Autism and periods

Autism and periods

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

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

We will be discussing

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

Period products

What are periods?

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

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

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

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

When do periods start?

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

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

PMS (premenstrual syndrome)

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

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

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

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

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

Managing your periods when you have autism

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

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


autistic female having period symptoms

Challenges associated with periods and autism

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

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

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

Feelings your daughter with autism may be feeling:

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

Executive function deficiency, including:

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

How to support your autistic daughter with her periods

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

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

Consult your daughter’s pediatrician

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

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

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

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

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

Related Glossary Terms

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Foods to avoid with autism

Foods to avoid with autism



Disclaimer

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

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

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

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

In this article, we’re going to discuss:

Foods to avoid with autism

Foods to avoid for children with autism

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

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

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

Food Ingredients children with autism should avoid

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

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

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

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

best diet for a child with autism

What is the best diet for a child with autism?

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

Beneficial vitamins and minerals:

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

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

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

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

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

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

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

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

Podcast

Additional Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Behavior Functions of ABA Therapy

What are the 4 Behavior Functions of ABA Therapy?

Behavior Functions of ABA Therapy
There are four categories of Behavior Functions: Sensory, Escape, Attention, and Tangible, commonly referred to as S.E.A.T.

When going to an ABA Therapist, they will evaluate a child and put their different behaviors into one of four behavior functions or behavior categories. They are as follows:

This helps the therapist to identify a behavior and a reason the behavior may occur, and then make a plan to either redirect the behavior when it occurs or use other tools within ABA therapy to replace the behavior with a more desired one. Therapists will work with both the parents/guardians as well as observe the child to determine behavior.

By singling out instances of a behavior they can determine where a behavior may occur in a category. For example, if a child asks for a cookie and they are given one, they are likely to ask for one again. An ABA therapist would place this scenario into ‘Access to Tangibles’ as the child is getting the physical cookie to have when asked.

Sensory Integration

# 1 Behavior Functions of ABA Therapy: Sensory Stimulation

This is when a child desires sensory input to help their muscular-skeletal and nervous systems to receive feedback easier. Children with autism have either under-sensitive or over-sensitive bodily awareness to normal input. For example, an itchy sweater can be annoying to an average person and they might get used it to by wearing it more often or ignoring it. However, for someone with autism that itchy sweater disrupts how they feel entirely and their body cannot process the feeling normally so it typically can cause an outburst or it can be the only thing they can think about all day.

For sensory stimulation, children with autism typically do something with repetitive movement. This helps their body receive sensory input feedback easier.

Some examples are:

  • hand flapping
  • rocking
  • touching objects or people
  • making loud noises and vocalizations
  • pen tapping
  • popping a toy in and out
  • twirling an object back and forth

Typically, Sensory Stimulation is fine to occur unless it harms the child or those around them. If that’s the case then the ABA therapist would work to redirect the harmful sensory stimulation to something safer.

# 2 Behavior Functions of ABA Therapy: Escape

Escape behaviors occur when a child with autism is trying to avoid a task or get away from too much sensory input at once. They may actively ignore something by turning their head away or hiding their eyes. They also may leave the environment altogether by walking or running. This can pose the possibility of danger to the child or to those around them. Therefore, it is important to have a designated spot or room that a child can go to that is safe for them when they do need to escape. Many schools have a sensory room that students can escape to that aids them in re-regulating with padded walls, a swing, and other manipulatives for sensory.

In order to reduce the occurrence of escape behaviors, ABA therapy encourages positive reinforcement strategies. By providing a child with rewards and verbal praise, the therapist can encourage them to stay and complete their tasks.

Additionally, prompts and cues can be used to remind a child what they need to do or that they are supposed to stay in one place. If a child is overwhelmed by sensory input, ABA therapy can also work to reduce the intensity of such input by providing more calming activities or a quieter environment.

ABA therapists will also use prompting and fading techniques to help a child learn and retain new skills while reducing their reliance on prompts or cues from the therapist. Prompting is a commonly used ABA strategy that is often paired with fading. These two techniques work together to promote correct responses from the child. Prompting involves employing strategies to encourage accurate responses while fading involves gradually reducing the prompt as the child becomes more familiar with providing the correct response.

Finally, extinction methods are often used in ABA therapy when behavior is particularly difficult to extinguish. Such as when a child does not receive candy when throwing a tantrum, the child gradually decreases the frequency of tantrums until they cease entirely. The learned behavior of throwing tantrums has become extinct.


