ABA Therapy

ABA Therapy Explainer: What’s a Functional Behavior Assessment?

When your child starts ABA therapy, there are a lot of vocabulary words and acronyms that seem to get thrown around, and it can take some type to truly get a grasp on it all. Functional Behavior Assessment, or FBA, is the one we’re going to focus on here.

A Functional Behavior Assessment is one of the primary ways our behavior therapy team works to identify a certain problem behavior, and then we develop a plan to address them – ultimately eliminating them or at least reducing them to a point they aren’t so prevalent.

Going through the process step-by-step helps our Cleveland ABA therapy team to get to the source of the behaviors so that we can start introducing replacements. The problem with trying to tackle a problem behavior without an FBA is that then you lack the “why.” WHY were they engaging in that behavior in the first place? Every behavior has a function. Trying to effect the extinction of a behavior without first figuring out its function is going to create a gaping opportunity other difficult behaviors to take root in its place. An FBA helps us figure it out first.

FBAs can be used in IEPs or as part of an ABA program. We only initiate them when the behavior has become an impediment. We’ll be looking at it as a team – in collaboration with parents too – to assess whether it’s urgent (is there a risk of harm to self or others?), whether there’s an underlying medical reason, whether it’s cyclical, and if it appears to be new or if this is a long-standing issue that has maybe just gotten worse. Finally, we want to know if this is something that is happening on a consistent basis. If it was a random, one-off reaction to a substantial – and uncommon – change in the environment, we probably don’t need to develop a plan to treat that, though we may note it. In cases where there may be multiple unexpected and detrimental behaviors, we’re likely to target them one at a time, beginning with the one likely to have the most significant adverse outcomes.

Brecksville ABA therapists

Brecksville ABA Therapists Offer “Time-Out” Alternatives

As Brecksville ABA therapists, our focus is on the study of behavior. When it comes to children with autism and other conditions, the interest is not only on what the challenging behavior is, but what the motivation – or function – is and how caregivers may be unintentionally reinforcing it. This brings us to the ever-popular approach of time-out.

You’re almost certainly familiar with the “time-out” strategy because it’s very popular. As explained by the CDC, timeout is when a child is removed from where the “misbehavior” occurred – deprived of fun, attention, or some other desired activity. Time-out is used for things like breaking a rule or not following a direction after a warning. It’s effective for lots of neurotypical kids because time-out is boring, and kids don’t usually like to be bored.

However, timeout isn’t effective for addressing all behaviors, and it’s may not be effective for every child. For children with autism spectrum disorder or developmental delay or some other disability, time-out can provide a safe space for them to work on calming themselves. However, it’s not going to be effective if:

  • The child is aggressive or using self-injuring behavior.
  • The child’s goal is to avoid the activity or interaction with others.

In both of these cases, time-out might inadvertently reinforce the challenging behavior. In the case of self-injurious behavior, putting them in a space alone isn’t likely to stop it. If the child’s goal is to avoid interaction or a non-preferred activity, time-out actually gives them what they want. In effect, adults may be inadvertently giving them a reason to engage in challenging behaviors to achieve the goal of getting in time-out.

ABA Therapy Brecksville

When Should Our Child Start ABA Therapy?

When your child is diagnosed with autism, there are so many unknowns. Families may feel as if they’re drowning in all the decisions with which they’re faced, compounded by the fact that few practitioners speak of long-term outcomes with any great degree of certainty. That said, early intervention – including ABA therapy – is one course of treatment on which most agree results in optimal outcomes.

When a parent asks, “When should my child start ABA therapy?” the answer is almost always going to be, “As soon as possible.”

What is Early Intervention? 

Early intervention therapy refers to a multi-disciplinary approach geared toward children under age 3 but up to 5. It’s a combination of speech therapy, occupational therapy, ABA therapy, and sometimes physical therapy that is initiated with the understanding that a child’s earliest experiences play a critical role in a child’s brain development. We know that kids who receive early intervention therapy do significantly better when it comes to learning new skills, overcoming challenges, and increasing both their academic success and personal independence, we know that kids who do not receive early intervention therapy may be substantially disadvantaged.

ABA therapy is most effective the earlier it starts. One of the earliest studies on the benefits of ABA therapy found kids who started before age 5 had better outcomes than those who started after they turned 5. Kids can usually start ABA therapy as young as 2 (sometimes earlier), and research has found doing so leads to significant improvements in both cognitive and adaptive skills.

