ABA therapy is widely considered the gold standard treatment for children on the autism spectrum – and it’s particularly valuable when it’s intensive, starts early, and is combined with other critical interventions, such as speech therapy and occupational therapy. That said, finding the right Cleveland ABA therapy provider for your child can seem daunting – particularly if you’ve already had a negative experience.
When implemented appropriately, ABA has proven unequivocally to help children learn invaluable skills in areas like communication, self-regulation, social interactions, and self-care. It is our firm belief and practice that the best form of ABA therapy is naturalistic, play-based, and enjoyable for the child. That’s not to say we don’t challenge our patients. We do, as it’s necessary for them to gain the skills we’re trying to teach them. However, sessions that are too intense, rely too heavily on negative reinforcement, or use goals that are beyond what is realistic for a child will not only yield less progress, they may actually set your child back.
The unfortunate reality is that not all ABA therapists are cut from the same cloth, and not all clinics hold themselves to the high standards that we do at Therapy & Wellness Connection. Unlike more established fields like speech-language pathology, occupational therapy, or physical therapy, ABA therapy is less regulated.
Certified behavior analysts, or BCBAs, do have an intensive credentialing process. Among the requirements for BCBAs:
- Earn at least a master’s degree or doctoral degree in Behavior Analysis or related field such as psychology or education, with a focus on behavior analysis – with courses covering ethical conduct, principals of behavior analysis, research and data analysis, problem identification & assessment, intervention consideration, implementation management, etc.
- Complete a minimum 1,500 hours of relevant, supervised experience in an ABA setting.
- Pass a national certification exam.
- Apply for certification with the Ohio Board of Psychology.
- Attend a Pre-certification workshop and exam on Ohio ABA regulations (as detailed in Chapter 4783 of Ohio Revised Code and the Ohio Administrative Code).
- Renew COBA certification every two years (which requires proof of at least 23 hours of continuing education, with a minimum 4 hours of training in ethics, professional conduct, or cultural competency).
While these standards align with what one might expect in a field of professionals working one-on-one with children who have complex behavior needs and challenges, the same is not true of registered behavior technicians, or RBTs. And it’s RBTs who primarily administer Cleveland ABA therapy – under the supervision of a qualified BCBA.
RBTs are paraprofessionals. They are required to meet the basic eligibility requirements (at least 18-years-old, have a high school diploma, pass a background check, complete 40 hours of training, complete an initial competency assessment), then apply, take & pass the RBT exam, and then maintain their certification with ongoing supervision, adherence to ethics, and annual renewal. So where as it takes hundreds and lots of education to become a BCBA, RBTs are providing the frontline care with 40 hours of training.
Of course, there are many RBTs who are excellent and provide stellar ABA services to their clients. There is ample scientific data supporting the value of ABA in general. But as the number of autism diagnoses has risen steadily over the last two decades (the CDC estimates 1 in 44 children has an autism diagnosis), so too have the industries that serve them. Not every provider or clinic is as rigid about who they accept or how much oversight they receive. That can compromise the quality of care, as the value of ABA therapy rests heavily on who is administering it.
All of this can feel overwhelming for parents looking to find the best possible treatment for their child.
Our TWC Cleveland ABA therapy team has some questions parents can ask to determine whether a clinic/ABA therapy provider is right for your child:
- What is the ratio of BCBAs to RBTs at your clinic? The lower the ratio, the better, but there may be some variation depending on their patients’ severity level.
- What training and expertise does your staff have? As mentioned before, BCBAs must have extensive education and training, and they are the ones who will be developing treatment plans for your child. But it’s the RBTs who will be implementing them. Ask whether the providers encourages staff to undergo ongoing training. Inquire whether they have direct experience with your child’s specific challenges and needs.
- What types of intervention are used in your ABA clinic? ABA therapy is not a one-size-fits-all approach. There are actually many different ways to administer this research-based treatment. Ask the provider about their therapy philosophy and approach. Some tend to use more discrete trial training (which is more systematic and usually involves a child sitting at a table) while others prefer a more natural, organic approach to learning. Some therapy clinics will use both, depending on the child. You will also want to know whether they use positive reinforcement. “Punishment” or negative reinforcement may be effective in altering behaviors, but it’s not necessarily the best approach – especially because when there is potential for it to be over-used or abused. Positive reinforcement should be the primary approach.
