What to Expect When Setting Up an ABA Therapy Program
Finding out that your child is not developing as they should be can be very overwhelming. Maybe you’ve just received a diagnosis of ASD and you’re not sure how to accept it or what to do next. Maybe it’s something that you’ve known all along but were hoping that he would “grow out of it”. Maybe your child does not have any diagnosis but as a parent, you know that they need some extra support. Maybe you’ve been recommended ABA therapy but you’re not sure what it is or not sure where to start. Whatever brought you to seek out ABA, we want you to know that you’re in the right place. ABA is individualized so that whatever your child’s specific needs are, the program should be tailored to fit those needs, taking into consideration what the parent’s goals are for the child. This can also leave people wondering about the process of starting an ABA therapy program.
If you’ve decided to pursue ABA therapy for your child, here’s what to expect to get the program up and running:
1. Look into funding options that are available in your area.
In Ontario, we are suggesting to all parents to make sure that they are on the waitlist for the Ontario Autism Program (OAP). It plans to be fully rolled out in 2018 and “will ensure autism services for children and youth are delivered consistently across the province, allow for flexibility and choice based on each child’s needs, and give families confidence in receiving quality services.”
With the funding, you have a choice between DFO (Direct Funding Option) and DSO (Direct Service Option). With DSO, you will be assigned a location/team from one of the funded providers (eg: Surrey Place, Kinark, etc). With DFO, you can choose to receive the money and use it towards your own provider and ABA service (FYI, you must submit invoices and prove that the money is going towards ABA).
2. Think about the type of ABA you want.
Centre-Based: This means there is a central location where you drop off and pick up your child (similar to daycare/school). While your child is there, he will be receiving some form of ABA therapy. Make sure you find out what the ratio is of therapist to student and how much group/social skills are incorporated. A really unique spin on the centre-based option is our School Readiness Program at KM Academy. Based out of 2 locations of First Foundations, we have the opportunity to teach using reverse integration (bringing daycare kids into our group) and integration (supporting our kiddos within the daycare group). There are many opportunities for social learning and natural peer interactions!
Home-Based: This means that the therapist comes to your home and carries out the ABA therapy program from there. Some parents like this option because they can be involved in the delivery and generalization of the goals. They know what the therapists are working on with their child, they can ask questions, and they can learn strategies from how the therapists teach. This option might be difficult for working parents who prefer to be able to drop off and pick up their child.
Sometimes, a combination of the two is an option.
3. How many hours of ABA do you need? And what time of day?
The amount of hours a child gets is sometimes directly correlated with the funding options available. For really young kids, you also want to take into account how much they can handle and how much you can squeeze into their schedule. We usually recommend starting with an amount that’s doable, and seeing how the child reacts to it – then you can always ramp up (preferable to starting with too many hours and having the child have a negative association). In terms of time of day – fresh is best!
4. Find a provider – make some phone calls!
Get some numbers of providers and find one that you like. Make sure to ask these questions when picking a quality provider. Some providers use a one-stop-shop approach – they will do your scheduling, find therapists, and send you the bill. Other providers provide more of a piece work approach by only providing the consultant or BCBA. This gives parents the flexibility to find a therapist that they like, arrange a schedule that works for them, and pay what they want. It also makes the therapist accountable to the family which sometimes works well. If you’ll be the one interviewing a therapist for your team, have your child be in the room and watch them interact with the therapist – how your child reacts will tell you a lot about the success of the match.
5. Arrange for an intake assessment
Once a provider has been chosen and therapists confirmed, there should be an intake assessment. During this assessment, a BCBA (or equivalent) should be meeting with you and your child to get an idea of the parent’s goals, the child’s skills, and what to include the program. This meeting can be done in about an hour, but this can vary. What we like to see: a consultant that gets down on the floor and plays with the kid! This is the best way to get to him and find out his strengths.
The consultant should then fill in an assessment – the ABLLS, VB MAPP or equivalent. This helps to provide a baseline of skills and should be updated every few months to monitor progress.
If you haven’t decided yet on how many hours you want, the provider can help with that at this point.
6. Get started!
The consultant may need a week or two from the intake to have the program ready to go. In the meantime, the therapist can begin building a relationship with the child by “pairing”. An ABA program should be supervised by a consultant about 10% of the hours of ABA. So if the child is getting 10 hours a week of ABA, the consultant should spend about 4 hours per month supervising the program. This could be more often, if needed. The consultant’s role is to make sure that goals are being met, any negative behaviour is under control, and the program is progressing as planned.
7. Ongoing support and parent training
Your child is more likely to succeed if you can follow through with the goals and generalize what they’ve learned. This can be difficult without your own support system – a spouse, friend, teacher, etc. Make sure that the ABA provider is giving you opportunities for parent training and to ask questions about the program, the binder and data sheets should always be available to you. Parent goals and opinions should be considered first and foremost so open communication is key.
Hopefully, you’re seeing your child make progress soon after beginning an ABA program. If you’re not, you may want to reassess any of the above steps and make any necessary changes!