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Social Stories and Autism

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Teacher reading a book to her kindergarten class
Developed by Carol Gray in 1990, Social Stories™ support preventative, or antecedent, strategies to help a child with autism successfully navigate challenging social settings. Social stories increase positive social behaviors and decrease challenging behaviors.

Structured routines and visual cues, among other transition strategies, help children with autism anticipate and respond well to changes in their environment. Social stories complement those interventions and help children with autism develop an understanding of the perspectives, emotions, and behaviors of themselves and others in specific settings.

At LeafWing Center, social stories may be integrated into our treatment approach depending on the needs of the child. Our therapists are experts in ABA therapy, proven to help children with autism. In this article, we will explain:

Call Us at (888) 436-2532

What Are Social Stories?

As defined by the concept’s author, Carol Gray, social stories are a “social learning tool that supports the safe and meaningful exchange of information between parents, professionals, and people with autism of all ages.”

Implementing the use of social stories in the classroom is a strategy that is likely not new to teachers. However, not all teachers know that they can be used to working with and teaching individuals with autism-specific skills surrounding social and behavioral needs.

In practice, social stories are characterized as follows:

  • Short: A social story is a mini book that describes a social situation and the appropriate social responses.
  • Specific: A social story teaches a specific desired response.
  • Individualized: A social story uses descriptive, encouraging, and positive language, details, and illustrations that:
    • Allow the child to see themselves and the people in their life reflected in the characters and dialogue.
    • Use the first-person point of view or the child’s point of view as well as present or future verb tense.
    • Answer questions the individual with autism may need to know to interact well with others (the who, what, when, where, and why in specific social situations).
    • Consider the child’s level of vocabulary and comprehension, attention span, learning style, and personal interests.

At LeafWing, our personalized approach lets us get to know the children and families we support well. We have many resources available for parents and caregivers of children with autism.

Request Enrollment Information

Goals of Social Stories

Research shows that individuals with autism benefit greatly from the use of social stories and that benefits increase when the social story development process begins with clear goal setting. The goals of social stories center on the perspective of the child with autism, which helps maintain a positive and encouraging tone. In addition, they reflect the inputs of the entire care team, leading to greater skill or behavior generalization.

  • Developing Skills for self-care, the classroom setting, and future work environments helps the individual work toward achieving targeted levels of independence.
  • Teaching Social Norms provides a blueprint to help the child with autism interact with the world around them.
  • Improving Sequencing gives children with autism the tools to move more easily from one task to another or from one environment to the next.
  • Addressing Negative Behavior keeps the child with autism and others around them safe.
  • Coping with Change in daily routine through social story interventions makes the unfamiliar feel more familiar.
  • Celebrating the child’s strengths and recent “wins” through a social story builds their confidence and increases their openness to new skills and experiences.
Request More Information

Benefits of Social Stories

The benefits of social story interventions are well documented. When constructed and implemented according to certain guidelines, they have been shown to help children with autism:

  • Increase shared understanding and empathy
  • Build confidence
  • Reduce anxiety

Social Stories for students with autism

Components of Social Stories

Social stories are written using four sentence types. They are customary to include two to five descriptive, perspective, or control sentences.

  • Descriptive Sentences: Provide information about the subject, setting, and action.
  • Directive Sentences: Describe the appropriate behavioral responses.
  • Perspective Sentences: Identify the possible feelings and reactions of others.
  • Control Sentences: Describe the actions and responses of the story participants.

A note on control sentences: For example, a control sentence might be, “A puppy barks to get its owner’s attention.” Or, “Ginny yelled to get the teacher’s attention.” Writing social stories for students who have the tendency to over-focus on a specific part of the story may require omitting the control sentence.

How to Write Social Stories

When creating a social story, there are ten steps to follow:

  1. Identify the target situation or concept.
  2. Define the target behavior or skill.
  3. Collect baseline data on the target behavior.
  4. Write a social story using the four-sentence types.
  5. Present one to three sentences on each page.
  6. Use photographs and drawings or icons.
  7. Read the social story to the child/student and model the desired behavior for them.
  8. Collect data on the target behavior.
  9. Review the data and the social story procedures and modify them if they are ineffective.
  10. Plan for maintenance and generalization.

