Autism learner

ABA Therapy at Home


Applied Behavior Analysis (ABA) therapy can be effectively implemented at home with proper planning and guidance, often involving behavior technicians who come to your home at specified times to work with your child. The length of the therapy sessions will be determined based on recommended treatment hours.

Let’s discuss some considerations and steps of ABA therapy in a home setting:


ABA Therapy at Home

Considerations of ABA Therapy Services at Home

ABA therapy at home services provides an invaluable resource for children and families who are looking to benefit from Applied Behavior Analysis (ABA) interventions. ABA is a type of therapy that focuses on using positive reinforcement and other behavior modification techniques to achieve desired behavioral changes in children. When considering ABA therapy services at home, there are a few important points to consider:

Consultation with a Professional: It is advisable to consult with a qualified behavior analyst who has experience and specializes in ABA therapy. They can assess your child’s unique needs, develop an individualized treatment plan, and provide the necessary guidance throughout the process.

Create a Structured Environment: It is helpful to establish a structured and organized environment at home to support the progress of therapy. This can include designated areas for different activities, visual schedules, and clear boundaries. However, this can also vary in treatment if the professional you are working with wishes to work on the generalization of therapy by varying the location in your home. That being said, whatever area is used for therapy, that area should be conducive to therapy.

Identify Goals: Work with the behavior analyst to identify specific target behaviors or skills you want to address through ABA therapy. These can be related to communication, social interaction, daily living skills, or reducing challenging behaviors.

Develop a Reinforcement System: ABA therapy uses positive reinforcement to encourage desired behaviors. Create a system of rewards or reinforcers that motivate your child. This can include verbal praise, tokens, small treats, or access to preferred activities or toys.

Implement Teaching Procedures: ABA therapy often uses discrete trial training (DTT) or naturalistic teaching strategies to teach new skills. These methods involve breaking down skills into small, manageable steps and providing repeated practice and reinforcement.

Treatment Consistency: Consistency is crucial in ABA therapy. Implementing the therapy techniques consistently across different caregivers and environments over time will yield the best results. Repetition can be necessary to ensure that a skill is learned and helps solidify skills, so your Board Certified Behavior Analyst (BCBA) will ensure regular practice and review sessions are planned for.

Data Collection: Keep track of your child’s progress by collecting data on their behaviors and skill acquisition or perhaps your treatment team will also handle this. The data that is collected helps evaluate the effectiveness of the therapy so that the therapy team can make necessary adjustments to the treatment plan as needed.

Collaboration and Training: Involve other family members or caregivers in the therapy process. For example, grandparents, adult children, and others who have or have had a hand in raising your child. The BCBA will collaborate with those individuals to ensure consistency among everyone and provide them with training on ABA techniques so that they can follow the treatment plan and support your child’s progress.

Generalization and Maintenance: The Board Certified Behavior Analyst (BCBA) and the treatment therapy team will help your child generalize the skills learned during therapy to other settings and situations (e.g., the grocery store). The BCBA will develop a plan to practice the learned skills in different contexts and gradually fade prompts and supports to promote independence and maintenance of skills.

Ongoing Communication with Professionals: Regularly communicate with the behavior analyst or therapist to discuss progress, address challenges, and receive guidance. They can provide ongoing support and adjust the therapy plan as needed. Additionally, if you also have your child receiving speech therapy or occupational therapy, all of those professionals should be communicating about therapy.

Remember that ABA therapy should be personalized to meet your child’s specific needs and should be implemented in a compassionate and supportive manner. The field of ABA is moving to an even more positive treatment approach. Working closely with your ABA professional and maintaining open communication to help ensure the effectiveness and success of ABA therapy your loved one receives at home.

Behavior Therapist at In-Home Service

Benefits of LeafWing’s ABA Therapy at Home for your child with autism

ABA therapy at home, provided by LeafWing Center, offers a variety of benefits for children with autism. ABA, or Applied Behavioral Analysis, is an evidence-based approach to helping children with autism develop essential skills and behavior management techniques. With LeafWing’s ABA Therapy at Home program, caregivers can have the support and guidance of an experienced ABA therapist in their own homes.

Here are just a few benefits of In-Home ABA Therapy:

Familiar Environment: In-home services may be more beneficial for children who struggle in large settings and could benefit from the familiar environment of their home. Meeting the therapy team in a comfortable space can make it easier for some to adapt to therapy and reduce distractions during skill-building.

Observe daily routines: The behavior technician can gain valuable insight into family systems, dynamics, and routines when they work with your child from home. This understanding of the natural home life can support caregivers in creating goals and building impactful skills for the child and family.

Experience personalized support in the comfort of your own home: Behavior technicians can provide care in the home, allowing them to address skills and behavior strategies in the child’s real-life settings. Home settings offer more opportunities for training in independent daily living skills and can help children function more independently and generalize those skills quicker than learning in a center.

Addressing challenging behaviors that occur exclusively at home: Children may exhibit different behaviors at home compared to daycare or preschool. For example, they might wander or act aggressively only at home. They may also struggle when certain individuals are present, like their dad or grandma. In these cases, offering in-home support allows us to identify the underlying causes and directly address these behaviors.

