ABA Resource for Parents

Also please note, these are the guidelines for a program based off of Lovaas Model ABA. An Early Start Denver Model (ESDM) program will look different to this. My knowledge of the ESDM is limited and as such, reference guidelines for an ESDM program have not been included in the site. Here's a listing of components to strive for when selecting a program. Hopefully these guidelines can help you make informed decisions when analyzing the treatment providers that are available to you.

 

• Team Members. Ideally your child's team should consist of one doctorate level staff member, with a degree related to Child Psychology or Behavior, then a BCBA level senior consultant to oversee the in home program, an intermediary staff member to operate between the senior consultant and the line staff, and then the line staff. Here is a more detailed listing of each of these.

 

Doctor. In a perfect world, a doctor would be acting as the senior consultant running your child's program, but with most treatment providers, you will not obtain this. A doctor who understands typical child development with a Psychology or Behavior related degree should be assigned to your program though. The level of involvement that they have with your child's program is going to look different by provider, if you're able to obtain doctor involvement. The answer to the question of how much involvement the doctor should have is, as much as you can obtain. At a minimum, the doctor would be reviewing the child's progress and deficits with the senior consultant every other week or more and subsequently making recommendations to the consultant based on these. Similarly, the doctor should meet together with the senior consultant and the family on a fixed schedule, in order to discuss progress and concerns. Again, in terms of the frequency of these meetings, the more frequent the better.

 

Senior Consultant. The senior consultant is typically the most important component of your program, as this is the think tank that is going to drive most of the child's programming and lead the line staff in their implementation of the program. BCBA certification achieved is desirable, but not absolutely necessary (equivalent experience is more important). The consultant should possess a degree related to Psychology, Behavior or Teaching and have many years of firsthand experience working directly with children on the spectrum 1:1. They should understand typical child development and be able to teach effectively.

 

Intermediary Consultant. An intermediary consultant is a therapist whose experience is advanced, more advanced than the line staff, but not quite as advanced as the senior consultant. Ideally they have more than three years of experience teaching children on the spectrum in a 1:1 setting. In most ABA treatment organizations, doctors and senior consultants' hours are at a premium, due to the demand for their services, so a go between is required to fill the gap between the line staff and senior consultant and to lessen the senior consultant's workload. The Intermediary Consultant's educational background ideally would be a degree obtained related to Psychology, Behavior or Teaching and BCBA Certification achieved.

 

Line Staff. The line staff is the important component that actually teaches the child the programs, as specified by the senior consultant and in some cases the intermediary consultant. They should be effective teachers, with an ability to keep the child engaged and enjoy interacting with children. lf they have a degree related to Psychology, Behavior, Teaching or even Speech Therapy, either completed or in progress, this is ideal, but it's not always possible to locate a provider that offer line staff with this level of experience.

 

• The child should receive 36 - 40 Hours per week of ABA Treatment, with 40 hours being optimal.

 

• Staffing Hours. The Senior Consultant on your team should be highly involved in your program and at your house for as many hours as you can obtain. This is necessary in order for them to keep a finger on the pulse of the child's progress and struggles, by working with the child and reviewing their data, as well as monitoring the effectiveness of the less senior staff. Some organizations may offer a senior consultant for 4 -6 hours per week, whereas others may offer a consultant for less than one hour each week. Minimal consultant hours such as this will not achieve the strongest results. In terms of the intermediary consultant, they should also be quite involved in the program. Again, in terms of how many hours they should be in your home working on the program will vary, but the more hours the better for your child. The line staff will be the staff that spends the most hours in your home as they're the ones actually executing the programs with the child.

 

• Teaching time during sessions. Initially, the sessions should be structured so that 75% of the time is dedicated to teaching, with the other 25% dedicated to data tracking and play. This may need to start out at 50% of the session time being dedicated to teaching and worked up to 75%, depending on whether or not the child can initially tolerate 75%.

 

• Play and encouraging the child's imagination are integral components of the program. lt's becoming widely accepted that play is a critical component of a successful ABA treatment program for Autistic children. lt improves socialization and imagination, and imagination is needed in order to develop a healthy Theory of Mind. The type of play will vary by age and be dependent on the child's current play skill level. The "Work in Progress" book referenced in the "Reference Books for Parents" section of this site contains a listing of what type of play typical children will do by age. The authors also reference misconceptions that parents commonly have regarding play; incorrectly thinking that it's not as important as the other components of their child's ABA program.

 

• There should be a purposeful sequence to the programming. Pre-requisite skills needed for later programs should be taught in the earlier programs. If possible, the program sequence should mimic the programming sequence that was used in the UCLA Lovaas Study or at least base itself on Lovaas Model ABA.

 

• Teaching at the table will be necessary, particularly at first, but moving teaching away from the table, to other locations, other rooms of the house, the back yard, maybe in the community, at the park for example are critical in order for the generalization of learned skills to occur.

 

• Accurate Data tracking of the child's programs. lt's imperative to keep accurate data of how the child is performing with each of the programs in order to identify where he/she is struggling and understand when to phase out mastered programs, and introduce new programs.

 

• Frequent review of the child's program data. Ideally this should occur at least once per week by the senior consultant on the team. The child's time is precious, and this data analysis ensures that the benefits of the program are maximized for the child.

 

• Once per week team meeting with all of the team members present, especially the senior consultant on the team. Ideally this will run for 2 hours in duration or more. Components of the meeting should include, discussing any programming that the child is struggling with, and demonstrating any programs that are being introduced for the first time.

 

• Positive re-enforcement through praise and rewards should be used during sessions to encourage the child to learn. Again, the "Work in Progress" book is a great reference point for this and goes into detail of how to prompt a child and then praise them, and the varying degrees of which to praise, based on the their performance on the particular instruction or task.

 

• Sessions should be as fun as is possible for the child. The teaching does not have to feel like work for the child. Positive, upbeat therapists can often maintain a child's attention and teach them while keeping the interaction enjoyable for the child.

 

• IQ Testing. Your child's IQ should be tested at least once per year in order to track his/her progress and serve as a baseline for their programming.

 

• Where possible, once the child is ready, there should be an emphasis on the child interacting with age similar typical peers. Initially this may include prompting of the child's responses and interactions with the typical peer. In the early phases, these interactions may be very simple, rolling a ball back and forth with the typical peer for example.