10 important considerations when choosing an ABA provider

The diagnosis rates of autism spectrum disorder (ASD) are up 10% since 2018. Even more, the Center for Disease Control (CDC) suggests that childhood ASD prevalence rates across the nation are as high as 1 in 54. As families receive an ASD diagnosis they also obtain a referral for applied behavior analysis (ABA) services. ABA services are seen as the gold standard to treat the symptoms associated with ASD. Choosing an ABA provider immediately after a child has been diagnosed with ASD can be a confusing and stressful time for families. The ABA provider marketplace has grown exponentially over the last three years and families often lack the experience to choose a provider.  It is important for families to consider the following questions before selecting an ABA provider. 

1. Does the ABA provider accept your healthcare insurance? Although most states mandate that healthcare providers cover ABA treatment for children affected by ASD, some healthcare plans are exempt. Families should have the ABA provider verify their healthcare benefit to ensure ABA is a covered service. Families should also inquire about out-of-pocket services payments such as healthcare deductibles and session co-payments.
2. Is there a waitlist for services? There is a critical shortage of behavioral professionals to accommodate the ABA services for all children affected by ASD. Families should speak with the ABA provider to determine the wait time, if any, for obtaining an initial behavioral assessment and ABA treatment.
3. Home-based, Center-based, or Community-based? ABA services may be provided in various locations. Home-based services occur in the child’s home and typically involves parent observation and session participation.  Home-based ABA allow skills taught during sessions to transfer to a family’s daily routines more easily. Center-based services, much like a school, provides a setting dedicated to treating many children affected by ASD in one place. These are typically clinics or centers which families typically drop-ff and pick-up their child from. Community-based services occur within the child/family’s community locations (i.e., grocery store, school, daycare, church). Sometimes home and community-based instruction are provided at the same time to increase skill development in the child’s natural environment.
4. How is the initial assessment conducted and how is it linked to my child’s goals? A Board Certified Behavior Analyst (BCBA) must always conduct an assessment before beginning treatment with your child. This assessment should include interviews with family and other caregivers, observation of your child, and standardized testing measures. The assessment tools completed by the BCBA along with your input should inform the measurable and observable goals that are added to your child’s treatment plan.  These treatment goals should be strongly informed by the family’s goals, priorities, and routines. A great recommendation is to come to the initial assessment prepared to discuss several skills that you and your family want your child to do. 
5. Learn about the clinicians providing ABA services to your child.  Ask questions about the credentials and qualifications of staff to ensure that there is a Board Certified Behavior Analyst (BCBA) completing the assessment and supervising the ongoing services and treatment plan. Ask your BCBA questions about their experience in the field of ABA and working with children affected by ASD. Background checks are common practice for most providers. Ask your provider questions about their policies in case of a concern or grievance. 
6. ABA is not a single or one size fits all program. How is treatment individualized for my child?  ABA is individualized and teaches skills that are important for everyday life for each child. All children are different and have unique strengths and needs, so all treatment programs should be unique as well. Services should always focus on the priorities of families and fit into the family’s lifestyle. 

• Ask how families are expected to participate in sessions. ABA providers should invite, welcome, and create environments that promote parent participation.  BCBAs starts with small participation goals, enabling parents to leave the teaching interaction feeling effective in promoting behavior change in their child.
• How will my family evaluate progress? BCBAs and behavior technicians should collect and maintain data on how your child in progresses towards achieving their goals each session. The data reflects how quickly your child proceeds towards independently achieving program goals. ABA providers also update treatment graphs regularly which reflect data from each program. Family members should have access to quickly review these graphs and evaluate if their child is making progress.
• Are the skills taught to your child generalizing into the natural environment? 
  Skills that are taught and used with only one person or in one setting are not going to be useful for your child. The treatment goals for your child should be taught among several individuals and in the natural setting. For example, if your child has only learned how to greet their immediate family members in your home but is unable to greet friends or neighbors when going to visit, then this skill has not been generalized and is not useful for your child. 
• Is my child having fun? A good ABA provider creates treatment plans that are informed by evidence on effective teaching, listening to and prioritizing family needs, and teaching essential life skills to children. ABA providers should create learning environments where children are happy, relaxed, feel safe and engaged.