Stronger bonds with loved ones: By serving in the home, technicians can spend more time with siblings and facilitate family interactions to help children strengthen their social skills.

An emphasis on behavior intensity: In certain cases, when a child’s behaviors are extremely intense and impede progress at the centers, in-home therapy may be a more appropriate choice. This allows the technician to collaborate with caregivers and develop a plan to address the behaviors before focusing on acquiring other skills.

Boost motivation: In-home therapy has the benefit of using familiar spaces, toys, and family members as reinforcers. For example, therapists can use backyard play as reinforcement, which is not typically available in a center setting. Additionally, therapists can teach caregivers to understand and use reinforcers as motivators. By coaching caregivers on how to use items at home for reinforcement effectively, it becomes easier for them to increase motivation on their own.

Advantages of ABA Therapy at Home Services for Parents

Advantages of ABA Therapy at Home Services for Parents

ABA therapy programs are effective in providing training to the learner’s parent or caregiver.

Easier access to caregiver training and coaching: Autism therapy impacts the whole family. LeafWing’s programs offer caregiver training and family education. Therapists can come into the home and involve caregivers in daily routines. They can also teach strategies for addressing behavioral issues. This helps with relational skills development and success.

Convenience: Our in-home service options provide convenient therapy without the need for travel, saving time for our families. This is particularly beneficial for caregivers who work from home.

Flexible, tailored hours: Leafwing Center customizes the in-home therapy schedule, considering medical recommendations. They offer comprehensive full-day programs as well as focused part-time therapy.

Insurance Coverage

How to Get Started

The first step to receiving home-based ABA therapy is to obtain an official autism diagnosis from a healthcare provider. Contact any of our locations to schedule an assessment.

Insurance Coverage for ABA Therapy

LeafWing Center works with an ever-growing number of insurance providers who cover ABA therapy for the treatment of autism. Here are just a few of the providers with whom we work with:

  • Aetna
  • Anthem Blue Cross of California
  • Beacon Health Options
  • Beacon Health Strategies
  • Blue Cross/Blue Shield of Illinois
  • Blue Cross/Blue Shield of Texas
  • Blue Cross/Blue Shield of Washington
  • Blue Shield of California
  • Blue Shield of California Promise Health Plans
  • CalOptima Direct (Orange office only)
  • CIGNA
  • Comprehensive Care Corp./Advanzeon Solutions Incorporated
  • Comprehensive Behavioral Care Incorporated
  • LA Care (Sherman Oaks office only)
  • Magellan
  • MHN Managed Health Network Incorporated
  • Molina Healthcare of California
  • Health Plus aka Multiplan
  • Magna Care aka Multiplan
  • Managed Health Network Incorporated aka MHN
  • Meritain Health
  • Optum UBH
  • Optum Health Behavioral Solutions
  • Pacific Care Behavioral Health
  • SCS-UBH aka Optum/UBH
  • United Medical Resources
  • United Health Care
  • Windstone Behavioral Health

If your insurance provider is not on the list, we recommend you contact them directly to learn more about their coverage. Please contact LeafWing Center if you have any questions about whether or not your provider offers insurance coverage for ABA therapy to treat autism.

After the assessment is complete, and your funding source has authorized ABA services, your provider will assign a team for your child. This team will include a supervisor and one or several Behavior Technicians. Expect to receive a schedule of services before the beginning of each month. Additionally, expect your ABA provider to reach out to you to receive your availability for services and to create a schedule that best fits your loved one’s needs.

Our team of healthcare professionals assists parents with every step of the process, including insurance verification and creating a weekly therapy schedule.

Unlock your child’s potential! Here at the LeafWing Center, we provide personalized care in the comfort of your own home, allowing us to address crucial skills and behavior strategies within your child’s natural environment. From getting dressed to participating in family mealtime, our experts will help your child thrive independently and quickly generalize their newfound abilities. Say goodbye to simulations and hello to real-life progress!

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 [email protected].

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 to do before and after telling your child with autism “No”

What to do before and after telling your child with autism ‘No’

What should happen before and after telling a child with autism ‘no’? Telling a child ‘no’ can be a difficult task for any parent or caregiver. The child may still be in the process of learning the concept of ‘no’. It’s possible that it hasn’t been enforced consistently in the past, resulting in a lack of understanding on the child’s part. Additionally, the child may believe that ‘No’ means they will never have access to the object or activity again, rather than realizing that it simply means they can’t have access at that particular moment. Children don’t always have a full understanding about why they are being denied what they want even if it is a harm to their safety. This can also seem like a monumental task for a parent of a child with autism. Children with autism can have a hard time processing big emotions and being told ‘no’ can produce multiple emotions of anger, sadness, and frustration.

Furthermore, during a typical school day, some objects or activities may not be available to the child, such as restricted computer use or not having access to a preferred toy while working. This can lead to challenges for the child in accepting the situation and potentially exhibiting negative behaviors.

