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Effective pediatric ABA therapy in New Jersey

Autism Treatment

Giving Noncontingent Attention To A Child After A Long Day

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An autism parent knows all too well the exhaustion that comes with balancing life outside the home and managing their child in the best way possible. After a long day, both parent and child are tapped out. 

The child has been exposed to stimuli throughout the day, and their emotional bucket is full. For the parent, they have had to put their game face on, bat the challenges that come with the outside world, and now need to make the most of their quality time with their family. But it can feel like entering a minefield.

The Journal of Applied Behavior Analysis has published positive findings that noncontingent reinforcement can benefit both the home and school setting.

Using noncontingent attention can help you nip inevitable meltdowns in the bud by stopping them before they start. And here is how and why.

What Is Noncontingent Attention? 

Little Girl And Mother Making A Heart With Their Hands

Noncontingent reinforcement (NCR) is a concept used in Applied Behavior Analysis (ABA) and can help reduce the challenging behaviors in children with autism. This is done by being pre-emptive and providing positive reinforcement meaningful to the child.

It is not related to the behavior, but it will soothe the child enough to prevent the challenging behavior from occurring in the first place when done correctly.

Autism moms and dads know that the massive meltdowns experienced at the end of a long day are not tantrums, lousy behavior, or obstinance. Instead, it is usually a result of enormous overstimulation. Once the child is safely in the bosom of their family, any restraint they have managed to hold goes out the window. Therefore, parents usually bear the brunt. And it can be exhausting.

If a child can receive the attention and soothing they need without it always being a reward for positive behavior, then a great pressure is tremoved from them.

Contingent attention is a reward that is directly linked to positive behavior. The child must do something to earn it. For example, if they eat their veggies, they can have some screen time. This has its place, but it can put pressure on an anxious child who wants the meaningful reward despite the fact that the ask feels too much.

In contrast, noncontingent attention is not dependent on any specific behavior or action. The child does not need to do anything to earn the reward, or attention. It’s not linked to a certain action, like eating vegetables, or even a certain time or period. It’s very beneficial in letting the child know they deserve special things, attention, and rewards just because, even if they aren’t eating their vegetables or getting good grades!

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Examples Of Noncontingent Reinforcement and Communication

Mother, Father, Son, And Daughter Laughing At Laptop On A Couch

If your child is verbal and likes to talk about their day or their latest obsession, take a moment to sit down and open the conversation. This immediately alleviates the anxiety building in them before they seek your attention.

A walk in the garden, interacting with their pets, sharing a favorite snack – whatever action will speak to your child’s needs can move mountains and limit disruptive behavior.

Finding time and energy to engage in small things that your child enjoys as soon as you get home may seem exhausting. You just want 5 minutes with a cup of tea, or you want to tackle that load of washing before the next chore, but it’s essential to realize that those ten minutes of undivided attention will gain hours of relative calm.

Why Is Noncontingent Reinforcement Important?

Imagine driving home after a long day, knowing you must prepare a meal. You are exhausted and have a million other things to do, but you know that your hungry family is expecting you to get on with it ASAP. When you get home, you discover that your partner has already done it. You didn’t ask – the meal was just prepared. The relief of not having to face it yourself will spill over into the rest of your evening.

It is no different when it comes to your child. Sometimes, the thought of seeking interaction brings about anxiety. But, after an exhausting day, it may be as simple as them finding the energy to try and communicate their needs. The relief is palpable when it is done without them even seeking it.

What Is A Noncontingent Reinforcement Schedule?

A noncontingent reinforcement schedule is a conscious plan to manage and pre-empt challenging autism related behaviors.

It is especially effective if the child reverts to difficult behavior to get attention. Any attention will often do, so negative behavior is an easy way to get it.

Father Hugging His Daughter's Shoulders While She Smiles And Holds A Phone

When a schedule is in place, the child anticipates positive interaction, leading to less anxiety. It’s the same reason why children with autism thrive on routine. When they know what to expect, they feel safer and in control.

No one knows your child as well as you do. You know what they crave and scheduling these little acts of quality time will be as beneficial to you as it is to them.

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Get The Support You Need!

