Tag Archive for: ABA

Speech Therapy

Nonverbal Autism

/in , , , , /by

The term nonverbal autism is used to describe individuals on the autism spectrum who have limited or no verbal communication skills. However, it does not necessarily indicate intellectual disability.

Nonverbal autistic children should not be automatically considered intellectually impaired simply because they lack speech. This assumption can lead to under-stimulation, which in turn can cause anger, frustration, and/or depression in the child or adolescent.

Let’s dive in!

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

Contact Us

Nonverbal Autism

What are the early signs of autism?

Based on research conducted in 2007, it was found that approximately 30-38 percent of parents of autistic children observed symptoms before their child’s first birthday. This number is unexpectedly high, considering that autism is often perceived as an issue that may not become apparent until later in childhood. In the majority of those cases, approximately 80 percent noticed signs by the time their child reached 24 months.

Early signs of autism include:

  • not responding to their name by 12 months old
  • not babbling or laughing along with their parents by 12 months old
  • not pointing to objects of interest by 14 months old
  • not playing pretend by 18 months old
  • avoiding eye contact or preferring to be alone
  • not meeting developmental milestones for speech and language
  • repeating words or phrases over and over
  • being upset by minor changes to their schedule
  • flapping their hands or rocking their body for comfort
Request More Information

 

When to see a professional

Don’t let your child fall behind! If you notice they’re not hitting their language milestones, it’s time to seek professional help.

If your child is not babbling or talking, it may be necessary to consult a therapist or speech-language pathologist to determine if nonverbal autism is a possibility. Let LeafWing investigate and assist your child in developing their communication skills.

Language development and speech in older children can be evaluated using a standardized vocabulary checklist, such as the Language Development Survey (LDS). This assessment tool can assist in identifying language delays in children between the ages of 18-35 months by analyzing their vocabulary usage and word combinations.

Call Us at (888) 436-2532

Nonverbal Autism

How is nonverbal autism diagnosed?

First, the parent should obtain a definite diagnosis from a medical professional who will conduct a series of tests, which include

  • physical examination
  • MRI and CT scans
  • blood tests
  • and hearing tests.

These assessments enable the professionals to eliminate any other developmental or physical disabilities hindering the child’s speech.

When it comes to diagnosing nonverbal autism in children, it can be a difficult task. This is because there are no clear distinctions between different types of communication difficulties, and it can be hard to differentiate between language delays and autism-related communication problems. The lack of verbal output for children with nonverbal autism typically makes the challenges associated with diagnosis even more difficult.

Unlocking the puzzle of nonverbal autism in children can feel like navigating a maze of communication challenges, where clear distinctions are scarce, and diagnoses are elusive.

Once the parent has a diagnosis, a therapist will use some standardized assessment tools that assess young children with significant language and speech delays, such as:

  • Gilliam Autism Rating Scale (GARS3) – is a comprehensive assessment tool that assesses communication, socialization, sensory functioning, play, self-help skills, and behavior in autism spectrum disorder patients.
  • Autism Diagnostic Observation Schedule (ADOS-2) – assesses an individual’s behavior, communication, and social interaction skills.

The assessment tools help to identify deficits or unusual patterns that may indicate the presence of autism spectrum disorder.

Click me

Nonverbal Autism

How do you work with a child who is nonverbal?

The first step in working with a nonverbal autistic child is to establish trust and rapport. This can often be done by taking time to get to know them, showing interest in their interests and hobbies, and acting as a supportive companion. It is essential to use clear body language and gestures when communicating, as well as verbal communication if appropriate. Additionally, it may be helpful to use visual tools such as

  • picture cards
  • calendars
  • simple visual schedules

to help children with autism better communicate what they need or want.

Nonverbal Autism: Visual Behavior Supports

Visual supports, such as pictures or other visual representations, can assist children in communication by facilitating the expression of emotions and frustrations. They also aid in comprehending social norms, such as initiating conversations and potentially reducing aggressive behavior.

Visual supports are like a superhero cape for children, guiding them on the path of good behavior and reminding them of the consequences that await if they stray. These magical tools not only help little ones remember the rules but also foster communication and build excellent relationships along the way!