Both parents and teachers face the obstacles of teaching a child how to cope when hearing the word ‘no’. So, what should you do before and after telling your child with autism ‘No’:

Before:

After:

What to do before and after telling your child with autism “No”

Think of an alternate saying before you tell a child with autism no

Before saying ‘no’ to your child, it’s important to avoid using that exact word. Simply saying ‘no’ can lead to negative behaviors. Instead, find a different way to explain why the answer is no.

For instance, if your child wants something at the grocery store:

Instead of saying: “No, you cannot have that!”
Say: “That’s not on our list today”.

This helps your child understand that the no is not a punishment and may happen at another point. You may even want to explain your reasoning through a social story to help the child understand why they cannot have access to a desired object or activity at a specific time. It’s especially helpful for children with autism. Remember to positively reinforce when the child stays calm and accepts ‘No.’

Consider the various meanings that can be conveyed by the word ‘No’:

  • You can’t have that right now.
  • You are not allowed to do that.
  • We are not going there today.
  • Danger.
  • Stop.
  • Don’t touch that.
  • Maybe.

What to do before and after telling your child with autism “No”

Give a Visual before telling a child with autism no

Children with autism do very well with visuals in all aspects of their lives, being told no is no exception to this. Visuals can be used in a first/then method. This works when you want to say no for right now. So maybe they want to play a game or do something fun but they need to finish homework. You’re not saying no to something fun forever but you need them to finish a task that is important beforehand. This is similar to what their typical peers’ parents go through as well. So, using a first/then chart is helpful to show a child with autism that they can have what they want after they have completed the assigned task.

Another way a visual could be used is through a Social Story. Social stories are a great way to teach a no that might put a child in danger such as not touching a hot stove or not running across the street while there is traffic. A social story could be used to show pushing the button to cross and then waiting for the light to tell them to cross. This shows a child that one action will always be a no (running across the street when it is not safe) and give them an alternate action to take to avoid the no (waiting for the walk symbol).

Allow time for a child with autism to process after telling them no

As with any child being told ‘no’ or ‘not right now’ can create a difficult emotion that they have to process through. It’s a fact of life that we cannot always have or do what we want when we want. However, it takes time to learn the skill of getting a no and moving on without causing a major undesirable behavior. Allowing time for children to process being angry and upset will teach them to deal with the emotion easier the next time. Just like any skill it can take time to practice, it will get easier the more the child understands a no and knows what they can do after.

Giving alternates after telling a child with autism no

A good way to help a child process being told no is to give them an alternative. For example, say a child wants a snack of chips, but it is close to dinner. Instead of saying no and being final, you could say chips aren’t an option right now, but you can have grapes or carrot sticks. This gives a child a choice of an alternate option to something they want while you’re still saying no to their original request. Giving an alternate option is a great way to help a child process through the ‘no’ quicker because now they have a choice to make and it seems to them that they are still getting something that they like.

Points to consider when telling a child with autism to accept the words ‘No’ or ‘Stop’

They have a:

  • strong drive toward favorite objects/activities
  • limited understanding of the concept of ‘No.’
  • difficulty in following verbal instructions
  • lack of understanding of why access is denied

Remember, telling a child with autism ‘no’ can seem like an obstacle to a task. However, knowing what to do before and after can make the process easier on everyone involved and the child learns that sometimes a no happens and it’s nothing to be overly upset about as there could be alternate options for their request or their request could be fulfilled at a different time. It is important to provide positive feedback when a child remains calm and accepts the response of ‘No.’

The Leafwing Center offers services to teach children the skill of accepting the word no, which can be reinforced at home. ABA therapists will create personalized plans based on the child’s ability level and are trained to address the behavior that comes with teaching the skill of accepting the word no.

Additional Resources

Glossary Terms

How to teach your child with autism to wait

How to teach your child with autism to wait

Parents often ask how to teach their child with autism to wait, as waiting is a part of everyday life. Waiting in lines, for food, or at stop lights is natural. However, waiting can be difficult for the average child, who may feel like waiting equals not getting what they want. For a child with autism, waiting can be even more challenging as they may struggle with understanding what it means to wait and how long it may take. However, there are a few ways to teach a child with autism how to wait, these are:

  • Practicing Waiting
  • Visuals
  • Social Stories
  • Distinguish between waiting and unavailable


How to teach your child with autism to wait

How do you practice the skill of waiting?

One of the first things in teaching your child with autism to wait is to practice waiting. Being able to practice waiting in low-stakes situations can help a child build up the stamina for waiting. Do not let a child’s first experience be out in public or in an unfamiliar place as they will need to process their emotions when it comes to waiting and it can be a stressful situation for everyone. Practice waiting at home so a child with autism can have a safe space to process the frustration or anger that can come with the activity of waiting. When they ask for their favorite treat, ask them to wait for two minutes the first time and explain why we have to wait. Continue to build up the time to practice them waiting and increase their stamina for waiting.

