After a series of appointments, evaluations, and assessments with various doctors and developmental professionals to get an autism diagnosis, parents may be a bit confused as to why an ABA therapy assessment is necessary.
However, this specific assessment is a very important step in creating a treatment plan for therapy that is unique to each and every child enrolling in ABA therapy. Unlike medical evaluations, which focus more on getting a diagnosis, ABA assessments look more closely at a child’s skills and behaviors to determine the goals most beneficial to work on in treatment.
They look at a child’s daily living abilities, communication skills, social abilities, play skills, problem behaviors, and other developmental skills and use their findings to create the best possible plan for them. ABA therapy is far from a one-size-fits-all type of treatment, and this individualization starts with the initial assessment.
In this article, we’ll break down what the assessment involves, why it is essential, and how parents can best prepare. This assessment process really does set the stage for the most effective therapy and the best possible outcomes.
What Is an ABA Therapy Assessment?
As mentioned above, an ABA therapy assessment is a comprehensive evaluation that is used to understand a child’s strengths, behaviors, skills, and challenges to create a personalized treatment plan. The assessments and evaluations that are completed before the ABA assessment, typically carried out by psychologists and medical doctors, are usually completed to obtain a diagnosis.
For many states, an autism diagnosis (with the official DSM, f84.0 diagnosis code) is required for insurance to cover ABA sessions with a client. They do look at the child’s skills and behaviors, but they are more so to determine if they meet the criteria for autism spectrum disorder (ASD). ABA assessments go a bit deeper in analyzing behaviors. This type of evaluation helps to determine which interventions will be the most effective and which goals will be the most helpful to work on.
The assessment process focuses on the child’s strengths and weaknesses. The BCBA on the case uses a few different assessment tools to gather data. They conduct the observation, caregiver interviews, and review other related records. This information helps them to create a treatment plan and determine the need for ABA therapy treatment.
Get Caring, In-Home ABA Therapy, Fast
Fill in the form below to discuss how your child could start therapy quickly, without the stress:
- Therapists Available
- Help With Insurance
- Quick Response
Why Is an ABA Assessment Important?
An ABA assessment is crucial because it establishes a baseline of a child’s skills and behaviors. The data collected serves as a starting point for measuring a child’s progress over time. The data collected during an ABA assessment gives BCBAs a clear picture of where the child currently stands. Once this is established, progress can be tracked.
In addition, it shows what strengths a child may have. For example, if a child is observed to have solid listening skills but struggles with communication skills, BCBAs can create a plan that focuses more on building those communication skills. It can also help to create interventions that utilize their own strengths. If needed, adjustments to goals or interventions can be made during the authorization period.
Beyond skill development, the assessment also helps to pinpoint challenging behaviors and potential triggers. Targeted interventions can only really be created once BCBAs know what behaviors are occurring and why they might be occurring. Whether it’s because of sensory sensitivities, communication difficulties, or environmental reasons, behavioral professionals can create programs to address the root causes of problems, rather than just addressing the behavior itself.
This method of practice is more effective and meaningful for promoting change in the long run. The assessment also ensures that treatment aligns with family goals and routines. BCBAs typically incorporate goals that caregivers would like worked on, along with other goals that aid in growth and development.
What Does an ABA Assessment Include?
1. Parent and Caregiver Interview
During an observation, it’s impossible to get a complete picture of a child’s skills and behaviors, so there is usually time spent talking with caregivers about the child. This interview goes more into detail about the developmental history, daily routine, strengths, and challenges that the child may face. BCBAs also use this time to discuss specific concerns that parents might have. This helps to ensure that the therapy goals align with the needs in their specific home environment, which helps to better generalize skills that are taught.
2. Direct Observation of the Child
The next part, and arguably the most important, is a direct observation. During this part of the section, the BCBA will watch the child. This might happen in a clinic, at home, or in school. This helps them to get a better understanding of their natural behaviors and interactions with people and things around them. Parents offer a lot of valuable information, but carefully observing the child gives BCBAs a clearer picture of how the child communicates, engages with others, and so on. They may also take note of self-stimulatory behaviors (commonly known as stimming), tantrums, or any difficulty they may have with transitions.
3. Skill-Based and Functional Assessments
When the BCBA interacts with the child, they use a series of skill-based and functional assessments to determine the child’s abilities. They evaluate verbal and communication skills, the ability to follow directions, and the ability to express needs. They also assess social skills (including how individuals interact with peers, joint attention, sharing, and parallel play), daily living skills (such as dressing, hygiene, and eating), and learning abilities (including problem-solving, memory, and attention span). Finally, a behavioral assessment is conducted to identify possible triggers for challenging behaviors such as aggression, self-injury, or elopement.