- Does your clinic provide any other specialized services? Children on the autism spectrum may be prescribed a number of treatments, including speech therapy and occupational therapy. They may also benefit from tutoring, homeschooling, social skills groups, specialized therapies (music, equine, etc.), etc. It can be very helpful for these kids to have a “one-stop-shop” for these services. Therapy & Wellness Connection is one such place where kids can receive multi-disciplinary services and interventions.
- What is the treatment plan? Treatment plans must be created specifically for your child, depending on a functional behavior assessment. The plan should include both proactive and reactive strategies to manage and reduce problematic behaviors and encourage socially appropriate behaviors/responses. Ideally, the plan of care is going to have clear functional goals and objectives that identify age-appropriate challenges that are both engaging and fun for the child – and most likely to be generalized into other environments. It should also include parent involvement and training, to some extent. The more carryover we can get across environments, the better.
- What sort of safety measures are in place at your clinic? You as a parent want to know what measures are taken to prevent abuse, what the procedure is for reporting concerns with parents, how often parent observations are allowed, how inappropriate/excessive/dangerous behaviors may be dealt with, etc. You also want some insight into how secure the facility/session will be, particularly if your child is at high-risk for self-harm or elopement.
If your child has been diagnosed with autism and referred to Cleveland ABA therapy providers for services, our team at TWC can help answer any questions you have about our staff, our facility, our philosophy, and our practice.
Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.
More Blog Entries:
Cleveland ABA Therapists on Differences Between Bribery vs. Reinforcement, Sept. 10, 2022, Cleveland Behavior Therapy Blog
Summer vacation has FLOWN by far too fast this year! Soon, we’re going to start seeing those bright, yellow school buses rolling through our neighborhoods as the new school year begins. Our Brecksville ABA therapists know this has been a unique and trying few years for many kids – and families. As it is, transitioning from summer break to another school year can be especially challenging for children on the autism spectrum.
A key goal for our pediatric ABA therapists and occupational therapists at Therapy & Wellness Connection is to help facilitate smoother back-to-school transitions. These can undoubtedly be difficult, but preparing ahead of time can make for a much easier ride into the next school year.
ABA Therapists’ Tips to Transition to Back-to-School
Some strategies you may consider implementing:
- Talk to your child – a lot – about what to expect in the coming school year. This can truly go a long way in reducing your child’s anxiety.
- Get a visual calendar. Some kids on the spectrum struggle with anxiety about when school will start and the changes you discuss will become reality. Just getting a simple calendar and physically crossing off the days will give your child something they can better conceptualize.
- Start practicing your school year routine. Start by waking him/her up a bit earlier than what they’ve become accustomed to over the summer. Do a few practice runs of what your morning routine will be before they leave for school. Having a visual schedule for this might be helpful as well – noting everything from waking up to brushing teeth to getting dressed to eating breakfast to getting on shoes and coat.
- Ask to take a tour of the school. Reach out to the school principal or your child’s IEP team. You might not get to meet the teacher, but at the very least, maybe you can arrange a tour of the building so your child can get acquainted with all the important spots (library, bathrooms, main office, playground, cafeteria, gym, etc.). Consider taking pictures that you can use for visual schedules or social stories throughout the year, if need be.
- Discuss emergency procedures ahead of time. Lots of children on the autism spectrum struggle with sensory issues related to noise volumes and unexpected breaks in routine. But of course, schools have fire drills and tornado drills as a matter of safety. Talk about this ahead of time with your child’s teacher, IEP team and your child. Point out where they will go and what will happen. Maybe keep headphones in a handy spot in case the noise of the alarms is too overwhelming.
- Make a visual daily school schedule. Lots of teachers of younger students already do this, but if you’re child is a bit older, they may not. Creating a general, visual schedule of what occurs in a typical day may go a long way in reducing anxiety.
- Send the teacher a note explaining a bit about your child – their strengths and weaknesses, sensory struggles, dietary restrictions and most effective reinforcements. Maybe your child can even help. This will be invaluable for the teachers and other staff. Make sure to include positive things about your child. Providing copies to the principal, aides, therapists, bus driver, music teacher, gym teacher, art teacher, etc. can be very helpful when it comes to the strategies they use to educate your child.