Boy screaming

# 3 Behavior Functions of ABA Therapy: Access to Attention

This is when a child with autism wants attention from others. This can be especially difficult for children with autism who are non-verbal. Just with their regular peers, attention-getting behaviors can be good or not so good.

Positive attention-seeking behavior:

  • by saying “Excuse me”
  • politely tapping the individual

Negative attention-seeking behavior:

  • crying
  • screaming
  • throwing objects
  • hitting
  • biting

An ABA therapist will work to help those not-so-good attention-seeking behaviors. For children with autism who are non-verbal, it may be beneficial to introduce an iPad or other such electronic device that acts as their words where they can ask questions, request what they want, and be able to appropriately and safely interact with those around them. Children with autism who can speak may still benefit from sheets with different visuals that can aid them in identifying what they want.

The four main behaviors that an ABA therapist might focus on with regard to attention-seeking behaviors are:

  1. Teach the child appropriate ways to request attention through modeling. ABA therapists will model expected behaviors and help the child learn and imitate those behaviors. This can be done through verbal and/or visual cues, depending on the child’s abilities.
  2. Replace inappropriate attention-seeking behavior with positive reinforcement such as verbal praise or rewards like a toy or a sticker when they do something right.
  3. Teach the child to recognize when they are being too demanding for attention and give them strategies to control their behavior.
  4. Encourage the child to participate in activities that promote social interaction and provide positive feedback for appropriate behaviors. This could include activities such as
    • sports,
    • art,
    • music,
    • puzzles,
    • and more.

#4 Behavior Functions of ABA Therapy: Access to Tangibles

This is when a child with autism wants access to preferred reinforcers which can also be known as rewards. Rewards can come in many different shapes and forms:

  • Toys such as blocks, cards, cars
  • Food items such as chips or sweets
  • Electronics such as TV, iPad, music

Just like how people may eat a sweet as a reward for a good game or completing a task, the same works for those with autism. Access to tangibles can work really well as rewards but it can also backfire and cause undesirable behavior to occur if not done properly.

When a child completes a necessary task then access to tangible things can be a great reward. For example, a child completes their morning routine of getting dressed and brushing their teeth. The parent can say “Good job! You did it all by yourself and for that, you get 15 minutes of access to watch your favorite YouTube show before breakfast.” A blend of positive statements and tangibles can help shape behaviors and motivate them to complete tasks that are requested of them.

Next time you hear an ABA therapist talk about the acronym SEAT you now know about Sensory Stimulation, Escape, Access to Attention, and Access to Tangibles. Although an ABA Therapist will interview you to learn more about your child and their behaviors. You can help identify your child’s behaviors into one of these four categories to help out. Such as knowing which sensory stimulations or tangibles your child prefers can help therapists already start to build a plan of what they can redirect when an undesirable behavior occurs.

ABA therapists help individuals with developmental disabilities, like autism, learn new skills and behaviors using evidence-based techniques. They also support families and caregivers in understanding and managing behaviors.

Unlock your child’s full potential with the help of Leafwing Center! Our team of highly trained Behavior Analysts, Assistant Behavior Analysts, and Technicians are here to provide the resources, time, and expertise needed for your child with autism to succeed in life. Together, we’ll create an individualized plan tailored to their unique needs, ensuring they thrive in any environment they encounter. Let us be your partner on this incredible journey!

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?

Autism Friendly Jobs

Autism-Friendly Jobs

Autism-Friendly Auticon
When is it a good time to start thinking about an autism-friendly job for your autistic child? Part of becoming an adult is entering the workforce to put your skills to good use and make an income. Many people around the age of 16 begin to take entry-level jobs over the summers to start exploring what their skills and strengths may be for future careers. Getting a job for a person with autism can be difficult as they might not know what their skills are or have trouble maintaining a job with needs that are different from other typical employees. Doing some research can be helpful for those with autism to find a job that best fits them. Looking for autism-friendly employers, and autism-friendly jobs, knowing about the different groups helping those with autism find jobs.

We are always thinking about our children in their current state, but our children will become adults. Then what? Let Leafwing be a resource when developing your child with autism for the next phase of their life – adulthood.

Autism Friendly Jobs

How to find an autism-friendly job

It’s also important to consider what kind of job may fit an individual’s needs and abilities best when looking for an autism-friendly job. Jobs that are repetitive and require minimal communication may be ideal for those who need structure and routines in order to succeed at work. There are many different types of jobs available, so it’s important to explore all options before settling on one position.

