Applied Behaviour Analysis (ABA) is a research based, scientific method that began with the work of B.F. Skinner. The science measures observable behavior.  It looks at what occurs before a behaviour (antecedent) and what happens after a behaviour (consequence). In addition, the methods of ABA are applied by breaking down skills into simple steps and teaching each step in succession. Skills are taught with the use of prompting or cuing to assist learning. A correct response is followed by positive reinforcement which increases the likelihood that a behaviour or response will occur more often in the future.

ABA based intervention is validated for Autism Spectrum Disorder (ASD), but is also applicable to children with other developmental disabilities. It is a set of principles and guidelines upon which educational programs are based and should not be used synonymously with a specific program. An ABA program targets specific developmental areas such as:

Other names encountered within the field of ABA are: Verbal Behavior (VB), Discrete Trial Teaching (DTT), Natural Environment Teaching (NET), Pivotal Response Teaching (PRT) and Fluency-based instruction. Each use a specific method of instruction and are all are based on the principles of ABA.

In behavioral applications to autism treatment, Behavior Consultant usually refers to the person who designs and manages the intervention program. Currently there is no regulatory body, so anyone can call themselves a "Behavior Consultant". The Behavior Analyst Certification Board offers voluntary certification for Behavior Analysts at the Bachelors and Masters/PhD levels.

A Board Certified Behavior Analyst (BCBA) will have (at minimum) a masters level education including 5 graduate-level behavior analytic courses, approved supervised or mentored experience, and pass a standardized examination. While the type of graduate degree is not specified, many BCBAs will have graduate degrees in Behavior Analysis, Psychology, or Special Education.

A Board Certified Assistant Behavior Analyst (BCABA) will have (at minimum) a Bachelors degree including required behavior analytic course work, approved supervised or mentored experience, and pass a standardized examination. NOTE: It is strongly recommended that BCABAs work under the supervision of a BCBA.

The Autism Special Interest Group of the Association for Behavior Analysis (International) has Guidelines for Consumers of Applied Behavior Analysis Services to Individuals with Autism and Related Disorders. These guidelines include recommended education/credentials/training/experience and can be viewed at:
http://www.abainternational.org/sub/membersvcs/sig/contactinfo/Autism.asp

The Behavior Analyst Certification Board Inc. is a non-profit corporation established as a result of credentialing needs identified by behaviour analysts, state governments and consumers of behaviour analysis services. The BACB’s mission is to develop, promote and implement a voluntary international certification program for behaviour analyst practitioners. The BACB credentials BCBA (Board Certified Behavior Analyst) and BCABA (Board Certified Assistant Behavior Analyst). Individuals with a BCBA certificate must have doctoral or master’s level education while individuals with BCABA certificate must have bachelor’s level education. All BCABAs are strongly urged to work with the supervision of a BCBA. Our Clinic Director is BCBA and all Program Managers or Supervisors at ABALC are either already BCBA, BCABA, or are completing the requirements to prepare for the certification examination.  You can find more information at: www.bacb.com

Intervention plans are developed and ABA implemented for a child targeting specific developmental areas (e.g., imitative skills, receptive and expressive language skills, fine motor skills, etc.) which are derived from an assessment of those areas. The program is then implemented or taught within the home of that child. An individual trained to carry out program goals is known as a Behaviour Interventionist (BI).

A home program will range between 8 to 40 hours per week depending on the goals developed for a particular child (and family budget). Guided by a Program Manager (Behaviour Consultant), BIs will work with a child for a set amount of time per day and week teaching the skills required to attain the goals outlined in the child’s program. A BI will use various techniques and teaching methods, guided by the science of ABA. They will be taught techniques empirically proven to be effective and for which they are trained and supervised by senior staff who are experienced and skilled. 

In addition, a BI will work with other team members to support the overall implementation of a child’s program. The direct service intervention team consists of a Program Manager who develops and monitors the entire program, (may include a Program Supervisor) and who supervises and trains BI’s, and BI’s who teach the specific skills to achieve the goals. A team meeting typically occurs once per month and includes the child’s parents, PM/PS, and BIs. During the team meeting goals are developed and programs reviewed. It is at the team meeting where goals, objectives, strategies and problem solving are discussed to ensure the success of the child and to identify any appropriate changes needed so the child progresses successfully.

Many research studies have documented the effectiveness of intensive behavior analytic interventions for autism. Howard, Sparkman, Cohen, Green, & Stanislaw, (2005) suggest that, “Findings from early intervention research indicate that intervention that is intensive, long in duration, and delivered directly to children (rather than caregivers) produces better outcomes than intervention that lacks those elements?. However, there is relatively little research on the effects of treatment intensity (hours per week) and duration (how many months or years intervention).