Types of Visual Behavior

  • First-Then Boards: breaks tasks down into smaller, easy-to-understand segments. It is a visual display of something that your child prefers and will receive or can participate in after they complete a task that they do not prefer.
  • Contingency Maps: shows a child what will happen if they engage in a particular behavior. However, unlike a first-then-board, a contingency map depicts both sides of the coin – what will happen if the child does what is expected of them and what happens if they do not.
  • Visual Daily Schedules: the expectation of the events in their day. Visual schedules help mitigate anxiety and lend a sense of predictability. You can create a visual daily schedule with photographs, drawings, or written lists, beginning with the first thing your child should do in the morning and ending with the last thing they should do at night.

Guidelines for Communication with Nonverbal Autistic Children

No matter where your child falls on the autism spectrum, they can communicate in some manner. Even if they are nonverbal, there are a variety of strategies that can be used to help them express themselves and build meaningful relationships with you and others.

  • Encourage play and social interaction. All children learn through play, and that includes learning the language. Interactive play provides a delightful chance for you and your child to communicate. Play games that your child enjoys. Incorporate playful activities that promote social interaction. For example, singing, reciting nursery rhymes, and gentle roughhousing. During your interactions, crouch down close to your child so your voice and face are closer, increasing the chance of them looking at you.
  • Imitate each other. Copying your child’s sounds and play behaviors will encourage more vocalizing and interaction. It also encourages your child to copy you and take turns. Make sure you imitate how your child is playing – so long as it’s a positive behavior. For example, when your child rolls a car across the floor, then you, too, roll a car across the floor. If they crash the car, you crash your car, too. Be sure not to imitate inappropriate behavior like throwing the car!
  • Focus on nonverbal communication. Gestures and eye contact can build a foundation for language. Encourage your child by modeling and responding to these behaviors. Exaggerate your gestures. Use both your body and your voice when communicating – for example, by extending your hand to point when you say “look” and nodding your head when you say “yes.” Use gestures that are easy for your child to copy. Examples include clapping, opening hands, reaching out arms, etc. Respond to your child’s gestures: When they look at or point to a toy, hand it to them or take the cue for you to play with it—similarly, point to a toy you want before picking it up.
  • Give time for your child to talk. It’s natural for us to want to fill in the missing words when a child doesn’t quickly respond. It is vital to give your child lots of opportunities to communicate, even if they are not talking. When you ask a question or see that your child wants something, pause for several seconds while looking at them enthusiastically. Watch for any sound or body movement and respond promptly. The promptness of your response helps your child feel the power of communication.
  • Simplify your language. Be literal and obvious in your choice of language. Say precisely what you mean. Speak in short phrases, such as “roll ball” or “throw ball.” You can increase the number of words in a phrase once your child’s vocabulary increases.
  • Follow your child’s interests. Rather than interrupting your child’s focus, follow along with words. Use simple words about what your child is doing. By talking about what engages your child, you’ll help them learn the associated vocabulary.
  • Consider assistive devices and visual supports. Assistive technologies and visual supports can do more than replace speech. They can foster its development. Examples include devices and apps with pictures your child touches to produce words. On a simpler level, visual supports can consist of images and groups of pictures that your child can use to indicate requests and thoughts.

It is important to remember that clear and concise instructions are more effective for children. The level of language used should be appropriate for the child’s current language abilities. As the child progresses and succeeds, instructions can become more complex and include more language.

Respect your child’s current communication level. Though your child may be nonverbal, their thoughts and emotions are just as valid as those of a verbal person. It is essential to learn how to listen to the communication attempts that your child makes, such as gestures, facial expressions, vocalizations, or body language. Respect what your child can do rather than focusing on what they cannot yet do.

Request More Information

Nonverbal Autism

How ABA therapy can help with nonverbal autism

ABA therapy is effective in identifying and targeting skill development goals. It typically addresses skill deficits across various domains, which vary depending on the individual needs of the learner.

Behavior analysts must only use ABA-based treatment programs that are proven effective for specific difficulties. This is known as evidence-based practice. Treatment programs can be tailored to each person, but they all share a solid foundation of methods proven effective through repeated implementation in real-life situations.

Let Leafwing be your partner in unlocking your child’s full potential. We pride ourselves on creating a solid bond between your child and our therapy team, especially at the start of the ABA therapy program. Our staff is dedicated to building a positive relationship with your child, not just at the beginning but throughout the entire program. In the first few weeks, we focus on play and conversation to make your child feel at ease and enjoy their time with our Behavior technician. This ensures positive experiences and maximizes learning rates for extraordinary results.

Call Us at (888) 436-2532

Glossary Terms

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Speech Therapy

Nonverbal Autism

/in , , , , /by

The term nonverbal autism is used to describe individuals on the autism spectrum who have limited or no verbal communication skills. However, it does not necessarily indicate intellectual disability.

