If your child has recently been diagnosed with Autism Spectrum Disorder (ASD), your diagnosing physician may have recommended that your child receive intensive behavioral therapies or intervention. It can be a very overwhelming process to navigate and understand what exactly these specialists are recommending for your child.
Applied behavior analysis (ABA) is the application of the principles of behavior towards behaviors which are meaningful or socially significant. Most commonly the principles applied are reinforcement, punishment, and extinction. Most commonly, your child will work directly with a trained professional under the supervision of a Board Certified Behavior Analyst (BCBA) who is required to oversee the professional. These professionals are called different titles depending on the company or agency: paraprofessional, teaching assistant, therapist, technician. If the individual working with your child holds a credential from the Behavior Analyst Certification Board (BACB) they may be a Registered Behavior Technician, or RBT. These professionals will utilize paper or electronic data to collect progress on the client they are working with. It is required data be collected in order to ensure treatment is effective.
ABA services most simply are intended to address two areas: reduce behavior which is not beneficial to the learner, such as aggression, and to increase behavior which would be beneficial, such as increased vocal outputs to get needs met. There is not a goal for normalization, such as making the child no longer autistic. This is a marketing ploy many agencies may utilize to increase their client drive. While we can teach many replacement behaviors to help individuals get their needs met, the goal is never to remove the actual neurotype of autism. We are here to support increasing independence, teaching language, and working alongside families to produce outcomes that result in the learner and their families having the highest quality of life possible for their unique situation.
It is important to note that ABA cannot take the place of other services such as speech therapy, occupational therapy, or talk therapy. These specialists are so good at what they do and it is worthwhile to work with them in tandem with an effective ABA team. Collaboration is a key part of effective treatment! If an ABA clinic claims to address these specialists' areas of expertise, please continue with caution as it is not accurate, nor ethical, for these claims to be made.
ABA services can be ran across a variety of settings, but the BCBA overseeing the case will work with the family to determine what is most appropriate for the specific case. This is another core tenant of ABA treatment: it should be individualized to the specific learner. There should not be goals for the child that are simply "cookie cutter" format. One learner's goals will be completely different from another.
The biggest thing to remember is that this does qualify as a medical treatment and requires diagnosis to receive, therefore families have the right to object to components, ask questions about treatment, and terminate services if they do not feel it is best for their family.
Some goals you may see targeted in ABA treatment are: expressive language (ie: talking), receptive language (how the child responds to instructions), community safety, behavior reduction, independent living skills (toileting, dressing), and most importantly parent/family guidance. It is critical to have family involvement on a regular basis for effective ABA therapy. This includes meeting with the family, reviewing data, discussion of progress, reviewing how to teach new skills and respond to behavioral concerns, as well as direct testing of behavior skills by the BCBA.
In an average day as a BCBA, I may go to someone's home with materials and prepare for the session in advance. I typically will inform the families of what goals will be ran that day so they can prepare as well. When I arrive, I will do a brief check in on how the client is doing that day, have they eaten, when they last toileted, this type of information. I will note any variables in my data such as if their allergies are flared up or any changes in the immediate environment. One common one right now is the presence of holiday decorations around the home. I will then spend some time with the learner to build relationship with them and will begin the teaching components, offering breaks as needed. If anything is needed, I will check in with the present guardian or caregiver. Parents and caregivers should be included at anytime and during specific lessons to promote the client learning with them as well. Data is collected throughout this time and at the end of the session, I brief the family on how the session went and what we will do the next time.
Ultimately, there should be no secrets or confusion between clinical team and the family. If you sense any secrecy, this would be a major red flag.