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What is In-Home or ABA Therapy for Autism?
In home therapy for Autism Spectrum Disorder (ASD) can include various therapeutic approaches, including speech and language therapy, play therapy, and Applied Behavior Analysis (ABA). ABA therapy at home usually involves a professional therapist who works with the patient to comprehend the context in which negative behavior occurs. This approach examines the causes of negative behavior to help each patient anticipate and manage it.1
These therapies happen outside a traditional health care facility and at the patient’s home. However, since ABA therapy calls for specialized education and certification, parents rarely implement the program. Instead, an ABA therapist will regularly visit your home to work with your child.
The scientific understanding of human behavior is a foundational component of ABA therapy’s evidence based therapeutic strategy, which aids in communication, learning, and interacting with others. ABA therapy helps those with developmental disabilities like autism, which affects 1 in 54 American children, according to the most recent CDC report.2 It also affects boys more often than girls.
Nearly 30% of US children with ASD do not receive any kind of treatment, according to a study on the prevalence and treatment patterns of ASD.3 These findings highlight the urgent need to comprehend and solve the challenges preventing children from receiving the necessary care.
What to Expect With Autism Therapy at Home
For children with autism, there are many different kinds of behavior therapy. Many are successful when a therapist works one-on-one with the child. In home therapy for autism seems to perform best for early interventions with kids under kindergarten age. Many families find that having a child begin learning at home provides them much-needed comfort.
Be aware that the main objective of any effective in home therapy for autism is to transition the child into a typical preschool or kindergarten socialized setting. Therefore, a home program is not permanent, but remember that some children with more severe cases of autism need up to 40 hours of behavioral therapy a week.
In addition to some medications that help manage some of the behavioral signs of autism, such as irritability and hostility, the following are various types of at home therapy for autism, many of which are based on ABA techniques:
- Applied Behavior Analysis (ABA): ABA therapy is the most popular type of behavioral treatment for autism. Positive reinforcement serves as the fundamental ABA therapy approach. Rewarding the child for adaptive behaviors encourages change in inappropriate behaviors. ABA therapists do not punish unacceptable behaviors; instead, they are highlighted. Through observation and evaluation of constructive behavioral change, the therapist will be able to identify the child’s needs. If one of their strategies fails, they can adopt a different one. While in home ABA therapy is frequently the cornerstone of autism treatment, other therapies can supplement it, giving your child the most comprehensive treatment plan and positive results.
- Play Therapy: Play therapy is precisely what it sounds like: it involves learning while playing. Over time, play therapy helps autistic children improve their social and communicative abilities and capacity for imaginative play and symbolic play.4
- Speech Therapy: Young children with Level 2 or 3 autism may require early speech therapy interventions. This is particularly true for those who stop picking up new words and phrases at a young age or start to lose verbal communication skills. While some at home autism therapies need parents to collaborate with therapists or have training in particular therapeutic modalities, qualified speech-language pathologists (SLPs) conduct speech therapy.
- Floortime: Play therapy and floortime are quite similar. However, the foundation of floortime is that parents should seek to widen their autistic child’s “circles of communication.”5 In other words, parents can push their child to engage in back-and-forth communication (verbal or nonverbal), which can be extremely difficult for those with autism.
- Relationship Development Intervention (RDI): RDI is a therapeutic approach created especially for parents. It makes use of developmental theories, such as floortime, to assist parents in helping their kids develop socialization skills. But unlike floortime, RDI has a predetermined set of objectives and activities, and getting started with it necessitates working with a professional.
- Parent-Child Interaction Therapy (PCIT): A sizeable number of kids with autism spectrum disorders exhibit aggressive behaviors that make it extremely challenging to leave the house or participate in everyday activities. For kids that exhibit these aggressive tendencies, there is Parent-Child Interaction Therapy (PCIT). PCIT alters how parents and kids connect and enhances parent child relationships. Parents acquire specific skills to foster a stable and supportive relationship with their kids while boosting their positive conduct and reducing negative behavior.
- Early Start Denver Model (ESDM): Based on ABA techniques (ABA), the Early Start Denver Model (ESDM) is for autistic children between the ages of 12 and 48 months.6 The child is encouraged to improve language, social, and cognitive skills via play and group activities.
- Discrete Trial Training (DTT): This systematic ABA technique breaks abilities into manageable, “discrete” parts. The trainer progressively imparts each of these abilities. Trainers utilize observable reinforcements for desirable behavior along the way, including a candy bar or similar for a child.7 Over time, the therapist gradually eliminates prompts and rewards.
