Jumat, 29 Juni 2012


Educational needs of children with Autism are unique and required unique responses. Programs have to be intensive and individualized on the level and learning style of the learner. Teachers need specific training on a number of teaching procedures (reinforcement, shaping, chaining, etc.). Curricula needs continuous updates and adjustments on the base of progresses and difficulties. 

Home-based programs are an educational option to meet these requirements. ABA home programs have been constantly growing in popularity in the last 20 years becoming the standard for the education of children with Autism and severe language delays. 

ABA Home Program structure

An in-home ABA/VB program is typically run for approximately 25 to 40 hours per week. The majority of the instruction is provided in a structured format (discrete trials) at the child's home but most of the programs also involves NET (Natural Environment Teaching) sessions that may take place in community setting (e.g. play ground, play groups, school). 

The program is run conjointly by:
  •  a Consultant who assesses a child’s needs, trains the Tutors, designs and periodically (e.g. weekly, every 2 weeks, monthly) monitors  and update the curriculum of the home program.
    The typical structure of an ABA program
  •  Tutors/Therapists who provide the direct instruction to the child during home teaching sessions. Typically sessions are 2 to 4 hours long. Depending on the total amount of hour per week, 1 to 4 tutors may take turns over the day or the week to run the program. Therapists are trained and closely  supervised by the consultant in the implementation of the curriculum. The position usually suits college students and fresh graduates who are interest in special education. Former experience in ABA is not usually required as intensive training and supervision is provided by the consultant. The tutors' role involves also to prepare educational resources for the program (e.g. pictures, visual boards) 
  •  Parents provide inputs on child’s needs and work with the consultant and therapists in identifying the short and long term goals of the program. They are also encourage when possible to actively participate in the program and in the training. Parents participation is one of the main advantages of home programs and results in better generalization of the skill acquired.

The 5 Steps to Set up an Home-Based ABA Program

1. Hiring the ABA consultant. 

The consultant should be qualified in ABA and specialized in designing ABA programs with children with autism. The Board Certified Behavior Analyst (BCBA) is an international organization responsible for the certification of Behavior Analysts. Professionals that hold the BCBA certificate have a Masters Degree, have attended successfully the coursework required and have at least 1500 hours of work supervised by an experienced Behavior Analyst. 
The consultant's role start with the assessment of the child's need. On the base of this evaluation he will write an individualized program for the child. 

2. Hiring therapists.  

Therapists do not necessarily need former experience but they do need strong motivation and interest in working with children with special needs and leaning ABA. The best candidates are usually university students or fresh graduates in psychology or education. It is advisable that the therapists live or work close to the child's house so that travel time and expenses can be kept at a reasonable level. 
It is possible for parents can run some sessions per week as therapists. Of course this option results in a financial benefit but it has to be said that may be highly demanding and exhausting for parents to tutor their child. 
Some programs may benefit from the identification of a Lead Therapist. This role is usually covered by the most experienced therapist in the team. The role's responsibilities includes: Shadowing the new therapists for the initial sessions, Passing the data on to the ABA consultant,Coordinating and supervising other tutors in preparing educational resources, Reviewing mastered task and setting up new immediate targets.
Therapist salaries vary depending upon a number of factors such as geographic area, years of experience, time for commuting, etc.
The therapist job is with no doubts challenging both physically and emotionally. It is important that therapists are motivated and committed to work in the program for a reasonable long period of time. Programmed pay raises (eg. at 3, 6 and 1 year) may help. 

3. Prepare the setting and the resources for the program:

- Therapy Space: One room in the child's house should be set up to conduct the therapy.The room should have a table and two chairs, space for playing and shelves for arranging the materials.

- Materials: A number of item highly favorite by the child should be available in the room during the session. These materials (e.g. favorite games, sensory toys, etc.) are essential to keep the child motivated. It is reccomended that at least part of these items are available to the child only during the therapy sessions (isolated reinforcements) to keep high their value for the child. 

- Program folder: The folder should collect and order the instructional directions written by the consultant, the data sheets, the session notes, the therapist's hours, etc.

4. Initial training.   

Once the tutors have been hired the ABA consultant will conduct the initial training. It is important for tutors to receive adequate training before they start working with the child. Parents are encouraged to attend the training even if not actively participating in the program as tutors.

5. Monitoring and updating the Program

Periodic meetings with the ABA consultant are required to monitor the child’s progress closely, update regularly the program and provide ongoing supervision and training to the tutors. Meetings with the consultant are also an opportunity to discuss problems with implementation of the program. 
Initially meetings should be frequent (typically 2 or 3 time per month) to assure closely supervision and intensive training to the new team. 
Regular Team meetings between the team of tutors and parents may be also beneficial to ensure teaching consistency.

Further online and offline resources on the topic:

How to Start A Home Based ABA/VB program? A Parents Manual - by Geetha Athreya & Chitra Sharathchandra

Resources for Running an ABA Program - by Rsaffran

Sundberg and James Partington (1998) - Teaching language to children with Autism and other Developmental Disabilities. Behavior Analyst Inc.

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