Autism & ABA question — The Bump
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Autism & ABA question

Hi all,

I was just curious how many mom's of children with autism have them in ABA?  My daughter is 3 years old and currently is receiving around 20 hours of ABA a week and also gets 1 hour of OT & 1 hour of ST each week as addition to a little play group/preschool class she's in one morning a week.  It sounds  like a lot to me and she is slowly but surely making progress....but my question is how many hours of these therapies is your LO receiving and do you feel like it's helping?  I've read most kids should be getting 30-40 hours a week of ABA and I'm just worried maybe 20 is not enough? She is making progress, but I just can't see how we would fit much more in since she still is napping.

Any advice / experience would be greatly apprceciated.



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Re: Autism & ABA question

  • Nice to meet you.  Your twins are too cute!  My son turned three in January and receives 35 hours a week of ABA.  He goes to a clinic that offers many different therapies so he is pulled out once a week for speech and physical therapy.  The nap thing is hard because our insurance will only pay for a 20 min rest time. He is not a big napper at home on the weekends but therapy is a lot more work so he often naps after ABA.  I don't really have advice because I think what works for every child and family is different but maybe speak with the BCBA and discuss your concerns?  When we had his first evaluation the BCBA recommended full time but we were all a little apprehensive with him being only two at the time that it might be too long of a day.  So we increased his time slowly and he has been doing awesome!  You might also research what your insurance will cover.
  • DS1 receives 32.5 hours per week of ABA. He started just before he turned 3 and it was tough on him. He had stopped napping already but this program was more work than day care was so he was tired. We had a long drive home so he often fell asleep in the car and then it was kind of a disaster after he got home and we woke him up. That problem got better after a few months. DS1 also gets 2 hours of occupational therapy each week, arriving 1 hour late to his ABA program on those days.

    We are not planning to increase DS1's hours of ABA (he just turned 4). His program is 32.5 hours per week so it's not an option there and I think it is enough anyway.

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  • annibesannibes member
    edited March 2015
    Current research suggests that children with autism need at least 25 hours per week of quality intervention with low adult-to-child ratios to make good progress. Here's the cool part: it doesn't matter what intervention it is. ABA, DIR/Floortime, PLAY Project, etc- all can help the child progress. Some of the models teach parents how to work with their kids which can maximize the amount of treatment a child gets. I do not have the articles with me, I have them at work- I will look for them tomorrow.
  • @crystaleyes39 - I assume the 20 hours + other therapies was based on the recommendation in your daughter's psychological/ASD screening and diagnosis.  With this being a spectrum disorder, it should not be surprising that some children are mandated 25 hours and some are mandated 40 hours.   If you are not comfortable with the mandate you received, I would encourage getting a second opinion in the form of another evaluation from a different behavioral psychologist/psychiatrist.  

    My son was diagnosed few weeks ago and I actually have his IFSP meeting later today, but the screening recommended 25 hours (20 hours of ABA, 4-5 ST and 1-2 OT sessions).  Our psychiatrist said we should do 25 hours of ABA but it is really 20 hours from therapists and at least an hour per day of engaged involvement from us as parents.

    If you are unable to get the mandate increased, is there room to increase your involvement at home?  Does your ABA therapist have you doing a lot already, or can they guide you more?  

    On a side note, we personally want to add more naturalistic approaches on our own, to supplement the mandated therapy.  I have read wonderful things about the Early Start Denver Model, but it is not used at all by any of the EI therapists in our area.  Our psychiatrist suggested picking up the ESDM book that is aimed at parents and caregivers called "An Early Start For Your Child With Autism", which I will link below.  I do not have anything to compare it to, but I am 5 chapters through and I like it a lot!  It can take an exhausting amount of energy trying to do your own at home"therapy" but this approach makes it not like therapy at all and the ESDM method is validated by randomized clinical trials to be very effective per the Autism Speaks link below.

    As with anything else, do what feels right to you as a parent!

  • Both of my boys have been diagnosed with ASD.  My four year old is enrolled in a preschool with behavioral therapists in the classroom throughout the day.  He has one on one ABA for 2-3 hours each morning in class, and 1 hour of ST and 1 hour of OT per week.  My two year old is in a toddler class with typical peers and his teachers are not BTs, but he also has one on one ABA for 2-3 hours per day in his preschool classroom provided by a therapist and 1 hour of ST and 1 hour of OT per week.  I have seen improvements in both of my boys since starting therapy.  At times it's difficult to say whether it was just time for them to blossom in one area or another even without therapy.  But I can tell there are some skills and strategies I know have come from therapy that are working.  My four year old also used to have a lot of aggression and anxiety issues that are doing much better, which I attribute to the ABA and PCIT.  :)  I hope things go well for your little ones!
  • What is ABA? My 4 year old was diagnosed with Autism in December and we just put his IEP together. He gets speech once a week, OT once a month, and specialized instruction every other week. What is this 30-40 hours a week business? Is there something we should be doing, but aren't?

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  • ABA is applied behavior analysis. It is known as the gold standard treatment for children with autism. Many children with a diagnosis of autism are recommended to receive ABA therapy by the diagnosing physician. What treatment did your doctor recommend? We are not yet in the public school system so I don't know what ours would be able to provide.

  • I am a BCaBA and provide ABA therapy and programs for clients.  I also have a little boy on the spectrum.  Around here it is not realistic for most families to have their child in 1:1 therapy for 30 + hours a week.  I would be happy to set a family up with programs for that and train the providers and so forth if they want to do it, but typically I will do 1:1 therapy with a child for 2-6 hours a week and then train caregivers including parents.  The goal is often to really include the ABA approach in daily interactions and make the approach as naturalistic as is reasonable.  If a child is in school I will also reference their IEP and work with the school, writing in IEP goals to programs and referencing state standards (I am also a teacher).  I also think ABA works best as one components in a treatment package-- I am not an expert on speech or occupational therapy and someone else should serve that role.  I also think PLAY project can be great-- my DS receives this too.  Again, this is one intervention where the provider will work with you and train you and you can then apply the things you learn.  It might sound difficult to think how you can fit all these hours in-- but maybe think of things in segments of 5 10 or 15 minutes.  We do 5 minutes here, another 15 there, maybe 30 minutes before dinner, 15 after, etc.  When you consider how you can do ABA at the grocery store and other places you can easily see how to fit in many hours.
  • For my 2 1/2 year old, we do modified ABA 2 hours a week with a therapist, then an additional 14 hours a week with me. I've been taught how to/what to do to follow our modified program by our ABA therapist. We also integrate the concepts in to our day-to-day lives (reward chart etc during feeding and the like). DS also receives OT and speech every week.
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