ABA Therapy is a behavioral approach that uses environmental strategies, positive behavior
supports, positive reinforcement and antecedent and consequence strategies to teach new skills
and behaviors. Just as there is no “one size fits all” ABA treatment plan, choosing the right
service model is unique to each individual, their family, and their specific needs. When choosing
a treatment setting keep in mind the following when determining what is right for you and your
family.
Clinic: In lieu of a BCBA or RBT(Registered Behavior Technician) having services in your
home, parents may take their child to the clinic for sessions. One advantage of clinic sessions is
the increased opportunities for social interactions. Depending on your child’s treatment goals,
this setting can be ideal if your child’s treatment plan includes peer play, turn taking & sharing,
conversational skills, etc. Additional benefits include specific reinforcers (toys and games, etc)
at the clinic that may not be available at home and a controlled environment that can limit
distractions easier. However, for more intensive behaviors such as self injurious behavior, or
aggression, session in the clinic setting may not be appropriate. Additionally, due to services
being in the clinic, caregivers may not be able to see how goals are being implemented at the
clinic so additional parent training may be required outside of clinic session times. Due to
location or budget & time restraints this setting may not be appropriate for each family.
Home: ABA sessions within the home, entails a BCBA or RBT travelling to your house, to
provide ABA services. In this setting, more intensive behaviors may be targeted such as
tantrums, aggression and self injurious behaviors. Parents may also have additional
opportunities to observe goals being implemented, ask questions, and implement behavioral
strategies with team support. In-home sessions allow for the clinical team to observe behaviors
in a more natural setting. This setting may be advantageous for individuals who are working on
self-help skills such as chores, toileting/bathing, functional communication, coping skills, etc.
However, opportunities for socialization with peers may not be as readily available and in home
services may have prove to be distracting to some learners.
Telehealth: Depending on client age, the type of goals being targeted, or the location of a
family, telehealth services may be the best option. For example, for adolescents and adults who
are less impacted, telehealth may be a great way for a clinician to work on skills such as
boundaries setting, ACT (Acceptance and Commitment Therapy), social skills strategies etc.
Some disadvantages to this model may be the limited opportunities for social interaction and
some goals may be harder to implement with families (such as goals that require a higher level
of prompting). This model may also not be appropriate for younger children who need a
caregiver to stay on task. Telehealth can also be beneficial for parent consultation and support
as the care team may be able to meet with families in more remote locations, and families who
would like to consult with a Behavior Analyst but do not need ongoing, intensive care.
Community:
Services in the community may be appropriate for practicing community engagement and
integration, self help skills, shopping, taking public transportation, etc. This service setting may
be very advantageous for adolescents and older individuals. However, this service setting may
not be appropriate for more intensive behaviors and may be harder (though not impossible) to
implement with staff who are telehealth. Additionally a community setting may not be
appropriate for individuals who engage in unsafe behaviors (such as eloping).
Social Skills Group:
Social Skills groups are a wonderful setting for individuals who would like to meet peers, learn
social skills, safety skills, boundaries and communication skills. While different social skills
groups may be tailored to different age groups, it may not be an appropriate option for
individuals who are unable to attend to tasks for longer periods of time or may display more
intensive behaviors (such as disruptive or aggressive behaviors).
Pre-School/School
ABA services provided in pre-school/school settings are appropriate for school aged children
and adolescents. In pre-school goals may include introducing sharing and turn taking, functional
communication, toileting, transitions and tantrums. In school, Depending on what is in your
child’s IEP days and times along with goals may vary(Calaba.org). ABA staff may work with your
child on staying on task, following directions, and disruptive behaviors (such as aggression,
tantrums and Self Injurious Behaviors). While this setting may be ideal for students who need
behavioral support in school, skills learned may be harder to generalize to a home setting, so
additional services and support in home or in additional settings may also be required.
These are just a few of the settings ABA can be implemented in. Choosing a treatment setting is
a highly personal one that may vary depending on family and staff availability, location, and
client’s goals. We recommend that if you have any questions regarding the appropriateness of
treatment setting you speak to your child’s ABA team to determine what is right for you.
