Questions to ask prospective ABA companies/providers

Do you provide comprehensive ABA programs? How many hours per week of ABA therapy do your clients typically receive?

Some ABA programs are focused primarily on reducing maladaptive or “problem” behavior, but are not intended to teach the child new skills across a wider range of developmental domains.

Comprehensive ABA programs will focus on teaching a wide variety of skills, in addition to working on behavior management for maladaptive behaviors. These comprehensive programs will work on increasing the child’s skills across developmental domains including:

  • Communication
  • Play
  • Social/emotional skills
  • Safety skills
  • Independent living
  • And more 

Comprehensive ABA programs will typically recommend around 30+ hours/week of 1:1 intervention for children under the age of 5. Once children are in school, these programs will typically offer 10-15 hours per week of ABA therapy outside of school times. 

Comprehensive ABA programs are considered “best practice” for children diagnosed with ASD.

What is the age range of the clients you serve and are you able to provide services to children at all levels?

Children with a diagnosis of ASD may have a wide variety of abilities, behavioral needs and skill deficits when they begin ABA therapy.  It is important to ensure that the ABA provider you will be working with has the experience and expertise necessary to create and implement a program that is individualized to your child’s specific needs. 

Will there be a Board Certified Behavior Analyst (BCBA) working on my child’s treatment team?

All ABA programs should be developed and supervised by a BCBA. 

The BCBA may collaborate with other supervisors, such as Assistant Behavior Analysts (BCaBA) or seasoned behavior therapists in developing objectives and teaching procedures for the child’s program, but ultimately the creation of the program (the goals, teaching procedures, behavior intervention plans, etc.) and all subsequent changes to the child’s program should be overseen and approved by a BCBA. 

This typically requires that each child’s program have at least 1-2 hours/month of BCBA supervision, with more BCBA supervision hours required for early intervention programs (20+ therapist hours/week). 

Are all of your 1:1 behavior therapists RBT or BCAT certified?

RBT stands for Registered Behavior Technician and BCAT stands for Board Certified Autism Technician. 

If therapists are RBT or BCAT certified, this means that they have gone through a standardized training of at least 40 hours and have passed a clinical exam that qualifies them to practice quality ABA therapy. 

Therapists who do not have this type of certification are not held to any standardized qualifications.  

What type of training do your therapists receive while working with your company?

Every behavior therapist that works with your child should be receiving consistent, frequent, and ongoing supervision and training from a behavior analyst (BCBA or BCaBA).

Behavior therapists (RBTs and BCATs) cannot provide services independently. They are required to have supervision and on-going training from a certified behavior analyst to ensure that their teaching procedures are being implemented correctly, that the data is being collected accurately, and that the program is having the intended effects on the child’s behavior and skill development.  

Where are your ABA services conducted?  Do you provide community-based services (i.e. at daycare settings, the park, the grocery store, etc.)?

Some companies provide all of their ABA services in a clinic setting, some provide services in both clinic and home settings, and some companies have services that are entirely home-based. 

You do not need to have a large home or a designated therapy space in your home in order to receive in-home services.  In fact, most children will benefit from receiving services in a variety of spaces in their home and community settings.

Children also benefit from having opportunities to practice the skills they are learning in community-based settings such as the mall, the movie theater, etc.  Research has shown that progress may be limited for children who only receive ABA services in a clinic setting where parents are not present/able to participate and where there are not real-world opportunities to practice new skills.

How often should I expect changes to the therapists and supervising behavior analysts on my child’s treatment team?

Some ABA companies make changes to the therapy teams at regular intervals (i.e. intentionally at the start of each new school year) while other companies may have high staff turnover rates that mean changes to therapy teams are more frequent.

Of course, there are no guarantees that your child will have the same therapists for years to come, and some changes to the therapists on your child’s team are beneficial in order to ensure that your child is able to learn from different therapists and utilize the skills they have already learned with a wider variety of people.  But it is important to know what you should expect from an ABA company in general regarding staff changes. 

How frequently can I expect the BCBA to be involved in my child’s program?  How often will they: 

-observe my child’s ABA sessions?
-meet with parents and caregivers?
-meet with the behavior therapists outside of session?

