Finding ABA frustration

[Anonymous]

Amaze ABA therapy is the biggest scam in the world! Avoid them at all costs

[Anonymous]

Anonymous wrote:

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

Ughh this is such a lesson in the unintended consequences of pushing for autism services to be covered by insurance. Congress needs to reign in private equity and stop it from destroying businesses. The whole model where they load the business up with debt and then take off is insane. Maybe anti-trust or some kind of tax consequences can do it. You shouldn’t be able to take out loans to buy a business and then merge with that business and leave it in debt.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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

Ughh this is such a lesson in the unintended consequences of pushing for autism services to be covered by insurance. Congress needs to reign in private equity and stop it from destroying businesses. The whole model where they load the business up with debt and then take off is insane. Maybe anti-trust or some kind of tax consequences can do it. You shouldn’t be able to take out loans to buy a business and then merge with that business and leave it in debt.

+1 I truly believe there is a special place in hell for private equity people that buy up ABA programs, nursing homes , child care centers and who knows what else. What kind of person decides, hey, I think I'm going to make tons of money off of the most vulnerable people in society!