Have you heard of Applied Behavior Analysis (ABA) therapy?
ABA is a scientific set of principles based on research that helps build meaningful and significant social behaviors for families and individuals.
ABA therapy is especially common for children diagnosed with Autism Spectrum Disorder (ASD), especially with younger individuals or those still trying to acquire basic skills. While ABA can be used for a wide range of conditions, we will focus on its use in autism.
ABA is not the only treatment for ASD, however, it currently has the most scientific validation, which is why the US-based healthcare system has increasingly adopted it as the first line of treatment. The world seems to be following the US in this approach and ABA is growing in popularity everywhere. Outside of the US, Europe and then Latin America has the highest rates of ABA treatment.
The rise of institutional acceptance of ABA within the United States, including changes under Obamacare, has meant rising demand for ABA. ABA practitioners go through years of post-graduate training, and while more and more graduate schools offer ABA programs, and more and more individuals become practitioners, there is still a shortage of practitioners in the market. This shortage has meant a rise in the cost of ABA therapy, which can present a real challenge for families, particularly those in low-income households. Privately financed ABA (i.e. not though insurance, public school or government programs) is generally cost-prohibitive to families, so we’ll discuss how you can receive coverage through insurance and government-mandated programs.
So how much does ABA therapy cost? Before we dive into pricing, we’ll first give you more details on what ABA therapy is, what conditions it helps treat and how it relates to ASD.
As always, keep in mind that the research in this article is based on our own findings and experiences in the space. Every child and situation is unique, and it’s important not to lose sight of that fact, so please do your own research but feel free to use this article as a handy guide.
What is ABA Therapy?
As mentioned above, Applied Behavior Analysis is based on the science of learning and behavior.
Behavior analysis helps us understand:
- How behavior works
- How behavior is influenced by the environment
- How learning occurs
One of the central elements of ABA therapy is its ability to ready a child for the real world. It applies our understanding of how behavior works in real-life situations. The primary goal of ABA is simple: to decrease behaviors that are harmful or negatively impact learning, and increase behaviors that are helpful and productive.
ABA therapy programs work to increase language and communication skills, improve focus, memory and social skills while decreasing problematic behaviors. This is all achieved through simple but effective reinforcement strategies.
ABA Treats a Range of Conditions
The methods used in Applied Behavior Analysis have been studied and improved for decades. In fact, ABA has been used to help children with Autism Spectrum Disorder and related developmental disorders and disabilities since the 1960s. As a result, they’ve helped many learners gain different skills, which range from learning a new language to adopting healthier lifestyles.
ABA is used in the treatment of a range of conditions, including:
- Autism Spectrum Disorder (ASD)
- Substance misuse
- Cognitive impairment after brain injury
- Attention Deficit Disorder (ADD)
- Eating disorders
- Anxiety and related conditions (panic disorder, OCD and phobias)
- Anger issues
- Borderline personality disorder
- Language-based learning disabilities (LBLD)
What is ABA Therapy for Autism Spectrum Disorder?
Applied Behavior Analysis is a scientifically-validated approach to Autism Spectrum Disorder management. It’s a method of treatment that’s becoming accepted by the medical community serving ASD patients.
Many experts consider ABA to be the best treatment for children with ASD, often in conjunction with other approaches. ABA involves several phases, allowing for an approach that’s tailored to your child’s specific needs and abilities. This personalized, individualistic approach is one of the main reasons for its effectiveness.
Keep reading to find out more about each of these phases.
Consultation and Assessment
First, schedule a consultation with a therapist trained in ABA. This consultation includes a functional behavior assessment (FBA). During the session, the therapist will ask about and evaluate your child’s abilities, strengths and challenges.
As your child interacts with the therapist, they will make observations about the child’s communication level, skills and behavior. They may also arrange home and school visits to witness the child’s behavior in these spaces.
In order for ASD treatment to be effective, it must be customized to meet the specific challenges and needs of each child. ABA therapists will talk to you about specific interventions that fit your child’s environment and behavior. In addition, they’ll ask about integrating certain strategies into your home life.
Developing a Plan
Next, your child’s therapist will use findings from the initial consultation to develop a formal therapy plan. This plan will align with your child’s needs and include concrete treatment goals.
Often, these goals will relate to reducing harmful and problematic behaviors, such as tantrums or self-injury. They’ll also stipulate the reinforcement of positive pro-social behaviors such as improving and increasing communication skills.
This plan is a helpful tool for parents, caregivers and teachers because it outlines specific strategies all these parties can use to work towards the treatment goals. Coordinating care is extremely important, and this plan ensures that everyone who works with your child works as a team and is on the same page.