Nonverbal autistic children should not be automatically considered intellectually impaired simply because they lack speech. This assumption can lead to under-stimulation, which in turn can cause anger, frustration, and/or depression in the child or adolescent.

Let’s dive in!

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

Contact Us

Nonverbal Autism

What are the early signs of autism?

Based on research conducted in 2007, it was found that approximately 30-38 percent of parents of autistic children observed symptoms before their child’s first birthday. This number is unexpectedly high, considering that autism is often perceived as an issue that may not become apparent until later in childhood. In the majority of those cases, approximately 80 percent noticed signs by the time their child reached 24 months.

Early signs of autism include:

  • not responding to their name by 12 months old
  • not babbling or laughing along with their parents by 12 months old
  • not pointing to objects of interest by 14 months old
  • not playing pretend by 18 months old
  • avoiding eye contact or preferring to be alone
  • not meeting developmental milestones for speech and language
  • repeating words or phrases over and over
  • being upset by minor changes to their schedule
  • flapping their hands or rocking their body for comfort
Request More Information

 

When to see a professional

Don’t let your child fall behind! If you notice they’re not hitting their language milestones, it’s time to seek professional help.

If your child is not babbling or talking, it may be necessary to consult a therapist or speech-language pathologist to determine if nonverbal autism is a possibility. Let LeafWing investigate and assist your child in developing their communication skills.

Language development and speech in older children can be evaluated using a standardized vocabulary checklist, such as the Language Development Survey (LDS). This assessment tool can assist in identifying language delays in children between the ages of 18-35 months by analyzing their vocabulary usage and word combinations.

Call Us at (888) 436-2532

Nonverbal Autism

How is nonverbal autism diagnosed?

First, the parent should obtain a definite diagnosis from a medical professional who will conduct a series of tests, which include

  • physical examination
  • MRI and CT scans
  • blood tests
  • and hearing tests.

These assessments enable the professionals to eliminate any other developmental or physical disabilities hindering the child’s speech.

When it comes to diagnosing nonverbal autism in children, it can be a difficult task. This is because there are no clear distinctions between different types of communication difficulties, and it can be hard to differentiate between language delays and autism-related communication problems. The lack of verbal output for children with nonverbal autism typically makes the challenges associated with diagnosis even more difficult.

Unlocking the puzzle of nonverbal autism in children can feel like navigating a maze of communication challenges, where clear distinctions are scarce, and diagnoses are elusive.

Once the parent has a diagnosis, a therapist will use some standardized assessment tools that assess young children with significant language and speech delays, such as:

  • Gilliam Autism Rating Scale (GARS3) – is a comprehensive assessment tool that assesses communication, socialization, sensory functioning, play, self-help skills, and behavior in autism spectrum disorder patients.
  • Autism Diagnostic Observation Schedule (ADOS-2) – assesses an individual’s behavior, communication, and social interaction skills.

The assessment tools help to identify deficits or unusual patterns that may indicate the presence of autism spectrum disorder.

Click me

Nonverbal Autism

How do you work with a child who is nonverbal?

The first step in working with a nonverbal autistic child is to establish trust and rapport. This can often be done by taking time to get to know them, showing interest in their interests and hobbies, and acting as a supportive companion. It is essential to use clear body language and gestures when communicating, as well as verbal communication if appropriate. Additionally, it may be helpful to use visual tools such as

  • picture cards
  • calendars
  • simple visual schedules

to help children with autism better communicate what they need or want.

Nonverbal Autism: Visual Behavior Supports

Visual supports, such as pictures or other visual representations, can assist children in communication by facilitating the expression of emotions and frustrations. They also aid in comprehending social norms, such as initiating conversations and potentially reducing aggressive behavior.

Visual supports are like a superhero cape for children, guiding them on the path of good behavior and reminding them of the consequences that await if they stray. These magical tools not only help little ones remember the rules but also foster communication and build excellent relationships along the way!

Types of Visual Behavior

  • First-Then Boards: breaks tasks down into smaller, easy-to-understand segments. It is a visual display of something that your child prefers and will receive or can participate in after they complete a task that they do not prefer.
  • Contingency Maps: shows a child what will happen if they engage in a particular behavior. However, unlike a first-then-board, a contingency map depicts both sides of the coin – what will happen if the child does what is expected of them and what happens if they do not.
  • Visual Daily Schedules: the expectation of the events in their day. Visual schedules help mitigate anxiety and lend a sense of predictability. You can create a visual daily schedule with photographs, drawings, or written lists, beginning with the first thing your child should do in the morning and ending with the last thing they should do at night.

