It is estimated that 1 in 59 children in the United States have autism spectrum disorder (ASD), making it one of the most common developmental disorders in the country.

Although the symptoms and severity of ASD can vary greatly, children with autism often struggle with communication challenges. This makes it difficult for them to connect with others and express their thoughts, needs, and emotions.

However, with the proper intervention, children with autism spectrum disorder can learn and improve their communication and social skills. One such intervention is Applied Behavior Analysis (ABA) therapy – which has been proven to be one of the most effective treatments for autistic children.

In this guide, we will discuss how ABA therapy works, its benefits, and why it is considered one of the best interventions for children with autism. Let’s take a look.

What is ABA Therapy?

Applied Behavior Analysis (ABA) therapy is a scientifically proven treatment approach used to improve the behaviors and skills of children with autism. It’s based on the principles of learning theory and behavior analysis, in which therapists use positive reinforcement techniques to teach new skills and behaviors while reducing harmful ones.

ABA therapy is a highly individualized treatment tailored to meet each child’s unique needs and goals. The ABA therapy sessions are structured and by a board-certified behavior analyst (BCBA) following a detailed assessment of the child’s needs. A registered behavior technician (RBT) will implement written programming basesed on treatment prescribed by the BCBA. RBT’s collect data to track progress and the BCBA will then make necessary adjustments as needed. BCBA’s also work closely with parents and caregivers, providing them with strategies to reinforce skills learned in therapy in everyday situations.

The goal of ABA therapy is to help children with ASD acquire new skills and behaviors that will enable them to lead more independent and fulfilling lives. These skills include communication, social interaction, and daily living skills. ABA therapy also focuses on reducing problem behaviors such as aggression and frustration.

How Does ABA Therapy Work?

ABA therapy is a goal-oriented approach that involves breaking down desired skills and behaviors into small, manageable steps. These steps are systematically taught to the child through repeated practice and positive reinforcement.

The process often begins with an assessment to identify the child’s strengths, weaknesses, and specific areas that need improvement. Once these goals are established, the BCBA designs a personalized intervention plan. This plan includes teaching strategies, reinforcement techniques, and data collection methods to track progress.

In ABA therapy, positive reinforcement is a crucial component in promoting behavior change. This involves providing rewards or praise for desired behaviors and ignoring or redirecting unwanted behaviors. By consistently reinforcing positive behaviors, the child learns that these actions lead to desirable outcomes and are more likely to be repeated.

ABA therapy also involves teaching the child how to generalize their skills in various settings and situations. This means that they learn to use their new skills not just in therapy sessions, but also at home, school, and in the community.

Ultimately, the goal is for the child to independently apply these skills in everyday life without prompting or assistance from others.

The Impact of ABA Therapy on Communication Skills

Through the systematic application of the principles we just discussed, ABA targets language deficits commonly associated with ASD, such as….

  • Expressive and receptive language delays
  • Limited vocabulary
  • Difficulties in social communication

By breaking down communication into smaller, manageable components, the therapy team can effectively teach individuals with ASD various communication skills, including verbal language, nonverbal communication (such as gestures and facial expressions), and functional communication strategies like requesting, labeling, and initiating conversations.

What is the Evidence that ABA Therapy is Effective?

The US Surgeon General and the American Psychological Association have both recognized ABA as an evidence-based treatment for autism. Numerous studies have established that intensive, long-term therapy using ABA techniques can significantly improve the functioning of children with autism.

Regarding communication skills, research consistently demonstrates this therapy’s effectiveness in individuals with ASD. Studies have shown that structured ABA interventions can lead to improvements in expressive language abilities, such as increased use of words and longer utterances, as well as gains in receptive language skills, including understanding and responding to verbal instructions.

Furthermore, ABA techniques such as discrete trial training (DTT) and naturalistic teaching strategies have been successful in fostering social communication and pragmatic language skills, enabling individuals with ASD to engage more effectively in social interactions and navigate various communication contexts.

ABA therapy is also beneficial for parents and caregivers as they are actively involved in the treatment process. Therapists can provide guidance and support to parents, teaching them how to reinforce positive behaviors and effectively manage challenging behaviors.

