By Dr. Hanna Rue and Justin Funches
COVID-19 has changed the daily life of most families in the United States. Many in the autism community are now faced with challenging decisions. Families must decide how they’ll continue their child’s therapy program. Should they increase or decrease therapy hours? Consider online therapy? Or just keep things the same?
This is a complex decision with no simple answer. Every loved one with autism has different needs and faces different challenges. Each family must consider their situation and determine what’s best for them when speaking with their Behavior Analyst.
When making these tough decisions, there are several important factors that each family should consider.
Intensity of Challenging Behaviors
There are families who face significant challenges due to their child displaying aggression, self-injury, elopement, or other dangerous behaviors. For these families, clinical support is critical to maintaining safety in the home. Families concerned about managing their child’s challenging behaviors have to compare the risks of COVID-19 to the safety risks posed by the challenging behavior. In these situations, when continuing services is a matter of safety, it’s important to work with your clinical team to ensure proper health and safety procedures are in place. LEARN has implemented successful practices including pre-session health risk assessments, frequent handwashing, thorough sanitization of workspaces, restricting parent/caregiver participation, and limiting the number of technicians in the home.
Families with high risk individuals in their home, such as elderly or immune-compromised family members, may decide to put home-based ABA services on hold or move to online therapy – which reduces the risk for vulnerable household members.
While ABA services in the home can be delivered safely through strict health and safety protocols – none of these strategies are fool-proof. The only way to fully social distance and receive ABA services is through online therapy via services such as teleABA. In households where the risk of having staff in the home is too great, continuing ABA therapy online helps to decrease the risk of COVID-19 exposure and allows therapy (and progress) to continue.
The provision of ABA therapy via computer, tablet or smartphone.
“By starting teleABA services, the family was able to help maintain their child’s behaviors when they couldn’t access session in-person.”
Risk of Skill Loss and Behavior Regression
There are families who have witnessed significant improvement in their child’s communication and social skills. These families may determine that the benefits of continuing in-home ABA services are greater than risks of COVID-19 – which we minimize by working closely with a clinician and taking ALL recommended precautions per the CDC. Other factors such as location in the U.S. and access to reliable technology impact a family’s decision to continue home-based ABA services.
Opportunities for Additional Learning
While the widespread closures of schools and center-based programs has created a challenge for many families, it’s also created opportunities for additional learning opportunities. In some circumstances, children may benefit from increased intensity of services in the home. Whether that’s to support new skill acquisition or work on a behavior reduction program. This could be particularly relevant for young learners and older learners focused on learning life skills.
It is our hope that the considerations outlined above will help families determine the best path forward. There is no one-size-fits all but we will partner with you to determine how your family can continue to benefit from ABA therapy. Whether that means keeping things the same, changing the intensity of service or embracing teleABA, every family has the opportunity to get the support that fits their individual needs. We highly recommend that families don’t go too long without services and work with their BCBA to find a solution to their challenges, as well as stay up to date on community news and happenings.