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Behaviour Intervention based on the learning principles of Applied Behaviour Analysis (ABA) is, to date, the most effective therapy to help individuals with autism reach their full potential.
There are many other “therapies” that one sees in the media, but keep in mind that a theory, a book or a testimonial, is not research. It is important to become a savvy consumer of autism services.
ABA incorporates the:
It’s important for ABA to focus on socially significant behaviours including reading, academics, social skills, communication, and adaptive living skills. It should also focus on the safety of the autistic individual and incorporating long term positive mental health goals.
Adaptive living skills include gross and fine motor skills, eating and food preparation, toileting, dressing, domestic skills, time and punctuality, money and value, home and community orientation, and work skills.
ABA can also be used to learn new skills that can lead to greater enjoyment. For example, learning to read music so one can partake in band class or read choir music.
ABA is effective at any age or level of ability. A non-verbal toddler may work on saying the word “ball”, while an older or highly verbal child might work on extending conversation topics so that not all conversations have to be about their own particular interests.
ABA programs are versatile and can be tailored to various skills, such as zipping up a coat, acquiring safety skills in public, practicing self-advocacy, brushing teeth, or playing a musical instrument like the clarinet.
Progress is achievable for all children undergoing ABA, given a skilled consultant who can identify their needs and design targeted programs. If data indicates a lack of progress, consultants can adapt strategies accordingly. If a parent isn't satisfied with a child's progress, considering a change in service providers might be a viable option.
Watch the video on “Quality ABA” to better understand all necessary components of a good ABA program
In navigating a perplexing world, individuals with autism might display challenging behaviors like self-injury, aggression or extreme fears as coping mechanisms. Applied Behavior Analysis (ABA) has proven effective in diminishing, substituting, or eliminating these behaviors, keeping the child safe in the community, and leading to a substantial enhancement in the overall quality of life.
An ABA team should be made up of a Board Certified Behaviour Analyst (BCBA) and Behaviour Interventionists (BI).
The BCBA is often called a “Behaviour Consultant”, but they should have the BCBA qualification or be working under the supervision of a BCBA. The BCBA assesses the child and designs programs that will target an increase in beneficial behaviours (such as reading, tying shoes or having meaningful peer interactions) and decrease interfering or risky behaviours (such as eloping or self-injury). BCBAs have a Masters or Doctorate degree specializing in autism.
The Behaviour Interventionist is a front-line worker who will implement the programs one-on-one with the child. The BCBA should train the BIs on each program and needs to make sure that all BIs on the team are consistent with their program delivery. BIs do not necessarily have accreditation. Some may have taken courses on ABA, but the BCBA needs to train them to the specific program delivery for the child they are working with. A BI should not work with a child if they have not had training by the BCBA.
To begin your family’s journey with ABA, you will have to find a well-qualified Behaviour Consultant (sometimes called a BC). A consultant should at least be a Board Certified Behaviour Analyst (BCBA) or a Board Certified assistant to a Behaviour Consultant (BCaBA). You can find Behaviour Consultants in your area through the Registered Autism Service Provider (RASP) list at Autism Information Services BC, but not all of them are BCBA.
Your behaviour consultant should assess the child and write individualized programs with long term and short term goals. Taking data to see if short term objectives are met is critical.
Watch Welcome to Autism part 4 to learn how to recognize the qualities of a good consultant. As well, join the ASN closed parent Facebook group where you can ask other parents about their experiences with consultants.
One of the first choices to make is whether to engage the services of an ABA Clinic or run a Home-Based ABA program.
Running a Home-Based ABA team requires hiring (and firing) a BCBA and BIs, managing
their hours, keeping track of finances and buying learning materials. However, the program is run in your home so parents can have more control on culturally safe, personally significant goals, not just what is on the consultants developmental milestones chart. As well, parents can help generalize whatever is learned. A huge benefit of a home program is that the BI can facilitate play dates with neighbourhood children or school classmates. And your Autism funding is spent on direct services to your child instead of going towards overhead, accounting, and management costs.
However, the family may not be in a position to manage a home-based program for a variety of reasons. Taking a child to a clinic may be a good start for getting the child early intervention. Some clinic settings offer preschool-like settings where the child is able to have interactions with other children.
Whether you choose a Behaviour Consultant for a home program or a clinic program, CHECK WITH OTHER FAMILIES on their experience with that consultant before signing any contract.
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Once you have an ABA consultant lined up, you will need to hire a team of Behaviour Interventionists (BIs) to work one-on-one with your child.
New teams should start with 4 to 6 BIs as you may lose one or two within the first month. A child will often start with 10 hours and work up to nearly 30 within a few months. Less if a child can get quality intervention during school or preschool hours. Note that therapy should include much more than just table work. BIs can also work on swimming skills, riding a trike or bike, staying safe when going for a walk, playing games, etc.
The number of therapy hours will be determined by your consultant. It is important that BIs have at least 3 shifts per week if they are new, so that they get experience intensively. This is a difficult balance to work out. You don’t want to be short of BIs, but you also need to offer enough hours to the BIs. It is better to be overbooked, than have too few learning opportunities for your child.1
You can advertise for BIs on the ASN Facebook group “ABA Therapists in BC”, at local schools and colleges or universities (preferably in the Psychology dept), on Starbucks notice boards, on Craigslist and on Support Worker Central.
Note the age of your child, where you live and what times of days are needed to fill. You might also want to state any talents your child wants to learn.
It is helpful to have at least one experienced BI. See if your own consultant can recommend someone from their other families or check on ABA Therapists in BC. Otherwise, you can hire “green” BIs (those who don’t have any experience). One advantage to hiring green BI’s is that they tend to be loyal to your family first and will usually stay longer on the team.
Your consultant provides ongoing training for all the BIs on your team.
Usually your consultant will spend 8 hours or so assessing your child and developing programs. Then they will meet with the new team and teach them how to deliver the programs.
If you have a lead therapist, that person can work with all BIs for the first month to make sure they are all delivering the programs consistently. This is less expensive than paying the consultant to do it, and just as effective.
The consultant can overlap any new therapists once they have been trained up, to tweak any outstanding issues.
We recommend you watch our Running an Effective ABA team on our Workshops page.
You can claim Behaviour Interventionist hours worked under Autism Funding, At Home Program, Supported Child Development or Respite, or if funding runs out, you can claim Child Care expenses (if both parents work) and lastly, as a medical expense for tax credit (use “tutor”). BI’s can be contracted if they work on other teams, or employees if they work specific hours only on your team. But it’s vital that you keep track of BI hours worked and have their signature confirming those hours worked.
Track Your Hours:
Then enter hours into the AFU invoice or Daycare/Medical Expense invoice. These spreadsheets can be changed and added to as needed:
At the end of the year, we recommend you summarize hours worked with one Year End BI Receipt. Do separate receipts for different funding sources and make sure they add up to the total income from that BI.
Once you have your team up and running, you will have to act as the child’s case manager. You will be the one to make sure everyone is doing their job and doing it well. This is not a job that parents usually want to have, but your child’s team will work best if you are involved. You will need to “let go” of people who are not working out. This includes BI’s as well as consultants. Keep an open communication going with the consultant to understand why all programs are run and to suggest goals that would be helpful for the child and the family.
Always remember that you are not married to your consultant. It is important to listen to your instincts and to get feedback from others if it seems like a BC or BI is not a good fit with your family.
If a BI is having difficulty, it might be that they simply need more training. It is important to remember this. Training a green BI is not easy, but the long-term results can be fantastic.
Reach out to the Autism Support Network to get feedback if you have any concerns.
AUTISM SUPPORT NETWORK BC
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