Category: Blog

Applied Behavior Analysis (ABA) is a common type of therapy for people with autism. We know that parents can have a lot of questions about ABA therapy before they feel comfortable making an informed decision.

Therefore, we’ve put together this guide explaining what is ABA therapy for autism. This is based on the questions that parents ask us on a regular basis here at Golden Care Therapy.

What is the purpose of ABA therapy? 

Applied behavior analysis therapy focuses on improving specific behaviors and skills in people with autism. Some of these behaviors include:

• Social skills
• Communication
• Reading, studying and academics
• Fine motor dexterity 
• Hygiene and grooming
• Domestic activities

How does it work?

ABA treatment is based on proven scientific theories from the behavior field of psychology, such as operant conditioning and Antecedent-Behavior-Consequences (ABC). Essentially, ABA seeks to encourage desired behavior through a system of rewards and consequences.

Here’s how it works in practice:

• An ABA therapist identifies a needed skill
• As the child engages in the desired skill or appropriate behavior they gain access to reinforcing items.
• Over time, these rewards encourage the child to continue engaging in the targeted skills   

Where do therapy sessions take place?

Session locations will depend on the therapy provider and your requirements. They can take place in the home, at daycares or within therapy centers. Here at Golden Care Therapy, we specialize in in-home and community ABA therapy, as well as social skills groups.

what’s the recommended amount of aba therapy?

There is no recommended amount of ABA therapy. However, weekly therapy typically ranges from 10 to 20 hours.  

Who provides ABA therapy and what training do they have?

ABA therapy services must be provided by a Board Certified Behavior Analyst (BCBA). A BCBA is not a physician, however the training and qualifications requirements are vigorous and include:

• A masters or PhD in psychology or behavior analysis or education.
• Passing a national certification exam
• Seeking a state license (in certain states)

The BCBA writes each treatment plan and then works with Registered Behavior Technicians (RBT) or behavior technicians, who deliver the therapy. 

What’s an ABA treatment plan and how does it work?

You will hear the term “treatment plan” used a lot in applied behaviour analysis therapy. A treatment plan is a written document that lays out structure of your child’s ABA treatment.

BCBAs use interviews, assessments and observations to create individual treatment plans. This is a collaborative process which parents are involved with throughout.

The treatment plan with contain specific treatment goals. Your child’s ABA therapy will then be based around these treatment goals. To ensure that everyone involved with your child’s development is on the same page, it will also contain strategies for parents, caregivers and teachers. The plan is then  regularly monitored and updated as progress is made.

On a more practical point, insurers usually require a treatment plan before coverage can be confirmed.

DOES my health insurance Provide cover?

The short answer is yes. However, the specifics of insurance coverage depends on a few factors. 

Firstly, you need to check what type of benefit plan you have. This will determine what protections are in place at either the state or federal level:

• Fully insured plans (or otherwise state regulated plans): These plans are regulated by state law and all 50 states have taken action to require coverage for ABA therapy. Here’s a complete list of autism coverage by state.
• Self funded plans: These plans are regulated by federal law. The Mental Health Parity and Addiction Equity Act prohibits insurers from imposing more restrictions on mental health treatments compared to other medical and surgical treatments. Therefore, insurers can’t place limitations on ASD therapies, if no such limitations exist for the treatment or other medical conditions. 

Once you’ve determined what type of benefit plan you have, you can check your state coverage (if on a fully insured plan), then talk to your insurer to confirm coverage. If you live in New Jersey, you can also read our detailed guide to autism insurance coverage in NJ.

What’s the science behind ABA therapy?

Both the US Surgeon General and the American Psychological Association consider applied behavior analysis therapy to be an evidence-based best practice treatment. 

Over 20 studies have proven that ABA therapy delivered for between 1 to 3 years, improves outcomes for many children with autism. These improved outcomes include intellectual functioning, language development and social functioning.

Want to find out more about?

We hope that this blog post has helped to answer some of the questions you have around what is ABA therapy for autism. 

Our blog provides lots of resources for parents of children with autism, including other information on ABA therapy. The blog also contains other practical advice articles for parents.

If you live in New Jersey and would like to find out more about the ABA services we provide to children with autism, you can get in touch here.

For parents of children with autism, one of the first things to clarify after receiving an Autism Spectrum Disorder (ASD) diagnosis is the insurance coverage. Thankfully, insurance coverage in New Jersey, at both the state and federal level, provide plenty of protections for patients. 

In this guide to insurance coverage for ASD in NJ, we provide an overview of the protections in place.

First off, what type of benefit plan do you have?