The Benefits of Early Intervention with ABA Therapy

Early intervention is crucial for children with autism as it can significantly improve their overall developmental and social outcomes.

ABA therapy is most effective when started before the age of six when the brain is still developing, learning language skills, and has a higher capacity for change. However, it can still be beneficial for older children and autistic adults.

Is ABA Covered by Insurance?

The answer is sometimes. Many private insurance companies are required by law to cover ABA therapy for children with autism. Still, coverage may vary depending on which state you live in, your insurance provider, and the specific terms of your policy.

All Medicaid plans are required to cover ABA therapy if it is deemed medically necessary for a child (under the age of 21) with autism. It’s best to check with your insurance provider to see if ABA therapy is covered under your specific plan and what requirements or limitations may apply.

Ready to Get Started with ABA Therapy?

If you think that your child could benefit from ABA therapy, the Children’s Autism Center is here to help. Our team of experienced and compassionate BCBA’s, RBT’s, and SLP’s will work with your family to develop a personalized treatment plan that addresses your child’s specific needs and goals.

We understand that navigating the world of autism therapy can be overwhelming, but our caring staff will guide you every step of the way. We are committed to helping children with autism reach their full potential and lead happy, fulfilling lives.

Contact us today to learn more about our ABA therapy services.

Autism Commission on Quality LogoAccreditation in healthcare is “paramount to ensuring safe, effective, and high-quality patient care” (LaPelusa & Bohlen, 2023).  Accreditation involves a comprehensive assessment of organizations, including a review of their policies, procedures, and overall performance, to verify their alignment with nationally recognized standards.  Accreditation also provides organizations with “a roadmap to identify and correct areas for improvement”( LaPelusa & Bohlen, September, 2023).

In 2022, CASP founded the Autism Commission on Quality (ACQ) to “establish and promote organizational standards that improve the quality, effectiveness, and outcomes of ABA services for individuals and families impacted by autism. ACQ’s vision is for all recipients of applied behavior analysis services to reach their full potential through access to organizations offering the highest level of care” (About – Autism Commission on Quality (ACQ)

ACQ is dedicated to improving the impact of ABA services for the autism community through both education and accreditation of ABA agencies.  While CAC currently holds accreditation by the Commission on Accreditation of Rehabilitation Facilities (CARF) as well. Founded in 1966, CARF is a broader look at our organization through the lens of rehab facilities.  We are required as a Medicaid waiver provider to achieve CARF accreditation, but CARF does not offer ABA agency specific feedback while ACQ does.

The months long process of ACQ accreditation included submission of our policies, de-identified incident reports and other documents, and our manuals (HR, Employee, Parent).  The ACQ portal has nine different subject areas (Business Operations, Clinical Personnel, Clinical Operations, Patient Protections, Quality Assurance, Ethics, etc.) where a number of questions were posed to determine how our agency is structured and how policies are applied. This submission was followed by an interview with our leadership team to answer questions and clarify any policy, procedure, or application the ACQ committee had questions on.  Two of our Clinical Supervisors (BCBAs) were also interviewed by the ACQ team.  The Clinical Supervisors were asked to show via video a treatment protocol with a client.  Questions on the treatment protocol were asked of the Clinical Supervisor.  Families and staff were surveyed by ACQ on a variety of questions specific to either services or employment. Finally, a meeting was held to answer final questions from all of the submissions.

On November 20, 2023, CAC was notified that we had passed the process of assessment and were awarded a two-year accreditation with ACQ!  We also received constructive feedback on how to improve.

When we made the decision to deploy resources to seeking ACQ accreditation, it was the benchmarks/standards and feedback that we deemed most valuable.  The ACQ accreditation is an indicator that we are meeting the high standards of an accrediting body specific to our field, and the feedback and benchmarks are a guide to how we can continue to meet those high standards.  It is part of our mission statement that we provide ‘the highest quality treatment’ we possibly can.  We understand the need for efficient and effective care and continuing to ask how we can do better is how we get there.

We are thankful to each of you who took the time to provide feedback to ACQ.  We are also grateful to the ACQ team for taking the time to teach and guide CAC on how to do better.  The bottom line is that we believe accreditation is how we provide the best care we possibly can to the families who trust us with their children.  We will always continue to seek ways we can improve and accreditation is a solid standard from which to begin.