- Pivotal Response Treatment (PRT): PRT focuses on fostering “pivotal areas of development” to assist children in acquiring the social skills necessary for success at home, school, and society.8 PRT is distinguished by its goal of inspiring the child to desire social interaction. Focused on fostering our natural desire to interact with others, communicate, and play, PRT can benefit people of all ages.
- Occupational Therapy (OT): Sensory integration problems linked to autism are frequently treated with OT. It also aids in teaching fine motor skills necessary for daily living, such as dressing, using utensils, and writing. OT aims to enhance the quality of life and ability to fully engage in everyday activities.9
How Much Does Autism Therapy at Home Cost?
While many insurance carriers are mandated to cover the cost of evidence based therapies for autism treatment in most states, including Tennessee, a variety of contributing factors influence the overall cost of autism therapy at home. Some of the most significant factors include:10
- Geographic location
- Supply and demand for ABA therapists
- Level of autism that your child is experiencing
- How many hours per week are needed? (10-20 is usually more than enough)
- The therapist’s desired rates and amount of experience
- Duration (in months or years) of time spent working with a specialist
One hour of ABA therapy from a board-certified ABA therapist typically costs around $120. But, again, these are average costs and can be affected by many variables.
According to the Centers for Disease Control and Prevention (CDC), children with autism require an average of $17,000 more in care annually than children without the condition. Children with severe autism may need an extra $21,000 per year compared to neurotypical peers.
Pros & Cons of In-Home Autism Therapy
There is great emphasis on the value of parental or caregiver involvement regardless of whether the therapy program is based at home or in a facility. The child can fully engage in the therapy when the parents or other caregivers are involved and educated on how to carry out the program independently.
In one study, ten non-verbal autistic children were randomly assigned, aged 20 to 65 months, to one of two speech-development models: the Early Start Denver Model or PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets). Both groups received daily home interventions from parents in addition to 12 weekly one hour therapy sessions.
Over the course of the study, eight of the ten kids established vocabularies with at least a few single words that they regularly and spontaneously used. The researchers pointed out that, given that the children only received 12 hours of direct intervention, at home parental engagement most certainly played a substantial role in fostering language development.11
With that in mind, below are a few pros and cons of autism therapy at home:12
- Children learn skills in their homes, where they feel safest and most at ease, and where they naturally spend their time from a very young age.
- Generalizing a skill learned in one environment and applying it to another, such as in clinical-based autism therapy, can be difficult for people with autism.
- The growth and development of early toddlers and children’s bodies and brains depend on parents and caregivers maintaining a routine that includes suitable nap times. This is challenging to adhere to in a clinical-based environment.
- Children can exhibit different behaviors at home than in the clinic, giving a therapist a more accurate view of the problems that need addressing.
- Fourteen hours a week of floortime therapy at home helped 47% of the participants make substantial progress, according to a 2012 study involving 34 children, ages 2 to 6. 70% of the study’s children benefited from this therapy, with an additional 23% exhibiting adequate progress.13
- Due to living arrangements, job schedules, service accessibility, and other factors, home-based services might not work for some families and individuals.
- Therapists can manufacture environments in center-based programs to expose children to specific circumstances and teach them important skills.
- For instance, if a child is starting school, staff can set up a setting that resembles a classroom and assist the child with learning fundamental skills like listening to instructions and engaging in a group setting.
- At home therapy for autism doesn’t always provide a controlled and structured environment as center-based therapies can.
- Despite high success rates, there is still much controversy surrounding ABA therapy and its long-term effects.14
How to Choose the Best In-Home Autism Treatment Program?
With Athena Care’s multiple behavioral health centers throughout Tennessee, behavioral health testing and autism treatment services are within reach. Open Monday through Friday, 7:00 a.m. to 6:00 p.m., our expert care coordinators can assist you with any questions or concerns about the best in home autism treatment program for you and your family.
Here’s a list of qualified psychologists and ABA therapists organized by city and information about their backgrounds and specialties. Before deciding on a professional, remember that this person will be entering your home, essentially becoming a part of you and your child’s day-to-day routine for prolonged periods. Therefore, it’s important to ask many questions and inquire about the following:
- Credentials: education, training, license, and years of experience
- Ideally, your child’s therapist should be a Registered Behavior Technician (RBT). In addition to completing numerous hours of ABA training, Board Certified Behavior Analysts (BCBAs) monitor and supervise RBTs .15
- Additionally, does the therapist have experience working with children similar in age and behavior to your child?