Guidelines for Communication with Nonverbal Autistic Children

No matter where your child falls on the autism spectrum, they can communicate in some manner. Even if they are nonverbal, there are a variety of strategies that can be used to help them express themselves and build meaningful relationships with you and others.

  • Encourage play and social interaction. All children learn through play, and that includes learning the language. Interactive play provides a delightful chance for you and your child to communicate. Play games that your child enjoys. Incorporate playful activities that promote social interaction. For example, singing, reciting nursery rhymes, and gentle roughhousing. During your interactions, crouch down close to your child so your voice and face are closer, increasing the chance of them looking at you.
  • Imitate each other. Copying your child’s sounds and play behaviors will encourage more vocalizing and interaction. It also encourages your child to copy you and take turns. Make sure you imitate how your child is playing – so long as it’s a positive behavior. For example, when your child rolls a car across the floor, then you, too, roll a car across the floor. If they crash the car, you crash your car, too. Be sure not to imitate inappropriate behavior like throwing the car!
  • Focus on nonverbal communication. Gestures and eye contact can build a foundation for language. Encourage your child by modeling and responding to these behaviors. Exaggerate your gestures. Use both your body and your voice when communicating – for example, by extending your hand to point when you say “look” and nodding your head when you say “yes.” Use gestures that are easy for your child to copy. Examples include clapping, opening hands, reaching out arms, etc. Respond to your child’s gestures: When they look at or point to a toy, hand it to them or take the cue for you to play with it—similarly, point to a toy you want before picking it up.
  • Give time for your child to talk. It’s natural for us to want to fill in the missing words when a child doesn’t quickly respond. It is vital to give your child lots of opportunities to communicate, even if they are not talking. When you ask a question or see that your child wants something, pause for several seconds while looking at them enthusiastically. Watch for any sound or body movement and respond promptly. The promptness of your response helps your child feel the power of communication.
  • Simplify your language. Be literal and obvious in your choice of language. Say precisely what you mean. Speak in short phrases, such as “roll ball” or “throw ball.” You can increase the number of words in a phrase once your child’s vocabulary increases.
  • Follow your child’s interests. Rather than interrupting your child’s focus, follow along with words. Use simple words about what your child is doing. By talking about what engages your child, you’ll help them learn the associated vocabulary.
  • Consider assistive devices and visual supports. Assistive technologies and visual supports can do more than replace speech. They can foster its development. Examples include devices and apps with pictures your child touches to produce words. On a simpler level, visual supports can consist of images and groups of pictures that your child can use to indicate requests and thoughts.

It is important to remember that clear and concise instructions are more effective for children. The level of language used should be appropriate for the child’s current language abilities. As the child progresses and succeeds, instructions can become more complex and include more language.

Respect your child’s current communication level. Though your child may be nonverbal, their thoughts and emotions are just as valid as those of a verbal person. It is essential to learn how to listen to the communication attempts that your child makes, such as gestures, facial expressions, vocalizations, or body language. Respect what your child can do rather than focusing on what they cannot yet do.

Request More Information

Nonverbal Autism

How ABA therapy can help with nonverbal autism

ABA therapy is effective in identifying and targeting skill development goals. It typically addresses skill deficits across various domains, which vary depending on the individual needs of the learner.

Behavior analysts must only use ABA-based treatment programs that are proven effective for specific difficulties. This is known as evidence-based practice. Treatment programs can be tailored to each person, but they all share a solid foundation of methods proven effective through repeated implementation in real-life situations.

Let Leafwing be your partner in unlocking your child’s full potential. We pride ourselves on creating a solid bond between your child and our therapy team, especially at the start of the ABA therapy program. Our staff is dedicated to building a positive relationship with your child, not just at the beginning but throughout the entire program. In the first few weeks, we focus on play and conversation to make your child feel at ease and enjoy their time with our Behavior technician. This ensures positive experiences and maximizes learning rates for extraordinary results.