Also, it is important to create a trusting and safe environment for your child with autism as this can help with waiting. Make sure to reward them for their patience and explain the consequences when they do not wait. Give them choices between two activities or items that can help them understand why one has to wait, such as allowing them to choose which toy they get first and the other one after they’ve waited.

How to teach your child with autism to wait

Wait Visuals for autism

Visual aids can be helpful for children with autism to learn and process new tasks. These aids may include timers or wait symbols to indicate waiting periods. The timer helps the child understand that the wait will end and they will receive what they want. If there are other children present, a wait sign acknowledges the child with autism’s needs and communicates that attention will be given as soon as possible. This reassures the child that they have not been forgotten.

It’s also important to remember that for a child with autism, it might take longer for them to process the instructions of having to wait. So, it’s best to give them enough time and repeated reminders if necessary. The goal is to teach your child the ability to pause and think before responding rather than impulsively reacting.

You can practice this by:

  • role-playing scenarios with them
  • using visual cues
  • rewards

When teaching your child with autism to wait, it’s important to remain consistent, patient, and understanding. It can be helpful to provide visual cues like a timer or picture that shows how long the wait time is going to be.

Use verbal reminders:

  • Count down from 10
  • Repeat instructions in smaller chunks

Additionally, positive reinforcement such as praising your child and offering rewards for successful waiting can help encourage desired behavior. For example, if your child is able to wait a certain amount of time before asking for something, you can reward them with extra playtime or a special treat. It’s also important to stay calm and provide positive reinforcement during times when the waiting process gets difficult. Being consistent, understanding, and reinforcing good behavior teaches your child with autism to wait can be difficult, but the end result is a reward that they desire.

Wait Social Stories for autism

Social stories are a way to teach children with autism to wait. They use visuals and characters to depict real-life experiences. For instance, waiting in the grocery store can be addressed with a social story. The story can feature a child with the same name as the real-life child waiting in line for check out at a specific grocery store, even including the name of a cashier.

A good social story would include:

  • The who
  • The what
  • The where
  • The why
  • Should be written in a positive manner (what should happen instead of what not to do)
  • Include real-life feelings the child could face in that situation

The story should be written in the first person and should include visuals of the child waiting in line, interacting with the cashier, and getting their food. It can also include a few sentences about how long it took for the checkout process to finish. The social story should end with a positive outcome that reinforces to the child that waiting is an important skill to have and something they can do.

Distinguish between “wait” and “unavailable”

When teaching your child with autism to wait, it is important to help them distinguish between “wait” and “unavailable.” Waiting can be a difficult concept for someone with autism to understand, but it is essential for their development. To make the distinction clear, explain that waiting means that something will happen soon and that they should remain patient until it does, whereas unavailable means that it won’t happen at all or not for a long time.

Unavailable:

For example, let’s say your child wants cereal for breakfast but you are out of their favorite cereal. You would not want to teach the wait skill here because they are not going to be getting their cereal. Therefore you must show them that unfortunately, they are going to have to pick something else because their cereal is currently not available in the house. You can do this by showing an empty container to show that the cereal is all gone.

Waiting:

Teaching the skill of waiting only works when there is something for the child to receive at the end of the waiting whether tangible or not. This could be the item they wanted to eat or buy or going to the park or leaving the grocery store for home.

Teaching the skill of waiting can be very beneficial to everyone involved. It can prevent meltdowns and undesirable behavior from occurring. Additionally, waiting is a skill that everyone has to learn and put to use in everyday life. Similarly, to their peers, children with autism can struggle at first with the skill of waiting. Therefore, teaching a child with autism to wait through practice, visuals, and social stories can improve their waiting endurance.

The Leafwing Center offers services to teach children the skill of waiting, which can be reinforced at home. Two common difficulties that we encounter when working with families over the years are regarding waiting and when a child is told no.  These two scenarios can be overwhelming as they are often accompanied by the most intense challenging behaviors. ABA therapists will create personalized plans based on the child’s ability level and are trained to address the behavior that comes with teaching the skill of waiting.

Other Related Article

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 [email protected].

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?

Strategies to use for the park with your child with autism

There are some simple strategies to use when going to the park with your child with autism. Going to the park can turn into a nightmare quickly if the child with autism starts to feel overwhelmed or surprised. Many parents don’t take the necessary steps to help minimize the meltdowns of children with autism and run into barriers when taking their children out into the community.

Strategies to Help You Go to the Park with Your Child with Autism

Challenges for children with autism at the park

The park is one place where children typically enjoy their freedom and thrive, which can be a nice relief for many parents. Although, for parents of children with autism, this can be a stressful situation for many reasons.

  • Children with autism may not have the social skills to play with other children and they may not interact in ways that are socially appropriate.
  • Some children might have the tendency to run or wander away (elope).
  • Other children may have difficulties with transitions and therefore, leaving the park is always a struggle for the parent of a child with autism, more so than that of a parent of a typically developing child.

Nevertheless, there are some strategies for parents of children with autism to practice to help relieve some of these stressors and make the park a more enjoyable experience for everyone.

