What Happens In An ABA Therapy Session?

June 10, 2019
By: BI Staff

If your child has been diagnosed with Autism Spectrum Disorder (ASD), chances are you’ve heard of ABA therapy.  But what is ABA exactly, and what happens in an ABA therapy session?

ABA (Applied Behavior Analysis) is the leading evidence-based therapy for Autism Spectrum Disorders (ASD).  It’s the “best practice” treatment for ASD recommended by the U.S. Surgeon General and the American Psychiatric Association.

Describing a typical ABA session is tricky, because ABA therapy sessions are customized for each child. No two children are alike, so neither are their ABA treatment plans.

Our clinicians work with you to develop a treatment plan that is unique to your child and based on their skills assessment.

Most sessions include several types of therapies and interactions that prepare your child for a variety of situations outside the therapy setting.

Here’s what you can expect when your child enters ABA therapy.

“Billy” is a lively, but non-verbal two-year-old with a shock of unruly black hair. He has just started ABA therapy, and one of his goals is to let someone cut his hair. Each time he hears the sound of the hair trimmer, Billy moans and hides anywhere he can. As part of his therapy, we work out a sequence of steps involved to help him achieve this goal. His parents told us how much Billy loves the guitar, so each time he sits in the barber chair with the cape around his neck, he gets his guitar. Once he can do that step consistently, we introduce the sound of the hair trimmer so that he can become accustomed to that. Finally, Billy should be able to generalize this skill outside of the therapy setting and inside the local barber shop!

Types of Trainings Used in a Typical ABA Session

Most sessions include two types of trainings which are targeted towards helping your child master needed skills and apply them in real-life situations.

  • Discrete Trial Training (DTT): During a DTT session, a therapist works with your child at a tabletop. It’s a more formal interaction, where each opportunity to teach the skill has a discrete beginning and end. For example, your child might practice a specific vocal skill multiple times, and receive feedback and/or a reward from the clinician after each attempt.
  • Natural Environment Training (NET): This therapy takes a skill learned during DTT and applies it to real life situations where they need to interact with family, peers, or others.

DTT helps your child masters skills more quickly and efficiently, because the child receives reinforcement after every trial. Then, NET helps your child more easily generalize the skills so he or she  can use them outside of therapy.  Both types of training are important.  We refer to them as the “dream team” because they help your child more quickly master skills and apply them in real-life situations.

What Does a Typical ABA Therapy Session Look Like?

Treatment in an ABA session is always one-on-one and customized for each individual child. However, most sessions have the same basic activity flow.  Here’s an example therapy session that incorporates both DTT and NET therapy to help a child who has problems formulating speech:

  • DTT: The therapist might begin by teaching the child a “B” sound like “bah.” The therapist provides reinforcement when the child succeeds. Once the child has acquired that, the therapist adds a “reinforcer” skill that’s directly connected to the skill being taught. For example, teach that a ball begins with the “bah” sound.
  • NET: Next,[L2] the child begins to apply the skill in a more natural manner like playing with the ball, responding to a request to “point to the ball,” or practicing the sound learned when shown a ball.

The types of reinforcement vary and depend on what works for each individual child.  They include rewards like verbal praise, a hug, a snack, or access to a tangible item, like a favorite toy.

Some therapy sessions also include circle time with other children and their therapists .  Your child is still one-on-one with his or her therapist, but in a social setting with other children. We use circle time to help children learn to function better in a social environment, particularly a school-like setting. The session may include tasks like taking turns, sitting next to a peer, raising your hand before speaking, or parallel play next to a peer.

We may also work on adaptive skills such as hygiene, grooming, feeding, and many others. We also use our gross motor room to teach and generalize gross motor and fine motor skills using a behavioral approach.

How Does ABA Help Improve Problem Behaviors?

“ABA  is 100% function-based.  Everything we do during therapy is focused on the causes of a behavior.  We ask why the child engages in a maladaptive behavior and determine how we can help him or her learn a more appropriate response.” 
~ Kelly Walker, Clinical Director, Allen, TX center

Some children with autism display behavioral problems that impede learning. In other cases, children act out when they don’t have the communication skills needed to verbalize their needs and wants.  In both situations, when there’s a deficit in the ability to communicate, children may develop maladaptive behaviors to compensate.

For example, a child may learn over time that she can get attention from her mother by crying or exhibiting tantrum behavior.  In that situation, we would explain to parents that she is exhibiting these behaviors because she wants attention, then work with the family to teach her a replacement behavior in order to get the attention she wants. We might teach her to say, “Mom, can I have a hug?” or to hold up her arms as a non-verbal cue that she wants to be held.

How Are Parents Involved in ABA Therapy?

Parents are partners, and parental involvement is as important as the therapy. You will work with our clinicians and with your child outside of therapy sessions to reinforce skills at home. This type of “ABA homework” helps children learn to generalize a behavior and apply it outside a therapy session.

For instance, suppose your child needs to learn to ask for help when she needs something instead of acting out by climbing on the counter to get a snack or using another attention-getting behavior. We would ask you to set up situations at home where the child can practice asking for help in appropriate ways and offer reinforcement when she is successful.

In this way, the entire family is involved in ABA therapy – particularly regarding redirecting barrier behaviors towards more appropriate responses.  The family and caregivers must be on board because children need consistent feedback in order to generalize behaviors outside therapy.  For example, if aggression with a sibling is a problem, we encourage you to bring the sibling to a therapy session. If grandparents frequently care for your child, but aren’t on board with treatment methods, we can invite them to a session so they can understand how the therapy works.

“We help all members of your family develop the skills they need to become supportive members of the treatment environment. If the skills can’t be generalized at home, our work isn’t done yet.”

~ Kelly Walker, Clinical Director, Allen, TX center

How Do I Know the Therapy is Working?

Prior to developing a treatment plan, we evaluate your child to measure his current levels of functioning and identify areas with opportunity for growth and development. These measurements allow us to benchmark your child’s level before therapy and track his process as treatment proceeds.

Our assessment process produces a treatment plan designed for your child’s unique needs. There’s no set program  and no cookie-cutter treatment. Every child’s treatment plan is different because every child brings a unique set of skills and challenges into therapy.

We collect data in real time, on a platform that our parents can access via a parent portal. It allows us to show the child’s progress towards goals. Every six months, we revisit the treatment to assess your child’s progress and skill acquisition. The treatment plan is adaptive; we adjust it as needed to meet your child’s needs and improve performance.  It’s very exciting to see how many skills a child develops over time!

“We’re  trying to work ourselves out of a job.  We want to prepare your child for real life situations, interactions, and environments. We don’t want your child to be in therapy forever.”  
~ Anusha Sadruddin – Clinical Operations Manager, Allen, TX ABA Center

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