- Specialties and services offered
- Treatment techniques and philosophies
- Does the therapist use only ABA techniques or other forms of therapy?
- Insurance companies they work with
- Session length
Insurance may be able to help cover the cost of in-home ABA therapy. Find out if your insurance provider can help with the costs by filling in our confidential insurance verification form below.
Alternatives to Autism Therapy at Home
If autism therapy at home isn’t an option for you and your family, there are alternatives. Alternative and complementary therapies are frequently utilized alongside more conventional methods, like ABA therapy. Specialized diets, herbal supplements, chiropractic adjustments, art therapy, mindfulness, and relaxation techniques are a few examples.16
Before beginning a complementary and alternative treatment, you should always consult with your primary care physician.
- Applied Behavior Analysis Degree Programs. “What Is In-Home ABA Therapy?” ABA Degree Programs, 12 July 2022, www.abadegreeprograms.net/faq/what-is-in-home-aba-therapy.
- “Autism Spectrum Disorder (ASD): Causes, Symptoms, Treatment and Outlook.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/8855-autism. Accessed 2 Aug. 2022.
- Xu, Guifeng, et al. “Prevalence and Treatment Patterns of Autism Spectrum Disorder in the United States, 2016.” JAMA Pediatrics, vol. 173, no. 2, 2019, p. 153. Crossref, https://doi.org/10.1001/jamapediatrics.2018.4208.
- Solomon, Richard, et al. “PLAY Project Home Consultation Intervention Program for Young Children With Autism Spectrum Disorders.” Journal of Developmental & Behavioral Pediatrics, vol. 35, no. 8, 2014, pp. 475–85. Crossref, https://doi.org/10.1097/dbp.0000000000000096.
- Rudy, Lisa Jo. “6 Easy, Lower-Cost Ways to Become Your Child’s Autism Therapist.” Verywell Health, Dotdash Media, Inc., 4 Mar. 2021, www.verywellhealth.com/low-cost-autism-therapies-parents-can-provide-at-home-4172365.
- “Early Start Denver Model (ESDM).” Autism Speaks, www.autismspeaks.org/early-start-denver-model-esdm. Accessed 2 Aug. 2022.
- Elder, Lauren, PhD. “What Is Discrete Trial Training?” Autism Speaks, 5 Sept. 2018, www.autismspeaks.org/expert-opinion/what-discrete-trial-training.
- “Pivotal Response Treatment.” Yale Medicine, 30 Oct. 2019, www.yalemedicine.org/conditions/pivotal-response-treatment.
- “Evidence-Based Treatment Options for Autism.” Children’s Hospital of Philadelphia, 1 July 2017, www.chop.edu/news/evidence-based-treatment-options-autism.
- Tatom, Carol Rbt. “How Much Does ABA Therapy for Autism Cost?” Autism Parenting Magazine, 2 Feb. 2022, www.autismparentingmagazine.com/aba-therapy-autism-cost.
- Rogers, Sally J., et al. “Teaching Young Nonverbal Children with Autism Useful Speech: A Pilot Study of the Denver Model and PROMPT Interventions.” Journal of Autism and Developmental Disorders, vol. 36, no. 8, 2006, pp. 1007–24. Crossref, https://doi.org/10.1007/s10803-006-0142-x.
- Molko, Ronit. “Home-Based Vs. Center-Based Services for Autism.” Forbes, Integrated Whale Media Investments, 24 May 2019, www.forbes.com/sites/forbesbooksauthors/2019/05/24/home-based-vs-center-based-services-for-autism/?sh=54a5e2b01d35.
- Pajareya, Kingkaew, and Kaewta Nopmaneejumruslers. “A Pilot Randomized Controlled Trial of DIR/FloortimeTM Parent Training Intervention for Pre-School Children with Autistic Spectrum Disorders.” Autism, vol. 15, no. 5, 2011, pp. 563–77. Crossref, https://doi.org/10.1177/1362361310386502.
- Miller, Caroline. “The Controversy Around ABA.” Child Mind Institute, Child Mind Institute, Inc., 15 Apr. 2022, childmind.org/article/controversy-around-applied-behavior-analysis.
- Cicolello, Megan M. “How Can I Best Prepare for an ABA Therapist in My Home?” Autism Parenting Magazine, 21 June 2021, www.autismparentingmagazine.com/best-prepare-for-aba-therapist.
- “Treatment and Intervention Services for Autism Spectrum Disorder.” Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 9 Mar. 2022, www.cdc.gov/ncbddd/autism/treatment.html#Complementary-Alternative.
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