Steps:

  1. Individuals should identify their strengths and skills that can be beneficial in the workplace. These can include computer skills, problem-solving abilities, or creative thinking. Knowing what qualities to showcase when interviewing for a job can help individuals with autism stand out from the crowd.
  2. It is important to connect with organizations or groups dedicated to helping those on the autism spectrum find employment. These types of organizations have resources and services tailored specifically for those with autism such as job placement programs and training opportunities. They also provide support during the process of finding and applying for jobs.
  3. It is essential to research companies that are known for their efforts in hiring people with autism. These companies often have programs in place to ensure that people on the spectrum are given equal opportunities as others. Websites such as Autism Speaks offer a list of potential employers who are known for providing jobs for individuals on the spectrum.

By taking these steps, those with autism can increase their chances of obtaining an autism-friendly job and having success in the workplace!

Autism-Friendly Employers

Autism-Friendly Employers

One way to find autism-friendly employers is to research companies that have been noted for their efforts in hiring people with autism. These companies often have programs in place to ensure that people with autism are given the same opportunities as others. Additionally, websites such as Autism Speaks offer a list of potential employers who are known for providing jobs for people on the spectrum.

List of autism-friendly employers:

  • AMC Theaters: works with the FOCUS program which gives the same opportunities to autistic people to earn a wage and benefits alongside other typical associates.
  • Chevron: works with PathPoint which helps to place those with autism into jobs that match well with their skills.
  • CVS: works with people with autism to get job training and get a job coach to help them find a job that meets their skills.
  • Ford: developed FordInclusiveWorks to help those with autism get jobs in the company and combat issues that people with autism face in keeping jobs.
  • Google: the website states that they accept, thrive, and benefit from the skills that people with autism bring to the workforce. They also allow for accommodations during the interview and training processes.
  • Grocery Stores (Kroger, Giant Eagle, etc.): many grocery stores will hire people with autism of all ages from teens, to young adults, and adults to do entry-level jobs such as bagging, cart return, and stocking.
  • Home Depot: Both CVS and Home Depot work with the same group to help those with autism get job training and match their skills to jobs. To date, 1,000 people with autism have gotten matched with jobs at Home Depot.
  • JP Morgan Chase: launched the Autism at Work program to hire those with autism and allow them access to needed accommodations in the workforce.
  • Lowe’s: won many awards for their inclusive workplace. They offer many opportunities once hired such as scholarships, tuition reimbursement, job coaching, and skill training.
  • Walgreens: works with the group “retail employees with disabilities” and has a special evaluation process for those with disabilities to make sure that they are placed in a job that promotes and uses their strengths.
  • Walmart: scored a 100% on the Disability Equality Index (which measures how well a company is doing with hiring, training, and keeping employees with disabilities). As stated on the website people with disabilities including autism should not feel intimidated to apply for any job on the website.

Autism-Friendly Jobs

Based on the number of companies that will hire a person with autism, it is safe to say that any job could be autism-friendly as long as the person meets the skills required for the job. So, a person with autism should not limit themselves to only certain jobs or only entry-level jobs. A person with autism should first determine what interests them and what their skills and strengths are to determine what kind of job would be suitable for them. They can use a group that provides mentors and training for them to be ready for the workforce as well as use the company they apply for to gain access to the needed resources for them to be successful.

Samples of autism-friendly jobs

Finding employment for individuals with autism can be a challenge, but there are some jobs that are particularly suited to those on the spectrum. Autism-friendly jobs typically have certain qualities, such as being predictable, requiring minimal social interaction, and providing sensory input. These types of jobs may offer great opportunities for individuals with autism to reach their fullest potential.

Here is a list of some potential job opportunities for those on the autism spectrum:

Let Leafwing Center help with the daily routine for your autistic child, so you can have a successful bedtime routine. Our ABA therapists are trained in creating personalized plans that match your child’s ability levels.

  1. Computer Programmer – Computer programming is an excellent job for individuals with autism because it is logical and predictable and offers plenty of solitary work time.
  2. Pharmacy Technician – Pharmacy technicians often work in a quiet environment behind the counter in a pharmacy, filling prescriptions and managing inventory. This type of job requires attention to detail, which many autistic individuals excel at.
  3. Web Designer – Autistic people have the inherent ability to process large amounts of information quickly and accurately, making web design an ideal job opportunity for them. Web design involves designing websites or graphics using software tools; this type of job allows autistic people to utilize their skills without having to interact with others too much outside their comfort zone.
  4. Data Entry Clerk – A data entry clerk typically works alone in a quiet office environment entering data into computer databases or spreadsheets; this kind of job requires accuracy and focus which are traits often seen in autistic people.
  5. Dog Groomer – Dog groomers need to be patient and gentle when dealing with animals, which makes it an ideal career choice for someone on the autism spectrum who enjoys working with animals or has experience working in animal care settings such as kennels or veterinary clinics. Additionally, grooming dogs also involves very little face-to-face contact with clients making it easy for someone who might otherwise feel uncomfortable interacting socially.
  6. Accounting Clerk – Accounting clerks often work independently preparing financial documents such as invoices or accounts receivable/payable records; they also handle routine accounting tasks like recording transactions or reconciling accounts—all tasks that require precision and attention to detail—traits many autistic individuals possess!

