What autism services look like

Autism and Applied Behavior Analysis (ABA) services are provided in a variety of venues, such as in person, in the home, at school, within the community, and in office settings. Secure, encrypted Skype sessions are available for families living in rural areas. Because caring for individuals with Autism is all-encompassing, it’s common for many people to be involved in the treatment. Typical members of a client’s “team” include the parent/caregiver, any involved extended family, a Board Certified Behavior Analyst (BCBA), a Registered Behavior Technician/Behavior Technician (RBT/BT), and other professionals, such as a physician, speech/language pathologist, and daycare/school staff, among others. The BCBA works with each of these individuals to develop specific features of the intervention plan.

The role of the BCBA

The role of the BCBA is to train staff and team members on how to appropriately implement the agreed-upon interventions, ensuring clients receive high-quality services, as well as observing and supporting team members providing direct services to clients. On average, the treatment team meets monthly to review and adjust the client’s current plan; data about the intervention is gathered and reviewed to help tailor a client’s direct services they receive. Through an electronic health records program, the client’s family has access to the interventions and data to monitor the client’s progress in the program.

The first 30 days

Within the first 30 days of treatment, a trained clinician conducts the initial assessment and intervention planning. Insurance authorization is also performed during at this time. After the first 30 days, the client (and caregiver) meets with staff members providing the services. As mentioned above, the team works together to identify the most socially significant behaviors to address during treatment, and services are scheduled accordingly. The amount of services provided range from 5-20 hours per week, which is based on the assessment and insurance authorization.

The first two weeks

During the first two weeks of services, it may appear as though the staff is simply playing and interacting with the client and not addressing the interventions. However, this period is critical, as it helps to forge a positive and fun client-clinician relationship, which builds a strong foundation for the difficult work ahead in treatment. Through treatment team meetings, two to three target goals or skills will be identified and implemented one at a time as the client progresses. Once the client masters a particular skill, new skill is taught.

Interventions

Interventions include fun, interactive activities that engage the client in learning new skills and how to “generalize” them across various settings; in fact, the client’s own interests are often used to engage them in treatment. Natural Environment Teaching (NET) utilizes the real life events to teach and coach skills to children. For example, intervention may occur on the playground when teaching a child how to take turns with peers, or staff may use dinner time or a board game to coach a child on staying engaged in a certain task.

Brett Gilleo