Is Your Provider Any Good?

It is difficult for most families to assess the quality of their ABA programs. Appropriate interventions and procedures can vary significantly, depending on a child’s age, developmental level, and responsiveness to intervention. However, regardless of these variables, families should be concerned if they observe the following conditions in their programs: 

Recommended service levels differ from evidence-based levels. Familiarize yourself with the scientific research on Early Intensive ABA (check the Association for Science in Autism Treatment website at asat.org). If your program is inconsistent with evidence-based procedures, discuss the matter with your provider. The most experienced person you see on a weekly basis has less than 36 months of experience. Effective Early Intensive ABA programs involve a curriculum of hundreds of programs delivered over the course of 2-4 years. The person responsible for the weekly management of your child’s team needs years of experience. Your child has 25-40 (or more) programs currently on acquisition. Too many concurrent programs slow down children’s acquisition rates, and make it almost impossible for supervisors to effectively manage tutors’ implementation of each program. Your staff does not have instructional control of your child. If your staff spends 50% of their time trying to coax or persuade your child into cooperating, your 40-hour-per-week program is now a 20-hour-per-week program. Skills learned under these conditions are unlikely to generalize to real- world settings. Programs are consistently on acquisition for 2-4 months, or longer. This may indicate that the programs are simply not being done, not enough time is spent on each program, that an appropriate task analysis has not been completed, or that the skills are not developmentally appropriate to the child’s current level of functioning. Programs are not presented in a developmentally-logical order. For example, conversation skills should be introduced after children are able to generate novel present-tense and past-tense descriptive sentences. Your child has a tantrum when he/she is told “no.” This may be an indication that insufficient rewards are being used, children are being allowed to repeatedly fail within programs, a task analysis has not been completed, or that developmentally-inappropriate skills are being targeted. over 

*Originally presented by Gregory Buch, Ph.D., at the Organization of Special Needs Families Conference, May 15, 2009, Cupertino, CA Are My Child’s ABA/Early Intensive ABA Services Any Good? How Parents Can Assess the Quality of Intensive Behavioral Intervention Programs 

Skills are repeatedly gained and lost. This may indicate that developmentally-inappropriate skills are being taught, mastered skills are not being integrated into subsequent higher-level programs, or skills are not being generalized to real-world settings. Your child used to be very responsive to one-to-one instruction, but now tantrums when tutors introduce new tasks. This may indicate that reinforcers have not been adapted for a child’s maturation. The impact of food and physical reinforcers tends to diminish for some children as they mature and develop a broader set of play skills and interests. This may also indicate developmentally-inappropriate tasks or insufficient task analysis. Your child knows what a quadrilateral is, but can’t tell you what he/she had for lunch. This suggests that intervention has focused on memorization skills (e.g., moving from 100 expressive object labels to 500 expressive object labels), rather than on increasing the complexity of communication skills (e.g., moving from one-word verbalizations to full-sentence verbalizations). Your program list gradually drifts into all play-based, nonverbal activities. This suggests that your team is losing reinforcement control, and is consequently reducing the demand level of the program to prevent noncompliance and tantrums. You are sticking with your current provider because you like your tutors. It’s a common mistake. Don’t overlook concerns about your program’s content and direction, simply because you are fond of the personnel who work directly with your child.