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Autism learner

ABA Therapy at Home


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

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


ABA Therapy at Home

Considerations of ABA Therapy Services at Home

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

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

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

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

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

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

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

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

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

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

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

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

Behavior Therapist at In-Home Service

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

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

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

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

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

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

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

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

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

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

Advantages of ABA Therapy at Home Services for Parents

Advantages of ABA Therapy at Home Services for Parents

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

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

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

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

Insurance Coverage

How to Get Started

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

Insurance Coverage for ABA Therapy

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

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

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

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

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

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

Related Glossary Terms

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Autism learner

ABA Therapy at Home


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

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


ABA Therapy at Home

Considerations of ABA Therapy Services at Home

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

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

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

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

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

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

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

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

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

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

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

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

Behavior Therapist at In-Home Service

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

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

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

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

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

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

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

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

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

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

Advantages of ABA Therapy at Home Services for Parents

Advantages of ABA Therapy at Home Services for Parents

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

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

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

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

Insurance Coverage

How to Get Started

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

Insurance Coverage for ABA Therapy

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

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

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

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

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

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

Related Glossary Terms

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Observational Learning and Children with Autism

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:


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.

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.

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 [email protected]

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

How has DSM-5 affected an autism diagnosis?

Many parents and individuals with autism were afraid that DSM-5 might bring major changes to their diagnosis in the sense of services and insurance coverage. The DSM -5 main purpose was to help categorize disorders into “classes” with the intent of grouping similar disorders to help clinicians and researchers when diagnosing individuals with autism.

DMS-5

What is the DSM-5?

The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM) to guide healthcare professionals in diagnosing mental health conditions. The manual’s fifth edition – DSM-5 – took effect in May 2013. In the medical profession, it is commonly referred to as ‘the bible of psychiatry.’ The DSM-5 lists the signs and symptoms of autism spectrum disorder and states how many of these must be present to confirm a diagnosis of autism spectrum disorder. Psychiatrists and clinical psychologists alike seek to reference patients against a checklist of behaviors provided in the DSM-5.

The importance of being diagnosed with autism

An official (clinical) diagnosis is deemed necessary for a number of reasons, some of which include:

  • Better access to disabled services by registering with the Department of Work and Pensions (DWP) as disabled.
  • Improved conditions in an educational setting for example the Individual Education Plans (IEPs).
  • Improved employment conditions as diagnosis leads to support/protection under The Autism Act 2009.
  • Improved sense of ‘self’ as the individual seeks to understand his/herself better.

Years later, it’s clear the DSM-5 did not cut services for people already diagnosed with an autism spectrum disorder. A growing body of evidence, however, shows that its criteria do exclude more people with milder traits, girls, and older individuals than the DSM-IV did.

Autism Spectrum Disorder

How does the DSM-5 change the way autism is diagnosed?

The first change with the new edition of the DSM is to combine the formerly separate diagnoses of autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not-otherwise-specified into one group with the name of autism spectrum disorder.
The second change is the combining of the three domains that appeared in DSM-IV

  • Qualitative impairments in social interaction
  • Qualitative impairments in communication
  • Restricted repetitive stereotyped patterns of behavior

The third change is a change in the criteria within the social/communication domain that were merged and streamlined to clarify diagnostic requirements.

Clinicans

What developed based on the change to DSM-5?

The two categories symptoms that evolved were

  • Persistent deficits in social communication/interaction and
  • Restricted, repetitive patterns of behavior

The following rationale was provided:

  1. Deficits in communication and social behaviors are inseparable
  2. Delays in language are neither unique to autism (i.e., they appear in other disorders) nor are they universal (i.e., not all individuals with autism have them)
  3. The changes improved the specificity of the diagnosis while not compromising the sensitivity
  4. Increased sensitivity across severity levels of autism
  5. Secondary analyses of data sets support the combination of categories.

Additional assessment for:

  • Any known genetic causes of autism (e.g. fragile X syndrome, Rett syndrome)
  • Language level
  • Intellectual disability and
  • The presence of autism-associated medical conditions (e.g. seizures, anxiety, gastrointestinal disorders, disrupted sleep)

Creation of a new diagnosis of social communication disorder, for disabilities in social communication without repetitive, restricted behaviors.

