All About ABA

When you have a child who lives with autism, you are always on the lookout for supportive, loving ways for them to blossom into their best self. Enter ABA therapy, a type of play-based behavioral therapy that can help a child improve social and behavioral skills—all in a warm, nurturing environment.

If you are just starting your ABA journey, you likely have many questions and concerns, including “What is ABA therapy for autism, exactly?” and “How does ABA therapy work?” This guide will answer all your questions about ABA therapy so the child in your care can get the support they need to thrive. 

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What is ABA Therapy?

First, what does ABA therapy stand for? Simply put, ABA stands for applied behavior analysis. It’s defined as a therapeutic intervention that helps children with autism spectrum disorder and other developmental and behavioral conditions learn essential communication, socialization, and behavioral skills. 

ABA Therapy Meaning

If you’ve googled “ABA therapy meaning,” you’re not alone—19,000 people searched Google last month to learn what the phrase means. ABA therapy is highly effective at teaching children the specific skills they need to navigate the world. But ABA therapy extends beyond the skills a child will learn; it emphasizes all aspects of a child’s unique self, embracing them for who they are and unlocking their potential.

No two children with autism are alike, and ABA therapy for autism is tailored to a child's needs. ABA programs are flexible, humanistic, and play-based, using strategies like positive reinforcement, prompting, and shaping to help a child grow and develop the skills they need for everyday life.

Gold Standard Treatment

ABA therapy is considered the gold standard of treatment for autism spectrum disorder, with decades of research and clinical evidence behind it. It’s the behavioral therapy backed by major medical organizations, including the American Psychological Association, the American Academy of Pediatrics, and the U.S. Surgeon General. 

Main Goals of ABA Therapy

What is ABA therapy for? ABA has two main goals:

• Teaching a child important skills

These skills include reducing deficits in areas such as communication, socialization, self-help, and adaptive functioning.

• Reducing challenging behaviors

Examples may include tantrums, aggression, self-injury, eloping, and repetitive behaviors (i.e., behaviors that interfere with learning, safety, or daily life).

How ABA is Different from Other Therapies?

Several therapies may be useful for people with developmental or behavioral issues. These therapies include speech therapy, occupational therapy, and other behavioral and mental health therapies.

Whether to use one of these therapies typically depends on the symptoms a child experiences and their specific needs.

For example, if a child’s primary symptom is a speech delay, they will likely see a speech therapist. If a child struggles with fine motor skills, managing activities of daily living (dressing, feeding, toileting), and sensory processing, they may seek care from an occupational therapist.

Most of these therapies address one or two symptoms; however, ABA therapy addresses the broader needs of a child on the autistic spectrum and can help a child develop skills in more than one area of life.

At the same time, ABA behavior technicians often coordinate with other therapists—including teachers, pediatricians, mental health providers, neurologists, speech therapists, and occupational therapists—to address the broader range of a child’s needs.

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How Does ABA Work?

There are a few main strategies and principles that ABA therapy utilizes. These include:

• Data-driven approaches, based on science and research about learning and behavior
• Individualized assessments and treatment plans
• Positive reinforcement to increase desired behaviors
• Prompting, which includes assistance, reminders, and cues to enhance learning
• Shaping, teaching a new skill by reinforcing successive small steps toward the final goal
• Task analysis or chaining procedures, which break a complex skill into a sequence of smaller steps and teach them in order
• Augmentative and Alternative Communication (AAC) systems are used to assist with communicating wants and needs, enhancing socialization and engagement with others.
• Natural Environment Training (NET), in which skills are taught in the environment where they occur and will most likely be utilized
• Generalization procedures, ensuring skills transfer across different settings, people, and situations
• Maintenance procedures to ensure skills persist over time after they’re learned.

What a Typical Session Looks Like

ABA therapy can take place in several different types of locations, including a school, an ABA center, your home, or even online via telehealth. The type of provider who typically delivers ABA therapy is a Board Certified Behavior Analyst (BCBA). In these sessions, in addition to learning more about what a typical session involves, you’ll get answers to questions like “what does an ABA therapist do?” and information about certifications and qualifications.

Initial Assessment

Before beginning formal sessions, ABA behavior technicians complete assessments and work with caregivers to come up with a list of specific goals based on the assessment. Each assessment is based on a child’s specific needs and is done in conversation with caregivers and their child. In this way, ABA therapy is both child-based and family-based. 

