ultimate goal of ABA is to teach learners the skills and behaviors necessary to achieve their fullest potential and live a high quality of life. For some, this means supporting the reduction of harmful behaviors, such as aggression and self-injury. For others, it could mean teaching communication skills that enable them to meet their needs and self-advocate. 

Often, when a child is first diagnosed with autism, the diagnostician recommends ABA as a first line of care. This is because there is a large body of research supporting its efficacy within the autism population. Read on to learn more about what ABA therapy entails, including:

  • The benefits of ABA
  • How ABA Therapy works
  • Insurance coverage

…And more!

Benefits of ABA Therapy

There are numerous benefits to ABA therapy. The benefits each child experiences can vary significantly based on various factors, including their unique needs, strengths, particular goals, intensity of care, and family participation. 

Benefits of ABA Therapy may include:

Promotion of self-advocacy skills–Empowering children to self-advocate is vital for enhancing their quality of life. Developing self-advocacy skills instills a sense of control and autonomy in their lives.  

Increased adaptive behaviors–Through targeted skill acquisition programs, many children improve their independence in adaptive living skills, such as dressing, managing money, food preparation, household chores, and even vocational skills.

Reduction in behaviors that interfere with learning–For children who exhibit behaviors that are harmful, interfere with learning, or affect interpersonal relationships, ABA interventions can reduce these behaviors while teaching more adaptive replacement skills. 

Improved functional communication–Everyone deserves a voice. Whether that voice is expressed vocally or through augmentative and alternative communication (AAC), ABA can teach vital skills to improve a learner’s ability to communicate with others effectively. 

Enhanced social and play skills–Social skill support is a common area of focus in ABA. Social skill goals may include learning to recognize emotions and nonverbal cues in others, sharing and taking turns, holding conversations, active listening, and developing friendships, among many others. 

Strengthened problem-solving skills–Learning to identify challenges, develop solutions, and resolve conflicts can support a lifetime of success. 

Increased safety awareness–Many children with autism struggle to understand unsafe situations and require support to develop safety awareness in areas like emergency preparedness, online safety, stranger awareness, identifying potential hazards, and water and fire safety. 

Development of self-care skills–Through systematic programming, children can develop self-care skills, including grooming, hygiene, and mealtime routines.

How ABA Therapy Works

ABA therapy starts with an initial intake assessment where the behavior analyst meets with the child and the parent(s) or caregiver(s). The behavior analyst conducts assessments to evaluate the child’s strengths and areas of need to inform their goal development. They also interview the caregivers to gather information about the child’s experiences, strengths, needs, and family concerns. Understanding a family’s culture is important in care delivery, so they also take time to learn about the family’s culture and priorities. 

After the behavior analyst completes the assessment, they analyze the data to develop an individualized treatment plan. This plan will include the goals that therapy will work on, criteria for discharge, recommended hours, and more. 

The number of therapy hours recommended will vary based on the learner’s unique needs. Many children attend ABA therapy for 15-30 hours/week. 

Therapy Team

ABA therapy is usually provided by a team of behavior technicians and a behavior analyst. Sometimes, an assistant behavior analyst or other mid-level supervisor role is also a part of the team. 

Therapy is most often conducted 1:1 with a behavior technician (BT) or Registered Behavior Technician (RBT) implementing the treatment plan programming with the learner. The technician works directly with the child, teaching individualized skills and implementing behavior interventions as created by the behavior analyst. 

The Board Certified Behavior Analyst (BCBA) leads the therapy team. This individual conducts assessments, develops individualized treatment plans, behavior intervention plans, and clinical programs, trains and supervises technicians, and conducts parent training. The BCBA also closely monitors learner progress and regularly makes adjustments to programs as needed.

ABA Settings

One unique aspect of ABA therapy is that it can be conducted in a wide range of settings. As a highly individualized approach to care, children receive therapy in the locations that are the most beneficial for them. For many children, especially younger learners, therapy is provided in a clinical setting. Clinics offer an excellent opportunity for 1:1 instruction and access to peers to support social and pre-academic readiness skills. 

Another primary setting for ABA therapy is in a learner’s home. Home is where we spend the majority of our time. Therefore, many children benefit from care provided in this natural setting with goals embedded into their daily routines and activities. Home settings also offer an increased ability to incorporate parents and family members into a child’s care, increasing generalization and long-term skill maintenance. 

Sometimes, children receive ABA therapy in their school or daycare. Depending on their individualized goals, they can also receive ABA in other community settings. For example, a child who struggles with following safety instructions out in the community may have therapy conducted at a playground, store, or other location that their family commonly visits. A child learning to handle money and make purchases could have therapy sessions held at a store to practice these real-world skills. 

ABA may also be offered via telehealth, especially for those living in rural areas with limited access to care providers. 

Types of Therapy Services

Direct 1:1 Therapy–The most common ABA service is 1:1 therapy provided by a behavior technician. The BT works directly with the learner, teaching skills in a fun and engaging manner to support their short and long-term goal development. 

Supervision/Protocol Modification–The BCBA overlaps the behavior technician on an ongoing basis to oversee care. They ensure the technician implements the treatment plan goals accurately and that the child is progressing. When new programs and intervention plans are needed, they implement these and train the technicians on them. 

Caregiver Training/Support–Family involvement is an essential component of ABA therapy. Research shows improved outcomes when parents play an active role. The end goal is to transition care back to the family, so it is important to ensure the caregivers can implement behavior-analytic strategies to help their child learn and grow. BCBAs meet with parents to provide guidance on personalized goals that further support their child’s progress. 

Social Skill Groups–Some children also attend social skills or playgroups to improve their peer interaction skills. This is an excellent opportunity to develop friendships, conflict-resolution skills, and more. 

Collaboration With Other Providers

Many children who receive ABA therapy also attend school and/or other therapies, such as speech or occupational therapy. ABA clinicians often collaborate with teachers and other professionals to ensure consistency and enhance outcomes. This may be done via meetings, phone calls, email updates, in-person observations, or co-treats.

At Therapeutic Treehouse, we recognize that each child is incredibly unique and requires a multifaceted approach to address their specific needs. As such, our multidisciplinary team regularly collaborates to drive the best possible outcomes for each learner.

ABA Insurance Coverage

Thanks to the increase in autism state mandates, most insurance plans cover ABA therapy. However, to qualify, the child typically needs to have an autism spectrum diagnosis and meet the requirements for medical necessity. Contact your insurance provider for information about your specific plan benefits.

Is ABA Therapy Right For My Child?

It can be challenging to navigate through the sea of information out there to choose the best therapeutic approach for your child. At Therapeutic Treehouse, we understand these struggles that many families face. We employ a multidisciplinary approach to care, ensuring each child receives care perfectly tailored to their needs. ABA therapy may be right for your child if they need support in communication, social, interfering behavior reduction, or adaptive living skills. 

If you’re in the Palm Beach area, we would be happy to help you further explore the care options available for your child. Contact us to discuss further!

References

Chacko, A., Jensen, S., Lowry, L., Cornwell, M., Chimklis, A., Chan, E., Lee, D., & Pulgarin, B. (2016). Engagement in behavioral parent training: Review of the literature and implications for practice. Clinical Child and Family Psychology Review, 19(3), 204-215.  https://doi.org/10.1007/s10567-016-0205-2

Dr. Stephanie Renfrow only accepts private pay.
Very short waiting list for assessments!
For scheduling, please email: DR.RENFROW@GMAIL.COM
Call or Text: 561-413-7759
For more information, visit her websites at:
www.childpsychologyboca.com
www.adcboca.com

Located in Boca Raton