Specific changes in diagnostic criteria for autism spectrum disorder (ASD):

  • Eliminates subtypes of ASD including Asperger’s disorder and Pervasive Development Disorder (PDD-NOS) from the scientific lexicon
  • Symptoms reduced to two domains: social interaction/communication and restricted/repetitive behaviors
  • Eliminates language delay as a diagnostic symptom
  • Addition of hyper- or hypo-reactivity to sensory stimuli to list of symptoms of restricted/repetitive behavior
  • Onset of symptoms in early childhood (rather than before age 3 years)

DSM-5 guidelines for persistent deficits in social communication/interaction

Difficulties in social communication

Signs in this area include:

  • rarely using language to communicate with other people
  • not speaking at all
  • rarely responds when spoken to
  • not sharing interests or achievements with parents
  • rarely using or understanding gestures like pointing or waving
  • using only limited facial expressions to communicate
  • not showing an interest in friends or having difficulties making friends
  • rarely engaging in imaginative play

DMS-5 guidelines for restricted, repetitive patterns of behavior

Restricted, repetitive, and sensory behavior or interests

Signs in this area include:

  • lining up toys in a particular way over and over again
  • frequently flicking switches or spinning objects
  • perform repetitive behaviors like hand-flapping, rocking, jumping, or twirling
  • speaking in a repetitive way
  • having very narrow or intense interests
  • needing things to always happen in the same way
  • having trouble with changes to their schedule, or changing from one activity to another
  • showing signs of sensory sensitivities like becoming distressed by everyday sounds like hand dryers, not liking the feel of clothes labels, or licking or sniffing objects

The diagnosis indicates support levels for each area. This means that children might have different support levels for their social communication skills compared to their restricted, repetitive, and/or sensory behaviors. Or they might have the same support level for both.

Remember, non-clinical can assess a person, but a medical professional can diagnose a person.

Levels of support can change over time. This happens as children grow and go through transitions. These transitions include moving from child care to primary school to secondary school, or changes in family life like the birth of siblings.

Minor revisions with DSM-5-TR

The DSM-5-TR version was updated for clarity on the wording of the diagnosis. The first change, it now reads “associated with a neurodevelopmental, mental, or behavioral problem.” The second change is to broaden the idea of specifiers.

The diagnosis may be suspected by developmental screens done at 9 months, 18 months, and 24 months of age. The key is to find out as soon as possible if a child is on the spectrum. That way, you can line up resources to help your child reach their full potential. The sooner that starts, the better. Each child is uniquely different with their own personality and interests. Let Leafwing help you start the support that your child deserves.

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

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Motivational words

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

The benefits of Choice boards and ‘Wait’ support in the classroom may vary depending on the need of the student with autism. Different Choice boards may need to be developed based on the motor and communication skills of the student. As such, it can display the objects, pictures, icons, or words that would represent a menu of activities or reinforcers. It is vital the pictures represent the actual object so the student can connect the picture and the object. These can easily be created with supplies such as poster paper, card stock, whiteboards, or on any surface that you can attach or write on. Choice boards are often placed next to a student’s daily schedule and when a designated time arrives, students simply select a preferred activity from the board. Choice boards with preferred activities can be placed near the free time or break time area of the room, and provide a stimulus for independent selection of activity. Choice boards can implement structure, and provide a routine that becomes familiar to students with autism which aids in decreasing anxiety.


Choice boards for autism in the classroom

What are Choice boards for autism?

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

When to use a Choice board in the classroom

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

How are Choice boards used?

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

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

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


Wait Support for students with autism in the classroom

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

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

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

Guidelines to determine the type of ‘Wait’ support

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

Examples of wait times at school

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

Wait support tools

  • Visual timers
  • Countdown strips
  • Distractors

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

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

Again, be sure to teach waiting skills across a variety of settings to increase the likelihood of generalization. Even using a peer model or a peer buddy during waiting times can offer support for desired behaviors. Additionally, specific ‘physical supports’ such as chairs near the waiting area, setting a timer, or holding a picture representing “wait” can also help a student learn this concept.

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

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

Other Related Articles:

Strategies for autism in the classroom
Supporting students with autism in the classroom with an assignment notebook
Autism communication strategies

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Teaching Action Labels to Children with Autism

Oftentimes as a parent with a child with autism, it can be difficult when your child is struggling to meet normal child growth and development milestones. One way to help children with autism in the development of words and understanding of the world around them is through action labels. Giving a child with autism a way to communicate using action labels can aid in a more smoothly operating daily routine. These action labels also help to expand a child with autism’s vocabulary and increase their identification skills of people, objects, and actions.

Teaching Action Labels to Children with Autism

What are action labels?

