Social Stories and Autism

Developed by Carol Gray in 1990, Social Stories™ support preventative, or antecedent, strategies to help a child with autism successfully navigate challenging social settings. Social stories increase positive social behaviors and decrease challenging behaviors.

Structured routines and visual cues, among other transition strategies, help children with autism anticipate and respond well to changes in their environment. Social stories complement those interventions and help children with autism develop an understanding of the perspectives, emotions, and behaviors of themselves and others in specific settings.

At LeafWing Center, social stories may be integrated into our treatment approach depending on the needs of the child. Our therapists are experts in ABA therapy, proven to help children with autism. In this article, we will explain:


Teacher reading a book to her kindergarten class

What Are Social Stories?

As defined by the concept’s author, Carol Gray, social stories are a “social learning tool that supports the safe and meaningful exchange of information between parents, professionals, and people with autism of all ages.”

Implementing the use of social stories in the classroom is a strategy that is likely not new to teachers. However, not all teachers know that they can be used to working with and teaching individuals with autism-specific skills surrounding social and behavioral needs.

In practice, social stories are characterized as follows:

  • Short: A social story is a mini book that describes a social situation and the appropriate social responses.
  • Specific: A social story teaches a specific desired response.
  • Individualized: A social story uses descriptive, encouraging, and positive language, details, and illustrations that:
    • Allow the child to see themselves and the people in their life reflected in the characters and dialogue.
    • Use the first-person point of view or the child’s point of view as well as present or future verb tense.
    • Answer questions the individual with autism may need to know to interact well with others (the who, what, when, where, and why in specific social situations).
    • Consider the child’s level of vocabulary and comprehension, attention span, learning style, and personal interests.

At LeafWing, our personalized approach lets us get to know the children and families we support well. We have many resources available for parents and caregivers of children with autism.

Goals of Social Stories

Research shows that individuals with autism benefit greatly from the use of social stories and that benefits increase when the social story development process begins with clear goal setting. The goals of social stories center on the perspective of the child with autism, which helps maintain a positive and encouraging tone. In addition, they reflect the inputs of the entire care team, leading to greater skill or behavior generalization.

  • Developing Skills for self-care, the classroom setting, and future work environments helps the individual work toward achieving targeted levels of independence.
  • Teaching Social Norms provides a blueprint to help the child with autism interact with the world around them.
  • Improving Sequencing gives children with autism the tools to move more easily from one task to another or from one environment to the next.
  • Addressing Negative Behavior keeps the child with autism and others around them safe.
  • Coping with Change in daily routine through social story interventions makes the unfamiliar feel more familiar.
  • Celebrating the child’s strengths and recent “wins” through a social story builds their confidence and increases their openness to new skills and experiences.

 

Benefits of Social Stories

The benefits of social story interventions are well documented. When constructed and implemented according to certain guidelines, they have been shown to help children with autism:

  • Increase shared understanding and empathy
  • Build confidence
  • Reduce anxiety

Social Stories for students with autism

Components of Social Stories

Social stories are written using four sentence types. They are customary to include two to five descriptive, perspective, or control sentences.

  • Descriptive Sentences: Provide information about the subject, setting, and action.
  • Directive Sentences: Describe the appropriate behavioral responses.
  • Perspective Sentences: Identify the possible feelings and reactions of others.
  • Control Sentences: Describe the actions and responses of the story participants.

A note on control sentences: For example, a control sentence might be, “A puppy barks to get its owner’s attention.” Or, “Ginny yelled to get the teacher’s attention.” Writing social stories for students who have the tendency to over-focus on a specific part of the story may require omitting the control sentence.

How to Write Social Stories

When creating a social story, there are ten steps to follow:

  1. Identify the target situation or concept.
  2. Define the target behavior or skill.
  3. Collect baseline data on the target behavior.
  4. Write a social story using the four-sentence types.
  5. Present one to three sentences on each page.
  6. Use photographs and drawings or icons.
  7. Read the social story to the child/student and model the desired behavior for them.
  8. Collect data on the target behavior.
  9. Review the data and the social story procedures and modify them if they are ineffective.
  10. Plan for maintenance and generalization.

Social stories can be revisited as often as necessary, depending on the child’s receptiveness. Patience is key to the process.

Children with autism frequently do not maintain or generalize skills they have learned. Having a plan for maintenance and generalization helps improve the likelihood they will hold onto newly acquired skills. LeafWing therapists and caregivers will ultimately fade the use of a social story and plan activities to assist the student in generalizing skills across content, persons, environment, and situation.

Related Glossary Terms

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

Supporting students with autism in the classroom with an assignment notebook

One way to support students with autism in the classroom is to give them an assignment notebook. It will give them the feeling of inclusion, especially if all the students have one. While some students with autism are ultra-organized, others need support to find materials, keep their locker and desk areas neat, and remember to bring their assignments home at the end of the day. Present assignment notebooks to the whole classroom to stay organized with assignments from the teacher. This is an effective organizational strategy for students with autism spectrum disorder, especially older students who possess the prerequisite reading, writing, and organizational skills in an assignment notebook. All academic tasks and their due dates are listed in the notebook, and the student will take them to school and home every school day. The most effective support would include a sample of each assignment’s appearance. Students on the spectrum tend to be visual learners.

Visual Type Examples:

What will be covered in this post


Supporting students with autism in the classroom

What should the assignment notebook contain to support students with autism?

Ideally, it should contain examples of completed resources (math equations, definitions, filled-out problems, etc.), as these would function as visual examples to complete assignments correctly. Although simplified assignment books are acceptable and effective depending on the student, the classroom teacher would need to check the notebook at school to ensure all information and expectations are included.

Alternatives to classic note-taking to help with assignments

  • Record the lesson
  • Use another student’s notes
  • Use the teacher’s outline and fill in the blanks


Supporting students with autism in the classroom with an assignment notebook

Teachers use assignment notebooks to support students with autism in the classroom

A poor classroom environment for autism can be a grave disadvantage to students with the condition. Most notably, it can cause them difficulty engaging in learning activities and coping with daily life. What’s more, these issues can have a lasting impact on them.

This is why, as a teacher, it’s crucial for you to be aware of the educational implications of autism and how to adopt effective autism instructional strategies. By integrating suitable autism learning styles and alleviating any discomfort in the classroom, you will enable autistic students to take part in learning more comfortably and become better prepared for their future.