If you are like me, the question, “What do you want to be when you grow up,” is a difficult question. When I was a kid, my answer was always, “I want to be Jack Hanna (America’s famous zookeeper).”  I love animals of all kinds and could think of nothing better than spending my days with them. In my teenage years, I found more things that interested me, such as teaching, psychology, making fancy coffee, travel and exploration, cooking, interior design, and the list goes on and on.

Picking just one thing that I wanted to be forever was an impossible task. In college and graduate school, I changed my program of study multiple times. And then, I found Applied Behavior Analysis (ABA). I started off as a behavior rehabilitator (what we call a Registered Behavior Technician or RBT© today) working with kids with autism, and I was hooked! I loved kids with autism, and I loved ABA.

But, in graduate school, I learned that ABA has been used with so many different populations (e.g., kids, adults, military personnel, medical personnel, the general public) to solve so many different world problems (e.g., educational challenges, pedestrian safety, driver safety, effective nurse training programs, pollution, and waste reduction). My mind was blown. There was finally a field I could work in where I didn’t have to pick one thing.

ABA also appealed to my practical worldview – it’s based on science, data, and individual needs and produced viable solutions to many of the problems we face in our communities today. While I could go on about the limitless potential of ABA, I am going to focus on careers related to autism since that has been my life’s work. But ABA is effective for WAY MORE than just individuals affected by autism.

If you are just getting into the field or unsure what adventures could await you, you might consider starting as a Registered Behavior Technician (RBT). This is an entry-level credential requiring a high school diploma or equivalent, 40 hours of approved training and skill demonstration, and a written exam. As an RBT, you would be directly responsible for implementing a treatment plan written by a BCBA (Board Certified Behavior Analyst) with your clients.

In training, you will learn the basics of ABA and how we use the science to change behavior in meaningful and significant ways, and you get ongoing supervision, support, and training from a BCBA for at least 5% of your work time. How cool is that? In this role, you get to teach skills to help individuals lead more independent and fulfilling lives!

If you already know you love ABA and want to pursue a bachelor’s degree in ABA, you can become a Board Certified Assistant Behavior Analyst (BCaBA). In this role, you serve as the intermediary between the BCBA and the RBT. This certification requires a more intense board exam, and additionally, it requires extensive college coursework in ABA and over 1,000 supervised fieldwork hours. With all that knowledge and experience, as a BCaBA, you get to help with assessing client skills, writing treatment plans, training RBTs, and ensuring your clients are making progress in socially significant ways.

Still can’t get enough ABA…time for graduate school! BCBAs have master’s degrees with an intense focus on learning the concepts and principles of behavior analysis, applying those techniques to address client needs, and teaching others to implement procedures effectively. In addition to coursework, BCBAs accrue 2000 hours of supervised experience and must pass an intense board exam.

As a BCBA in the field of autism, you typically get assigned a caseload of clients that desperately need your expertise to develop treatment programs to help them reach their goals and overcome obstacles. You also get a team of RBTs to train and support in implementing your treatment programs, and sometimes you get support from a BCaBA. You might work in homes, schools, clinics, hospitals, or the community to help your clients where they need it most.

ABA is a lifelong career for many people, and everyone’s path into and through ABA looks different. Some folks come in knowing they want to become a BCBA. Others have never heard of ABA and “fall” into the field just wanting to help people. However or wherever you start, each position can be lifelong as you hone your skills and adapt to the ever-changing needs of your clients and community.

You can also expand your skillset, gain more experience and education, and work your way up to leadership roles. After the master’s level BCBA, you can pursue a doctorate degree in ABA and become a BCBA-D (doctoral level). Many people with BCBA-D credentials are leading large organizations, teaching in universities, or actively researching more effective and efficient ways to apply the science of ABA to the needs of the world. So, what do you want to be when you grow up?

In the field of ABA, you don’t have to choose. You can try out lots of different roles, populations, or locations, and you can open yourself up to new opportunities as they present themselves. As we say in ABA, “All data is good data, even if it tells you that you need to do something different.”

If you’d like to learn more about our career opportunities, please click here.


More information

Click here to be directed to the Behavior Analyst Certification Board (BACB).