One analysis by the Institute of Child Health & Human Development revealed that when we intervene with a fourth-grader as opposed to a kindergartner, it takes four times as long to make the same progress – not only because of the explosion of brain development that occurs in those early years (and the plasticity of a young brain, which is primed to learn new things), but also because there is a substantial increase in skills kids are expected to have mastered by Grade 4.

In some cases, therapies can start in infancy, with goals and strategies of course tailored to the age and the individual.

By incorporating early intervention ABA therapy, kids can avoid more substantial learning challenges in the future.

How Does Brecksville ABA Therapy Help My Child With Autism?

When a child has autism, they typically have deficits in communication and social skills, and these go hand-in-hand with maladaptive behaviors. For all of us, behavior is a form of communication. Kids on the spectrum who lack many fundamental communication skills may use behavior in ways that are not expected to communicate their needs and desires. Families sometimes do more harm than good when they don’t understand the function of the behavior and end up reinforcing it. For example, a common motive for behavior is attention. It may not matter whether that attention is negative. When you respond to it with eye contact, physical contact and a heightened reaction – even an angry one – it may still be reinforcing the behavior. If the motive of the behavior is to evade and you put them in a “time out,” you are unintentionally reinforcing the behavior.

ABA stands for applied behavioral analysis, and it is where we deep dive into the “why” of the behavior. We ask, “What function does it serve?” and see if adjustments can be made to the antecedent or consequence that may result in altering maladaptive behaviors or encouraging expected behaviors. The earlier this process starts, the more adaptive children are to changing their behaviors. We can teach kids how to use functional communication to replace behaviors that are unexpected. We can also educate parents on how best to respond in ways that don’t unintentionally reinforce difficult behaviors.

What If I Don’t Want My Child to Be Labeled? 

We recognize that one of the reasons some parents shy away from early intervention therapy is because of potential stigma and concern that an autism diagnosis might set them on a path that would result in a long-term, detrimental label.

One thing to keep in mind is that stigmas are shifting. There is more awareness and acceptance. People increasingly recognize that autism doesn’t just look a certain way. It is a spectrum, and individuals on it can indeed grow to be happy, healthy, highly-functioning and invaluable members of society. Early intervention therapy is what sets children up for success. ABA therapy is a critical part of that.

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.

Additional Resources:

Treatment and Intervention Services for Autism Spectrum Disorder, U.S. Centers for Disease Control and Prevention

More Blog Entries:

How Our Brecksville ABA Therapists Teach Flexibility, Sept. 17, 2021, Brecksville ABA Therapy Blog

child developmental regression

Child Developmental Regression & What To Do About It

Child developmental regression is when a child loses certain developmental skills they previously acquired. It might seem as if they’re almost moving backward in their development. This is different from developmental delay, when kids reach certain milestones later than expected or their developmental progress flattens or stalls.

The condition is pretty rare, though it is sometimes associated with a number of diagnoses, each warranting prompt attention and intervention. The good news is that for the more common conditions, treatment can be effective when problems are caught early.

Examples of the conditions most commonly associated with child developmental regression are:

  • Autism spectrum disorder. This condition isn’t always associated with child developmental regression, but as researchers have noted, it is the most frequent condition in which regression is diagnosed. In rare instances, it can be associated with Heller’s Syndrome, also known as child disintegrative disorder (CDD). This is characterized by late onset (age 3 and older) developmental delays, social function, motor skills, and even cognitive function. Children with CDD will develop typically for the first 2 to 10 years before sharply regressing.
  • Neurodegenerative disorders. These include conditions like Rett’s Syndrome and Metachromatic leukodystrophy.
  • Trauma or stress. Traumatic or stressful events can cause some children to regress in some respects or act younger than their age. Examples of this include things like potty accidents, sleep disturbances, decreased independence and behavior disruption.

For this article, we’re focusing primarily on regression as it pertains to autism. It should be noted though that with the other conditions, medications, therapies, and other supports are known to help manage symptoms, prevent complications, and improve life quality.

What We Know About Child Developmental Regression and Autism

Regression with autism appears to occur very rapidly or gradually. In either case, the child struggles to regain skills they’ve lost.