4. Functional Behavior Assessment (FBA)
A functional behavior assessment (FBA) is a crucial component of the evaluation for children exhibiting challenging behaviors. An FBA helps to identify the reason that behaviors may be occurring. They use information from ABC data collection, which looks at what happens before and after a behavior, to determine if a behavior is occurring to gain attention, escape a task, access an item, or fulfill a sensory need. By breaking down behaviors this way, professionals can determine why a behavior is occurring and design a behavioral intervention plan (BIP) that reduces challenging behaviors by teaching alternative responses.
5. Standardized ABA Assessment Tools
Standardized ABA assessment tools are used to evaluate developmental progress and behavioral needs. One of the most commonly used tools for children 5 and under is called the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP). The VB-MAPP looks at language and social skills to determine communication goals. The Assessment of Basic Language and Learning Skills-Revised (ABLLS-R) is also widely used and measures abilities in communication, social, and academic skills. The Assessment of Functional Living Skills (AFLS) focuses more on daily skill activities such as eating, getting dressed, bathing, and so on.
What Happens After the ABA Assessment?
Once the assessment is complete, the BCBA carefully goes over the results to create an individualized treatment plan made specifically for the child. It outlines specific goals and determines the recommended number of therapy hours per week.
For children who require less support, less hours may be recommended. For children who may need more support in their daily lives, the BCBA may request more hours per week. Hours for ABA can vary vastly, from less than 10 to over 30 hours weekly. Collaboration with parents is a key part of this process to ensure consistency between therapy sessions and home life. The BCBA will discuss with caregivers different ways to reinforce learned skills and how to manage behaviors outside of therapy time.
How Can Parents Prepare for an ABA Assessment?
There are a few things that parents could do to prepare for an upcoming ABA assessment. Firstly keeping a type of behavior log can be helpful, although having one is not necessary. When a challenging behavior occurs, caregivers can document the behavior, where it happened, what happened before, and other relevant information. This can be helpful for remembering information when asked about it during the parent interview. Keeping note of specific behaviors, even without surrounding information, can be helpful.
More importantly, gathering medical and developmental history records is necessary. This can help to streamline the process, especially since much of this information is required for insurance approval of an ABA treatment plan. This also allows for the BCBA to get a better, more complete picture of the child’s background.
Finally, taking some time to reflect on the child’s strengths, weaknesses, and daily challenges can be helpful. As someone who has completed many, many ABA assessments, this is one set of questions I am sure to ask parents every single time. We are certainly the most reliant on the data collected during the observation, but parent input has always been incredibly helpful. Thinking about these things ahead of time can make the interview process go much quicker and smoother.
Common Misconceptions About ABA Assessments
It’s just another autism diagnosis test. → Not true!
At this point in the treatment process, autism has already been diagnosed. There is no need to complete another autism evaluation if it has already been diagnosed. In addition, BCBAs cannot diagnose autism spectrum disorder or any other condition (unless they are also a board-certified clinical psychologist, but those are pretty rare). BCBAs go into ABA assessments already aware of the client’s medical history. They are focused on writing goals and planning interventions to help in the treatment of autism.
ABA only focuses on bad behaviors. → Nope.
There is certainly a component of ABA that focuses on problem behaviors, but ABA is also used to teach new behaviors. Social skills, motor skills, daily living skills, communication skills, play skills… the list goes on. Nearly all of the clients I’ve worked with in my career have spent much more time working on these types of skills, not just problem behaviors.
The assessment is stressful for the child. → Another misconception.
The assessment is different for each child. BCBAs use play-based techniques to figure out what skills a child may have. They may feel a tiny bit of frustration if a skill is probed that they cannot do independently, but the BCBA is trained to recognize such moments and acts to ensure that the process stays positive. If that happens, the BCBA usually ends the tasks, records the response, and moves on to another activity to minimize stress. Otherwise, an assessment will typically look like play mixed with seemingly random types of instructions.
Conclusion
An ABA therapy assessment is the first and arguably most important step in creating a successful plan for children with autism. While diagnostic assessments work to diagnose a child with autism, the ABA assessment works to help in the treatment of autism spectrum disorder. The assessment process includes parent interviews, direct observation, evidence-based assessment tools, and behavior analyses to gather information to design the best possible treatment plan. Parents can make this step run smoothly by being prepared to answer questions and by gathering necessary documentation before the assessment date.
For most parents, the process of finding a BCBA to start therapy starts with the child’s primary care physician. Pediatricians are usually familiar with some of the ABA companies in the local area and often refer parents to different providers. If the parents are not satisfied with the options given by medical providers, the Internet is a great source of information. Using a search engine to look up local providers in your area is a good place to start. Parents can also look through reviews, or even visit forums for parents of children with autism to connect with others and ask questions about providers.
