Patrick Blevins MA, BCBA & Melissa Wintz-Dykstra MS
Applied behavior analysis (ABA) is the application of the science of behaviorism to teach skills so that individuals can participate in socially significant activities that improve their lives. ABA services may be delivered within the home, community, and/or in a dedicated clinic. ABA agencies hire professionals credentialed through the national Behavior Analyst Certification Board. These professionals have competed rigorous education, subscribe to a code of ethics and practice interventions that are evidence-based through research. ABA based interventions are implemented by registered behavior technicians (RBT) who follow behavior support plans written by a masters or doctoral level Board Certified Behavior Analyst (BCBA) in collaboration with the family. ABA is a growing field in New Mexico with local and national providers expanding their businesses across the state on a daily basis.
Research shows that ABA based therapy may make a significant positive impact in an individual’s behavior (Granpeesheh, Tarbox, & Dixon, 2009; Tiura, Kim, Detmers, & Baldi, 2017). However, when initially considering ABA based therapy parents may experience a number of different emotions and including feeling: overwhelmed with pressure to begin services immediately after diagnosis; frustrated with long waitlists when navigating the choices of available providers; or stymied by a lack of services near their home. These are some of the realities that are currently being faced by parents in NM. Although finding appropriate supports may be stressful, it is important that parents educate themselves and become an advocate in the development and monitoring of all therapeutic services.
When considering ABA based therapy, it is crucial that parents work with providers to design interventions that consider the individual linguistic and cultural priorities of the family. This may involve interviewing a number of different agencies to determine the best fit for your family. Once a provider is chosen, families should feel empowered to oversee intervention plans. It is best practice for providers to make sure that parents are able to understand every element of the therapeutic process including assessments, intervention plans, and goal completion. If this is not the case, it is perfectly reasonable to ask for support from the provider. It is also appropriate for the family to determine whether or not any given RBT or BCBA is a good fit for your needs. This might mean requesting credentials of each team member working with your child, asking to observe your child’s sessions, and requesting the opportunity to review daily clinical notes.
If you hire an ABA agency and issues arise that are not being resolved in a timely manner, or if something just doesn’t feel right to you it may be time to discuss whether or not ABA services are a good fit for your family at this time or with this particular agency. Ultimately, parents are the experts when it comes to knowing the needs of their children. The following considerations may help increase one’s knowledge of what quality therapeutic practices are and may assist parents to make appropriate decisions about the welfare of their children.
Considerations for hiring a potential ABA provider:
- What experience do the employees that will be working with you have?
- Ask to see the credentials and background check of anyone who may have contact with your child.
- What is the caseload of the BCBA who will be working with your child?
- Are RBTs supervised in person or remotely through an electronic device? Ask providers to demonstrate what remote supervision may look like (note: remote supervision does not indicate poorer quality and may facilitate service delivery in rural areas).
- How often will the supervising BCBA meet with you to discuss changes to the intervention plan? How soon can you expect to receive a response to requests for changes to the program?
- What are the policies and procedures for addressing potential conflicts with staff or scheduling?
- Consider developing a list of behavior goals that are socially important to you and your family and that you would like to prioritize in the intervention plan (Behavior analysts are trained to assist with breaking down complex social skills into component parts that can be taught in discrete sessions).
- For school aged children, ask what experience the ABA agency has working with schools?
- To assist with scheduling services, ask about what other therapies the agency may provide such as speech/language, social work, and/or occupational therapy?
Resources:
https://nevadaautism.com/wp-content/uploads/2017/09/ABA_Guidelines_for_ASD.pdf
https://www.bacb.com/ethics/ethics-code/
https://autismpdc.fpg.unc.edu/national-professional-development-center-autism-spectrum-disorder
References:
Granpeesheh, D., Tarbox, J., & Dixon, D. R. (2009). Applied behavior analytic interventions for
children with autism: a description and review of treatment research. Annals of clinical psychiatry, 21(3), 162-173.
Tiura, M., Kim, J., Detmers, D., & Baldi, H. (2017). Predictors of longitudinal ABA treatment
outcomes for children with autism: A growth curve analysis. Research in developmental disabilities, 70, 185-197.