How parents can prepare children with autism for the park

The key to going to the park is to plan and prepare ahead of time. Give lots of warnings to help minimize the meltdowns. Predictability allows the child to feel more secure. When they feel uncomfortable and out of control is when the meltdown is triggered.

Tips on how to prepare:

  • Let the child have a say. Ask them what they would like to try first at the park.
  • Share the schedule. Let them know what to expect. If transitions are difficult, let your child know from the time of arrival how much time he or she will have at the park. Have a visual countdown (e.g., boxes that are crossed off every 5 minutes) until it is time to leave. If your child prefers electronics and timers, start a timer on a phone or electronic device instead.
  • Stick to the schedule. Prepare to leave. Have an exit strategy. Provide reminders when time is almost up, so your child is not “surprised” when it is time to transition. When time is up, it helps to have something positive that your child can look forward to after the park (e.g., frozen yogurt, pick up brother, dinner, or treat in the car).
  • Start small. Try not to overload them by having them try everything at the park. Take one thing like the swings and show them how you use the swing.
  • Bring identification. If your child tends to wander or run away you might want to consider having identification. You might tell yourself that you will be close by, but it is always better to be safe than sorry.
  • Facilitate the play. Consider sparking interest in your child for other people, activities, toys, and conversations by pointing these out in his or her environment: “Wow, those kids are going down the slide really fast, that looks fun!” or “That boy has a really cool race car, maybe you can ask to see it?” These are minimally intrusive ways to promote engagement with surrounding people, objects, and activities.
  • Prepare a To-Go bag with calming tools.
    • Sunglasses
    • A wide-brimmed hat
    • Fidget toys
    • Stuffed toy
    • Chewing gum
    • Weighted blanket
    • Bottled water and healthy snacks

With repeated exposure and positive interactions with people and activities at the park, your child’s positive engagement at the park may be reinforced over time. In other words, it may get stronger, and more frequent, and trips to the park can turn into something he looks forward to.

Strategies to Help You Go to the Park with Your Child with Autism

How ABA therapy can help with your park experience

Kids learn through play. ABA therapy can build the skills children need to play by incorporating naturalistic teaching. We want them to experience a park setting in a safe environment and how to use the equipment at their own pace.

ABA therapy can help with:

  • Taking turns
  • Use equipment appropriately
  • Following directions

We hope that these strategies may help relieve some of the stress associated with going to parks and both you and your child can enjoy and have fun!
Don’t stress yourself out if your child does not enjoy being at the park. It is fine. It may not be a good fit. Don’t push the issue. Find something else that your child feels comfortable participating in that offers sensory-friendly activities like museums, theme parks, or movie theaters. Just make sure they are having fun during their playtime.

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 [email protected].

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?

Traveling with your child with autism

Traveling with your child with autism anytime soon? Does it involve a long car ride? It’s time to start planning how to keep your child busy and how to make the long drive as enjoyable as it can be. Some children with autism may do really well on car rides as it provides them with time to do enjoyable things such as looking out the window and watching the trees and other cars go by. Some may enjoy listening to the music in the car, or even sleeping throughout the trip! Other children may not do so well and parents may run into troubles such as crying, screaming, kicking seats, and even trying to get out of seat belts. Regardless of how easy or how difficult your car rides are, some of the below strategies may assist with making the ride a bit more enjoyable.

Traveling with your child with autism

Preparation before traveling with your child with autism

We all prepare in some fashion before taking a trip and it is no different when traveling with your child with autism. The unknown can be scary. Prepare your child for the trip.

What to discuss with your child with autism before the road trip

  1. Talk with your child about the purpose of the trip.
  2. Talk about where you are going. You might create social stories to present this information more clearly with visuals. Remember, any type of visual support will reduce anxiety and increase interest.
  3. How long it will take, and the stops along the way. Use schedules, maps, and even photo albums to help understand where you are going and whom you will see.
  4. Make it clear why you’re taking this trip together.

Keep it positive as something to look forward to. Prepare a snack bag as well as a toy bag ahead of time so you have food when your child is hungry and toys when your child is bored. Toys such as drawing boards, electronics (iPad or similar device) on which the child can play games or watch movies, travel games such as perfection, and books may work well to keep your child occupied.

What to bring on the trip

  • Hand sanitizer
  • Flushable wipes
  • Extra batteries and chargers
  • Changes of clothing in case of accidents
  • Plastic bags
  • Medicine for nausea or other physical ailments
  • Extra headphones

Traveling with your child with autism: Safety Tips

Before you leave your driveway remember to switch on the child lock so that the rear door cannot be opened from the inside. If your child is someone who tries to get out of the seat belt, then you may consider getting covers or locks for the buckles in the backseat. Also, make sure that the child’s car seat is installed correctly. You can also make the car seat more comfortable for the long car ride by adding more padding under the seat cover.

Traveling with your child with autism

Strategies to use throughout traveling with your child with autism

Remember to be realistic. Your child may need to take some regular breaks and be able to get out of the car to stretch or run around. Look for signs that your child may be anxious, such as body language, and take pit stops as needed. Take extra time if needed and break the trip up if possible. Plan to spend the night in a hotel, or take the scenic route and turn it into a mini-vacation where your family can enjoy a few sights along the way.