Action labels are a way for a child with autism to communicate and be able to acquire language skills. The goal with action labeling is for the child to be able to label objects, people, and actions correctly as well as have an understanding of what the word means. For example, starting with the 5 senses during a child’s daily routine can help to identify common things they interact with and come in contact with in an everyday setting. When teaching action labels, it is important to reduce background noises and distractions as much as possible so that the child can solely focus on the objects being labeled.

When should you start teaching action labels?

When action labels should be taught is different for each child. However, there is a checklist that once completed is seen as a good time to begin teaching action labels.

Checklist includes:

  • beginning to show an interest and interacting with their environment
  • interacting with other people
  • having a daily routine
  • knows more than a few words or can demonstrate an understanding of more than a few words

A good way to start is using ongoing actions. For example, with the word jump. You would ask the child to show me jumping and they would start jumping. Then have them identify the action on someone or something else. Have mom start jumping, and ask what am I doing and the child would respond with jumping. When you begin teaching action labels it is important to practice over and over again. The correct and consistent use of the label does not happen overnight.


Teaching Action Labels to Children with Autism

Why are action labels important?

Action labels are one method to help children with autism communicate. Since children with autism typically develop language later than their peers, action labels can provide that missing piece to a child with autism. Neurotypical people use words as a form to label objects, actions, people, and concepts. Babies learn this from those around them, acquiring words and understanding what words mean by watching others. However, as stated prior children with autism typically have language deficits which makes learning these everyday word labels difficult. Therefore, teaching them how a label is a vital component to aid the child with their progress of language development and interaction with the world around them and others.

What are common challenges in teaching action labels?

Some common challenges in teaching action labels include a delay in using, limited imitation skills, lack of understanding, and difficulty inconsistent use.

  • Delay in use: As had been said children with autism typically have a delay in language use or use simpler language than the rest of their peers. This delay in language use can cause a delay in the child’s ability to acquire the skill of labeling and using action labels consistently.
  • Limited imitation skills: Most babies and young children acquire language through imitating others around them. When they hear adults using language, they try to repeat back what they said or use it at a later time. However, children with autism typically do not have the developmental interest in focusing on their parents and copying them.
  • Lack of understanding: Once children with autism are taught labels, they may use them through memorization rather than actually understanding what it is that they are labeling. They just use them out of habit or to appease rather than actually connecting what it is they are labeling with a word or action they understand.
  • Difficulty inconsistent use: Unless label teaching is consistent in all places of a child’s life, a child with autism will not be able to consistently use labeling. So, if labeling is taught at school, it should also be reinforced at home and vice versa.

Teaching a child to label correctly can truly expand their view of the world around them. Words are used as a way to communicate within the world, so giving that tool to a child with autism can be extremely vital. Using modeling, prompting, and reinforcement in all aspects and environments of a child’s life increases their consistent use and true understanding of the labels.

Let Leafwing Center help with developing some action labels for your autistic child, so they can be successful in communicating in the world around them. Our ABA therapists are trained in creating personalized plans that match your child’s ability levels.

 

 

Related Articles:

Autism Communication Strategies
Strategies For Autism In The Classroom

Glossary Terms:

Functional Communication Training (FCT)
Picture Exchange Communication System (PECS)

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

What not to do with a child with autism

Oftentimes it is suggested what to do with a child with autism. However, equally as important is what not to do. It is necessary to know and understand what not to do in order to be able to provide the best environment for a child with autism.

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

Let Leafwing professionals educate you and your child on some key components and techniques when raising a child with autism to reach their full potential.

Don'ts of Autism

What not to do with discipling a child with autism

It can be hard to know what to do and not do in terms of discipline with a child with autism. Their development is different from their neurotypical peers so it is vital to make the distinction.

  • Do not punish for typical autistic behaviors. Stimming, meltdowns from overstimulation, and spams are all behavior they cannot control. They are part of a normal every day for a child with autism.
  • Do not be confusing in your reasoning. When explaining to a child with autism a reason for the consequence, use clear logic they can understand. Avoid things like metaphors, hypothetical scenarios, and complex vocabulary.
  • Do not use punishments that are not age/developmentally appropriate. Use consequences to help your child grow and learn. Behavior is a form of communication. Learn what your child is trying to communicate and help them better communicate that next time with positive action.

Your child with autism may not understand the traditional discipline techniques as well as the consequences of their actions. As a parent you might feel frustrated by this, but you need to refrain from any kind of physical or verbal punishment that could have a negative effect on your child. Remember, all children learn from imitation, so try to respond to your child’s behavior clearly and gently. Consistency is the key for all children when it comes to discipline. Do it with a loving heart. When children know you are disciplining them because you love them and want what is best for them then it has a more positive outcome.

