Friday, July 5, 2013

Newly Diagnosed….Now what??







For years I have received emails or phone calls from parents wanting to begin ABA services for their child, and full of more questions than answers. Even for people who know what ABA can do, they usually don’t know how to get started. Most parents who contact me are confused and frustrated, and still dealing with the emotional blow of the Autism diagnosis. Some parents have told me they wish the Autism diagnosis came with a fact sheet, or road map of what to do next. That would be pretty difficult to do. Autism impacts each child differently, and an Autism diagnosis is somewhat like a gemstone with many different facets and depths to it. There is no “Autism prescription”. The treatment package will vary from one child to the next.  

Now that I have a blog, I am so-o-o-o happy to share this information with a wider audience. Information is only helpful when it is shared, so give the information in this post to anyone you may know who needs ABA therapy but maybe they’ve never heard of it, or don’t know where to start.

I'm going to generalize a lot in this post because ABA services vary so greatly based on location. Here is a generic guide of how to begin ABA therapy:

- The first thing you need to do is locate the ABA providers in your area. There may be agencies that send therapists to your home, private Autism schools, or centers where you drop your child off for therapy. If your child is under 3 there should be free Early Intervention services available to you, although early intervention doesn’t always offer ABA.  Contact the ABA providers to determine who has availability. It isn’t uncommon to contact an agency and be told there is a long waiting list. This can actually be a positive, because it means the company doesn't have adequate staff to cover cases. Instead of cramming a heavy caseload on their staff, a company will start a waiting list and take the time to hire quality staff. If there are no ABA providers in your area, I suggest starting your own in-home ABA program. Parents will often ask me where to go to find ABA therapists. There is no easy answer to that question. You may need to put up flyers on college campuses, ask other parents for recommendations, or hire non-trained individuals and pay a Consultant to train them. The average hourly rate for an independent ABA therapist is $12/hour.

-Sometimes if you get a referral or contact individuals through your insurance, the roles of ABA providers are not properly explained. Here is what I mean by that: usually an ABA Therapist and a BCBA do not perform the same tasks. Often parents contact me after getting a referral and they inquire about starting ABA therapy. I then have to explain that I provide case supervision and consultation; not direct 1:1 therapy. Which can be highly disappointing to families. Are there BCBA's who work 1:1 with clients? Sure there are. But typically, if you are new to ABA what you want are ABA direct staff first, and then once you have a team in place you want a BCBA to supervise everything and create the treatment plan.

- The next step will be securing funding. The provider will inform you if they accept insurance, Medicaid, have a sliding fee scale, offer scholarships, or they may even tell you about grants available in your local area. If there are Regional Centers in your area, they are the ones who typically pay for ABA so you should contact them first. If the provider does accept insurance, you may have to secure the funding before services can even start. This is because sometimes insurance companies take months and months to approve services, so the provider may need to determine up front that the insurance company will actually pay the claim. If you live in an area without ABA mandated services, you will need to locate funding sources yourself, or possibly pay out of pocket for therapy.

- Now that you have a provider and funding, you are ready to begin ABA therapy. Whether the provider comes to your home, or you take your child to the center/school, you (by “you” I mean all caregivers) will need to receive ABA training. For many agencies and companies this is mandatory—families cannot begin therapy until they have completed initial family training. If you are working with an independent contractor (they work for themselves, not an agency) then I highly recommend you request initial training from that person. If the independent contractor is not qualified to conduct trainings, you may need to receive training separately. It will be very important that the family learn how to apply the fundamental techniques of ABA. In order to see the most benefit from the ABA therapy, the family must reinforce what the therapists are teaching. This will be very hard to do without ongoing caregiver training.

- Lastly, what is most important about beginning ABA therapy is understanding that ABA is a lifestyle change and a commitment. It isn’t something you “kinda sorta” do. You will likely have a team of professionals coming in and out of your home several times each week, and it can be annoying, frustrating, invasive to your privacy, and overwhelming. Its also important to remember: Autism doesn’t take a day off, so ABA shouldn’t take a day off. ABA therapy shouldn’t stop because the family moves to a new home, the ABA therapist is sick, the grandparents are visiting for Thanksgiving, or because school starts. When the ABA providers are not working 1:1 with your child, then guess who is now the acting ABA therapist? That’s right, you are.