What Happens in a Session

ABA therapy often takes a play-based therapy approach. It’s not the same as rote table drilling of different skills. This means that ABA occurs in an environment that resembles a child’s everyday life (usually school or home) while they engage in normal, familiar activities, accompanied by their ABA behavior technicians.

Sessions enact the typical activities a child engages in at their school or home environment. This allows them to translate these skills into the places where they are most needed. Building specific skills over time with frequent practice allows a child to function more independently and harmoniously. 

ABA Therapy Activities

Some of the activities that often take place in ABA therapy include:

• Visual strategies (visual schedules, visual organization, and visual work systems)
• Fine and gross motor skill work
• Adaptive skill building, like hand washing, shoe tying, and snack preparation
• One-on-one work with behavior technicians and sometimes with other children, to develop social skills
• Play-based learning, which may include board games, role-play, puzzles, sensory play, and arts and crafts
• Communication skill building (e.g., Augmentative Communication Systems)

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What Skills Does ABA Target?

ABA therapy for autism isn’t cookie-cutter. It’s a highly personalized, science- and research-based method adapted to a child’s needs. ABA therapy targets the skills each child needs to strengthen and the behaviors they need to modify.

That said, depending on a child’s needs, ABA typically targets certain general skills. These include:

• Communication skills
  Expressing needs and preferences, conversation skills, and the ability to ask and answer questions.
• Social skills
  Understanding social cues, interpreting social gestures, taking turns, playing games, engaging in age-appropriate activities with peers, and self-regulating around others.
• Daily living skills
  Dressing, eating, tooth brushing, personal care, toilet usage, and adopting a daily routine.
• Reduction of challenging behaviors
  Decreasing tantrums, self-injury, aggression toward others, and eloping (wandering or running away from a safe area, often due to overstimulation).
• Academic and pre-academic skills
  Early literacy and math skills, learning to break learning tasks into more manageable chunks, engaging in problem-solving, and communicating academic needs.

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Is ABA Effective? What Research Shows

There is ample evidence that applied behavior analysis therapy (ABA) is a highly effective way to improve the lives and outcomes for children with autism spectrum disorder. Several different meta-analyses have found that ABA provides meaningful improvement in adaptive behaviors, including expressive language, socialization, and communication skills.

A 2018 meta-analytic study published in Research in Autism Spectrum Disorders found that ABA therapy programs for autism can be effective at teaching children essential skills. The areas where these programs especially shone were in improving cognitive abilities, communication skills, expressive language, and receptive language. ABA therapy programs were also effective at improving adaptive behaviors and socialization skills. 

ACES Outcomes

One way ACES ABA Therapy stands out is by achieving stronger clinical outcomes with individualized dosing. Current research shows that more ABA therapy hours do not necessarily lead to better outcomes. ACES uses a comprehensive assessment to determine the right therapy intensity for each child—typically 20–25 hours per week for comprehensive programs—rather than prescribing the same number of hours for everyone. 

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Myths / Clarifications Section

Addressing ABA Therapy Controversy

The truth is, ABA therapy sometimes gets a bad rap. This can leave parents and caregivers unsure whether to try it with their child. 

Where the Controversy Comes From

The controversy surrounding ABA therapy is partly based on the way it was performed historically, soon after the therapy was developed and first utilized. During the 1960s and 1970s, ABA therapy was typically more drill-based and emphasized compliance. It had more of a “follow directions” feel. This often led to children who were unable to make decisions for themselves and made them more vulnerable to being taken advantage of by others.

Unfortunately, in some places, ABA therapy is still practiced in this way. Certain ABA behavior technicians and ABA centers emphasize strictly eliminating problematic behaviors rather than therapy that lets children access the entire diverse spectrum of human expression. This type of therapy often focuses more on following instructions and reducing maladaptive behaviors rather than providing choices and autonomy.

How Modern ABA Has Evolved

Thankfully, modern ABA therapy has evolved so that growing and learning don’t have to emphasize skill drilling or focusing only on behavior elimination. Instead, ABA therapy now takes a more holistic, child-centered approach. It doesn’t focus on erasing a child’s identity, but working with them to teach skills that will allow more autonomy and independence. It offers real choices to children and their families—and it celebrates those hard-won achievements.

ACES is an “assent-based ABA,” an approach that is client-centered and focuses on someone’s voluntary participation in therapy. Assent-based ABA means the child’s voluntary participation guides treatment, and therapy stops or adjusts when the child withdraws assent. We focus on trust building, the ability to self-advocate, and autonomy, instead of a coercive approach. The “assent” is communicated continually via both verbal and non-verbal cues.

