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Want to Know More About Applied Behavior Analysis?
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What is Applied Behavior Analysis therapy (ABA)? ABA is the cutting edge, gold standard treatment for behavioral modification and has become known as the therapy for individuals diagnosed with Autism Spectrum Disorder. ABA Therapy is research-based and is defined by it’s empirically backed methodology. In fact, ABA is the only proven intervention for children on the Autism spectrum to reduce problem behavior and increase rate of learning. The Surgeon General endorses intensive ABA therapy as the treatment for individuals with Autism Spectrum Disorder due to the long history of efficacy and scientific nature of the therapy. While Autism treatment is a primary use of Applied Behavior Analytic services, ABA is a therapy that is clinically proven to reduce inappropriate behavior and to increase socially desired behavior and skill acquisition rates in ALL individuals. ABA is, simply put, the science of teaching new skills and reducing problem behavior.
Unlike other therapies, individuals may need to participate in ABA therapy every day and/or for several hours per day. Magnitude and frequency of therapy varies from a comprehensive, intensive approach to a need-specific focus dependent upon the recipient of the therapy. The clinically necessary amount of time spent in ABA therapy sessions can range from 5 to 40 hours per week and is determined during an initial assessment with a professional trained in Behavior Analysis. Participation in the full amount of treatment that is deemed clinically necessary by a Behavior Analyst is directly linked to the success rate and overall outcome of ABA as a therapy. The amount of time that a person spends receiving ABA therapy varies, especially when under the control of an outside funding source. When introduced early, a child can receive ABA services for 2-4 years, on average. It is not uncommon, however, for an individual to receive treatment of continually decreasing intensity for 5-8 years until they’re meeting all of the milestones of their same-age peers. The clinically necessary recommendation of time engaged in therapy is reassessed by the clinician as milestones and goals are met and is reduced until the client is fully faded out of treatment.
The core value of ABA is that of reinforcement. Whether goals are set to learn new skills, reduce inappropriate behavior or both, the fundamental component is to reinforce desired response and extinguish undesired responses. Behaviors and skills that are chosen to be targeted during therapy are specifically ones that are socially significant to the client and have some impact on their lives. Reduction of behaviors that would not serve to improve the lives of the client or those around them (i.e. sleeping on the right or left side of the bed) are not selected for intervention. The science of ABA recognizes only behaviors that are overt; behaviors selected for reduction are those that are measurable, observable, and intervenable. Skills that are selected for goals are those that are measurable, overt and relevant to the client in some way.
Some methodology used to teach new skills during ABA therapy includes modeling, prompting and shaping, as well as reinforcement. These techniques, to name a few, are implemented throughout the entirety of therapy sessions. In order to promote participation and progress from clients and to prevent the opportunity for such long therapy sessions to become aversive, ABA is play-based therapy that uses naturalistic opportunities to promote learning acquisition. ABA therapists often utilize child-lead play and naturally occurring environmental arrangements to teach new skills and to pair themselves with preferred items or games, which, in turns, promotes a higher rate of compliance and appropriate responding. ABA therapy sessions often look a lot like just playing with friends with the addition of the recurring prompting and redirecting.
ABA therapy for older and higher functioning clients utilizes all of the same concepts, but on a wider scope. The targeted goals for these clients might be job maintenance, conversational skills, hygiene/self-care or following recipes rather than learning to speak or to hold a pencil correctly, but the intervention is foundationally the same. ABA can be used to teach any skill and to reduce any behavior (excluding behaviors caused by medical conditions). Parent, caregiver, teacher and other stakeholder participation in the delivery of ABA therapy is crucial to the client’s rate of success. Research shows that even progress made during intensive ABA therapy can be undone outside of treatment hours without parent buy-in and efforts. Parent/caregiver training is a core value of ABA, in that it allows for clients’ families to implement interventions in the home, school and community that are congruent with those implemented during therapy sessions.
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What Services are Available?
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Post-diagnosis consultation
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Evaluate psychological report, determine appropriate and feasible future plan.
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Discuss educational placement and/or needed therapies.
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Address parent concerns (educational, behavioral, rate of learning, etc.) and provide resources to parents/clients to accommodate any future changes in supports or services.
