By Rebecca Womack
Applied Behavior Analysis: A Bridge Worth Crossing
Moments of difficult news can feel like they are suspended in time. When a parent learns their child has been diagnosed with Autism Spectrum Disorder (ASD), they can experience a range of emotions. Facing an unknown future, families often educate themselves as quickly as possible so they can plan for what next steps to take. After making the diagnosis, the health care provider shares various recommendations to help guide the lifelong pathway of childrearing. This usually includes the referral to begin applied behavior analysis (ABA) therapy. Confirmed as an effective treatment by the US Surgeon General in 1999, ABA therapy can bridge the seeming limitations of ASD to the endless potential within each child.
So what is ABA therapy?
It is the application of research-based principles of learning and motivation to modify behavior. Simply said, it’s a way of changing behavior in a meaningful manner. By observing how people act, their environment, and the circumstances surrounding behavior, significant changes can occur. This includes the reduction of actions that can be problematic, strengthening the child’s current abilities, or teaching them new skills. For example, a child with ASD may have a meltdown when they become frustrated. ABA therapy can provide them with the skills to express their wants and needs, decreasing the need to engage in problem behaviors. It can be used to teach them how to make friends, or improve their current relationships.
Parents are tasked with contacting someone who has been trained in ABA therapy. The most common type of therapist they will encounter is a Board Certified Behavior Analyst (BCBA). A BCBA is a therapist who has a master’s in either education, psychology, or ABA. Prior to obtaining the certification, they must take extensive behavior analysis-based graduate coursework, complete 1500 hours of supervised field work, and pass a comprehensive exam.
Treatment begins with a detailed assessment of the child’s history, medical information, and educational background. The BCBA will also assess the child’s skill level through observations, parent interviews, working one on one with the child, and using various tests. All these elements work together to provide the BCBA with a baseline of information to guide program planning. By sharing their expectations for treatment outcomes, the parents provide the BCBA with the tools necessary to individualize goals and objectives.
By supporting the child’s individuality while strengthening their skills, they can achieve greater independence. The ability for a child to speak for themselves, to care for their own needs, or to make friends is priceless.
Therapy can take place across a variety of settings, but especially in those locations where problems most likely occur. For young children, this usually is in the home or a clinic setting. For slightly older children, BCBAs may also work with them in their school or out in the community. It’s very common for sessions to occur on a daily basis. Research indicates that younger children benefit from at least 36 hours of ABA therapy per week (Eldevik, S., Hastings, R.P.,Hughes, J. C., Jahr,E., Eikeseth, S., &Cross, S. 2010). While this initial amount may be overwhelming to consider, an aim of ABA therapy is to transition from a comprehensive program to a more focused model. This means that the BCBA will initially be working with the child to address a wide variety of skills to help them achieve developmental milestones. As the child makes progress, weekly session hours will be reduced to reflect their decreasing need of support.
ABA therapy occurs as long as there are goals for the child to achieve. The BCBA will continue to work closely with the family, while continually assessing the progress made, and any other obstacles to overcome. Parents need to feel like the therapist has a thorough understanding of their child’s progress while maintaining consistent communication. The BCBA should be open to working with all other professionals who are involved in the child’s life. A collaborative approach is necessary for supporting the continuity of care while making the way for treatment generalization.
ABA therapy does not make it any easier to deal with an ASD diagnosis, but it does provide parents with options. The option of therapy leads down a pathway of hope through an evidence-based approach designed to facilitate the child’s utmost potential. By supporting the child’s individuality while strengthening their skills, they can achieve greater independence. The ability for a child to speak for themselves, to care for their own needs, or to make friends is priceless. ABA therapy is the bridge that begins with these ultimate goals in mind. And that’s a bridge worth crossing.
Since graduating from her masters program at North Dakota State University, Rebecca Womack has been privileged to serve adults and children in the field of applied behavior analysis (ABA) in a variety of capacities. From facility based care, to working group homes, day centers, schools, and homes of families, her experience includes implementing evidence based therapy across multiple settings. She has traveled to different countries in Asia to provide consultation at adult treatment centers and for families with children who have autism. She has also given presentations to health and educational professionals on the use of positive behavior supports. Additional experiences including administrative work, advocacy, staff and parent training, and supervision.
Ms. Womack’s current duties include working as the Clinical Director of ABA Services for Achieve Beyond. The pediatric clinic provides in home and center based ABA therapy. She was also appointed as the Director of the Behavior Analysis Advocacy Network (BAAN). Focused on increasing the dissemination of quality behavior analytic services, Ms. Womack has worked with policy makers to help resolve insurance barriers that prevent best practices for ABA therapy, and has created resources to aid Behavior Analysts in writing plans based on medical necessity. Whatever the role, her ultimate goal is to always make a significant and meaningful impact through the science of Behavior Analysis.