Parent-Led In-Home ABA Program

*Great resource: Behavioral Intervention for Young Children with Autism: A manual for parents and professionals by Catherine Maurice, Gina Green, and Stephen Luce.


 This is a very important topic that's close to my heart. I love working with families who are new to ABA therapy or Autism. I got my start in this field working with families in rural or international areas who knew very little about behavior therapy, or the diagnosis of Autism. It was challenging, but I learned a lot. Today with advances in technology, research, and with SO many parent-friendly resources available, its much easier for parents of newly diagnosed children to know what to do and how to get connected to help or resources.

Even if you never knew anyone Autistic before your child was diagnosed, its likely that you have read a book or article, or seen someone on TV discussing Autism. Yet despite all of that parents have so many questions about treatment options. Just type the word "Autism" into a search engine and watch how much information you get back. This mass amount of information can be hugely intimidating for parents who are new to Autism.

This post is specifically for families who want to start an in-home ABA program for their child. If you are in that situation there are either no providers in your area, or for various reasons you cannot access the providers in your area (such as lack of funding, excessive waitlists, etc.).

In order to be brief I will focus in on 4 critical areas: After the Diagnosis, Why ABA, In-Home ABA, and Maintaining Balance.

• After the Diagnosis- Once parents receive confirmation that their child is Autistic, there are often a series of emotions that follow. Please understand: Autism should not be viewed as some horrific announcement. Yes, Autistic children may learn, progress, and interact differently than a typically developing child but "different" and "bad" are not synonymous. After receiving a diagnosis, the truth is you are now able to access treatment options. Many treatment options are only available if your child has a diagnosis. There are just so many decisions to make and no one can make these decisions for you. The clinician who gave you the diagnosis cannot give you a "Recipe For Success" for Autism. There is no standard treatment plan of what to do next. Many new parents ask me for one, but it doesn't exist. What you want to focus on is a therapeutic method that addresses your child's unique deficits and weaknesses. That may mean ABA therapy, and it may not. When working with special needs children the goal is to help them reach their personal level of "successful".  For some children that may mean they will always require significant care across their lifespan. For other children that may mean they will eventually hold a job, live alone, and report high levels of life satisfaction.

• Why ABA?- Once you have decided on pursuing treatment for your child now you have the decision of what therapeutic method to select. Just to name a few options: Occupational Therapy, Speech Therapy, Early Intervention Services, Physical Therapy, etc. The list of treatments for Autism is ever growing, and ever changing. Certain treatment methods are dropped and labeled as "fads", and other methods change and morph into something else. What is most important when deciding on a treatment method is to look at your child's needs. What skills do they need in order to have a better quality of life? Determine your child's needs and then select a therapeutic method that will meet those needs. It is important to select a therapeutic method that has empirical data to support it, and has been proven to work with specifically with Autism. It's nice if a therapy works great for children with speech disorder, but how do you know it will work for your Autistic child? Especially if the provider has no Autism experience? I see that a lot, where my clients will begin a new therapy or enrichment program but quickly be asked not to return because the instructors don't know how to teach them/can't handle the challenging behaviors.  The treatment method should also have a method of showing progress and gains, which many treatment options out there are lacking. Without proper data how do you know the treatment is working? If you are spending hundreds of dollars on a treatment, don't you want evidence that it is working?  It is important if you are spending time and money on a treatment method that you are confident in its track record. 

• In-Home ABA- If you have decided on ABA as a treatment, you have a few choices available. Your child's school can deliver ABA treatment to your child during the school day, you can contact a local company who will send therapists to your home, or you can run the in-home program yourself. Obviously, the last option is the most labor intensive on you, the parent. However not every school offers quality ABA services, and not every family lives near an ABA company (especially if you live in a rural, or international area). Often times even if you do, the agency has a long waiting list. Waiting lists in this field are very, very common because the demand is so high. If you are considering running your child's in-home therapy program, then great for you! I love to encourage parents to take charge and not to wait around for a spot on a waiting list to come available. That may take months or even years, and that's valuable time that you could spend teaching your child. To get started you will need to assess your child's abilities, hire therapists, hire a Consultant/ BCBA, and gather supplies and materials. As far as resources and supplies, you need to know what programs you will be teaching in order to know what materials you need. A great resource on writing ABA programs is:   "Behavioral Interventions for Young Children with Autism" by Catherine Maurice.  This book is amazing, and I haven't come across a more parent friendly resource. I am also a fan of: "The Verbal Behavior Approach" by Mary Barbera, that focuses on Verbal Behavior.  Basically, Verbal Behavior is a form of ABA that focuses on communication and language being taught/increased behaviorally.  

• Maintaining Balance- Once you have your in-home program off the ground, you may find that your household has become an ever changing flow of therapists, schedule changes, meetings, and chaos. It can be a strange experience to get used to having therapists in your home several hours a day. If you have other children they may resent the fact that no therapists come over to play with them.  Juggling therapies, hiring therapists, attending team meetings...it may all get to be just too much. Its important to remember to keep a balance and to stay organized. Running an ABA program is somewhat like owning a business. You need to stay on top of staff, keep up with progress, handle hiring and firing, make suggestions for performance improvement, etc. If you are organized it makes everything so much easier. Create a system that works for you and stick to it. As the in- home program is implemented and time begins to pass, it is essential to hire a BCBA (or equivalent). If you cannot afford to hire one to completely run the program, then you can ask the BCBA for their consultation rates. You can also ask if they have a sliding fee scale, or provide a discount if you sign up with other families in your area. I find that most families seek outside help when things start to go wrong or progress stalls. Or as I like to say, for "troubleshooting". I strongly recommend if you are having issues with your in- home program, to consult with a BCBA before you make any decisions. If you don't understand why you need a BCBA, I strongly recommend this amazing blog post, from Thinkingautismguide.com.

 Below is a list of resources for starting or running an in-home ABA program. I hope they are helpful.

BOOKS

Let Me Hear Your Voice – A Family’s Triumph over Autism, Catherine Maurice
Teaching Developmentally Disabled Children – The Me Book, O.Ivar Lovaas 
Behavioral Intervention for Young Children with Autism, Maurice, Green & Luce 
Teaching Children with Autism, Robert & Lynn Koegel 
Visual Strategies for Improving Communication, Linda Hodgdon
Treasure Chest of Behavior Strategies for Individuals with Autism, Beth Fouse



WEBSITES

These websites are a great resource for parent-therapists who do not have access to, or cannot afford to hire ABA professionals.

 http://www.maximumpotentialkids.com
 http://www.rethinkfirst.com
 http://www.autismabacurriculum.com