The first thing you need to do is confirm what type of benefit plan you have, as this will determine which health benefits are covered. This will either be:

• A fully insured plan/small group plan/NJ State Health Benefits and the School Employees’ Health Benefits Programs: These plans are regulated by state law, and the New Jersey Autism and Other Developmental Disabilities Mandate 2009 provides specific provisions. The below section provides more details on this.   
• A Self funded plan: These plans are regulated by federal law, rather than state law. As such, these plans have different provisions for ASD coverage. The below section provides more details on these provisions.  

If you’re not sure which type of benefit plan you have, speak to your employer or your insurer. Generally speaking, smaller businesses provide fully insured plans, while larger businesses provide self funded plans.  

coverage on fully insured plans

For parents with fully insured plans, the Autism Insurance Mandate 2009 provides a number of robust protections for patients. These include:

• Prohibiting the denial of coverage on the basis that therapy is not restorative.
• Mandating coverage for incurred expenses for occupational, physical and speech therapy that is medically necessary.
• Mandating coverage for Applied Behaviour Analysis to treat a primary diagnosis of ASD, if it’s prescribed through a treatment plan. 

When the mandate first came into effect, it placed a number of restrictions and limitations on cover. This included:a cap of $36,000 and a 30-visit maximum for therapies per annum, as well as an age cap of 21.  

However, following the Affordable Care Act the mandate no longer has a monetary, visit or age limitation. These changes were effective as of January 2015. 

A few other important points to be aware of with the mandate include:

• Therapy must be prescribed through a treatment plan.
• While physicians are required under the mandate to create a treatment plan, many insurers allow, or in some cases require, a Board Certified Behavior Analyst (BCBA) to do this. You should therefore confirm this with your insurer.
• Insurers may only request an updated treatment plan once every six months.  

coverage on self funded plans   

As discussed above, the Autism Insurance Mandate does not apply to self funded plans. This is due to the fact that these plans are governed by federal rather than state law. 

However, there are still patient protections in place, that can ensure cover for autism. These include:

• The Affordable Care Act. This prohibits insurers from placing annual or lifetime limits, or rejecting cover for pre-existing medical conditions
• The Mental Health Parity and Addiction Equity Act. This prohibits insurers from imposing more restrictions on mental health treatments compared to other medical and surgical treatments. Therefore, insurers can’t place limitations on ASD therapies, if no such limitations exist for the treatment or other medical conditions.         

What are the next steps?

Now you know the different provisions for autism insurance coverage in the state, you can begin your conversations with your insurer to confirm coverage.  

And if you haven’t already done so, you can begin talking to treatment service providers and discuss treatment plans for your child. Your chosen treatment provider will work with you to confirm coverage with your insurance provider. 

If you want to find out more information about the treatment plans we offer, you can learn more here. 

Pumpkins are making their appearance all over, and homes and stores are sprouting spooky decorations. Halloween season is a super exciting time for most neurotypical kids, but for children with Autism, this holiday can present a unique set of challenges. So, here are some simple Halloween tips for children with Autism.

1. Prepare in Advance

Children with Autism may have a harder time adjusting to the different set of implicit rules that Halloween brings, and it’s important to prepare your child accordingly.

• Talk about the Do’s (knock on door, say thank you after receiving candy) and the Don’ts (help yourself to candy on your own).
• Try role playing trick or treating to make sure that your child feels comfortable with what is expected of him/ her.
• Create a visual story of the trick or treat routine. Go through it with your child and explain what to expect throughout.

2. Tackle the Costume Dilemma

Let’s face it. Most costumes are itchy, uncomfortable, and just plain annoying to wear. For a child with sensory processing issues, this can pose an extra issue.

• Try out theses sensory friendly Halloween costumes.
• Have your child try out the costume a week before Halloween for a few hours to see if adjustments are necessary.
• Bonus brownie points- have your child turn his/ her obsession into a Halloween costumes. Check out this link for cool inspiration!
• And remember- if your child doesn’t want to wear his/ her costume, that’s okay too! Talk about what they don’t want to wear, see if they’d like costume adjustment, but ultimately, it has to work for you and your child, not anyone else.

3. Safety First

Halloween can be a scary time for parents of children who tend to wander off. Some quick tips:

• Dress in light up when going out at night. Have your child wear light up sneakers, glow stick bracelets/ necklaces, or a reflector.
• Take a picture of your child just before leaving the house, so that you have an updated picture in what your child is currently wearing
• Consider skipping trick or treating if that doesn’t work for your child and staying home instead to greet neighborhood children together.

Keeping these Halloween tips for children with Autism in mind will hopefully ease some of the stressors of the day. But- most important of all- remember that there is no “right” way to celebrate the holiday! Keep doing what works for you, and have a Happy Halloween!

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About us: Golden Care Therapy is an ABA agency servicing  New Jersey and Pennsylvania children with Autism. We bring you the individual care of a small agency, together with the results borne of thousands of hours of successful in home ABA sessions. To learn how we can help your child, contact us today and speak with our clinical director!