Applied Behavior Analysis (ABA) therapy is a personalized autism treatment that teaches both functional and behavior skills to children with autism. Because ABA therapy is so customizable, there is no single objective assessment tool for measuring a child’s progress. Outcome measurement for ABA therapy is nuanced.
How ABA Professionals Assess Children With Autism
At the beginning of the ABA therapy process, each child with autism undergoes an extremely thorough assessment from a board-certified behavior analyst (BCBA). The assessment includes multiple elements:
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The BCBA will interview the parents to learn about the child’s behavior and background. This gives the parents a chance to share details regarding timelines, behaviors, and more.
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The BCBA will observe the child interacting with his or her parents. Generally, there is no specific or structured activity. Watching the child play and engage allows the BCBA to see how the child naturally interacts and responds.
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The BCBA will engage with the child. Direct interaction yields valuable insights about the child’s needs. The BCBA may ask questions to observe how the child responds, whether verbally or non-verbally.
Once the assessment is complete, the BCBA will review all the gathered observations and data. BCBAs may use several different assessment tools and benchmarks to qualify the data, depending on the child’s age, behaviors, and other criteria.
The BCBA uses all this information to create a personalized autism treatment plan. Each child’s ABA treatment plan will be totally unique based on his or her needs, age, and other key factors. The treatment plan includes:
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A comprehensive outline of the child’s background and current abilities, based on information gathered in the initial assessment.
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Goals for treatment, such as desired skills to learn or maladaptive behaviors to address.
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The exact steps to achieve each goal, broken into bite-sized pieces.
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Timelines for each goal.
The BCBA is required to supervise 10% of the child’s treatment. For example, if a child is receiving 25 hours of ABA therapy every week, the BCBA will be present for 2.5 of those hours. This gives the BCBA ample opportunity to observe the child’s progress directly.
But most of the treatment plan is executed by a registered behavior technician (RBT). The RBT will work with the child directly over the weeks and months, implementing each step of the treatment plan and reporting back to the BCBA.
Formal progress assessments are conducted every six months throughout the child’s ABA therapy program. Many of the same benchmarking tools are used for objective measurement of the child’s progress. Anecdotal, nonquantifiable data from the BCBA, the RBT, and the parents will also be considered. All this information is used to adjust the next stage of the treatment plan.
What Do ABA Therapy Assessment Tools Measure?
BCBAs may use several different assessment tools and benchmarks to qualify the data, depending on the child’s age, behaviors, and other criteria. This might include:
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Progress toward a specific skill. For example, if a child is learning how to put on a pair of shoes, an assessment tool might measure how many steps of the process the child has mastered in a given timeframe.
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The frequency of maladaptive behavior. The RBT, the BCBA, and the child’s parents may keep a record of how often a child has a maladaptive behavior and chart whether it’s occurring less often.
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Stress levels in the child’s parents or caregivers.
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Social skills or social responsiveness. This might refer to the child’s progress toward saying “hello” to a classmate or reacting appropriately to body language.
Every child’s ABA treatment program will be highly customized based on his or her specific needs and developmental milestones. ABA therapy professionals use a variety of flexible tools to ensure that every child is being assessed accurately so the next stage of the treatment program is planned appropriately.
To find out what it means to get an official autism diagnosis, click here.