Planning out the mileage of the trip and dividing that mileage up into small chunks can be very helpful. If you are driving 300 miles, break this up into 10 chunks of 30 miles (or even 20 chunks of 5 miles, depending on how often your child may need positive reinforcement for good behavior). Every 30 miles that your child behaves well (define this for your child such as sitting nicely, no screaming, and no kicking) he or she is allowed to pull a prize out of a prize bag that you have prepared ahead of time with treats, small toys, and special items that your child will enjoy. Children with autism often dislike uncertainty and that uncertainty often creates overwhelm and behavior problems. To avoid this, draw out squares on a piece of paper so he knows how many squares are left until you arrive at your destination. Possibly make the halfway point a very large prize, if he or she earns it.

Trying to rush travel can lead to more stress and increases the chances for something to go wrong or for you to forget something. Take some deep breaths, relax, and listen to some soft music to help you unwind, especially if you get caught in a traffic jam. The theme is to plan ahead so you and your family can be prepared for the long trek ahead.

Have fun and Bon Voyage!

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 [email protected].

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?

Grocery shopping with your child with autism

Grocery shopping with your child with autism can be quite stressful for parents. A grocery store is a place that can be a sensory overload for your child who is autistic; the bright lights pulsating overhead, low-grade music, people, kids, and carts milling around, water sprayers misting the vegetables, and the coupon dispensers with their blinking red lights waving coupons at eye level just to name a few. Your approach to the shopping experience can make a world of difference for you and your child with autism. It will require some preparation from you to enhance the shopping experience for your child who is autistic. Some simple Grocery Shopping Preparation tips will help to relieve the stress that comes with shopping with your child with autism. However, depending on how you choose to look at it, this routine life skill can also be a wonderful learning experience if parents take the time to follow a few simple strategies.

Grocery shopping with your child with autism

Preparation before your grocery shopping with your child with autism

Before the shopping experience begins, it may be beneficial to state what is expected from your child. Provide clear rules and expectations for the shopping trip.

Suggestions for teaching three crucial parts of a grocery store visit:

  1. Safe walking to and from the car;
  2. Quiet in the car;
  3. Appropriate conduct in the store.

If this is your child’s first time to the grocery store and they are prone to meltdowns, then start small. Allow your child with autism to bring a small toy for comfort. Set a time of how long it will take.

Make a list of items in the order that you walk through the store, either drawn-out, printed out, or cut out from advertisements that your child can keep track of during the shopping trip. Keep in mind that it is hard to backtrack through the grocery store if you have forgotten an item with a child who is autistic. These can be items they prefer and would be interested in tracking and finding. Ask your child to cross out the items or put the picture in an envelope when you both find the item, signifying one step closer to being done with the shopping experience. Another option would be give your child a shortened list without all the items you need to get on it. A simple trick is to save the last item on your list to correlate to your child’s last item on their list so that they can directly relate that the grocery shopping trip is done when they cross out the last item on the list.

More and more grocery stores are trying out what is called ‘Quiet Hour’ which is a more autism-friendly atmosphere for individuals who need fewer distractions and sensory overload. Check out in your area if there are any participating.

Dad and son at the grocery store

Techniques to use while grocery shopping with your child with autism

Get your child involved in the shopping experience by allowing them to push the cart, select and put the items in the cart, place contents on the conveyor belt, and stay near the cashier until the groceries are bagged. Make the shopping experience fun.

Furthermore, use the experience to teach language skills. Grab a green and a red apple and ask your child to identify which one is red. Grab a big and a small can of tomatoes and ask your child to identify which one is bigger. Ask your child to label items that you grab from the shelves, especially preferable items. Based on how advanced your child’s speech is, tailor what you ask of them to their level.

Don’t forget, it is important to provide continuous positive feedback for when your child is participating in the shopping experience. Try not to draw attention to behavior that is not appropriate at the grocery store. This can be accomplished by providing a reward at the end of the shopping experience. When your child with autism masters the basic skills of shopping, reward them by having one of their favorite food items on the list and allowing them to pick it up. For example, if your child loves Hershey candy bars, then put them as the last item on the list and keep reminding them that good behavior then will allow them to have their favorite item. Keeping their “eyes on the prize” encourages them to stay motivated, attentive, and happy.

Have a backup enjoyable activity that your child can engage in while you are completing the remaining part of the shopping trip that is not on their list. A small coloring book, games on your phone, a squishy toy, or some music through headphones may work to keep them engaged.
Lastly, if your child has difficulties walking through an entire shopping experience, allow your child to catch a ride on the shopping cart only if they have walked and helped for a certain amount of time, or when all of their grocery lists are completed. If you base it on time, be sure to have a visual chart (e.g., have 5 boxes, each representing 2 minutes) or timer for them to know how much time they have left of walking.

