Making Your In-Home ABA Therapy More Effective

  • Making Your In-Home ABA Therapy More Effective

    Shanti Kurada

    ABA is often the first, and in some cases the longest intervention a child on the spectrum receives.  If implemented correctly, it can be very effective with skill acquisition.  However it is not always easy to make it work in an optimal manner.  It is important for parents to be trained in the basic principles of ABA.  Without parent competence, involvement and input, the programs may not be meaningful, and generalization becomes a challenge.  Here are some steps that would help parents work effectively with providers to get the most out of their ABA therapy.

    KNOW and Observe Your Child - Understand your child’s strengths and challenges.  Know your child’s personality, his preferences and dislikes.  The more you know your child, the more you can help shape the program to fit your child’s needs and learning style.

    Spend time interacting with your child and make objective observations about him.  Your observations should neither be excessively critical nor should you exaggerate his abilities.  Your observations should be based on what you see, not what you wish for or what you believe.

    Write Down Your Observations - Keep a journal and write down your observations.  Writing down your thoughts helps you crystallize them.  As you write down your thoughts, you may be able to clarify something in your own mind and refine your initial observations. Use your journal to keep track of any onset of new challenges or the development of new skills.

    Define Goals and Objectives - Based on your general understanding of your child, and specific observations, make a list of goals.  The goals may be things you wish your child could do (such as recognizing patterns and sequences) or they may be things you see other children doing (such as eating independence).  You could look up developmental milestones on the Internet for your child’s developmental age, and base your goals on these.

    Discuss your goals with your provider.  Your provider may explain to you why your child is not ready to work on certain goals – in this case, the pre-requisite skills need to be identified and addressed.  Your provider may suggest additional goals that you did not think of.  With your provider’s help, make your goals more specific and measurable.

    Understand the Programs - Discuss the programs that will be put in place to address goals.  Add any inputs as needed.  Programs need to be well defined and the steps clearly laid out.  For example a program that teaches matching needs to specify if 3D objects or pictures will be used, in a field of how many, and if the pictures need to be identical or not.  How many trials will be run?  What constitutes mastery?  How will the child be rewarded?  These details need to be sketched out before the program is introduced.

    Materials used for programming must be appropriate to the program and your child.  If your child has a gluten/casein intolerance, let your provider know.  For example, regular play dough can be replaced with GFCF play dough, especially if the child tends to mouth materials.

    Track Progress and Problem Solve - Track your child’s progress with the programs.  Read the communication log.

    Make a list of things to discuss at clinic time.  If your child is not progressing on a given goal, the program needs to be adjusted.  The following questions should be pondered:

    • Is the child not motivated?  Should he be working for a different reinforcer?
    • Is the child confused as to what is being asked?  Should the materials be presented differently?  Should the instruction be given differently?
    • Is the goal too difficult for the child’s developmental level?  Should pre-requisite skills be taught first?
    • Is the goal too easy?  Is the child bored?
    • Is the child’s physical health okay?  Has he been sleeping well?  Make sure he is not hungry during session times.
    • Are there other distractions in the house?  Are siblings playing or watching TV?
    • Are there any changes to routine, either at home or school, that could be causing anxiety?
    • What behaviors are getting in the way and how can these be resolved?
    • Is there inconsistency among different tutors, in the way the program is being run?
    • Is the program being run in the exact way it was designed by the supervisor?

    Be an Effective Team - Maintain a good relationship with your provider.  Listen to her point of view with an open mind.  Deal with disagreements constructively.  If you do disagree, state your point of view objectively without making personal accusations.

    Initially the parent is the expert on the child while the tutor is the ABA expert.  However over time, the parent, through observation must learn and understand the basic principles of ABA.  This is essential not only to help make the programs meaningful, but also to help generalize skills in the community.  Similarly, the tutor, over time, must gain an increased understanding of the child – not only his likes and dislikes, but also his personality.  A tutor who knows the child very well would be able to predict how a child would react in a given situation.  Thus she can anticipate and avoid behaviors, and set him up for success.  A good tutor-parent team is one that collaborates, and can do wonders for a child’s development.

    Manage behaviors appropriately - Behavior management is the most important piece of ABA.  It doesn’t matter how many skills your child acquires, if he engages in negative behaviors.  Behavior issues takes away opportunities to participate in activities with typical peers.  Negative behaviors make your child more segregated, less included, and mask his skills.

    It is very important that environmental modification be used to avoid behaviors as much as possible.  This can include the use of supports or the removal of distractions or aggravations.  When negative behaviors do occur, it is important that they be managed appropriately, and resolved in a positive, timely manner.

    Generalize to the Real World - The ultimate goal is for your child to be able to use his skills in the real world.  Make sure you understand the programs well enough to be able to help your child generalize them in a variety of settings – with friends, family, and out in the community.

    Be Positive - Maintain a positive outlook toward your child’s development.  Always set goals within your child’s reach.  Take pride in him regardless of his accomplishments and setbacks.  Take breaks from learning – set aside your worries and expectations from time to time and have fun with your child.  A happy, emotionally secure child is always more receptive to learning.

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