How Much ABA?

Written by Luis Vera

 

At The SEED Center, our mission is to provide positively impact the lives of individuals with autism spectrum disorder, ​therapeutic services that both across the spectrum and across their lifespan.

Whether this is your first time researching an ABA provider or your fourth or fifth time (we hope and believe this we’ll be your last stop), a frequent question that comes to mind for a lot of caregivers is “how much ABA is enough? How many hours of ABA does my child need?” The answer to that, as with many things in life, is: it depends. What I can tell you though, without hesitation, is that in the majority of cases, anything less than 10 hours a week of ABA treatment, say 1 hour a week, could/should be considered glorified babysitting.

Why do I say that? Well, think about it, if your child has multiple goals that need to be worked on across various developmental domain​s and​ for just ​one ​of those goals it could honestly take hundreds of learning trials for your child to achieve true mastery of that skill. It is very unrealistic that 1 hour a week of ABA could achieve that level of progress. Essentially, determining the ideal treatment dosage of ABA therapy for your child is a complex decision, composed of many factors that have to be considered.

Per the Behavior Analyst Certification Board (BACB), “ABA treatment programs for ASD incorporate findings from hundreds of applied studies focused on understanding and treating ASD published in peer-reviewed journals over 50 years. Treatment may vary in terms of intensity and duration, the complexity and range of treatment goals, and the extent of direct treatment provided. Many variables, including the number, complexity, and intensity of behavioral targets and the client’s response to treatment help determine which model is most appropriate. Although existing on a continuum, these differences can be generally categorized as one of two treatment models: Focused or Comprehensive ABA Treatment.”

According to the guide ‘​Applied Behavior Analysis Treatment of Autism Spectrum Disorder​’ published by the BACB, the attempt to answer how many hours of ABA therapy is described as “an analysis of multiple variables, such as the intensity of treatment goals, client needs & severity of deficits, and client response to treatment. A range of 10-25 hours/week for focused treatment and 30-40 hours/week for comprehensive treatment is recommended.” In other words, treatment dosage is based on medical necessity.

What’s the difference between Focused and Comprehensive Treatment, besides how many hours my child is being serviced?

According to the BACB, determinations as to whether ABA treatment should be focused or comprehensive and the intensity of treatment should be based on the ​medical necessity​ of the treatment for each learner rather than the individual’s chronological age, duration or nature of previous ABA services.

The following is an excerpt from an update to the guide published in February 2019 by the BACB that highlights the distinction between Focused and Comprehensive treatment.

 

INTENSITY OF TREATMENT

The Guidelines note that treatment intensity (sometimes referred to as dosage) typically comprises both the number of hours of direct treatment per week and the total duration of treatment. The comments that follow focus primarily on the number of hours of treatment per week.

Focused ABA Treatment is described in the Guidelines as”…treatment provided directly to the client for a limited number of behavioral targets[functional skills, problem behaviors].” Intensity levels in a range of 10-25 hours per week are mentioned, with the caveat that the intensity may need to be higher depending on the nature of the target behaviors and other considerations, individualized to each client. For instance, behaviors that put the client and/or others at risk of harm may well warrant high-intensity focused ABA treatment for some period of time. Those may include maladaptive behaviors to be reduced and/or adaptive behaviors that need to be developed or strengthened in order to enhance the client’s health, safety, and overall functioning.

Comprehensive ABA Treatment  is described as “…treatment of the multiple affected developmental domains, such as cognitive, communicative, social, emotional, and adaptive functioning” as well as maladaptive behaviors. The Guidelines state that intensity levels of 30-40 hours per week are common and necessary to achieve meaningful improvements in a large number of treatment targets. The Guidelines emphasize, however, that the intensity of comprehensive treatment must be individualized to the client’s characteristics and other factors. To expand on those points, we note that analyses of data from multiple studies of comprehensive ABA treatment for children with ASD show that

Whether ABA treatment is focused or comprehensive, the guidelines make it clear that treatment is comprised of services delivered directly to the child based on medical necessity which is pinpointed to the needs of every individual. In circling back to the original questions of “how much ABA is enough? How many hours of therapy does my child need?” the answer is not that simple, it depends…..on the medical necessity of your child.

 

References:

BACB Guidelines


Westport, CT

Westport, CT

Westport is one of the best places to live in the state of Connecticut. Our town got its start in agriculture, primarily structured around the onion growing industry. In the early years of the 20th century, Westport began to experience a cultural expansion. Artists, musicians, authors, and others began migrating to Westport to be free from commuting demands. F. Scott Fitzgerald, author of the Great Gatsby, settled right here in Westport!