- Allow them to take their favorite sensory item with them the first day or even week. Kids coping with sensory overload can find great comfort in certain objects (fidget spinners, squish toys, stress balls, etc.). If that’s true for your child, consider allowing them to take one of their favorite items with them – and make sure your child’s teacher, bus driver, aides and others are aware of it and why your child has it.
- Meet the bus driver. If at all possible, see if you can take a quick tour of one of the school buses.
- Write a note of thanks. If the first several weeks go well, let the teachers and other staff know how much it means to you that they’ve helped facilitate a smooth transition!
Finally, don’t be afraid to ask for help. If you have any questions about how to ensure your child has a smooth transition into the 2021-2022 school year, our Brecksville ABA therapists and occupational therapists are available to help you find solutions!
Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Cleveland, Brecksville-Broadview Heights, Akron and surrounding communities. We also offer summer camp, day programs, homeschooling, alternative schooling, virtual therapy and education, vocational counseling and more. Call us at (330) 748-4807 or send us an email.
More Blog Entries:
Brecksville ABA Therapist Insight: Autism and Self-Injurious Behavior, June 21, 2021, Brecksville ABA Therapy Blog
Wearing a mask has become required in many stores, restaurants, public event sites and schools. But complying with these mandates can be very difficult for children with disabilities and/or sensory processing needs. But our Cleveland ABA therapy team knows that doesn’t mean they cannot learn to overcome these aversions, particularly when it is a public health issue.
School districts across Ohio have various degrees of restrictions (some remain closed with only virtual school provided, others give parents the option to participate in virtual or in-person schooling and some are fully open). But just recently, the CDC released a series of guidelines for what it will take to safely re-open schools. As The New York Times reports, “the point of most agreement (among pediatric experts) was requiring masks for everyone: students, teachers, administrators and other staff. All respondents said universal masking was important, and many said it was a simple solution that made the need for other preconditions to opening less essential.”
If your child struggles with mask-wearing, our Cleveland ABA therapy team can help by incorporating it into our sessions, little-by-little, with positive reinforcement. But there are also ways you as a parent can help your child with this as well.
It’s well-established that racial disparity exists in numerous aspects of U.S. healthcare, with higher rates of illness and infirmity and lower rates of insurance coverage and quality care. Now, our Cleveland ABA therapists have learned of a new study published in the journal Pediatrics that found Black Americans are diagnosed with autism spectrum disorder at a much later stage than their White counterparts. In turn what this means is they are missing out on essential early intervention treatment that is critical to helping them overcome significant social and academic challenges in life.
Important to note: It’s the parents delaying the diagnosis, according to study authors.
“There’s something going on in the system,” said Dr. Daniel Geschwind, professor of neurology at the University of California and director of the Center for Autism Research and Treatment. In the study, Black parents reportedly noticed something was “not quite right” early on and sought medical help – and had insurance to cover evaluations and treatment. Even so, approximately 4 in 10 had to see a medical provider numerous times before their child received an autism diagnosis. Our ABA therapists know that getting appointments with specialists who can give a diagnosis like that can take well over 6 months each. (And lack of access to the kind of professionals qualified to make an autism diagnosis was specifically listed as one of the factors contributing to delay for about one-third of Black children ultimately diagnosed.)
ABA therapy, short for “applied behavior analysis” and sometimes referred to as “behavior therapy” is considered the gold standard when it comes to treatment of autism and some other conditions. Among the most common questions our Akron ABA therapy providers are asked by parents:
- “How do I teach my child?”
- “How can I reduce these behaviors?”
- “What am I supposed to be doing?”
These are important inquiries, and we’ll start by saying this: Our Akron ABA therapy is immeasurably more successful when parents take an active role. A fairly recent study published in the journal Behavior Analysis in Practice cited numerous examples of research to support the idea that when parents are more involved in their child’s therapy, outcomes are more positive for a wide range of students across social behaviors and academic skills.
Perhaps the most helpful answer is: Learning. You’re supposed to be learning.