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Applied Behavior Analysis (ABA) / Behavioral Therapy – Home Based

teacher conducting private lesson with a child

Overview

Applied behavior analysis, or ABA, refers to a variety of behavioral therapy treatment options that are based on the principles of behavior analysis. ABA uses scientifically-based techniques for understanding and changing behavior and is the most widely accepted approach to assess and intervene with individuals with autism spectrum disorder (ASD) or other developmental challenges or delays. This type of therapy is conducted one-on-one, is customized for each person, and is appropriate for individuals of all ages.

Our program is designed to increase language and communication, improve attention and focus, and decrease problem behaviors. We build on each person’s interests and strengths using structured and fluid opportunities to facilitate learning. During ABA therapy, skills that are useful in everyday life are broken down into easy-to-learn steps, with positive reinforcement and goal-focused treatment that meets the unique needs of each individual. At its core, ABA therapy helps individuals function more effectively in their natural environments.

In ABA-based behavioral therapy, a Board-Certified Behavior Analyst (BCBA) oversees treatment of the patient, with direct support typically provided in the home by a behavior interventionist (BI). The BCBA provides oversight through in-home supervisory visits with the BI.

Throughout the process, progress is measured to ensure the teaching approach is working. These routine assessments guide adjustments or modifications to the personalized treatment plan that may be necessary or appropriate to ensure continual progress toward goals. During supervisory visits, the BCBA works with the BI and the patient to ensure that the treatment plan is being followed and that the prescribed therapy is moving the patient forward.

Our home-based ABA services are delivered in the home. Visits are scheduled to fit each family’s needs, preference and availability.

Using Telehealth in ABA-Based Behavioral Therapy

Telehealth is used throughout healthcare, allowing patients to connect to many kinds of practitioners. Telehealth is rapidly growing in the field of ABA and may improve access to care for individuals diagnosed with ASD or other developmental disabilities. Telehealth can be as simple as using a phone, tablet or computer to connect face-to-face with your healthcare provider, similar to how you may chat with family or friends who may live out-of-town.

In some situations – like when the patient lives in a more isolated community or in an area where there is a shortage of BCBAs – the BCBA that is providing supervision may have limited ability to travel to in-home therapy sessions. In these situations, telehealth adds great value and benefit to the treatment of the patient. By using telehealth, the BCBA can remotely join sessions more often. This allows the BCBA to observe the patient, speak with the parents or other caregivers and address issues, questions, progress and goals more frequently.

When using telehealth, it’s important to note that this approach doesn’t replace the BIs who provide hands-on care during in-home ABA sessions or the in-home supervision visits by the BCBA, but instead is a way for the BCBA to provide additional supervision hours to supplement the time they spend providing in-home supervision. By increasing the frequency of supervision and communication with patients and caregivers, BCBAs can modify treatment plans and interventions more frequently, as well as regularly conduct trainings with BIs providing the direct care. As a result, the pace of treatment and progress may accelerate, with patient outcomes and satisfaction improved.

Before beginning the use of telehealth, the patient’s supervising BCBA must deem telehealth as clinically appropriate for the patient’s specific needs, and the patient and/or their family must give approval. Telehealth is not suitable in all cases. Protocols, procedures and technology that are proven effective and that maintain confidentiality and privacy are already in place. Success stories have been well documented, and service providers are preparing to expand the service to meet the needs of more patients.

Who Pays for Care

In California, healthcare insurance companies – and the health plans they offer – are regulated by the state and are required to provide coverage for behavioral health services for individuals 21 years of age or under, including coverage for treatment of conditions such as autism.

This means that if your child or other family member has healthcare insurance through a health plan in California, your insurance provider should help you cover the costs for appropriate and necessary treatment for autism and other similar conditions. That’s the good news. But benefits and coverage can vary, and even if your health plan covers treatment for autism, you still need to explore and understand the details of the specific coverage you have. If you have healthcare coverage through your employer, through Covered California or through some other arrangement, it’s important that you contact your insurance provider before beginning treatment to ensure you fully understand the specific coverage provided by your health plan.

Depending on the patient’s age, diagnosis, geographical location or type of insurance coverage in place, care for your child may be available through your local regional center. Regional centers are affiliated with the California Department of Developmental Services (DDS) and in some cases can help coordinate access to state-funded behavioral therapy services for children and adults with intellectual and developmental disabilities, including autism and related conditions. To identify and contact your local Regional Center to determine if you qualify for state-funded services, visit https://www.dds.ca.gov/rc.

Services Provided By:

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February 17, 2020 | Stephanie London, MA, BCBA, and Niki Mostadim, PsyD

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People with developmental disabilities including autism can connect face-to-face with their healthcare providers using phones, tablets and computers. This approach is called “telehealth” and it offers benefits including increased supervision and communication between healthcare providers and clients, expanded access to care, and better outcomes.

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