Today, Westport has developed into a center for insurance, finance, scientific, and technical services. Our proximity to New York City, our excellent cultural opportunities, and affluent neighborhoods make Westport, CT an excellent place to live and raise a family.

Autism Services in Westport

Autism Spectrum Disorder is a complex developmental condition that affects social interaction, speech, communication, and behavior. The effects of ASD and the severity of symptoms vary with each individual person. Because some of the more obvious signs of ASD present at around 2-3 years old, many families with young children find themselves dealing with a new diagnosis.

two young boys playing at a playground

The SEED Center is here to help. We work with members of the Westport community to provide comprehensive, state-of-the-art treatment and services for individuals diagnosed with autism, including Applied Behavior Analysis, social skills training and parent training.  In addition, we are in network with several major insurance companies.  We proudly work with clients of all ages throughout the Westport area; including our home-based services and center based services in our state-of-the-art center in Stamford.


Reinforcing Behavior

            Photo by Thiago Cerqueira on Unsplash

Reinforcing Positive Behavior

Always try to reinforce appropriate behavior especially if your child is working on his communication skills. Reinforcing behavior will encourage your child to repeat the behavior. For example, your child could be working on instigating conversation, so when he instigates conversation, you want to positively reinforce.

Avoid Missing Opportunities  

Not surprisingly, it is easy to neglect reinforcing behavior. Have you ever been having a conversation on the phone and your child comes up and says, “Mommy, I want to play outside!” and you say, “Shh, I’m on the phone”? For a child working on instigating conversation, this could discourage him to start a conversation in the future. It can be easy to miss opportunities to reinforce.

Prioritize your Child’s Goals

 Always be mindful of your child’s goals. Prioritize their goals, whether it is to start conversations or speak without prompts. Although you may be frustrated when your child interrupts your conversation, remember that you are focusing on the bigger picture: for your child to improve his communication skills. Have you family and friends onboard and help them understand the language skill your child is working on. This way, everyone can help ensure your child’s positive behavior is reinforced as often as possible. Plan ahead and be ready to reinforce your child!


Holiday Tips

blue chair with holiday decorationsThe holidays are a fun time, usually filled with family and friends! However, the holidays can mean stress and anxiety. For a child with autism, the holidays mean a disruption to their daily routine, which can become overwhelming. To help, we have created some tips to ensure your family can have a fun holiday with little stress!

1. Try a Practice Run: Anticipate the holiday gathering by practicing for a large family dinner, greeting of friends and family, loud music and crowded spaces. Practice this type of environment at home and give your child tips so when they are at a large gathering, they feel more prepared!
2. Create a Method to Ask for a Break: If you do not already have one, help your child find a way to communicate that they need a break from the environment. If this method works well, use it all year!
3. Ask for Help: Talk to a close friend or family member ahead of time and ask them for assistance. Need help engaging your child while you help clean up dinner? Need help when you receive a rude question about your child’s autism diagnosis? Have your friend or family member be ready to be your assistant throughout the event!
4. Update Schedules and Calendars: If your child uses any visual schedules or boards, be sure to update these with appropriate symbols to help prepare your child for the events related to the holidays.
5. Create a List of the Unexpected: Create a list of everything new and different that could occur over the holidays. Brainstorm a method to address the unexpected events and avoid any conflicts before they happen.
6. Reflect on the Success: Recognize how much you and your child have accomplished in the past year. Relatives may especially recognize your child’s growth because they do not see your child everyday, embrace their positivity. Remember to be proud of your child and all the challenges they overcame in the past year!

Rely On Us For Autism Treatment

After this holiday season, contact the SEED Autism Center for more information on our autism treatment and therapy services. We are dedicated to seeing your child excel in life!