What not to do with tasks for a child with autism

What not to do with tasks for a child with autism

Children with autism are able to complete tasks and chores similar to other children. These are necessary to help them become independent and learn essential life skills. Practice tasks with Forward Chaining or Backward Chaining methodology. Use the method that your child feels more comfortable with.

  • Do not have too many expectations. Have a few clear expectations for a child to be able to remember and follow.
  • Do not only have verbal instructions. Many children with autism are visual learners. Therefore, provide both words and pictures. For example, a picture of a toothbrush with toothpaste on it to remind them to brush their teeth.
  • Do not make them do less just because they have autism. Children with autism are just as capable as their peers. They may need a little more help when completing a task but they can still do it. Holding a child back from their full potential will only hurt them in the long run.

Remember at the Leafwing Center your ABA therapist can put together an Acquisition Skill Plan to help hone in on a skill that needs to be refined to help your child progress in basic analysis tasks like getting dressed, brushing teeth, or combing their hair.

 

What not to do when interacting with a child with autism

What not to do when interacting with a child with autism

People can often feel awkwardness or uneasiness when interacting with a child who has autism. However, there are just a few key concepts to remember for the interaction to easily go smoothly.

  • Do not get into their personal space. Many children with autism do not like to be touched especially when it’s unexpected. Give them their space.
  • Do not only see them as a child with autism. Autism is part of their identity but it is not their whole identity. When interacting with a child with autism, treat them like you would treat anyone else with kindness.
  • Do not beat yourself up over making a mistake. As a parent of a child with autism (and just a person in general), you are going to make mistakes. So, give yourself grace, apologize, and move on.

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.

 

Autism Feeding Issues

What not to do during meal time with a child with autism

Meal times can be a stressful time for everyone in a household that has a child with autism. With all the different textures and flavors, it can be intimidating. 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. Refer to your pediatrician about any food allergies with your child .

  • Do not make choices for them. Allow a child with autism to make choices for themselves within reason. This will give them the confidence and independence to do it on their own next time.
  • Do not yell at them. For any child, this can be overwhelming but for a child with autism, this increase in sound can trigger a meltdown. Additionally, it doesn’t help fix the situation in the end.
  • Do not rush or pressure them. Eating and meal times can be a very difficult time for a child with autism. Allowing them to go at their own pace and providing a safe environment for the child is a necessity.

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.

Having a child with autism is a learning process for everyone. You as a parent are going to be constantly learning the new and best way to help your child with autism navigate new experiences with the world around them. There is no one-size-fits-all when it comes to the approach of developing a child, alone a child with autism. Learn from these ‘What Not to Dos’ and adjust your approaches with your child.

Leafwing Center has professional BCBA therapists that can help you and your child navigate through the stages of development as your child grows. Call us today to see how we can help!

Other Related Articles:

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Strategies to use for the park with your child with autism

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

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

Challenges for children with autism at the park

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

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

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

How parents can prepare children with autism for the park

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

Tips on how to prepare:

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

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

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

How ABA therapy can help with your park experience

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

ABA therapy can help with:

  • Taking turns
  • Use equipment appropriately
  • Following directions

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

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Strategies for autism in the classroom

Each student with autism is unique therefore each student will have unique needs in the classroom. However, there are many strategies and basic principles of effective instruction that can be implemented for students with autism within the classroom. Many of these strategies provide structure and teach a variety of skills across content areas of the natural and traditional classroom setting. These include:

Strategies for autism in the classroom

Autism in the classroom: strategies for success

  • Assignment Notebooks
  • A Routine
  • Classroom Environment
  • Communication

Students with autism can thrive in the classroom with a few strategies for success. One of the ways is with an assignment notebook. An assignment notebook is an easy way to have a visual for students to be able to know and understand what is expected of them and what is coming up next in class.

Another strategy is through a routine. A routine makes a great strategy for success for autism in the classroom. Routines are necessary for all students but particularly those with autism. A routine allows for consistency and for a student to know what is coming next. Change is bound to happen at school once in a while with substitute teachers, fire drills, etc. Change can be difficult and a barrier in the classroom for students with autism so keeping things the same most of the time will lead to success in the classroom setting.