In addition to providing employment opportunities for individuals with autism, companies that offer these types of positions can benefit from their employees’ unique skill sets and strengths. For instance, those on the spectrum may have an aptitude for highly structured tasks or an ability to focus intently for long periods of time.

Ultimately, finding a job that suits an individual’s skill set can be a great way to empower individuals with autism. With the right job and support from employers and coworkers, those on the spectrum can reach their fullest potential in the workplace.

Groups that help those with autism find jobs

It may be beneficial to work with organizations or groups dedicated to helping individuals with autism find employment. These organizations often provide job placement resources and services that can be tailored specifically for those with autism. For example, the Autism Society of America has a job placement program that helps connect employers with qualified candidates on the spectrum.

List of groups that partner with individuals with autism to find jobs:

  • Autism at Work: created by JP Morgan Chase to allow those with autism to get the tools they need to succeed. Anything from training, career advice, mentors, and lunch buddies
  • FOCUS Program: stands for Furthering Opportunities, Cultivating Untapped Strengths. The program works with people across all states to employ people at AMC theaters.
  • Ken’s Krew: created by a group of parents who had children with autism as they were worried about them finding satisfactory employment. Their mission is to recruit students with autism in schools, evaluate them for their strengths and skills, provide training, find and help them apply for employment, and support them through employment and beyond.
  • PathPoint: a non-profit that helps people with autism pursue their hopes and dreams through strengthening workplace abilities, building life skills, and developing meaningful relationships.
  • REDI: stands for Retail Employee with Disabilities Initiative. This group helps people with autism gain valuable career skills that give candidates the tools to be successful in any retail setting.

Those with autism have the ability much like anyone else to obtain and maintain a job out in the real world. It just takes a few simple steps to identify the strengths and skills the person has, work with a group supporting those with autism in the workplace, and connect and work with employers who are autism-friendly to be successful. Getting a job can create even more opportunities and offer a chance to gain additional skills for those with autism.

Finally, it’s important to remember that anyone can succeed in any job if they have the right support and guidance from their employer. It’s essential that employers understand how individuals with autism think and act differently than others in order to create an environment where everyone feels comfortable and capable of doing their best work. With some extra patience, understanding, and support from employers, individuals with autism can achieve great success in the workplace!

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

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?

Using Time Warnings To Help Students With Autism

How do time warnings help students with autism? Transitions occur for everyone throughout the day whether that is from one task to another one or from one environment to another. One of the most difficult parts of the day for a student with autism is transitioning. This can be difficult because students may be engaging in an activity that they enjoy and they do not want it to end or they don’t know what is coming next and that causes fear. Students with autism thrive off of the need to have predictability in their daily lives. Teaching time warnings to students with autism can aid in them learning to be flexible and be prepared for the coming change in activity. This can be achieved by attaining these four things:

  • Understanding what time warnings are
  • How to use time warnings to achieve desired results
  • Coupling auditory reminders with time warnings
  • Coupling visual cues with time warnings
Using time warnings to help students with autism

Is it time? Do I need to get ready to go to my next class?

What are time warnings?

Time warnings are a frame of reference for students with autism to process how much time is left in an activity. Time warnings are actual timers or time limits being set to aid students with autism in transitioning either from activity to activity, environment to environment, or activity to reward. Without these time warnings, students with autism can be very distraught when it’s time to move and this can cause undesired behavior to occur. Time warnings can be used in addition to and with visual schedules as well as star charts. Time limits can be listed next to the item on visual schedules so that students with autism can set their own timer for the activity.

