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When is a good time to start ABA therapy?

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

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

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

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

Research supports an early start for ABA therapy

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


Start ABA therapy

Benefits of Starting ABA therapy early

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

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

It’s never too late to start ABA therapy

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

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

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

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

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

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


When to start ABA therapy

Untreated autism spectrum disorder symptoms worsen over time

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

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

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?

When is a good time to start ABA therapy?

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

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

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

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

Research supports an early start for ABA therapy

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


Start ABA therapy

Benefits of Starting ABA therapy early

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

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

It’s never too late to start ABA therapy

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

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

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

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

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

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


When to start ABA therapy

Untreated autism spectrum disorder symptoms worsen over time

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

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

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 Assignment Notebooks to Help Individuals with Autism in Classrooms and Other Settings

An effective organizational strategy for students with Autism Spectrum Disorder, especially those who are older and possess the prerequisite reading, writing, and organizational skills is an assignment notebook. All academic tasks and their due dates are listed in the notebook and the student will take it to school and home every school day. The most effective support would include a sample of how each assignment should look. Ideally, it should also contain examples of completed items (math equations, definitions, filled out problems, etc.) as these would function as visual examples of the correctly completed assignment. Although, simplified assignment books are certainly acceptable and can be effective depending on the particular student. The classroom teacher would need to check the notebook at school to make certain all information and expectations are included. At home, the parents or caregivers monitor the notebook to make sure the student has successfully completed all necessary assignments or activities to the level expected of them. A signature section for each day can provide an additional layer of thoroughness. This can include a signature section for the parent who monitors the assignment book and/or the student who completes the assignments. Essentially, these assignment books function as a visual checklist to help students stay organized and on-task. These are pretty standard in schools, yet it is imperative they are used to help students with ASD succeed.

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

We hope that you find the use of assignment books as a helpful organizational tool to promote homework and academic task completion!

How is Applied Behavior Analysis Different From Psychology?

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

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.

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)

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

Using Time Warnings To Help Students With Autism

Now is the time? Kid and clock: preschool child preparing for the school

Giving students warnings about time remaining in an activity can provide a helpful frame of reference. Time limit warnings should be paired with an auditory or visual cue, such as a bell or card. Towards the end of the work activity, the teacher should verbalize, ‘five minutes left, ‘two minutes left’. For students requiring additional support, the verbal que can be paired with the gestural pointing to the timer and manually signing ‘finished’ using sign language. When preparing students for the end of an activity that has a natural ending point, such as a game or a timed-test, the teacher should alert students that a transition is approaching by making such a statement as, ‘only a few more cards and the game is over’. Finally, time warnings or making transitional cards as part of the student’s routine can also help students with autism develop the capacity to be flexible for change. Additionally, 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. For example, the teacher can say, ‘once you finish that problem, you can begin to get ready for recess. All of these simple, yet very effective support strategies are easy to use, and help both students and teachers during everyday classroom activities.

Who Can Provide ABA Therapy?

Applied Behavior Analysis (ABA) therapy is typically provided by Board Certified Behavior Analysts (BCBAs), Board Certified Assistant Behavior Analysts (BCaBAs), Registered Behavior Technicians (RBTs), and paraprofessionals.

A BCBA is a person who has met the educational and professional training requirements established by the Behavior Analysis Certification Board. A BCBA will typically hold a Master’s degree in Psychology, Child Development, or a related field. Some BCBAs may also hold a doctoral degree in one of these fields and are referred to as BCBA-Ds (doctorate level BCBAs). The primary duties of BCBAs include: conducting clinical assessments, establishing skill based and behavior goals, updating and modifying treatment goals, conducting parent and caregiver trainings, supervising Registered Behavior Technicians and BCaBAs, ensuring the ABA program is implemented correctly and effectively, and writing progress reports required by funding sources.

A BCaBA (assistant Behavior Analyst) works under the supervision and direction of a BCBA and has similar duties as a BCBA. A BCaBA is also certified by the Behavior Analysis Certification Board and has met the necessary training and education requirements. A BCaBA will typically hold Bachelor’s degree in the field of Psychology, Child Development, or related field.

As stated by the Behavior Analysis Certification Board, an RBT is a person who practices under the close, ongoing supervision of a BCBA, BCaBA, or BCBA-D. The Registered Behavior Technician is primarily responsible for the direct implementation of ABA services. This is the person who is typically working 1:1 with an individual in designated treatment settings (home, school, clinic, etc.) RBTs must be over 18 years old, possess at least a high school diploma, go through a designated training program, and pass other eligibility requirements. RBTs do not conduct assessments or create treatment programs, however they implement the treatment program designed by a Behavior Analyst and collect data on progress.

