Applied behavior analysis (ABA) is a behavioral intervention therapy that focuses on many different skill domains and provides support to children with autism spectrum disorder (ASD) and their families. High-quality ABA is individualized and goals will change and adapt as your child grows and gains new skills. Your child’s therapy team will work with you to determine the appropriate level of treatment hours. How much ABA therapy each child needs is different for every child, but clinicians use a consistent set of criteria to assess each client, including assessment tools and tests, the child’s growth in skill acquisition, the severity of their diagnosis, caregiver involvement, and more.
Who determines how much therapy my child with autism will need?
Before a child starts ABA therapy, a Board Certified Behavior Analyst (BCBA) will provide an initial assessment to a child, using a criterion-referenced assessment tool such as the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) or Assessment of Basic Language and Learning Skills (ABLLS-R). These tools help clinicians assess your child’s current adaptive functioning levels compared to other children in their age group.
During the assessment, the BCBA will also observe any interfering behaviors or potential barriers to skill acquisition. Using the assessment results and reports from caregivers, the BCBA will then create a treatment plan for your child. Your child’s treatment plan will include goals and expected milestones, as well a recommendation for a set number of ABA therapy service hours.
How many hours per week will my child spend in therapy?
Services may take place anywhere from 10 to 40 hours per week, depending on the level of a child’s needs. Research suggests that, especially for early learners, higher treatment hours and more intense therapy results in higher rates of skill acquisition. For this reason, we encourage high treatment hours for our early intervention clients under the age of 6.
Typically, ABA therapy treatment plans follow two models:
- Comprehensive ABA: high-hour services (between 25-40 hours per week) aimed at teaching new skills across multiple domains and reducing challenging behaviors
- Focused ABA: decreased hours in therapy (typically 10-25 hours per week) that aim to improve skills within only a few domains; requires less service hours per week
Depending on your child’s age, the severity of their diagnosis, their needs, and their goals, your therapy team will optimize their most effective treatment plan.
For how long will my child with autism have to attend therapy?
Throughout the child’s time in therapy, their clinicians will reevaluate their weekly service hour recommendations often. Typically, BCBAs make treatment plan updates every 6 months. At these intervals, your child’s team will also attempt to gauge how long they should attend ABA therapy. Depending on your child, this may vary significantly. Some children may only attend therapy for 6 months to a year, while others may spend many years receiving ABA therapy.
Many factors may affect how long a child with autism may need to attend ABA therapy before they move on to meeting their transition goals. Often, those factors include the severity of the autism diagnosis, caregiver involvement, and adherence to the treatment hour recommendation.
How does the severity of my child’s autism diagnosis impact their treatment plan?
Per the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), released in 2013, an Autism Spectrum Disorder (ASD) diagnosis will be accompanied by a severity level (level 1, 2, or 3) by the diagnostician.
- Level 1 ASD is noted for children displaying “mild” symptoms and who “require support”
- Level 2 ASD is diagnosed for individuals who “require substantial support”
- Level 3 ASD is defined as an individual “requiring very substantial support”
As a parent or caregiver, you understand your child’s support needs. Your child’s therapy team will work with you to create an individualized plan that addresses their needs. Just as support needs look different for every child, so do treatment plans, and your ABA therapy provider will take diagnostic criteria into account when creating your child’s plan.
How does my involvement impact my child’s therapy?
Caregiver involvement, sometimes referred to as parent training or family guidance, should also take place during a child’s time in ABA therapy. Caregivers should work alongside the BCBA to create goals for their child, and the BCBA will also help the caregivers achieve their own goals.
When parents participate actively in ABA, their child is more likely to generalize and maintain the skills they learn during therapy. Whether parents want to learn to effectively teach their child functional communication, or want to feel more confident in responding to their child’s interfering behaviors, parent training can help. When parents and caregivers learn effective strategies for skill acquisition and behavior reduction for their child, research shows that their involvement impacts their child’s progress.
When will my child “graduate” from ABA therapy?
BCBAs usually begin to recommend a “fading” of hours when a child has shown improvement in skills and reduced interfering behaviors. Within the child’s treatment plan, BCBAs will often note a transition and/or discharge plan, which will include a plan for fading service hours. This plan will outline the goals and milestones that the BCBA recommends the child should complete before reducing weekly service hours.
As the hours decrease, the BCBA will ensure that the child maintains their skills across different settings and individuals. The purpose of fading ABA hours is to provide support to the child, while also observing their ability to learn within the least restrictive setting. Through this time, if the child continues to show skill acquisition and maintenance without interfering behaviors across environments (e.g. at therapy, at home, at school, in their community, etc), the BCBA will continue to fade hours until the child meets criteria to “graduate,” or discharge, from ABA therapy.
It is important to note, however, that, even after discharging from ABA therapy, the child may need to seek out ABA therapy again to help address needs throughout adolescence or adulthood. As the child ages, clinicians often shift ABA therapy to the home, school, or community-setting, rather than a clinic-setting, which is more common for younger children. By providing ongoing support, ABA can help individuals learn the necessary skills to be as successful and functional as possible within any stage of their lives.
Learn more about ABA therapy for children with autism at BlueSprig
BlueSprig offers evidence-based autism treatment, including early intervention and services for adolescents with autism in 19 states across the country. Our compassionate approach to ABA therapy encourages children to grow, fosters their confidence, and teaches them the skills they need to succeed. If you think ABA therapy is right for your child, find a BlueSprig center near you to get started.