Applied Behavior Analysis at the Boh Center

We believe ABA should be used in a way that helps the individuals we work with meet the goals that are important to them, sets them up for future learning, and helps them to access and participate in activities and with others in meaningful ways to them. Our ABA program involves caregivers and family members in the goal setting process from the onset of therapy. When the individual receiving therapy is able to, they are also an integral part of the goal setting and intervention planning process.

We believe ABA therapy can and should be person-centered. We strive to achieve this goal by tailoring our therapy services to the individual’s wants and needs. We value family input and we work with families and individuals to ensure that we are addressing their priorities through all of our work. We begin our therapy process by gathering detailed information about our patients’ strengths and areas that might benefit from some level of support and teaching. This information is gathered directly from the patient through direct conversations (when possible) and by observing the things they say, do, or express through their emotions. Parents and caregivers are also important sources of information during this process. During our goal setting process, we work with families and individuals to determine the areas in need of support. We provide education as needed and believe that it is important to focus on goals that are pivotal for future learning.

We believe it is important to tailor the type of therapy and the number of hours to what is truly needed and what any given individual is likely to benefit from. We do not believe that all autistic individuals or other individuals seeking ABA need the same number of hours of therapy. We also do not believe that every autistic individual or other individuals seeing ABA need the same types of therapies, including ABA. We know as a general rule more is better, but we don’t know how much is optimal or how much is too much. We are working hard to figure out the best system for suggesting how much therapy is needed for any given individual. Our providers carefully consider several factors when recommending an amount of therapy: age of the child/individual, number of skill areas in need of support, family and individual desires about therapy time, and the environments that therapy services will occur in. We currently offer a range of focused and comprehensive services that vary in hours from 1 to 3 hours per week up to 25 hours per week based on the individual needs and preferences of our patient and their caregivers.

We believe it is crucial for caregivers to learn ways to support growth and progress at home. This is done by teaching caregivers ways to teach and support their child or family member naturally throughout the day during the routines and activities they regularly have. This provides increased learning time for the child or individual, but also focuses on teaching them in a very natural way that helps them to learn how to do things within the contexts of when it needs to happen. At the Boh Center, parents and caregivers are always invited and encouraged to be participants in our sessions. In addition to regularly scheduled coaching sessions, parents and caregivers have the option to be present in the room, watch through a 2-way mirror, or take the lead in teaching during all sessions. When therapy is provided in community settings, all teaching takes place during the natural routines and activities occurring in that setting.

We believe our patients should have access to an enriched environment within and outside of specific therapy sessions. We take care when setting up a therapy environment, whether it be within our clinic or when providing services in community settings. We believe the individuals we work with should have access to the same stimulating and fun environments that all individuals their age do. However, we also work hard to ensure that those enriched environments are tailored to the desires and needs of our specific patients. We ensure that all environments we work in include toys, materials, and activities that interest our patients and are things they want to play or engage with. We also work to make needed changes to those settings to address any physical or sensory needs our patients may have.

We believe it is important to ensure the level of difficulty of the skills worked on through therapy sessions is manageable for the individuals we work with. We break skills down into manageable pieces and work to build a foundation for more complex skills a person may need as they get older. These steps are taken ensure that the individuals we work with do not feel that they are in a constant state of frustration during learning. Our providers ensure that skill building sessions are balanced with tasks that allow the individual to feel successful.

We also believe it is important to help our patients learn ways to appropriately refuse or advocate for things they do not want to happen. We do this by teaching appropriate refusal behaviors that are not harmful to individual or others around them to ensure they have a way to tell us when they don’t like something or want something to stop.

We believe in the value of a multi-disciplinary approach to therapy and work to integrate information from other therapies into our sessions. We attempt to regularly discuss therapy goals and progress with other disciplines and ask for consultation as needed. We also provide consultation to other therapies as needed and requested. For example, as we work to build communication skills for a patient, we incorporate those strategies being used in the person’s speech therapy sessions. This often includes sign language or modified sign language, picture-based communication, or speech generating devices. When we begin ABA with a patient who does not have a speech therapist involved, we often use a multiple strategy approach to see which way of communicating the person we work with prefers while waiting for specific guidance from a speech therapist.

We believe it is imperative to work to reduce and/or eliminate harmful behaviors the patient may display. There are times when our therapy sessions focus on reducing or eliminating harmful behaviors. The behaviors we focus on in these types of programs are those that have the potential to cause property damage or injury to the person or others around them. We might also focus on behaviors that create safety concerns for the individual. Often times these behaviors are those that may lead to considerations of loss of access to community and preferred settings or activities. It might include behaviors that have become barriers for the person to be able to do the things they enjoy. We view any behaviors considered harmful or challenging as forms of communication. We take steps to determine specifically why a person is using these harmful behaviors. We look at things in the environment that may be contributing. We look at things within the person that may be contributing. And we look at how others respond to the behaviors that might be contributing. This information is used to find ways to change the triggers of the behavior when possible, to teach a less harmful way for the same need to be met, to teach a more effective and less harmful way to tell others what is needed, and to help others respond to the person with dignity and care and in a manner that helps reduce the chances that the behavior continues to happen.