Other professionals such as Marriage and Family Therapists and Licensed Clinical Social Workers may also provide ABA therapy in some instances. However, the majority of ABA services are provided by Behavior Analysts and Registered Behavior Technicians. Other paraprofessionals, including individuals pursuing undergraduate or graduate degrees in Psychology and related fields and/or pursuing certification by the Behavior Analysis Certification Board, may also provide ABA therapy under the Supervision of Behavior Analysts.

How to Teach Children with Autism How to Play Independently

Do you ever wonder how you make it through each day, getting your child dressed and to school?  What about shopping, laundry, house cleaning, and dinner? Somehow you do it, and that is enough for anyone to be proud of.  We want to provide you with some additional techniques that may help with the time when your child with autism is home and needs to be looked after, but you also have things to accomplish.

Preparing dinner is a great scenario that many parents have difficulties with.  The solution for many parents is to put a movie on, give the child the iPad, or to allow the child to engage in whatever self-stimulatory behaviors they enjoy most (e.g., running around the house repeating phrases, flapping objects up and down, or rolling cars back and forth on the floor while lying down staring at them).  Although these may be activities that make your child happy and allow you to get dinner ready, there are additional techniques that foster appropriate independent engagement by your child with autism during times you cannot provide your full attention.

Activity schedules work wonders for this purpose. Activity schedules are visual guides that lead a person through a series of activities, leading to an ultimate prize.  Visual schedules help with transitioning from one activity to another with minimal prompting.

There are some pre-requisites to being able to utilize schedules although these can be worked on in the meantime if your child does not have them.  Your child should be able to independently play with some objects, even if the object is as simple as a peg board, or as complex as a 100-piece Lego structure.  Laminate pictures of these activities and velcro them to a vertical strip hanging on the wall.  At the bottom should be a picture of what your child really wants to do in the moment, even if it’s dinner!  If your child has never had experience with an activity schedule, guide them through the process of pointing to the first picture, finding the activity, playing with the activity, putting the activity away, taking that picture off the schedule, pointing to the next picture, and so on and so forth until the ultimate activity or item is achieved.

Some tips: start with only one or two activities until your child can independently utilize the schedule and transition from activity to activity.  Also, remember that the activities should be somewhat preferred by your child, as this is their independent time and we want to increase the success of them playing independently.  If they dislike activities, this increases the chance of challenging behaviors and the need for more of your attention.  It may take a few days, or even weeks to develop this skill. Over time, your child will be able to complete this task with increasing independence, practice decision making and pursue the activities that interest him or her and it will give you some much needed time to get things done while at the same time knowing that your child is being productive.

When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

The following are things that you should expect as a parent when you begin treatment for your child with Autism.

You and your child have a right to a therapeutic environment.  This means that the teaching environment set up to help your child is one in which socially significant learning occurs.  As a client, your child also has the right to services from an agency in which their number one goal is the personal welfare of your child (e.g., safety, treatment efficacy, advocacy). This means that all energy put into the program is to help your child become more independent and lead a better life.

It is also your child’s right to have a treatment program supervised by a competent behavior analyst. Unfortunately, as the rates of autism have increased, so have the number of treatment programs allegedly providing assistance to children with autism.  Furthermore, in many locations, the demand presently outweighs the supply for trained, experienced behavior analysts. It is imperative that the credentials and qualifications of your service provider be credible.

Your child has a right to be provided with a program that teaches functional skills. Functional skills are skills that a child can use in their everyday life and that furthers their independence (tying shoes, initiating conversation, engaging in cooperative play, etc.). There is little benefit in taking the time and dedication to teach a child something that cannot be incorporated or used in their everyday life.

Assessment and ongoing evaluation are crucial components of any ABA program, and should be expected.  This includes setting up a program based on the individual needs of a child and continuing a program based on the ongoing needs of a child. These needs will continually change, therefore ongoing assessments and modifications are imperative, necessary, and a right.

Parent and caregiver trainings should be included in the ABA program. These typically include meetings between parents or caregivers and their service provider in which valuable ABA strategies are discussed, demonstrated, and implemented. The focus of these meetings is to educate parents about various but individualized ABA based techniques they can implement with their child to address challenging behaviors, reinforce desirable behaviors, and promote generalization of progress.

Lastly, and perhaps most importantly, a child with autism has the right to the most effective treatment procedures available. In this case – scientifically validated treatment programs which today have only been shown to be based on ABA principles and techniques.

