ABA is often used for children and young adults with autism spectrum disorder who have difficulty with communication and emotional control and who need to increase their adaptive, social, functional, and academic skills. The techniques are based on learning theory that serves to help individuals gradually develop more acceptable methods of interacting with others in a variety of different environments. It can be highly effective in changing behavior for large numbers of autistic individuals.
Of course, no treatment modality is 100% perfect 100% of the time.
There are definitely many challenges associated with applied behavioral analysis for the ABA therapist, the clients, and the parents/caregivers, and teachers. In this article, you will learn about 7 challenges that ABA therapists and those who hire them face.
1. Applied Behavioral Analysis is Expensive
Time equals money in many cases and ABA therapy requires an intensive time commitment. Depending on where the treatment occurs will determine the cost. ABA therapists can work out of their very own office, travel to homes and go out into the community with clients, can push into schools, and some also work in residential facilities or other certified programs.
Healthline has monetary estimates for you to read, but please remember that these are general averages and things can range from state to state and person to person.
- Generally, one hour of ABA therapy from a board-certified ABA therapist costs around $120, though this number can vary.
- Some experts recommend up to 40 hours of ABA therapy each week, but in reality, therapists usually work with clients for 10 to 20 hours a week.
- Assuming your child needs an average of 10 hours of ABA per week at a rate of $120 per hour, treatment would cost $1,200 per week. Many children show improvement after a few months, but every child is different, and ABA therapy can last up to three years.
Note that though therapists who aren’t board-certified may provide treatment at lower rates, it’s recommended to work with a certified ABA therapist or a team that’s supervised by a certified therapist.
The costs of this much therapy can be prohibitive for most people. Many people choose to hire private practitioners, which cost significantly less. The involvement of parents in the therapy can help to facilitate the therapy, but not all parents are willing or able to provide the time commitment necessary for effective results.
Money is quite an important factor when considering ABA therapy.
2. Finding Highly-Trained ABA Therapists Is Difficult
While it is true that a large number of individuals who are trained in ABA techniques is not currently available, more learning institutions are beginning to offer the training for those interested in working with the ASD population. The development of the Behavioral Analyst Certification Board has provided a method of ensuring that therapists are properly trained and can offer the best outcomes for individuals engaged in behavioral analysis programs. In a 2018 study, it was found that “the per capita supply of certified ABA providers fell below the benchmark in 49 states and was higher in the Northeast than in other regions” and that New workforce policies are needed to increase the supply of certified ABA providers to meet the needs of youths with ASD,” (Zhang, 2019).
There is a high need for ABA therapists, so if you are reading this and are interested, head on over to the BACB site and learn how to reach that goal. There is currently licensure in 31 states and that is continuously growing.
3. Finding a Work-Life Balance
This is definitely a challenge for those who work in any sort of educational or mental health field. Finding a balance between working in an on-the-go environment and trying to leave work at work, along with having a life outside of work can be tricky. The daily work stressor of being an ABA therapist can be tiring; dealing with challenging behaviors, handling the business side of things, and multi-tasking throughout the day are typical in this field. Making sure that therapists practice self-care outside of the workday is imperative. Some examples of activities that can be added to a self-care routine include spending time in nature and away from electronics, getting exercise and eating healthy, practicing yoga or meditation, or getting thoughts out through journaling or talking with friends or family. Leaving work at work is crucial and not taking things personally is as well. Once you get home, take a deep breath and leave it all behind until the next day.
4. Teaching Parents the Appropriate Execution of Strategies
Another challenge for ABA therapists is teaching parents and teachers strategies and interventions for their child/student; and not just simply teach them, but ensure that they are doing things consistently, accurately, and appropriately so that all of the hard work the therapist has put in doesn’t go to waste. Generalizing skills can be difficult for children, and when a new person is executing the delivery of something, such as a hold, a type of reinforcement, or a consequence, things may not be perfect. ABA therapists must be able to not only train their client, but the client’s parents and teachers in order for the execution of strategies to be effective. This can take a lot of work if done correctly, and it isn’t a process to be rushed.