Using time warnings to help students with autism

How to use time warnings with students with autism

Just like with anything else using time warnings and achieving the desired result is going to take time and practice. It cannot happen overnight. An easy way to make the process go smoothly is to incorporate the student into setting the time. Buying a big timer or clock for school or at home can make it so the student can set the required time themselves. This way they are fully aware that a transition is coming. The more time a student has to anticipate a change in the schedule the better prepared they are to make the change. When a student with autism has to abruptly stop their current activity and proceed to something new, it can be upsetting for them as they have not had enough time to process that the activity will be coming to end.

Coupling auditory reminders with time warnings to help students with autism

Although a physical timer that goes off when finished is a great auditory cue to students with autism, other auditory reminders can be used with time warnings to further aid in transitions. Some examples include:

  • a bell
  • auditory time left reminder
  • verbalizing a natural end to a task to lead to a reward’

A bell or other sound such as a chime can be used as an auditory signal to students with autism that a task or activity is coming to an end and it is time to transition to the next task or activity. This sound can also help with sensory input for a child with autism without being loud or too overwhelming. Teachers can also provide auditory time left reminders to students. A timer may be counting down but sometimes if a student is very engaged in the activity, they could forget the visual cue. Therefore, a teacher giving a ‘five minutes left or two minutes’ oral reminder can serve as a marker for students that time is almost up. Giving multiple time-left reminders works best as a constant way to provide time reference to students with autism. Oftentimes activities have a natural end such as completing a puzzle, chart, game, or card stack. Letting students verbally know that there are just a few more pieces, cards, and turns left and that something desirable is upcoming can help with the transition. For example, saying ‘two more puzzle pieces left then it’s time for recess’ signals to the student that they have almost completed their task.

Visual Schedule

Coupling visual cues with time warnings to help students with autism

Many students with autism have an if/then chart or a first/next chart. These can be used as great visual cues to go along with time warnings. Students know that they will complete one task first and then move to another task, reward, or change their environment. As many students with autism learn and thrive off of visuals, this can be a great way to show time warnings. The visual cue could also come naturally with the task. For example, if a student is working through a stack of cards, as the card stack diminishes that is a visual cue that the task is coming to an end. As previously stated, displaying the timer for a task can be a visual reminder to the student as their time warning. They can see the timer going down and know that a transition will occur when the timer has been completed. It can also be helpful to sign the word finished at the end of a task as another visual reminder to students especially if the student is sensitive to auditory reminders.

Main key points to autism and time warnings

Time Warnings can be a great way to help a student with autism get accustomed to change. Introducing these time limits can take time but can result in making a smoother day for both the student and the teacher. These time warnings allow for the student to take on the responsibility of preparing for the transition. Coupling with visual and auditory cues as well as a lot so practice can produce the desired result for everyone involved.

Leafwing Center is a good resource and starting point when trying to incorporate time warnings at home and at school. Let the ABA therapist build a starting point of how to use time warnings for your child with autism. Call us today!

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?

IS ABA therapy covered by my insurance

Applied Behavior Analysis

ABA therapy

ABA is considered an evidence-based best practice treatment by the US Surgeon General and by the American Psychological Association.

A qualified and trained behavior analyst (BCBA) designs and directly oversees the program. They customize the ABA program to each learner’s skills, needs, interests, preferences, and family situation.

The BCBA will start by doing a detailed assessment of each person’s skills and preferences. They will use this to write specific treatment goals. Family goals and preferences may be included, too. There may be parent training involved to be consistent in the child’s progress.

A branch of psychology concerned with employing evidence-supported interventions or instruction forms the basis of Applied Behavior Analysis (ABA). Examples of ABA-centered interventions encompass but are not limited to, Discrete Trial Teaching, Casual Teaching, Central Response Training, and Functional Communication Coaching.

The philosophy behind ABA therapy is:

  • To teach a child how to do something (e.g., prepare for school, behave better, play with others, or do things for himself or herself)
  • To provide interventions to those who may deal with pervasive developmental disorders such as autism spectrum disorders
  • To break a new skill down into very small steps
  • To provide a reward to a child for each step they do, even if they need help
  • Child friendly, and rewards a child with things or activities they like
  • To personalize the therapy to the level of the ability of the child
  • To measure the child’s skills regularly in order to adjust the teaching level

Some ABA teaching programs include:

Generally, children start receiving ABA treatment between the ages of two and six. If a child is two when beginning treatments, they can use ABA to cultivate superior communication abilities and teach them to obey simple instructions – all in preparation for preschool. For older children, ABA is often used as part of the child’s education, to teach social skills, and daily living skills or to help change problem behaviors.

