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What is Home-Based vs. Center-Based ABA Therapy?

Children and teenagers who have autism can benefit greatly from receiving Applied Behavior Analysis (ABA) therapy from a professional who is ABA certified. The purpose of ABA therapy is to change behaviors by either increasing or decreasing specified target behaviors; the role of an ABA therapist, or BCBA, is to observe the child in multiple environments, collect data on target behaviors, analyze the data, and create a plan to modify the behavior(s). With 80% of children with autism receiving services through school or community programs, it is no wonder there are various options to help them to be successful. 

ABA therapy does not solely have to take place during a one-on-one clinical session. It is recommended that ABA therapy be generalized to multiple settings and with different adults. Children who are participating in this type of therapy have the option to engage in sessions at school, in the community on outings, in a therapy-type session, or a clinical setting, such as an autism center. 

Home-Based ABA Therapy

Autism interventions do not have to happen primarily within a center-based ABA program—they can also be experienced at home. While school, community, and clinical interventions are developed to explicitly target behaviors within those settings (i.e., a learning intervention in school or a social-appropriateness intervention in the community), home-based ABA interventions are typically only used within the home, but some can also be generalized to other settings. 

In a Forbes article written by Ronit Molko Ph.D., BCBA-D, she states that “The biggest benefit to home-based intervention is that it allows children to learn skills in their home environment where they feel comfortable and secure, and where they naturally spend their time at a very young age. This intervention also lends itself to the involvement of caregivers. Essential daily living skills, like hygiene or personal care, eating, and bathing, are typically easier to teach in the environment in which those activities occur.”

She does, however, list some challenges that might limit home therapy from taking place, such as parental work schedules, living space, and availability of services in a specific area. 

The experts at Autism Home Support list a few other benefits to providing ABA interventions within a home setting: 

Services that are provided in the home environment allow skills to be targeted in the environment in which they are most likely to occur. Being in the home opens up the opportunities to learn to cook in their kitchen or clean up toys in their playroom.

Skills can be targeted in their most natural environment using items and circumstances that the child will come into contact with daily. Social skills can be targeted with siblings using games that are already owned by the family.

While working on behaviors at home with a child with autism has wonderful benefits and may be necessary to modify specific at-home behaviors, center-based ABA therapy programs also have numerous benefits. 

Center-Based ABA Therapy 

Children with autism can also participate in therapy via a center-based ABA program. Interventions can take place in the school, community, and during outpatient one-on-one therapy sessions in a more exclusive clinical environment. 

School-based ABA can be conducted in the classroom or any other space within the school in which problem behavior is taking place. These services can be provided by a district-wide board certified behavior analyst (BCBA) and can be requested by the parent, SPED teacher, or IEP team. A Functional Behavior Assessment (FBA) would first need to be conducted, analyzed, and a Behavior Intervention Plan (BIP) would need to be developed. The BIP needs to be implemented for a length of time while data is collected to determine if the interventions are successful. In the meantime, a student who is receiving ABA therapy in a public school can meet with the BCBA and teacher (who will be trained on the interventions by the BCBA) to work on either increasing or decreasing target behaviors. The ABA therapist, BCBA, and/or teacher and paraprofessional can all work together to teach more acceptable behaviors to the student.

Clinical-based ABA programs are centers where children with autism can go during the day (sometimes instead of school and sometimes before and/or after school depending on the severity of the problem behavior(s)). 

Dr. Molko, who was previously quoted above, says this about center-based ABA programs:

“While a child may have some structure in a home environment, the staff at centers can create and enforce a structured routine using the clinical setting. They can control the environment, control distractions, and create mock situations to teach skills—like paying attention, taking turns, and following instructions. They can enforce the skills while familiarizing the child with the environment and routine of specific tasks. Environments can also be manufactured in center-based intervention to expose children to specific situations and teach critical skills. For example, if a child is preparing to attend school, staff can create an environment that mimics the classroom and help the child learn the basic skills, like following directions and participating in a group environment.”

This option is beneficial for those children who consistently fail to respond safely around other children and need a more controlled environment with less unpredictable factors to deal with. 

Community-based programs can be conducted via the school if the child goes out on community or vocational-based skills, during home visits, or as part of the clinical-based program. As stated before, the generalization of skills is quite pertinent to success and going out into the community with the child who has already begun practicing those skills at home, in the school, or a clinical setting is the way to go. A child practicing newly learned skills can do so at the grocery store, at the mall, or a park with the supervision of a specialist. 

Home-based and center-based ABA programs each have their pros and cons; and there is always a hybrid option to consider. Regardless of what path a parent chooses to take in regards to their child’s treatment, it is important to choose a reputable company (or go through the school district if the IEP team decides) that has certified ABA therapists and BCBAs. ABA therapy can do wonders if experts are at the wheel and the team working with the child is consistent and persistent. 

Brittany Wilson

Master of Education (M.Ed.) | Northeastern State University

Behavior and Learning Disorders | Georgia State University

April 2020

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