Selecting the Right Number of ABA Therapy Hours for Your Child: A Balanced Guide
When embarking on the journey of Applied Behavior Analysis (ABA) therapy for a child with autism, one of the most pressing questions parents face is determining the optimal number of therapy hours. The recommendation of 30-40 hours per week can seem daunting, raising concerns about how a child will adapt to such an intensive schedule. This guide aims to navigate these concerns with sensitivity, balancing the child's needs, age, daily routines (including naps), and the unique goals for their development.
Understanding the Recommendation
The suggestion for 30-40 hours of ABA therapy is grounded in research indicating that intensive intervention can lead to significant improvements in communication, social skills, and behavior management. However, this recommendation is not a one-size-fits-all. It's crucial to consider the individual child's needs, their ability to engage in sustained periods of learning, and the family's schedule. For children diagnosed with high-functioning autism who primarily need support with social skills and may not have significant behavioral concerns, a minimum of 4-6 hours per week of focused ABA therapy can be effective. This targeted approach allows for the development of social competencies and mild behavior adjustments without overwhelming the child.
The Research
In 1987, Dr Ivar Lovaas and his team at UCLA conducted a groundbreaking study on the impact of intensive (30-40 hours a week, one-on- one) ABA therapy for children diagnosed with ASD. Through the study, it was found that of the children receiving the intensive therapy, “47% achieved normal intellectual and educational functioning, and the other 50% were placed in special education classes” (Lovaas, 1987). This early intensive behavioral treatment (EIBT) model created through the study has been peer-reviewed and used in different settings with similar results. Since the original study, the effectiveness of intensive ABA therapy has been replicated through many peer-reviewed studies offering similar results, indicating the reliability of the therapy model (Birnbrauer & Leach, 1993; Cohen, Amerine- Dickens, Smith, 2006; McEachin, Smith, Lovaas 1993).
The early intensive behavioral treatment model has maintained its effectiveness and reliability so well that it continues to be a practice used at Orchid Academy along with other reliable and evidence-based practices such as, discrete trial training (DTT), natural environment teaching (NET), and fluency-based instruction.
Natural environment teaching gives clients the opportunity to learn in their natural contexts using their interests (Sundberg &
Partington, 1998).
Fluency based instruction allows clients to build their skills through rapid practice to increase their retention, endurance, stability as well
as their ability to apply these skills in other environments (Johnson & Layng, 1992).
By incorporating these practices into the early intensive behavioral treatment model, more impactful and successful long-term outcomes for children with ASD can be achieved.
Lovaas and others have shown that it can be detrimental to a child’s progress if they do not receive enough ABA services, especially during early development. Establishing the foundational skills of a child early on can help increase their school readiness, independence, basic life skills, and promote long term outcomes and these can be made possible if children are provided with 30-40 hours ABA therapy.
Considering the Child's Age and Needs
Young Learners: For very young children, especially those under three years old, therapy hours might be on the lower end to accommodate their attention span and need for naps. However, early intervention is key, and starting with a manageable schedule that gradually increases can be beneficial.
School-Aged Children: For older children, especially those attending school, balancing therapy with educational commitments and leisure time is important. Integrating ABA therapy into a child's daily routine requires flexibility and understanding from the therapy provider.
Seeing the Growth and Adjusting Accordingly
Many families start with reservations about the intensity of ABA therapy, opting for fewer hours. However, as they begin to see the positive changes in their child—be it in communication, social interactions, or reduced problem behaviors—the desire to increase therapy hours grows. Witnessing tangible progress often shifts perspectives on what is manageable and beneficial for the child.
Flexible and Individualized Approach
Selecting the right number of therapy hours is a process that should be revisited regularly. It involves:
Continuous assessment of the child's progress and response to therapy.
Open communication between parents and ABA providers to adjust the schedule as needed.
Sensitivity to the child's overall well-being, ensuring they have time for rest, play, and family.
When discussing ABA therapy schedules, it's essential to feel comfortable engaging in open dialogue with your provider about finding a compromise that suits your child's and family's needs. Many parents wonder if it's possible to start with fewer therapy hours and gradually increase as they observe their child's progress and adapt to the routine. This approach allows families to ease into therapy, reducing potential stress for both the child and the family unit.
Feedback from other families who have navigated this path can be incredibly valuable; many share that starting with a manageable schedule and adjusting upwards was beneficial for their child’s development and their family dynamics. Additionally, accommodating parents' work schedules and the child's other commitments is a common concern. A flexible ABA provider understands these challenges and strives to work collaboratively with families to create a therapy schedule that respects the family’s time, the child’s other activities, and the overall goal of supporting the child’s development in a holistic manner.
Conclusion
Deciding on the number of ABA therapy hours is a deeply personal decision that varies for each child and family. It's about finding a balance that respects the child's needs and the family's lifestyle, with the flexibility to adapt as the child grows and their needs change. By starting with an open mind and a collaborative approach, families can navigate these decisions with the support of their ABA team, ensuring therapy not only fosters development but also fits harmoniously into their lives.
References
Birnbrauer, J. S., & Leach, D. J. (1993). The murdoch early intervention program after 2 years. Behaviour Change, 10(2), 63–74. https://doi.org/10.1017/S0813483900005556
Cohen, H., Amerine-Dickens, M., & Smith, T. (2006). Early intensive behavioral treatment. Journal of Developmental & Behavioral Pediatrics, 27(2).
Johnson, K. R., & Layng, T. J. (1992). Breaking the structuralist barrier: Literacy and numeracy with fluency. American Psychologist, 47(11), 1475–1490. https://doi.org/10.1037/0003-066X.47.11.1475
Larcombe, T. J., Joosten, A. V., Cordier, R., & Vaz, S. (2019). Preparing children with autism for transition to mainstream school and perspectives on supporting positive school experiences. Journal of Autism and Developmental Disorders, 49(8), 3073– 3088. https://doi.org/10.1007/s10803-019-04022-z
Larsson, E. V., & Wright, S. (2011). O. Ivar Lovaas (1927–2010). The Behavior Analyst, 34(1), 111–114.
Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3-9. https://doi.org/10.1037/0022-006X.55.1.3
Sundberg, M. L., & Partington, J. W. (1998). Teaching language to children with autism or other developmental disabilities. Pleasant Hill, CA: Behavior Analysts, Inc.
Weiss, M.J. (2001). Expanding ABA intervention in intensive programs for children with autism: The inclusion of natural environment training and fluency based instruction. The behavior analyst today, 2, 182-186. https://doi.org/10.1037/h0099946