Additional Articles:

What is ABA therapy?
ABA Therapy Examples
Individualization in the Treatment of Children with Autism

Autism Feeding Issues

Meal times and feeding can be a hurdle in the life of a family with a child who has autism. There can be difficulties with eating due to different textures, smells, sounds, food allergies, aversions, or a lack of interest. However, there are many strategies to help children with autism overcome the hurdle and have an enjoyable meal experience.

Autism Feeding Issues

Autism and Food Sensitivity

Children with autism have an increased likelihood of possessing food sensitivities. Both food allergies and food intolerances are common in children with autism. These children are twice as likely to have some type of food sensitivity. These food sensitivities are common due to immune issues as well as differences in their digestive tracts, especially in regard to carbohydrates.

Children with autism can have food allergies. These are similar to the rest of their peers in that food causes a reaction within the body and can be life-threatening.

Food sensitivities can cause

  • gastrointestinal pain,
  • nausea,
  • gut issues, or
  • hives.

However, not all children with autism can vocalize this discomfort and it may lead to behavioral outbursts. They may become more upset or stressed during meal times, have meltdowns, or attempt to avoid food altogether.

Additionally, children with autism may experience food intolerances. This is not the same as allergies as there is no life-threatening aspect. However, it can still cause the same or similar behavior outburst. Two common food intolerances in children with autism are gluten and casein (a dairy protein).

Food intolerances can cause

  • stomach pain,
  • diarrhea or
  • constipation.

It can be helpful to take a child with autism to an allergy specialist and one that specializes in working with autism. They will be able to determine any food allergies or food intolerances to avoid during meal times. This can make the whole process go smoothly and rule out one possibility of a child avoiding food.

Autism Feeding Issues

What to do if your child with autism won’t eat?

The first step in determining a plan towards diet expansion for your child with autism who won’t eat is to see which problem category they fall into.

Feeding problems or “picky eating”– Some children with autism only eat less than 20 foods and do not include all the food groups. Once they eliminate a food or a group, they will not eat from it again. Determining if your child falls into this category as early as possible is necessary to help them get feeding intervention from a feeding specialist or occupational therapist.

Medical – Sometimes eating can cause a child with autism discomfort or pain. Some possible issues can be reflux, constipation, GI issues, or respiratory involvement. Finding a pediatrician that specializes in working with children with autism is vital in order to get the issues resolved or managed.

Oral motor – Eating involves the coordination of the lips, tongue, jaw, and facial muscles before swallowing. Oftentimes, this process is learned young. However, children with autism can have a breakdown in this learning process due to structural abnormalities. Getting help from a speech-language pathologist can help in strengthening and using these muscles to aid in eating.

How do you teach a child with autism to feed themselves?

Before a child with autism can feed themselves, it is important to establish a routine with the child so they become more comfortable. Try to eat at the same place and same time every day that way it establishes a sense of routine for the child. They know when the family sits down at the table, it is their indicator that eating a meal will be involved as well as the expectations during that time.

  • Begin with the basics. Start off with the child eating foods they already know and love to help them ease into the situation
  • Remove stressors or other sensory aversions before starting meal time. Sometimes smells or unusual sounds can be deterrents to a child with autism at meal time.
  • Support a child’s posture while eating. Oftentimes children with autism have poor trunk and core stability so they may lean or wiggle in their seats. Putting cushions, towels, or a stool can help children sit more comfortably at the table or eating space.
  • Get foods out of the packaging. Sometimes children only think they like a specific brand of food. Taking food out of packages eliminates the questioning if it came from a certain brand. Putting food into clear containers as soon as they are brought home and helping to introduce new brands of similar foods.
  • Avoid focusing on food and your child’s behavior. If during meal time, the family is talking and eating there is less pressure on the child to eat and they can go at their own pace without worrying about being watched or eating quickly.

Leafwing Center can work with you to design a plan for autism feeding issues that you may be facing with your child. Our ABA therapists are trained in creating personalized plans that match your child’s ability levels. ABA therapists are trained to address the behavior. If you are concerned about the health and wellness of your child then you need to contact your physician.

Additional Articles:

Foods To Avoid With Autism
Grocery Shopping With Your Child With Autism

Glossary Term:

Bio-Medical Approach

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?

How is Applied Behavior Analysis Different From Psychology?

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

Applied Behavior Analysis vs. Psychology

The main difference of Applied Behavior Analysis to Psychology

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

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

  • Forward Chaining
  • Modeling
  • Picture Exchange Communication System
  • Reinforcement Systems

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

ABA therapy differentiates from Psychology with whole family involvement

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

The main difference of Psychology to Applied Behavior Analysis

The main difference of Psychology to Applied Behavior Analysis

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

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

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

Applied Behavior Analysis and Psychology similarities

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

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?

