Choosing a therapist and BCBA for your child is essentially inviting someone into your family. Therapists are going to be there for the good and the bad. They will be there when your child accomplishes the small goals - goals that you have been working on for over 6 months. They will be there for the milestone birthdays, their first day of school. When you choose a therapist, they will be there for it all, so you want to make sure you know what you are looking for when it comes to that time.
I think it is important to know what the role of a therapist/technician is. In ABA (Applied Behavior Analysis) you will have a BCBA; they are a masters-level clinician that has also passed a board exam to certify them to practice behavioral analysis. Then you will have a therapist (depending on where you receive services, they could also be called technicians). These people are the ones that will be providing therapy 1:1 with your child. They receive the plans, protocols, interventions from the BCBA and implement them during the therapy session. So, when it comes down to choosing a therapist, or maybe simply knowing that you have a good therapist (if you don’t get to choose) comes down to a few things.
Though experience is important, it is good to keep in mind that it is not the most important. As a BCBA, I have been with new therapists that are enthusiastic, bright and accept feedback graciously and implement it correctly. But, of course, with any job, having experience really helps when situations arise that you are unfamiliar with. Experience is something that will help navigate therapy sessions smoothly or be able to give sound advice. One last tidbit about experience: make sure when you ask about their experience, you keep in mind all relevant experience with children in general. Having experience in the field is helpful but, having experience with children that have ASD is something that I would be looking for.
When you are looking for a therapist, make sure you are looking for a personality that not only your child will get along with, but you as well. It’s important to find someone that is enthusiastic, engaging and able to remain positive and take direction. Observation is something that I would ask for early on in their therapy. As a parent or guardian, you want to see them engaging your child in play and work, sitting on the floor with them, and providing naturalistic teaching opportunities and a positive atmosphere. What I often tell parents is that ABA shouldn’t look boring or like work, it should be a fun environment where your child is learning.
Just like anything you are striving to make progress on, consistency is key. Look for a therapist that is consistent with their methods, attendance and interactions with you and your child. Consistency is especially important when a therapist in implementing ABA, or as a parent and you are implementing programs such as Goally. Knowing that your therapist is keeping consistent with programs, protocols that their BCBA has put in or feedback that you have given them will help with the overall success of ABA.
Each therapist has a different style and approach to how they implement a therapy session. This is important to keep in mind when you are observing your therapist in their session. The structure of the therapy should be the same across the board. These include the programs and how they are implemented, what behaviors they should be targeting, and if they are using any devices (such as Goally), they should all be implemented in the same manor. Once you determine the style that works best for you and your family, this will help with the outcome of ABA and the programs within ABA.
Go with Your Gut!
When in doubt go with your gut. I have had plenty of parents say to me, “she is really nice, but I don’t think she’s a right fit for our family.” That is ok, because at the end of the day, it’s your child and your family and if you don’t believe it to be a good fit, then it’s not a good fit. If you are working with a quality provider or company, they will be open to the feedback and will place a different therapist with your child.
These tips on how to choose the right therapist also align with how to choose the right BCBA. Here are some additional, comprehensive questions you can write down or print when you are looking to pick the right BCBA.
Supervision Received by a BCBA
The Behavior Analyst Certification Board recommends that the BCBA be involved and present. In practice, your BCBA should see your child and their therapist at least once per week. This is to help ensure that the programs and protocols are being run appropriately and are updated when needed.
Individualized Goal Prioritization
Goals should be determined and prioritized based on the assessment completed by the BCBA and family input. The order in which goals are prioritized will be unique to each child but should be a topic of discussion with your BCBA. Ideally, they should increase independence for the child and promote less prompting from the parents. Using a device like Goally will assist with the independence of task completion and your child.
Constant Monitoring of Goals
Data should be collected on each goal & reviewed at least every 2 weeks by a BCBA. This could be on your Goally device - data that was collected by a therapist in your session. This data will determine if adequate progress is being made or if therapy should be changed to ensure the child makes meaningful progress as quickly as possible.
ABA should involve and teach parents strategies to manage problem behavior and teach skills to their child. The BCBA will set up parent training and provide different ways to help the parents with the overall success of ABA, as well as assist with any strategies or other ways the parents may be facilitating independence at home.
Overall, Therapy Should be Naturalistic and FUN! Your therapist should be focused on teaching your child how to access more meaningful, motivating, and fun interactions while working within naturalistic contexts (e.g. play, community, with peers, etc.)
Erin Donahue resides in the mitten state (Michigan!) along with her dog and husband. She has been a BCBA for 3 years and in the field of ABA for going on 6 years. She loves advocating, educating and helping this wonderful community.
Editor's note: This information is not meant to diagnose or treat and should not take the place of personal consultation, as needed, with a qualified healthcare provider and/or BCBA.