How to Identify Quality ABA Therapy

Good quality applied behavior analysis will always provide the following:

• Working collaboratively with the child and their family to come up with a treatment plan that feels right
• An individualized, evidence-based approach, engaging the child in activities they might do in their preschool, elementary school, or other learning environments
• Tailoring activities to the child’s needs, interests, and sensibilities
• Creating goals and tracking progress so that families can see what is working and where more progress may need to be made
• Celebrating a child’s differences, and not making the child feel that they have to change the core of who they are to fit into a more neurotypical mold
• Data-based decision-making by a highly trained ABA Supervisor available to explain all aspects of the child’s program to their family
• High-quality interventionists supervised regularly by an ABA Supervisor
• A focus on meaningful skill acquisition and behavior reduction that allows the child opportunities to engage in all settings
• A collaborative approach between the ACES team and parents, families, caregivers, and others involved in the child’s life

How to Spot Low-Quality ABA Therapy

While modern ABA has evolved, not all providers have quite kept pace. Here are a few signs to watch for when evaluating ABA therapy providers:

• Inexperienced behavior technicians

Look for providers with seasoned clinical leadership and mentorship programs for newer behavior technicians.

• Minimal assessment

Comprehensive evaluation requires multiple assessments across different environments and behavioral categories—communication, social skills, adaptive behaviors, and more.

• One-size-fits-all treatment

Quality ABA is individualized and based on a child’s specific needs, not a predetermined formula to maximize billing.

• No parent training

If a provider doesn’t include regular caregiver training sessions, they're missing an important component of treatment.

• High staff turnover

Ask about the average behavior technician's tenure when evaluating providers.

• Table-based approach

Although learning at a table has its place, if therapy consists primarily of drilling skills at a table rather than teaching in real-world environments, the provider is likely using outdated methods.

• Lack of data transparency

You should have clear access to a child’s progress. If a provider doesn’t share specific outcome metrics, that’s concerning.

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Different Settings for ABA

One of the wonderful aspects of ABA therapy is that it’s flexible and portable. We’re fond of saying, “Where behavior lives, ABA lives” because therapy functions best in natural environments. ABA therapy for autism can take place in a variety of different settings, each with different benefits you’ll want to consider. (for example, in-home vs center-based ABA therapy). 

Some of the different settings in which ABA takes place include:

• At an ABA learning center
• In your home
• At a school or after-school center
• At a work site

Center-Based ABA Therapy

An ABA center is a place that’s fully focused on ABA therapy. These centers are typically staffed by ABA behavior technicians and have plenty of equipment (including toys!) and educational resources to create an enjoyable and enriching experience for a child. What a child learns in center-based ABA therapy is often focused on the necessary skills needed to thrive at home, school, and community settings. Center-based ABA therapy is better equipped to prepare a child for life outside their home. 

In-Home ABA Therapy

Receiving ABA therapy with a board-certified behavior analyst in your home can also be beneficial because it teaches a child skills in an environment that’s familiar and where many of their day-to-day tasks take place. It also means that family can be involved in the process, which can be helpful and meaningful to a child’s growth. Sometimes these services can even take place via telehealth. 

School-Based ABA Therapy

When ABA therapy happens in a school or after-school setting, the approach is highly collaborative, with ABA behavior technicians working closely with teachers and families. Often, the type of skills that are worked on is in line with the child's IEP goals. ABA therapy in school environments can help children thrive academically, socially, and behaviorally.

ACES' Strategic Approach

ACES offers ABA therapy in numerous settings. Our service locations include:

• ACES Learning Center
• ACES at Home
• ACES at School
• ACES After School Program
• ACES in the Community
• ACES at the Work Site

Here’s what to know about each of these offerings. 

ACES Learning Center

Our learning centers offer comprehensive ABA services. From our ACES Learning Center - Early Learners Program to our after-school services, we offer a wide range of therapy services that can be tailored to a child’s needs. Play-based learning is at the core of these services, along with structured teaching, positive reinforcement, and features “shared control,” where a therapist guides the session, but provides frequent opportunities for choices and input from the child during learning. The environment is supportive, empathetic, safe, individualized—and most of all, fun. 

ACES at Home

There is no place like home, and ACES at Home brings professional, evidence-based care to the place where a child is the most familiar. ABA behavior technicians will work with a child and their caregiver or family to build skills that can be utilized at home, as well as at school. Play, creativity, and positive reinforcement are emphasized, along with research-based methods to help a child build essential skill sets.