The experts at ABA Parent Training state:
“When working with parents, it is important to remember to work together collaboratively rather than in an expert-client dynamic. Parents have knowledge and know the history of their child. This information along with their parental insight combined with the professionals knowledge of effective treatment strategies can be combined in a collaborative manner to individualize the services and create the best chance for optimal outcomes for the child.”
5. Eliminating Non-Harmful, Adaptive Behaviors
Just because a behavior is unusual does not mean that it is causing harm to the person exhibiting the behavior or to others around them; nor does it mean that those behaviors are maladaptive. An example of this type of behavior is stimming, which are repetitive or unusual body movements or noises such as grunting, hand-flapping, tapping a desk, etc. The function of the behavior stimming is typically to regulate emotion, to increase or decrease stimuli, and simply because it feels good. No one is getting hurt (typically) during stimming, therefore an ABA therapist does not need to address this. Some inexperienced people in the field may exhaust energy trying to tame behaviors they deem as inappropriate when they are really just a manifestation of the disability.
The writers at The Autism Site made a good point…
Alternatively, let’s say these “unusual” behaviors were harmful in some way: they interfered with the child’s daily life, they were distracting or harmful to themselves or others, or they were considered inappropriate. Then what would we do?
Well, we would help eliminate the behaviors, of course!
Related: What Are ABA Interventions for Tantrums?
How Can I Handle Challenging Behavior From a Child with Autism?
6. ABA in the Age of COVID
ABA therapy is difficult to do with someone digitally. There are educational, social, and physical limitations that are now common for ABA therapists to deal with due to COVID-19 restrictions. When a therapist must socially distance with a client, they are unable to practice strategies with them in close proximity, which many strategies call for. While students are now familiar with navigating their learning via Zoom, Google Classroom, or on other digital platforms, conducting behavioral analysis with children (or adults) is much more complex, and at times not even possible. ABA therapists rely on close proximity during sessions for behavior modification training, active prompting, facilitated play, certain methods of data collection, and many structured activities that produce data. A child is not going to act the same way sitting in front of a computer interacting with a therapist compared to if they were doing an in-person session in the home, school, community, or office. It just isn’t natural and the data will not be as accurate and consistent. Many behaviors just can’t be recorded digitally. Maintaining privacy and controlling the therapy environment are other limitations of going digital with therapy. Teletherapy is definitely better than nothing though, and ABA therapists (and everyone else) can’t wait for this pandemic to be over so everything can go back to normal (Purdue Global).
Related: 5 Ways to Help Children Cope with Their Changed Lives During the COVID-19 Pandemic
7. The Physical Demands
ABA therapists often have high physical demands placed before them. Working with children with challenging behaviors, those with autism, and those with developmental disabilities can be active, become aggressive, may elope from the therapy area, or engage in property destruction. Children in general can be hyper, wild, and forget about personal space. And if an ABA therapist is working with an adult with certain disabilities, the extra height and weight of the individual make the physical demands even more challenging. In order for ABA therapists to perform their duties and responsibilities, they really need to get on the level of the client and interact with them with positive energy and
Here are examples of physical requirements listed on a basic position description for an ABA therapist:
- Must be able to lift up to 50 pounds
- Must be able to lift and carry clients with adaptive equipment.
- Must be able to assume and maintain a variety of postures (kneeling, squatting,
crawling, sitting, standing) for extended periods of time.
- Must be able to sit on the floor or stand for extended periods of time.
- Must be willing and able to restrain/hold/transport and utilize quick body
movements as indicated in the Behavior Intervention Plan in the course of
working with children with challenging behavior.
- Must have manual dexterity to perform specific computer and electronic device
functions for data collection.
- Must be physically present at the assigned job location, which may include home,
school, and community placements.
It is obvious that ABA therapists need to be able to do quite a bit physically in order to perform their day-to-day duties with clients in all sorts of environments.
As you can clearly see, ABA therapists and those who work closely with the client receiving the services overcome daily obstacles and challenges. Overcoming these issues offers the opportunity to provide a highly effective therapy for children who need intensive re-training for behavioral issues that occur with autism spectrum disorder. As more practitioners become available, these applied behavior analysis challenges are likely to be more easily resolved.
ABA Programs Guide Staff
Updated February 2021