Additional ways students with autism can be supported in the classroom

  • Have student repeat back directions
  • Provide task analysis for multi-step tasks
  • Break large chunks of work into smaller parts
  • Using graphic/visual organizers (e.g., organizational, attentional issues)
  • Providing notes for lessons in (subject)
  • Providing outlines for lessons in (subject)
  • Using visual cues (PECS, words, charts, cards) to review schedule, expectations
  • Ensuring that student writes homework assignments legibly
  • Ensuring student has homework assignments and materials before departure
  • Providing study carrels or dividers for independent work
  • Providing preferential seating
  • Providing seating away from distractions
  • Providing seating without visual distraction in the visual field (windows, etc.)
  • Structuring for minimal auditory distraction
  • Providing task analysis, breaking down goals into small steps
  • Using manipulative materials to increase participation in the learning experience
  • Providing peer tutoring/paired work assignment

 

How parents can help with the assignment notebook

At home, parents or caregivers monitor the notebook to ensure the student has completed all necessary assignments or activities to the level expected of them. A signature section for each day can provide an additional layer of thoroughness. This can include a signature section for the parent who monitors the assignment book and/or the student who completes the assignments.

When a child also has autism, parents can encounter additional challenges when it comes to task completion, including attention deficits, tantrums, or difficulties with organization. This section includes tips for working through those days when homework is more challenging to complete due to a lack of cooperation or interest. It also includes additional resources and suggestions for caregivers.

If there is going to be a disruption in the typical homework routine, have a conversation with your child with plenty of notice beforehand (i.e., “Since we are going to your school concert tonight, you will need to finish your homework before we go. We can not go if your homework is not finished.”)

Tips for Homework Success:

  • Figure out when the best time to tackle homework is. Some kids need time to relax after school, while others want to get it done right away. Some kids are early risers – morning might be the best time. You know your child.
  • Look for an area that doesn’t have a lot of distractions.
  • Use special interests to motivate. Some autistic children obsess over their favorite interests. Learn to tie that into the homework completion as an award.
  • Present expectations. Set ground rules like no television, computer games, or friends until homework is completed. Be firm in sticking to them so the child knows what is expected of them and that it doesn’t keep changing. Habits and understanding expectations take time to develop, so creating consistency early on is important.
  • Color code subjects. Designate a color for each subject. Talk to the teacher to see if they already have one at school. You can replicate the exact colors at home.
  • Provide positive verbiage about why homework is necessary. Show how what they are learning can be applied to everyday experience.

Parents’ role with homework:

  • Stay positive. Don’t let your frustrations surface. This could make the situation worse. You might need your spouse to step in at this time.
  • Share responsibility with your spouse. Don’t shoot for perfection because your child might become defiant if they feel that they can’t reach your expectations.
  • Be available for help. Stay close by so your child doesn’t have to go looking for you, which can disrupt their work and cause them to become distracted.
  • Be a role model.
  • Provide positive reinforcement. Enforce good homework practices.
  • Advocate with others. Work with teachers and the school. Have a good line of communication with your school team.
  • Teach your child to advocate for themselves. Students with autism may be nervous about asking for help and expressing their needs. Work with your child and the adults who work with them at school to develop a way for the student to self-advocate in a way that makes sense to them.

Remember to allow your child to use tools to help their learning, such as PECS, OneNote, etc. When technology and education come together, possibilities become realities. The true purpose of education is to create possibilities and obtain benefits for a fuller and better life.

The purpose of the assignment notebook for students with autism

Essentially, these assignment books are visual checklists to help students stay organized and on-task. These are pretty standard in schools, yet they must be used to help students with ASD succeed.

As with most strategies for students on the spectrum, the specific skills required to effectively use an assignment book will need to be taught or should already be in the student’s repertoire.
Peer Support

How to encourage the students with ASD to participate in the assignment notebook

In addition, motivation needs to be taken into consideration. The teacher or support staff may need to provide additional reinforcement when the naturally occurring contingencies (i.e., assignment completion) are not sufficient. For example, if a student completes all daily assignments within a specified time frame, let’s say, homework that was assigned Monday through Thursday, then on Friday, they may receive access to a special activity or item. Another way to help students “buy in” to the idea of assignment books is to individualize assignment books so that they include items, characters, colors, or designs that are preferable to the student. Students can customize their assignment books to increase the book’s value and help boost motivation.

Structuring this time daily will allow all learners to be organized and thoughtful about how they prepare to transition from school to home. Specific skills can even be taught during this time (e.g., creating to-do lists and prioritizing tasks).

We hope that you will find assignment books a helpful organizational tool for promoting homework and academic task completion!

Related Glossary Terms

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

Choice Boards and “Wait” support for students with autism in the classroom

Choice boards and ‘Wait’ support in the classroom benefit autistic students based on their individual needs. Different Choice boards are necessary depending on the student’s motor and communication skills. These boards can display objects, pictures, icons, or words for various activities or reinforcers. It is important for the pictures to accurately represent the actual objects for the student to make the connection. Choice boards can be easily made using materials like poster paper, card stock, whiteboards, or any writable surface.

We will discuss two techniques for supporting students with autism in the classroom:

  1. Choice Boards
  2. Wait Supports

Choice boards are commonly used alongside a student’s schedule to allow them to choose activities at designated times. These boards are usually placed near areas for free or break time, encouraging independent selection of activities. Implementing choice boards can create structure and routine for students with autism, helping to reduce anxiety.


Choice boards for autism in the classroom

What are Choice boards for autism?

A Choice board is a type of visual environmental support that can benefit students, especially students with ASD. Choices should be incorporated into as many activities as possible, as choice boards provide students with decision-making opportunities and a sense of responsibility for their behavior and work. A Choice board may or may not have written words describing the image.

How are Choice boards used?

When introducing a Choice board to a student with autism, make sure to show the board, read the choices aloud, and point to the choice you are reading. You need to wait for the student to select a choice by either pointing, removing the choice, handing it to you, or verbally choosing.

When to use a Choice board in the classroom

  • Reinforcers
  • Rewards
  • Activiities or Actions
  • Materials or Supplies

What are the benefits of using Choice boards within the classroom?

Choice boards are used to encourage communication, provide a visual reminder of what activities are available, and encourage independent decision-making throughout the day within the school setting. Offering a choice before an activity/task begins may increase the likelihood of participation and decrease the possibility of a student with autism engaging in challenging behaviors.

Choice boards are most effective when the choices are appropriate and make sense at the moment. If a choice cannot be honored in that scenario, then it should be removed from the choice board. Failing to do so only frustrates the student when the choice cannot happen and decreases the likelihood of them wanting to use the choice board.

Additionally, similar to their average peers, if there are too many choices, students can become overwhelmed and either take too long or avoid making a choice. The opposite is also true, only having two choices in every instance for a choice can decrease the effectiveness of a choice board. Those making the choice boards should continually evaluate if there are too many or too few choice boards.


Wait Support for students with autism in the classroom

Why are ‘Wait’ supports important for children with autism?

Similar to Choice boards, ‘Wait’ support is another visual strategy or tool that can be incorporated throughout the school day. As we know, waiting is a difficult skill for many children, with or without disabilities. However, for students with autism, in particular, waiting typically presents problems because time is an abstract concept, they are not aware of the social rules of waiting, or they do not comprehend the reason for waiting.