Autism and Communication Difficulties

Autism and communication difficulties go hand in hand. A failure to develop language is one of the earliest signs of autism. The ability to identify the distinct signature of this deficit in very young children has become increasingly important, given that the presence of speech before five years of age is the strongest predictor for better outcomes in autism.

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

Let Leafwing professionals educate you and your child to develop the language skills that will help guide your child to reach their full potential.

Autism and Communication Difficulties

Signs of autism and communication difficulties

For the child with ASD, these developmental processes appear to be hijacked taking the form of impaired or delayed language abilities at a very early age.

Some language skills including articulation, vocabulary, and grammar appear to be relatively preserved. In contrast, the difficulties that appear as robotic and abstract use of language are clearly evident. Language impairment varies with age and developmental level. The child with ASD typically uses words to regulate his or her environment to demand or protest. They’re less likely to communicate for social reasons, like sharing information.

Ways Autistic Children Communicate:

  • mimic or repeat other people’s words or phrases, or words they’ve heard on TV, YouTube or videos. They repeat these words without meaning or in an unusual tone of voice.
  • use made-up words
  • say the same word over and over
  • confuse pronouns, referring to themselves as ‘you’ and the person they’re talking to as ‘I’.

They also often have difficulty knowing when and how to communicate with people in socially appropriate ways. For example, they might not make eye contact or let another person take a turn in a conversation.

Ways ABA programs help autistic children with their communication difficulties

Most ABA programs will teach a child using simple and concise language at the beginning stages of the program. For example, if the goal is to teach a child to imitate a ‘clap’ the teacher would simply say, “Do this” or “Copy me” while demonstrating the action. The instruction would be limited to as few words as possible (in this example, two words and then a demonstration of the action). The teacher would refrain from using a longer instruction that contains more words such as, “okay, now I’m going to do something and I want you to watch me and then copy me after I’m done. Are you ready?” For a child who has difficulty understanding language, this instruction is laden with words that are unnecessary to complete the instruction and probably will include many words that the child does not presently know.

Approaches used by ABA programs:

  1. Create a reason to use language
  2. Through play
  3. Model the language
  4. Build the child’s language skill
  5. Reward the child for language use

Techniques used with autism and communication difficulties:

  • Use short sentences – for example, ‘Shirt on. Hat on’.
  • Use less mature language – for example, ‘Playdough is yucky in your mouth’. Point to your mouth.
  • Exaggerate tone of voice – for example, ‘Ouch, that water is VERY hot.’
  • Encourage and prompt the child to fill the gap when it’s the child’s turn in a conversation – for example, ‘Look at that dog. What color is the dog?’
  • Ask questions that need a reply from the child – for example, ‘Do you want a sausage?’ If you know the child’s answer is yes, you can teach the child to nod their head in reply by modeling this for the child.
  • Give the child enough time to understand and respond to questions.
  • Practice communicating with the child on topics or things they’re interested in.

Over time, many autistic children can build on these beginnings and learn to use language in more typical ways.

Autism learner

How are language difficulties in autistic children treated?

When working with an ABA program they will have a speech-language specialist perform a comprehensive evaluation on the child. The speech-language pathologist is a health professional trained to treat individuals with voice, speech, and language disorders. Furthermore, they address social, play, cognitive skills, and feeding and swallowing challenges as well. The speech-language pathologist will design an appropriate treatment program to prevent further developmental delays. In addition, the speech-language pathologist might make a referral for a hearing test to make sure the child’s hearing is normal.

Teaching children with ASD to improve their communication skills is essential for helping them reach their full potential. There are many different approaches, but the best treatment program begins early, during the preschool years, and is tailored to the child’s age and interests. It should address both the child’s behavior and communication skills and offer regular reinforcement of positive actions. Most children with ASD respond well to highly structured, specialized programs. Parents or primary caregivers, as well as other family members, should be involved in the treatment program so that it becomes part of the child’s daily life.

Speech therapy might include:

  • interacting through talking and playing, and using books, pictures other objects as part of language intervention to help stimulate language development
  • modeling correct sounds and syllables for a child during age-appropriate play to teach the child how to make certain sounds
  • providing strategies and homework for the child and parent on how to do speech therapy at home

Autism and communication difficulties: other means of communication

Augmentative and alternative communication (AAC) means all of the ways that someone communicates besides talking. People of all ages can use AAC if they have trouble with speech or language skills. This provides another way to help them communicate other than verbally. AAC can include sign language, gestures, pictures, computer tablets, and other electronic devices.