Social stories can be revisited as often as necessary, depending on the child’s receptiveness. Patience is key to the process.

Children with autism frequently do not maintain or generalize skills they have learned. Having a plan for maintenance and generalization helps improve the likelihood they will hold onto newly acquired skills. LeafWing therapists and caregivers will ultimately fade the use of a social story and plan activities to assist the student in generalizing skills across content, persons, environment, and situation.

Contact Us

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?

Social Stories and Autism

/in , , , , /by

Teacher reading a book to her kindergarten class
Developed by Carol Gray in 1990, Social Stories™ support preventative, or antecedent, strategies to help a child with autism successfully navigate challenging social settings. Social stories increase positive social behaviors and decrease challenging behaviors.

Structured routines and visual cues, among other transition strategies, help children with autism anticipate and respond well to changes in their environment. Social stories complement those interventions and help children with autism develop an understanding of the perspectives, emotions, and behaviors of themselves and others in specific settings.

At LeafWing Center, social stories may be integrated into our treatment approach depending on the needs of the child. Our therapists are experts in ABA therapy, proven to help children with autism. In this article, we will explain:

Call Us at (888) 436-2532

What Are Social Stories?

As defined by the concept’s author, Carol Gray, social stories are a “social learning tool that supports the safe and meaningful exchange of information between parents, professionals, and people with autism of all ages.”

Implementing the use of social stories in the classroom is a strategy that is likely not new to teachers. However, not all teachers know that they can be used to working with and teaching individuals with autism-specific skills surrounding social and behavioral needs.

In practice, social stories are characterized as follows:

  • Short: A social story is a mini book that describes a social situation and the appropriate social responses.
  • Specific: A social story teaches a specific desired response.
  • Individualized: A social story uses descriptive, encouraging, and positive language, details, and illustrations that:
    • Allow the child to see themselves and the people in their life reflected in the characters and dialogue.
    • Use the first-person point of view or the child’s point of view as well as present or future verb tense.
    • Answer questions the individual with autism may need to know to interact well with others (the who, what, when, where, and why in specific social situations).
    • Consider the child’s level of vocabulary and comprehension, attention span, learning style, and personal interests.

At LeafWing, our personalized approach lets us get to know the children and families we support well. We have many resources available for parents and caregivers of children with autism.

Request Enrollment Information

Goals of Social Stories

Research shows that individuals with autism benefit greatly from the use of social stories and that benefits increase when the social story development process begins with clear goal setting. The goals of social stories center on the perspective of the child with autism, which helps maintain a positive and encouraging tone. In addition, they reflect the inputs of the entire care team, leading to greater skill or behavior generalization.

  • Developing Skills for self-care, the classroom setting, and future work environments helps the individual work toward achieving targeted levels of independence.
  • Teaching Social Norms provides a blueprint to help the child with autism interact with the world around them.
  • Improving Sequencing gives children with autism the tools to move more easily from one task to another or from one environment to the next.
  • Addressing Negative Behavior keeps the child with autism and others around them safe.
  • Coping with Change in daily routine through social story interventions makes the unfamiliar feel more familiar.
  • Celebrating the child’s strengths and recent “wins” through a social story builds their confidence and increases their openness to new skills and experiences.
Request More Information

Benefits of Social Stories

The benefits of social story interventions are well documented. When constructed and implemented according to certain guidelines, they have been shown to help children with autism:

  • Increase shared understanding and empathy
  • Build confidence
  • Reduce anxiety

Social Stories for students with autism

Components of Social Stories

Social stories are written using four sentence types. They are customary to include two to five descriptive, perspective, or control sentences.

