By Nahoma Presberg, MS BCBA NYS-LBA
What do you do in ABA therapy, anyways? You might get this question a lot as a BCBA, and for good reason! ABA is a powerful technology that can be used to teach so many skills and reduce a wide variety of interfering behaviors. The possibilities are endless!
So how do we figure out what we should be teaching?
Assessment
The assessment process is (obviously) extremely important for putting together a curriculum. During the assessment process, we’re looking to get an understanding of:
- The learner’s skills
- The family’s concerns
- The reasons they’re seeking ABA services
- Perspectives from other providers
You may also want to take a look at my post about how to pick a social skills assessment.
Scheduling
Next we need to consider the schedule of services. Is the family looking for comprehensive services which may be as many as 20 or 30 hours a week? Or maybe they’re looking for therapy to focus on one specific concern.
Working with Insurance
Depending on your state, if you are providing ABA services covered by health insurance, there may be more specific rules about the kinds of goals that they will cover. Typically, these rules indicate that the goals must all be related to reducing the symptoms of autism. While this is a rather loaded statement, ultimately this means that goals must be related to the core deficits of autism, i.e. restricted and repetitive patterns of behavior or communication deficits.
Incorporating Family Preferences
One of the most important metrics of our therapy is social validity. Social validity addresses the extent to which the therapy makes a meaningful difference in our client’s and stakeholder’s lives. Families and clients have a lot of insight into what would make the biggest difference in their lives. For example, the family might have a tradition of going to the beach every summer but our client struggles with managing the different routines of a vacation schedule. We may choose to work on supporting the preparation and flexibilities skills required for our client to be able to successfully participate in vacation with the rest of the family.
Our Role as Advocates
In our role as advocates, sometimes it is our job to help families understand more about autism or what is realistic to expect of their child at different points in their development. ABA therapy (particularly parent training) can be an important opportunity to teach families about autism in ways that might help them make their home more accommodating for their child or understand about what additional environmental supports might be needed.
Next Steps
Once you’ve compiled all this information, you’ll probably have a long list of skills you want to work on. You might need to prioritize and think about certain goals as “core” priorities, and other as supporting goals. There can often be a sense of urgency when looking at all of the things you want to teach but remember that slow and steady wins the race. It’s ok to prioritize just a few key goals that are really going to help your client the most and expand from there when they’re ready.
About the Author
Nahoma Presberg, MS BCBA NYS-LBA, is a Board Certified Behavior Analyst. Nahoma obtained their master’s degree at the University of Rochester in Human Development. They have been working with clients in their homes for the past 6 years but has over a decade of experience supporting children with developmental disabilities. Nahoma is passionate about neurodiversity affirming care and thoughtful programming that helps every client thrive.
For more information about Nahoma, you can visit their website at https://www.nahomapresberg.com/.