What is ABA?
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.
What is a Behavioural Consultant?
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.
What is Board Certification?
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 Clinical Director is BCBA-D and all Program Managers or Supervisors at ABA LC 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
What is a home program?
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).
For children under the age of 6 a home program will typically 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 that 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.
What is the number of recommended hours of intervention per week?
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.
Who are the behaviour interventionists (BIs)?
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.
I need a behaviour consultant. Do you have availability?
The Behaviour Consultants for ABA Learning Centre, even those that are Board Certified Behaviour Analysts, are supervised by Dr. Suzanne Jacobsen, Founder, and Dr. Elizabeth Athens, Clinical Director. ABA Learning Centre has a number of Program Managers, and Program Supervisors, Student Program Supervisors who are in the process of completing the requirements to become certified. All ‘Program Managers’ are Board Certified Behaviour Analysts. All ABA LC Program Managers and Program Supervisors have education in behaviour analysis and supervised experience in providing intervention programs. Program Managers are assigned as a ‘case manager’ for each child’s program. Dr. Athens is kept informed about each child’s program and his or her progress through direct consultation and monthly team meeting minutes. Dr. Athens 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 ABA LC 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, VB-MAPP and ESDM assessments and updates, prepare BPIs (Behaviour Plan of Intervention), monitor and update programs, and provide training and supervision to behaviour interventionists.
How long is your waiting list?
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 ABA LC’s intake team, met your Behaviour Consultant and signed your contract with ABA LC, the average time to implementation of a program is around 4-6 weeks depending on: the completion of the ABLLS-R, VB-MAPP or ESDM assessment; the number of programs required to address the objectives for your child; and the hiring and training of BIs (behaviour interventionists).
Do you use a strict Lovaas approach?
No, we don’t. Our intervention is contemporary 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.
How can I find out more about Verbal Behaviour?
You can go to various websites to find out more about verbal behaviour. To start with, go to:
www.abacentre.ca then, try:
What is ABLLS-R, VB-MAPP, or ESDM assessment?
The ABLLS-R is the Assessment of Basic Language and Learning Skills- Revised, VB-MAPP is the Verbal Behavior Milestones Assessment and Placement Program and ESDM is the Early Screening Denver Model. All are curriculum guides, and skills tracking system for children diagnosed with autism and other developmental disabilities. These assessments provide the opportunity to investigate many skills necessary for a unique child to communicate with others and to gain new functional skills for independence and academic learning. The appropriate assessment tool is chosen based on the individual learner’s current skills, age and any barriers that may be interfering with learning. Skills for the following areas are investigated: Referencing, Joint Attention, Cooperation and Reinforcer Effectiveness; Basic Language skills; Social skills; Academic; Self-Help and Motor Skills.
How long does it take to conduct an assessment for program planning?
The typical assessment is conducted over two to three sessions which are each about two hours long but this may vary based on the level of the child’s cooperation and present skills. During the first two sessions the Program Manager/Supervisor assesses child’s current skill level in the area of referencing, joint attention, language, basic learning skills, academic and motor abilities. Interview is conducted with parents and caregivers who can often provide information about the child’s self-help skills, preferences and strengths. Parents are encouraged to share their concerns and to identify their priorities regarding the objectives for intervention. When appropriate, 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.
How and where are the ABLLS-R, VB-MAPP, or ESDM assessments conducted?
The assessments are 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 assessments are conducted at the ABA LC Clinic in Richmond or at the child’s home with the caregivers present. The location will depend on the kind of program you are receiving from ABA Learning Centre. The parents can choose to be present at the time of testing. The assessments involve 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 and if your assessment is to take place at our centre, the rooms in which the assessor will work 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.
What will the family receive after the ABLLS-R, VB-MAPP, or ESDM assessment has been completed?
For children under the age of six years old, upon completion of the assessment parents will be provided with the testing protocol (record booklet) containing criterion – referenced information regarding the child’s current skills, and the Behavior 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 current information of each objective, explanation of the teaching procedures, materials that are required to implement the program, and mastery criteria. A BPI is usually a plan for the first six months of the child’s program but, should the child be a rapid learner, the plan may be revised monthly at the regular team meeting. The rate at which the BPI is adapted and continued to be developed will depend on a child’s learning level. For example if a child masters skills quickly, then his or her BPI will be updated and changed more frequently than a child who may take longer to master the skills. BPI’s are usually completed within 4 – 5 weeks of a program beginning; however, the more available a family is for the Program Manager Program Supervisor to meet with the child, the faster the BPI will be completed. Assessments to update the programs for a child are planned and are an integral part of the monthly services. Typically, an ABLLS-R or VB-MAPP will be updated at a minimum, annually. You will be provided graphs which illustrate the mastery of objectives with each update.
