ABA therapy is generally provided by a team of trained clinicians, including a BCBA (Board Certified Behavior Analyst), a program supervisor, and several behavior therapists. The BCBA generally oversees your child’s program, completes the assessment of your child, creates a skill acquisition and/or behavior intervention plan, and works with your insurance provider to get authorization for your child’s program. A program supervisor is considered a mid-level provider; they implement the plan created by the BCBA and provide guidance to the behavior therapists.The behavior therapists work directly with your child to implement the treatment plan during therapy sessions.
A BCBA (Board Certified Behavior Analyst) is a clinician who holds graduate-level certification in behavior analysis and whose practice standards are overseen by the Behavior Analyst Certification Board. In order to become a BCBA, one must have a master’s degree, complete specific coursework in Applied Behavior Analysis, and pass a board exam. In order to maintain certification, BCBAs must participate in ongoing training and remain in good standing with the Behavior Analyst Certification Board.
Behavior therapists provide 1:1 instruction to clients using techniques from the field of Applied Behavior Analysis (ABA), as directed by a Board Certified Behavior Analyst (BCBA). In addition to teaching new skills, they collect data on the client’s progress and provide caregivers with in-the-moment modeling and coaching.
At Kyo, our behavior therapists receive over 50 hours of training before they start to work with clients. They must also pass a DOJ and FBI background check, TB test, and be vaccinated for COVID-19. Kyo behavior therapists must maintain a Registered Behavior Technician certification or other state-specific ABA licensure.
For more information, read this article written by one of our behavior therapists about what they do on a day-to-day basis.
ABA therapy can occur in a wide array of environments, including homes, therapy centers, schools, after-school programs, summer camps, and other community locations. The location of therapy services should be determined by the therapy team, in collaboration with caregivers. Your child’s therapy may be scheduled to occur in multiple locations, and those locations may change over time, based on your child’s needs. When teaching new skills, it’s important to generalize those skills across various environments where the skill may be used. For example, when teaching conversational skills, initial lessons may occur during therapy sessions at home. Once mastered at home, the skill may be reinforced by therapists during playdates at a park or in school.
High-quality ABA therapy programs will require some level of parent or caregiver participation. The level of involvement will depend on the therapy team’s recommendations, the child’s skill level, and the location of therapy sessions. At Kyo, we believe involving parents and caregivers in the treatment process is integral to a child’s success. Because ABA therapy targets socially significant behaviors, it’s important for the whole family to provide information about what skills are needed and what behaviors impede everyday functioning. Teaching parents how to implement ABA strategies and respond to behaviors increases the likelihood that these skills are practiced outside of therapy sessions. This helps a child learn skills faster and generalize them across different people and environments. Research has shown that consistent parent involvement leads to significant increases in developmental skills that are maintained over time.
Parent participation can look very different on a case-by-case basis, but generally will include some elements of direct teaching of ABA principles or strategies, discussions with the care team about the child’s progress on specific goals, completion of standardized assessments or parent surveys, and observation of ABA therapy sessions.
Applied Behavior Analysis (ABA) is a therapy based on the science of behavior and learning. ABA therapy is useful in teaching new skills and in decreasing challenging behaviors. . ABA therapy has been extensively researched and is widely accepted as the best treatment for people diagnosed with autism. It is considered an evidence-based best practice treatment by the U.S. Surgeon General and the American Psychological Association.
ABA therapy encompasses a wide array of different methodologies that can be adapted to meet the needs of specific individuals. In the 1960s, Dr. O. Ivaar Lovaas pioneered ABA for children with autism by using behavioral principles to teach them new skills. Lovaas used Discrete Trial Training (DTT)—high levels of repetition, prompting, modeling, and reinforcement—to achieve results. However, Lovaas’ methods used not only reinforcement but also punishment, which proved counterproductive for children whose lives the therapy was meant to improve. Over time, ABA has shifted away from DTT to play-based, naturalistic therapy.
ABA therapists now rely on reinforcement-based procedures, and the field has moved away from exclusively adult-directed tasks to therapy sessions that involve a more natural back-and-forth between the therapist and the child. Therapists and children share control over the direction of activities, and clinicians design treatment based on the natural course of skills progression that occurs in child development. These more naturalistic, “developmental” models of therapy teach children to say “big truck,” or “red truck,” before “I want truck please.” This is in keeping with how children naturally learn to communicate – they learn to speak in two-word phrases that have a noun and modifier, before they learn to speak in sentences.
