Choosing therapies -- OT v ABA — The Bump
Special Needs

Choosing therapies -- OT v ABA

DS will be 5 tomorrow (sigh...) and is in kindie in an awesome ASD program.  He's previously been in self-contained classrooms and struggled, so making this switch was a great choice.  I am constantly getting reports on how good he is doing and how smart he is.  The class is 5 kids, 1 teacher, 2 aides, with OT and ST per IEPs.  He gets a lot of one-on-one time with the teacher, but will also work independently at his station on assignments.  He gets 1.5 hours of speech and 1 hour of OT through school.  OT does How Does Your Engine Run with him, and there is a sensory area in the classroom, with crash pads, spinny chairs, swings, etc. 

We have been supplementing with private therapy since he was 2.  Right now he gets 2 hours of speech, 1 hour of OT, plus private swimming lessons once a week.  So our time is pretty full.  We are in the process of getting approved for ABA through a Medicaid waiver -- he will certainly be approved, it is just a matter of completing the paperwork.  This will be to help with behavioral concerns -- bolting, hitting, screaming, etc.  So we are confronted with dropping some therapy, because the just is not enough time in the day to do everything.  DH and I already agreed to drop down to 1 private speech a week, but now I am considering dropping OT as well, with the idea being that he gets OT at school to help with sensory issues and a lot of one-on-one time working on fine motor skills with the teacher and the aides.  We're seeing less and less of the sensory outbursts that led us to seek OT in the first instance -- he is pretty good at stepping aside and calming himself when things get overwhelming.

Obviously, you don't know my kid so you can't tell me what to do.  But has anyone else had to decide between ABA and OT?  Am I crazy to think of dropping the hour of private OT?  Is there anything else we should consider before making the decision?

Zachary, 8.31.2007 * * * Adam, 3.24.2010


Re: Choosing therapies -- OT v ABA

  • Do you already have a waiver?  I only ask because my DD has a Medicaid waiver and they were telling me how great Medicaid is because it covers ABA. I was super thrilled. DD has autism/spd. Anyways, I have not been able to find any ABA programs in the area (NOVA) that accept Medicaid. Or ST, OT for that matter. 

    So I guess check into that first. And from what you have explained, it seems like you have figured out a sensory diet that works for him so maybe ABA is worth a try?   

  • The two Medicaid ABA providers to check out in NOVA are CARD (long waiting list) and PERS (  PERS is newly approved for Medicaid and did not have a waiting list for ABA -- they are who we are using.
    Zachary, 8.31.2007 * * * Adam, 3.24.2010

  • Thanks for your thoughts, Auntie.  We're seeing exactly what you say -- now being able to cope with sensory triggers.  As an example, they had an all-school water day last week, and he sat on the side, wrapped himself in a towel, and watched and laughed.  A year ago, he would have been a screaming, running mess.

    Our district does not have a pure ABA classroom.  He is in a "Multi-Interventional Program for Students with Autism." From the school website: "We implement many research-based teaching methods including discrete trial training, pivotal response training, incidental teaching, functional communication training, and social skills training. All of our instruction is data-driven and the individual needs of each child are always the top priority. When appropriate, it is the goal to have most students access the general education setting to learn and socialize with their grade-level peers."  The change between last year and this is shocking to me -- I get notes home every day about how well he is doing (my initial reaction was, "Are you sure you are writing about my kid?").

    I was shocked to find 2 ABA providers -- one friend has been getting services through CARD for months and raves about them.  Another has used PERS privately, and so I called to line up private therapy.  I was shocked to find they had become a Medicaid provider.  I am not going to cancel anything until we actually get rolling.

    Zachary, 8.31.2007 * * * Adam, 3.24.2010

  • While my son is much younger, I kbnow for us we got very little out of OT but LOVE his ABA therapist and program. It's been amazing for him! So assuming you have a good provider, I'd say to go for the ABA.
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