How do I Choose a Qualified ABA Therapy Provider? Learn from a Hopebridge BCBA

BCBA Oascha Cross Shares Questions to Ask When Selecting a Provider for Applied Behavior Analysis

All parents want to do what is best for their children. These choices start before they are born, when choosing what to eat during pregnancy, selecting a name, then a crib, a pediatrician…the decisions are never-ending as they get older and each seems more important than the last! When you have a child with autism spectrum disorder (ASD), however, one of the most significant decisions you can make (besides choosing to schedule a diagnostic assessment) is selecting your child’s applied behavior analysis (ABA therapy) program.

If you are in this position and do not know where to start, let our Board Certified Behavior Analysts (BCBA) give you an insider’s perspective. In the latest article in our BCBA Series, Hopebridge Regional BCBA Oascha Cross outlines key aspects parents should review when selecting the best ABA therapy program for their children. Within her guide, she shares some of the top questions to ask providers, as well as some questions to contemplate themselves.

BCBA OASCHA CROSS ANSWERS: ‘I DON’T KNOW HOW TO CHOOSE AN ABA PROVIDER…WHAT FACTORS SHOULD I CONSIDER?’

ABA therapy will have a huge impact on your child’s life, as well as that of everyone in the family. Starting the process can be exciting and nerve-wracking all at once, and knowing where to begin in your search can be challenging. Besides focusing solely on the most convenient location, shortest waitlist or insurance acceptance (while all still valid!), here are the main considerations I suggest parents look for when seeking an ABA provider that is the best match for your family:

Research shows children learn better in a center-based intensive treatment model

ABA Environment
Choosing which setting is best for your child is a personal decision and there are a number of factors to examine. Therapy settings include centers, in-home and schools.

• Center-based therapy
  Of course we are partial to center-based therapy at Hopebridge, as research shows children learn better in a center-based intensive treatment model. When reviewing a center, consider whether you can provide appropriate transportation, as well as all the advantages that might outweigh a longer travel time, if there is one. Think about the ability to have multiple services in one place, access to peers to build play and social skills, and the availability of novel toys, equipment and staff. Does this center give parents access to observe their child in the space where he or she interacts with staff and other children, and is parent training available? Schedule a tour, and then take into account its cleanliness, presentation of staff, and overall, how “alive” it feels. These are the spaces your child will spend most of his or her time… are the rooms bright and colorful; full of energy, laughing children and smiling staff? You want to feel secure with your choice, and your first impression can make or break it.
• In-home therapy
  On the other hand, a home-based program requires no travel and parents have the ability to observe the Registered Behavior Technician (RBT) at all times, while also having easy access the materials used during therapy. While this is can be a positive aspect of home care, it can also provide challenges for parents who work or have other children, as it also requires a guardian to be present in the home at all times. With an intensive treatment model, that can mean someone outside your family is in your home for up to 35 hours a week. It can also be difficult for parents to distract themselves during high behaviors. When your kid is crying, it is natural to want to be the person who holds them and tells them everything is going to be ok. Unfortunately, since that can affect therapy, it may take some extra distractions to disconnect from what is happening in the next room. This type of therapy setting has low social interaction, so ask yourself how important social skills with peers in a group environment are to you.
• Therapy at school
  Some schools offer aides that may have experience in ABA therapy. This can be a good option for families who want their children to continue an education curriculum. Like center-based therapy, it offers elements like peer interaction, schedules, a lunch time routine and instruction with group settings, and also has the potential for other services. The challenging area for school-based therapy is it is not as comprehensive, nor do many school programs have BCBAs on staff to lead the curriculum. Those that do have BCBAs tend to work more with kiddos who have behavior or conduct issues, so some children may not get as much attention or an individualized treatment plan that tailors to an ABA model. For this reason, many parents opt for a more personalized, center-based approach as school preparation before entering the classroom.

Services Offered
If your child needs more than ABA therapy, evaluate how each service will fit into a daily or weekly schedule. Does this ABA provider offer other services, like diagnostic evaluations, speech therapy and occupational therapy (OT)? Some, like many of Hopebridge’s centers, serve as a one-stop shop, where parents know their child can get everything he or she needs in one place.

If the provider is not able to provide other services internally, how do they collaborate with others for the good of the child? For instance, how flexible are they and do they allow breaks in the middle of the week for a patient who requires other services? Are they willing to integrate skills into the other service’s world to increase generalization into daily life? Will they work with recommendations from another external provider?

As BCBAs, we want to be able to do it all, but often need to rely on a multidisciplinary team that makes transitions stronger in all aspects of the child. Prior to serving as a regional BCBA for Hopebridge, I helped open one of our centers in Cincinnati, Ohio. We do not yet offer all of our Hopebridge360 services in that center, but were encouraged by our leadership team to make time for their outside services in the schedule. It was our responsibility to collaborate with those providers in order to give families the best possible experience and chance of success. Now that I lead multiple centers in my assigned region, I am able to view how collaboration works seamlessly in some of our other centers that house multiple services, like OT and speech. I am proud that no matter which Hopebridge center families choose, we can provide the best of both worlds.