If you are struggling with a child with autism and need support when implementing noncontingent reinforcement, Circle Care Services in New Jersey is here to help. Our staff is equipped to help your child and your family with communication, social skills, behavior concerns, and parent training. Call us now.

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What Is Chaining & Why Is It Important?

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Many children with autism struggle with behavioral issues, which is often why parents seek out ABA therapy. Applied Behavior Analysis (ABA) is a popular therapy for treating autism and other developmental disorders. Children with autism think differently and need different kinds of support, and ABA therapy allows the child to learn skills in a more supportive environment. 

What is Chaining in ABA Therapy?

One teaching method that’s typically incorporated in ABA is something known as a behavior chain or chaining. This method, which breaks the steps of directions into instructions that link to each other (hence, the term “chaining”), allows kids to complete an entire task that they otherwise would have struggled to complete. The string of behaviors links together to create a terminal behavior.

ABA Therapist Teaching Young Boy Skills Using Chaining Techniques

Chaining is useful because it helps children become proficient in completing complex directions that involve multiple steps. Its 3 main approaches (forward chaining, backward chaining, and total task chaining) are all designed to help a child learn complex, multi-step skills, like learning to wash their hands independently.

How is Chaining Done?

Chaining works by breaking a task down into small steps and teaching each step by itself within the sequence.

Let’s use the example of a child learning to wash their hands independently. In chaining, the child might start with learning how to turn the faucet on. Once the child has learned this initial skill, the next step might be for the child to learn how to put their hands under the water. After that, the child might learn how to scrub their hands.

The child continues to learn all the steps of washing their hands until they can wash their hands completely on their own. This process is done with the supervision and guidance of an ABA therapist, who then works with the parents to ensure progress is made at home. ABA therapy is, after all, only one part of the process! It’s important for practice and progress to be made at home, so the child can get used to performing these tasks in various settings. 

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When Should Chaining Be Used?

Chaining is usually recommended when a child consistently misses or skips steps, completes steps incorrectly, or is only able to perform some of the steps.

For example, when learning how to wash their hands, the child simply touches the faucet handle instead of turning it. That would be an ideal situation to incorporate chaining. The task of washing hands would be broken down into smaller steps, including the step to turn the faucet handle, and each step would be taught by itself until the child can independently wash their hands all on their own.

Parent Showing Child How To Wash Hands With Soap Using Chaining Techniques

Another example would be the child independently turning the faucet on, rinsing their hands, and turning the faucet on, but consistently failing to get soap. Chaining would be used similarly in this example. The task would be broken down into smaller, more manageable steps until the child can perform the entire task, including getting soap, in its entirety all by himself or herself. 

How do the 3 Types of Chaining Procedures Work?

Chaining works by building off of the skills that the child already knows. Based on what steps the child has already mastered or feels comfortable with, there are different chaining methods that can be used. The following methods can be used independently, or sometimes used together to help give the child support. 

Forward chaining

This type of behavioral chain begins with the first step. The child has to complete the first step on their own, and they’re prompted for all the remaining steps. Using the washing hands’ example, the child would independently turn on the faucet, and all the steps that follow would be prompted. Forward chaining is the recommended method if the child is able to complete one or more steps at the beginning of the behavior chain.

Backward chaining 

Backward chaining is much like forward chaining, but instead of having the child independently complete the first step, you have them independently complete the last step. For example, when teaching the child how to wash their hands, you prompt the child to perform every single step except the last one (e.g., drying their hands with a paper towel), which they complete on their own.

Total task chaining 

This chain involves teaching the complete behavior chain one step after the other. Unlike forward and backward chaining, total task chaining doesn’t start or end with the child completing a step independently. Instead, the adult walks the child through all the steps, prompting whenever necessary. For some children with autism, total task chaining is too difficult and complex. Therefore, forward chaining and backward chaining are more commonly used for children who fall on the autism spectrum.

What’s the Difference Between Chaining and Task Analysis?

Chaining and task analysis often go hand in hand with each other. In fact, chaining is based on task analysis, which recognizes individual steps as requirements for the mastery of a task.