Motivating Children With Autism

Motivating Individuals Living with Autism: Intrinsic and Extrinsic Motivation

Motivation can be challenging issue for most of us. Take for example the fact that a lot of us struggle to exercise or to get on a diet even though these lifestyle changes could likely make a huge difference in our health and consequently, our quality of live.  In Behavior Analysis we sometimes discuss motivation by categorizing it in two ways—intrinsic and extrinsic. Looking at motivation in this way gives rise to an interesting conceptual discussion which points back to the work behavior analysts do with children with autism. Intrinsic motivation refers to motivation that would be described as coming from within a person. That is, you do something because you like it. For example, the prima ballerina that rehearses 8 hours a day because she wants to be able to perform exceptionally. Extrinsic motivation on the other hand refers to motivation that comes from others or our environment.  For example, some employees in a manufacturing company may show up to work on time to avoid getting in trouble with the boss (a quick footnote is that our behavior is under many influences and thus there are many sources of motivation on behavior at any given moment. These are rudimentary examples to help facilitate the point of motivation).

The same intrinsic and extrinsic motivational mechanisms apply with children living with autism. Many children with ASD are not interested in doing all of the things that we would like them to do or other tasks or skills that other typically developing children do.  Some of our children on the spectrum may choose to engage in repetitive play or ignore others. It is not uncommon for children with autism to attend to things that only they find interesting. And when this free time is interrupted or when they are asked to attend to something or someone else, they may appear unmotivated to learn or disinterested. In some cases, other challenging behaviors may be occasioned if we follow-through with our demands.

Without motivation, the learning process may be significantly slowed down if not impossible; therefore, at every stage of an ABA program, every effort is made to increase a child’s motivation to learn. Ample time is spent finding out what things a child likes (e.g., reinforcer surveying or reinforcer sampling) and what things will motivate them to attend long enough to learn.

Motivation in an intensive Applied Behavior Analysis program may initially take the form of something external (extrinsic), such as being rewarded with their favorite foods, candies, or activities. Often times, verbal praise and high-fives or anything that a child may find enjoyable is used. However, it is hoped that over time, this motivation will transition from extrinsic to intrinsic such that a child will engage in learning for personal joy and accomplishment (e.g., building a block house and being happy with the completed structure) and for that reason, rewards like candy or other foods can be systematically reduced while more natural rewards take their place.

Using extrinsic rewards is a common concern that others may have when their use is considered in an early ABA program. However, as long as individuals managing ABA programs plan ahead and strive to transition from extrinsic into more intrinsic forms of reinforcers over time, the use of extrinsic forms ought to be considered in their child’s program in order to facilitate learning early-on in the service.

Parenting Survival Skills

Do you ever feel like your child or children take all of your energy and you therefore have no energy to give to your spouse, partner, or friends?  This is very normal although so important to pay attention to, be mindful of, and work at.  Humans are social beings and we need that support network to function in our daily lives.  Without it, we will get worn down and we will eventually see turmoil in our relationships, work, and ways of parenting.  Below are some relationship recommendations that are so important when raising children, more importantly, children with autism.

First, ensure that you have a close adult companion who you can confide in.  If you have a spouse or partner, it will most likely be them.  If you do not have a spouse or a partner, identify a close friend who you can have real, open conversations with and who can call on when in times of need.  It’s important to let someone know what you are going through and how you feel.  Someone who just listens can be a great source of strength.

Second, have high levels of communication with your partner about your parenting strategies, away from your child.  It is so important to have consistent parenting styles and strategies.  Disagreeing during an episode with your child will only increase the stress and make matters worse.  The communication needs to happen when you are alone with each other and you can come to resolutions.  This will help in times when one parent needs a break and the other parent can step right in and be consistent with the strategies that the first parent was just using.  Just as a marriage builds a relationship, a child builds a team.

Ask for help, especially at first. Don’t hesitate to use whatever support is available for you. Your family and friends are there to help, but may not know how.  Maybe you can just have someone take the kids out for an afternoon? Or cook dinner for your family one night.

If you can, allow yourself to take a break, take some time away.  It can be as simple as taking a walk or even going to see a movie, going shopping or visiting a friend can make a world of a difference. Schedule fun adult time on a regular basis, away from your child, with your partner or close friends.  This is so important!  Parenting is difficult and brings many challenges to relationships.  It is important to spend time together, focusing on the two of you and not worrying about your child in the next room.

Lastly, don’t forget to rest.  If you are getting regular sleep, you will be better prepared to make good decisions, be more patient with your child and deal with the stress in your life.

Remember that if you want to take the best possible care of your child, you must first take the best possible care of yourself. Relax, have fun, and focus on you!

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How To Make Long Car Rides More Manageable With Children With Autism

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

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

Providing visuals can be another great strategy in making long road trips more manageable.  Use schedules, maps and even photo albums to help understand where you are going and whom you will see. Any type of visual support will reduce anxiety and increase interest.

Your child may need to take some regular breaks and be able to get out of the car to stretch or run around.  Look for signs that your child may be anxious, such body language, and take pit stops as needed.

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

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

The theme is to plan ahead so you and your family can be prepared for the long trek ahead.

Have fun and Bon Voyage!