At the Children’s Autism Center, we encourage parents to become educated in the practices of ABA therapy. We operate on the team approach and consider the parent to be a co-informant and partner in their child’s therapy. The more the parent is involved in their child’s therapy – the more prepared and confident they feel managing behaviors outside the center. CAC is here to support you as you go on that journey.

Parents/Guardians have ample opportunities to learn about ABA (Applied Behavior Analysis) therapy and to be an active part of their child’s team. Below are ways that CAC ensures parents are a part of their child’s care team.

Parent Training: Parents/Guardians are required to attend Parent Training to achieve a working knowledge of ABA. It is important that parents understand the principles of ABA therapy and how we use the principles for our interventions.

Parents will learn about data collection. All of the programs are evidence-based, so data collection is critical to determining the success of programs. Parent training is scheduled at the parent’s convenience and is open to all primary caregivers.

Parent Meetings: Parent meetings are a vital part of our treatment. Meetings with the parent/guardian ensure that the team understands your challenges and successes at home. This will lead to more effective teaching and generalization of skills. Home, school, and community-based services are also available to aid in the generalization of skills. These are all options that can be discussed at parent meetings.

One of the best ways to learn is through observation. Parents are encouraged to schedule observation times at the center. This will allow the parents to watch our skilled staff work with their child and to be able to ask questions.

The staff at CAC is committed to ensuring that you, as a parent/guardian, have the tools needed for your child to succeed.

Vision (September 26, 2005): When a small group of parents first received the news that their children were diagnosed on the autism spectrum, they never dreamed they would open a center for evidence-based services. They were, like most parents, trying to figure out what the diagnosis meant and what to do the next moment. When they came together with a common goal, however, the result was the first applied behavior analysis (ABA) center in Northeast Indiana: Children’s Autism Center (CAC).

The focus for the CAC founders was building a center for compassionate AND effective care. Their children were still developing communication skills, so it was important to the parents that the children were cared for in a kind, respectful, and patient manner; their children could not tell them otherwise so trust in the staff was huge.

Effectiveness was the other critical component for the founders. Days are slow but weeks are fast and every week that passed could either mean gains, stagnation, or losses in terms of learning for their children. The group pushed for gains and efficient use of time.

Since the incorporation of Children’s Autism Center in 2005, the focus of CAC has remained true to the founders- providing the highest quality of effective, compassionate care possible.

Ann Zelt, one of the founding board members, says:

“CAC came into being as there was a need in our community to provide effective medically proven compassionate treatment to children with autism as there were no other local alternatives. Excellence was the standard from the very beginning as the children and their families deserved such. The priority of helping the child and family improve their quality of life was a given. Furthermore, we felt strongly, as we still do, that all children regardless of ability to pay deserve such necessary treatment.”

As the organization was built, it was quickly apparent that every member of the CAC staff and Board of Directors is important to realizing the goals.

Over the years, we have found that retention of our staff ensures efficiency and effectiveness – as well as being a tremendous boost to our culture. We have talented and dedicated staff who have been with the organization ten years or more. Recruitment of new talented staff is a critical element as well. Fresh innovation comes from both new talent and actively seeking learning from the field of ABA and business.

Dani, our trainer for newly hired RBTs, is the first staff member who molds our team. Dani notes:

“As the RBT trainer, I believe it’s important to not only teach our new staff the skills to be an RBT, but also teach and model the importance of how to interact with the children we serve. In our training we have a hands on and interactive training and as their trainer I take every opportunity I can to teach them how to make learning fun and facilitate fun in our training environment!

We have an open-door policy in our training room and the RBTs and clients are encouraged to visit from time to time so we can model how much we care about our clients and invest in their success. I also believe the group concept of our training aids in learning and growth because we are able to discuss and share our experiences and grow together as practitioners and as a support system as we continue on our CAC journey.

At the end of training I always encourage the new staff to remember it’s important to use the skills you learned with the clients we serve but also model acceptance and understanding of autism in the community you are in, because if we do that together we can make the world a better place for any child or adult with autism, not just those in our care.”

