Montreal

What is ABA therapy for autism?

ABA therapy – or applied behaviour analysis – is an intense, one-on-one therapy designed to help children with autism learn language, communication and interpersonal skills.

Experts say parents of children with autism should seek certified therapists not shy to be videotaped

Saif Ullah, 4, who has autism, plays with his ABA therapist, Meghan Turnbull at ASD Montreal, a private clinic. (CBC)

ABA therapy – or applied behaviour analysis – is one of a number of therapies available for children with autism. 

Programs are typically drawn up according to the child's needs and involve intense one-on-one therapy, designed to teach language, communication and interpersonal skills to help children integrate into school. 

Autistic children don't learn in the same way as other children, so therapy sessions have to be fast-paced and as fun as possible to hold their attention, so they can absorb what they are learning.

Tasks are often broken down into small steps. Sessions are usually jam-packed with games, imitation and matching exercises that are rewarded with a goody – anything from a musical bear that the child can squeeze, to a ball that lights up or a food treat. 
Two-and-a-half-year-old Louis, who has autism, watches a video with his ABA therapist, Odette Zarate, at ASD Montreal - a private clinic. (CBC)

''You want every moment to be a teachable moment,'' said Marc Lanovaz, an autism expert at the University of Montreal.

''It seems like a lot for a young child, but if it's done right, it doesn't seem like work for the child. It seems like we're playing around, we're just having fun while encouraging a lot of learning.''

There can be some downtime to give therapists a chance to organize the next activity or record data, but it shouldn't be long.

Finding an ABA therapist 
'You want every moment to be a teachable moment,' says Université de Montréal autism expert Marc Lanovaz about ABA therapy. (CBC)

For parents who turn to the private sector for ABA therapy, a recommendation from a professional is important.

They should also check to make sure the person is certified by the U.S.-based Behavior Analyst Certification Board and check on the therapist's reputation.

''Does anyone know this organization?'' Lisa Reisinger, a psychologist with the West Montreal Readaptation Centre, said she would ask. ''Does anyone know this therapist? Do they do good work?"

"Because once you're in the private sector, it's a little more tricky, and there's a certain amount of work that needs to be done to make sure your child is going to be in good hands.''

The vice-president of the Quebec ABA Association, Myra-Jade Lui, said if a therapist is reluctant to be observed working with a child, parents should be concerned. (CBC)

Although being board-certified is not required in Quebec, Reisinger said parents should expect it.

Supervisors should be working closely with the ABA therapists or technicians they hire to carry out their programs.

Board-certified behaviour analysts who are supervising therapists are supposed to drop in and watch their technicians work regularly. 

Parents should be at those sessions so they can understand what's going on, raise concerns and see what changes are made to their child's program.

Lisa Reisinger, a psychologist with the West Montreal Readaptation Centre, said parents should ask lots of questions before settling on a private ABA therapist or technician for their child.

''Parents should be able to describe what their child is working on,'' said Reisinger. ''They should know what level of success their child is at. And it should be clear to them what is being used as a reinforcer, so, for example, they aren't using the same reinforcer at home and then it's not as effective.''

Reisinger says there should not be any negative reinforcement or rough behaviour between the therapist and the child.

If the therapy is being done in an office, parents can often watch the session through a double-sided mirror. But if it's done at home, parents should not be shy about asking for a videotaped session.

Myra-Jade Lui, the vice-president of the Quebec ABA Association, said there are some red flags that parents should look out for, including a technician that doesn't want to be observed.

If the therapy is being offered in the home, parents should ask for a video from time to time to see what the therapist is doing.

Also, if the child is non-verbal, but they really don't seem to gel with their instructor, parents should take note.

''We need to pair ourselves really well with these kids,'' said Lui. ''So if you get a kid who, when the instructor walks in the house, turns and screams, it either means we're not doing enough work on the side of making sure we have a good enough relationship with them. Or something may be going on there, and we need to investigate that.''


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ABOUT THE AUTHOR

Leah Hendry

Journalist

Leah Hendry is an investigative reporter with CBC in Montreal. She specializes in health and social issues. She has previously worked as a reporter for CBC in Vancouver and Winnipeg. You can email story ideas or tips to montrealinvestigates@cbc.ca.