What is ABA therapy?
ABA stands for applied behavior analysis. It's a therapy that teaches skills like talking, playing and daily routines in small steps, and it's the therapy most insurance plans and Medicaid pay for after an autism diagnosis.
What ABA is, in plain words
Applied behavior analysis (ABA) is a therapy that rewards helpful behaviors and discourages harmful ones to build skills, and progress is tracked with data. Source: Centers for Disease Control and Prevention.
ABA goals often include better communication, social skills, self-care, play, and daily living skills. Source: Centers for Medicare & Medicaid Services.
A Board Certified Behavior Analyst (BCBA) designs the treatment plan and oversees care, while a Registered Behavior Technician (RBT) works directly with the child under that supervision. Source: Centers for Medicare & Medicaid Services.
The CDC says behavioral approaches have the most evidence for treating autism symptoms and names ABA as a notable example. Source: Centers for Disease Control and Prevention.
The American Academy of Pediatrics lists ABA among appropriate autism treatments, and the American Psychological Association calls it evidence-based, though neither calls it the only best choice. Source: Centers for Medicare & Medicaid Services.
What a session looks like
A therapist works one-on-one with your child, at a center, at home or sometimes at school. They practise one skill at a time, such as asking for a toy or washing hands, and praise or reward each step that goes well.
The therapist writes down what happens in every session. A behavior analyst reads those notes, watches sessions and changes the plan when a goal is met or isn't working. You should get parent training too, so the skills carry over at home.
How many hours: Focused ABA is usually 10 to 25 hours a week and comprehensive ABA is usually 30 to 40 hours a week, per CASP guidelines; CMS says needs can range from 5 to 40 hours a week. Source: Council of Autism Service Providers (CASP), hosted by UC San Diego, Centers for Medicare & Medicaid Services.
How to start ABA therapy
- Get a diagnosis. Most plans won't pay without one. Find an autism evaluation.
- Check what your plan pays. Insurance and Medicaid, state by state.
- Call two or three providers. Ask about your plan, ages, waitlist and whether they work at home or in a center. ABA therapy near you.
- The assessment. A behavior analyst meets your child, sets goals with you and asks your plan to approve the hours.
Why some people criticise ABA
Some autistic adults say ABA tried to make them act less autistic, and older forms used punishment. Today's ethics rules ban harmful methods, but you should still ask hard questions.
What it costs
ABA is billed in 15-minute units, so the bill follows the hours. Medicaid usually pays all of it for children who qualify.