Complementing Center-Based ABA Interventions with In-Home Care

In-home applied behavior analysis (ABA) therapy for children with autism and other developmental disorders consists of highly flexible and versatile programs that supplement or replace facility-based care. ABA home care allows applied behavior analysts to accommodate children and families with special needs in the home to ensure access to effective therapy.

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Depending on the needs of the child, the parent, and the availability of the applied behavior analyst, in-home ABA services can replace or complement center-based interventions.

Many applied behavior analysts find that providing in-home therapy to children with autism facilitates learning and decreases undesirable behaviors because the ABA services are delivered in an atmosphere the child finds safe, familiar, and non-threatening. This allows the applied behavior analyst to better manage the child’s behavior so ABA therapies and techniques can be more effectively implemented.

For example, Cincinnati Children’s Hospital Medical Center, in a 2013 Best Evidence Statement, found that adding home-based developmental interventions to complement center-based interventions for children with autism spectrum disorders (ASDs) or other pervasive developmental disorders was shown to improve:

  • A child’s IQ in families with high stress
  • Communication
  • Gestures produced
  • Play skills

It was also shown to have a significant impact on the child’s parents, resulting in:

  • Reduced parental stress
  • Reduced parental depression
  • Increased parental satisfaction with child outcomes

How Applied Behavior Analysts Provide ABA Therapy in the Home

Providing ABA therapies and interventions in-home is not unlike center-based interventions, as the goal is to development treatment/behavior plans with objective and measurable goals. Behavior analysts provide a detailed initial assessment of the child’s ability, develop appropriate goals accordingly, and selects treatment methods with the in-home environment in mind, which often presents unique opportunities to incorporate parents and siblings in therapy.

Home-based care also allows applied behavior analysts to meet regularly with the family to review the child’s progress and make treatment adjustments as needed.

Home-based ABA therapy provides applied behavior analysts with the opportunity to improve a child’s:

  • Social skills
  • Self-help skills (e.g., toilet training, self-dressing, self-care, eating, etc.)
  • Family interactions (e.g., performing chores, shopping, eating out, etc.)
  • Verbal behavior
  • Academics
  • Independence

In-home ABA therapy provides the ideal setting for teaching children daily living and household skills, as it allows the applied behavior analyst to implement interventions in the setting where the behavior will take place. In other words, ABA therapies may be most effective when taught in a natural environment instead of a simulated one.

For example, using ABA therapies to teach a child to use the toilet is best accomplished in the child’s own bathroom, instead of a bathroom in a behavioral center or other unfamiliar location.

In-home therapy also facilitates parent/caregiver training, a necessary component of any ABA program.

The Link Between In-Home ABA Therapy and Successful Parental Involvement

The parent-child relationship is fundamental to a child’s social and behavioral development. The National Professional Development Center on Autism Spectrum Disorders lists parent-implemented interventions as effective “evidence-based” practice for children with autism.

Numerous studies have found that parental teaching results in more frequent verbalizations, spontaneous speech, and specific words and improvement in the social interactions of a child with ASD.

In-home care provides better, and more opportunities for parent and caregiver training, thereby allowing them to reinforce the ABA interventions and increase the chances that the child will maintain the desired behavior.

Tele-Health Services Increase Access to Home-Based ABA Therapies

A lack of access to ABA services remains a problem throughout much of the nation, particularly in rural areas. Telehealth—the use of technology (usually videoconferencing) to deliver services like ABA—has brought ABA therapy to many individuals who otherwise would not have access to it because of their geographic location.

Often called telebehavioral health, distance-based ABA services are arguably one of the most successful applications of telehealth across the spectrum of clinical services.

Telebehavioral health is also beneficial for patents who may be fearful and resistant to meeting face-to-face with applied behavior analysts in a clinic setting or those unable or unwilling to engage in center-based ABA therapy. It serves as a cost-saving measure for many families, as it eliminates travel time and the need to miss work. Applied behavior analysts can deliver ABA interventions quickly via teleconferencing sessions at times convenient to the parents.

The Health Resources and Services Administration (HRSA) identifies telebehavioral health services as cost-effective and efficient, improving care delivery and increasing access to experts like applied behavior analysts not located in the community.

Telebehavioral health allows applied behavior analysts to work part-time for multiple clinics via a convenient remote location, such as their home, thereby increasing their availability to clients.

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