In a traditional DTT approach to therapy, a child might be taught to identify colors by touching flashcards placed in front of them on a table. In Kyo’s child-centered therapy model, a kid who loves balloons might be presented with different colored balloons to identify by color, with the therapist blowing up the balloon or letting it zip around the room, once the child responds correctly. Another child who is fascinated by vehicles might learn to identify colors when the therapist presents different colored matchbox cars.
We believe naturalistic, child-centered ABA therapy is one of the most effective ways to teach children with autism. We meet families where they are, to teach children in ways that feel comfortable for them and motivate them to develop new skills. Celebrating neurodiversity means incorporating a child’s unique personality into the therapy plan to deliver effective, purposeful treatment. The result is more meaningful moments for children and their families.
There is no standard format for what Kyo therapy sessions look like as in a child-centric model each child’s therapy program is guided by their unique interests and goals. However, generally speaking,ABA therapy sessions involve a behavior therapist working directly with your child to teach new skills. Therapy sessions are often naturalistic and play-based, with the therapist using a fun, quick pace of instruction, engaging the child right away. In this model, control of activities is shared between the therapist and the child. While some skills may be best taught using highly structured learning tasks, many skills can be learned through play. The behavior therapist may bring additional materials to sessions such as visual schedules, token boards and novel games in order to work on your child’s goals. During some sessions a program supervisor or Board Certified Behavior Analyst (BCBA) will provide feedback and modeling to the behavior therapist to ensure the programs are being implemented correctly. In order for therapy sessions to be successful, it’s important that initially the behavior therapist is allowed time to “pair” with your child. The first few therapy sessions may consist largely of pairing activities, which involve the therapist “pairing” themselves with items and activities that the child finds to be motivating. Demands will be kept low during this time, so that the therapist and child can focus on building rapport. While parents don’t need to participate in all of their child’s therapy sessions, it is expected that they will regularly observe strategies used by the therapy team and follow up with these same strategies after therapy sessions end.
ABA therapy focuses on developing skills that are determined to be socially significant for the individual person. Programs generally target two main areas: behavior regulation and skill acquisition. Behavior intervention goals generally focus on reducing maladaptive behaviors (behaviors that impede basic functioning, learning, or access to the community), increasing coping skills, and teaching functional replacement behaviors. Skill acquisition goals focus primarily on increasing skills in the developmental areas of communication, socialization, and daily living skills. All of the goals in your child’s program should be based on an assessment of their current skills and designed specifically for them.
Choosing a therapy and a provider for your child is a significant decision. We believe all families should research the options available to them before deciding on what services will be most beneficial for their child. There is a seemingly endless amount of information available on the internet about ABA therapy, its various methodologies, and its efficacy. When looking for information, it’s important to consider the source. While there is a large body of scientific research on ABA, there are also some websites providing misinformation and/or a very narrow view of ABA therapy.
Some resources we recommend are:
You can reach Kyo’s Client Services team by calling (877) 264-6747 or by emailing firstname.lastname@example.org. You may also schedule an appointment with our team to start the process of enrolling in ABA therapy by visiting our enrollment page.
Choosing a provider who will understand your child’s needs and provide a therapy model that fits with your values can be a daunting task. There are numerous ABA therapy agencies and therapy options, and it can often be difficult to tell from a website what those therapy services will look like. When looking for a provider, it can be helpful to ask to speak to a clinician in your area, to discuss their experience, methodology, and philosophy of treatment. Let them know what style of ABA you are looking for and ask if that’s something they provide. Don’t be afraid to ask about the training and experience that is required of the staff that will be working directly with your child. Provider availability and wait lists may also be a factor in your decision; ask what the wait times are for the providers in your area. Gather information on how much involvement will be required of caregivers and how convenient it is to change the time, location, or therapist, if needed. ABA is a goal-based therapy with measurable outcomes for your child. Talk with the provider about how progress with therapy will be measured.
Just because you start with one ABA agency doesn’t mean you have to stay with them, if you feel it’s not working for you or your family. You can request to change providers and try another agency that may be better aligned with your preferences.
Before starting ABA therapy, caregivers should consult their child’s physician. Your child may need to be assessed and given a formal diagnosis or recommendation from their physician in order to qualify for services. Next caregivers should contact their insurance provider or the ABA provider of their choice. The ABA provider will work with you and your insurance company to secure authorization to begin an assessment for ABA services. After the assessment is completed, the assessing clinician will determine whether ABA therapy is appropriate for your child. If so, they will submit their recommendation for treatment to your insurance provider. In some cases, ABA therapy may be provided by your child’s school district as part of your child’s Individualized Education Plan (IEP), or it may be provided through a community health center or public agency. Some families who do not have ABA as a covered benefit may elect to pay for services out of pocket.