References:
https://calaba.org/media/content/CalABA-Setting_of_Care.pdf
ABA Therapy is a behavioral approach that uses environmental strategies, positive behavior
supports, positive reinforcement and antecedent and consequence strategies to teach new skills
and behaviors. Just as there is no “one size fits all” ABA treatment plan, choosing the right
service model is unique to each individual, their family, and their specific needs. When choosing
a treatment setting keep in mind the following when determining what is right for you and your
family.
Clinic: In lieu of a BCBA or RBT(Registered Behavior Technician) having services in your
home, parents may take their child to the clinic for sessions. One advantage of clinic sessions is
the increased opportunities for social interactions. Depending on your child’s treatment goals,
this setting can be ideal if your child’s treatment plan includes peer play, turn taking & sharing,
conversational skills, etc. Additional benefits include specific reinforcers (toys and games, etc)
at the clinic that may not be available at home and a controlled environment that can limit
distractions easier. However, for more intensive behaviors such as self injurious behavior, or
aggression, session in the clinic setting may not be appropriate. Additionally, due to services
being in the clinic, caregivers may not be able to see how goals are being implemented at the
clinic so additional parent training may be required outside of clinic session times. Due to
location or budget & time restraints this setting may not be appropriate for each family.
Home: ABA sessions within the home, entails a BCBA or RBT travelling to your house, to
provide ABA services. In this setting, more intensive behaviors may be targeted such as
tantrums, aggression and self injurious behaviors. Parents may also have additional
opportunities to observe goals being implemented, ask questions, and implement behavioral
strategies with team support. In-home sessions allow for the clinical team to observe behaviors
in a more natural setting. This setting may be advantageous for individuals who are working on
self-help skills such as chores, toileting/bathing, functional communication, coping skills, etc.
However, opportunities for socialization with peers may not be as readily available and in home
services may have prove to be distracting to some learners.
Telehealth: Depending on client age, the type of goals being targeted, or the location of a
family, telehealth services may be the best option. For example, for adolescents and adults who
are less impacted, telehealth may be a great way for a clinician to work on skills such as
boundaries setting, ACT (Acceptance and Commitment Therapy), social skills strategies etc.
Some disadvantages to this model may be the limited opportunities for social interaction and
some goals may be harder to implement with families (such as goals that require a higher level
of prompting). This model may also not be appropriate for younger children who need a
caregiver to stay on task. Telehealth can also be beneficial for parent consultation and support
as the care team may be able to meet with families in more remote locations, and families who
would like to consult with a Behavior Analyst but do not need ongoing, intensive care.
Community:
Services in the community may be appropriate for practicing community engagement and
integration, self help skills, shopping, taking public transportation, etc. This service setting may
be very advantageous for adolescents and older individuals. However, this service setting may
not be appropriate for more intensive behaviors and may be harder (though not impossible) to
implement with staff who are telehealth. Additionally a community setting may not be
appropriate for individuals who engage in unsafe behaviors (such as eloping).
Social Skills Group:
Social Skills groups are a wonderful setting for individuals who would like to meet peers, learn
social skills, safety skills, boundaries and communication skills. While different social skills
groups may be tailored to different age groups, it may not be an appropriate option for
individuals who are unable to attend to tasks for longer periods of time or may display more
intensive behaviors (such as disruptive or aggressive behaviors).
Pre-School/School
ABA services provided in pre-school/school settings are appropriate for school aged children
and adolescents. In pre-school goals may include introducing sharing and turn taking, functional
communication, toileting, transitions and tantrums. In school, Depending on what is in your
child’s IEP days and times along with goals may vary(Calaba.org). ABA staff may work with your
child on staying on task, following directions, and disruptive behaviors (such as aggression,
tantrums and Self Injurious Behaviors). While this setting may be ideal for students who need
behavioral support in school, skills learned may be harder to generalize to a home setting, so
additional services and support in home or in additional settings may also be required.
These are just a few of the settings ABA can be implemented in. Choosing a treatment setting is
a highly personal one that may vary depending on family and staff availability, location, and
client’s goals. We recommend that if you have any questions regarding the appropriateness of
treatment setting you speak to your child’s ABA team to determine what is right for you.
References:
https://calaba.org/media/content/CalABA-Setting_of_Care.pdf
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