Assess the grocery shopping with your child with autism experience

Remember to take your child often to the grocery store. Taking them to the grocery store once or twice each week is now part of their routine and something they expect and even look forward to.

Don’t be discouraged based on one trip to the grocery store with your child on the spectrum. Not all trips to the grocery store end in triumph and when things don’t go so well, tell yourself that success emerges from routine and persistence. Trying again (and again and again) is an important part of the learning process for your child with autism. It is important to learn life skills that they will need to know how to do later in life.

We all have good days and bad days and that holds true to our children. You’ll be pleasantly surprised when you see your child starts to take simple steps toward a positive grocery shopping experience as long as you don’t put limits on your time and expectations of your child with autism.

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 [email protected].

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?

Alternative Behavior Examples to Decrease Challenging Behaviors

What are alternative behavior examples? Alternative behavior examples are acceptable or positive behaviors taught to your autistic child to replace challenging behaviors.

Imagine this, your child climbs on the kitchen counter to reach for a box of cookies high in a cabinet. Can you implement a plan to decrease or eliminate the behavior of climbing on the counter? Yes, but simply stopping one behavior is not an alternative behavior example. Frequently, your child will just learn another challenging behavior to get the same result. Your child might yell or throw a tantrum because they want to eat cookies.

Let’s think of alternative behavior examples. An alternative behavior could include teaching your child to appropriately request the box of cookies. This might look like signing “food” or “cookies”, or pointing to a picture of the options in the cabinet. Or, your child may use some other mode of communication based on your child’s repertoire of skills.

Teach Alternative Behavior Solutions

Teach Alternative Behavior Solutions

Alternative behavior examples require teaching and repetition. At first, assist your child when you begin to see the signs of them seeking a snack by guiding them through the physical movements of communicating by pointing, exchanging a picture, signing, or modeling the words they should use. Gradually fade this assistance until they choose the alternative behavior on their own, without engaging in the challenging behaviors.

In practice, it is always best to teach alternative behavior examples. Caregivers can learn to ask, what is an alternative behavior for this challenge? Choosing individualized alternative behaviors that fit your child’s personality will help. Teaching alternative behavior examples can make unlearning the challenging behavior a faster process.

Types of Challenging Behavior in Children

There are four reasons why children may engage in challenging behaviors.

  • Access- to get something the child wants
  • Escape- to get out of doing something they don’t want
  • Attention- to get others to pay attention
  • Self-stimulatory/Automatic- because the behavior itself feels good or pleases them

Your child still needs to access what they want. Choose alternative behavior examples that do lead your child to obtain what they would like—access, escape, attention or self-stimulatory freedom.

Model Alternative Behavior Examples

Let’s say your child screams and throws objects when they are done with their dinner. What is your child seeking? Your child is trying to escape or get out of something—the dinner table. There are a number of alternative behavior examples you might teach your child instead of throwing and screaming.

  • Teach your child to signal that they are “all done” using whatever mode of communication is appropriate for your child.
  • Have your child pass you an acceptable object as a sign that they are finished at the table.
  • Teach your child to point at a picture that represents leaving the table.

It may be helpful for you to model the alternative behavior examples. If you point at the “all done” picture each time you are finished with your meal, your child will observe your alternative behavior example. It is important to allow your child to leave the table immediately, every time they choose the appropriate alternative behavior.
With consistency, challenging behaviors will decrease as your child learns they do get what they would like when choosing an alternative behavior example. As your child gets used to the process, acceptable behaviors become habits and the alternative behaviors become stronger over time.

Decrease Challenging Behaviors

For attention-based challenging behaviors, ask yourself what is something the child should be doing? To choose alternative behavior examples, consider your child’s repertoire of skills. Some children feel as though they are getting your attention even when being lectured or reprimanded about their choices.

When your child engages in a challenging behavior, state the problem in a sentence instead of lecturing. In addition, carve time out of your day to spend more time with your child when they are behaving appropriately.

It’s easy to assume your child should always make good choices while you get work done. Instead, schedule breaks to praise them and enjoy time with your child when they are engaged in appropriate behavior. You can spend time playing a favorite game, watching a favorite TV show or talking about school or life.

Alternative Behavior Examples to Decrease Challenging Behaviors

Manage Challenging Behaviors

When your child engages in challenging behavior because it feels good, this can require the caregiver to put more thought into choosing alternative behavior examples. Choices should include behaviors that are not harmful and tend to be controllable.

For example, your child may engage in repeating words or phrases, or vocalize sounds that are not socially appropriate. What is an alternative behavior that still allows your child freedom? You can allow your child to engage in these behaviors in a particular environment, like their bedroom.

One alternative behavior example is teaching your child to ask for “talking in my room”. This may help you both gain control over where they may engage in this behavior. When your child engages in the self-stimulatory behavior, you can work toward the child using the communication phrase and then going to the specified location. Self-stimulatory behaviors can be very difficult to address on your own, even with alternative behavior examples, especially when the behavior is self-injurious in nature.