RBTs and BCATs are required to be supervised/observed at least once a week by a certified behavior analyst (BCBA or BCaBA), on average. This supervision can be remote but is best done in person, in the presence of the client, where immediate and objective feedback can be provided, and where the behavior analyst can model new procedures as needed.

It is also important that parents/caregivers have regular contact with the BCBA who is overseeing the child’s program to discuss the changing expectations and strategies to use with the child regarding managing challenging behaviors, promoting the use of communication skills and independent living skills, etc.

The more contact the BCBA has with the parents, caregivers, and the therapists who work with the child, the better.

How do your therapists collect and report data to the behavior analysts?

Per ABA best practice standards, behavior therapists will collect data after every response your child provides/every target behavior your child engages in.

The data they collect is a crucial part of tracking your child’s progress and ensuring that their ABA program is effective in teaching new skills and reducing maladaptive behavior as designed. The data that is collected also allows the therapists and behavior analysts supervising the program to identify any areas where the child is not making adequate progress and adjust the teaching procedures as needed.  

Do the BCBAs at your company have a clinical supervisor who regularly checks for treatment integrity?

Especially as new BCBAs come into the field, they will need a supervisor who is checking in on their treatment plans, supervision methods, and data analysis to ensure clinical integrity. This will ensure that each BCBA is also being held accountable to the ethics code and standards of the science that they are bound to as ABA providers. 

How is it determined what goals the child will be working on?

It is important that the behavior analysts on your child’s treatment team are using formal assessments to determine what deficits exist in your child’s learning repertoire and that the results of those assessments drive the creation of the goals and teaching strategies utilized with your child in their ABA program.

The goals your child is working on should also be age-appropriate and should target socially significant behaviors in a variety of domain areas (i.e. communication, social skills, play skills, daily living skills, etc.)

How often is a child’s program/treatment plan updated?

Most insurance companies require an updated progress report on the child’s program every 6 months; however, the supervising behavior analysts should be making updates to the objectives and changes to the teaching procedures much more frequently than that. 

An integral part of a quality ABA program is that the data are showing that the child is consistently making progress on their goals, and if the child is not making progress, the teaching procedures should be altered as needed on a regular (weekly or bi-weekly) basis. 

What types of parent training do you offer to generalize a child’s new skills and behaviors to the home environment?

Effectively teaching a child new skills also involves taking the skills and behaviors learned in a controlled environment (ABA sessions), and transferring them to new environments, with new people. Often, this requires parents’ involvement in sessions and even data collection by parents outside of sessions. 

Observation and training for parents that is conducted by a behavior analyst in the home setting is an important part of this process. 

Is there a requirement for parent participation in ABA sessions?  Are there requirements for parents’ participation in training and meetings with the treatment team?

The more that parents can be involved and informed about their child’s ABA program, the better.  Research has shown that the children who make the most progress have parents who are involved in the process from the start. This includes having a structured and comprehensive parent training component that allows parents the opportunity to learn and practice the ABA strategies and techniques that will best support their child’s progress outside of ABA sessions.

That said, parents are often trying to juggle their own professional and personal commitments and will benefit from knowing what each ABA company will be requiring of them before starting services. 

What financial obligations will we have while participating in ABA services?

Some agencies may require that parents procure specific materials or educational resources for their children, especially if the ABA services will be conducted in the home setting.  If all or any part of the ABA therapy and/or supervision your child receives will not be covered by insurance, it is important to find out what the out of pocket costs will be for your family.  

What other services does the company offer besides 1:1 ABA intervention? Do your behavior analysts collaborate with other types of service providers?

Some ABA companies are able to offer other services that your child may qualify for such as Speech therapy, Occupational therapy, Social Skills group classes, Vocational training for older children, etc. 

While convenient, it is not necessary that your child receive all of their services from the same company. However, it IS important that the ABA therapists and/or supervisors collaborate and be open to input from other service providers so that the child’s services do not conflict with one other. 

A child whose service providers are able to collaborate and work as a team will be much more likely to reach their full potential. 

What is the process for determining when and how to fade 1:1 ABA services and what does that look like?

At some point, intensive 1:1 services will no longer be appropriate for your child and other services such as social skills groups and vocational training may become the primary focus.

Parents should be aware of how this determination will be made, what the next steps might be, and how they will be informed about such changes in the future.