What is Applied Behavior Analysis?

Applied Behavioral Analysis, or ABA, is the practice of applying principles of learning to alter behaviors of social significance. Through ABA Therapy, new skills are learned, and problem behaviors are eliminated. ABA therapy is the most effective treatment for children with Autism, however it is a treatment approach that can be used with anyone, whether they have a diagnosis or not. ABA Therapy focuses on the behavior that is observable and measurable, not on the diagnosis or condition of the individual.

By analyzing behaviors, we understand how the behavior works, how it is affected by the environment and how learning takes place. Once we understand how the behavior interacts with the environment, procedures can be developed and applied in the natural environment. Procedures may include applying rewards and consequences consistently to help replace undesired behaviors with desirable ones. Procedures may also include altering variables in the environment to yield desired behavior changes. The long-term objective is a decrease in unwanted behaviors and an acquisition of new skills.

ABA is considered an evidence-based practice. “Evidence based” means that ABA has proven effective through scientific studies. It is a process that involves designing a treatment plan according to the analysis of on-going research in the field of ABA, and of course the therapist’s clinical expertise.

BENEFITS OF ABA

ABA Therapy is an effective treatment used in treating undesirable behaviors. Any behavior can be targeted for change, but some of the more common targeted maladaptive behaviors include:

Physical Aggression
Verbal Aggression
Property Destruction
Tantrums/Meltdowns
Elopement
Disruptive Behaviors
Off-task Behaviors
Pica
Threatening Behaviors
Stealing
Lying
Self-Injury
Self-Stimulatory Behaviors
Enuresis/Encopresis

ABA Therapy is also an effective treatment to help an individual acquire or new skills, some of which may be functional replacement skills for maladaptive behaviors of concern. By applying positive reinforcement to these appropriate behaviors, a direct result is an increase in the behavior. Targets for increase may include, but are not limited to:

Communication skills
Compliance skills
Social skills
Tolerance skills
Time on task
Appropriate leisure skills
Community environment participation
Complying with classroom routines/ transitions
Daily living skills
Independent skills

What Is Involved In an ABA Program?

A good ABA program is one that is tailored to the individual based on their unique needs. Programs are not predetermined. Rather, they are designed for the individual based on information gathered about the behaviors. Goals are set based on the current levels of functioning (the baseline levels). The program should be flexible and may change based on the individual’s progress or lack thereof. Progress is determined based on data collected during treatment sessions with the ABA therapist, as well as data collected outside of treatment sessions by the caregivers. An ABA program is considered successful if the individual achieves and maintains the identified long-term objectives. This is determined by comparing current behavioral data with baseline levels.

Treatment Team

A Board Certified Behavior Analyst (BCBA) leads each treatment team. The BCBA assesses the individual and designs the behavior program and treatment plan. In addition, they train caregivers, analyze data, and modify interventions accordingly. Depending on the needs of the individual, the team may include additional therapists at the BCaBA (Board Certified Assistant Behavior Analyst) and/or RBT (Registered Behavior Technician) levels. The team is determined by the BCBA after the Behavior Assessment has been completed and the recommendations for ongoing services are made. If the BCBA recommends additional therapists to help carry out the plan, they supervise these therapists in the implementation process.

source: “What Is ABA?”.Autism Speaks, https://www.autismspeaks.org/applied-behavior-analysis-aba-0. 08/14/2020.

Getting Started with the ABA Process

REFERRAL: The first step in accessing ABA services through Johanna McDonald LLC is obtaining a referral for services. Oftentimes referrals come from doctors or psychologist. Some referrals also come from schools, case managers, other therapy providers, or the parents/ caregivers.

CONTACT US: Once you receive your referral for ABA (or if you are self-referring), make initial contact with us either via phone or email. Upon initial contact, we will determine preliminarily if ABA is a covered benefit with your insurance provider (if you are planning to use insurance coverage) and if we have a therapist that we can match you with. At this time, we will also discuss the out-of-pocket cost for you (if there is one). There are grants and scholarships that can help with some of these out-of-pocket costs.

INSURANCE REQUIREMENTS: Your insurance may have certain criteria that must be met before they will pay for ABA therapy. We can help you with this process! Common criteria required by insurance providers includes:

A current referral for ABA therapy with the ICD-10 diagnosis code, and a signature from an MD level physician or PhD level psychologist.
A CDE (Comprehensive Diagnostic Evaluation) completed by a specialist such as a developmental pediatrician, neurologist, or psychologist. Most insurance providers do require that the individual has a diagnosis before they will cover ABA therapy. Autism Spectrum Disorder is typically a covered diagnosis, but there are other diagnoses that may also be accepted.
Cognitive Evaluation
Adaptive Assessment

INITIAL ASSESSMENT: Once we have gathered criteria necessary for ABA Therapy insurance coverage, we will proceed with requesting the authorization for the Initial Assessment. The Initial Assessment authorization may allow as little as 3 hours or as many as 12 hours of BCBA time to complete the entire process. The authorized length of time depends on the insurance provider as well as the BCBA’s recommendation. The initial Assessment may include one or more of the following:

Functional Assessment Interview with caregiver and client
Observation of client in one or more settings
Functional Analysis
Data collection to gather baseline levels of target behaviors for increase and decrease
Adaptive Assessment
Skills Assessment
Other suitable assessment tool chosen by the BCBA
Reviewing Information provided from other providers or sources
Analyzing data
Determining initial objectives
Developing an initial Treatment Plan and Behavior Plan

ONGOING TREATMENT: Once the BCBA completes the initial assessment, we will send it to the insurance company in order to obtain the authorization for ongoing ABA therapy. At this time, the therapist(s) will schedule the ABA sessions. Here are a few general things that you can expect from ongoing ABA services:

Caregiver training and performance evaluations
Data collection by therapists and family – this is the basis for justifying medical necessity for our services and monitoring progress
Probing and developing procedures for reducing problem behaviors and increasing functional skills
Teaching new skills in a variety of categories
Generalizing treatment across different settings and caregivers