Call Us at (888) 436-2532

Glossary Terms

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Autism learner

ABA Therapy at Home

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

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

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ABA Therapy at Home

Considerations of ABA Therapy Services at Home

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

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

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

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

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

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

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

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

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

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

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

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

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Behavior Therapist at In-Home Service

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

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

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

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

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

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

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

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

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

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

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Advantages of ABA Therapy at Home Services for Parents

Advantages of ABA Therapy at Home Services for Parents

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

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

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

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

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Insurance Coverage

How to Get Started

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

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Insurance Coverage for ABA Therapy

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

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

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

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

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

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

Related Glossary Terms

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Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Observational Learning and Children with Autism

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One of the main obstacles to learning that many children with autism face is a lack of observational learning skills. Observational learning requires the coordination of cognitive functions and the processing of social information. Cognitive functions include the domains of perception, memory, learning, attention, decision-making, and language abilities. We will explore the reasoning behind why children with autism struggle to learn just by using observation.

In this article, we’re going to discuss:

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Child copy the same puzzle

What is observational learning?

Observational learning is a method of learning where individuals observe and model another person’s behavior, attitudes, or emotional expressions. According to American psychologist Albert Bandura, it is not necessary for the observer to imitate the behavior; they can simply learn from it. Observational learning is an important aspect of Bandura’s social learning theory.

Four prerequisites for observing behavior:

  • Attention
  • Retention
  • Reproduction
  • Motivation

Prerequisite for observational learning: Attention

To learn from a model, you must pay attention to their behavior. Many things can affect your attention. If you’re tired, sick, or distracted, you won’t learn or imitate the behavior. The characteristics of the model also matter. People pay more attention to attractive, similar, or prestigious models who are rewarded. Athletes and successful adults have a strong influence. However, this can also be used in negative ways. For example, children may imitate gang members if they see them gaining status or money.

Prerequisite for observational learning: Retention

Observational learning plays an important role in helping children with autism learn new skills and behaviors. While some children with autism may be able to imitate behavior they have seen, many are unable to do so due to their limited abilities to remember, process and recall information. This can make it difficult for them to learn through imitation alone.

Prerequisite for observational learning: Reproduction

A person needs to be physically and mentally capable of copying observed behavior. For example, a child watches a basketball player dunk and tries to do the same but can’t reach the hoop. An older child or adult might be able to dunk after practice. A young horse sees another horse jump over a creek and tries but ends up in the water. The horse simply isn’t big or strong enough yet, but with growth and practice, it could eventually jump like the other horse.

Prerequisite for observational learning: Motivation

Observational learning is heavily influenced by motivation. Without a reason to imitate the behavior, attention, retention, and reproduction will not be enough. Bandura identified various motivating factors for imitation. These include the model being reinforced for the behavior, receiving incentives, or witnessing the model being reinforced. These factors can also act as negative motivations. For example, if the observer knows that the model was punished or threatened for the behavior, the likelihood of imitating it decreases.
Boy playing doctor

Observational Learning Examples

The following are instances that demonstrate observational learning has occurred.

  • A child watches their parent folding the laundry. They later pick up some clothing and imitate folding the clothes.
  • A young couple goes on a date to an Asian restaurant. They watch other diners in the restaurant eating with chopsticks and copy their actions to learn how to use these utensils.
  • A child watches a classmate get in trouble for hitting another child. They learn from observing this interaction that they should not hit others.
  • A group of children play hide-and-seek. One child joins the group and is not sure what to do. After observing the other children play, they quickly learn the basic rules and join in.
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Influences on Observational Learning

Bandura’s research indicates that there are various factors that can enhance the likelihood of behavior being imitated. We are more likely to imitate:

  • Individuals who are perceived as warm and nurturing
  • Individuals who receive rewards for their behavior
  • Individuals who hold positions of authority in our lives
  • Individuals who share the same age, gender, and interests as us
  • Individuals we look up to or who hold a higher social standing
  • When we have been rewarded for imitating the behavior in the past
  • When individuals have a lack of confidence in their own knowledge or abilities
  • When the situation is unclear or unfamiliar

Observational Learning Science class

Uses for Observational Learning

Observational learning can be used in the real world in a number of different ways. Some examples include:

  • Learning new behaviors: Observational learning is commonly employed as a practical method for teaching individuals new skills. This may involve children observing their parents completing a task or students watching a teacher demonstrate a concept.
  • Strengthening skills: Observational learning is an important method to reinforce and enhance behaviors. For instance, when a student witnesses another student being rewarded for raising their hand in class, they are more inclined to raise their hand themselves when they have a question.
  • Minimizing negative behaviors: Observational learning has a significant impact on reducing undesirable or negative behaviors. For instance, witnessing another student receiving a reprimand for not completing a task on time may increase the likelihood of one finishing their own work promptly.
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What learning style do autistic children have?

