By: Blair Ortman, BCBA
ABA therapy can take place in a wide variety of settings, affording the opportunity to work on skillsets where it is most relevant for the learner. From a caregiver’s perspective, the choice to receive therapy in home versus in clinic or in any other environment, can be stressful and frustrating. BCOTB provides intensive early-intervention therapy in the clinical setting because in-clinic ABA therapy has several advantages when done properly, with caregiver involvement, community consultation, and coordination of care.
Supervision and Oversight
On average, BCOTB exceeds the minimum standards of supervision for Registered Behavior Technicians (RBTs). RBTs are mandated to receive supervision for 5% of their hours across at least two supervision sessions each month. This means that an RBT who works 40 hours per week and roughly 160 hours per month receives 8 hours of supervision each month (roughly two hours per week). This guideline represents the minimum standard of acceptable supervision. RBT staff are directly supervised by Board Certified Behavior Analysts (BCBAs) and Board Certified Assistant Behavior Analysts (BCaBAs). In clinic settings, such as at BCOTB, additional supervision is easily achieved because travel time for BCBAs and BCaBAs is greatly lessened and nearly eliminated. The more supervision an RBT team member receives, the more feedback he/she has received on performing best practice and the more likely he/she will be successful with teaching appropriate skills at an appropriate rate. Increased supervision and oversight increases the likelihood that programming is run correctly with a high level of consistency. At BCOTB, BCBAs and BCaBAs are readily available to answer staff questions, check in on sessions, and provide general guidance. This represents a strong advantage to in-clinic therapy.
Proper Therapy Procedures
Therapy provided in a clinical environment is also easily controlled, meaning the room can be arranged to best facilitate learning. While community settings provide rich opportunities to target social skills and more complex verbal skills, a clinic sets the stage for learning preacademic and essential life tasks in a manageable way, with materials arranged for the learner’s success.
Strong Therapy Teams
In addition to receiving supervision during session, BCOTB’s RBTs also receive supervision during designated “case meetings” with other RBTs and the BCBA/BCaBA in charge of a client’s programming and therapy. Case meetings are essential to ensuring that all staff are running programming and responding to problematic behaviors in a consistent manner. In-clinic therapy affords the opportunities for therapy teams to meet together on a regular basis to strengthen communication and collaboration, which is a hallmark of BCOTB’s services.
It is often beneficial to have a clear date, time, and setting for caregiver support sessions. Caregiver support sessions are meetings during which the BCBA/BCaBA meets with caregivers and identifies goals and areas for growth in either the management of problem behavior or the acquisition of new skills. The certified staff member explains and models therapy techniques and gives caregivers the opportunity to practice therapy procedures and receive feedback. While caregiver support can certainly be effective in any environment, the consistency of regularly scheduled sessions without other distractors present (e.g., answering the phone, needing to make dinner, answering the door, petting the dog, etc.) is invaluable for clarifying goals and making treatment most consistent.
Ultimately, the choice to receive therapy in a particular setting is a decision that caregivers must make. BCOTB encourages caregivers to ask questions and to choose their child’s therapy setting based on his/her unique needs, skillsets, and goals. Children who are older and/or who already have complex verbal skills (e.g., can recall past events, speak in full sentences, answer a variety of “wh” questions, demonstrate some reading comprehension, etc.) and/or social skills may benefit more from receiving therapy in the community setting. BCOTB offers a free consultation for caregivers to discuss possible therapy settings and to tour BCOTB’s locations. Contact us today for more information!