We also know that if a student waits too long or is not engaged in some type of activity, even if it is a simple activity such as putting a backpack away or clearing a desk, then unwanted behaviors will likely occur. Therefore, students with ASD will typically require specific instructions to develop appropriate waiting behaviors.

Guidelines to determine the type of ‘Wait’ support

When developing ‘Wait’ supports, you need to determine if the student has the prerequisite skills that are necessary to engage in waiting behaviors. Students have to wait on many occasions throughout the day.

Examples of wait times at school

  • Wait to access a preferred activity or object
  • Wait for the bus in the morning and afternoon
  • Stand in line to leave the classroom
  • Wait for lunch to be served
  • Wait for everyone to be quiet for circle time

Wait support tools

  • Visual timers
  • Countdown strips
  • Distractors

First, role-play and practice waiting using different instructions and in different settings when you want to identify this skill.

Keep in mind that when you are practicing ‘learning to wait’ with your students, make sure it is authentic and in an actual setting where you would expect the student to use this skill.

Again, be sure to teach waiting skills across various settings to increase the likelihood of generalization. Even using a peer model or a peer buddy during waiting times can offer support for desired behaviors.

Additionally, specific ‘physical supports’ such as chairs near the waiting area, setting a timer, or holding a picture representing “wait,” can also help a student learn this concept.

5 Tips for Using Wait Times:

  • Give Reminders. For example, if the wait time is three minutes, at one minute, point to the time and say you have one minute left.
  • Practice. Build up the amount of time spent waiting through practice just like any skill; waiting takes practice over and over again.
  • Repetition. Incorporate wait times into the schedule so students can get used to it becoming part of the daily routine.
  • Provide Visuals. Incorporate colors as an additional time visual. Red could mean wait. Yellow could mean almost 1 minute left. Green means the waiting is up, and it’s time for an activity or reward after waiting.
  • Flip Cards. Use flip cards as a means for waiting, such as starting from 10 and counting down to 0, as it incorporates two skills at once.

As you know, for any kind of learning to take place, it is essential for students to have an active involvement with their teachers, peers, and the curriculum. Given that students with autism tend to be passive learners, it is necessary to plan activities that require students to become active participants. This can occur by creating opportunities for students to respond. Research supports a functional relationship between academic performance and how often a student can respond. Therefore, the more students participate in an activity, the more off-task and disruptive behaviors will decrease.

Let LeafWing Center help establish some basic Choice boards and ‘Wait’ support techniques for your child that simulate the classroom setting. This will aid and decrease anxiety when the student is ready to make the transition to the classroom. Make sure to share the methods with the child’s teacher to help reinforce the foundation that has been established by the ABA therapist for children with autism.

Related Glossary Terms

Other Related Articles:

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

How is Applied Behavior Analysis Different From Psychology?

The answer to this question is that while many people have historically viewed applied behavior analysis as a branch of psychology, the two disciplines take fundamentally different and antithetical perspectives to account for variability in human behavior.

This article will address some of the primary differences:

Applied Behavior Analysis vs. Psychology

The main difference between Applied Behavior Analysis and Psychology

In general, Behavior Analysis does not concern itself with mental states or inner thoughts when describing why we behave the way we do. Rather than focusing on “the mind,” behavior analysts look at behaviors, or in other words, what we do, as a consequence of things that happened previously. Simply put, we will repeat things when the consequences are pleasant and stop doing things when the consequences are unpleasant. Behavior analysis, as it suggests, focuses on treating behavioral problems from a purely behavioral perspective/lens. Functional analysis, which gathers data to establish trends, and then a subsequent intervention program or plan that utilizes various forms of operant learning is applied.

ABA therapy is used to help improve social and behavioral skills. The program consists of lessons that are broken down into their simplest forms like:

ABA therapy is widely used for children on the spectrum to help them develop basic task analysis skills, such as getting dressed, eating a meal, brushing their teeth, or combing their hair. These methods can easily be transferred to different settings, such as home, school, and social services.

ABA therapy differentiates from Psychology with whole family involvement

It is important to note that ABA therapy does not start and end with the learner. Highly effective ABA programs will involve family members, caregivers, and other stakeholders in the child’s environment. One of the goals of ABA programs is to transfer knowledge of the techniques and strategies used in the program to other individuals in the child’s life. This is usually achieved through parent and caregiver training sessions. In these training sessions, a Behavior Analyst or qualified Supervisor will instruct the parent or caregiver on various techniques that are shown to be effective in the ABA program. This is usually accomplished through verbal instruction, role play, modeling, and demonstrations of the techniques by the parent/caregiver while feedback is provided. Hence, the transfer of knowledge from the ABA provider to caregivers in the child’s life is another way in which ABA therapy is effective.

The main difference of Psychology to Applied Behavior Analysis

The main difference between Psychology and Applied Behavior Analysis

Psychology focuses on the mind. As a discipline, psychology largely hypothesizes internal explanations (personality traits, mediating forces, and other structures in the brain, etc.) for differences in human behavior. Psychology looks to explain behavioral variability by appealing to internal causes that are typically seen as inside the mind (e.g., mood states, personality traits, hypothesized structures such as ego and/or drive states).

Psychology can be used in an involuntary setting like juvenile justice in lieu of punishment or assessment of treatment. A psychologist can also be seen in learning settings like schools and other educational institutions. The treatment focuses on the person and their background. This type of treatment is research-based and aims to improve the lives of children and families.

In short, the difference can be stated as follows: In the ENVIRONMENT (Behavior Analysis) versus inside the MIND (Psychology).

Applied Behavior Analysis and Psychology similarities

Even though Applied Behavior Analysis (ABA) focuses on behavior and Psychology focuses on the individual’s mind, there are some similarities. They both have a firm commitment and a deep desire to help others. They both need to have excellent listening abilities and strong communication skills. These two professions must be empathetic, friendly, and reliable because of their interactions with children as well as adults. Their end result is to identify problems and develop solutions.

LeafWing Center offers ABA therapy to support children in developing task analysis and behavioral and social skills. Our qualified professionals conduct detailed assessments and create clear treatment goals to help learners improve skills and behaviors associated with undesirable symptoms.

Related Glossary Terms

Other Related Articles

Podcast

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

Autism and periods

Autism and periods
For many young teens, getting their period can be a challenging time as they navigate the physical and emotional changes that come with it. But for those on the autism spectrum, these challenges can be even more pronounced. Sensory sensitivities, difficulties with emotional regulation, and communication issues can all make dealing with periods particularly tough.

One of the biggest challenges for individuals with autism during their period is sensory sensitivities. Many people with autism already struggle with sensory processing issues, such as being overly sensitive to sounds, lights, textures, and smells. When it comes to menstruation, these sensitivities can be heightened and make the experience even more overwhelming.

We will be discussing

Parents often focus on their children’s current state, but it’s important to remember that they will grow into adults. LeafWing can be a valuable resource for parents navigating their autistic children through the transition into adulthood.

