I recently found out that my child has an Autism diagnosis. What do I do now?
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What is Applied Behavior Analysis and how can it help my child?
Applied Behavior Analysis (ABA) is the application of empirically validated approaches used to bring about meaningful changes in behavior. Understanding how one’s interaction with their environment shapes the skills that they learn and demonstrate is central to treatment. Behavior Analysts observe, interact and assess each client to determine what purpose behaviors serve in their environment and focus on replacing any maladaptive behaviors by teaching positive skills that meet the same needs and improve quality of life. Highly individualized, each treatment package is based on assessment results and the specific needs of the individual. Pro-social behaviors that have been proven to be highly effectively taught through ABA include language and communication, social skills, self-care skills, social-emotional development, independence in daily routines, school-prep skills and much more.
Does my child need a diagnosis to access therapy services?
A diagnosis is generally not required to access therapy services in many situations. For clients utilizing Medicaid as a funding stream, for example, a doctor’s screener showing developmental delays will often be sufficient for purposes of approval for services. Some private insurances may require a formal diagnosis. We will work together with your individual funding stream to gather the necessary components for your child. If a diagnosis is required by your insurance to approve services, we can refer you directly to a list of outside diagnosticians in which we work together closely, to help streamline this process for you.
How do I get started? What information will you need?
What if my child doesn’t have a diagnosis yet?
We can help. If you suspect that your child may have Autism, ADHD, or another disorder and would like a diagnostic evaluation, we can refer you to an outside clinician who can evaluate your child and with whom we can provide ongoing collaborative care. Depending on your individual funding source, a diagnosis may not be necessary to begin therapy. In these cases, we will work together with your child’s primary care physician to first determine medical necessity and recommend treatment to be eligible for coverage.
What should I expect when starting ABA services?
Following an intake meeting, a treatment plan with therapy recommendations will be written and submitted to you and your funding source for approval. After approval, a consultant will contact you to determine an ongoing therapy schedule. We require at least one session per week to be held at one of our clinical locations, with limited exceptions. Depending on the individual needs, remaining sessions may take place in the clinic, or in the home, school and/or community.
Frequency of therapy varies dramatically based on the needs of the individual served, but can range anywhere from two to thirty-five hours per week (2-7 hours per session) depending on baseline levels and goal areas to be addressed. Initial sessions are important for building rapport between client and clinician, understanding what motivates and reinforces the client, and probing out various interventions to ensure that the strategies utilized are best-suited to the individual.
If the client is a child, the child and the clinician will spend some time getting to know each other through play! Establishing a positive and trusting relationship is critical to maximize a child’s learning potential. Once rapport is established, the clinician will target multiple goals, with a focus on those in the written treatment plan. Teaching of treatment plan goals typically include a mix of time spent with the clinician working one on one with the child learning skills in controlled setting, and time spent with the parents and school or other community members involved to ensure that the skills generalize to the natural environment. CAC believes that when all environments related to an individual’s daily life can coordinate and collaborate on approaches and strategies, learning can be maximized to the benefit of all involved. Because of this, most treatment plans will include at least one goal targeting generalization of skills with parents or in other relevant natural environments.
Who will be working with my child and what kind of supervision will they receive?
Your child will be assigned a single clinician or multiple clinicians depending on the amount of therapy received. Each clinician with CAC is certified by the Behavior Analytic Certification Board (BACB) as either a BCBA (Board Certified Behavior Analyst), or BCABA (Board Certified Assistant Behavior Analyst) or an RBT (Registered Behavior Technician).
Immediately after intake, it is likely that your child will have an extra clinician available to assist with the startup of your child’s program. This clinician is involved to help provide an extra layer of support for the child, the family, and the consulting clinician, to ensure that all clients get a smooth startup. Every clinician at CAC operates as part of a clinical team, so it is common that another clinician will occasionally observe and give input into your child’s session to problem solve any barriers as they arise and that at least two sets of eyes are on each client’s programming to ensure that they are progressing at the targeted rate.
What is a BCBA, a BCaBA, and an RBT?
A BCBA is a Board-Certified Behavior Analyst who has a Master’s degree or higher, has completed coursework specific to behavior analysis, has attained all required hours of supervision and has passed the board exam.
A BCaBA is a Board-Certified Assistant Behavior Analyst who has a Bachelor’s degree or higher, has completed Master’s level coursework specific to behavior analysis, has attained all required hours of supervision and has passed the board exam. A BCaBA practices under supervision of a BCBA.