 Photo by Elena Ferrer on Unsplash

Ten Things to Know About ASD

little girl sitting outside in the sun1. Autism is a spectrum disorder. This means that the spectrum varies from person to person. There is a range of skills and abilities among individuals with autism. As a result, some individuals with autism are completely unable to verbally communicate and have little social skills, while other individuals may have little trouble communicating and interacting socially.
2. Autism is diagnosed using the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5). Autism is a neurodevelopmental disorder. The DSM-5 is used for treatment recommendations and to diagnose. The diagnostic criteria includes deficits in social communication, difficulty interacting with others, and repetitive interests or behaviors.
3. Asperger’s syndrome (AS) is no longer a diagnosis. AS typically refers to a person with autism who has difficulties with social interactions and communication. Asperger’s syndrome used to have a separate diagnosis from autism. However, in the DSM-5 Asperger’s syndrome falls under autism spectrum disorder.
4.Each individual with autism is unique. Although there are criteria for an autism diagnosis, individuals with autism express different characteristics and function at different levels.
5. Shows on TV usually depict individuals with high functioning autism. In many TV shows, a character with autism is depicted as high functioning. However, the reality is that the majorities of those with autism have more severe difficulties and require much more support than the characters on TV. TV does not accurately represent the autism population.
6.There is no cure for autism, it is treatable. Since there is a range or deficits in individuals with autism, no two treatments are the same. Treatment for autism is customized by the needs of the individual, their family and caregivers.
7.Applied Behavior Analysis (ABA) is the most supported treatment for autism. The U.S. Surgeon General endorsed ABA as the treatment of choice for autism. There are over 30 years of research supporting the positive effects of ABA therapy on decreasing inappropriate behaviors and increasing communication and social behavior.
8.Autism treatment is covered by insurance. In 2014, current procedural terminology (CPT) codes were established by the American Medical Association to be used to bill insurance companies for ABA treatment.
9.Early treatment yields better results. Autism can be detected early in life. It is recommended that individuals with autism receive treatment services as early as possible.
10. 1 in 59 children are diagnosed with autism. This is an increase of the prevalence of autism. It is important to be knowledgeable in order to best support individuals with autism.

What You Can Do For Your Child

Visit our site to learn more about how we can help your child with autism. We are dedicated to providing a variety of treatments and therapies to help your child excel in their life!

Photo by Melissa Askew on Unsplash

Tips to Prevent Bolting

Young girl running down sidewalkPhoto by Caroline Hernandez on Unsplash

Running and Bolting

Having a child that runs or bolts can be terrifying for a parent. When a child takes off it can be nerve-racking to think of the outcomes of their ‘bolting’ and ‘running’ behavior. Are they going to run into the street? Will they run out of the building? Are they going to take off with a stranger? The child may be ‘bolting’ for multiple reasons, she may want attention, she may want to avoid an activity, or she may seek a more stimulating environment. As parents, teachers, and caregivers, we must understand how to appropriately react to a child that runs. The best strategy is to avoid situations that permit the child to runoff, however, if this is not possible, we must minimize the amount of attention the child receives. If we give a child attention for undesirable behaviors, like running off, we are encouraging and rewarding the behavior. This means the child is likely to continue their habit of running off.

Prevent the Situation

The best way to stop running and bolting is to prevent the situation. Do whatever you can to keep the child in the classroom, house, car, etc. Once the child steps out of the safe space the chances of her bolting and running off will increase. When she runs off, it is likely that your instincts will be to chase after her. However, chasing after the child will only reinforce the behavior and increase the chances of her running off again. Although at times, it will be impossible to not chase after a child, especially if her safety is at risk. If she does end up bolting, try not to give her a lot of attention. Once you are able to reach her, calmly walk her back to the room. Also, avoid talking or lecturing her, as this will give her the desired attention, and avoid eye contact. Have the child return to the activity that she was working on before bolting.
 
If you are in a school environment, be familiar with all the building exits and have a plan with fellow staff members and security guards to prepare for a bolting situation. Again, hopefully, the bolting situation will be avoided, but if it occurs you are much better off to prepare to appropriately handle it.
 
For more resources on how to help handle different situations with your child, view our resources.


Social Emotional Learning

Engaging in social activities can be challenging but it is especially challenging for individuals with autism spectrum disorder (ASD). Individuals with ASD usually have difficulty with social emotional learning (SEL). SEL includes social awareness, understanding perspectives, initiating social interactions, controlling emotions, and engaging in conversations. At The SEED Center, we focus on social emotional learning. We help to prepare our clients for social settings, including school and work places.

Unfortunately, for those lacking SEL skills, it can be difficult to make friends, maintain relationships, instigate conversations, and transition into new environments. SEL skills are essential for children and adults. In the school setting, SEL skills help children engage appropriately with their peers. Also, SEL skills focus on social awareness. For adults, SEL skills play a large role in the ability to get and keep a job. While employers seek a talented applicant, they also look at SEL skills during the interview process to see who could work well with others.