ACES at School

ACES at School works alongside teachers and school staff to address a child’s social, behavioral, and academic needs. Our ABA behavior technicians can help develop and implement a child’s Individualized Education Plan (IEP), in coordination with a child’s teachers, behavior technicians, and other school staff. ACES at School emphasizes individualized care and support, and we work closely with families as well as school staff.

ACES After School Program

In addition to support during the school day, ACES offers after-school support as part of the ACES Learning Center - After School Program. This program focuses on the same evidence-based, empathetic, holistic care as other ACES programs. There are options for 1:1 services as well as collaborative group sessions.

ACES in the Community

Each month, ACES curates various opportunities for children to access settings in their community during ACES in the Community programming called our Community Integration Program (CIP). Children are provided support to integrate into community settings and are offered opportunities to generalize the skills they have learned in the home, center, and school settings.

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ABA Therapy Cost and Insurance

One of the first questions for parents and caregivers at the start of their journey is: how much does ABA therapy cost? Every insurance plan is different, and insurance coverage for ABA services can get tricky. That said, ABA services are often covered by health insurance. 

Does Insurance Cover ABA?

It depends on your particular insurance, but most insurance plans will cover ABA services. Often, you need pre-authorization from your insurance company to begin services. This includes a formal autism spectrum disorder diagnosis done by a licensed psychologist or physician. You can also ask your insurance company for an in-network diagnostician.

It can be helpful if your provider directly shares medical documentation with your insurance company. Sometimes, even if services are covered, there will be out-of-pocket expenses that you will be responsible for, such as copayments, deductibles, and coinsurance.

Understanding Costs

ABA therapy costs can vary by funding source (often insurance) and what your ABA therapy plan looks like. Each plan is different and based on a child’s needs. Most health insurance companies will cover some of the cost, and you’ll have to pay out-of-pocket for the remainder or a copay. Sometimes your state or a child’s school district will cover some or all of the cost of services. 

Support for Navigating Health Insurance

We know that understanding insurance and paying for ABA therapy can be challenging. That’s why ACES will do the legwork for you. ACES Welcome Center has a team ready to walk through the verification of benefits and the entire process of getting care for a child. We are in network with over 100 insurance companies, and can help you understand your eligibility, navigate verification and paperwork, and help set up services for you through your insurance carrier. 

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What to Expect: The ABA Process at ACES

There are several steps along the road to a child receiving ABA therapy, and the ABA process involves several different components: intake, an assessment, ACES services, and ongoing progress reports and check-ins.

Intake Process

Before services begin, the ACES Welcome Center team will help you navigate receiving a diagnosis from a health provider, your health insurance eligibility, understanding what a child’s needs are, and helping you schedule your ACES assessment.

ACES Assessment

Your ACES assessment is your first chance to meet the ACES therapy team and to share your questions and concerns about treatment. It's also an opportunity for the ACES team to get to know a child and their family. 

Here’s what to expect during your assessment:

• A child will be observed, and your behavior technician will ask questions about the child’s social skills, communication skills, independent living skills, and behaviors. 
• During the assessment, therapy goals will be discussed. 
• Finally, a report will be generated that will outline what therapy will entail, as well as how many hours will be required to meet your goals (the dosage).

Services Begin

Next, services will begin in the location that will best meet the needs of a child—either at school, home, or at an ACES Learning Center. Services will follow the plan agreed on by you and a child’s ABA behavior technician, with an emphasis on play-based, skill-building, child-centered therapy. 

Reports and Check-Ins

You will be actively involved in the child’s journey and have transparency into their progress. ACES implements the following tools to communicate with caregivers, to ensure you stay up-to-date on a child’s progress:

• Access to a digital parent portal with data showing goal progress
• Monthly Parent Training meetings with an ABA Supervisor to discuss progress
• Visual graphs showing how a child’s goals are progressing
• Monthly check-ins with a child’s ABA Supervisor to reassess what's important based on current progress

When Will I See Results?

It usually takes a minimum of two to three weeks before you notice any behavioral changes in a child. This is just an average, however—some children will show progress in as little as a few days, while others will take months before progressing. In addition, you may see improvements in some behaviors and not in others, as each behavior will take differing amounts of time to see progress.

Why Behaviors May Get Worse Before They Get Better

Importantly, sometimes behaviors fluctuate before improving, and, at times, things actually get worse before they get better. This is known as an “extinction burst,” where behaviors may become more pronounced before showing improvement. It’s essential to be prepared for these fluctuations, to recognize that progress isn’t always linear, and to stay consistent with a child’s therapy.