It is important to look at the resources and experiences of the company as a whole and the experience of the staff that will be working directly with your child.

Company Size and Experience
Both size and experience can affect the quality of therapy, but it is not the end-all-be-all. Small centers do not necessarily equal little experience, but the growth of a larger autism therapy network like Hopebridge can play a big part in how services are provided. Hopebridge has been on both sides – starting as a small, community autism clinic in Indiana, and now is a multi-state network with a team of hundreds across the country. Through that growth process over nearly 15 years, we have been able to find holes in the model and fill in any gaps. That size and experience enables us to build a team of professionals that includes Care and Benefits Coordinators, executive-level staff, regional BCBAs and more, which allows direct therapists and BCBAs to focus solely on the kiddos.

Not only is it important to look at the resources and experiences of the company as a whole, but also the experience of the staff that will be working directly with your child.

Some questions parents may want to ask when interviewing providers include: “What is your experience with my child’s specific challenges?”  “What assessments do you use?” “Do you specialize in any areas, such as potty training?” and “How do you maintain your knowledge and requirements in the field?” When answering, do they contribute with responses you understand and are comfortable receiving? It should not be taboo to ask these types of questions when it comes to your child’s success.

Your Child’s Therapy Team
When selecting your child’s ABA provider, consider who is on the team and how they are trained. Is it a sole practitioner or a group of individuals collaborating on goals?  At Hopebridge, for example, in addition to the RBT and BCBAs, we also have a supporting role within each center – an ABA trainer – who is specifically dedicated to ongoing training to make sure staff is always ahead of the game. Parents should feel comfortable asking how staff is trained and how they maintain their credentials.

It is also important parents feel comfortable with their child’s direct therapist, so ask to hear the provider’s pairing process. At Hopebridge, we attempt to make sure our children are paired appropriately with staff. Each team member is competent and has the knowledge, but the energy between the therapist and child needs to also be there. We want to make sure there is a connection and take this into consideration when creating individualized therapy teams.

Understanding what age range the provider has experience treating because it can play a huge factor in the environment, tools, peer interaction and overall outcomes.

Program Focus
Learn the focus of the program. Some providers gear programs toward early intensive behavioral intervention, like Hopebridge, while others may specialize in adolescence. If it mainly focuses on ages 2 to 10 and the individual is 15 years old, this provider may not be the right match. Parents should understand what age range the provider has experience treating because it can play a huge factor in the environment, tools, peer interaction and overall outcomes.

Parent Training
As parents, you are the most important people in your child’s life, so make sure there is a role for you. Like our BCBAs at Hopebridge, providers should be trained to work off of parental input to create goals for the kiddos.

Qualified ABA providers should offer effective parent training that empowers you with the strategies or tools to work with your kiddo to apply skills at home. Ask how often parents meet with the therapy team. What systems and processes are in place to give parents an idea of the child’s progress? Ensure there is a path to obtain your own knowledge and in-home application of some of the most basic skills.

Extra Support
Some providers offer extra support for parents and staff that can enhance the effectiveness of therapy, so take the time to understand what is available. For instance, the Hopebridge team includes an ABA director, regional BCBAs and a team of more than 100 BCBAs who can link to each other for clinical overview and support, plus an experienced clinical support team on the back end to support behavior analysts on especially challenging cases or extenuating circumstances, as needed.

Additional management and administrative roles, like those in the full-service insurance, billing and intake departments, not only help therapy teams focus on what they do best – ABA! – but also exist to take pressure off parents. They happily handle referrals, obtain authorizations and troubleshoot so parents do not need to manage the extra work.

TAKEWAYS FOR PARENTS

Look at the quality of the company, experience, credentials and history. This is one of those cases where there is no silly question. You need to know your child is safe and progressing toward the best life possible with this provider, while also ensuring it is a good fit for your family overall. If you meet with a provider and do not feel comfortable voicing your opinions, it may not be the right place for your child.

If you walk into a Hopebridge center and immediately smile after viewing all the cuteness, we are probably the right fit for you! That gut feeling plays a large role. Considering the services work for you, feeling good about a place can be the ultimate determinant.

Oascha Cross, Hopbridge Regional BCBA

LEARN MORE

Oascha Cross began with Hopebridge as a BCBA working out of the Miamisburg center in Ohio and now acts on the autism therapy network’s clinical leadership team. She strongly believes in serving not only the children, but the families of those she treats. As a result, she uses her experience to proactively advocate for parents and shape programming in new centers as Hopebridge continues to grow. In addition to ABA, Oascha also specializes in yoga therapy for individuals on the spectrum.

If you are interested in finding out for yourself whether Hopebridge is a match for your child, please get in touch with us to visit a center near you for a tour.