As my four years of college were coming to an end, I was very aware that I needed to get a job. Apparently, getting a job is much easier said than done when your degree is in psychology. I spent hours scouring LinkedIn, filled out dozens of applications, and watched every episode of Gilmore Girls (not everything has to be productive), but had no success finding something in my field of study.
That’s when a friend of mine told me about Applied Behavior Analysis (ABA). I remember learning about behavior analysis in school, and by ‘learning,’ I mean there was just one section in one chapter of one textbook in one class that mentioned ABA. That being said, I had no idea what it was. My friend had interned at a company nearby as a registered behavior technician (RBT) while she was in school, and planned to stay until she decided what her next steps would be. Needless to say, we were both fully committed and started school to become board-certified behavior analysts (BCBA) within the first six months in the field.
What does this all have to do with asking your ABA clinician questions? Well, that’s a good question. The point of my seemingly pointless story is this: ABA is not a widely known or understood service outside of those who administer it. While this is likely because the field itself is young compared to others, this leaves families in a vulnerable position.
If you’ve experienced the diagnostic process for autism in one way or another, you probably know what I’m talking about. You bring your child to the developmental pediatrician because you noticed a few delayed milestones, and you come home with a thirty-page diagnostic report referring you to six different kinds of services and hundreds of providers. You may not know anything about autism, let alone what all of these services do or which one will be best for your child (hint: there’s never just one!). You begin a bunch of services at once, and here comes the ABA clinician recommending thirty hours a week, but you don’t know why. This is where we get into the questions you should ask your ABA provider, and I’ll also sprinkle in reminders of your child’s rights during treatment, and your rights as their caregiver.
What is ABA, and what can I expect from the services?
A good question to start with is “What is ABA?” Let your clinician explain what the treatment is, who is involved, and what your expectations are as the caregiver. Based on their response, this may prompt more questions you want clarified. Do some research before, and if there are things you’re unsure about, feel free to bring them up. This is a question that I recommend families ask during the intake process. Make sure that ABA is the right service for you and your family.
What happens now?
You may be a caregiver of someone who is getting assessed for ABA services. If that’s the case, you’ve probably found yourself asking “what happens now?” at some point in the process. It may feel like things are moving really fast at times, then slowing down, and then speeding up again, especially when insurance is involved. Each insurance company has its own requirements and documentation needed to have services approved. This can impact how quickly the turnaround is from a client getting assessed to when they actually receive services. Ask your clinician where you’re at in the assessment process. They may not have an exact estimate for your start date, but they should be able to provide you with what to expect next.
Why?
One of my favorite questions I get from families is “Why?” This one is simple, but it can cover a lot of ground. “Why should we be working on that goal?” “Why are you recommending that amount of hours?” “Why do I need to be involved in treatment?” ABA treatment should be individualized to what your child needs, so never be afraid to ask your clinician why they’re making the recommendations that they are. This should also be a collaborative experience, where your clinician is working with you and your family. While the path to a child’s independence will look different for every family seeking ABA, the goal remains the same: working together to equip you and your children with tools they can use to access what they want and need in the environment you’re in.
I also want to emphasize the importance of the word “can.” In my practice, I like to think of the skills I’m teaching as tools in a toolbox. They are there when you need them, but they’re your tools to use at your discretion. We all have different interests and ways we enjoy interacting with the world. For example, I can teach you how to read, but you always have the choice not to.
There’s a very popular article cited in our field titled “Balancing the right to habilitation with the right to personal liberties: the rights of people with developmental disabilities to eat too many doughnuts and take a nap” (Bannerman et al., 1990). I often think about this article, especially when I’m designing goals for my clients. Learning different skills is important, but only because of the outcomes those skills make possible. Washing your laundry will keep your clothes smelling clean, making a meal allows you to eat what and when you want, and learning different games can open the door to more opportunities for making friends. But whether you use those tools is always your choice. Which leads me to the final question you should ask your ABA provider:
How will this improve the quality of life and happiness of my child?
This question should drive treatment, no matter what your path to independence looks like. Ask this question often, to both your clinician and yourself. You’ll feel more confident as a caregiver who is trying to do what’s best for your child, and it will also keep you and your clinician aligned with what therapy should look like. ABA is not a one-size-fits-all kind of treatment. It’s meant to meet clients and families where they are and help them interact together to get where they want to be.
So let that question give you confidence. Use it as a focal point for how you measure progress. At the end of the day, our goal is the same: your child is happy, healthy, and able to make their own choices.
Let us start this collaborative journey to progress with you. Reach out today at acclaimautism.com
For more reading on this topic, please check out the following resources:
Bannerman, D. J., Sheldon, J. B., Sherman, J. A., & Harchik, A. E. (1990). Balancing the right to habilitation with the right to personal liberties: the rights of people with developmental disabilities to eat too many doughnuts and take a nap. Journal of applied behavior analysis, 23(1), 79–89. https://doi.org/10.1901/jaba.1990.23-79
