Nikki Gray is a Board Certified and licensed behavior analyst. As the CEO & Founder of The Indiana Institute for Behavior Analysis, Nikki oversees and guides clinical and administrative procedures in order to ensure that clients receive the best care and that employees are supported and trained.f
The decision for a family to place their child in ABA Therapy is not one that is taken lightly. Many families have no idea what they should expect from an ABA Therapy provider. Below, I list 10 things that families should look for on their search to aide in their decision making process.
1. An Open Door Policy
If your child is enrolled in ABA, you should have an expectation that you can come and observe a session at any time. The BCBA may not be available if you pop in unannounced, but observing the technician should be an acceptable and standard practice for center based services. Scheduling a time or only seeing your child in one room (and not throughout the center as they normally would be) should be a red flag. Parents, just like our vendors, volunteers, and potential employees, are able to sign agreements to keep information confidential about other clients who may be served within the center setting to eliminate concern for HIPAA violations.
2. Weekly Communication
Communication is key for all relationships to work. Communication should be a minimum of atleast weekly from your child’s ABA provider. This can be in the form of announcements, hygiene needs, program updates, and requesting that you sign off on billing for insurance.
Your child should be assessed using a standardized assessment tool at a minimum of once every six months. This can be the ABLLS, VB-MAPP, AFLS, EFLS or other assessment tool. These assessments should be reviewed with you and used to guide the direction of your child’s ABA Therapy Program.
4. Data Collection
Data should be collected daily on your child’s goals and progress. This data should be available to be reviewed with you at your request. Many providers use online data collection systems which have parent portal areas. The parent portals will often allow for the parent to view their child’s data and monitor progress.
5. Parent Training
Parent Training should be offered a minimum of once per month to discuss your child’s programs, progress, communicate any changes, and to give you an opportunity to observe sessions and implement techniques with the support of the BCBA.
6. Parent Input in Goal Development
Programming should include parent input in the development of treatment plan goals. Parent's personal and family goals should be included and prioritized in treatment planning.
7. Opportunity to Provide Feedback
There should be opportunity to provide feedback and give input about your thoughts and feelings regarding your child’s programming. Your feedback should be respected and responded to. Meetings, email, phone conversations, or texting are some of the mediums that should be available for you to provide feedback.
8. Correct Billing
No matter who the payor is – private insurance or Medicaid-you have the right for billing practices to be explained to you and for billing to be billed correctly. Honest billing is one of the simplest ways to ensure that fair insurance reimbursement for ABA Therapy continues to be an option for individuals with Autism and other developmental and neurological disorders.
9. 1:1 Staffing
ABA Therapy agencies who bill the medical code 97153 are telling the insurance company that therapy was provided for your child and the technician working with your child was only working with your child. If your child’s technician was also working with another client, the billing procedure code should reflect that. The billing code for a technician working with more than one client at a time is considered a group code and is billed as procedure code 97154. Ask agencies what their procedures are in the event that a technician calls off. If staffing levels do not permit 1:1 staffing, group codes should be billed and this should be reflected on your billing statement.
10. BCBA Consultation
BCBAs are required to supervise your child’s therapy weekly. The BACB guidelines call for therapy programs to be supervised at 10% of the hours provided. Many insurers will not authorize at this amount; the standard hours that we receive for supervision are around 5%. This means that if your child is authorized 40 hours of ABA per week, the BCBA should be present (observing therapy, providing in the moment feedback, updating programs and training on new protocols and plans) for at least 2 hours per week.
Great ABA agencies understand the importance of and embrace the opportunity to partner with parents to provide the best possible outcomes for their child. When you are looking for an agency, look for a company that is willing to listen to your concerns and your desires, design programs to teach your child the skills you want them to learn, and willing to come alongside you to provide you the education, support, and advocacy you need to help your child be as independent as possible.