Period products

What are periods?

Periods are a natural process that occurs in females as part of their reproductive cycle. For most females, this happens every 28 days or so, but it’s common for periods to be more or less frequent than this, ranging from every 23 days to every 35 days.

Your period can last between 2 and 7 days, but it usually lasts about 5 days. The bleeding tends to be heaviest in the first 2 days.

When your period is at its heaviest, the blood will be red. On lighter days, it may be pink or brown.
Parents need to communicate with their young autistic daughter that this is normal and does not mean you are injured or hurt.

It is important for parents to discuss the entire menstrual cycle with their daughters, not just focusing on the bleeding part. For example, you can start by explaining that her body will start to go through puberty. During puberty, a young woman begins to ovulate, releasing a mature egg from one of her ovaries. The ovaries are located in the pelvis and are the female reproductive organs. If the egg is fertilized by a sperm in the fallopian tube, pregnancy occurs. The fertilized egg attaches to the uterus lining, where the placenta forms. The placenta provides nutrition and oxygen to the fetus from the mother. If the egg is not fertilized, the lining of the uterus is shed during menstruation. This will help ensure that they better understand why this occurs every month.

When do periods start?

Periods usually begin at around the age of 12, although some girls will start them earlier or later.

A delay in starting periods isn’t usually a cause for concern. Most girls will begin having regular periods by ages 16 to 18.

PMS (premenstrual syndrome)

Changes in your body’s hormone levels before your period can cause physical and emotional changes.

This is known as PMS (premenstrual syndrome) or PMT (premenstrual tension).

There are many possible symptoms of PMS, but typical symptoms include:

  • feeling bloated
  • breast tenderness
  • mood swings
  • feeling irritable
  • spotty skin
  • low sex drive (loss of libido)

These symptoms usually improve when your period starts and disappear a few days afterward. Not all women who have periods experience PMS.

Managing your periods when you have autism

  1. Educate your daughter early so there are no surprises about the symptoms that her body will be experiencing and reduce the anxieties. Talk to her about the menstrual cycle, why she has a menstrual cycle, and the changes her body will be going through.
  2. Have a plan in place. Start talking about all the sanitary products and how to use them.
    The main types of sanitary products are:

    • Sanitary pads – strips of padding with a sticky side you attach to your underwear to hold them in place. One side of the pad is made of an absorbent material that soaks up the blood.
    • Tampons – a plug of soft material inserted into the vagina to absorb menstrual blood. A brand new product called TINA (Tampon INsertion Aid) helps individuals with disabilities to insert the tampon into the vagina.
    • Period panties/underwear – they are worn like underwear, but have extra padding to absorb the flow and protect from leaks, while keeping you feeling fresh.

autistic female having period symptoms

Challenges associated with periods and autism

Parents need to understand that adolescence can be challenging for young females, especially those with autism. Effective communication, task analysis, support, and patience are essential for helping them navigate this new stage in their lives. Parents can decide to use forward chaining or backward chaining techniques when trying to prepare their daughters to care for themselves during their periods.

One key aspect for parents to keep in mind is the heightened stress their daughter may experience during this time. The physical changes, emotional fluctuations, and sensory sensitivities that often accompany menstruation can be overwhelming for individuals with autism. Parents should be prepared to provide extra support and understanding during this period.

Parents need to recognize that their daughter may struggle to communicate her feelings and needs during her period. It is essential to create a safe and open environment where she feels comfortable expressing any discomfort or concerns she may have. Parents can use visual aids, social stories, or other forms of communication to help facilitate communication during this time. Additionally, providing her with the necessary support and resources to manage her period effectively can make a significant difference in her overall well-being.

Feelings your daughter with autism may be feeling:

  • confusion due to the lack of clear, detailed information about periods and the common terms being used.
  • feeling worried about disruption to routine, like:
    • changes in showering and toileting routines
    • having to wear period products
    • having to use public toilets
    • understanding why periods might change monthly due to age, stress, or childbirth
  • understanding and being able to communicate the symptoms of premenstrual syndrome (PMS)
  • change in mood swings and elevated meltdowns

Executive function deficiency, including:

  • remembering to carry period products
  • knowing the sequence of changing a sanitary pad or tampon
  • knowing when to change a sanitary pad or tampon

 

How to support your autistic daughter with her periods

Autistic females may require additional support in understanding and preparing for menstruation. Providing clear descriptions and explanations in advance can help in alleviating confusion and stress.

Different individuals may require information in a format that is tailored to their needs, such as visual aids, social stories, books, pictures, and videos. It is important to use clear and straightforward language when discussing menstruation, as euphemisms and slang terms can cause confusion and anxiety.

Consult your daughter’s pediatrician

It is important to consider potential underlying factors when observing significant changes in your child’s behavior, such as pain, discomfort, fear, confusion, sadness, or sensory overload. Watch for signs like self-injury, changes in appetite or sleep, frequent complaints of feeling unwell, or a sudden disinterest in previously enjoyed activities.

Certain behaviors may indicate a medical problem or a significant mood issue. During adolescence, there is a higher prevalence of depression and anxiety in individuals with ASD, especially in those who are older and possess greater verbal and cognitive abilities.

Puberty brings hormonal changes for young teens, along with a more complex social environment. This can lead to feelings of being different from peers and increased levels of withdrawal, depression, and anxiety. Many teens struggle to express their emotions during this time, which can result in challenging behaviors.

If you notice any of these signs in your autistic daughter, it is important to consult with her pediatrician. They can help determine if a medical issue may contribute to the behavior changes or if emotional issues are at play.

LeafWing can be a valuable resource for developing individuals with autism for their transition into adulthood, as it is important to consider their future beyond the current state of childhood.

Related Glossary Terms

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

Foods to avoid with autism

Disclaimer

While some studies suggest a link between certain foods and autism symptoms, it is important to note that research in this area is still evolving. As of now, there is no concrete evidence to support the claim that avoiding certain foods can improve autism symptoms. This blog post outlines best practices for all individuals.

Children with autism have strong preferences when it comes to food. The tastes, smells, textures, and different colors of food can all be an obstacle to eating. This can cause children with autism to avoid certain foods or food groups altogether. This can lead to its own set of problems, such as not getting enough nutrients or having bouts of constipation. However, there are some foods or food ingredients you do, in fact, want to avoid feeding your child with autism due to the adverse effects.

In a nutshell, some foods/food ingredients to avoid with autism are:

  • Sugar
  • MSG
  • Artificial ingredients
  • Toxins
  • Dairy
  • Gluten
  • Corn

In this article, we’re going to discuss:

Foods to avoid with autism

Foods to avoid for children with autism

Dairy is a major food you avoid feeding your child with autism. Dairy can cause inflammatory problems which cause brain fog and the inability to concentrate. It can also impair immune functioning within the body. Oftentimes when a child with autism removes dairy from their diet, they are more apt to reduce bowel problems, reduce hyperactivity, and increase talking and oral responses.