Young Boy Answering ABA Therapist's Questions For Chaining Exercise

As you well know, chaining breaks a task down into a series of small steps and teaches each individual step within the sequence. Similarly, when conducting a task analysis, the ABA therapist first needs to determine the task that needs to be taught. Afterward, they write down the steps of the task, making adjustments as needed. 

The therapist will then present the task to the student and watch their performance with each step of the task. Based on what they do and how they perform the task you gave them, the therapist is able to observe and gather insights. They can then decide which chaining techniques to use, and they start incorporating the chaining techniques. 

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Conclusion

As you can see, chaining can be a very effective way to teach children certain tasks, especially everyday repetitive tasks like washing hands and using the toilet. Because the method breaks down tasks into smaller, more doable steps, it’s helpful when teaching kids how to perform longer, more complex tasks.

But no two children are the same. Every child has their own strengths and weaknesses, and that’s why there are 3 types of chaining: forward chaining, backward chaining, and total task chaining.

Though this is most often used by therapists as a part of ABA therapy, it can also be used at home by parents. If you’re curious to get your child involved in ABA therapy, or you just want to know more about chaining, reach out to the therapists at Circle Care. We’re a New Jersey-based ABA therapy agency, and we help families of children with autism all across New Jersey. Reach out today to learn more about using chaining with your child!

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What is ABA Therapy and How Does it Work?

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ABA (Applied Behavior Analysis) is an evidence-based therapy that has been widely accepted as the primary form of therapy for children and adolescents with autism.

A Woman Helping A Little Girl Work On A Foam Puzzle

What is ABA used for at Circle Care?

ABA therapy is used to improve behaviors like social skills, reading, academics, and communication as well as learned skills like grooming, hygiene, fine motor dexterity, job proficiency, and even simple things like a child keeping his room clean.

The Goal:

To establish or increase socially acceptable behaviors and diminish or extinguish socially unacceptable behaviors that would cause the child to feel excluded from social settings and peers. 

How is this accomplished?

At Circle Care Services, one of our Board Certified Behavior Analysts, (BCBA) will:

  • Analyze atypical behaviors
  • Identify the triggers that bring on each one.
  • Outline a plan to alter the child’s experience.
  • Break down long term goals into bite-sized achievable steps which are then
    • Practiced
    • Reinforced
    • Mastered

For example:

Daniel’s mom says “he tantrums all the time” but upon analysis, his BCBA identifies that his tantrums occur when attention is being diverted from him to others. Now, the BCBA will outline a step-by-step plan to reach the desired long-term goal; developing a more appropriate way of getting attention. The plan is then implemented and skills are practiced, reinforced, and mastered.

I want to help my child.

Beginning ABA Therapy Services for your child

First, a Circle Care BCBA will set up an interview with you and your child to gather all the information needed for successful therapy sessions. 

Your child’s likes and dislikes are important for creating positive reinforcement, both through fun activities and prizes and treats.

A Little Boy Playing With Blocks While A Woman Holding A Clipboard Watches

The BCBA will then perform a Functional Behaviour Assessment (FBA). 

What is this?

  • Observing and collecting data about your child’s behavior
  • Identifying which behaviors to target in therapy
  • Create a treatment plan for the Registered behavior tech (RBT) who will actually be working with your child.
I want to start with an evaluation

What does it look like when my child is in therapy?

Once you’ve decided to pursue ABA therapy for your child, the process can seem a bit scary. You’re not sure what to expect when starting ABA, and you don’t know what a session will entail. Though this can look a little different for every child, your ABA agency will be sure to go over the treatment plan with you.

Once the treatment plan is in place, it’s time for your child to meet one of our Registered Behavior Technicians (RBTs) who will provide the individualized ABA session at each visit. 

Our RBTs work under the close supervision of our board-certified behavior analysts (BCBA) with an occasional visit to update the treatment plan when your child masters skills and new programs are added.

Our ABA therapists work towards establishing a good working and playful relationship with your child. ABA sessions should be something that your child looks forward to!

If your child is dreading the arrival of the therapist, it could be concerning, but don’t jump to replace the therapist immediately. Sometimes it takes some time for your child and the therapist to “pair” for the first couple of sessions. In ABA therapy, we call this process “pairing”.