How much will my program cost? What is the average cost of a program?
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. We are sensitive to the fact that many parents are limited to their child’s Autism Funding for services and we can work within the funding amounts to provide a quality program for your child.
How does your fee structure work?
If you are participating in a home program, the team that would be assisting you from ABA Learning Centre would work with you to find times for sessions that work with both your and the schedule of the Program Manager or Program Supervisor. The charge for our Program Managers, Program Supervisors and Student Program Supervision is based on an hourly rate. This rate varies from $70/hr to $150/hr, depending on the qualifications and experience of each individual.
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 ABA LC 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.
If you are participating in a centre-based program you would have a flat monthly rate for services that would vary depending on the program that your child would be participating in. 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.
Can I save money by having a team meeting once every two months?
No! (Not for children under the age of six) The team meeting is a vital and mandatory part of the program, for the reasons outlined above. 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 a 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.
Does ABA Learning Centre provide Behaviour Interventionists?
ABA Learning Centre only provides Behaviour Interventionists (BIs) for our centre based programs. For home programs, our consultants may have a BI on another home team that is looking for more clients, but we cannot guarantee it.
ABA Learning Centre recommends that families hire private BIs to work with their children, if they are running services from home. The reason for this is a private BI will have a lower billing rate than a BI that you hire through an agency. An agency will have a ‘cost’ of having an employee as they have to pay their vacation pay, EI, etc. and the cost of having that employee will be built into their billing rates. You will be able to get more hours of intervention from a private BI per month because usually they are at a lower bill rate. Parents can explore several options to advertise the position. Some of these options include: posting ads on community bulletin boards, college and university bulletin boards, or internet job postings such as Indeed and Craigslist.
The Program Manager or Program Supervisor working with your child can assist you with the process of screening and hiring a BI to ensure that you are hiring a knowledgeable individual. They can also then train that private BI on your child’s intervention program. When you employ BIs yourself, you are responsible for obtaining criminal record checks, registering and paying WCB premiums, etc.
Does your organization have a set-up fee?
ABA Learning Centre does have a set-up fee for most of their programs (usually excluding Social Skills programs); however, which program your child is participating in and the age of your child will reflect what that set-up fee is. When you have submitted your intake application with ABA Learning Centre, you will book an intake meeting, a free information session, and a representative from ABA Learning Centre will discuss all program fees with you at that time. All set-up fees are 100% covered by the Autism Funding.
How do a hire a BI?
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: posting ads it on community bulletin boards, college and university bulletin boards, or internet job postings sites such as Indeed or craiglist.
How long will it take before my child will speak/use the potty/stop throwing tantrums?
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.
We do encourage parents to make functional life skills a high priority. It is very important that children are toilet trained, can feed themselves and can put on jackets and shoes before they enroll in schooling. So, depending on your child’s age, these should be made the priority objectives (at 4 years of age minimum). Tantrums are “normal” for many two year olds and four year olds without autism so it is important for your PM to do functional assessments to determine appropriate interventions to eliminate tantrums that may be the result of communication, frustration, “control”, etc. and you may be asked to actively participate in providing supports and consequences when the issue of tantrums is being addressed.
Where do I go from here?
Autism Information Services BC(AIS BC) is the organization responsible for providing information to parents whose children have had a diagnosis of ASD. Parents should contact AIS BC to gather information on all types of therapy for children diagnosed with ASD. Contact AIS BC at 1-844-878-4700 or email AutismInformation@gov.bc.ca
Applying for services from ABA LC
If you wish to apply to ABA LC for your child, please complete the intake form on at www.abacentre.ca and forward it to Joseph Carpenter at email@example.com or by fax to 604-232-9515. By filling out the intake application you are NOT under any obligation to use services from ABA Learning Centre. The intake application gives us some basic information about your child, their learning levels, your goals for them and your geographical area so that we can match you up with an appropriate Program Manager. The intake application will also give us some context and insight into your child so that we can discuss the appropriate programs that we would be able to offer. Any information submitted is kept confidential. Your intake application will be reviewed within three business days and you will be notified if there is an ABA LC Program Manager in your area who has room on their caseload, and their availability to meet with you. When you have submitted your intake application with ABA Learning Centre, you will book an intake meeting, a free information session. You will be meeting a representative from ABA Learning Centre and the Program Manager that would potentially be working with your child. At the time of the intake meeting we will discuss the fees associated with the program that you choose is the best fit for your child.
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