They tend to have strong visual skills because autistic children tend to focus on details, rather than the whole. Also, autistic children are often visual learners. This might be because visual information lasts longer and is more concrete than spoken and heard information.

What are some challenges that children with autism face when learning?

School activities that may be particularly challenging for students with autism spectrum disorder (ASD), include social interactions, noisy or disordered environments, intense sensory stimulation, and changes in expected routines.

Social interactions can be difficult for children with autism, since they may have difficulty understanding non-verbal communication cues such as facial expressions and body language. They may also find it difficult to interpret or respond to the tone of someone’s voice, or the inflections that are used when speaking.

Noisy or disordered environments can also be very confusing for students with autism. They may not be able to block out background noise well and may become easily overwhelmed.

Intense sensory stimulation can be a major challenge for children with autism, as they may be easily overwhelmed by loud noises, bright lights, and other environmental factors that can cause an overstimulation response. Observational learning is one strategy that can help children with autism cope with intense sensory stimulation. Through observational learning, the child’s behavior is modeled after another person who is better able to tolerate the sensory and changes in expected routines.

In what kind of learning environments are autistic children most successful?

Children with autism thrive in a structured and predictable environment. Establish routines early on and keep them as consistent as possible. In a world that’s ever-changing, routine and structure provide great comfort and support to a child on the autism spectrum.

Let LeafWing partner with you to ensure that your child achieves their maximum potential. Leafwing takes pride in building a rapport between the learner and the therapy team, especially at the beginning of the ABA therapy program. The staff should work on establishing a positive relationship with your child. This is important not only in the beginning but throughout the program. During the first few weeks, there will be a lot of play and conversation with your child to make them feel comfortable and have fun with the Behavior technician. This creates positive experiences and improves learning rates for better outcomes.

For more information regarding this topic, we do encourage you to speak with an ABA technician or email us at info@leafwingcenter.org

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Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

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

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

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

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

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

Before:

After:

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

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

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

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

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

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

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

  • You can’t have that right now.
  • You are not allowed to do that.
  • We are not going there today.
  • Danger.
  • Stop.
  • Don’t touch that.
  • Maybe.
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What to do before and after telling your child with autism “No”

Give a Visual before telling a child with autism no

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

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

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

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

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Giving alternates after telling a child with autism no

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

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

They have a:

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

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

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

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Glossary Terms

How to teach your child with autism to wait

How to teach your child with autism to wait

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

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

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How to teach your child with autism to wait

How do you practice the skill of waiting?

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

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

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How to teach your child with autism to wait

Wait Visuals for autism

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

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

You can practice this by:

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

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

Use verbal reminders:

  • Count down from 10
  • Repeat instructions in smaller chunks

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

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Wait Social Stories for autism

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

A good social story would include:

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

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

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Distinguish between “wait” and “unavailable”

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

Unavailable:

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

Waiting:

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

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

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

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Other Related Article

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

IS ABA therapy covered by my insurance

Applied Behavior Analysis

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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.

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Additional Articles:

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

Autism Feeding Issues

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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.

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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.

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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.

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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.

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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 info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Autism and Communication Difficulties

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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.

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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.

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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.

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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.

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Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Autism and bedtime routine

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Design a bedtime routine that can be a win-win situation for your autistic child and yourself. Bedtime can be one of those nightly events which many parents love or hate or both! It means that peace and quiet are soon ahead, but it also can mean that a huge struggle is about to proceed. Many children with autism have difficulties either transitioning to bed, falling asleep, or even staying asleep all night long. Any of these difficulties can increase stress and tension in your home. Keep in mind that no single suggestion will be for all children but getting the right amount of sleep will allow your child to perform better academically, encourage the development of motor skills, and allow them to maintain a better mindset. Not to mention, it’ll help you get a fuller night of rest, too!

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a child sleeping

Bedtime routine for children with autism

The first step to a healthy sleep starts with the daily routine. Be consistent. By creating a visual schedule, it helps to remind your child what they should be doing and what is to come. Take pictures of all events (e.g., dinner time at the table, bath time, reading books, and the child in bed), laminate the pictures and a piece of construction paper, and Velcro each picture either horizontally or vertically on the paper. When each event is completed, you can guide your child to take off the picture and point to the next event which helps them to actively check off their tasks.

Praise your child for successfully completing steps in their bedtime routine. Descriptive praise is when you tell your child exactly what it is that you like. For example, ‘I like the way you’ve found a spot for everything in your room’. This helps your child understand exactly what it is that they’ve done well. It’s also more genuine than non-specific praise like ‘You’re a good boy’. For younger children, you could use a reward chart.