A Woman Smiling And Holding Up A Piece Of Paper With A Smiley Face And Another One With A Frowny Face While A Little Girl Points To The Paper With The Smiley Face

Our therapists are good with children: energetic, playful, and creative enough to integrate the treatment plan into playful activities so that the work doesn’t feel like work – it feels like fun! 

This is included in what we call natural environment training: taking a skill that has been worked on in therapy and applying it to a more natural setting, like playtime. This helps your child to generalize a skill in more than one area, rather than learning it only while sitting at a desk with the therapist.

Learning Pivotal Skills In ABA Therapy

In the beginning stages of therapy, some of the most essential skills to establish are the pivotal skills that all other skills will hinge from. Pivotal skills include:

  • Motivation
  • Self-initiation
  • Self-management
  • Responding to multiple cues

Without pivotal skills, it is hard for a child with autism to focus. 

These skills are foundational, and when mastered through praise and reinforcement, your child will be likely to repeat and use them in other areas.

Children with autism who master pivotal skills are able to sit and listen and have the motivation and the self-management to work to improve communication and language skills.

This helps them grow academically and socially.

I want this for my child!

What a Circle Care ABA Session Looks Like & The Treatment Plan

How long is a session?

  • This will vary depending on the age of your child and the number of hours that are required to reach the decided-upon goals.
  • Every child is approved for a specific number of hours per week up to forty hours per week, depending on need.
  • On average, most sessions in your home will run for no less than two hours. 

Where do sessions take place?

Our RBT will choose a space to start the session based on your wishes, the child’s interest, and their own assessment of where they can be most successful to accomplish the goals of the day. 

With playful interaction, your child will warm up to the idea of spending time together at the table, in the playroom, or anywhere where your child will be able to achieve the desired outcome.

Our RBT has the tasks of keeping your child focused while running the program, entering real-time data as it occurs, and delivering reinforcement when your child responds appropriately. 

The behavior tech will also keep your child’s motivation high to keep working. The best way to do this is to be prepared by having materials ready for the session and having the work environment as distraction-free as possible. 

It is the job of our RBT to team up with the caregivers to accommodate therapy in a manner that works well for your whole family. Some of the challenges that may need to be addressed are:

  • Find a distraction-free setting where your child can be attentive.
  • Finding a place for siblings to hang out while the session is going on.
  • Figuring out if it is best for the parent or caregiver to be present or not while the RBT is working with the child. 

At Circle Care, maintaining a respectful and professional openness to accommodate each other is a very important priority.

A meaningful conversation between you and our therapist will help result in an arrangement that will be practical for your family members and productive for your child with autism. 

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Discrete Trial Training and Natural Environment Training

If a child with autism has communication skills deficits, Discrete Trial Training is commonly used to start teaching them the skills that they need.

It is an extremely repetitive type of teaching and it can be difficult to keep the child motivated without a heavy schedule of reinforcement. For example, the RBT might present a picture of a cat and say “cat” and then ask the child, “What is it?” 

When the child answers “cat”, the RBT reinforces the child with praise and smiles and whatever other reinforcers have been identified.

A Woman Sitting And Blowing Bubbles While A Little Girl Sits Beside Her Watching And Smiling

How do our RBTs know what keeps your child motivated? Is it a certain toy? A minute on the tablet? Coloring? Tickles? Bubbles? A Skittle? If it is unclear what motivates your child, the RBT or the BCBA can conduct an informal preference assessment and get an idea that way.

It can be tricky because what works one week may not work the following week. Our therapists realize the importance of remaining flexible and being ready to conduct some quick informal preference assessments when a child with autism switches things up.

As your child builds upon those pivotal skills and reaches some of the goals in communication and social skills, our RBTs will help the child to transition those skills to more natural situations. For example, a child may be able to say “ball” each time a picture card is held shown, but will the child say “ball” if the RBT holds one up and waits for the child to request it? That is the goal! To generalize the skill to give it meaning!