Another food to not feed your child with autism is corn. It is another food that promotes inflammation. This is due to the fact that corn is high in omega-6 fatty acids rather than good omega-3 fatty acids. Additionally, corn is considered a grain, not a vegetable, therefore the nutritional value is low.

Finally, a food to avoid with autism is sugar. Although sugar can be within many foods as an ingredient it can also be its own food group. High amounts of sugar in a diet are not good for anyone but especially children with autism. It is common for children with autism to show signs of hyperactivity so limiting sugar can help to balance this out. Also, limiting sugar can help to improve concentration and decrease impulsiveness.

Food Ingredients children with autism should avoid

Monosodium Glutamate (MSGs) is a food ingredient you should avoid as it is very similar to sugar. Consuming large quantities of MSG can cause overstimulation in the brain and lead to hyperactivity. Many overly processed foods will contain MSGs as it is a flavor enhancer to get you to eat more of that food.

Artificial ingredients are another food ingredient to avoid feeding your child with autism. Avoid foods that have artificial dyes, colors, flavors, additives, and preservatives. Once again these are good for all people to avoid but especially children with autism as it can cause issues with development. It can also cause stomach irritation as well as being linked to disrupting normal emotional processing.

Additional food you should not feed your child with autism is toxins. Not toxins such as chemicals or dyes but rather mercury or PCBs. Mercury can often be found in fish and red meats which is good in moderation but can be extremely harmful in large quantities. Polychlorinated biphenyls (PCBs) which are commonly found in dairy products and pesticides found on unwashed produce should also be avoided as they can have adverse effects on the brain and the immune system.

Finally, a food ingredient you should avoid feeding your child with autism is gluten. Gluten is often a cause of stomach sensitivities and upsets. It can also decrease motor and thought coordination. Gluten is also known to cause a decrease in good bacteria in the gastrointestinal system. This can cause issues with stress and anxiety.

best diet for a child with autism

What is the best diet for a child with autism?

A healthy diet for children with autism means eating whole foods such as fresh fruit and vegetables, meat, eggs, beans, nuts, seeds, and whole grains. Foods naturally higher in vitamins and minerals are good for autism.

Beneficial vitamins and minerals:

  • Omega-3s
  • Vitamin B12
  • Vitamin B6
  • Vitamin C
  • Magnesium
  • Vitamin D
  • Zinc

Omega-3s help to fight inflammation in the body. Omega-3s can be found in a whole range of food including:

  • Salmon
  • Free-range eggs
  • Grass-fed beef
  • Free-range chicken

It’s important to try to include these types of food around three times per week.

Vitamin B12, Vitamin B6, Vitamin C, and Magnesium all help with the nervous system and improve common symptoms associated with autism. Dark, leafy green vegetables, chickpeas, salmon, peppers, citrus fruits, broccoli, and cauliflower are all high in B6 and Vitamin C. Nuts, seas, and whole grains contain Magnesium. A child with autism could obtain these nutrients through supplements as well.

Vitamin D, especially Vitamin D3, when provided to a child with autism, greatly improves attention span, and eye coordination, and decreases adverse behaviors. Children with autism can also obtain Vitamin D through enriched cereals, eggs, many types of fish, and Vitamin D-enriched orange juice.

Finally, Zinc is a great vitamin to include in a diet for a child with autism. Improving Zinc levels has been shown to help children with autism to be less resistant to trying new foods. Zinc can be obtained through shellfish, beans, peas, cashews, lentils, and almonds.

In truth, between half and almost 90% of kids with autism manifest food selectivity. Consequently, they are more likely to consume less of a properly balanced group of nutrients and minerals from fresh fruits, veggies, and free-range proteins than typical children. When Leafwing Center is made aware by the guardian that there are no food sensitivities then a customized feeding meal plan can be formulated that is tailored to the child with autism to facilitate integrating the essential provisions for appropriate development and to aid with food selectivity. If you are concerned about the health and wellness of your child then you need to contact your pediatrician.

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Additional Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

What is ABA therapy?

Applied Behavior Analysis (ABA) therapy is an evidence-based scientific technique used in treating individuals with Autism Spectrum Disorder (ASD) and other developmental disabilities. In general, ABA therapy relies on respondent and operant conditioning to change or alter behaviors of social significance. ABA therapy differs from behavior modification in that ABA therapy changes behavior by first assessing the functional relationship between a particular or targeted behavior and the environment. The ultimate goal of ABA therapy is for the learner to gain independence by learning and developing new skills, which will result in an increase in positive behavior while reducing the frequency of negative behaviors.

Table of Contents

 

ABA therapy to treat autism and other developmental disabilities

There is a common misconception that ABA therapy is only effective in the treatment of autism. ABA therapy can also treat those who suffer from attention deficit hyperactivity disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, and/or other developmental/intellectual disabilities. Children, teenagers, and adults alike with ASD can benefit from ABA therapy. ABA therapy produces results in individuals by targeting the modification of challenging behaviors while improving attention skills, play skills, communication, motor, social, and other skills. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

ABA therapy

ABA therapy is effective

Applied Behavior Analysis (ABA) is a scientifically backed, highly individualized treatment method that can be effective in many ways. The ways in which ABA can be effective depend on several factors, including, but not limited to, the individual needs of the learner, frequency of treatment, specific interventions, and the environment in which services are implemented.

ABA therapy and challenging behaviors

One of the ways in which ABA therapy is effective is through the identification and treatment of challenging behaviors. Effective ABA programs will identify challenging and undesirable behaviors at the onset of services. The function or purpose of the challenging behavior(s) will be identified, and a comprehensive Behavior Intervention Plan (BIP) will be established. An effective BIP should include research-backed principles to reduce unwanted behavior and replacement behaviors. Replacement behaviors are behaviors that achieve the same result as the challenging behavior. Still, they are considered to be socially appropriate, easy to engage in, and, generally speaking, more desirable than challenging behavior. For example, if it is determined that a learner engages in aggressive behaviors to escape a difficult task, replacement behaviors that will be taught may include requesting a break or asking for help. Hence, one of the ways in which ABA therapy is effective is through the assessment and treatment of undesirable behaviors.

