During the treatment of autism spectrum disorder (ASD) in children, one of the most crucial factors for success is the use of Applied Behavior Analysis (ABA) therapy. However, what is the minimum amount of therapy sessions for a child?
The balance between underprescription and overprescription of therapy hours is not purely an administrative task, as it might have direct implications on the child’s progress and well-being along with outcomes in the long term. For many parents and professionals, the challenge arises in the attempt to point out how many hours would lead to successful therapy without having any adverse risks associated with either one of them.
For example, a paper in The Journal of Autism and Developmental Disorders, demonstrates that (a) high hours of treatment may yield little to no benefit, and (b) treating in excess of 10 hours a week may cause the child to suffer burnout, stress, and in rare cases regress.
That balance is absolutely right, and in this blog we are going to look at both underprescription and overprescription, what they do, and how to achieve that just right balance for the best possible result.
Understanding ABA Therapy Hours
ABA therapy is an evidenced-based treatment that is aimed at enhancing targeted behaviors and learning new behaviors. The therapy can be administered in different areas, from homes to schools to the community, and a child’s total number of therapy hours that they see also plays a significant role in the outcome of the therapy.
Typically, therapy hours range from 10 to 40 hours per week, and some programs suggest that early intervention is closer to 20 to 40 hours for young children because this has been most effective in helping them catch up on their developmental milestones. However, as many families and therapists will readily tell you, “Quality beats quantity,” and it is very important to strike a balance between the two.
Balancing Underprescription and Overprescription of Hours in ABA Services
What is the Underprescription of ABA Therapy?
Underprescription refers to providing a child with a minimal number of hours for ABA therapy. There is a high possibility of leading to the underdevelopment of a desired skill or behavior. Although the actual number of hours administered may differ depending on the changing needs of the child, underprescription is usually the outcome of an overly restrictive approach based on either a lack of resources or a wrong perception of how the child might develop over a given lapse of time.
In the case of underprescription, children may not receive enough reliable practice and feedback to result in needed behavioral improvements. This may be observed through delayed development of skills, lack of exposure to generalize skills within a variety of environments, and/or presence of maladaptive behaviors.
For example, a child may receive only 10 hours of therapy per week and may not improve more than slight changes in communication skills, social interactions, and daily life activities. In particular, this limitation within the short therapy sessions may cause frustration to the child and the caregivers, and they may not see the desired outcome or even the long-term effect of ABA therapy.
Potential Consequences of Underprescription
- Limited Progress: There might not be enough developmental progress in core domains including communication, social skills, or adaptive behaviors.
- Missed Opportunities for Skill Generalization: Skills learnt in therapy will not generalize to the usual situation when skills are acquired in a therapeutic context without sufficient practice in varied situations.
- Parental Stress: The few hours of therapy might be burdensome to the parents as they feel the need to compensate, thereby increasing the stress and dissatisfaction of the family.
- Regression: In some instances, the skills are not consolidated, and regression or even stagnation in development could happen.
What is Overprescription of ABA Therapy?
On the other hand, overprescription is giving too many therapy sessions to a child for one reason or another, although not proven necessary or of good use to that particular child’s special needs.
Despite the fact that intensive therapy has proven beneficial in certain cases, overprescribing the therapy could precipitate unseen adverse results, particularly if the therapy strategy continues unchanged from the child’s progress.
This is mainly because of a tendency to provide the most therapy sessions to the client to be able to get early or deeper improvements. However, the reverse may happen if the therapy schedule becomes overwhelming to the child. Remember, ABA therapy is not a one-size-fits-all model. What works for one child may not work for another.
Potential Consequences of Overprescription
- Burnout: Long treatment time leads to the burnout of a child who therefore becomes exhausted and disinterested. Over-treatment of a child will leave them frustrated and not willing to continue coming for more.
- Social and Emotional Strain: Overdoses of therapy hours for a child lead to having little time left for natural playtime or free time that is crucially necessary for emotional and social development in children.
- Reduced Motivation: The greater number of hours of therapy to which a child is exposed can also make a child lose their motivation or an ability to learn proper reinforcement, leading to a challenge to long-term change of treatment.
- Overprescription also brings along with it increased family stress, especially for parents who already deal with extra sources of stress and burden. Such stress is damaging to the welfare of the child.