SEL can be taught through targeting behaviors, collecting data to monitor progress, and using positive reinforcement. At The SEED Center, SEL can be improved through one on one ABA therapy sessions, social skills groups, job and life skills trainings. If you believe your child could benefit from social emotional learning, please call The SEED Center today at 203-674-8200.


Back to School Tips for Parents of Children with Autism

The new school year has started, bringing new beginnings and excitement into your child’s life! Daily schedules, routines, and expectations have changed. Also, your child is meeting new people, has a new classroom and a new teacher! For children with autism spectrum disorder, going back to school can be overwhelming and stressful. To help, we have gathered a list of helpful back to school tips that can be implemented now and for school years yet to come.

How to best support your child:

  • Stay involved and up to date on your child’s Individualized Education Plan (IEP)
  • Meet with your child’s teacher to discuss any triggers your child may have and the best methods to handle these triggers in the classroom
  • Be sure to familiarize your child with their school by providing them with a map or tour to help them locate the nurse’s office, bathroom, cafeteria, classrooms, etc.
  • Make sure your child’s clothing is comfortable and will allow them to remain comfortable throughout the duration of the school day
  • Try keep your child’s routine during holidays and breaks close to that of the school year so your child is mentally and physically prepared for school
  • Explain your child’s daily routine and use visuals if necessary so your child knows exactly what to expect each day
  • Always expect the unexpected!

How Our Autism Treatment Center Can Help:

There will be many big moments like this in your child’s life. You can’t be prepared for everything, but you can prepare for different milestones. Different situations are going to cause different questions to arise. The SEED Center helps you and your child prepare for many of life’s curveballs. With various programs and a caring staff, we are dedicated to seeing your child grow and thrive in their everyday lives. Please give us a call or browse our site for more information and useful resources!


Positive Reinforcement Strategies for Bedtime

It’s no surprise that bedtime can be very difficult for children (and parents too!) There are many guesses as to why our children fight us on going to bed on time. It could be because they are not actually tired yet, they are scared of the dark, or they do not want to miss out if older siblings or parents get to stay up later.

 

In an ideal world, our children would be able to complete their bedtime routine (brushing teeth, changing into pajamas, etc.) without many reminders. They would remember to use a quiet voice, ask politely for things, and play or read quietly in their room if they are not tired enough for bed. However, as a parent, you know that’s usually not the case.

 

So what can you do the increase the likelihood that your child will be able to complete their bedtime routine without fussing or needing constant prompts?

  1. Remember to be clear and direct (IF THEN statements)
    1. IF you go brush your teeth THEN we can read a book
  2. Use rewards
    1. Reward your child with a token if they complete their bedtime routine as desired (child brushes teeth, puts on pajamas, and turn on nightlight, etc.) Once your child receives a certain amount of tokens to meet a goal, then they can ‘cash’ in their tokens. For example, 10 tokens can mean extended TV time or a trip to get ice cream.

Whichever technique you find useful, remember to be consistent. Make sure you’re rewarding your child if they demonstrate the proper behaviors and to encourage them to be successful. Be sure to give the reward directly after the desired behavior. With your encouragement and consistent reward, bedtime should become easier for you and your child!


Distinguishing between kid-behavior and ASD-behavior

older brother playing with younger autistic brotherPhoto by Hisu lee on Unsplash

Autism diagnoses are never easy. It can be overwhelming and tiresome to learn about how to best support your child’s needs. Debatably, one of the most difficult aspects of having a child with autism is learning how to distinguish which behaviors are autism-related and which behaviors are simply related to being a kid.

Children alike enjoy playing games, expressing creativity, and so on. Likewise, children are capable of throwing tantrums, whining when they do not get what they want, and possibly engaging in dangerous behavior.

So how do you know whether or not to worry about certain behaviors? How do you know if your child’s behavior is because of their autism diagnosis or simply a factor of them being a kid?

A few ways to determine this is by answering the following questions:

-How severe is the behavior?

-How frequently does the behavior occur?

-How long does the behavior occur?

-How does the behavior of your child compare to their peers?

-Is the behavior preventing your child from learning?

-Is the behavior preventing your child from interacting with others?

Call Our Autism Treatment Center For More Help!

            Addressing these questions can help you determine whether or not your child’s behavior is due to them simply being a kid or an aspect of their autism diagnosis. If you believe that your child’s behavior is more severe and occurs more frequently than your child’s peers, you may need to address your concerns with your child’s BCBAs in order to target that particular behavior. It is important to remember that children with autism are still just kids! If you have any additional questions about your child’s behavior, please reach out to our healthcare professionals at The SEED Center.

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