Getting Started with ABA: Asking the Right QuestionsAugust 11, 2021
Applied Behavior Analysis (ABA) therapy is an evidence-based treatment that can improve the quality of life of people with autism. This kind of therapy is tailored to the needs of each person with the goal of building skills and reducing dangerous or harmful behaviors.
ABA programs can be intensive, with children often spending 20 to 40 hours each week with a behavior technician. It is usually less intensive for adolescents and adults, with these groups typically receiving fewer hours of therapy per week. While programs for adults require less time investment, therapists still work closely with families to apply learned skills to everyday life. To ensure a good experience for everyone, choosing a quality, board-certified behavior analyst (BCBA) is essential.
It’s important to find an ABA provider who is a good fit for you and your family. If a person trusts their therapist and enjoys spending time with them, therapy will be more successful—and fun!
Understanding the basics
High-quality ABA therapists are certified, experienced and follow the ethical guidelines laid out by the Behavior Analyst Certification Board (BACB). To become a BCBA, they need to:
- Earn a master’s degree or Ph.D. in psychology or behavior analysis
- Pass a national certification exam
- Seek a state license to practice (in some states)
BCBAs work directly with their clients to create an ABA treatment plan based on individual needs, goals and challenges. Treatment is often carried out by a registered behavior technician (RBT) or board-certified assistant behavior analyst (BCABA) under the supervision of the BCBA.
You may hear RBTs and BCABAs referred to by a few different names, including behavior therapists, line therapists, and behavior technicians. These therapists work directly with children and adults with autism to practice skills and work on the goals written by the BCBA.
How do I choose an ABA provider?
When choosing an ABA provider, the first step is ensuring that all therapists have the right credentials. Make sure that there is more than one BCBA on staff who is trained to meet the needs of you and your family.
Here are some basic questions you can ask to understand a provider’s qualifications:
- How many BCBAs and behavioral therapists do you have on staff?
- Are your BCBAs licensed with the BACB and through the state?
- What background checks are given to BCBAs, behavioral therapists, and other staff members?
- What training do your therapists receive? How often?
- What are your areas of expertise?
- How much direct supervision do behavioral therapists receive from BCBAs weekly?
- How many hours per week of therapy can you provide?
- How many therapists will be working with me or my child?
- Do you offer home-based or clinic-based therapy?
- Do you have any exclusion criteria? Are there people who you do not feel comfortable treating?
- Do you have a wait list?
- What type of insurance do you accept?
Then, you should dig deeper to understand how the therapist approaches ABA therapy. The following questions can help you evaluate whether a provider will be a good fit. Remember to trust your instincts during these conversations!
- How long have you been practicing ABA therapy and what kinds of results have you seen?
- What is your experience treating people with needs similar to me or my child? This age group? This type of behavior? This communication style?
- What does a typical ABA session look like?
- What props or tools do you use during the therapy?
- How do you set and re-evaluate goals? Do you consider parental input?
- How do you identify the underlying causes of harmful or destructive behaviors?
- What metrics do you use to measure progress? How will progress be tracked?
- How do you deal with a difficult session or client?
- How do you handle safety concerns? How can I alert you if I see any practices I don’t like?
- How often can I watch a therapy session?
- How will you ensure consistency among the therapists working with me or my child?
Watch out for red flags
Your choice of an ABA provider often comes down to how well you and your family click with a therapist. If your child is in therapy, don’t be afraid to observe a few sessions. If you see or experience anything that makes you uncomfortable, ask questions and be honest. Bad therapy can have a major impact on anxiety, depression, and PTSD, so it’s important to choose carefully.
Here are some red flags to look out for that might signal a harmful approach:
- Insufficient supervision by an experienced BCBA.
- Inability to respond to concerns.
- Use of punishment instead of positive reinforcement.
- Aggressive or controlling interactions.
- Unwillingness to listen and stop when the client is overstimulated.
- Lack of data showing progress.
- Offering general recommendations without a personalized assessment.
- Not involving the autistic person in planning and goal setting.
- Focusing on getting rid of “problem behaviors” rather than learning new skills.
- Forcing eye contact and fighting stimming or hand flapping.
Good ABA therapy is not about curing, healing or reducing autism symptoms. The therapist you choose should work with autistic people to help them navigate the world while respecting their needs and boundaries.
This is an important, long-term relationship. It’s worth taking the time to find the right fit.