The organization’s founding parents had lofty goals and visions of creating a supportive space for autistic individuals in our community. Almost twenty years later, this work is never done. We can always do better and be better. It is so inspiring that Children’s Autism Center’s Board of Directors and Staff are continually pushing forward and evaluating how the organization can further its impact on our community. It is an honor and privilege to serve our community with this team.

At the Children’s Autism Center, we often talk about the need for family involvement in therapy. Some might wonder why we focus so much of our efforts on families when much of the early research in Applied Behavior Analysis with children with ASD focused on intensive center-based early intervention. When parents and caregivers of children with ASD are already struggling to balance so many other things, why do we insist they also be heavily involved in ABA therapy?

There are several reasons why we do this, and some may surprise you.

1. Parents and caregivers know their child’s needs.

Sometimes when a clinician is trying to select goals for social significance, we end up missing the mark for what is important and meaningful in that child’s home, community, and school. As clinicians, we come with our own biases and learning histories.

Things that may be important to us, might not be as big of a priority for our clients in their everyday lives. By looking at skills the family prioritizes, we can address barriers to other activities that might ease the burden of caring for a child with ASD.

For example, if a caregiver is stressed about taking their child to large family events, we would want to work on helping our client be more successful at family events. Doing this simple thing could open many avenues of support for that caregiver. Further, parents who have more involved social support networks tend to experience less stress, which directly relates to health outcomes for children (Ozbey et al., 2007).

We need to work with parents and caregivers to identify goals that are socially significant and meaningful for them. By focusing on these skills in the short run, we can achieve more in the long run.

2. The research on child outcomes supports parent and family involvement.

In those early studies that recommended 40+ hours of therapy per week, many of those hours were delivered by parents in their homes, in addition to the hours spent in the clinic (Smith & Eikeseth, 2011). When parents are involved in teaching their children the skills worked on in therapy, not only do the kids master more skills, but they are also able to apply those skills in new ways and in new environments.

In ABA, we call this “generative instruction,” meaning that our kids are able to generate new responses in varying environments with different levels of difficulty and effort (Johnson, et al., 2021). Our goal in ABA therapy is to get our clients to the point where they no longer rely on us for learning new things, but rather the environment they live in provides all of the lessons and reinforcement to learn new things and grow in new ways. We can’t do that without parental involvement.

3. Self-advocates are more effective at changing systems than clinicians.

The most effective movements in history have been won by self-advocates, not others advocating on their behalf. Think of the people you recall as the lead voices in the Civil Rights Movement, the Woman’s Suffrage, the Americans with Disabilities Act. Most people picture Martin Luther King, Jr., Susan B. Anthony, and Judith Heumann; they don’t picture politicians or clinicians advocating on behalf of those they serve. It is often the people who are being discriminated against that have the loudest voice and most compelling experience to share.

Professionals and others can support them by providing a platform, funding, and research, but the individuals and their families who experience ASD are the best ones to tell the world what they need. In 2001, the first legislation passed for insurance to cover ABA services for individuals with ASD was fought for by 5 mothers, right here in Indiana.

And every one of the 50-states to follow, was brought to legislators and fought for by parents of children with ASD who wanted more for their children and wanted the system to change to support the health and wellbeing of their child. As children age, and become adults, that self-advocacy is such an important skill for them to learn, and who better to learn it from than a parent.

In summary, at Children’s Autism Center, we understand that families are under an immense amount of pressure. We work creatively around challenging schedules to help families to access training and support, so that their child has the best possible outcomes. We want to create a community where our clients, their families, and their communities can come together to work towards common goals. We embrace family involvement, and we fully believe that our clients have better lifelong outcomes when their families are involved. It is why we say, “Where families come first,” in our tagline.

References

Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont). 2007 May;4(5):35-40. PMID: 20806028; PMCID: PMC2921311.

Johnson, K., Street, E. M., Kieta, A. R., Robbins, J. K. (2021). The Morningside model of generative instruction: Building a bridge between skills and inquiry teaching. Sloan Publishing.

Smith, & Eikeseth, S. (2011). O. Ivar Lovaas: Pioneer of Applied Behavior Analysis and Intervention for Children with Autism. Journal of Autism and Developmental Disorders, 41(3), 375–378. https://doi.org/10.1007/s10803-010-1162-0

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