Finding the Right Balance: The Way to Navigate Between Underprescription and Overprescription
Personalization is the secret to optimal outcomes in ABA therapy. Therapy hours should not be based on the application of a rigid, standardized approach but on a detailed, individualized assessment of the child’s unique needs, strengths, and goals.
The following are the criteria to use in determining those suitable therapy hours:
- Ongoing Assessments: Maintain regular follow-ups to monitor and correspondingly adjust the therapy hours. ABA therapists have to constantly track data in regard to the child’s progress to ensure that there’s a match between the number of hours of therapy the child requires.
- Parental Involvement: Include the parents in the decision-making process. The family should be empowered to give their feedback about how the child has reacted to the treatment and be involved in a planning process that is cooperative in nature, with therapists and other providers, in developing an appropriate treatment plan that is suitable enough to meet the needs of that child.
- Gradual Changes: First, one establishes the suitable number of therapy sessions and adjusts them accordingly in terms of increase and decrease based on the improvement and mental state of the child. Most children start with more than the rate of treatment visits at the beginning of the intervention and then reduce therapy hours over time as they reach their goals.
- Consulting Experts: Seek counselling from board-certified behavior analysts (BCBAs) trained to provide behavior analytic services individualised for each client. They may have experience structuring the therapy sessions, so there is a guarantee that the treatment plan is effective yet not excessive for the child.
- Consider the Child’s Developmental Stage: The age and maturity level of a child will determine the amount of therapy required. Higher session time initially could be beneficial to younger children, and less intensive treatment may be required for older children, after the development of firm foundation skills.
Seeking ABA Services From Willow Reach ABA
We at Willow Reach ABA know that every child is different, and, therefore, the ABA therapy programs will be so designed as per each child’s needs. Our aim has always been to provide a caring, entertaining, and supportive environment wherein therapy can be conducted in an in-home ABA setting or within the community setting.
We understand that families are the cornerstone of the success of any intervention. The work by our therapists is closely linked with parents so that the therapy hour and the therapy mode are at least not stressed out and made as effective as possible. We create a partnership between our team and the family, ensuring that every decision is made collaboratively to suit the child’s evolving needs.
We also put emphasis on flexibility with in-home ABA therapy services; that is, adjusting the hours of therapy as long as it suits the provision of the best care that each child may need in the care of their own home. Our compassionate and experienced team is dedicated to making ABA therapy a positive and productive experience for the entire family.
Conclusion
This balance between under-prescribing and over-prescribing ABA therapy hours determines the quality of care to be provided to children with ASD. It is just a matter of providing an adequate number and kind of therapy to enable children to achieve meaningful improvement without unnecessary stress or burnout.
With this customized approach, and continuous monitoring of progress, experts can determine the number of hours of therapy that a child should receive.
We at Willow Reach ABA believe in customized, compassionate treatment that supports families and helps children grow and develop. If you are looking for a provider who understands the fine balance of ABA therapy hours, we are here to help guide your journey.
Frequently Asked Questions (FAQs) About ABA Therapy Hours
- How do I know my child receives just the right amount of hours of ABA therapy?
The number of required sessions will depend on the child’s age, developmental stage, and the targeted goals of the therapy. In this way, through regular assessments as well as feedback from the therapist, it will be determined whether the therapy sessions are enough or need to be increased or decreased.
- Is there such a thing as overprescribing ABA therapy to my child?
Yes, overprescription of ABA therapy can lead to burnout, demotivation, and stress for both the child and the family. There is a need to strike a balance between creating progress and not letting the child get overwhelmed.
- How does Willow Reach ABA personalize ABA therapy for my child?
Willow Reach ABA customizes individualized treatment plans for each child according to the specific needs of the child. In close collaboration with families, we ensure that therapy is both effective and enjoyable for the child, without causing stress but rather focusing on growth.
- How often should the ABA therapy hours be reconsidered?
ABA therapy sessions need to be periodically reevaluated, i.e., on average every 3 to 6 months, to ensure that the plan is still in accordance with the development of the child and meets their needs.
- How do parents become involved in the Willow Reach ABA treatment process?
At Willow Reach ABA, we have a collaborative approach. We welcome active feedback and participation from parents to be shared and to participate within the elaboration and adaptation of the therapy plan of the child, to maintain its efficacy and to be supportive.
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