8 Key considerations when choosing an ABA service provider for your child with autism

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Applied Behaviour Analysis (ABA) is an empirically validated science used to improve or change socially significant behaviours by focusing on understanding how behaviours are learned, the impact of the environment on behaviour, and learning new behaviours. The demand for ABA has grown over the two last decades and as a result, independent ABA providers and centres have multiplied.  This article is not intended as a critique or endorse specific ABA providers or centres.  Instead, this is intended to provide some thoughts on criteria to consider when choosing an ABA provider to meet your child’s needs.  I have highlighted some things that you may find important to consider as you explore your options.  

1. Is there a Board Certified Behaviour Analyst (BCBA) on the team?

You may encounter professionals who have been in the field of Applied Behaviour Analysis (ABA) for many years and are very good and knowledgeable but are not ‘board certified’.  Be wary of these individuals say things like ‘it’s just letters’ or ‘I don’t need to be certified to provide quality ABA’.  While this may be true in limited circumstances; the best providers will also have a BCBA on the team to assist with program development.  Having a BCBA as part of the team is not ‘just letters’.  A BCBA is a masters-level graduate that has completed rigorous coursework with intensive supervision to learn and apply all the skills needed to assist an individual to gain skills and decrease challenging behaviours.  BCBA’s are required to learn and demonstrate (at a high level of understanding) the behaviour principles and concepts for a wide range of challenges.  They are also bound by a code of ethics and responsibility to the Behaviour Analysis Certification Board and are required to obtain ongoing ‘continuing education units’ or training to maintain their certification.  This means that a BCBA is required to remain up to date on the practice of ABA.  They are definitely professionals you want on your team.  

2. Is your child having fun?

ABA should be fun.  Your child should want to go to therapy, they should feel comfortable with the therapist and genuinely open to being with the therapist.  This of course doesn’t mean that there won’t be challenges.  It may take some time for the therapist(s) to develop a relationship with your child. What you should observe is a therapist(s) that puts forth the effort to build a strong and positive relationship with your child.  This will go a long way toward your child’s skill development, especially when your child finds the targeted skill difficult.  Ask the provider what they do to build the relationship or “pair” with your child.  Also, watch what efforts are made to make learning fun for the child.  

3. Make sure an assessment(s) is included when beginning with a service provider.

An assessment of the child’s current skill level will help an ABA provider to target skills that need to be learned or strengthened and help determine the best intervention/strategy they believe will be most beneficial.  Be wary of service providers that tell you how many hours you require or offer you ‘off the shelf’ interventions without an assessment.  ABA is an individualized treatment.  An assessment is best practice and is required to determine what the clinical needs of the individual are.  

4. Data, data, data

All ABA providers require data collection to inform the interventions and strategies they are using.  Data is how ABA providers know if skill-building (or behaviour reduction) is occurring and also gives them information to make revisions to the intervention they are using.  If you are a caregiver to an individual receiving ABA intervention, you will be required to take data also.  Be wary of providers that do not involve you in this process.  A good ABA provider will want to know if the skill can be demonstrated outside of the therapy environment.  After all, the skills being learned need to ‘live’ outside of the therapy session into the ‘real’ world, that is the point of it all.   

5. Staff Supervision and Training 

A well-trained professional that receives quality supervision is the most important factor in the provision of high quality, effective ABA treatment.  You should inquire with a provider how often junior staff receive supervision and what are the credentials of the supervisor.  You should also know how often staff receive training.  You want to be sure that the ABA provider you choose receives regular supervision and training staff by a qualified professional.  Be wary of providers with limited supervision and training opportunities for the staff.  Providers that do not spend the time ‘growing’ their staff are likely not providing high-quality treatment.    

6. Is Caregiver involvement required?

A caregiver should be involved in the entire process from the initial assessment, program development, data collection, and assisting to make sure skills learned are used in the natural environment (school, home).  Be wary of ABA providers that do not want your input or feedback.  Parents are the expert when it comes to their child and should be consulted at every opportunity.  

7. Reinforcement and Punishment

The main difference between reinforcement and punishment is that reinforcement adds or strengthens behaviours and punishment removes or weakens behaviours.  A piece of the ethical code that a BCBA must follow states “Behaviour Analysts recommend reinforcement rather than punishment wherever possible” (4.08a of the BACB compliance code, retrieved from https://www.bacb.com/wp-content/uploads/BACB-Compliance-Code-english_190318.pdf ).  Punishment procedures can be something as simple as removing a token from a token board.  For example, whenever possible ABA providers should be adding tokens to reinforce, not removing them to punish.  Be wary of ABA providers that jump straight to punishment type procedures before exhausting all strategies that use reinforcement to build skill.    

8. Costs

You will find that the costs associated with ABA services can vary greatly across agencies.  Don’t assume that higher prices mean higher quality.  Like any business, buildings, marketing, salaries, training all impact the cost of service.  Instead, ask about the stability of the staff.  A higher turnover rate generally means that the provider is spending a lot of money on the training and supervision of new staff.  This can affect both costs and quality of service you are provided.  

In Conclusion

This is not an exhaustive list but rather these ‘tips’  you may find helpful as you wade your way through selecting an ABA provider.  I hope this information gives you the information to make an informed decision!