This summary briefly explains the steps involved in setting up an ABA home programme and describes the roles of each team member involved. Guidelines are in place in order to ensure that a well-structured and successful programme is designed and implemented, taking into account all of an individual’s needs. Keys to the success of each programme include: communication among all of the team members and family; constant monitoring of the child’s progress; and intensive implementation of the designated programme.
The following guidelines are based on the model that was in place in ABA schools in the Republic of Ireland, whereby a supervisor oversaw a number of programmes within each school and tutors implemented the programmes with each individual child on a 1:1 or group basis. Regular meetings were conducted among: the parents of the child; the child’s supervisor; the child’s key tutor; and other members of the multi-disciplinary team. The latter often included the Occupational Therapist (OT) and Speech and Language Therapist (SLT), who are often key contributors to programmes.
1. Who Runs The Programme?
Home programmes are set up and overseen by a supervisor. Supervisors of ABA home programmes must have a postgraduate qualification in the area of Applied Behaviour Analysis (ABA) and must be a Board Certified Behaviour Analyst (BCBA) as recognised by the Behaviour Analysis Certification Board BACB. They should have extensive experience in: conducting assessments of need; writing Individualised Education Plans (IEPs); and designing and implementing behaviour support plans, functional analyses, and functional assessments. Supervisors can also be directly involved in programmes. They conduct supervision meetings on a regular basis (usually bi-weekly, or more often on request) and liaise closely with the family and other members of the multi-disciplinary team. Supervisors also write educational reports based on their behavioural assessment of a child and these may be used in schools for children with special needs.
The tutor is the person who implements the home programme with the child directly for an amount of hours per week as decided by the parents and agreed with a supervisor. If a programme is funded by the Department of Education, tutors must meet the criteria for home tuition, as specified by that body. Tutors must have a recognised teaching qualification or a “qualification in autism” or “a qualification in an applied approach to teaching children with autism” or a degree in psychology. The most common educational backgrounds of ABA tutors include: graduates of psychology; someone who is currently enrolled on a postgraduate training course in Applied Behaviour Analysis (ABA); or someone possessing a teaching qualification. It is extremely important that the tutor has been appropriately trained to use the principles of ABA.
2. How Is The Programme Set Up?
Before a tutor can begin work with a child, the supervisor must conduct an assessment of the child’s current skill level, meet with the child’s parents to produce an individualised education plan and compile a folder of programmes for the tutor to use. The process is described in more detail below.
The supervisor carries out an assessment of skills. Such assessments include the Assessment of Basic Language and Learning Skills ABLLS, and the VB-MAPP. This initial assessment gives an overall description of the child’s skill level in various areas such as: communication; academic skills; self-management; gross and fine motor skills; and play. This assessment crucially highlights the child’s competencies and deficits, and thus gives an indication of goals to focus on in the home programme.
(B) Individualised Education Plan (IEP) Meeting
An IEP is drawn up following an in-depth meeting between the supervisor and the child’s parents. This allows the supervisor to hear what goals the parents would like incorporated into the programme. For example, they may discuss where they would like to see their child in six months or a year’s time and they may highlight specific skills they feel would be of immediate importance to their child and the current context. This meeting also gives the parents the opportunity to discuss at length what they see as the behavioural difficulties of their child. This session is referred to as an IEP meeting because it generates the basis of the IEP.
(C) The Child’s Individual Folder of Programmes is Compiled
The supervisor compiles all of the information from the assessment and from the IEP meeting and draws up a Programme List. This list contains all of the programmes that need to be used to teach the necessary skills to the child. This programme list is the long term goal, from which an initial Workplan is taken. A workplan incorporates all of the programmes currently being worked on by the tutor(s). It is presented at the front of an A4 folder and consists of a list of the names of each programme within the folder. Each programme will have a Long Term Objective (LTO) stated at the top of the sheet and will have attached graphs to present the data taken during each teaching session in order to clearly illustrate the on-going progress of the child.
Within the folder, programmes are taken from a range of skill areas selected from those examined during the initial assessment. Examples include: academic literacy (reading, writing, spelling and numeracy); communication (e.g. speaker and listener skills); self-management; play; and gross/fine motor skills. The degree to which each of these areas will be focussed on varies from child to child and depends on factors such as age and individual needs.
(D) Tutor Begins Working with the Child
Once the numbers of hours have been agreed between parents and tutor(s), the implementation of the programme can begin. The tutor will come to the child’s house and implement the programme (teaching skills in each of the required areas), using the principles of ABA. Data is collected by the tutor during each programme and is graphed on a daily basis. Tutors monitor the child’s progress within each programme, making amendments as necessary. They should notify the supervisor immediately if issues arise within a programme. Otherwise, progress is reported at the scheduled supervision sessions (see below).
While there is a lot of information in the above points, it should be noted that a programme can be fully set up within a number of days!
3. What Happens After This?
(A) Supervision Sessions
Supervision sessions take place on average every two weeks, or more frequently if requested by the parents. The programme supervisor attends a tutoring session to monitor the progress of the programme and to ensure it is being implemented as it was designed. These sessions also give an opportunity to discuss any issues that have arisen and any amendments that need to be made to the programme. Concerns of parents can also be discussed during this time. However, in situations where parents have concerns or anxieties about programmes or their child’s behaviour, they should contact the supervisor who will arrange an immediate meeting.
(B) Re-assessment using ABLLS / VB-MAPP
A re-assessment of the child’s skills and deficits will occur on average every six months. Children on intensive home programmes can make a lot of progress within this time and it is necessary (and exciting) to keep track of the behavioural changes in each of the skill areas. This also ensures that the home programme is continues to meet the specific needs of each child.