Ivar Lovaas (1987) demonstrated that children receiving 40 hrs per week (for at least 2 years) of intensive behavior analytic intervention made significantly larger gains than those receiving only 10 hrs per week. Furthermore, almost half of the children receiving intensive behavioral intervention achieved outcomes that placed them in the "normal" range of intellectual, communication, and adaptive functioning.

Eikeseth, Smith, Jahr, & Eldevik (2002) delivered behavioral intervention to 13 children with autism (ages 4-7 at beginning of study) for 28 hrs per week for 1 year. Seven of the 13 children (58%), at follow up, achieved scores in the normal range for functioning.

Howard and colleagues (2005) provided 25-30 hrs/week for children under age 3 and 35-40 hrs per week for children over age 3. They also included two control groups. One group received “eclectic"" intervention (i.e. TEACCH, some DTT, and sensory integration) in a non-intensive (15 hrs per week) community special education program and one receiving regular special education (30 hrs per week). After 14 months, various outcome measures were substantially and statistically significant for the behavior intervention group but not for either of the control groups. Therefore, the results of this study (and others) demonstrated significant improvements in intellectual functioning, communication skills, and adaptive behavior as a result of behavioral intervention. These gains were larger than those reported by Anderson, Avery, Dipietro, Edwards, and Christian (1987) for preschool children with autism who received behavioral intervention for 15-25 hrs per week for one year.

The intensity of behavioral intervention is important for accelerating a learner’s acquisition rate beyond the normal rate in order to close the gap between the learner’s skills repertoire and his/her typically developing peers. However, it is unlikely that this gap will be closed within one year’s time. This means the duration of intervention will often be 2-3 yrs or more. In the "best case" scenario, this gap will be closed and the learner will function at the same level as his/her peers. However, research indicates that fewer than half of children receiving a competently delivered behavioral intervention program will achieve this level of functioning. Regardless, for most children, the gap will continue to be closed as a result of behavioral intervention.

On the other hand, at least 2 published studies (Eikeseth et al., 2002 & Howard et al., 2005) have demonstrated that equally intensive alternative or eclectic treatments DO NOT yield comparable results. Worse yet, it is projected that learners in such programs would continue to lose ground to their same aged peers if they continue in such programs.

So, back to the question we started with… what is the recommended number of hours per week? Currently, we don’t have adequate research to answer this question on a student-by-student basis. However, the literature tends to supports intensive behavioral intervention (i.e. 20-40 hrs per week). In addition, certain learner characteristics need to be considered. For example, learners who are 2 yrs old and those who are 5 yrs old will have differences in the number of hours per week that they can successfully handle.

Generally, more seems to be better. But it is important to note that behavioral intervention continues beyond the number of 1-on-1 "therapy hours". The goal is to create a 24 hr/day 7day/wk (24/7) therapeutic environment. This means actively including parents during "down time". Assuming 12 hrs of sleep per day, there are nearly 90 waking hrs per week. This means more time with parents than interventionists, even if receiving 40 hrs per week of intensive intervention. 

BIs are the individuals who work directly with your child on a frequent basis implementing programs, lesson plans, and behavior procedures as designed by the Program Manager. The BIs are trained and supervised on an on-going basis by the Program Manager. They should possess a minimum qualification of a grade 12 diploma and have a strong interest in working with children. They must have a criminal record check (CRC). Their rates will vary based on their training, experience, skills and responsibilities.

Dr Suzanne Jacobsen is a registered psychologist, Board Certified Behaviour Analyst (BCBA) and clinical director of ABA Learning Centre (ABALC). When you sign a contract with ABALC, Dr Jacobsen is the senior behaviour consultant.  Dr. Jacobsen’s behaviour intervention caseload is full so she is not currently taking new families. However she provides supervision and mentoring to a number of Program Managers and Program Supervisors who are either board certified or in the process of completing the requirements to become certified. All ABALC Program Managers and Program Supervisors have education in behaviour analysis and supervised experience in providing intervention programs. They are assigned as ‘case manager’ for each child’s program. Dr Jacobsen is kept informed about each child’s program and his or her progress through direct consultation and monthly team meeting minutes. She acts in a consultative capacity to support, advise, educate, supervise and facilitate the Program Managers and Program Supervisors to ensure the best possible service for a child and his/her family. This allows ABALC to serve many more families than we otherwise could. Our Program Managers and Program Supervisors are extremely well-qualified, and in other organizations could call themselves behaviour consultants. We feel it is important for you to have access to the combined skills and experience which our team approach can offer. Our Program Managers and Supervisors can perform ABLLS-R assessments and updates, prepare ITPs (Intensive Treatment Plan), monitor and update programs, and provide training and supervision to behaviour interventionists.

