Frequently Asked Questions
“ABA” stands for “applied behavior analysis”, a discipline that applies the science of behavior to create meaningful outcomes and improve quality of life by alleviating important human problems. ABA is not any single technique, curriculum, or treatment, but is instead a distinct field of practice that has defined characteristics. In our work, ABA includes the use of direct observation and measurement of the child in their environment, clear descriptions of procedures, the analysis of data to determine the effects of an intervention, and a focus on creating meaningful outcomes that generalize to new settings, people, and situations.
Through early intensive intervention, children on the autism spectrum or with other developmental needs are likely to learn skills more rapidly and successfully, resulting in greater independence and inclusion in educational settings. However, the benefits of ABA are not limited to young children. ABA can be used to address behavioral concerns and teach important skills to individuals across the lifespan, as well as to support individuals with a range of diagnoses and challenges. Our area of specialization is in early childhood, but we support our learners as they transition to school. If our learners continue to need substantial support as they age, we help families connect with the services they need.
Some criticize ABA for teaching in a rote manner that leads to “robotic” use of skills. However, effective ABA uses a variety of teaching strategies to build skills that are fluid and generalize to a variety of situations. Additionally, research in ABA has addressed important repertoires, such as joint referencing (referencing others and gaining information from people in our surroundings) and perspective taking, which enable an individual to respond flexibly in complex social situations. We strive to teach children to respond independently, advocate for themselves, and to generalize those skills in new environments and situations.
Many people equate ABA with one-on-one, discrete trial teaching in a highly structured setting. While ABA may involve one-on-one, structured intervention, many other practices fall under the umbrella of “ABA”. For example, peer mediated intervention, supported inclusion, and natural environment teaching are all examples of ABA procedures. The particular procedure, teaching format, and setting depend on individualized treatment needs, and in most cases treatment involves intervention in a variety of formats. During Cascade ABA in-home sessions, an interventionist may involve siblings and parents in a child’s learning. During clinic sessions, each child will receive instruction from at least one interventionist, and will be surrounded by peers and other interventionists in a positive social environment. During sessions in community preschools, one interventionist supports each learner in participating in preschool routines with peers.
Yes! We strive to coordinate care with other providers, such as speech language pathologists, occupational therapists, and early intervention/school providers. Since other therapy sessions are generally shorter and less frequent than ABA sessions, we ask that parents work with other providers to schedule at times that don’t overlap with available ABA sessions. We value collaboration with other service providers, and contact other providers on a regular basis depending on each learner’s needs (quarterly at minimum) to ensure consistency and share ideas.
Most health plans and the Oregon Health Plan cover ABA for children with an autism diagnosis, though prior authorization may be required. Coverage and access to ABA may vary based on circumstances such as type of health plan, age, and the state in which the plan is located, and out of pocket costs such as deductibles and copays may apply. To find out whether ABA is covered by your health plan and if we are an in-network provider, contact your health plan directly or contact our office.
Parents complete a workshop series in ABA and are asked to practice skills outside of sessions. During in-home sessions, a parent or caregiver must be home and available to help with therapy as needed. Parent input and approval is sought throughout the therapeutic process to make sure that treatment aims are meaningful and improve quality of life for their child. Parent meetings take place monthly at minimum to ensure consistent parent involvement, but can occur more frequently if parents are available. Parents who are able to be more involved are welcome to do so, since we see even greater benefits when parents practice skills outside of sessions. For early learners who don’t easily generalize skills outside of therapy sessions, we ask parents to join therapy sessions on a regular basis, so that they can learn strategies for supporting their child’s learning.
Therapy generally occurs between the hours of 8am-5pm on weekdays. We are open year-round with the exception of major holidays. Therapy takes place in home, at our clinic, and in community settings, including community preschools and private schools when feasible. The locations of sessions for each child depends on availability of clinic space, family preferences, and each child’s readiness for preschool.
It is of utmost importance that a child be a willing participant throughout therapy, often referred to as “assent”. We may provide physical guidance if a child needs help, but only if the child is comfortable with receiving help. If the child is showing signs of discomfort, we will use other strategies to help the child, such as finding a new way to present the skill, waiting for the child to be ready, or finding new ways to gain the child’s interest. Throughout therapy, respecting a child’s autonomy is critical, and we work to teach children self-advocacy skills so that they can let others know their wishes and preferences.
We believe the use of aversives to change behavior is a violation of human rights, and we believe strongly in the use of positive behavior support. We use positive reinforcement to teach new skills, and do so in a way that takes into account natural reinforcement. Punishment results in many negative side effects, does not teach new skills, and presents many ethical concerns. We never apply aversive stimuli to suppress or reduce unwanted behavior. Removal of privileges or preferred items may be used if developmentally appropriate and when appropriate to the context (e.g., taking a temporary break from a toy if it is used in an unsafe manner despite instructions not to do so), but only in conjunction with teaching appropriate skills, self-advocacy, coping skills, and other replacement behaviors.
Behavior analysts believe that we all do things for both “extrinsic” and “intrinsic” reinforcement. For example, most adults go to work to earn a paycheck, but also because we enjoy the work that we do and interactions with others during the course of our workday. A more important question for behavior analysts is whether we are teaching skills in the context of reinforcers that will support the skill in the natural environment. At times, we may need to use contrived reinforcers that do not typically follow a particular behavior. However, we must be careful that contrived or artificial reinforcers are faded as soon as possible and do not overshadow more natural reinforcers. We are also careful not to use reinforcers that may be harmful (e.g., providing candy or food out of context), and we are careful not to restrict favorite activities or items in a way that causes distress. Our job is to increase the enjoyment of our learners, not to lessen it!