What happens in ABA therapy sessions?
Deciding on the right treatment for a child or young person with Autism Spectrum Disorder (ASD) takes time and careful research. Applied Behavior Analysis, or ABA therapy, is one of the best ways to help children and young people with ASD set goals and live a happy life as a functioning adult. But many parents of a child with autism may be wondering, what happens in ABA therapy?
An overview of ABA therapy
ABA is an evidence-based therapy that involves making interventions to help improve one’s everyday social behaviors and develop skills to manage day-to-day activities, which in turn helps to decrease problem behavior and improve symptoms. Children of all ages can benefit from ABA therapy, although the earlier one’s treatment begins the better the chance of success.
Sydney Finkenbine M.Ed., BCBA, LBA, is the Clinical Director of Michigan at Illuminate, leaders in the field of ABA therapy. Certified since 2017 and with many years of experience working with children, adolescents and adults with various disabilities, Sydney is passionate about what can be achieved with ABA therapy.
“Behavior is everything, and Applied Behavior Analysis involves working on this,” Sydney says, developing daily or independent living skills and communication, to work and playing skills. “It’s a very focused type of therapy where repetition is important, with success achieved by practicing the skills across multiple settings and with numerous people.”
What does an ABA treatment plan include?
- Treatment begins
- Coordinated care
- Data analysis
The team at Illuminate works to a six-step treatment plan. First, a diagnosis is made. Next, insurance details are taken and the process of gaining authorization for treatment begins. Third, an assessment takes place, and an individualized treatment plan is created. Fourth, treatment begins, and therapists implement ABA techniques that are specific to each child’s needs. Fifth, care is coordinated across various settings, and sixth, data analysis and direct supervision are used to measure progress.
For parents wondering what happens in ABA therapy sessions, every treatment plan is carefully tailored to a child’s specific needs. “We do an initial assessment and establish what their goals are: what their parents’ goals, and those of other caregivers,” she explains. “The treatment revolves around improving the ability to communicate: can the client ask for help, can they communicate their wants and needs? Often, the negative behavior that we see at the initial assessment decreases as communication skills improve.”
ABA treatment can be administered anywhere, and settings are chosen based on what best suits the child or young person – varying depending on the requirements of each session. This could be in-house, in-community (supporting typical store visits or attending routine appointments), or in their educational setting. Clinic-based treatment is the most controlled setting. In these sessions, therapists will consider the child’s needs and control the environment accordingly, from objects to noise.
Example of an ABA therapy session
What happens in an ABA therapy session depends on the individual. For instance, a child could be working one-on-one with their designated technician to develop a particular skill, or they could be doing an activity with others. The duration of each session varies from an hour to several hours, depending on the child’s needs.
An example of an ABA therapy session could involve assisting with language development or breaking down behaviors into manageable pieces, which can be learned and practiced over time. Repetition and positive reinforcement are key. “It’s about being responsive, and meeting the client where they are,” says Sydney. “If they’re working on skills to help them be successful in school, what does success look like for them? Is it participating in a group, or is it sitting and tolerating the noise and lights around? It’s about identifying the ultimate goal and the skills we need to teach to get them there.”
Establishing a rapport between the technician and client is vital, and initial sessions are dedicated to building a relationship. Therapists will explore a client’s likes and dislikes; where their interests lie, and what ‘fun’ looks like for them. This exchange is crucial to forming trust, and identifying the best ways to engage and communicate with a client.
Figuring out the best mode of communication for each client is also important: are they going to use sign language, a communication device, or verbal language? “If we’re using verbal language,” explains Sydney. “We might work on the word ‘help’. We would create situations where the client might need help: opening a milk bottle, or using the restroom. We will then work on a skill repeatedly in a lot of generalized ways – with the goal of increasing skills.”
ABA Therapy Techniques
Technicians use a wide range of ABA therapy techniques and these are determined based on a child’s needs. “The ABA therapy techniques we use depend on the client’s learning level, their age and their history with therapy,” Sydney explains. “As children get older, we increase natural environment learning, because sitting at a table looking at cards is not as important as going out into the community and practicing skills.”
In early intervention, Discreet Trial Training (DTT) is used. This approach breaks down skills into small steps: for example, sitting at a table focusing on identifying animals, building to interaction with animals.
At other times, an ABA therapy technique using natural environment teaching is used – taking a natural environment, and utilizing the resources within it to teach skills: going to the restroom, working out if they go in the men’s or women’s room; if they are sitting down for lunch, identifying some of the fruit.
Parents may also wonder if some ABA therapy techniques are suitable for different personalities, or if the approach differs depending on the severity of the ASD. “It depends,” says Sydney. “There is skill building, but there are also barriers to learning, which could be a child being very hyperactive or not having a lot of language yet. If a person has a lot of learning barriers, we might focus on decreasing some of those first – we can then start to teach other skills.”
End goal and the future
An assessment of a child’s progress will typically take place every six months and involves reviewing the skills that have been taught, looking at what progress has been made and deciding what other skills may need to be introduced.
The goal? “That someone isn’t in intensive therapy for the rest of their life,” says Sydney. “We do work with kids into adulthood; it just looks a little different as people age. You never really discharge from ABA therapy – but it ebbs and flows, and always evolves in response to needs.”