Some researchers have concluded that while regression among some kids with autism can be very real, many instances are more likely a pileup of deficits and missed indicators that finally become unmistakable. Parental reports that classify the onset of autism can often be flawed – not because parents aren’t paying attention to their kids, but because they usually aren’t child developmental experts who even know what to watch for.

In other words, loss of social interest or communication deficits can take place at varying ages and to different degrees – it just becomes more noticeable at certain points. When it happens to kids who are little older, it can appear drastic and sudden. When it happens in kids who are a lot younger, it can seem very subtle.

In the past, doctors used to think that “regressive autism” was a subtype of autism, but the more we learn about the condition, the more those lines have been blurred. One study published in the Journal of Developmental and Behavioral Pediatrics found as many as 1 in 5 cases of autism involved regression – a rate that has risen as we’ve grown to include more people with unique presentations of autism.

Often, it looks something like this: An 18-month-old who seemed to be developing typically “withdraws suddenly,” ignoring his own name, talking less (to the point of not talking at all), ignoring engagement with other kids to play almost exclusively with inanimate objects, losing previous interests, and appearing to obsessively focus on a few things or activities. This may occur at the same time as the child begins to display behavior characterized as “odd” and repetitive.

Although doctors used to consider “regressive autism” to be its own subset of the condition, physicians increasingly argue that such classifications aren’t as pertinent because most kids with autism lose some skills, and there is a lot of variation on the types of skills they lose, to what degree, and at what age. A study published in the journal Autism in 2016 found that there were a range of onset patterns, with some parents reporting early developmental delays with no skill loss to no delays and then a clear loss of skills. Ultimately, this may tell us something about the onset of the condition, but it doesn’t necessarily change the approach and treatment in helping kids “catch up” in their social, emotional, and communication skills.

Child developmental regression typically occurs among children younger than 3, with the average age being around 21 months. The risk of children losing their developmental skills becomes increasingly unlikely the older they get, but early intervention speech therapy, occupational therapy, and ABA therapy can help them retain what they have and make gains where they’ve fallen behind.

Early Intervention Therapies Can Help Kids Who Have Developmental Regression

When it comes to children with autism, regardless of the onset pattern, waiting for the child to “catch up” on their own simply isn’t going to work.

Our Brecksville speech therapy, occupational therapy, ABA therapy, physical therapy, and special education team work together as a team in formulating an early intervention plan that can help children on the autism spectrum communicate, play, and learn. Our approach is going to be based on the skills they have compared to the skills they should be displaying for a child their age.

Therapy is not a “quick fix” solution. It is a commitment for families, but is well-established as one of the most effective means of treating children who’ve experienced developmental regression attributed to autism.

Therapy & Wellness Connection – your connection to a life without limitations – provides speech therapy, occupational therapy, ABA therapy, physical therapy, and special education services to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, vocational counseling and more. Call us at (330) 748-4807 or send us an email

Additional Resources:

Why Act Early if You’re Concerned About Child Development, U.S. Centers for Disease Control and Prevention

More Blog Entries:

At What Age Should My Child Begin Brecksville Speech Therapy? Oct. 16, 2021, Brecksville Speech Therapist Blog

Teen & Young Adult Social Group

Teen & Young Adult Social Group in Brecksville

Our teen & young adult social group at Therapy & Wellness Connection in Brecksville is available to teens and young adults to help with key social skills critical for navigating everyday interactions and making friends. A.I.M. is a therapist-led group that is all about accepting our differences and what makes us unique, identifying mindfulness strategies with behavior analysis, and moving forward with strategies of psychological flexibility and making new friends.

Social Group Every Wednesday

Teen and young adult social skills group is held every Wednesday from 4:30-6 p.m. Call or email Therapy & Wellness Connection in Brecksville to sign up today!

Therapy & Wellness Connection – your connection to a life without limitations – offers speech, occupational, physical & ABA therapy, as well as social groups, summer camp, day programs, homeschooling, alternative schooling, virtual therapy and education, vocational counseling and more. We’re headquartered in Brecksville, Ohio. Call us at (330) 748-4807 or send us an email.

Brecksville ABA therapists

ABA Therapists: Helping Your Child With Autism Transition Back-to-School

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.