ABA is a commitment to a lifestyle change, and I can quite honestly say that parents who don’t understand or agree with that commitment do not see the progress they are expecting to see from ABA therapy.


**Quick Tip: For those of you still on the fence about if ABA therapy is necessary for your child, I suggest reading my “What is ABA?” post. 

Resource: Autism Speaks 100 Day Kit

10 comments:

  1. Words cannot express how GRATEFUL I am that you have shared so much information, examples, experiences and wisdom on this blog! I am someone who has spent the bulk of my career doing traditional psychotherapy and just made the leap into the world of ABA, of whihc I have virtually no experience. EEEK! I was hired at a small practice several weeks ago that does in home ABA treatment and to say that I feel like a fish out of water would be an understatement. It is a strange experience to go from feeling so "effective" in a past role as a therapist, to now feeling as if you have no clue at all how to be effective with these amazing children. While the company I work for is wonderful, and I have textbooks from the BCBA courses I've started, YOUR blog posts have been the game changer for me. From the examples you give, the way you blend technical terms and everyday language, IT CLICKS. After spending the past few days reading back on all your posts (and taking notes :), I finally am feeling more confident and like in time, I CAN ACTUALLY DO THIS WELL!!! Thank you from the bottom of my heart for sharing your expertise with the world. Its professionals like you that made me want to do ABA in the first place!

    ~Anna

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    1. Hi Anna!

      First of all, welcome to the world of ABA :-)

      Thank you SO much for your kind words! I really appreciate it. My blog is very fun for me, and I enjoy just giving away information to people who need it all over the world. So I am so glad to hear that the blog is helpful for you as you begin your journey into the world of ABA.

      And yes, you CAN do this :-) Good Luck!

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  2. I am so grateful for all the information on this site. Thank you immensely. I dont live in the US but I find all the information very helpful and useful Thanks alot!!

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    1. Hello & Thanks for stopping by!

      I am so happy to be able to share information with people all over the world. Please share the blog with anyone who you think could benefit from it.

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  3. LOVE THIS BLOG!!!!!!

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  4. Hi Tameika!

    I was wondering where you are based? I'm currently an undergrad and wasn't sure if I should pursue a Masters or PhD. Eventually I would like to get a PhD, but in terms of a job, I'm not sure what would be better. Also, I've been trying to find this information online, but i'm not successful! Could you tell me what the job availability is in Michigan/ the average pay in Michigan? Thanks!!!

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    1. Hi there!

      I am based in GA, Since I dont live in Michigan, I really dont know anything about the career prospects in that state.

      It can be pretty difficult to determine job availability/average pay rates in a particular area, I have found that many companies tend to be hush-hush about publicly posting salaries. It takes a lot of digging, talking to people in the field, and networking, to really determine the best career path and what annual salary you can expect to bring in. Start with the state level association for Behavior Analysis (if that is your anticipated field of study, you didn't specify so I am assuming) and reach out to people already working in ABA in your state. They are your best source for information.
      Good luck!

      Tameika

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  5. Greetings, Ms. Meadows,

    I live in the mountains of western NC with my 3 children, 2 of whom are diagnosed with ASD (3 yr old girl and 4 yr old boy). No ABAs or BCBAs anywhere near my area. Having no other options I can see, I'll need to become their ABA therapist. I'm an MSW and MPH, and I hope/think/pray I can handle it. I'm a stay-at-home Dad mostly raising them by myself. OT & speech supplied by local school system but it's insufficient. Do you ever do long-distance consulting as a BCBA?

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    1. Hello!

      I do provide remote consulting services, you can look on the right sidebar for "Professional Consultation" and click on that to get more information, or you can just contact me directly at Tameika.meadows@Gmail.com

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