  • Descriptive Sentences: Provide information about the subject, setting, and action.
  • Directive Sentences: Describe the appropriate behavioral responses.
  • Perspective Sentences: Identify the possible feelings and reactions of others.
  • Control Sentences: Describe the actions and responses of the story participants.

A note on control sentences: For example, a control sentence might be, “A puppy barks to get its owner’s attention.” Or, “Ginny yelled to get the teacher’s attention.” Writing social stories for students who have the tendency to over-focus on a specific part of the story may require omitting the control sentence.

How to Write Social Stories

When creating a social story, there are ten steps to follow:

  1. Identify the target situation or concept.
  2. Define the target behavior or skill.
  3. Collect baseline data on the target behavior.
  4. Write a social story using the four-sentence types.
  5. Present one to three sentences on each page.
  6. Use photographs and drawings or icons.
  7. Read the social story to the child/student and model the desired behavior for them.
  8. Collect data on the target behavior.
  9. Review the data and the social story procedures and modify them if they are ineffective.
  10. Plan for maintenance and generalization.

Social stories can be revisited as often as necessary, depending on the child’s receptiveness. Patience is key to the process.

Children with autism frequently do not maintain or generalize skills they have learned. Having a plan for maintenance and generalization helps improve the likelihood they will hold onto newly acquired skills. LeafWing therapists and caregivers will ultimately fade the use of a social story and plan activities to assist the student in generalizing skills across content, persons, environment, and situation.

Contact Us

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?

Motivational words

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

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Choice boards and ‘Wait’ support in the classroom benefit autistic students based on their individual needs. Different Choice boards are necessary depending on the student’s motor and communication skills. These boards can display objects, pictures, icons, or words for various activities or reinforcers. It is important for the pictures to accurately represent the actual objects for the student to make the connection. Choice boards can be easily made using materials like poster paper, card stock, whiteboards, or any writable surface.

We will discuss two techniques for supporting students with autism in the classroom:

  1. Choice Boards
  2. Wait Supports

Choice boards are commonly used alongside a student’s schedule to allow them to choose activities at designated times. These boards are usually placed near areas for free or break time, encouraging independent selection of activities. Implementing choice boards can create structure and routine for students with autism, helping to reduce anxiety.

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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 benefit 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.

How are Choice boards used?

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

When to use a Choice board in the classroom

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

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 likelihood of participation and decrease the possibility of a student with autism engaging in challenging behaviors.

Choice boards are most effective when the choices are appropriate and make sense at the moment. If a choice cannot be honored in that scenario, then it should be removed from the choice board. Failing to do so only frustrates the student when the choice cannot happen and decreases the likelihood of them wanting to use the choice board.

Additionally, similar to their average peers, if there are too many choices, students can become overwhelmed and either take too long or avoid making a choice. The opposite is also true, only having two choices in every instance for a choice can decrease the effectiveness of a choice board. Those making the choice boards should continually evaluate if there are too many or too few choice boards.

Request More Information

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, they are not aware of the social rules of waiting, or they do not comprehend the reason for waiting.

We also know that if a student waits 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 unwanted behaviors will likely 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 various 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.

5 Tips for Using Wait Times:

  • Give Reminders. For example, if the wait time is three minutes, at one minute, point to the time and say you have one minute left.
  • Practice. Build up the amount of time spent waiting through practice just like any skill; waiting takes practice over and over again.
  • Repetition. Incorporate wait times into the schedule so students can get used to it becoming part of the daily routine.
  • Provide Visuals. Incorporate colors as an additional time visual. Red could mean wait. Yellow could mean almost 1 minute left. Green means the waiting is up, and it’s time for an activity or reward after waiting.
  • Flip Cards. Use flip cards as a means for waiting, such as starting from 10 and counting down to 0, as it incorporates two skills at once.

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. Given 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 can respond. Therefore, the more students participate in an activity, the more off-task and disruptive behaviors will decrease.

Let LeafWing Center help establish some basic Choice boards and ‘Wait’ support techniques for your child that simulate 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.

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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?

Can Autism be treated?

