What are Some Red Flags I Should Look for in an ABA Provider?
While we would love to tell you that no one has ever delivered subpar ABA services, this unfortunately is just not the case. In order to prevent you from getting into one of these situations, here are a few red flags to look out for:
Red Flag #1: Cookie-Cutter Programming
“Cookie cutter programming” is a broad term I use when looking at past programming experiences to describe programming that is not individualized to the needs of each individual. For example, if one of the goals you are wanting to address is increasing independence in their daily life, ask your potential BCBA how they normally teach these skills. If the answer uses more than a few general statements, this could be an indicator that they might not be tailoring their program to fit the needs of each client, but rather relying on what will simply “get the job done.” With any ABA provider, you should insist that your loved one’s goals are tailored specifically for them. After all, we are dealing with individuals on the Autism Spectrum and they are not exactly alike. You deserve for your child’s needs to be addressed specifically and not generally.
Red Flag #2: Large Caseloads
One of the first things I would recommend asking any potential BCBA is what their current caseload size is and what their maximum caseload size is. This is one of the most telling ways to predict how hands on your child’s BCBA will be in their treatment. Generally speaking, once the caseload exceeds 10 clients, the face time the BCBAs have with each client drastically decreases. Obviously there are exceptions to every rule, but this is a good thing to be on the lookout for!
Red Flag #3: Infrequent Face-to-Face Supervision
Infrequent face to face supervision is another red flag you want to be aware of. If you are in a clinic setting or receiving in-home services, it is very important to know how much time your child will get of direct supervision from the BCBA per week. Minimally, your child’s BCBA should be providing supervision to your child for 10% of their therapy hours. Again this is another rule that will likely have exceptions as well due to a variety of factors, but will be important to take note of.
Red Flag #4: Swift Punishment Procedures
Frequent or quick use of punishment procedures is another red flag to keep an eye out for in ABA providers. While there is a time and a place for these procedures (with caregiver consent, of course), they should always be a last resort. This is due in part to the stress it puts on the learners, but also because punishment is not an effective tool for long term behavior change. B.F. Skinner, the father of ABA, perfectly summarizes this in his 1963 book, Science and Human Behavior. The basic idea that it all boils down to is that while punishment can decrease behaviors in the short term (under ethically questionable circumstances), it does not maintain this change once the punishment stops. An easy example to point to is a child who grows up in a very strict environment, then when they go off to college they drink and party their education away. These types of things happen because there needs to be an alternative behavior that is being strengthened to replace the behavior that is being targeted for reduction.
Red Flag #5: Lack of Antecedent-Based Procedures
A lack of antecedent based procedures is something that we feel very passionate about at Foxhole Therapies. While we know the use of consequence procedures (reinforcing behaviors we want to increase and withholding reinforcement for behaviors we don’t want to see) are a vital component of ABA, they are not the only tool that we have as clinicians to change behaviors. The use of antecedent based interventions is highly valuable because it identifies why the behavior is occurring, then alters the circumstances to prevent it from needing to occur. This is a highly effective and minimally invasive way to change behaviors that almost immediately benefits the learner, the clinicians, and the caregivers.
Red Flag #6: Lack of Parent Involvement and Consent
Lastly, if you, as the parent or guardian are not being actively involved and consenting to the treatment your child receives, this is a HUGE red flag. Not only is informed consent a part of our ethics code as behavior analysts, it also is vital to ensure progress that is made in the clinical setting can continue. Gaining informed consent helps to prevent potentially traumatic situations for the learners and improves their relationships and trust with the clinicians. As a guardian of a child with Autism, you know your child best. If something ever feels uneasy or harmful, you can and should question it until you feel comfortable or know enough on the topic to decide if you want to continue. There have been countless reports of adults who grew up in ABA that are now coming up and explaining the trauma they endured due to a lack of consent. If you do not feel that you are being actively informed of your child’s treatment, you have every right to ask why not.
Foxhole Therapies: We’re in this together!
We know that this topic can be touchy and scary, but our hope is to be able to show you what ABA can and should look like for your family. If that is something you want to learn more about, we would love to hear from you. Email firstname.lastname@example.org to learn more about how we can be in this together!