No Two Sessions Are Alike

Every session will be different. There will be days that are filled with successes and other days that are filled with frustration. The RBT will take careful data and detailed notes that the BCBA can look over and discuss with the RBT to make improvements, add or delete programs or change direction on something that was previously discussed. 

Because each child’s therapy is so unique, parents must receive one on one training to carry over what is being taught and practiced with the RBT. The BCBA is responsible for parent training and will steadily educate parents about what they can do to contribute to their child’s overall success. ABA is most successful when parents are willing participants in the therapy that their child is receiving. The more that parents know about how ABA works, the more successful the child with autism will be because there will be consistency in the way that everyone is communicating with each other and with the child.

Sessions can take place at home, in our clinic, and even at school. 

The most important aspects of therapy are a skilled RBT who is:

  • Keeping your child-focused
  • Taking accurate data 
  • Following the treatment plan as written by the supervising BCBA.

Our therapists are flexible, provide frequent breaks and get to know your child well enough to avoid anything that triggers negative behaviors or escalations. 

At Circle Care, we aim to make ABA a positive and fun experience for your child with ASD; one that they look forward to on those days during the week that are dedicated to therapy. The more positive reinforcement that is tied to the experience the greater success that there will be overall with the treatment plan.

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Sensory Difficulties & Winter Clothing

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Children with autism often have sensory issues that make sounds, smells, sights, and textures difficult to tolerate. When a child with autism is able to communicate and describe what they don’t like then it is fairly easy to resolve the issue. However, if a child with autism is non verbal, they may have a bit more difficulty expressing what exactly is triggering their senses.

To exacerbate the communication difficulty is the fact that sensory issues in children with autism cause them to struggle to the extent that everything else that is happening around them becomes secondary or insignificant. They are hyper focused on the sensory overwhelm, and they can’t think about anything else. They may become irrational and frustrated, acting out or tantruming all because of a material that is bothering them, and you’ll never know it.  

Many parents see this kind of behavior when their children with autism are taken to new environments, such as getting a haircut. They may not understand why their child is acting out, or what’s upsetting them. Sometimes it’s the environment, but more often, it’s actually what the child is wearing. And because it’s so difficult for the child with autism to communiciate, it is tough to recognize clothing sensitivities in children with autism.

I want to speak with an ABA therapist.

What is fabric sensitivity?

Perhaps you have experienced the following scenario: a well meaning relative buys a holiday sweater for you. To show your appreciation, you put it on. Ten minutes later, you are itchy and hot. Not only that, the label is also scratching the back of your neck to the point that it feels like your neck is being rubbed raw.

Little Girl In A White Sweater Pulling A Pink Knit Hat Over Her Eyes

Children with autism who have sensory sensitivities associated with clothing can feel very uncomfortable (as described above) with a variety of clothing and fabrics. It might even surprise you that a simple cotton shirt could be a potential sensory issue. Perhaps the label is annoying your child or maybe the shirt is rubbing against their body in the wrong way.

Take notice of how your child responds to different fabrics when you buy new clothing. How does your child respond to:

  • Cotton
  • Flannel
  • Nylon
  • Wool
  • Denim
  • Sweaters
  • Silk

A fabric does not have to be itchy or heavy to cause a problem. A light, silky material might tickle or stick to them when they sweat and cause annoyance. It will vary from child to child.

Does my child have sensory issues with clothing?

Cheerful Siblings In Winter Outfits Playing Together On A Snowy Day

A good way to determine if your child has sensory issues with their clothing is how they respond when it is time to get dressed. Children with autism appreciate repetition and rely on routine. When it comes to clothing, the reliance on repetition and routine transcends, and children with autism tend to gravitate to the same items of clothing. Sometimes this repetition is connected with comfort.

If your child has tantrums over getting dressed or seems inconsolable after being dressed, you might consider whether something that he/she is wearing is irritating him/her.

If your child repeatedly removes certain items of clothing, you might be able to determine what the common cause is with the items that he/she is removing.

I want to learn more.

How do you fix sensory issues on clothes?

The best approach to helping your child with clothing sensitivity issues is to figure out what bothers them. While there are some ABA therapy skills and sensory tools available to help them cope, the best method is to find out what material bothers them, and remove the triffer. It may take some time, and it might take some trial and error as you try to find a solution by trying various clothing items.