Challenging behaviors

A child or adult with autism spectrum disorder may have limited, repetitive patterns of behavior, interests or activities, including any of these signs:

  • Performs repetitive movements, such as rocking, spinning, or hand flapping
  • Performs activities that could cause self-harm, such as biting or head-banging
  • Develops specific routines or rituals and becomes disturbed at the slightest change
  • Has problems with coordination or has odd movement patterns, such as clumsiness or walking on toes, and has odd, stiff, or exaggerated body language
  • Is fascinated by details of an object, such as the spinning wheels of a toy car, but doesn’t understand the overall purpose or function of the object
  • Is unusually sensitive to light, sound, or touch, yet may be indifferent to pain or temperature
  • Doesn’t engage in imitative or make-believe play
  • Fixates on an object or activity with abnormal intensity or focus
  • Has specific food preferences, such as eating only a few foods or refusing foods with a specific texture

ABA therapy and skill development goals

Another way in which ABA therapy is effective is through the identification and targeting of skill development goals. ABA therapy will typically address skill deficits across several domains. These domains will vary and depend on the individual needs of the learner. For example, skill development goals may be targeted to address deficits in communication, self-help skills, motor skills, social skills, or play skills. Again, the specific skill development goals that are chosen by the family and ABA team will vary based on the current clinical needs of the learner. Ultimately, the goal of skill development programs is to improve the learner’s quality of life and promote more independence.

How your therapist provides ABA therapy

ABA therapy is highly customized to the individual’s particular clinical needs. Typically, an ABA therapist implements a Behavior Intervention Plan (BIP), skill-building lessons (these are commonly called “programs’ in the field of ABA), and engages in play with the learner.

The BIP is specific to each learner. The BIP will focus on developing a strategy that relies upon ABA principles to effectively reduce challenging or unacceptable behaviors while promoting an increase in socially appropriate and desirable behaviors. The techniques the ABA therapist may use include positive reinforcement, redirection, shaping, or extinction (just to name a few). The skill-building lessons or programs the ABA therapists conduct will also vary from individual to individual based on their clinical needs. These might include lessons such as washing hands, number/letter/color identification, initiating and maintaining play with a peer, reciprocal conversation, motor skills, and so much more.

ABA therapy and skill development goals

Creating the ABA therapy behavior plan

A Board Certified Behavior Analyst (BCBA) is responsible for conducting the initial and ongoing assessments and developing the BIP and skill-building programs. The BCBA also serves as a liaison between and consults with the family/caregiver so the most effective and individualized behavioral and skill-building goals are designed. Once developed, the plan is implemented by the ABA therapist.

The role of the ABA therapist

The ABA therapist is primarily responsible for implementing the various plans. Therapists are trained and supervised by a BCBA. They interact directly with patients and work toward the specific and individualized goals written by the BCBA, typically in a 1:1 setting. The ABA therapist will spend significant time getting to know the learner. The ABA therapist will engage the learner in play, conversation, and other desirable activities. These interactions help establish and maintain a good rapport between the ABA therapist and the learner. Since many learning opportunities are presented during play and conversation, a skilled ABA therapist will seize these opportunities to work on developing desirable skills. Some of the skills that can be taught loosely during play and conversation include but are not limited to sharing and turn-taking, reciprocal conversation (asking each other questions and answering each other’s questions), waiting and tolerance (such as waiting for your turn or tolerating winning/losing appropriately), imaginative play (pretending to act like characters), pretend play, environmental labeling, and so much more. The work of an ABA therapist is dynamic, creative, educational, compassionate, and fun.

Related Glossary Terms

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

Why Does ABA Help Children With Autism?

Autism Spectrum Disorder (ASD) is a condition related to brain development that impacts how a child perceives and socializes with others, causing problems in social interaction and communication. The disorder also includes limited and repetitive patterns of behavior. The term “spectrum” in autism spectrum disorder refers to the wide range of symptoms and severity.

Many families ask similar questions when considering treatment options for their child who has been diagnosed with autism spectrum disorder.

  • What is Applied Behavior Analysis (ABA) therapy, and is it an effective treatment for children with autism?
  • What makes ABA therapy effective in helping improve the lives of those affected with autism?
  • How does ABA therapy involve the family? Is ABA therapy the right treatment for my child with autism?

The professional ABA therapists at LeafWing Center will provide you and your child with the support and therapy required to ensure your child is receiving the highest quality autism care.

We will discuss:

 

ABA therapy for children with autism: Early childhood development

We all know that typically developing children learn throughout all waking hours, even when they are not being formally taught. Typically developing children watch other children, watch adults, watch TV, learn from school, and incorporate what they have learned into their repertoire.

Oftentimes they only need to see something once or twice before it comes easily to them. Parents are often amazed at their children’s learning and frequently ask, “Where did you learn to do that?” When children learn to speak, they often begin to ask questions of others in their environment. From the basic “why” question that parents so often get asked to more elaborate questions about “How this thing works, or how that thing works.” They become their own self-contained information seekers.

Learning is different for children with autism. Children with autism learn much less from their environment. They are deficient in what’s called observational learning or learning via imitation. In other words, children with autism aren’t as skilled at learning by watching others do something and imitating what they see without specific instruction.

Children with autism typically have decreased language skills, understand less of what is said to them, and ask fewer questions of others. For most children with autism, you cannot expect to put them in a classroom setting and have them learn and absorb what the teacher is saying, mainly as a direct result of the characteristics of autism.

ABA therapy for children

ABA therapy is designed to help treat children with autism

ABA therapy programs are effective in treating children with autism because they create very structured environments where conditions are optimized for learning. Over time, these very structured environments are systematically changed so that the environment mimics what a child could expect if and when they are placed in the classroom.

Essentially, an ABA therapy program works with a learner by creating a somewhat unnatural or atypical learning environment for the child, such as teaching them in a distraction-free, one-to-one environment in their home. The structured environment makes it more conducive for the child to learn.

The learning environment will change over time so that it more closely resembles a typical classroom environment – an environment the child will encounter when they are of age to attend school or are reintegrated into a typical classroom setting. It is important to note that the main premise of an ABA program is teaching a child, “how to learn,” so that they will no longer need such structured and specialized services.

The ultimate goal of ABA therapy is for the learner to gain independence by learning and developing new skills resulting in an increase in positive behavior while reducing the frequency of negative behaviors.

Other reasons ABA therapy works for children with autism

ABA therapy programs are also highly individualized and account for a learner’s difficulty transitioning from one learning environment to another. A child with autism may not necessarily practice a skill at school just because they learned it at home.

How an ABA therapy program can be effective depends on several factors, including, but not limited to, the learner’s individual needs, frequency of treatment, specific interventions, and the environment in which services are implemented. With ABA therapy, the earlier the intervention, the better.

ABA therapy effectively treats children with autism

ABA therapy effectively treats children with autism

Autism affects every child differently, and while cases of autism may be similar, no two cases are ever the same. Some children with autism may be mildly or moderately impacted, while others may be profoundly impacted. Applied Behavior Analysis (ABA) therapy is a type of therapy that can improve social, communication, and learning skills through positive reinforcement of those children diagnosed with autism. Most experts consider ABA to be the gold-standard treatment for children with autism spectrum disorder. ABA therapy benefits both the autistic child and their family:

  1. ABA therapy is more fully supported by scientific research than any other treatment option
  2. ABA therapy helps both the learner and the parent(s)/caregiver
  3. ABA therapy teaches skills necessary for socialization
  4. Parents and teachers can capitalize on the strengths and skills of the learner
  5. Children are better positioned if they can function independently
  6. ABA therapy can prepare children to advocate for themselves

Applied behavior analysis (ABA) has been shown to help a wide range of children with autism spectrum disorders (ASDs) learn skills that increase their independence and improve their quality of life into adulthood. Children with autism each have their own diverse life experiences; therefore, each child requires individualized assessment and treatment services.