Additional Resources:

Helping kids with autism transition back to in-person school: 10 tips, UC Davis Health

More Blog Entries:

Brecksville ABA Therapist Insight: Autism and Self-Injurious Behavior, June 21, 2021, Brecksville ABA Therapy Blog

behavioral regulation ABA

Study: Behavioral Regulation Difficulties Linked to Sleep Problems Among Kids With Autism

A new study found that difficulty sleeping – a common problem for children on the autism spectrum – is associated with behavioral regulation difficulties later in childhood. This longitudinal study drives home the importance of helping families address the sleep problems kids with autism have as early as possible.

Of course, this isn’t entirely shocking news to our Brecksville ABA therapy and occupational therapy team. It’s been well-established that getting high-quality sleep is key for everyone’s general health. A child who isn’t well-rested (just like any adult) is going to be cranky and more tantrum-prone. Still, the research sheds additional light on how vital it is for doctors and therapists to provide the support and tools to help children with autism struggling with sleep issues. In turn, this may help foster improved behavioral regulation as they get older.

The analysis, published in the journal Sleep and reported Spectrum News, is one of the first studies to look closely at the long-suspected connection between executive function (mental skills that include the ability to manage one’s own behavior to achieve certain goals) and poor sleep quality among children with autism.

Of course, many kids have sleep troubles the first few years of life. These too are associated with lower executive function, but these typically resolve after a few years. Children with autism are known to be more likely to suffer from long-term sleeping problems, which many researchers had previously opined were connected to poor executive function.

This study, which began in 2005, followed 217 children with autism, starting between the ages of 2 and 4 and then again several years later. The children’s executive function, as reported in surveys by parents and teachers, were evaluated four times when they were between the ages of 7 and 12.

What they found was severe sleep troubles were linked with reduced ability to regulate behavior. Interestingly, other types of executive function (ability to order their own thoughts, reflect on them, etc.) didn’t appear to be tied to sleep trouble.

Further, researchers concluded the age at which sleep disturbances occur can make a difference. For instance, kids who struggled to fall asleep between the ages of 2 and 4 didn’t have any behavior regulation issues a handful of years later. But when kids were taking a long time to fall asleep when at the ages of 6 and 7, they showed noticeable behavior regulation issues the following year. As for why this is, study authors opine it may have something to do with the fact that many kids between the ages of 2 and 4 wake up frequently, whereas older kids typically don’t.

It’s important to note the study doesn’t clearly indicate a causal relationship between poor sleep and reduced executive function, though that is what many researchers suspect. It’s probable, though, that executive function is impacted by a variety of factors, sleep patterns included.

Our Brecksville pediatric occupational therapists have several strategies we can share to help your child with autism get a better night’s sleep. These include addressing sensory seeking or avoiding behavior (weighted blankets, looser pajamas, developing bedtime routines and social stories, etc.), managing the child’s physical environment and helping families adjust their schedules to make for smoother transitions.

Therapy & Wellness Connection – your connection to a life without limitations – provides occupational therapy to children in Cleveland, Brecksville-Broadview Heights, Akron 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

Additional Resources:

Autistic children’s sleep problems linked to behavioral regulation issues, July 5, 2021, Spectrum News

More Blog Entries:

How Occupational Therapy Can Help Treat Children With Sleep Problems, Feb. 15, 2020, Brecksville Occupational Therapy Blog

Akron ABA therapists

ABA Therapists Can Help With Autism Food Aversions

Mealtimes are awash in rich sensory experiences, with an array of smells, temperatures, textures, sounds, tastes and interactions. Most people enjoy mealtimes and sharing these experiences with loved ones. But our ABA therapists recognize that for children on the autism spectrum, mealtimes can present significant sensory challenges, leading to stress, sensory overload and meltdowns. Difficulties with communication can pose additional challenges for everyone.

Of course, it’s not uncommon for any child to be picky at times, but kids on the autism spectrum may be highly sensitive not just to something’s flavor, but its texture, shape, smell and color. They may have a strong preference for a very small selection of foods, and might even have an overwhelming need to eat those same foods on the same plate or in the same place at each meal.

You may notice that people with autism sometimes develop their own strategies to limit their sensory input during mealtimes. They may become:

  • Overly selective in their foods.
  • Inflexible in their mealtime routines.
  • Refuse to eat/eat limited amounts.
  • Prone to escape (elope, cover their ears, eyes, nose and/or mouth).
  • Repetitive in their behaviors to self-soothe.