An important element of ABA therapy and coordinated care is that it relies on teachers, parents and caregivers to help reinforce desired behaviors when the child is not in therapy.
An ABA therapist will show you and your child’s teachers strategies to help reinforce the work being done in therapy.
In addition, the therapist will provide training on how to avoid types of less effective reinforcement. A consistent approach from parents or caregivers will result in better outcomes, so your therapist will help you to manage behaviors such as tantrums and meltdowns in a consistent and constructive way.
Lastly, ABA therapists aim to uncover the causes of important behaviors. Often they will note what preceded a behavior (antecedent), the behavior itself, and the result of the behavior (consequence) in the data collection technique called ABC data. This is a critical part of helping a therapist to understand the child’s motivations. At that point, the therapist can help the child to replace their approach with more constructive behavior.
Depending on how your child responds, other interventions may be required. Your child’s progress will be carefully monitored during the process. This allows for frequent evaluation, allowing therapists to use the unique strategies they find are working best for your child.
ABA Therapy Cost
ABA therapy programs are available through both private companies and government-contracted agencies. These can range from small local agencies to large regional or national groups. Generally, and especially in a healthcare setting, therapy will be overseen by a Board Certified Behavioral Analyst (BCBA), who does the evaluations, the treatment planning and the parent training. However, direct therapy with the child is often done by one to two Registered Behavioral Technicians (RBTs). There are some differences in designations based on what state you are in, and education settings, like your child’s school, may not have the same certification process.
When therapy is provided through private insurance according to the model above, the child will receive some amount of weekly RBT hours (ie therapy hours), which the insurance pays, as well as a smaller number of hours for the BCBA to supervise the therapy. There is some variance in how much therapy costs in total, but a decent rule of thumb is that insurance companies pay roughly $30,000 per year to treat one child with ASD. This is why it’s so prohibitively expensive for families to afford treatment privately.
In addition, autism-specific public and publically funded schools increasingly also provide ABA as part of the overall education. This can also be extremely expensive. On average US states spent ~$12,000 per pupil per year on pre-kindergarden through 12th-grade education in 2019. Autism specific schools tend to spend many times that per pupil.
Therefore, most funding for treatment comes either from private insurance, publicly funded education institutions or government insurance programs. To find out more about whether your health insurance must cover the cost of ABA therapy, check out this article to review your state laws. The medical coverage you have and the treatment you’re seeking will play a part in whether you’ll be covered.
Remember that even if your insurance doesn’t cover “autism treatment,” there’s still a good chance you can get certain components covered. For any questions pertaining to insurance, we suggest contacting your insurance provider.
Reducing the Cost of Care
The high costs relating to therapy for children with ASD, and the fact that medical insurance doesn’t always cover treatment, means that many families are searching for more affordable options for applied behavior analysis services.
Private ABA Providers
These days, there is a range of private clinics that see ASD patients. While many don’t offer free services, they often have a sliding scale for low-income families.
Remember that many ABA providers offer free consultations and some will provide free treatment depending on the needs of the family.
Both public and private social service agencies offer free or discounted ABA services. These are often supported through donations or by government assistance programs. Families who qualify can enjoy low-cost or free services for their children.
To qualify as a family, you must pass certain standards for diagnosis and income level. Low-income families with a child who has an official ASD diagnosis will often qualify.
These services are sometimes integrated into other programs that don’t offer ABA therapy. After-school programs and day-cares are examples of such services.
Sometimes, the agency serves as a centralized resource. These agencies offer case management services and will help direct families to other free or low-cost ABA resources.
Free ABA Services
The most common source of free ABA services is your local school system. The Individuals with Disabilities Education Act of 2004 mandates that school districts provide appropriate and free public education for all students. This includes students with disabilities.
Districts are required to offer accommodations to serve a disabled student in the least restrictive environment possible to provide for their education. Although this doesn’t require the school to provide ABA services, most will do so.
Since ABA is the most scientifically validated treatment method for autism, schools are more likely to support this form of treatment. Urban and suburban areas are the most likely to have ABA within the public school system, but there has been a much needed push in recent years to give this option to families in rural areas. Additionally, an increasing amount of special education teachers are choosing to focus their graduate studies on learning ABA treatment methods.
The CDC writes, “A notable treatment approach for people with an ASD is called applied behavior analysis (ABA). ABA has become widely accepted among health care professionals and used in many schools and treatment clinics.”
As you can now see, there are many factors that impact the cost of ABA therapy services. In an effort to support the ABA and ASD communities, we hope this was helpful!
If you have any additional questions or feedback, please let us know.