Get Help Teaching Alternative Behavior Examples

Each time you find yourself facing a challenging behavior, take a deep breath and start to brainstorm, what are alternative behavior examples? You can make a list of alternative behavior examples to model and try. If one alternative behavior isn’t a great fit, try another alternative behavior example from your list. If you continue having difficulties addressing your child’s most challenging behaviors, it is a good idea to reach out to a trained professional as soon as possible.

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 [email protected].

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?

The Advantages of Applied Behavior Analysis (Podcast Episode)

A team of knowledgeable professionals from The LeafWing Center share their expertise about applied behavior analysis. They discuss the basics of the technique, what a good ABA program entails, reasonable expectations and the many benefits to be gleaned from this type of treatment. This is an in-depth tour of what ABA is and how it works.

Listen to the Podcast Episode here:
The Advantages of Applied Behavior Analysis Podcast

 

 

How to Make a Visit to the Grocery Store a Learning Opportunity for Your Child with Autism

A visit to the grocery store for parents with a child with autism can be quite stressful. On the other hand, it can also be a wonderful learning experience if parents take the time to follow a few simple strategies.

Before the shopping experience begins, it may be beneficial to state what is expected from your child, approximately how long it will take, and what can be expected afterwards. A method to increase motivation may be to state a clear if/then contingency. For example, “Johnny, if you stay next to mom/dad, help pick out your items, then after shopping we can get visit a nearby store you like.”

Make a list of items, either drawn out, printed out, or cut out from advertisements that your child can keep track of during the shopping trip. These can be items they prefer and would be interested in tracking and finding. Ask your child to cross out the items or put the picture in an envelope when you both find the item, signifying one step closer to being done with the shopping experience. Give your child a shortened list without all the items you need to get on it. Save the last item that you get for his list so that he can directly see when the last item is crossed out, you are done!

Have a back-up enjoyable activity that your child can engage in while you are completing the remaining part of the shopping trip that is not on his list. A small coloring book, games on your phone, a squishy toy, or some music through headphones may work to keep him engaged.

Use the experience to teach language skills. Grab a green and a red apple and ask your child to identify which one is red. Grab a big and a small can of tomatoes and ask your child to identify which one is bigger. Ask your child to label items that you grab from the shelves, especially preferable items. Based on how advanced your child’s speech is, tailor what you ask of them to their level.

Last, if your child has difficulties walking through an entire shopping experience, allow your child to catch a ride on the shopping cart only if he has walked and helped for a certain amount of time, or when all of his grocery list is completed. If you base it on time, be sure to have a visual chart (e.g., have 5 boxes, each representing 2 minutes) or timer for him to know how much time he has left of walking.

Hopefully these strategies will aid in creating a productive and enjoyable grocery shopping experience for you and your child!

What should you do IN RESPONSE to your child engaging in challenging behavior?

Remember those four reasons why people may engage in challenging behaviors discussed in the previous post?  People may want attention from other people, may want something, may want to get out of something, or may enjoy how the behavior feels.  If you haven’t already read it, we suggest reading the prior post so the information below is as useful as possible.

This post will focus on reactive strategies, based on the reason your child is engaging in the particular challenging behavior.  In other words, what should you do in response to your child engaging in the behavior?  This is probably the most stressful for parents as they may wonder if what they are doing is right.  They may wonder if they are hindering or helping their child.  Hopefully we can provide some guidance.

If your child engages in a particular challenging behavior to get something that he/she wants, it is important for him to learn that his behaviors do not lead to getting what he/she wants.  You should avoid giving them what they want when engaging in the problem behavior, and even after the behavior ends.  The child should only be allowed to get what they want if he engages in a more appropriate behavior, which we will discuss in a future post. This can be difficult for parents as giving the child what they want quiets them down and relieves much of the stress in the home or community setting.  The problem is that your child will learn this connection and continue to engage in this behavior in the future when they want to same thing. It will become a repeated cycle.

If your child engages in a particular challenging behavior to get out of something, such as homework or eating dinner, it is important to not allow him to get out of the situation until they engage in a more appropriate behavior.  If the child hits and screams while doing homework, it is important to follow through, require them to complete a few more problems without hitting and screaming, and then they can leave.  More appropriate behaviors to get out of doing things they don’t want to do will be discussed in future posts.

If your child engages in a particular challenging behavior to get attention, you should avoid providing attention to them until the behavior is not occurring or he engages in a more appropriate behavior to get your attention.  Providing attention only teaches them that this bad behavior leads to what they want.  This connection needs to be disconnected and the child needs to be taught more appropriate ways to get attention.

Last, if your child engages in some challenging behavior because it feels good, such as head banging, it is important to block this behavior so that this particular behavior does not provide the sensory satisfaction that your child is receiving (in addition to preventing them from doing harm to themselves).  You can physically block the behavior or there are many devices created for this purpose.

Stay tuned for a future post providing suggestions for what to teach your child to do instead of engaging in the bad behaviors they currently know will get them what they want.  Just reacting how we have described above will not teach new, appropriate ways to get what they want.  Teaching a new, more appropriate behavior is the key to decreasing challenging behaviors.

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