We attempt to provide service to everyone in a fair and timely fashion, but "first-come, first served" cannot always be implemented. Your child is an individual and your family and circumstances will not be the same as anyone else’s. It is our job to put together a team who will work well within your family dynamic, your goals for your child, your child’s needs and temperament and your budget. We have staff members serving the needs of families all over the lower mainland.  How long you wait for service depends on if we have a Program Manager working in your area and if they have enough room in their caseload to fully serve your child’s needs. We understand that the rules and regulations surrounding your funding make it difficult to wait, however the needs of your child are paramount, and we will not do anything less than our best for your child.

Once you have met with the Clinic Director or designate and signed your contract with ABALC, the average time to implementation of a program can be as short as 2 weeks depending on: the completion of the ABLLS-R assessment; the number of programs required to address the objectives for your child; and the hiring and training of BIs (behaviour interventionists).

No, we don’t.  Our intervention is applied behavior analysis (ABA) based on Skinner’s Analysis of Verbal Behaviour, and we use intensive teaching (IT which means discrete trial teaching) and Natural Environment Teaching (NET).  Children do not learn when they are unhappy, bored or stressed. It is our job to make sure that your child has good reasons to want to try new and difficult tasks so we will consider your child’s motivation and interests in planning specific activities to help your child learn language, play skills and skills for independence.

You can go to various websites to find out more about verbal behaviour.  To start with, go to:

www.abacentre.ca         then, try:
www.drsjacobsen.com
www.christinaburkaba.com
www.verbalbehaviornetwork.org
www.vbforum.ca

The ABLLS-R is the Assessment of Basic Language and Learning Skills- Revised, curriculum guide, and skills tracking system for children diagnosed with autism and other developmental disabilities. The ABLLS was developed by James W. Partington, Ph.D. and Mark L. Sundberg, Ph.D. in 1998 and the 2006 revision was completed by James W. Partington, PhD.  The ABLLS-R assessment provides the opportunity to investigate many skills necessary for a child to communicate with others and to gain new functional skills for independence and academic learning. Skills for the following areas are investigated:  Cooperation and Reinforcer Effectiveness; Basic Language skills; Social skills; Academic; Self-Help and Motor Skills.

The ABLLS-R Assessment is conducted over two to three sessions which are each about two hours long. During the first two sessions the Program Manager/Supervisor assesses child’s current skill level in the area of language, basic learning skills, academic and motor abilities. Parents and caregivers can often provide information about the child’s self-help skills. Parents are encouraged to share their concerns and to identify their priorities regarding the objectives for intervention. Caregivers will be asked when they would like the assessment of their child’s social skills. This assessment is conducted in the student’s preschool or school where the Program Manager/Supervisor observes how the child interacts with peers and follows group or individual instruction.

The ABLLS-R assessment is conducted by a qualified Program Manager or a Program Supervisor, who has been assigned by the ABA Learning Centre to work with the child. The ABLLS-R assessments are conducted at the ABALC Clinic in Richmond or at the child’s home with the caregivers present. The parents can choose to be present at the time of testing. The ABLLS-R assessment involves direct observation of the child’s skills, thus it is important to first establish rapport with the learner. ABA Learning Centre provides a child-friendly environment. The rooms in which the assessor works with the child are spacious, bright, colourful and contain numerous toys, board games, books and videos which the child is free to explore during testing. The PM/PS will evaluate the child’s skill level using both academic materials and various toys and games in which the child shows high interest. Skills are examined at the table by giving specific instruction and also by more natural method, such as structured and purposeful play.

Upon completion of the ABLLS-R assessment parents will be provided with the ABLLS-R protocol (record booklet) containing criterion – referenced information regarding the child’s current skills, and the Behaviour Plan of Intervention (BPI) developed by the Program Manager or Program Supervisor who has been assigned to work with the child. The BPI lists educational objectives based on the assessment of the learner’s current level of abilities. The plan contains detailed information of each objective, explanation of the teaching procedures, materials that are required to implement the program, and mastery criteria.

Once again, your program will be an individualized treatment plan for your child.  We do not use a ‘one size fits all’ approach. We will do our best to work with your budget, however it is simply not possible to give you a decision regarding costs before meeting your child, discussing your goals and obtaining some baseline data through assessment. A similar life example might be: if you buy a pre-fabricated sofa at IKEA, you know from the price tag how much it will cost you. If you wanted a custom-made piece of furniture, you would have to make lots of decisions and provide lots of information to the carpenter before he could give you a quote. We will ask you what your budget allows each month for your child’s program and then we will tell you the hours of service we can provide within that budget.