The classroom environment itself is also a strategy for success for students with autism. Structure and predictability facilitate the student’s understanding of the environment, which can help decrease worry or agitation the student might have. This is really important for students with autism who tend to react negatively or really have a difficult time with changes and unsent uncertainty in their environment. These types of students are often overwhelmed by sensory stimuli. Therefore, an overload of sensory at once can be very stressful and cause a negative reaction within the classroom. By limiting loud noises, certain light frequencies, textures, and control of temperature, the classroom can become a great place for a student with autism to learn and be successful.

The last key to strategies for success for autism in the classroom is communication. As with routines, clear communication is important to all students but a significant necessity for students with autism. Keeping directions clear and simple prevents any confusion from occurring and allows students with autism to process instructions easily. Students with autism oftentimes do not understand common phrases or figurative language so communicating in a direct manner with short tasks allows for the student to process and complete the task in a timely manner.
Classroom setup for students with autism

Ways Autism impacts Learning in the classroom

Autism impacts learning in many ways. Students with autism have difficulty adapting their behavior to different situations. When there is a change in their normal routine or something is out of the ordinary it can be highly stressful for students with autism. They also have challenges socially interacting with others. In lower elementary grades, oftentimes learning occurs through play with other students. This can be an obstacle for students with autism. Some students with autism need to be moving in order to learn. This can pose an issue in the general education classroom setting because of space constraints as well as the possibility of distracting other students.

Strategies for autism classroom set-up

One of the main strategies for a classroom setup for students with autism is to label materials and spaces. Setting up the classroom a certain way can increase a student with autism’s ability to be successful in the classroom setting. We can help students understand expectations, and in general, make sense of their entire environment. Researchers have defined environmental support as “aspects of the environment, other than interactions with people, which affect the learning that takes place”.

Predictability and sameness are significant factors throughout students’ daily lives. One way to address these elements in the classroom is with “Environmental Supports”.

Examples of environmental support

  • Labels
  • Boundary settings
  • Visual schedules
  • Behavioral-based education tools
  • Activity completion signals
  • Choice boards

Students with autism can get overwhelmed easily or become overstimulated. Have a designated calm down area. When the instances occur, it is easier on everyone if there is a designated area for the student to go to aid in their self-regulation. The space should be quiet and include items they may use to help calm down and re-focus themselves.

All of these environmental support strategies are a simple yet effective way to help a student respond appropriately in their day-to-day activities throughout their school day. Environmental support can be effectively utilized across all environments and all settings to help support individuals with ASD. Additionally, environmental support has been shown to increase student independence, and help stimulate language.


Sensory activity strategies

Sensory activities strategies for students with autism to help with focusing in the classroom

Sensory activity strategies for students with autism can help to minimize the feeling of being overstimulated. However, there are activities within the classroom setting that can help students still experience sensory and learn while doing so. Targeted sensory activities can aid a student with autism in the classroom to stay grounded and focused as well as fulfill their need for movement.

Some sensory activities can include:

  • Stamping on Paper
  • Slime Play
  • Fidget Toys
  • Using shaving cream for letters or math
  • Rhythm instruments
  • Finger painting
  • Playdough

Students with autism may struggle with these types of play. The goal is to figure out the unique needs of each unique student with autism. Some types of sensory experiences are calming and successful for one student, but may be extremely overstimulating for another. However, once the best sensory play is found for a student it can really open the door and decrease some of the challenges to learning. Sensory activities can improve social skills, hand-eye coordination, as well as fine motor skills. It can also help to challenge a student’s brain that they typically do not use and be a key to being successful in the classroom setting.

Again, we want to emphasize that each student is unique and the strategies used need to reflect their unique needs.

Other Related Articles:

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Grocery shopping with your child with autism

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

Grocery shopping with your child with autism

Preparation before your grocery shopping with your child with autism

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

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

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

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

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

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

Dad and son at the grocery store

Techniques to use while grocery shopping with your child with autism

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

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

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

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

Assess the grocery shopping with your child with autism experience

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

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

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

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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

Autism communication strategies

Autism communication strategies are techniques that help your autistic child develop their language and communication skills. Language impairment in communication is one of the main diagnostic criteria for a child with autism, specifically a delay in or total lack of spoken language. Many children may have difficulties not only expressing themselves but also understanding what other people say. Adults may think that the child is just ignoring them but in reality, the child may not understand what the adult is saying. Imagine going to a foreign country with people speaking a language that you do not understand and having no means of figuring out what the people are saying. If someone says, “Hey you, come here” in their language, would you respond? If you don’t understand what they are saying you probably would not respond. This is how your child might be feeling.