A lot of people wonder if using AAC will stop someone from talking or will slow down language development. This is not true—research shows that AAC can actually help with these concerns! People who use AAC can also learn how to read and write.

Main key points to autism and communication difficulties

In the initial stages of an ABA program, the more concise and simpler the instruction, the more successful the child will be. It is important to note that the simplicity or complexity of language used should be based on the child’s language repertoire at the time of assessment. Over time, and with success, simple and concise instructions will be elaborated and more language will be incorporated into the instruction.

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?

Transition strategies for autistic students

Transition strategies for autistic students can be very beneficial when trying to help them move successfully from one activity to another. Every student has to transition multiple times through a given school day. By giving autistic students warnings about the time remaining in an activity can provide a helpful frame of reference. Individuals with autism spectrum disorders (ASD) may have greater difficulty in shifting attention from one task to another or changes in routine. The autistic child struggles with making the cognitive adjustments necessary to move on. As a consequence, transitions in autism are often plagued with stress, anxiety, and frustration. A number of supports to assist individuals with ASD during transitions have been designed both to prepare individuals before the transition will occur and to support the individual during the transition.

The benefits of transition strategies for students with ASD:

  • Reduce the amount of transition time.
  • Increase appropriate behavior during transitions.
  • Rely less on adult prompting.
  • Participate more successfully in school and community outings.
Transition strategies for autistic students

Time to transition to the next classroom

Why incorporate transition strategies for autistic students

Transitions are a large part of any school day, as we move to different activities or locations. Studies have shown that up to 25% of a school day may be spent engaged in transition activities, such as;

  • moving from classroom to classroom
  • coming in from the playground
  • going to the cafeteria
  • putting personal items in designated locations like lockers or cubbies
  • gathering needed materials to start working

Some students with ASD may have difficulties associated with changes in routine or changes in environments, and may have a need for “sameness” and predictability. These difficulties may eventually hamper one’s independence and limit the student’s ability to succeed in a school setting. A variety of factors related to Autism Spectrum Disorder may lead to difficulties during transitions.

Additionally, the neuropsychological process known as the ‘Executive Function’ is heavily involved in making transitions. This function helps the brain to shift and reallocate attention and other brain resources when required. In autism, there are often gaps in this system. Because of these gaps, the brain may struggle with stopping one task and transferring attention and other thought processes onto another.

Transition strategies for autistic studentsDifferent types of transition strategies for autistic students

When deciding which transition strategy to use, you need to think about the individual. Usually, verbal cues like “You have 5 more minutes to do your work” are harder for students with ASD to process. Verbal concepts relating to time are hard for them to grasp especially if telling time is not a strong point for them. Furthermore, it doesn’t allow them enough time to prepare themselves for the transition. Visual transitions seem to work better like:

  1. Visual Timer: A timer that visually shows in red how much time is left when the red indicator is gone then the student needs to transition to the next activity.
  2. Visual Countdown: A list of tasks that are removed until they are gone which means it is time to transition.
  3. Elements of a visual schedules: An actual schedule so the student can see the sequence of activities that will occur for a given period then they are able to transition better to the next activity.
  4. Use of Objects, Photos, Icons, or Words: An actual object or a photo of an image or words that the student can hold that explains the transition.
  5. Use of Transition Cards: The card represents what the student will be transitioning to next with the use of a word spelled out or an image of the transition displayed for the student to refer to. These are very helpful concrete learners.
  6. Fixed Container/Box: It is beneficial to have a container in a certain location that the student can put their materials in before transitioning to the next location or activity. Furthermore, teaching students to put away materials in the completion of an activity can function as a natural queue that one activity is ending, and that another is beginning.

Concrete cues help to answer any questions that autistic students might have about the transition and can reduce confusion and help in developing productive transition routines. Learn what cues work best for your student with autism. Team members should examine how the environment and the transition strategies are working best for the autistic student. You may need to use multiple cues to help the autistic student transition more smoothly. Be aware if an area is too crowded, loud, over stimulating or averse for some reason, individuals may resist transitioning to that location.

Structure and consistency will help reduce the amount of work that the brain needs to do to make a transition. It helps to keep materials for upcoming tasks in an easily identifiable and consistent place. Keeping the general order of daily tasks consistent can also help to make transitions become more automatic.

All of these simple, yet very effective support strategies are easy to use, and help both students and teachers during everyday classroom activities.

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?