Finding ABA frustration

[Anonymous]

Anonymous wrote:You won’t find an ABA provider who will do less than 10 hrs a week and usually they reserve that for maintenance. As a new patient, they will probably push for 15 hours or more. Your best bet would be to see if you can find an ABA provider who can push into preschool if the principal will allow it. I’m assuming you’re at a private preschool/daycare?

OP said her kid is in FCPS PAC, which is 3 full days per week (same hours as K-6 ES) + 2 half days. It doesn’t leave time for much else other than a short private speech or OT/PT appointment on the half days.

[Anonymous]

Anonymous wrote:Very reputable companies will not insist on minimum hrs, especially not 20 hrs for a 4 yo whonis receiving other services. I would recommend our provider but they are out in MD and OP is in VA.

I'm in MD looking for someone - would you mind sharing your provider?

[Anonymous]

Your options will expand if you go private pay and look for a BCBA willing to do 1:1 with heavy focus on parent and caregiver training. If you have $$ you can hire a nanny (or several therapists rotating) and train them in ABA and have them accompany the child to school and provide in home services. That’s usually the best option for increased direct services while bypassing significantly inexperienced RBTs.

You don’t want less than 20 hours per week at age 4 as it’s supposed to be intensive services at that age, usually 20-40 hours per week, plus parents providing additional services when ABA providers aren’t present. Try looking at local colleges to hire one or more 1:1/ nanny type people that can be trained. Look in psych departments in ABA classes or child development/ special Ed departments.. While not a perfect option you will at least get to directly choose the background of those working most closely with your child and have much more control over scheduling.

This is the way home based ABA was done 15-25 years ago before insurance paid for everything. A BCBA was hired as a consultant, parents directly hired 1:1 therapists, BCBA provided intensive one time weekend training for 1:1s and parents, then provided direct support and training to individual therapists usually weekly (with more support initially, fading supervision and giving more responsibility as they progressed), videotaped and reviewed direct sessions if they couldn’t be there directly (we had lots of out of state consultants in the very early days), weekly parent training, and monthly team meetings, minimal direct service by BCBA consultant (maybe 1-2 sessions per week if they were local), BCBA acted as liaison between home and school services and in IEP meetings.

I worked on many teams like this years ago and while very intensive for parents they worked extremely well- therapists could go to school during the year and in the summer go to the Pool or summer camp and essentially be working on ABA goals almost nonstop. Most families had 3-5 rotating therapists to cover the entire week (usually limited to 1 maybe 2 in the school for consistency), provide respite/babysitting on evenings and weekends, etc. We even went on vacation with the families sometimes. The children got very intensive programs and services and made quick progress despite most of us not being experienced when hired.

I miss those old days, it’s what home-based intensive early ABA was intended to be like IMO. ABA therapists (that’s what we called them, now called RBTs) were trained by BCBAs and supported to the point that they could become BCaBA-like/supervisory (don’t think that title existed yet when I started) through direct experience and training. It created a system where the BCBAs acted more like consultants and could see one “new” client that required more support and 10+ other clients on a consultative or weekly or bi-weekly and sometimes monthly rotating basis depending on level of the ABA team and parent training.

It was much more parent centered as well,new families starting would “borrow” well-trained therapists to assist in ABA team start up (the most time intensive part), teach other families how to make materials, had play dates together with common therapists, etc. Several parents even got their BCaBA or BCBA certification just to learn more and went on to support other families.

Maybe try to get something like this started- if you know 1-2 other families with similar needs it’s actually not as difficult as it sounds because you can share so many things and have a local support system.

[Anonymous]

My DD has had ABA services for the past 3 years. The RBT goes in to her daycare every morning for 3 hours, so we get 15 hours weekly. She didn’t qualify for county services so this is the only intervention she gets. We have been very lucky to have had the same RBT for the entire 3 years. The techs often need to work a certain number of hours per week, so they might not be interested in a job that requires just a few hours weekly.
If you only need limited hours you can see if you could work directly with a BCBA.

[Anonymous]

^ I should mention that we almost always provided services on weekends, 1 direct 2-3 hour session Friday evening or sometimes a short Direct session followed by dinner with the family or something like that; usually 2 sessions per weekend day so maybe Saturday a 9-12 1:1 services, 1-4 community or play date, then sometimes another 1:1 service from 5-7 for some families; usually similar on Sunday or accompanying to church in AM then afternoon 1:1 at home and maybe a short playdate in the late afternoon.

Yes, it was that intensive for most families, and almost everyone wanted weekend hours. That’s all I worked during college and was always in demand turning down new families and filling in for people on other teams.

So you can definitely fit in the 20-40 + hours in a week, it just depends on what you want to sacrifice really. Very few parents didn’t want any weekend hours, most wanted at minimum an extra set of hands to help out during a birthday party or family outing. We had specific 1:1 at home goals as well as community goals (and maintenance objectives) so we never ran out of things to work on despite the setting.

[Anonymous]

Anonymous wrote:You won’t find an ABA provider who will do less than 10 hrs a week and usually they reserve that for maintenance. As a new patient, they will probably push for 15 hours or more. Your best bet would be to see if you can find an ABA provider who can push into preschool if the principal will allow it. I’m assuming you’re at a private preschool/daycare?

Not true…find a BCBA who is private and works for you and not the other way around. We have that arrangement. We started with 2x/week & now alternate.

[Anonymous]

Following. I’m looking for services for a 10 year old boy. I haven’t been able to find anyone in Northern Va. (Loudoun County).