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

Autism communication strategies

Interventions to improve communication with autistic children

A Speech Therapist or Pathologist is the lead professional in the assessment of an individual’s understanding and use of language and can provide information about you or your child’s level of language development. They can also provide support planning for intervention, and advise of which strategies can be the best use to support the development of communicative skills.

Applied behavioral analysis (ABA) is a type of therapy that can improve social, communication, and learning skills through reinforcement strategies. Many experts consider ABA to be the gold-standard treatment for children with autism spectrum disorder (ASD) or other developmental conditions.

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.

Autism communication strategies: Visual supports

Visual supports are concrete cues that help communicate and build language skills. This can incorporate the use of symbols, photos, written words, and objects to help children with autism to learn and understand language, process information, and communicate.
We take for granted the different ways we communicate daily which include:

    • Language: The way we represent information – what words mean and how we put them together.
      • Receptive – refers to how your child understands language.
      • Expressive – refers to how your child uses words to express himself/herself.
    • Speech: A verbal means of communicating – using sounds to make words.
    • Non-verbal methods: gesture, facial, expression, eye contact, etc.
    • Pragmatics: The way in which individuals use language in social situations. It includes following the ‘unspoken’ rules of conversations, for example, taking turns.

Many children on the autism spectrum respond well to visual information. Visual information can be processed and referred to over time, whereas spoken communication is instant and disappears quickly.

Visuals can involve communication books or boards that use images and/or words on cards to help the individual learn the word and its meaning. The child can point to the image when they want to communicate. For example, if the child is thirsty, they can point to an image of a glass of water. As the child learns more symbols and words, they can use them to create sentences and to answer questions. Others can also use the images to communicate with the child. This is known as the Picture Exchange Communication System and can be used in the development of intentional and functional communication.

Another autism communication support tool is known as a visual or picture schedule. This helps individuals learn the steps of a routine, like getting ready for bed. A series of pictures show the steps in order and over time they learn each step.

Furthermore, visual schedules can be used to show a person on the spectrum what is happening next or show when there is a change in routine. As people on the spectrum generally don’t like change, this can help them prepare for a change and cope with it more easily. This enables the language surrounding change to be more easily understood and allows individuals to refer back to schedules throughout the task and throughout their day.

Augmentative and alternative communication (AAC)
Autism communication strategies: Augmentative and alternative communication (AAC)

Augmentative and alternative communication (AAC), helps individuals who cannot talk or are very hard to understand. 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 includes:

  • Sign language
  • Gestures
  • Pictures, photos, objects, or videos
  • Written words
  • Computers, tablets, or other electronic devices

AAC can help children with autism and can even assist with developing spoken communication. 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.

Speech generation devices either play pre-recorded words via a switch or button or sound out text that is typed into them. Using the previous example, a child who is hungry can press the ‘food’ picture button and the device will say, ‘I want to eat.’
While these tools can be used to replace speech, they can also be used to help a child develop speech. They do this by helping the child to recognize sound patterns and can be used with visual aids to build language skills.

These systems can also help children learn words as they begin to associate the sound and picture with each other. They also help by slowing down communication, giving the child more time to process the information and avoid becoming overloaded.

Autism communication strategies: Guidelines for nonverbal autistic children

No matter where your child falls on the spectrum for autism, they have the ability to communicate in some manner. Here are some simple guidelines to consider when trying to help your child to communicate with you as well as with 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 to them, 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 important 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 exactly what you mean. Speak in short phrases, such as “roll ball” or “throw ball.” You can increase the number of words in a phrase one 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 take the place of speech. They can foster its development. Examples include devices and apps with pictures that your child touches to produce words. On a simpler level, visual supports can include pictures and groups of pictures that your child can use to indicate requests and thoughts.

Remember, 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 that particular time. Over time, and with success, simple and concise instructions will be elaborated and more language will be part of their communication.

Autism puzzle
Autism communication strategies: how ABA therapy can help

ABA therapy is effective through the identification and targeting of skill development goals. ABA therapy will typically address skill deficits across several domains. These domains will vary and depend on the individual needs of the learner.

As behavior analysts, it is our responsibility to only administer ABA-based treatment programs that have been proven to be effective given a specific difficulty. This is called evidence based practices. The specifics of a treatment program will vary from one person to another, but the foundations of treatment programs are the same. A foundation derived from sound, empirically proven methods repeatedly implemented in the applied setting over time.

Listen to:

The Advantages of Applied Behavior Analysis (Podcast Episode)

 

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

Who Can Benefit From ABA Therapy?

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

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

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

What does ABA Therapy look like?

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

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

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

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

How do I start ABA Therapy?

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

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

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

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