An RBT is a registered behavior technician. An RBT has completed 40 hours of coursework related to behavior analysis, passed a competency exam and practices under direct supervision from a BCaBA and/or a BCBA.
What is the parent/caregiver’s role in ABA therapy?
CAC encourages parent involvement during behavior therapy sessions. Initially, while the clinician is building rapport, it is sometimes not necessary to be very involved as the clinician’s goal is to simply play, bond with your child and test out strategies. As time goes on and progress is made with goals, parents are encouraged to observe and practice alongside their assigned clinician on occasion. All of our treatment plans will include at least one parent goal, for the purpose of ensuring that treatment progress can generalize to other environments. For example, if we work with your child on a specific communication goal in the clinic that they master, a goal will likely be written to then teach family members how to support this skill in the home environment. Additionally, we do offer free access to online training courses for families to help understand some of the goals you may see in practice during behavior sessions. Please reach out to your assigned clinician if this is something of interest!
Do you work with siblings and/or peers?
Siblings and peers may be involved in portions of therapy if it supports the goals being targeted. For example, if your child has a goal to interact with siblings in play, the clinician may work first work one on one with your child to master interactive games, then bring in a sibling to help to generalize this skill to the natural environment. Similarly, if your child struggles to stay seated with the family at the dinner table and you choose to target this as a goal, the clinician may schedule a session to work with your child during this time to help support in this specific situation. CAC cannot be responsible for siblings during times when they are not active participants in the therapy, so a parent should need to remain available nearby when clinicians are working together with a sibling.
Am I allowed to observe sessions?
Absolutely! If your child is coming to the clinic regularly, we have an observation room for this reason and encourage parents to come in and watch sessions when they are able.
How will I know about my child’s progress with their goals?
Your child will have a treatment plan written by your consulting clinician that will outline the goals to be targeted and the desired progress during the upcoming 6 months. Clinicians take data each session to analyze trends and ensure that each client is making the level of progress we want to see. While your clinician will likely meet with you briefly at the end of each session, they will meet with you every 6 months to review your child’s treatment plan, go over the graphed data on their progress and update the goals to ensure that we are constantly pushing your child to their next skill level and addressing the goals that will have the greatest impact for the client and family.
While the treatment plan will outline the most crucial goals for that period, MANY additional goals are practiced during sessions that aren’t reflected on the treatment plan. ABA therapists are highly skilled at maximizing learning opportunities across a wide range of naturally occurring events. While your child may have 5 goals in their treatment plan for a 2-3 hour session, it would not be uncommon for them to be practicing 10-20 different skills during this time with the clinician.
Can you help in school? In the community?
CAC services and supports in multiple settings related to our clients, including schools, so long as the setting has given their approval and is open to collaboration and support. We value relationships with schools and related providers and believe that the more we can coordinate with all parties involved in our client’s daily life, the better the benefit to the client.
If you would like school support, please contact your child’s teacher or school psychologist for approval. CAC does not utilize pull-out therapy sessions while in the school environment, but instead will offer support in whatever form makes sense in the existing environment, whether it is offering in-the-moment training and collaboration with teachers and paras on a regular basis, helping to set up supports to promote learning or overcome challenges in the school environment ,or coordinating with teachers and school personnel as part of the IEP team for the purpose of generalizing learned goals across environments.
If community safety and community skills are priority for you and your family, CAC can help. With your consent, we can take your child out into the community and practice needed skills. Goals such as street crossing, stranger danger, staying with an adult, waiting in line, and more. These are all important life skills that can be practiced in community sessions.
Can my child receive services if they don’t have an autism diagnosis?
Our clientele has a wide range of diagnoses, and some have no diagnosis at all. We tailor our programming based on an individual’s specific needs and current skill levels, not on their diagnosis. In some situations, a funding stream may require a diagnosis for ongoing therapy. In situations that we feel cross-discipline support is most appropriate for your child, we may recommend and refer you to a collaborating diagnostician or ask for a release of information to be able to collaborate with existing clinicians working with your child as well.
What other supports are out there for my family? Where can I go for help?
While CAC specializes in Applied Behavior Analysis for individuals, families often have additional needs to help support their loved one. We will help to link families up with other supportive resources that may be helpful in caring for your loved one. Some possible supports available to qualifying clients include respite services, home modifications for individuals with disabilities, Movement and Music Therapy, Speech and Occupational Therapy, camps skilled in providing a specialized level of care, vocational training and job supports to name just a few. Community Center Boards (CCBs) specialize in helping families link up with funding and finding providers that are appropriate for their needs. We can help you get in touch with the one that serves your area or give you other referrals to specific providers when appropriate.