Your autistic teenager’s symptoms used to include a range of aggressive behaviors, including pushing, shoving, and scratching others. After obtaining an official diagnosis, treatment in ABA therapy (applied behavior analysis) was recommended. At first, you and the rest of your family noticed dramatic changes in your teen’s behavior. But then those changes stopped. It seemed like progress plateaued, and you may have even noticed regression in some areas. The changes have been so dramatic you wonder if the current situation is still working.
At Heartlinks ABA, we understand that every child and their journey is unique. When therapy stalls, it’s not a failure; it’s a signal that it’s time to reassess and realign your child’s treatment plan with their evolving needs.
What is ABA therapy?
In the world of autism treatment, ABA therapy is considered the bedrock. ABA has a long history of using a scientific method to understand and modify behaviors, and it uses positive reinforcement to encourage desired behaviors. It can help develop critical communication, social skills, and daily living abilities while addressing problems such as repetitive behaviors and tantrums in an approach that respects the child’s comfort and needs.
ABA treatment programs are individualized and should never be used as a “one size fits all” approach. Whether your child works with an RBT or a BCBA, their program will be written to meet the individual learner’s needs.
There are dozens of techniques used in ABA therapy, including shaping and tacting, as well as modeling and discrete trial training (DTT).
Why is my child’s ABA therapy not working?
Yes, ABA therapy is considered the gold standard in autism treatment, with a considerable success rate among children on the spectrum. However, if it doesn’t seem to work for your child, there could be several variables to explain why, and the answer may not be the ABA approach.
Unrealistic Expectations
Too often, parents start ABA therapy with the expectation that their child will change overnight that the harmful behaviors or stimming will disappear within the first few weeks. This can lead to disappointment or frustration if improvements aren’t seen quickly. It’s important to understand that ABA therapy requires a long-term commitment, and results may take months or even years to come to fruition.
Too Intense
ABA therapy often involves several hours of treatment a week, which may be exhausting, particularly for younger children, such as infants and toddlers on the spectrum. This can sometimes lead to autistic burnout, which is a state of emotional, mental, and physical exhaustion brought on by prolonged stress and overwhelming demands. Frequently, when children feel overwhelmed, they can become resistant to therapy, leading to less effective results.
If you think this may be the case, contact your ABA provider immediately to explore ways to modify the schedule. Options might include breaking up sessions into shorter periods with increased breaks or reducing the number of weekly therapy hours.
The Therapist
Whether your child works with an RBT (registered behavioral therapist) or a BCBA (board-certified behavioral analyst), their approach and personality should align with your child’s needs. The right therapist should be fun and able to engage your child while respecting their way of interacting with the world.
For example, if your child is non-verbal or has a sensory processing disorder, they may communicate through facial expressions, body language, or alternative communication methods. A skilled therapist should be able to read your child’s cues, adapt their strategies to their needs, and create an environment that encourages learning without causing distress.
The Wrong Reward
ABA therapy utilizes a positive reinforcement approach to encourage positive behavior. This motivator or reward must be meaningful enough to the autistic child that they want to continue with the positive behavior.
For example, your child’s therapist uses the Premack Principle to teach them independent living skills. Despite a preference assessment that determined sensory toys were a strong motivator for your child, they no longer provide the same outcome. Without meaningful reinforcement, your child may not feel encouraged to continue the positive behavior. Understanding what engages and excites your child is key to successful behavior intervention.
Setting
A therapy environment can dramatically impact an autistic child’s treatment by influencing their sensory experience, anxiety levels, and their ability to learn, which can either enhance or impede their progress. That’s why creating a structured setting can contribute to reducing their anxiety and improving communication.
An effective therapy environment incorporates several critical elements, including the following:
- Organized Materials: From structured workspaces to labeled bins, an organized workspace encourages independence.
- Designated Quiet Areas: Provides a sanctuary when the child is experiencing sensory overload.
- Visual Supports: Incorporate labels, schedules, and task analyses to improve understanding.
Signs it’s time to change therapists
ABA therapy can effectively support autistic children and teens in building communication, social, and daily living skills. However, progress takes time-typically several months to a year-and outcomes can vary depending on the child, the goals in place, and the therapist’s ability to tailor the program effectively.
Lack of Generalization of Skills
A key sign that an ABA therapist may not be a strong fit is when skills learned in sessions do not generalize to real-life situations. Suppose your child can successfully demonstrate behavior in a structured therapeutic setting but cannot apply it at home, in social settings, or at school. In that case, it may be time to reevaluate the effectiveness of their current therapist.
An effective ABA therapist should help children transfer learned skills to different environments or contexts, also known as generalization. If this isn’t happening, their treatment may require modifications, such as incorporating more naturalist teaching strategies, which could be incorporated into both at-home and in-class ABA therapy. It’s also worth considering whether a change in therapist could bring a fresh perspective or approach that better aligns with your child’s needs.
Regression
ABA therapy takes time, and some setbacks are expected in the learning process. Patience is key. However, if your child isn’t showing progress after a reasonable amount of time or begins to regress, this could be a red flag. Regression can manifest as a return of inappropriate behavior, often referred to as an extinction burst, difficulties in retaining new skills, or an overall decline in the child’s functioning.
In some cases, regression could also be linked to disintegrative disorder. In this rare condition, a child experiences a significant loss of previously acquired skills, including language, social skills, and motor abilities. These signs indicate that a change is necessary. They may suggest it’s time for a more intensive therapy schedule, re-evaluating treatment goals, or exploring alternatives such as music therapy that better meets the child’s needs. Switching to a therapist who better understands your child’s developmental profile can make a significant difference.
Lack of Engagement
Part of the success of ABA therapy depends on your child’s active participation. If they seem uninterested or disengaged during sessions, it’s important to note. For example, your autistic child may no longer enjoy the activities they used to, find it difficult to focus on tasks and avoid their regular responsibilities more than usual. In some cases, this avoidance may be linked to pathological demand avoidance (PDA), a type of autism characterized by extreme resistance to everyday demands, often due to anxiety and a need for control.
Addressing these symptoms is essential. Solutions might involve changing your child’s therapy plan or therapist. Adjustments may include introducing new reinforcers, integrating preferred interests, or shifting to a more flexible and child-led approach. Lack of engagement could also signal a mismatch between your child’s learning style and the therapist’s methods. In these cases, transitioning to a therapist with a different approach may renew progress.
On the other hand, a lack of engagement might signal your child has made tremendous progress and that they’re ready to move to a less intensive type of help. If this is the case in your situation, your certified ABA therapist should be able to help create a plan to reduce therapy hours while continuing to provide support.
Unable to Address All Issues
The focus of ABA therapy for autistic teens and children is improving behavior. However, it may not address the underlying emotional challenges they might be experiencing, including depression and anxiety, particularly in older children and teens. These challenges can hinder your child’s ability to engage in therapy and make progress.
If you notice signs of emotional struggle, consider speaking with your ABA provider about adding complementary therapies to your child’s treatment plan. These might include occupational, cognitive behavioral, and even speech therapy or others that target different aspects of development. In some cases, exploring a combination of treatments or switching to a therapist with more experience addressing co-occurring conditions can make all the difference in your child’s overall progress.
Heartlinks ABA: Personalized Care for Every Child
Heatlinks understands that there are many reasons your child’s ABA therapy may not be working, including the need for a new therapist or a combination of therapeutic approaches. That’s why we’re here to help. With locations in Georgia, New Jersey, North Carolina, and Indiana, our strength is creating personalized therapy plans for each client, including advising you on other therapeutic options if needed. Contact us today to learn more about how we can support your child’s treatment journey.