How Do You Know if ACES Therapy is Working?

ACES will share an immense amount of useful, easy-to-interpret data with you about a child's progress, and you can check your portal regularly to see how therapy is progressing. You will also be able to check in with a child’s ABA Supervisor during monthly meetings. If you have questions outside of these meetings, you should feel free to reach out to a child’s ABA Supervisor. ACES values a highly collaborative approach between caregivers and your ACES team.

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What Makes ACES Different

ACES is a trusted, well-known ABA therapy provider in the industry with over 30 years of experience. ACES cares deeply about each child and each family we treat, putting your well-being at the forefront of our treatment.

Here are some other meaningful differentiators that set ACES apart from other ABA therapy providers.

Top-Notch ABA Behavior Technicians

We have over 400 board-certified behavior analysts on our team. Our behavior technicians are also highly trained—ACES provides training far exceeding that required by other providers. Each new Board Certified Behavior Analyst (BCBA) ACES onboards receives extensive support, leading to improved outcomes and exceptional, data-driven care.

Individualized Care

ACES ABA therapy is highly individualized. We see each child we treat as a unique case, and our treatment plans take into consideration a child’s strengths and goals for improvement. We partner with caregivers, teachers, and other professionals during each step of the process. The goal of ABA therapy is to help a child reach their full potential, not simply to meet arbitrary markers or endpoints.

Better Outcomes, Fewer Hours

At ACES, we don’t believe that ABA therapy must entail 40-hour workweeks for everyone. In fact, most of our clients need fewer hours to meet similar goals. But none of this is at the expense of quality. We not only get better results than other organizations, but with less intensive, time-consuming therapy. 

The data backs this up. Take Vineland scores, for example, which evaluate how well a child manages daily living skills in comparison to their peers. 

At ACES, clients receiving 5-12 hrs/week achieve a 64% increase in Vineland scores in 10% less time than the ABA industry benchmark. For clients receiving 13-25 hrs/wk, ACES produces a 26% increase in Vineland scores in 19% less time than ABA industry benchmarks.

Comprehensive Assessments

Part of the reason we have such good outcomes is that we use multiple assessment tools for each client. Whereas competitors use one or two assessment tools, we use over seven tools, including Vineland, VB-MAPP, AFLS, SRS-2, DAYC, QOL, and PSI/SIPA. This is part of our blueprint for delivering top-notch services. 

Play-Based, Fun Activities

The type of activities a child engages in is meant to feel more like play than anything else. ACES creates an enriched learning environment that encourages engagement through creative, child-centered activities. These activities don’t feel like work for a child—they are meant to be fun, engaging, and meaningful ways to build skills and improve behavioral outcomes. 

Whole Family, Lifespan Approach

ACES ABA is here for the long haul with your family. Parent training, which leads to 4.5x better outcomes, is a core value for us, which means that you will be able to implement many of the activities and tools we use with a child on your own. 

To accomplish this, we have two graduation tracks:

• A skills graduation

The goal is to close the gap between a child’s chronological age and their developmental age.

• An adaptive/functional graduation

This sets up a child to function in your family ecosystem, even with ongoing, changing developmental needs.

White Glove Welcome Center

Managing insurance coverage and fees is a part of ABA therapy that can cause significant stress and headaches. We don’t believe families should have to shoulder this, in addition to the challenges they already face with their children.

Our philosophy is: “You don't have to understand fees and coverage. Provide your information, and we'll walk it through.” Our staff helps families navigate insurance verification, pre-authorization, and financial responsibility.

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Getting Started with ACES

ABA therapy for autism can be challenging to understand and navigate at first. Now that you have the answers to questions like “What is ABA therapy for autism?” and “What does ABA therapy stand for?”, it’s time to begin the process of getting services set up 

We understand how stressful this first step can be. That’s why we have streamlined the process at ACES—offering multiple therapy options, helping caregivers understand insurance coverage, and putting children first, so that they can succeed, grow, and thrive.

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References

Choi, K.R., Bhakta, B.B., Knight, E., Becerra-Culqui, T.A., Gahre, T.L., Zima, B.T., & Coleman, K.J. (2021). Patient Outcomes After Applied Behavior Analysis for Autism Spectrum Disorder. Journal of Developmental & Behavioral Pediatrics, 43, 9 - 16.

Makrygianni, M., Gena, A., Katoudi, S., & Galanis, P. (2018). The effectiveness of applied behavior analytic interventions for children with Autism Spectrum Disorder: A meta-analytic study. Research in Autism Spectrum Disorders.