At Kyo, starting ABA services is easy. You can book an appointment directly on our website to enroll directly. Our client services team or local regional director will be able to let you know if there is a wait time for an assessment.
If your child is receiving ABA therapy you may be wondering how to tell if your child is enrolled in a “high-quality” program. We recommend parents consider the following things when evaluating their child’s program:
The type and amount of insurance coverage your child can receive is determined by your individual insurance plan, as well as your child’s needs. Generally, state funded insurance plans must comply with all state laws regarding ABA therapy for qualifying individuals. Self-funded or federal insurance plans are not required to follow state law, as they are regulated by federal laws. All 50 states currently have laws in place requiring some level of coverage for individuals with an autism diagnosis; however, the amount of coverage can vary by state. In most states, Medicaid also covers ABA services for individuals under the age of 21, when ABA treatment is deemed to be medically necessary by their physician.
To learn more about insurance coverage in your state, look here.
If you are interested in enrolling in services with Kyo, we welcome you to contact our client services department to determine whether ABA therapy is a covered benefit under your health insurance plan. Kyo is proud to be in network with most major private insurance companies, as well as Medicaid and TRICARE. To see which insurance providers we work with in your area, please refer to our locations web page, or book an appointment to speak with one of our team members.
ABA therapy can be started at any age, but research has shown that it is best to start as early as possible. Children under the age of five have been shown to make the quickest gains over time in targeted skill areas. Each year, one in four children under the age of five are identified by their family doctors as being “at risk” for developmental delays. Such identifications are made by pediatricians during routine screenings at annual check-ups. Pediatricians and preschool teachers often recommend speech therapy, physical therapy, occupational therapy, or ABA therapy (Applied Behavior Analysis) as interventions, depending on a child’s specific needs. Many states now provide resources and therapy options for “at risk” children under the age of five who cannot otherwise access treatment without a formal diagnosis. Reach out to your pediatrician if you have concerns about your child’s development.
The amount of hours of ABA therapy a child receives varies and is based on the recommendation made by the clinician who conducted the initial assessment. Factors in determining the number of recommended hours include: the child’s age, the amount and severity of skill deficits, and the amount of other related services the child currently receives. If ABA services are funded through your private insurance company, the amount of recommended hours must be approved by your insurance provider before starting therapy services. Generally clients receive between 10 and 40 hours of ABA therapy per week. The amount of therapy a child is recommended to receive typically decreases over time in a step-down fashion as they acquire skills; the appropriate dosage should be reviewed on a regular basis. Revisions to recommended hours should be made as needed based on the child’s response to treatment. All ABA treatment plans should include specific and measurable criteria for fading or ending ABA therapy services.
The purpose of an ABA assessment is to determine a child’s overall developmental-behavioral profile, including behavioral excesses, skill deficits, and areas of strength. Insurance companies typically approve 8-10 hours for an assessment, which is completed over several sessions. An assessment generally includes a review of health and educational records; interviews of teachers, parents, and caregivers; observations in home, school, and/or community environments; and administration of formal assessment tools. The assessment tools used may vary between ABA agencies and are used to help clinicians gain a clearer picture on strengths and areas of need. During the parent interview, the clinician will work with you to identify your most pressing concerns and what skills you would like to see improved. A good ABA assessment should include a thorough review of all areas of your child’s development and should propose an intervention plan with specific strategies and measurable goals. At the end of the assessment, the clinician will provide you with a recommendation on whether ABA therapy is appropriate, as well as the amount of therapy your child should receive.
An autism diagnosis is not required to receive ABA therapy, but it is usually required in order for the cost to be covered by medical insurance. While most private insurance companies require a formal autism diagnosis to qualify for coverage of ABA therapy, there are some insurance policies that only require that ABA therapy be prescribed by a physician. If a family would like to try ABA therapy without a formal diagnosis, they can choose to pay out of pocket, but this can be cost-prohibitive for many families. While ABA therapy is most commonly prescribed for people diagnosed with autism, research has shown that ABA therapy can also be an effective treatment for other developmental disorders. Consult your child’s physician to see if ABA therapy is an option for your child.
Ready to enroll your child in Kyo’s therapy services? Please schedule a convenient time to connect with us below. Not ready to enroll just yet? Call us at (877) 264 6747 or email email@example.com to set up a free consultation or to learn more about Kyo’s services in your region.