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Plan meetings, appointments, evaluations needed for future supports/services.
Behavioral Assessment
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Evaluation to determine baseline for skill acquisition rate and behaviors for reduction. Includes direct observation, skill testing, parent/caregiver interview and requires follow up appointment for deliberation of derived treatment plan.
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Assessment tools vary between clients; all tools specific to Applied Behavior Analysis and Verbal Behavior. Assessment required to formulate treatment plan for future ABA services, educational needs, job placement assistance, etc.
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Direct assessment and indirect treatment planning time included in this service.
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For scheduling purposes-- Assessment (client and caregiver present): 2.5 hours. Treatment planning (indirect): 2 hours. Follow up meeting: 1 hour. Total of 5.5 hours for private pay clients.
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Treatment Planning
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Treatment plans derived from findings in the behavioral assessment include observation notes, client’s age equivalency, scores in domains tested during assessment (motor skills, communication, socialization, functional play, barriers to learning, etc.), measurable goals for behavior reduction and skill acquisition, transition/discharge plan (applicable only for clients beginning ABA therapy) and graphs to display assessment data.
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Treatment plans are used to paint a clear picture of current development to insurance companies and other funding sources where proof of medical necessity is required, schools/educational institutions, caregivers, physicians, etc.
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Follow-up appointment to discuss findings of assessment and goals as outlined in the treatment plan. (1 hour for follow up meeting).
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Direct 1:1 ABA Therapy
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Structured ABA therapy session with 1:1 client to therapist ratio. Skill acquisition and behavior reduction plans to be implemented during session, based on behavioral assessment outcomes. Social peer interactions available during most 1:1 therapy sessions. Provided in treatment facility unless otherwise deemed appropriate/necessary.
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Can include vocational training, on-the-job behavior modification, life & social skills training, in-home or in-school sessions, etc.
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Appointments can vary from 1 hour to 8 hours per day based on client. Will always provide current scheduling needs/authorized hours to office staff.
Direct Small Group ABA Therapy
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Structured ABA therapy session with a client to therapist ranging from 2:1 to 4:1. Data collection, skill acquisition programs and behavior reduction plans implemented in the same manner as 1:1 therapy sessions. Social skills training and peer interactions targeted heavily during group sessions.
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Billed at a lesser rate per therapy hour for both insurance and private payors.
Parent Training
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May occur in-home or in the treatment facility; goals determined based on behaviors of concern indicated by parents and outcome of behavioral assessment/parent interview.
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Goals set for parent training during Treatment Plan follow-up meeting. Goals for parent training include skills needed to implement client’s behavior reduction plan, skills needed to assist in alleviating deficits in client’s skill repertoire, etc.
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Scheduled trainings with parents to occur in designated setting (may or may not require child to be present) and to address specific goals needed to best foster growth and progress toward client’s goals.
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Can also include training for families, teachers, other care providers, etc. Training goals set individual for each stakeholder.
Educational Advocacy Consultation
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Meetings with parents to discuss school-related concerns. Review of documentation (meeting notices, behavioral reports, IEP/BIPs, etc.). Communicate with educational professionals on behalf of student/parent. Review with parents the student/parent rights, state laws, compliance codes, etc. as they pertain to concerns. Provide resources to parents to aid in ensuring educational/personal needs are met in the school setting.
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Typical reasons for meetings include: upcoming ARD/IEP meeting, behavioral concerns at school, suspicion of non-compliance by educators, desire for additional services/supports than current allotment, desire for placement adjustment, initial enrollment of a special needs child and other specific school-related concerns.
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Not covered by insurance.
Educational Meeting Attendance
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Educational Advocate to attend educational meetings, such as ARD/IEP meetings, parent-teacher conferences, etc., alongside caregiver/parent to ensure compliance, ethical decision making and to advocate for student and parent rights within the educational setting. Advocate to act as a liaison between educational professionals and parents/caregiver to provide knowledge, insight and requirements by law to both parties and to defend student/parental rights when addressing concerns and constructing plan of action for student.
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Preparation for educational meetings to be done during a consultation between parent/caregiver and Advocate prior to meeting date.