What Do ABA Therapists Do?
- October 11, 2021
As I clarified in a previous blog post, at Waypoints we don’t really think of ourselves as therapists. Instead, we work in the roles of educators, consultants, and environmental engineers. The term “ABA therapy” implies that there’s something wrong that needs to be treated. But really, ABA is about helping any learner to gain the skills they need to thrive—not changing who they are as a person.
The technical names of the positions that applied behavior analysis (ABA) practitioners serve in, when certified by the Behavior Analyst Certification Board (BACB), are Board Certified Behavior Analyst (BCBA) and Registered Behavior Technician (RBT). In Michigan, BCBAs can also become Licensed Behavior Analysts (LBAs).
Those are a lot of acronyms! In this post, I’ll explain what each role is responsible for, how practitioners in those roles interact with clients, and what you can expect during a typical ABA session.
ABA Practitioner Roles
What Is a BCBA?
BCBAs have earned at least a Master’s degree in the science of behavior analysis or a closely related major, completed fieldwork under the supervision of another BCBA, and passed a certification exam. They then continue to maintain their certification through continuing education requirements related to the science and practice of ABA itself, the Ethics Code for Behavior Analysts, and supervision.
As the requirement for ongoing education about supervision might imply, BCBAs are often not the ones working directly with clients on a day-to-day basis. Instead, they supervise RBTs, who in turn work with clients one-on-one. However, even though they won’t be present for every session, you’ll see a lot of your BCBA if you work with Waypoints! Each RBT receives in-person supervision at least twice per week, for at least 10% of the hours that they spend working with clients.
In addition to supervision, BCBAs also check in regularly with clients and their families in order to confirm ongoing social validity – investment in the goals being pursued, approval of the procedures being used, and satisfaction with the results. BCBAs are also responsible for conducting assessments. They design interventions based on assessment data, review scientific literature, and consult with clients based on their personal wants and needs. BCBAs then monitor the effectiveness of those interventions, and make any necessary adjustments to help clients meet their personal goals.
What Is an RBT?
RBTs are the ABA professionals who work closely with individual clients on a daily basis. RBTs have completed at least 40 hours of training about ABA, demonstrated mastery of their responsibilities via a one-on-one competency assessment, and passed a certification exam. They must also have graduated from high school (at minimum) and be at least 18 years old.
While supervising BCBAs design and monitor programs used during sessions, RBTs are trained to implement them, collect and graph data, and assist with assessments. The BACB provides helpful documentation of RBTs’ typical responsibilities as guidance for training and supervision.
An Overview of ABA Services
Hopefully that helps to clarify the overall roles of the different practitioners, but especially if you’re new to ABA or considering seeking out services for the first time, I’d also like to elaborate on what the overall process of working with Waypoints entails.
First, a BCBA meets with a client and their family members in order to determine whether ABA will be a good fit, and if so, what specific objectives to prioritize. Those goals will be based on a self-report from the client and family caregivers, as well as direct observation and assessment of the client’s current skillset. It’s also important to identify areas in which the client already excels, as they provide a foundation to build on—and should be celebrated!
Based on those initial assessments and client input, the BCBA designs specific programs that will be used during sessions, and trains RBTs to implement those programs. As progress is made during each session, the BCBA monitors learning outcomes on an ongoing basis, and makes adjustments to programs as needed.
One-on-One Sessions
What can you expect from a typical ABA session? After a BCBA has completed the first intake assessments and worked with a client and their family to set specific goals and plans, initial sessions with both the BCBA and RBTs focus on what we call “pairing.” Particularly when working with children, this involves playing with and getting to know the client. While the overall goal of ABA sessions is skill development, minimal demands are placed at this stage; this allows the client and the Waypoints team to build rapport and trust.
While pairing will continue throughout the entirety of services, skill building programs are added over time. Common strategies include using examples and materials that are directly relevant to the learner, breaking down long-term goals into achievable shorter-term checkpoints, and providing personalized learning supports during each step toward mastering new goals. Programs typically include a combination of Discrete Trial Training (DTT) and Natural Environment Training (NET).
DTT and NET
DTT is an ABA technique that involves presenting learning opportunities in a more controlled and structured academic format. For example, if a client’s goal is to learn color identification, DTT programs could alternate between the client being asked to point to different colors out of an array of colored flash cards or toys on a table, and being asked to label the colors of individual flash cards or toys held up one at a time.
Trials are presented relatively rapidly in order to provide a high pace of active learning opportunities, and feedback is given after every response. As needed, extra prompts might be added and then faded over time. This is simplistic, but a helpful starting point since it minimizes distractions and helps to clarify the specific concept being taught.
Our interactions with the real world at large are much more complicated than labeling and pointing to individual discrete stimuli, though! As such, NET helps to ensure that any new skills and concepts learned during DTT can be carried over to a more natural environment. For example, NET programs could capture naturally occurring learning opportunities such as asking the learner, “Could you hand me the blue crayon?” while coloring, or “Wow, what color was that car that just drove past?” while out for a walk.
The Whole Package
That was just one small example of one potential ABA program. I chose a simple example, but programs could cover motor skills, communication skills, academics, school or job readiness, conversation and other social skills, self-help, self-advocacy – the list goes on and on!
Sessions may last for a few hours at a time, and a client may participate in sessions multiple times per week. Those sessions are spent working together on all of the goals that have been established, ensuring the chance for regular learning opportunities and feedback. At the same time, we prioritize providing plenty of opportunities for client self-advocacy regarding when to work on what, such that the programs don’t become frustrating or repetitive.
If the structure and goals of ABA services sound like they would suit your needs, contact us at info@waypoints.life to learn more!
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