Here are some things to consider as you try to identify the offending fabric or item(s) of clothing that may be causing the distress:

Elastic

Young Boy With Bright Winter Clothes Looking At A Snowman’s Nose On A Snowy Day

Whether the elastic is on a pair of sweats or pajama bottoms it would be prudent to check and make sure that there are no red marks left behind. Check the waistline, wrists, and even ankles to make sure that socks with elasticity are not causing pain or/and limiting circulation. Diapers that are too tight around thighs fall into this category as well.

Socks

Check for holes that toes can slip through and hurt. Long socks that won’t stay up or short socks that roll down into shoes can be annoying.

Too Loose

Any item of clothing that is too loose can turn into frustration if the child is continually fixing, pulling up, or tripping over fabric or lacings. This is also a hazard.

Too Tight

Clothing that is too tight is uncomfortable. It can cause chafing, and in rare cases it can actually lead to small injuries like open sores.

Damp Clothing

Change a child immediately if they are in damp clothing. Damp clothing isn’t comfortable, and it can cause a chill or in some cases it can cause yeast infections. Yeast infections are associated with prolonged wearing of wet swimwear or damp underwear.

Sleeve Length

Some children don’t like long sleeves, and they will show their disdain for long sleeves by pushing them up on all of their long sleeve shirts. The same irritation can be true for any length, and it can only be determined by observing how your child responds to various sleeve lengths.

Buttons

Make sure buttons don’t dig into the belly button on jeans or slacks. 

Zippers

Use caution and try to avoid zipping skin into the zipper on pants, shirts, and jackets. Zippers can also cause irritation against the skin on certain items of clothing, and if the head of the zipper flips inward toward their skin it can be problematic. 

Static

Anyone who has put a shirt on only to find that their hair is pasted against their face can relate to this. A good solution is to use fabric softener or use a fabric softener sheet to rub against hair or clothing to tame the static. For hair, a quick squirt of hair spray on a brush and a quick brush through the hair usually calms things down.

Neckline

A neckline that leans against the throat can feel constricting. If you see your child pulling the neckline on a shirt, sweater, or jacket it is very likely due to the constricting feeling against the throat.

Labels

Labels can feel like a bolt of electricity or a hot match against the skin if they are left to rub against the skin over and over. Cut them off immediately.

Shoes

Make sure your child is wearing comfortable shoes with comfortable socks. Be sure that the shoes are neither too loose or too tight, and make sure there are no points where the shoes are rubbing and causing blisters.

Too Hot Or Cold

A child with autism may not make the best choices when getting dressed according to the weather. Be sure they can stay warm in the cold weather and cool in the hot weather. Teach them to dress appropriately for comfort.

Skin Irritation

If clothing seems appropriate and your child is still showing signs of discomfort, it could be skin irritation due to weather or a mild skin condition. Check for dry, flaky skin or mild irritation and treat accordingly.

Color

Children with autism are notorious for going through phases where they have particular preferences. For example, a child might insist on wearing only red shirts for a time and resist all other colors.

Your best strategy as a parent is to observe and teach your child with autism to communicate what is bothering them. Sometimes this is teaching them to point at something and say no.

Get in touch.

If you are struggling with a child who has autism, and you suspect sensory issues are a possibility, Circle Care Services in New Jersey is here to help. Our staff is equipped to help your child and your family with communication, social skills, behavior concerns, and parent training. Call us now. 

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How To Choose An ABA Agency For Your Toddler

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If your child has been recently diagnosed with autism, it is very likely that you are experiencing overwhelm and confusion about all of the “what next” items on your to-do list.

One of the first things that you should do as a parent or a caregiver of a toddler with autism is to take some time to process the news. Early intervention in toddlers is important, but there is nothing wrong with taking a couple of weeks to accept the news and allow time to feel all of the emotions that may accompany the news.

When you are ready, make an appointment with your pediatrician to discuss what options are available for your child, and what types of therapy services your child may need. Will your toddler need speech therapy? Physical therapy? Respite Care?