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There is no cure for autism spectrum disorder. Autism is a heterogeneous disorder, which means it is a medical condition with multiple root causes. In the medical field, genetic heterogeneity occurs when a single gene has different mutations or when there are mutations in different genes. In both cases, the same disease or condition occurs.

We will cover

However, ABA therapy can help build skills that individuals with autism lack. The goal of any effective ABA therapy treatment program is to maximize the learner’s ability to function by reducing autism spectrum disorder symptoms while supporting development and learning.
Other therapy options are

  • Speech Therapy – addresses challenges with language and communication
  • Occupational Therapy (OT) – life skills like bathing, dressing, and eating
  • Physical Therapy (PT) – help with fine motor skills like holding a pencil

Early intervention is critical to the effectiveness of any ABA therapy program. ABA therapy treatment programs are highly individualized to best suit the needs of the learner. While no two ABA programs will look the same, there are some general components that families and learners can expect from ABA therapy. LeafWing Center has an excellent staff of well-qualified professionals who work with families to provide ABA therapy to its clients.

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Therapy

Autism treatment options

Currently, no treatment has been shown to cure ASD, but several interventions have been developed and are used to treat autism. ABA therapy is the most widely accepted and well-used treatment option for children diagnosed with autism spectrum disorder.

ABA therapy is designed to reduce symptoms, improve cognitive ability and daily living skills, and maximize the ability of the child to function and participate in the community.

Our LeafWing team of professionals clarifies to our clients that ABA therapy is a treatment option, not a cure. To suggest there is a cure would imply that the scientific community has identified a definitive cause of autism and has a scripted recovery. As of today, no definitive cause of autism has been identified. While there is no single cause, research suggests that autism develops from a combination of genetic and nongenetic, or environmental, influences.

The scientific community has realized that it lacks diversity testing. They need to start evaluating Hispanic children similar to the way they did with European ancestry.

It is not uncommon for families to be discouraged upon learning there is no cure. We understand the sensitive nature of the conversation and work with families to help them see the many tremendous benefits of ABA therapy as a treatment option. From our experience, we provide families with accurate information regarding treatment goals to create realistic expectations. We emphasize that it is doable and assure that autism can be treated. Therapy evolves as the child with autism evolves in their skill level. The therapist will reevaluate the plan as needed. No two cases are the same.

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Autism treatment: What causes autism

While no single cause of autism has been identified, research has indicated several risk factors. Given the complexity of the disorder and that symptoms and severity vary, it makes sense that there may be multiple contributing factors.

Autism’s genetic risk factors

Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder. Still, other genes may affect brain development or how brain cells communicate, or they may determine the severity of symptoms. Some genetic mutations seem to be inherited, while others occur spontaneously.

Autism’s environmental risk factors

Researchers are currently exploring whether factors such as viral infections, medications, or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder. Research also shows that certain environmental influences may further increase – or reduce – autism risk in people who are genetically predisposed to the disorder. Importantly, the increase or decrease in risk appears to be small for any one of these risk factors:

Risk factors:

  • Your child’s sex. Boys are about four times more likely to develop autism spectrum disorder than girls are.
  • Family history. Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder.
  • Other disorders. Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms.
  • Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
  • Parents’ ages. There may be a correlation between children born to older parents and autism spectrum disorder.

One common misconception, and the source of controversy, is that there may be a link between autism and vaccines. Despite extensive research, no reliable study has shown a link between autism spectrum disorder and any vaccines.

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ABA Therapy

Treating autism symptoms

Applied Behavior Analysis (ABA) is a scientifically backed, highly individualized treatment method that can be effective in many ways. The effectiveness of ABA depends on several factors, including, but not limited to, the individual needs of the learner, frequency of treatment, specific interventions, and the environment in which services are implemented.

One way ABA therapy is effective is by identifying and treating challenging behaviors. Effective ABA programs will identify challenging and undesirable behaviors at the onset of services.

