What to Expect
As a parent of a child diagnosed with autism, we understand that you have already experienced numerous appointments, assessments, intakes, and interviews. This process can be confusing and overwhelming. Once you make it through the diagnosis and referral process and are ready to start ABA, you are faced yet again with another interview and assessment. We want to give you an idea of what happens during the assessment process. This process may look different for every individual, but the goal is always to get an idea of your child’s skills and behaviors in a calm, low-stress environment. We want you to feel comfortable and knowledgeable about what is happening in your child’s assessment, and we hope that after reading this you will feel just that!
Documentation Collection
Before coming in to begin the direct assessment process, certain paperwork will be required. You will be sent a lengthy intake packet which details background information, including medical evaluations and developmental history. After a clinician reviews all relevant records, our office will contact you to schedule an in-person direct assessment with one of our Board-Certified Behavior Analysts (BCBAs).
Assessment
There are multiple forms of assessments we use in our ABA assessments; these include:
- Interviews and Checklists from the parents
- Standardized tests, like the Assessment of Basic Language & Learning Skills (ABLLS-R) and the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP). These are two commonly used assessments that provide a general idea of the individual’s basic independent living and communication skills.
- Direct observation or observing what the individual does while taking objective notes.
Parent Interview
We want to get to know your child and your family! During this interview, which can last anywhere from 1-3 hours, we will discuss many topics including your child’s strengths and areas your child needs help with, what your child likes and doesn’t like, and goals you have for your child in the future. You may also be asked to fill out surveys or checklists about your child’s social skills, behaviors, etc. We want to know your child on ALL levels. Which means learning their interests, preferences, and the things they are wonderful at doing, as well as the challenges! We want to know your child as an individual and look forward to nurturing the positive aspects of who they are while helping you and your family target the skill and behavioral aspects that need modification.
Skill and Behavioral Assessment
What do we do with your child when we take them back for their assessment? Depending on their age, functioning level, and independence most of it is spent playing! The clinicians running your child’s assessment will have a predetermined set of skills they want to observe, which will help them determine a starting point for therapy. Throughout the assessment, they will use contrived learning opportunities to see how your child responds while taking data on their responses, but there is no correction if they answer incorrectly. We simply want to see what they know! For children who can sit and work for longer periods of time, this may entail them working through a book of pictures and answering various questions with breaks to play in between, at which time the clinicians can gather useful information about their play and social skills. For children who are not able to sit and work for periods of time, the entire assessment will be conducted while they play. For example, the clinician may hold up a stuffed animal your child is playing with and ask what it is to see if they can label the animal.
Treatment Plan Creation & Review
The complete onboarding process for a child may span from six to eight hours in total. This encompasses a comprehensive review of records, both direct and indirect assessments, a thorough analysis of the assessment results, and the formulation of an intensive treatment plan. Typically, an individualized treatment plan encompasses anywhere from 70 to 125 goals.
Following the treatment plan creation, the clinician will meet with you to review the assessment results and make a prescriptive recommendation of ABA treatment including 1:1 time with a Behavior Technician, supervision with your BCBA, and parent consultation to be sure parents are learning alongside their child. Moderate to severe symptoms of ASD require more recommended hours to meet the child’s developmental goals.
ABA therapy for your child is reinforcement based. When your child completes a task correctly, demonstrates positive interactions, or makes approximations toward a treatment goal, they’re given a reward to motivate repeated practice and develop a behavior repertoire. Studies show behavior is more effectively motivated by achieving something of personal value. In instances of problematic behavior, your child does not receive reinforcement and instead, the opportunity is used to teach a socially appropriate behavior as a replacement then followed up with reinforcement. A great example of this is increased communication. Many children on the autism spectrum engage in challenging behaviors as a form of communication. Rather than accepting a tantrum as a form of communication, the ABA team will teach your child to engage in communication through words and other appropriate actions.
Parental Involvement
Another important aspect of the treatment plan is the involvement of parents and other caregivers. You and your child’s support team (grandparents, etc.) will be updated and receive training in the strategies used in ABA. Through periodic meetings, you receive insight into the ABA team’s strategies, goals, and your child’s progress. Parents and caregivers should view this information as a teaching guide with instructions for measuring progress. These parent consultations also educate on safely minimizing the reinforcement of challenging behaviors such as tantrums or self-harm.
Ongoing Evaluation
A formal reassessment and progress report is generated and reviewed with the family every 6 months. During this reassessment, the BCBA carefully considers the child’s response to intervention and determines whether titration of services is deemed necessary. Transition planning to a less restrictive service is also taken into consideration at this time. BCBAs are constantly analyzing the effectiveness of treatment strategies and incorporating new tactics and new goals as appropriate.