What is ABA Therapy?

Note: I may earn money or products from the companies, products, or links mentioned in this post.

I get asked all the time about ABA therapy. What is it? Why do my kids need it? So I want to take the time to break it down and explain what ABA therapy is all about and what it’s so important.

What is ABA?

Short Answer: ABA stands for Applied Behavioral Analysis.

What does it mean? In layman’s terms, it means that behavioral principles are applied to everyday situations in order to increase or decrease certain behaviors. ABA therapy can be used to help with things like language skills, self-help skills, and play skills and to help manage and decrease behaviors such as aggression, self-stimming behaviors, and self-injury.

Even my son knows how to break it down and explain it:

Who Needs ABA?

While I personally believe there are many different disorders and syndromes that could benefit from ABA therapy, insurance only pays for this type of expensive therapy if the child has an autism diagnosis.

While a few insurances may cover this type of therapy in full, it is rare and most parents have to pay out of pocket or receive grants in order to get this therapy that can be $60,000+ per year, per child.

Two Types of ABA

Many people don’t know this, but there are two types of ABA therapy. They are:

• NET – Natural Environment Training
• DTT – Discrete Trial Training

“Natural Environment Teaching (NET) is utilizing principles of Applied Behavior Analysis to teach in the natural environment, ‘the real world’.” NET is the main type of ABA therapy both of my children receive.

I believe in NET because it is taught in my kid’s natural environment, the home. NET does not mainly use a structured setting but instead uses the child’s lead which is similar to play therapy.

In order to motivate the child with autism, the therapist uses things in the child’s home, outdoors, at school, or any other setting that the family prefers. We have taken our ABA therapists to the store with us to work on in-store behaviors. They have come to the zoo with us to help with social skills and learning about strangers and what to do if my son were to get lost. All we have to do is request it and usually they will come.

Discrete Trial Training (DTT) is teaching in a simplified and structured environment. Instead of the child being taught a skill at one time, the skill is broken down into steps and build back up using “discrete trials.” This type of therapy will look very structured such as at a table using flash cards. Here’s an example from EducateAutism.com:

Discrete Trial One

1. Teacher places one red and one blue card on the table in front of Jane
2. The teacher then says “point to red”
3. Jane responds by pointing to the red card
4. The teacher would say “That’s right! Great job!”
5. There would be a very short pause before a new discrete trial would begin

Discrete Trial Two

1. Teacher places one red and one blue card on the table in front of Jane
2. The teacher then says “point to blue”
3. Jane responds by pointing to the blue card
4. The teacher would say “You’re right! That’s Brilliant!”
5. There would be a very short pause before a new discrete trial would begin

Now, here’s where it can get confusing. While our therapists mainly do NET therapy, there are some DTT involved too. So if my daughter wants to play outside they might do a similar trial to the one above. One they are working on is laying down two cards and asking, “Which one do you write with?”

In the beginning, they have to pick up her hand, point to the pencil, and say, “We write with a pencil!” Once she can handle that, then they follow the above steps and wait for her to choose the right one.

If she does well with 2-3 of these questions then she gets to go outside to play. If she has a meltdown or has behavior problems, then she will have to stay in to do more questions until she can calm down and ask nicely to go outside.

Our therapists come to our home or come with us to appointments or outings to help teach our children in their natural environment. But some ABA therapists or clinics may say they teach NET, but they really don’t teach in a natural environment at all. Because if your child is in a clinic for ABA therapy, they are only learning in one environment and those skills will be lost or not be carried over to other places, especially the home.

There is so much more to it than these simple definitions. A lot of data must be recorded, a lot of testing to be done, and lots trial and error. Depending on your therapist, your child’s ABA therapy may look different from ours. It doesn’t necessarily mean it’s wrong or bad. It can also be dependent on whether the child is low or high functioning.

In the simple terms of a friend, “DTT is artificially constructed programming and NET allows the child to learn all the skills they need in the context of their own lives.”

For more on NET and DTT and their differences check out this file on their different techniques.

Who Teaches ABA Therapy?

• A BCBA – Board Certified Behavior Analyst
• An ABA Tutor

A BCBA is has a graduate-level degree and certification in behavior analysis. Those who are certified for this are usually independent therapists who provide behavior-analytic services. In our case, each of my children have their own BCBA.

They come 1-2 times a week to check on my kid’s progress, to train the ABA tutors, and to help answer any questions we have or with any troubling behaviors our children have developed. They also do all the testing and they are the ones that create each child-specific learning and behavior plan.

An ABA tutor is a therapist who works in the home with the child on a daily basis. She is the one who implements the learning and behavior plan made by the BCBA and tracks the skills that my kids have learned. I don’t know for sure what level of degree or certification an ABA tutor must have, but it is a much lower level than a BCBA.

 What ABA is NOT

• Free babysitting. I’ve heard many families say they don’t understand why they can’t leave the house when their child’s ABA therapist is in the home. They are not paid to babysit, they are paid (much like teachers) to help your children to learn life-long skills.

• Used to bribe kids. I hear this one a lot. It’s not about bribing the kids with free iPad time, toys, etc. It’s about rewarding for good behavior. See more on this here.

• Therapy for behavior only. Our ABA therapists have helped with speech problems, done feeding therapy, worked on social skills, helped us potty train, and help my son with his homework. It’s so much more than just “behavior training.”

• A for of physical punishment. No ABA therapist should ever use physical punishment as a “therapy” for autism. There are so many techniques (such as the hand-over-hand method) that can be used and if a therapist ever hurts your child, you need to report it right away.

There are many myths on what ABA therapy is and isn’t. If you are looking to get your child into ABA, I highly suggest you do research for yourself first to decide what it is you are looking for and which therapists would be best for your child and your family. For more on ABA myths and misconceptions click here:

• Top 10 Myths About Applied Behavior Analysis
• Myths and Misconceptions of ABA
• Common Misconceptions of Applies Behavior Analysis

A well-trained ABA therapist will be loving, but firm. Their relationship with the child will reinforce good behavior and the child should always look forward to the therapist coming over.

This type of relationship will help facilitate empathy, compassion, and theory of mind in your child. I don’t know about you, but that’s what I want for my children.

What about YOU? Does your child do ABA therapy? What are your thoughts on it?