How do I access ABA services?

Depending on your insurance, this may or may not be covered. We advise you to contact your insurance to see if ABL services are covered, especially if you are insured through an employer group plan. Sometimes, employers may elect for a plan that doesn’t cover ABA services.

How can I get in touch with Behavioral Health Links to receive services?

One can get in touch with Behavioral Health Links by calling us at 508-955-3995, or fill out the contact form. Our intake team will be in touch with you within 48 hours.

Can I get ABA services through Masshealth?

Yes. MASSHEALTH covers ABA services.

What is your age range?

We provide services to children ages 1-21.

Your address is in Worcester. Do you provide services outside of Central Massachusetts?

Yes we do. We provide services in Hampden, Worcester, Middlesex, Norfolk and Suffolk Counties.

Do you provide parent training?

Parent training is an integral part of the services we provide. Parents play a very important role in the success of children involved in ABA services and it is important that targeted skills are practiced at all times, during and outside of ABA sessions.

What should I do if I suspect my child has Autism?

If you suspect that your child has Autism, it is important to discuss these concerns with your pediatrician so that he/she may refer your child out for an assessment.

My child has PDD/Asperger’s/Hyperlexia, not autism. Does they really need all this ABA stuff?

The different labels used to describe the pervasive developmental disorders (PDDs) have little use other than to confuse parents and muddy their children’s legal rights. There are occasionally reasons why a qualified diagnostician may use one term rather than another, but for the most part the label really doesn’t matter. What counts is effective treatment.

The term “autistic spectrum disorder,” while not ‘official,’ does make the situation clearer. Individuals with PDDs vary widely in their degree of disability. The greatest mistake you can make is to believe (or not challenge the opinion) that because your child “just” has PDD then he or she does not need a high-quality, intensive program to help him or her “catch up” as quickly as possible. It is true that more severely disabled children will typically require more hours than those on the less severe end of the autism spectrum, but that is a judgment to be made by a qualified professional. The range is likely to be from 10 to 40 hours per week.

My son, for example, fits the published criteria for “the syndrome of hyperlexia.” This really means that while he has autism he also has above average ability (and motivation) to work with letters and numbers. But if we had stuck with the available literature on “hyperlexia” we would never have found the intensive ABA approach that has helped him so much.

What is an ABA program?

There are three components that all have to work together: people, programming, and practice. And they have to work together for quite a while – at least 4 years, usually longer.

The people include a behavior analyst ‘therapists,’ you and other significant family members, and usually (although perhaps not at first) your school staff. The behavior analyst (usually just called the ‘consultant’) is responsible for the other components, programming and practice. He will help train the therapists and you in the practice of ABA, and give you (your team) the curriculum (‘programming’) that tells you exactly what and how to teach. He will also periodically evaluate results and adjust the program as your child learns.

The therapists provide the actual instruction (usually one-on-one, but not always). Why the quotes above? The term therapist has a medical or professional implication: it implies training and certification in a specialty. Training and good practice are important in an ABA program too, but there is no specific degree, coursework, or internship required. In theory, anyone can learn to become an effective ABA instructor-college students, retired persons, freelance musicians, even exceptional high school students. A degree or specialized education may be helpful, but what counts most is reliability, enthusiasm, creativity, ability to follow directions, and just plain “being good with kids.”

Parents can be therapists too, if they have the time and the inclination, but this is very much a personal decision. It can be a way to save money, keep the hours up, and it certainly gives you better knowledge of your child’s program and progress.

School staff do not provide one-on-one service (except for specialists, who may or may not be working with the ABA program), but they are still very important-they are part of the environment in which your child will either learn or fail. This is a complex topic, but it’s certainly true that cooperation is critical; if they “don’t believe” in what you’re doing, or think they’re doing something better (but the evidence shows otherwise), then your child may not benefit from that environment.

The programming is, in my mind at least, the most distinguishing feature of an ABA program. Bits and pieces of the practice show up in other “methods” or therapeutic approaches. To my knowledge, there is no other program which puts so much care and thought into planning exactly what your child should be learning, how the material is paced, how it is reviewed, and how it is practiced across multiple settings. It is this tremendous discipline and attention to detail that makes it possible for some children to become truly indistinguishable from their peers in ‘just’ a few years.

Programming centers on discrete trial drills, the exercises that your child does one-on-one with a therapist to learn language, play, and social skills. These drills are completely individualized to your child; while there is a substantial core curriculum that all children must complete, which programs are introduced when, and what items are used for teaching, are carefully tailored to your child’s abilities and interests.
The pace of the drills is important too. It is quite possible to go too quickly, leading to superficial progress but not a solid, useful repertoire of skills. A good consultant will plan how often new items are acquired (taught), how often know (mastered) items are reviewed (maintained), and when it might be time even to hold off on new items and just spend a couple of weeks practicing mastered items.

Skills must be mastered across multiple settings (home, school) and with multiple people (therapists, parents, peers). This ‘generalization’ is done systematically with the goal of giving your child skills that he can use independently in any setting.

Finally, it is practice. How skills are taught, at first seems the most unusual feature of ABA. This is because the discrete trial format looks so very different from ‘natural’ teaching methods. But DT teaching is really only one result of applying ABA-the functional analysis of behavior-to the problem of helping your learning disabled child to progress to his maximum potential. A lot happens in those one-on-one sessions, but there are things that you and others can do at other times and in other settings to help your child learn. Again, a consultant will help you learn how to reinforce appropriate behaviors, to help your child, as he learns new skills, to discriminate desirable behaviors from undesirable “autistic” traits.

What kind of progress can I expect?

The amount of progress your child will make depends on two things: his innate ability to learn, and the quality of his instructional program. How much a child can learn given the best possible program is something no one can really predict, although there are indications from research that a higher developmental age (Lovaas 1987) and a younger chronological age (Fenske 1985) at intake are predictors of greater eventual progress. More recent experience suggests that the child’s progress in the first few months-a measure of his ability to learn-is related to long-term success, rather than his initial degree of disability. Above all, understand that this is a very poorly understood subject: there really are no reliable markers in a young child that predict what he/she will be like as an adult. (Note too that some children benefit from other interventions, such as diet or drugs that increase their ability to learn.)

Program quality is something you can influence. The number of hours per week is one obvious measure: since your child has a lengthy curriculum to get through, it is to his benefit to do it as quickly as possible. (This is one thing that many school administrators really do not understand; they believe that they can save money by doing fewer hours of programming each week, or fewer weeks each year. Yet the research suggests exactly the opposite: an intensive program is likely to be over sooner, while a lower intensity program may go on for years and years, costing much more in the long run.) Not only do more hours mean more learning, but if your child is not yet able to initiate appropriate activity, every hour spent learning is one fewer hour spent practicing undesirable activities. In the battle for your child’s future, every hour falls on one side of the ledger or the other; you want to tip the balance towards productive, quality time.

Instructional quality is just as important. As one administrator assured us, “Any idiot can do ABA.” This is true, but to do it well and actually help children takes a lot of training, attention to detail, and plain hard work. Children with autism are not often the best customers for good intentions; simply sitting down and trying to teach on instinct may lead to a wide array of unwanted behaviors, but little useful learning. The principle of providing positive reinforcement seems simple, but it’s rarely enough just to give a child a piece of candy every time he gives a right answer; there are many, many details and strategies which a good ABA teacher must master to really move your child through the curriculum as quickly as possible.