Anyone with suggestions for this area?

Not trying to highjack.

[Anonymous]

Anonymous wrote:Your options will expand if you go private pay and look for a BCBA willing to do 1:1 with heavy focus on parent and caregiver training. If you have $$ you can hire a nanny (or several therapists rotating) and train them in ABA and have them accompany the child to school and provide in home services. That’s usually the best option for increased direct services while bypassing significantly inexperienced RBTs.

You don’t want less than 20 hours per week at age 4 as it’s supposed to be intensive services at that age, usually 20-40 hours per week, plus parents providing additional services when ABA providers aren’t present. Try looking at local colleges to hire one or more 1:1/ nanny type people that can be trained. Look in psych departments in ABA classes or child development/ special Ed departments.. While not a perfect option you will at least get to directly choose the background of those working most closely with your child and have much more control over scheduling.

This is the way home based ABA was done 15-25 years ago before insurance paid for everything. A BCBA was hired as a consultant, parents directly hired 1:1 therapists, BCBA provided intensive one time weekend training for 1:1s and parents, then provided direct support and training to individual therapists usually weekly (with more support initially, fading supervision and giving more responsibility as they progressed), videotaped and reviewed direct sessions if they couldn’t be there directly (we had lots of out of state consultants in the very early days), weekly parent training, and monthly team meetings, minimal direct service by BCBA consultant (maybe 1-2 sessions per week if they were local), BCBA acted as liaison between home and school services and in IEP meetings.

I worked on many teams like this years ago and while very intensive for parents they worked extremely well- therapists could go to school during the year and in the summer go to the Pool or summer camp and essentially be working on ABA goals almost nonstop. Most families had 3-5 rotating therapists to cover the entire week (usually limited to 1 maybe 2 in the school for consistency), provide respite/babysitting on evenings and weekends, etc. We even went on vacation with the families sometimes. The children got very intensive programs and services and made quick progress despite most of us not being experienced when hired.

I miss those old days, it’s what home-based intensive early ABA was intended to be like IMO. ABA therapists (that’s what we called them, now called RBTs) were trained by BCBAs and supported to the point that they could become BCaBA-like/supervisory (don’t think that title existed yet when I started) through direct experience and training. It created a system where the BCBAs acted more like consultants and could see one “new” client that required more support and 10+ other clients on a consultative or weekly or bi-weekly and sometimes monthly rotating basis depending on level of the ABA team and parent training.

It was much more parent centered as well,new families starting would “borrow” well-trained therapists to assist in ABA team start up (the most time intensive part), teach other families how to make materials, had play dates together with common therapists, etc. Several parents even got their BCaBA or BCBA certification just to learn more and went on to support other families.

Maybe try to get something like this started- if you know 1-2 other families with similar needs it’s actually not as difficult as it sounds because you can share so many things and have a local support system.

Found this timely article. Confirm much of what you posted.

https://www.nbcnews.com/health/health-care/card-blackstone-kids-autism-private-equity-bankruptcy-rcna118544

[Anonymous]

I'm not local. But what people where I am do is-get on all the waiting lists of ABA places around you. Because they all have them. Also, ask around in online local groups for parents of kids with sn. Word of mouth is a good way.

But it's frustrating. I did have a wait on a list, and then I did start at a place that was just 12 hrs/week. Dd loved it for the whole 3 weeks we got...4 years ago this month (pandemic start)...that was some timing!

[Anonymous]

Anonymous wrote:Dislaimer: i know that ABA is controversial, but I"m not looking to discuss that here.

I have been looking for ABA for my 4 y.o. DD and it has been a complete nightmare. Do I really think she needs it? No, but trying can't hurt, and it's something her developmental pediatrician suggested. But I'm astounded at what I've encountered. Can someone explain the BTS parts of it? Lots of ABA companies out there that don't even seem legit, and why do so many absolutely require a 15-20 hour minimum? My DD goes to FCPS PAC and there is no way we are willing to cut school for this. After finally finding an ABA provider that seemed to meet our needs in October and all the back and forth correspondence since then, we've had 3 different case managers due to turnover. We finally met our behavioral technicain yesterday, and she just graduated highschool last year. What in the world? While she was very sweet and professional, she clearly was inexperienced and I am about to axe this altogether.

Can someone enlighten me about the world of ABA? And, if possible, recommend a provider in the No VA area before I axe this altogether?

This is rare to say on DCUM, but maybe they answer is that you understand completely and need to follow your research to its logical conclusion.

Have you also looked at OT?

[Anonymous]

All those techs are paid close to minimum wage, have to have a car, and get themselves all over town. Home-based ABA is extremely difficult in this kind of work environment.

[Anonymous]

Anonymous wrote:All those techs are paid close to minimum wage, have to have a car, and get themselves all over town. Home-based ABA is extremely difficult in this kind of work environment.

This depends on agency. My child's agency (not located in DC area or I'd share the name) pays 25-35 an hour. They do have minimums though. It's just not worth it to do the billing below a certain amount.

[Anonymous]

Anonymous wrote:All those techs are paid close to minimum wage, have to have a car, and get themselves all over town. Home-based ABA is extremely difficult in this kind of work environment.

My RBT gets more than minimum but she said she only takes on clients with at least a 20-hour commitment, so she gets at least 40 hours a week. It’s not affordable for her to do less. The good ones can pick and choose.

[Anonymous]

I know what ABA is but what is PAC?

[Anonymous]

Whatever you decide do NOT use amaze ABA they are so unprofessional