A typical daily routine for better sleep

It is important for the daily routine to be consistent with time and order. Make sure your child wakes up every morning at the same time. They eat breakfast at the same time. Whatever the routine, keep it consistent so the child learns what to expect. A routine helps signal the body.

Morning routine

  • Wake up at 7 am
  • Brush teeth
  • Take a shower
  • Get dressed
  • Brush hair
  • Make bed
  • Eat breakfast

Afternoon routine

  • Eat lunch at 12 pm
  • Exercise for 1 hour
  • Plan activity

Evening routine

  • Eat dinner at 6 pm
  • Watch TV
  • Play a board game with the family
  • Read a few books to quiet down

Bedtime routine

  • Put on pajamas
  • Brush teeth
  • Go to the bathroom
  • Dim the lights
  • Put on the white noise machine
  • Give a massage
  • Go to bed

Remember there are triggers that might enhance alertness during bedtime like caffeine. Caffeine can stay active in our body for up to 12 hours. Monitor caffeine intake as well sugar consumption in foods. Watching TV, videos, or playing on the computer, especially if the shows or games are scary or violent, can lead to kids with autism having more trouble sleeping.

Problems sleeping happen more often in autistic children who have restricted and repetitive behaviors (lining up toys, rocking, hand-flapping), anxiety, or sensory problems and can lead to having trouble paying attention, feeling restless, getting angry, and throwing tantrums.

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girl-sleeping

Autism and the successful bedtime routine

It can’t be stressed enough, to stick to a routine. Make bedtime routine no more than 20 to 30 minutes. The bedtime routine should be calming like reading a book, singing a song, or a massage. You know your child best. What is calming for one child may be stimulating for another. Design an area that encourages sleep. Make sure to only use your child’s bed for sleep. Keep the temperature in the room less than 75 degrees Fahrenheit. Don’t leave lamps or overhead lights on overnight. Nightlights can be used to provide some light. Using a white noise machine will help your child from being disturbed by noise around them.

If your child has a hard time falling asleep, or wakes up in the middle of the night, first consider if they take naps during the day. You may want to reduce these naps so your child is more tired at night time. If your child wakes up in the middle of the night, be sure to keep the sleeping environment calm and do not allow him or her to play games or leave their room. This may take many sleepless nights by the parents but it will pay off in the end. It is important that your child learn the skill of falling asleep without a parent present. All children and adults wake briefly during the night but quickly put themselves back to sleep by reestablishing associations used at bedtime. So if your child needs a parent present to fall asleep at bedtime, he might need a parent to help him fall back asleep during the normal awakenings.

The time you invest in putting a sleep routine for your autistic child now will save you many, many hours in the long run and you won’t have to do it forever. Once patterns are established, you will be able to reclaim a large part of your evening for yourself.

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Autism and bedtime routines: other considerations

It is important to address medical or psychiatric issues that potentially interfere with sleep. Your child’s medications might need adjustment if they affect his sleep. If your child suffers from a sleep disorder such as sleep apnea, sleep walking, sleep terrors, restless legs syndrome, they may need a referral to a sleep specialist. Some children with persistent insomnia will need further behavioral or pharmacological treatment to improve their sleep.

Children and Adults with autism tend to have signs of insomnia: It takes them an average of 11-15 minutes longer than most people to fall asleep. Many wake up frequently during the night. Some adults and children with autism have sleep apnea as well, a condition that could potentially cause them to stop breathing several times during the night.

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.

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Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

IS ABA therapy covered by my insurance

What is Applied Behavior Analysis?

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

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What is Applied Behavior Analysis?

An introduction to Applied Behavioral Analysis

Applied Behavior Analysis is the applied science of behavior formalized by B.F. Skinner. It is sometimes referred to as Behavior Modification, ABA, or Behavior Analysis. The theories, laws, and techniques have their foundations in years of basic research and describe some of the most fundamental things we know about behavior. Some early influences on the field of ABA include Watson, Thorndyke, Pavlov, and groups of psychologists, philosophers, and scientists in the late 1800’s and early 1900’s that pursued empirical science.

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Hallmarks of Applied Behavioral Analysis

Contemporary hallmarks of ABA include the Law of Reinforcement, functions of behavior, contextualism, and determinism. Let’s briefly look at these areas to get a better understanding of the field of Applied Behavior Analysis.

