Applied behavior analysis (ABA) therapy is intensive. A child spends 20 to 40 hours each week with a behavioral technician, and often, those sessions happen in the family home.
It's critical to choose the right provider. That person will spend a lot of time with both you and your child. And that professional's approach can mean the difference between enjoying therapy and hating every minute of it.
Start with the basics, including background checks and credential verification. Then, dig deeper and understand how this person approaches ABA therapy.
Take your time, and you will find the right partner for your child and your family.
Where to Start Your Search
You're far from alone. Your child has a team of experts that can help you connect with an ABA therapy provider. Online resources and professional therapy networks can also help you conduct a smart search.
Reach out to people involved in your child's care. This might include any of the following professionals who work with your child:
- Occupational therapist
- School counselor
- Speech therapist
These people know your child and what your child might need. Ask them to tell you about individuals or organizations that can help. Ensure that the data they give you is tailored to your child's circumstances.
Enhance these in-person conversations with additional outreach. The Arc Insurance Advocacy Resource Center recommends that families look into:
- The Behavior Analysis Certification Board. Search for qualified providers located close to your home or child's school.
- Online resources. Look for respected organizations that specialize in ABA.
- Autism publications. Do you subscribe to an online message board? Do you read autism-related magazines? These resources could connect you with a qualified provider in your area.
Don't worry about vetting all of your sources as you gather them. Keep your list long and robust for now. You'll narrow the field later.
Provider Credentials Matter
Qualify your list by searching for credentials. ABA is a technical, nuanced therapy. It takes time to learn how to administer it properly.
Skilled providers will know how to deliver tailored treatments, and they will have the qualifications that prove their educational prowess.
The International Board of Credentialing and Continuing Education Standards lists several different types of degrees.
- Board certified behavior analyst (BCBA): This person holds a master's degree or doctoral degree. The designation is held by people who have specific ABA training and are board certified to provide ABA.
- Certified autism specialist (CAS): This person holds a master's degree, has worked in the field for at least two years, and keeps current on autism research. They are certified in autism, but they may not have specific training in ABA.
- Autism certificate (AC): This person stays current in the field of autism, but there is no degree requirement. Someone with this certification might be a teacher, a bus driver, or even a medical billing clerk.
The BCBA certification is considered the gold standard for therapy. Someone with this education and certification demonstrates a deep commitment to ABA and autism. But there aren't enough of these providers to go around, says the Child Mind Institute.
The institute recommends the newer registered behavior technician (RBT) credential. Someone with this credential has a high school education and 40 hours of training. This person works under the direct supervision of a BCBA.
If you can, work with someone with an enhanced education. If you can't find someone like this, or the person you like doesn't hold this advanced degree, ensure that supervision is part of the program. Your child should have an expert on their treatment team.
Assess the Company
Some ABA providers are independent. They set up shop under their own names, and they treat clients without going through a formal company or clinic.
Others have business connections. If they do, deepen your research.
You may choose one provider within the business. If that person quits or breaks ties with the company, you may not be allowed to select a replacement. Your child may also encounter others, including substitute therapists, that you didn't evaluate during your search.
The Indiana Institute on Disability and Community recommends asking about:
- Organization. Ensure that the company has at least one BCBA on staff. If plenty of providers offer therapy, more than one BCBA may be required. Ask how your child's technician will work with these professionals to keep treatment on track.
- Background checks. Make sure routine checks are part of the hiring process.
- Input. Can you contest a treatment plan? How can you alert the company about a questionable practice?
- Supervision. How often can you watch a therapy session? Some centers allow for a taped session if in-person visits are disruptive.
- Documentation. Ask how your child's progress will be monitored and measured. Look over example documents, if possible. Ensure that you understand how the reports work.
If you're working with an individual, plenty of these questions remain applicable. Ensure that you understand your role, the documentation, and the plan.
Determine the Approach
ABA therapy shouldn't involve a series of drills applied per age, regardless of a child's aptitude. Instead, Autism Speaks says, skilled therapists tailor their work to the clients they see.
Sit down with your shortlist of providers and ask questions about:
- Assessments. What happens during the first few appointments? What does the person look for?
- Planning. How do those notes coalesce into a formal treatment program?
- Experience. How often has this person treated someone like your child?
- Typical sessions. What props or tools does this person use during ABA therapy? How does this person typically deal with a difficult session or child?
You can't ask about every program, every decision, and every plan. Since therapy is individualized, the technician may not know what will happen until the treatment starts. But these answers give you an understanding of what your child may experience.
Stay Involved in Treatment
You've made a decision about a provider, and treatment has started. Your work isn't quite done. Now, your child meets the provider. That could be the most important part of the whole process.
ABA is therapy, and it does involve tough conversations. An ABA provider must break down complex tasks into tiny pieces, and during each session, the child repeats those pieces for mastery. Conflicts sometimes appear.
But experts point out that ABA can be fun for kids too. Skilled behavioral technicians use games, physical activity, food, and verbal reassurance to keep kids engaged.
When it works, a child feels excited about therapy. They seem happy both before and after their sessions. And they learn skills they can put to good use.
But when the fit is poor, children may avoid therapy with meltdowns, tantrums, or silence. They may seem withdrawn or sad before or after therapy. And you may not see new skills emerge.
Your child has a voice and a choice in ABA therapy. As a parent, you can ensure that your child is respected. Watch for these signs and request a replacement if needed.
- Finding a Quality ABA Provider: A Parent Perspective. (July 2016). The Arc Indiana.
- ABA, BCBA, and CAS: What Does It All Mean? (August 2014). International Board of Credentialing and Continuing Education Standards.
- How to Know if You're Getting Good ABA. Child Mind Institute.
- What to Consider When Looking for a Qualified ABA Provider. (2014). Indiana Institute on Disability and Community.
- Applied Behavior Analysis (ABA). Autism Speaks.
- What Is ABA (Applied Behavioral Analysis) Therapy for Autism? (November 2019). Verywell Health.