Autism Diagnosis and now what? 7 steps on how to start an ABA programme

1. Supervisor: A successful ABA programme starts with the identification of the specialised clinician that will design and supervise it, will train parents and the therapeutic team, will be in contact with school and ultimately will be the person responsible for the overall student’s progress. The quality of the intervention based on Applied Behaviour Analysis (ABA), same as with any other scientific application, depends greatly on the supervisor’s training and experience and his/her choice is crucial for the student’s progress. An ABA supervisor should be trained in Behaviour Analysis, preferably be a Board Certified Behavior Analyst (BCBA) or Board Certified Behavior Analyst-Doctoral (BCBA-D), certification that requires a theoretical training at Master’s or Doctoral level and at least 1500 hours of supervised practice. By choosing a BCBA, we know that the ABA programme will be designed and supervised by a professional with extensive training in Applied Behaviour Analysis who follows the last scientific advances in the field through continuous training (a pre-requisite for maintaining certification).

2. Therapeutic team: It is important that the team of therapists who will work with a child have knowledge and experience in ABA programmes but more importantly be motivated to learn and be enthusiastic about teaching children effectively and the progress that can be achieved through ABA. The first two levels of certification in the science of Applied Behaviour Analysis are Registered Behavior Technician (RBT) and Board Certified assistant Behavior Analyst (BCaBA). Certified professionals from both levels of certification have theoretical and practical training in Applied Behaviour Analysis but must work under the supervision of a BCBA or BCBA-D and not independently and are, therefore, ideal candidates for the role of therapist or lead-therapist in an ABA programme.

3. Parents’ training: We know that the active participation of parents in an ABA-based intervention plays an important role in the child’s with Autism progress, since it can accelerate and generalise gains. For this reason, parental training is the key of any successful intervention. The supervisor of the ABA programme is responsible for scheduling frequent parental training sessions at both a theoretical and practical level. At the same time, the supervisor will be able to suggest scientific books, multimedia, articles and other tools that can complement parental training. Excellent books for parents at initial training stages are “Behavioral Intervention for Young Children With Autism: A Manual for Parents and Professionals” by Catherine Maurice, Gina Green and Stephen C. Luce as well as “The Verbal Behavior Approach: How to teach children with Autism and related disorders” by Mary Barbera and Tracy Rasmussen. An example of an excellent multimedia package designed for parents and professionals that seek an introductory training on Applied Behaviour Analysis is Simple Steps.

4. Space: An ABA-based programme conducted at home requires a space structure that will facilitate teaching and generalisation of skills. The supervisor of the programme will initially help the family choose and configure the spaces where intensive teaching, play and independent skills training will take place. The decisions on how to structure and adapt the house to the new needs of one of its members are made on basis of the entire family’s needs and always together with parents. ABA-based programmes conducted in a special centre or school environment aim to the generalisation of acquired skills and teaching of additional skills by parents at home. For this reason, the Behaviour Analyst who supervises the programme in the centre or school will also help structure the space at home, so that the best outcomes can be achieved.

5. Time: In the initial stages and always depending on each student’s individual needs, an intensive ABA-based programme might take place for 25 hours per week or more. The distribution of these hours between the home and school or special centre environments, the rotation of therapists, the duration and frequency of supervisions and all remaining details relevant to schedule will be discussed between the programme supervisor and the family, so that the best arrangements for the student and family are in place and progress is maximised.

6. Materials: At the start of an ABA programme, a few educational materials will be required, such as writing materials and toys. Gradually and as the student makes progress, the variety of educational materials will increase, toys will change as the student’s interests vary and there will be more frequent need for updating the materials we use. These changes will happen in collaboration with the therapeutic team who will transmit to the parents the student’s needs. It is important to remember that to start an ABA programme a few simple materials that do not bear a significant cost are sufficient and it is likely that most of these will already exist at home.

7. As we progress, it is important to remember that a successful ABA-based programme aims to the inclusion of the student in the group of peers. The amount of one-to-one teaching at home or at the specialised centre will build the skills that will allow for the gradual decrease of the intensive individualised teaching and the initiation of a systematic support system for the inclusion of the student at school or any other peer environment.

For details on evidence-based therapeutic intervention for autism, read our article here.

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