Law of Reinforcement

Simply put, the Law of Reinforcement states that behavior that is reinforced will continue to occur or will occur more often in the future. Conversely, a behavior that is not reinforced will not occur or will decrease in occurrence over time (though, sometimes we see a short increase after reinforcement is discontinued for a behavior that has been previously reinforced).Through a great deal of clinical experience, it has become apparent that one challenge with really applying this law and understanding its fundamental truth relates to a not having a good understanding of what reinforcement is or can be. Some general misunderstandings include the assumption that consequences most people would describe as positive or pleasant will function as reinforcers. For example, most people would assume that receiving a thank you note would be a reinforcer for a job well done. In practice, this is not the case. There are individuals that would have no interest in a thank you note, but would rather prefer a pay increase. There are, of course, some that would.

Oftentimes, people attribute what they would find reinforcing to another person. Life shows us, this is not the case. Conversely, when we talk about reinforcement, something that we think may be reinforcing may in fact be punishing (a consequence that causes a behavior not to occur or to decrease in the future). Similarly, reinforcers can vary in their magnitude or effectiveness depending on the environment and on what has happened in the time before the reinforcer is being used.

One final thought is that behavior is often under multiple schedules. Some of the schedules are reinforcing and some of them are punishing. The effects of the reinforcers and punishers that are a part of each schedule vary. This makes it challenging for all but only the most skilled Behavior Analysts to have a good understanding of reinforcement, reinforcers, and schedules of reinforcement. The field of Behavioral Economics is making strides in empirically describing these concerns. However, the law of reinforcement remains one of the important concepts in Applied Behavior Analysis.

Behavioral Function

One of the more recent (relatively speaking as it dates back to the very early ’80’s) concepts in Applied Behavior Analysis is behavioral function. Previous to this notion, the field was more commonly known as behavior modification and behavior was mainly changed by modifying consequences (e.g., reinforcers and punishers).

Research in the early 80’s demonstrated functional relationships between problem behavior and the conditions that reinforced it. This research led to the concept of behavioral function. Simply, a behavior must be analyzed in terms of what function (i.e., purpose) the behavior served for the individual performing it.

Nowadays, we commonly look at the inappropriate behavior that children with autism perform in these terms. We ask, “are they performing this behavior for attention? Are they performing it to escape or avoid something that they do not like? Are they performing the behavior to get access to something that they want? Are they doing it because it gives them some sort of pleasure?”

Additionally, there are two questionnaire-based assessments, the Questions About Behavior Function (QABF) and Motivation Assessment Scale (MAS), that assist users with determining the function of the behavior in question. The QABF was developed with adults who have developmental disabilities and the MAS was developed with children diagnosed with developmental disabilities.

Contextualism

Contextualism is a concept somewhat close to behavior function. In short, contextualism refers to analyzing behavior in terms of the context that it occurs. What are the characteristics of the environment? Is it loud? Quiet? Hot? Who is there when the behavior happens? What happens right before the behavior occurs? What happens earlier in the lead up to the occurrence of the behavior? What happens after?
All of these questions are things that we ask when we analyze behavior. Taking these things into consideration is why we refer to Applied Behavior Analysis as contextual.

Determinism

Our final hallmark of ABA is one of the more ephemeral concepts. It is complex and philosophical in nature and oftentimes needs to be reflected on to really get a grasp of it. This is the concept of determinism. This is also one of the more controversial concepts in ABA. Essentially, the concept of determinism says that our behavior is under the influence of our learning histories, the antecedents that occasion the behavior, and the consequences that reinforce or punish it. We are not operating under the umbrella of free will.

Like was said earlier, this is a controversial concept. Some say that our verbal behavior (i.e., thoughts) can control our behavior. In some cases, it may mitigate our behavior and, of course, it is behavior and therefore is under the same influences of antecedents, consequences and learning history. However, with the exception of the species-specific behavior with which we are born, we are products of our learning histories and present environmental factors.

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ABA therapy and skill development goals

Looking beyond the foundations of applied behavior analysis

Applied Behavior Analysis is an elaborate science of behavior and it has been applied in many arenas (businesses, animal training, individuals with developmental disabilities, individuals with Traumatic Brain Injury, etc.,). There are many laws and principles and even more techniques based on these laws and principles. Some of the main hallmarks remain those referenced above (i.e., reinforcement, functions of behavior, contextualism, and determinism).

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

Challenging behaviors

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

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

Applied Behavior Analysis therapy and skill development goals

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

Call Us at (888) 436-2532

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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