Let LeafWing Center assist in helping to improve your child’s overall quality of life by targeting problematic behavior and encouraging healthier alternatives. Call us today!

Related Glossary Terms

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

When is a good time to start ABA therapy?

When a child is first diagnosed with autism, parents and caregivers can be overwhelmed by thoughts wondering “what now?” One thing experts agree on is that starting therapy as soon as possible is the best and most effective means to treat your child’s autism. The earlier the intervention the better, so beginning Applied Behavior Analysis (ABA) therapy immediately following autism diagnosis is critically important in getting the most out of your child’s treatment. There are various important reasons why an “early start” enhances the effectiveness of any ABA therapy program. The LeafWing Center’s experienced and professional team of ABA therapists will work with you to ensure a thoughtful and effective ABA therapy program is provided to your child upon their autism diagnosis.

This article will cover

 

Reasons to start ABA therapy after your child’s autism diagnosis

Generally, “earlier is better” when it comes to starting ABA therapy. The best time to begin ABA therapy is typically immediately after a child’s autism diagnosis. At younger ages, children go through more frequent critical periods in their development. These critical periods are maturation stages in which the individual is particularly sensitive to stimuli in their environment. Teaching certain concepts in these formative years pays dividends in the long run.

Additionally, the earlier a child learns critical and age relevant behaviors and skills, the more productive and meaningful their time at school will be. The child will be able to access more of the curriculum if the necessary prerequisite skills are targeted early on. For example, a child who is taught to raise their hand to ask for help, initiate a social play interaction, and count from 1-10 during ABA therapy may gain the ability to absorb more from the academic and social environment at the school setting.

Research supports an early start for ABA therapy

Research shows that a child who starts ABA therapy in childhood has the potential to make significant improvements and emphasizes that ABA therapy is most effective the earlier it begins. Access to inclusive educational settings in a mainstream classroom is among the significant long term gains made by children who received early access to ABA therapy.


Start ABA therapy

Benefits of Starting ABA therapy early

Research indicates that early intervention can improve challenging behaviors and children’s overall development. Another reason early intervention is important is to ensure that challenging behaviors are addressed early on so that they do not have the opportunity to become entrenched with age. Without an individualized, function-based intervention plan, challenging behaviors can become worse (e.g. increase in frequency, duration, and severity) over time. This is because reinforcement, over time, can strengthen behaviors. If a young child is constantly engaging in challenging behaviors, without a behavior plan in place, those challenging behaviors may be inadvertently reinforced, therefore contributing to the possibility that they may worsen over time.

Early intervention provides the skills necessary to set the child up for long term success. The more skills a child is equipped with early on, the more of their social and learning environments they will be able to access as they grow. In fact, teaching “pivotal behaviors” and “behavior cusps” are a crucial component of ABA programs, particularly during earlier stages of the ABA program. While these two terms are related, they refer to behaviors that, when learned, result in new and positive changes across many areas of a child’s life.

It’s never too late to start ABA therapy

While there are significant benefits to starting ABA therapy as early as possible, there is a point at which it is “too late” to start. ABA programs are highly individualized to the needs of the learner and Behavior Analysts take into consideration numerous factors when designing an ABA program. These will include the learner’s current behavioral, social, academic, communication, self-help, and other needs from different curricular areas. This is why many individuals benefit from ABA therapy even when starting a program later in their development.

Therefore, while “earlier is better” is the common recommendation by most clinicians, ABA therapy can benefit many learners at various stages in their development due to its emphasis on individualization.

Starting ABA therapy to prevent your child’s autism from getting worse

Can the symptoms that define an autism spectrum disorder (ASD) diagnosis get worse?” The answer is yes, but, with the right ABA therapy provider, the symptoms can get better.

For families that are just now starting their ABA-based therapy services at home and/or in a school setting, it is crucial to identify what these symptoms or difficulties are exactly. Upon identifying, assessing, planning and implementing proper treatment programs, these symptoms can be either directly or indirectly addressed by the ABA services. With proper guidance of a BCBA, a sound comprehensive treatment plan may facilitate gains over a targeted amount of time.
A child or adult with autism spectrum disorder may have limited, repetitive patterns of behavior, interests or activities, including any of these symptoms:

  • Performs repetitive movements, such as rocking, spinning or hand flapping
  • Performs activities that could cause self-harm, such as biting or head-banging
  • Develops specific routines or rituals and becomes disturbed at the slightest change
  • Has problems with coordination or has odd movement patterns, such as clumsiness or walking on toes, and has odd, stiff or exaggerated body language
  • Is fascinated by details of an object, such as the spinning wheels of a toy car, but doesn’t understand the overall purpose or function of the object
  • Is unusually sensitive to light, sound or touch, yet may be indifferent to pain or temperature
  • Doesn’t engage in imitative or make-believe play
  • Fixates on an object or activity with abnormal intensity or focus
  • Has specific food preferences, such as eating only a few foods, or refusing foods with a certain texture


When to start ABA therapy

Untreated autism spectrum disorder symptoms worsen over time

There are some conflicting studies about autism and the prevalence of symptoms over time. That said, as with any symptom, untreated autism spectrum disorder symptoms will get worse over time. It is important then for families who have not yet received any prior ABA-based services to seek ABA therapy services in order to begin the process of managing the symptoms and reducing the learner’s undesirable behaviors. Early interventions have proven most effective in the treatment of autism. Those early interventions not only give children the best start possible, but also the best chance of developing to their full potential. The sooner a child gets help, the greater the chance for learning and progress. In fact, recent guidelines suggest starting an integrated developmental and behavioral intervention as soon as ASD is diagnosed or seriously suspected.

Families who previously received ABA therapy services may find themselves in a future position where they are having difficulty addressing the behaviors of their now older learner. Those families need to again seek out ABA therapy services to effectively address their child’s more current needs.

Related Glossary Terms

Other Related Articles

Podcast

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

Working Memory and Autism

Is there a relationship between working memory and autism? Children with autism may appear inattentive or disinterested in their surroundings. However, research has shown that their brain structure differs from that of their peers. Specifically, the prefrontal cortex (the region responsible for working memory) is significantly impacted in children with autism with increased gray matter volume. This connection between an abnormal prefrontal cortex and autism suggests a potential link between working memory and behavior. In a school setting, working memory plays a crucial role in learning. Therefore, it is possible that the difficulties children with autism face in learning and adapting may be related. Understanding how children with autism learn and develop is an essential step in addressing their unique needs.