How Do I Know How to Choose the Right Provider?

It is important to identify which types of professionals you will need to line up for your child. The ideal situation is one in which all of these professionals work in collaboration with each other to benefit your child. Your speech therapist should be open to discussions with your ABA provider. Your ABA provider should be open to meetings and discussions with your child’s teachers, therapists, and medical staff if necessary.

Mother Reading A Book To Her Toddler

ABA will most likely be the predominant form of therapy for your toddler with autism each week. Therefore, it is important to know what to look for so that you can be assured that you have a reputable agency working for the benefit of your child and your family.

I would like to speak with a Professional ABA therapist.

Here are some questions and considerations to keep in mind when you are seeking ABA services:

Is your ABA agency multidisciplinary? 

In other words, is your agency willing to work in collaboration with other professionals to monitor and adjust programming for your child? Finding an agency that is willing to work with other disciplines (speech, occupational, physical, academic, psychological) is important because it creates a strong network of professionals who will help your toddler to make progress at a higher and faster rate.

Is the staff certified, trained, and frequently monitored? 

The ideal ABA agency has highly qualified staff that employs certified registered behavior techs (entry-level certification) and board-certified behavior analysts (master level education) to evaluate clients and supervise behavior techs who deliver treatment plans.

Mother And Son Underneath Fluffy Blanket

RBTs should be monitored by their supervising BCBAs at least 10% of the time that they are delivering services to your child. This means that every ten hours should have an hour of supervision by a BCBA.

Proper supervision ensures that your toddler’s treatment plan is being updated and adjusted as often as necessary when progress is made. It also assures that adjustments can be made if a specific treatment plan is not working.

Is parent Involvement allowed and encouraged?

When your child is evaluated with your supervising BCBA, your input is one of the most important elements of creating an effective treatment plan. After all, the skills that your child needs are the skills that help your toddler to function at home with family, in school with peers, and out in the community. A parent or caregiver will know best what skills their child is lacking and causing emotional, behavioral, and social stress. A reputable ABA agency will value parent and/or caregiver input. You should always be welcome during sessions whether at home or in a clinical setting.

Do they offer parent training? 

A good ABA agency will require parent training. Parent training is required because the skills that are taught in therapy need to be carried out consistently at home outside therapy sessions as well. If a parent does not learn how to work with their toddler in the same way that the ABA therapist does, the parent or caregiver may find that the child behaves one way in therapy and in a completely opposite way when the therapist leaves. It is important that everyone that your child is in contact with is helping your child in a consistent way so that the child understands his/her expectations and learns appropriate skills and responses.

Which is better? Home-based therapy or center-based therapy? 

Most ABA agencies offer both options. The decision to use home or clinical settings will depend on what fits your family’s needs better. Some things to consider:

Home-Based Therapy

Home is a natural environment for your toddler. The child can use his/her own toys, parents can observe the sessions and participate, and the therapist comes to you. This eliminates travel for you as the parent or caregiver which can be a blessing if you have younger children in the house.

Center-Based Therapy

Mother Reading To Her Daughter In The Library

Center-Based therapy mimics the school environment, allows for easier access to social skills training with other children, parents can drop their child off and run errands or complete tasks without the child (take a break), and toys and equipment at the center are new and exciting for your child.

Do they have good reviews and/or referrals?

The worldwide web is a wonderful place to find information within seconds. Just a few minutes of searching for information about an agency can easily yield enough information to give you confidence in the agency or put you back on the search for something better if you don’t like what you read.

Referrals from a trusted friend or a professional (your pediatrician or psychologist) are always best. However, if you can’t get a personal referral then your own research online is your next best bet.

I want to learn more.

If you live in the New Jersey area, Circle Care Services is a reputable ABA agency that serves many families. Circle Care offers home and center-based therapy. We are strong advocates for parent involvement and parent training and we can help you to find the resources to pay for all of the various services that you will need for your toddler.

The Therapy Place in New Jersey works in collaboration with Circle Care Services. With over 10 years of experience in speech and occupational therapy services, the Therapy Place works with children and families in a clinical setting, home setting, or in schools. 

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