Another way ABA therapy is effective is by identifying and targeting skill development goals. ABA therapy typically addresses skill deficits across several domains, which will vary and depend on the learner’s individual needs.

As behavior analysts, we are responsible only for administering ABA-based treatment programs that have proven effective given a specific difficulty. This is called evidence-based practice. 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.

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

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

As we learn more about the complexity of autism spectrum disorder, there are 3 underlining goals involving treatment:

  1. Skill acquisition
  2. Removal of barriers to learning
  3. Improvement in functional living skills and quality of life

This has spurred the importance of collaboration in treatment to help improve the outcomes for individuals with autism.

Therapy Collaboration:

  • Speech Therapy
  • Occupational Therapy
  • Physical Therapy

Barriers to collaboration exist due to terminology differences, the reputation of ABA and OT, and evidence-based practice misperceptions. Clarification of roles is necessary to address overlapping therapy treatments, prioritizing the individual with autism.

Parents will do anything to ensure their child receives the best care possible. As such, parents and caregivers will be comfortable knowing that LeafWing Center provides the best care possible. In providing treatment, its well-qualified ABA therapy professionals will conduct thorough assessments both at the beginning of and throughout treatment, will provide clearly defined treatment goals, and will provide opportunities for the learner to develop skills and behaviors that mitigate some of the undesirable symptoms described above.

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Assessment Tools

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?

Child with light bulb thought

Why Does ABA Help Children With Autism?

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Autism Spectrum Disorder (ASD) is a condition related to brain development that impacts how a child perceives and socializes with others, causing problems in social interaction and communication. The disorder also includes limited and repetitive patterns of behavior. The term “spectrum” in autism spectrum disorder refers to the wide range of symptoms and severity.

Many families ask similar questions when considering treatment options for their child who has been diagnosed with autism spectrum disorder.

  • What is Applied Behavior Analysis (ABA) therapy, and is it an effective treatment for children with autism?
  • What makes ABA therapy effective in helping improve the lives of those affected with autism?
  • How does ABA therapy involve the family? Is ABA therapy the right treatment for my child with autism?

The professional ABA therapists at LeafWing Center will provide you and your child with the support and therapy required to ensure your child is receiving the highest quality autism care.

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ABA therapy for children with autism: Early childhood development

We all know that typically developing children learn throughout all waking hours, even when they are not being formally taught. Typically developing children watch other children, watch adults, watch TV, learn from school, and incorporate what they have learned into their repertoire.

Oftentimes they only need to see something once or twice before it comes easily to them. Parents are often amazed at their children’s learning and frequently ask, “Where did you learn to do that?” When children learn to speak, they often begin to ask questions of others in their environment. From the basic “why” question that parents so often get asked to more elaborate questions about “How this thing works, or how that thing works.” They become their own self-contained information seekers.

Learning is different for children with autism. Children with autism learn much less from their environment. They are deficient in what’s called observational learning or learning via imitation. In other words, children with autism aren’t as skilled at learning by watching others do something and imitating what they see without specific instruction.

Children with autism typically have decreased language skills, understand less of what is said to them, and ask fewer questions of others. For most children with autism, you cannot expect to put them in a classroom setting and have them learn and absorb what the teacher is saying, mainly as a direct result of the characteristics of autism.

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ABA therapy for children

ABA therapy is designed to help treat children 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 the classroom.

Essentially, an ABA therapy program works with a learner by creating a somewhat unnatural or atypical learning environment for the child, such as teaching them in a distraction-free, one-to-one environment in their home. The structured environment makes it more conducive for the child to learn.

The learning environment will change over time so that it more closely resembles a typical classroom environment – an environment the child will encounter when they are of age to attend school or are reintegrated into a typical classroom setting. It is important to note that the main premise of an ABA program is teaching a child, “how to learn,” so that they will no longer need such structured and specialized services.

The ultimate goal of ABA therapy is for the learner to gain independence by learning and developing new skills resulting in an increase in positive behavior while reducing the frequency of negative behaviors.