This article will cover

Autism and Working Memory

What is working memory?

Short-term memory, or working memory, helps us with executive functioning; this includes decision-making, task control, reasoning, and behavior regulation. It is necessary for processing information and managing multiple tasks simultaneously. This memory type helps children briefly remember information and use it to complete tasks. Working memory allows them to recall details from their environment, such as instructions, conversations, and visual imagery. It is vital for problem-solving skills and understanding cause-and-effect relationships.

For example, reading is a complex skill that requires coordinating various tasks, such as higher and lower-order reasoning. It involves decoding, activating word meanings, understanding arrangement, referencing prior knowledge, guessing unknown words, processing overall meaning, situating in context, and retaining comprehension. Children with autism face challenges in comprehension.

For children with autism, working memory deficits can both be a cause and a consequence of their difficulties. Working memory helps children process language, understand instructions, and plan task completion steps. Without the ability to access prior information or maintain focus on current tasks, children with autism may have difficulty following directions, comprehending conversations, or recalling essential facts.

Some challenges for a child with autism and working memory

Autism refers to a group of complex neurodevelopmental disorders that impact memory, communication, and behavior in different ways. As with any cognitive function, autism can present strengths and challenges in memory. It is crucial to understand that autism is a spectrum, and memory abilities and challenges can vary greatly among individuals.

One notable challenge is the difficulty in generalizing information, where individuals may struggle to apply knowledge learned in one context to different situations. The struggle is real when it comes to generalizing information. It’s like trying to fit a square peg into a round hole – sometimes, what we learn in one context doesn’t seem to apply in other situations. It’s like trying to teach a fish to ride a bicycle!

One hurdle that children with autism face is the art of seamlessly transitioning between tasks or activities. Their minds become stuck in a specific gear, making switching gears or adapting to new routines more challenging.

In addition, one might find themselves stumbling through social cues and struggling to decipher the hidden messages and unspoken signals accompanying human interaction.

Furthermore, children with autism may find it challenging to understand abstract concepts, as they tend to prefer concrete and tangible information.

The intricate workings of a child’s memory, particularly those with Autism Spectrum Disorder, are like a captivating puzzle waiting to be solved. Regarding working memory profiles, it’s fascinating to discover that high-functioning children might surprise us with their above-average verbal memory skills while low-functioning children might face challenges similar to those with specific language impairments. Let’s not forget, in the grand scheme of things, low-functioning ASD children often find themselves with a working memory that pales in comparison to their typically developing peers.

Learning Strengths of Children with Autism

The visual-spatial working memory profile does not show any deficits, which is why individuals with this profile perform well with visual cues such as pictures, visual activity completion boards, visual schedules, etc. Using visuals for children with autism can help reduce stress and anxiety that may arise during transitions between events throughout the day.

Visual-spatial working memory is an area of strength for those with autism. This type of memory refers to the ability to remember and recall visual images, spatial relationships, spatial orientation, and information contained in diagrams. It also includes the ability to manipulate objects in a three-dimensional space. Individuals with this type of working memory profile may recognize patterns easily and work out problems visually rather than verbally.

Another strength that individuals with autism possess is a strong capacity for attention to detail and the ability to focus on specific tasks and activities without becoming easily distracted. This can help children with autism stay focused when presented with difficult or tedious tasks that require concentrated effort and attention to detail. In addition, children with autism may be able to remember information more accurately than their peers due to their strong capacity for detail-oriented tasks.

Learning the strengths of a child with autism can help parents, teachers, and other caregivers better understand how to support them. By understanding their individual strengths, educators can create an environment that encourages learning by playing to those strengths. For instance, a child may be mainly engaged when presented with visual material or in music and art activities.

Working Memory and Autism

Visual Aids strengthen Procedural Memory

Procedural memory is a type of long-term memory that enables recalling tasks without conscious thought, such as walking, riding a bike, or driving a car.

When it comes to tasks, the more the child can describe the sequence, the more natural the task becomes, as it becomes part of their implicit/unconscious memory. In terms of events, the more the child can describe and demonstrate them, the easier it is for them to pay attention to details. This process strengthens their declarative memory, which is more explicit/conscious.

Repetition is an effective method for transferring information from short-term memory to long-term memory.

5 techniques ABA programs might use based on where the child is on the spectrum:

  1. Forming habits through incremental learning and repetition
  2. Using visual cues
  3. Memory Games
    • Sudoku
    • Match the cards
    • What’s missing?
    • I went shopping…
  4. Creating stories – Children on the spectrum can learn and remember lessons if they are told in the form of a story.
  5. Documenting events with pictures – Episodic memory helps remember past experiences from one’s life. Revisiting these pictures and rereading their descriptions helps them reconnect the memories and boost overall recall.

Discover the perfect learning strategies that will unlock your child’s potential! Adapt, practice, and adjust to their unique needs. And remember, if you ever feel stuck, seek professional help to ensure their success!

Working memory and autism

How ABA programs help with learning rates

ABA program is designed to teach concepts by breaking them down into simple teachable steps in a distraction-free environment, such as in their bedroom or a quiet room in the house.

For example, it may be too difficult for a child with autism to learn to count from 1-10 at once. Therefore, each number in the sequence will be taught one by one, at the pace of your child’s learning (chaining). On Monday, they may learn the number ‘one,’ on Tuesday, if they still maintain the memory of the number “one,’ they will be taught the number ‘two,’ on Wednesday if they still retain the memory of numbers ‘one’ and ‘two,’ they will be taught ‘three,’ and so on. While this may seem like a prolonged learning rate, a child will be introduced at the rate they can learn.

With a deficit in working memory, it is essential to note that clear, concise, and simple instructions are typically more effective in producing effective learning opportunities. This is why simple and straightforward language is often used in ABA programs.

For example, the instruction, “point to number 1” is a much more straightforward instruction than “can you please point to the piece of paper that has the number 1 written on it?” and, therefore, is more likely to produce the desired response.

However, it is also important to note that with continued success, as attention and learning rates increase, language and instructions should be modified to include more complexity. This will help to promote generalization.

Children with autism typically need to not only learn in small steps but also require much repetition until the skill comes easily to them.

Therefore, in an ABA program, the learning environment is structured to allow as much repetition as a child needs while maintaining their motivation and interest in learning. When children begin ABA programs, they may need many repeats of the concept before learning or mastering it. However, it is expected to find that over time, as a child learns “how to learn,” these repetitions become fewer and fewer, and learning rates increase. Some describe these phenomena as “learning to learn.”

LeafWing can partner with you to help your child reach their full potential. Leafwing focuses on building a solid relationship between the learner and the therapy team, especially at the start of the ABA therapy program. The staff works on developing a positive connection with your child, which is essential throughout the program. In the first few weeks, play and conversation will make your child feel comfortable and enjoy their time with the Behavior technician. This creates positive experiences and enhances learning for better results.

Related Glossary Terms

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Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?