Guidelines to Parents for Selecting an ABA Therapist
By: Smita Awasthi, BCBA, PhD Candidate
Finding the right therapist for your child is the key to your success outcomes. If you are going to trust your therapist with your child's development and growth, it is imperative you ask questions about your therapists training & background. In eastern cultures we tend to revere professionals like God. We believe they can never make mistakes, we hesitate to ask questions, we are afraid they will be offended, we accept inappropriate actions for fear of losing treatment hours, we accept professional arrogance & above all we accept everything without questioning.
This needs to change.
Identifying the best therapist for your child is key to helping your child overcome his / her deficits, but for this you need to ask questions. Asking questions will help the parent & professional understand each other. This helps develop a framework, where the parent informs about their expectation & the professional identifies workable solutions to meet those expectations. This becomes a significant step in forging a collaborative relationship between the parent & professional. 1 (Van Houten, R., Axelrod, S., Bailey, J. S., Favell, J. E., Foxx, R. M., Iwata, B. A., & Lovaas, O. I. (1988). The right to effective behavioral treatment. Journal of Applied Behavior Analysis, 21, 381-384.).
Step 1 : Know Your Therapist
As parents contact me, I am never asked about my credentials. They come with trust. Most stay to forge a long term partnership, some move on, but no one asks.
Here are some questions one needs to ask to identify an ABA therapist/p>
Where did you get your ABA education from ?
An ABA therapist is one who has done University courses in ABA. In India many therapists practicing ABA have attend workshops but have not done any University courses (as there are none in India). In case of the latter, you need to know which ABA professional are they working under or mentoring under.
Who is your mentor ?
All ABA professionals work under mentors. Board certified assistant behavior analysts work under BCBA's, those who have not had opportunities to study ABA at University work under BCBA / BcaBA or PhD's in ABA.
Are you Board certified ?
Board certified professionals are guided by the highest professional standards laid by Behavior Analyst Certification Board. Check www.bacb.com
Are you enrolled for continuing education programs from abroad ?
As ABA is not a subject in India yet, all Board Certified ABA professionals have to take courses including one on ethical practice or attend BACB approved workshops to maintain certification. Or re-appear for the exam once again. It is very important for parents to know that ABA is a developing science & there is a lot of research going on in the field of ABA's application in Autism, hence learning is the key to effective teaching practice.
Do you demonstrate teaching procedures ?
Any therapist practicing ABA will be able to demonstrate parents what to do to teach a skill. They will model & demonstrate. They will demonstrate the skill. In case they are unable to demonstrate, they should refer your child to another therapist. Guidance from a high chair is not what ABA therapists do.
How many active clients do you work regularly with ?
Can you give some references ?
My ABA therapist is not an Indian, are there different rules for non Indians ?
No. All professionals who are practicing ABA, come under international guidelines whose standards are set by BACB (Behavior Analyst Certification Board). Read www.bacb.com
Step 2 : Know the Tools Used For Assessment & Program Designing
Which Assessment Tool do you use ?
Making a detailed assessment is the key to program design. ABLLS - R or Assessment of Basic Language and Learning Skills -Revised 2006, is a great tool which many ABA therapists use.
VB-MAPP or Verbal Behavior Milestones Assessment & Placement Program is another assessment tool which is a Language & Social Skills assessment program.
Who has trained you to use these tools ?
Step 3 : Know What an ABA Therapist Does
How does the therapist begin ?
Begins with doing a "Preference Assessment", identifying reinforcers, & non-contingent pairing.
Does s/he play or teach ?
An ABA practicing therapist teaches at table in 1:1 setting, or in Natural Environment setting. The better the therapist skill the less it looks like teaching. Most of the time, children with autism, seem to be having fun.
What does the ABA therapist do ?
Teaches clearly defined goals in 1:1 setting, Keeps record, & works under supervisor.
How do you document progress ?
Therapists practicing ABA, take data during teaching and document details based on direct observation.They write behavioral definitions clearly and the data is based on principles of science.
Which skill area / domain do you focus on ?
All areas which are functional as per child's age.
Step 4 : Know Who Designs The Program
Who designs the learning program ?
Designing the program is key to learning outcomes. It is vital that the goals selected for your child are functional, target pivotal behaviors & are age appropriate. An ABA therapist who has not had an opportunity for University education in ABA, or is studying ABA, should ideally be consulting with a supervisor for making the program.
How often do you oversee the program ?
Therapists practicing ABA will work very closely with families and monitor progress weekly / fortnightly.
How do you deal with slow progress ?
Therapists practicing ABA, monitor learning in quantifiable terms, this enables them to take action when progress is slow.
Step 5 : Know how behavioral intervention is planned ?
What do you do when behavior issues crop up?
Most therapists will refer to a behavior analyst or work under their direct supervision. If someone gives instant advice, you need to know they are not practicing the science of ABA.
Step 6 : Know How is progress monitored ?
How often do we have meetings ?
Therapists practicing ABA, have meetings as often as possible and as often as needed. Different centers have different rules, however there is a lot of coordination that is expected between parents & therapists.
Step 7 : Know about parent involvement !
Do you train parents ?
Most professionals practicing ABA train parents and expect parents to be involved in the therapy process. As per research 30 - 40 hours of therapy is recommended(The development of a treatment research project for developmentally disabled and autistic children. Lovaas,O.I (1993), Journal of Applied Behavior Analysis, 26,617-630). This will not be possible without parent training & involvement.
How actively are parents involved in the treatment ?
Therapists practicing ABA,collaborate and work with parents considering all factors in the family & the child's environment. Treatment outcomes improve drastically (research), with parent involvement. All therapists using ABA, give details individualized program to parents & training parents is most effective from professionals. (research - McGimsey,J.F, Green,B.F & Lutzker J.R.(1995), Competence in aspects of behavioral treatment & consultations. Implications of service delivery & graduate training. Journal of Applied Behavior Analysis, 28, 301-315)
Step 8 : Know ethical practices
Do you work under influence of intoxicants ?
ABA professionals work under very high ethical standards. Hence anyone working under influence of intoxicants is not a true ABA professional.
Do you resort to reprimands or punishments when the child is naughty ?
ABA professionals do not use reprimands or punishment. Strict guidelines are laid down by BACB www.bacb.com, on ethical practice. Positive behavior practitioners will change environmental variable to change behavior rather than resort to punishment
Protecting the child
In case of any violations to ethical practices, the parent should end their contract with the therapist immediately and find a replacement. It is imperative for parents to educate themselves in ABA principles to know what is ABA.