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Other reasons ABA therapy works for children with autism

ABA therapy programs are also highly individualized and account for a learner’s difficulty transitioning from one learning environment to another. A child with autism may not necessarily practice a skill at school just because they learned it at home.

How an ABA therapy program can be effective depends on several factors, including, but not limited to, the learner’s individual needs, frequency of treatment, specific interventions, and the environment in which services are implemented. With ABA therapy, the earlier the intervention, the better.

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ABA therapy effectively treats children with autism

ABA therapy effectively treats children with autism

Autism affects every child differently, and while cases of autism may be similar, no two cases are ever the same. Some children with autism may be mildly or moderately impacted, while others may be profoundly impacted. Applied Behavior Analysis (ABA) therapy is a type of therapy that can improve social, communication, and learning skills through positive reinforcement of those children diagnosed with autism. Most experts consider ABA to be the gold-standard treatment for children with autism spectrum disorder. ABA therapy benefits both the autistic child and their family:

  1. ABA therapy is more fully supported by scientific research than any other treatment option
  2. ABA therapy helps both the learner and the parent(s)/caregiver
  3. ABA therapy teaches skills necessary for socialization
  4. Parents and teachers can capitalize on the strengths and skills of the learner
  5. Children are better positioned if they can function independently
  6. ABA therapy can prepare children to advocate for themselves

Applied behavior analysis (ABA) has been shown to help a wide range of children with autism spectrum disorders (ASDs) learn skills that increase their independence and improve their quality of life into adulthood. Children with autism each have their own diverse life experiences; therefore, each child requires individualized assessment and treatment services.

Let LeafWing Center assist in helping to improve your child’s overall quality of life by targeting problematic behavior and encouraging healthier alternatives. Call us today!

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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 Spectrum Disorder

Can Autism Spectrum Disorders Get Worse?

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Autism spectrum disorder is a complex, lifelong developmental disability that typically appears during early childhood and can impact a person’s social skills, communication, relationships, and self-regulation. Autism is defined by a certain set of behaviors and is a “spectrum condition” that affects people differently and to varying degrees. While there is currently no known single cause of autism, early diagnosis helps a person receive the support and services that they need, which can lead to a quality life filled with opportunity.

In the U.S., about 1 in 54 children has been identified with autism spectrum disorder (ASD), with four times as many boys with ASD as girls. It is in early childhood where autism is most typically diagnosed. It is also the best time for an intervention with autism therapy services, including applied behavior analysis (ABA) therapy.

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Studies have indicated that, left untreated, the symptoms associated with autism may worsen over time. LeafWing Center can help by providing treatment to your child diagnosed with autism spectrum disorder through its ABA therapy program.

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Start ABA therapy to prevent your child's autism from getting worse

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

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

For families that are just now starting their ABA-based therapy services at home and/or in a school setting, it is crucial to identify what these symptoms or difficulties are exactly. Upon identifying, assessing, planning, and implementing proper treatment programs, the ABA services can directly or indirectly address these symptoms. With the proper guidance of a BCBA, a sound, comprehensive treatment plan may facilitate gains over a targeted amount of time.

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

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

Autism is not cured once the goals of an ABA-based therapy program are met or exceeded. In fact, no cure exists for autism spectrum disorder, and there is no one-size-fits-all treatment. The goal of treatment is to maximize your child’s ability to function by reducing autism spectrum disorder symptoms and supporting development and learning. ABA therapy promotes the learner’s ability to function and reduces the severity or impact of the learner’s symptoms.

Some children may need six to twelve months of ABA-based services, while others may need the services for a more extended time. Irrespective of whether the services are needed for a relatively short time or on an ongoing basis, one of the greatest benefits of the therapy is that the parents/caregivers are given proper training so that the family may maintain and continue to generalize their child’s learned skills from the services, with or without the services from the ABA therapy team. Equally important is the parents’/caregiver’s ability to generalize their own skills when presented with similar situations that their child may face in the near future and again in the absence of an ABA team.