All associates of ABALC work independently and have the authority to set their own hours in support of a child’s program. The charge for our Program Managers, Program Supervisors, and behaviour interventionists is on an hourly rate. This rate varies depending on the qualifications and experience of each individual. You may also be asked to pay a monthly clinic service fee, which covers the provision of various administrative services, some ongoing opportunities for PM/PS and BI learning, and access to materials for use in your child’s program. We attempt to place PM/PS within specific geographic regions to reduce the time spent traveling. If your home is more than 30 km from the office of ABALC or from the location of the home of the PM/PS, there may be an additional charge to cover travel expenses. If you, and your BIs are able to attend team meetings at the Richmond office, it does eliminate the need to charge for any travel time for the PM/PS. Ultimately, our goal is to work with you to keep program management fees as low as possible in order to maximize individual therapy hours while maintaining the quality and integrity of the program.

No!  The team meeting is an essential part of the program, for the reasons outlined above. You need to know that you are an essential part of your child’s team, and you need to be kept knowledgeable about the program, and have an opportunity to contribute your experience and knowledge of your child to the team. When we devise an BPI for your child, we are designing a program that includes the hours of intervention that fit your budget, time for program development, data collection and analysis, and team meetings to communicate and ensure progress of your child. None of these activities is optional.  It is important that you understand the meetings are intended to ensure you and all the team members understand the programs, intervention strategies and progress as well as address any concerns that may arise during the month.

We do, sometimes, have trained BIs available to work as part of your child’s team. It may be necessary, or desirable, for you to hire untrained interventionists who may be trained by your Program Manager or may attend training at ABALC. There are always costs for training but it is essential to develop the interventionists' skills to ensure your child's program is implemented appropriately (please ask if you require more information on this aspect of the program). When you employ BIs yourself, you are responsible for obtaining criminal record checks, registering and paying WCB premiums, etc.  Interventionists associated with ABALC have the benefit not only of ongoing supervision and training for your child’s program, but also have access to regular training opportunities at ABALC. What you will pay for your interventionist through ABALC will reflect the interventionist’s training, experience and abilities. ABALC maintains a criminal record check for all employed BIs.

There are significantly higher costs associated with starting a program of therapy than for supporting the intervention once the program is in place. The assessment tools which were used to diagnose your child do not provide sufficient information to develop an BPI to write the Behaviour Intervention Plan for MCFD.  We use the ABLLS-R to develop an BPI and update that assessment regularly to chart progress and gather data. Your Program Manager or Supervisor will need to spend much more time in the first two or three months to assess and observe your child, meet with you, prepare a report for you to submit to MCFD, provide overlapping sessions with interventionists for training, supervise and help to implement the program. The set-up fee pays for the ABLLS-R protocol and assessment, initial program development, for ‘extra’ hours of program management or supervision, essential materials for your childs program, and for consultation hours from Dr Jacobsen who is available for ongoing support to the Program Manager and family. It is best for families to be given one set fee as a guideline – although each family’s needs are different, we know that the set-up fee of $3,200 will include the essentials to get your child’s program developed and implemented.

Generally parents have an option to hire their own BI or they may be referred to BI’s associated with and trained through the ABA Learning Centre if any are available. If the family hires privately, they are solely responsible for advertising the position, interviewing the potential interventionists and requesting a criminal record check. Parents can explore several options to advertise the position. Some of these options include: as advertising in their local newspaper, posting it on community bulletin boards, college and university bulletin boards, or internet job postings.

No professional can or should give you absolute guarantees about any aspect of your child’s development or behaviour. We will use the science of ABA to collect data which informs our decisions and to select techniques and strategies to assist you child in acquiring effective behaviours and skills for independence. We will use the regular team meetings as a time to share information, raise questions and concerns, and plan intervention strategies. You can expect your child to show progress in the areas of his/her goals over time and we will monitor the progress with regular data collection. Our aim is to help your child to realize his or her full potential, and find ways to interact with, and thrive in, the world.

Autism Community Training (ACT BC) is the organization responsible for providing information to parents whose children have had a diagnosis of ASD.  They also provide a wide range of valuable workshops for professionals and parents, which can help you to gain the skills necessary to help your child succeed. First task is to read the Frequently Asked Questions and Qualifications for Service Providers at: www.actbc.ca/. After that, you can review the RASP profiles to help you gain more understanding about the skills and expertise of the service providers who work in your geographical area.

If you wish to apply to ABALC for your child, please complete the intake form at www.abacentre.ca in the "Services" section and forward it to tricia@abacentre.ca. Your form will be reviewed within one week and you will be notified if there is an ABALC Program Manager in your area who has room in their caseload.