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:

• Is your child excited to see their team and engaged during sessions?
• Does your team involve you in decisions about goal selection and prioritizing what skill to teach next?
• Are sessions individualized to include your child’s interests?
• Do you feel you are receiving a sufficient amount of coaching and training from your team, or is therapy just focused on your child?
• How many learning opportunities are being presented during a session? Is the therapist able to incorporate a wide array of learning opportunities into activities, or is there a lot of “down time”?
• How many new skills has your child developed since starting therapy?
• Is your child making meaningful progress on the things you identified as being most important during the assessment?
• Do you feel your team values your input and listens to your ideas?

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 BCBA assessing your child will consider many factors when making an individualized recommendation for weekly therapy hours. These include standardized assessment scores, developmental level, age, severity of behaviors, and family priorities. We believe quality of time, over quantity, creates the best possible results.

An ABA assessment at Kyo includes the following steps:

1. A thorough review of relevant records including your child’s diagnostic evaluation, medical reports, and/or educational records (IEP). 
2. A parent interview to learn more about your child and determine your family’s priorities for ABA therapy. 
3. Two to three direct observation sessions with your child either in-person or via telehealth. These may occur across multiple environments (e.g., home and school) to get a complete picture  of your child’s current skills and areas of challenge.
4. Completion of a comprehensive assessment report that will be shared with you and your insurance company. This report will contain, among other things: recommended goals, treatment strategies, and a clinical recommendation for the number of service hours that should be provided.

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.