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ABA therapy used for ASD

Untreated autism spectrum disorder symptoms worsen over time

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

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

Related Glossary Terms

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Podcasts

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

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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.

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

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Autism 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.

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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: How we represent information – what words mean and how we combine them.
    • 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: How individuals use language in social situations. It includes the following conversation ‘unspoken’ rules, 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 to develop intentional and functional communication.

Another autism communication support tool is known as a visual or picture schedule. This helps individuals learn routine steps, 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 their day.

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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. Many people wonder if using AAC will stop someone from talking or 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 hungry child 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, which can be used with visual aids to build language skills.

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

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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 communicate with you and others.

  • Encourage play and social interaction. All children learn through play, and that includes learning the language. Interactive play provides a delightful chance for you and your child to communicate. Play games that your child enjoys. Incorporate playful activities that promote social interaction. For example, singing, reciting nursery rhymes, and gentle roughhousing. During your interactions, crouch down close to your child so your voice and face are closer 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. We naturally want to fill in the missing words when a child doesn’t respond quickly. Giving your child many communication opportunities is essential, even if they are not talking. When you ask a question or see that your child wants something, pause for several seconds while looking at them enthusiastically. Watch for any sound or body movement and respond promptly. The promptness of your response helps your child feel the power of communication.
  • Simplify your language. Be literal and obvious in your choice of language. Say precisely what you mean. Speak in short phrases like “roll ball” or “throw ball.” You can increase the number of words in a phrase once your child’s vocabulary increases.
  • Follow your child’s interests. Rather than interrupting your child’s focus, follow along with words. Use simple words about what your child is doing. By talking about what engages your child, you’ll help them learn the associated vocabulary.
  • Consider assistive devices and visual supports. Assistive technologies and visual supports can do more than 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.

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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 only to administer ABA-based treatment programs that have proven effective given a specific difficulty. This is called evidence-based practice. 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.

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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?

Speech Therapy

Nonverbal Autism

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

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

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

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Nonverbal Autism

What are the early signs of autism?

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

Early signs of autism include:

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

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When to see a professional

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

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

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

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Nonverbal Autism

How is nonverbal autism diagnosed?

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

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

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

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

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

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

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

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

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Nonverbal Autism

How do you work with a child who is nonverbal?

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

  • picture cards
  • calendars
  • simple visual schedules

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

Nonverbal Autism: Visual Behavior Supports

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

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

Types of Visual Behavior

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

Guidelines for Communication with Nonverbal Autistic Children

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

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

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

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

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Nonverbal Autism

How ABA therapy can help with nonverbal autism

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

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

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

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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

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

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

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ABA Therapy at Home

Considerations of ABA Therapy Services at Home

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

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

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

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

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

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

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

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

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

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

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

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

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Behavior Therapist at In-Home Service

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

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

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

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

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

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

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

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

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

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

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Advantages of ABA Therapy at Home Services for Parents

Advantages of ABA Therapy at Home Services for Parents

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

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

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

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

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Insurance Coverage

How to Get Started

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

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Insurance Coverage for ABA Therapy

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

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

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

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

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

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

Related Glossary Terms

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

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

In this article, we’re going to discuss:

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Child copy the same puzzle

What is observational learning?

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

Four prerequisites for observing behavior:

  • Attention
  • Retention
  • Reproduction
  • Motivation

Prerequisite for observational learning: Attention

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

Prerequisite for observational learning: Retention

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

Prerequisite for observational learning: Reproduction

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

Prerequisite for observational learning: Motivation

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

Observational Learning Examples

The following are instances that demonstrate observational learning has occurred.

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

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

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

Observational Learning Science class

Uses for Observational Learning

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

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

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

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

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

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

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

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

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

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

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

For more information regarding this topic, we do encourage you to speak with an ABA technician or email us at [email protected]

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Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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

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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.

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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.

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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.

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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.

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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.

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Frequently asked questions about ABA therapy

What is ABA Therapy used for?

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

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

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

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

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