ABA Therapy and Autism: What Is It and How Can It Help?
We all know about Speech Therapy and Occupational Therapy for Autistic individuals, but what about other forms of therapy that parents use? There is one form of therapy I’d like to bring to your attention. One age-old therapy that we’ve fought insurance companies over for years- ABA Therapy. Applied Behavior Analysis, or ABA therapy has been recognized as a successful Autism treatment since the 1960s. What’s it all about though? Some parents do not know, so let’s talk about it…
Applied Behavior Analysis
ABA is based on the idea that a person is more likely to repeat an appropriate behavior that is rewarded rather than a behavior that is ignored and/or looked over. The ABA therapist spend a great deal of time in a one on one setting with your child, helping them develop a quantity of different skill sets for daily life. They do this all while reducing the likelihood that the child will meltdown or engage in other problematic behaviors.
To break it down further for you, per Autism Support Network, “Applied” means that interventions are geared toward achieving ‘socially-important goals, helping people be more successful in natural settings such as homes, schools, and communities.’ “Behavioral” means that ABA focuses on ‘what people say or do, rather than interpretations or assumptions about behavior.’ And “analytic” means that assessments are used to ‘identify relationships between behavior and aspects of the environment before proceeding to intervention.’
Behaviors ABA helps with:
-meltdowns in general
-abuse to others
- preventing problems/prompting positive behavior
-teaching your child appropriate replacement skills
-managing consequences to behavior
The therapist should also:
-provide specific written recommendations and training, allowing caretakers to apply strategies under the circumstances in which they are needed
-evaluate the child’s progress on a regular basis using objective measures and criteria
ABA involves ‘ongoing data collection to evaluate whether behavior is changing in the desired direction and the goals are being achieved.’ The expectation is that outcomes ‘generalize’ across people, situations, and settings and continue over time. The way the therapist goes about working with your child is based on a program that they come up with that is tailored to your child’s specific needs. Therapy usually starts with an initial assessment from the therapist. The idea behind this assessment is to identify your child’s areas of deficit in skills and areas where your child is on track. From there the personalized plan is made and implemented. They use several different methods to do the therapy, the most common is to use PECS Cards, or the Picture Exchange Communication System.
ABA therapy is usually conducted by one therapist, or perhaps 2 or 3 rotating therapists. This is done either on a traditional basis:
-20-40 hours a week
-one on one with therapist
-done in home or in a facility specializing in ABA therapy
Or it can be done on a modified basis to allow for social time and other therapies. When done on a modified schedule everything is the same except the time is cut to around 10-15 hours a week. ABA Therapy is probably the most promising therapy out there, in this authors opinion. Not only is it endorsed by the American Medical Association, The American Academy of Pediatrics and The U.S. Surgeon General, it is endorsed by countless parents across the world.
While ABA is more widely covered now than before, it is still a battle in some areas to get it. My son has been referred for ABA on several occasions, we are still waitlisted years later. There are simply not enough facilities, and insurance companies are finding every excuse not to pay. In fact, after Obamacare was enacted only 32 of 50 states immediately started covering ABA, and Medicaid in most cases will find any excuse not to fund it.
The costs of ABA
ABA therapy is one of the priciest therapies out there, with a price tag of between $60 and $200 an hour, at 40 hours a week. For those of you wanting to know the math- that makes it $8000 a week or $416,000 a year on the high end and $2400 a month or $124,000 a year on the low end, without insurance. With the therapy being so successful many parents scramble to get their children this care, me being one of them. With meltdowns being so common with my son I feel as though ABA therapy could be the answer. However, it all has come down to the approval coming from the insurance company, which has now taken 18 months to come to the answer of no, again.
Now, what should I expect?
Per Autism Support Network, regardless of the specific practices that are being used for your child or the tailored system set up for them, ABA services should adhere to the basic characteristics. As a family member, one should expect behavior analysts to ‘have appropriate training and experience to implement ABA appropriately and perform the following functions:
Engage caretakers in goal setting, assessment, intervention design, plan implementation, and evaluation.
Define goals and behaviors of concern for children in observable terms.
Conduct a thorough assessment to identify antecedents and consequences affecting the child’s behavior.
Design individualized behavioral interventions based on the principles of applied behavior analysis that include strategies to prevent problems/prompt positive behavior, teach your child appropriate replacement skills, and manage consequences (e.g., reactions) to behavior.
Provide specific written recommendations and training, allowing caretakers to apply strategies under the circumstances in which they are needed.
Evaluate the child’s progress on a regular basis using objective measures and criteria’.
Of course, no behavior or meltdown is completely predictable or preventable; however, ABA therapy is a great resource to use to control these behaviors- if you are lucky enough to be able to get it for your child. All we can do in the mean time is cope with our children’s behaviors and educate ourselves and our children as to better ways to handle themselves and the world around them. Focusing on being able to communicate their needs effectively. ABA therapy is a good start in the process of making this a reality.