Introduction

Families with children on the spectrum can look into Applied Behaviour Analysis (ABA) therapy as it is a gold standard for behaviour and developmental challenges for children with ASD. ABA therapy is a type of therapy that uses the principles of learning and motivation to change behavior, which effectively improves social skills, communication skills, and behaviour. ABA therapy provides support and training for parents to manage difficult behaviours children on the spectrum display. ABA therapy is typically conducted by a trained ABA therapist and may involve teaching new skills, providing reinforcement for desired behaviours, and fading out unwanted behaviours.

There is a growing trend of family-centered approaches in ABA therapy, in which parents or caregivers shape treatment as these ABA practices are issued by ABA therapists with the knowledge that comes from caregivers, siblings, and other family members to review treatment and the treatment goals. It is helpful for family-centered ABA treatment as parents and those who care for the child are the best source of knowing the child’s strengths and needs, and family members spend most of their time with the child. Studies suggest that when families participate in ABA, the outcome results in minimized caregiver stress with improved independence of the child.

Understanding Family-Centered ABA Therapy: The Difference of Traditional vs Family-focused Interventions

Traditional ABA therapy approaches look at clinical-based therapy applications in which the clinicians or therapists are the experts. Therapy is provided in the clinic, with some input from the parents, however unlike family-centered ABA therapy, traditional ABA therapy focuses on observing, assessing, and teaching your child with the role of family as passive and clinicians role as prescriptive and all-knowing.

The intervention process for Family-Centred ABA therapy involves families, emphasizing their role as active participants. Family members work closely with the therapist to ensure that their values and goals are aligned with the strategies implemented at home.

When parents are consistently involved in therapy, this supports children’s progress by including learned strategies and interventions from home and implementing them in the community. Parents are the experts on their children which helps with tailored treatment.

The following stages are included in the intervention process:

1. Assessment for the child – the therapist conducts an assessment and finds the baseline to understand what level the child is at and recognizes and takes into account the family goals, challenges, and resources the family needs.
2. Treatment Goals – Collaboratively and based on the baseline, goals are set out to help with behaviours and take into account the priority of the family.
3. Interventions & family incorporation – the therapist will come up with strategies associated with treatment goals to help decrease or improve behaviours. Parents can be trained here to implement certain systems at home. I.e. rewarding positive behaviour. 
4. Training- The therapist will work directly with the child, and help train parents to implement these strategies at home, using role play to show how to develop these strategies in the natural environment
5. Collection and analyzing Data – this is an important part to have accurate data on the child’s progress to continue or tweak the interventions implemented. Having data from home can see if there needs to be more training or if there is consistency in various settings. The data would need to be evaluated and adjusted if there is an increase or decrease in behaviour. It is important to recognize what has been working overtime.
6. Generalization of skills – this can then be generalized into various settings to help with consistency over time.

A family-centered team includes a team such as speech therapists, occupational therapists, behavioral therapists, psychologists, and special education teachers who work together to address various aspects of the child’s overall behaviour and well-being. This team creates an individualized care plan that focuses on the child’s strengths, challenges, and goals.

Family-based approaches for ABA therapy keep generalization and stabilization for children and families to foster the child’s strengths and needs in the treatment process. As each child is unique, who is the best to know the child’s behaviour other than family members? This creates such a personalized approach that help families to achieve these goals much more approachable to the success and outcome.

Why The Rise of Family-Centered ABA Therapy in Ontario?

It’s no secret that family involvement plays an important role in the success and sustainability of interventions. There are fewer professionals in autism treatment in Ontario, and autism diagnosis in Ontario increasing as experts estimate that 1 to 2 percent of Canada’s population is autistic. This shows a need for many diverse treatment interventions and models. Family-centered interventions are shown to provide support and ensure an individualized plan of action. This could encompass:

1. Increased evidence of the importance of family support 
2. Having a holistic approach
3. Being Supportive of treatment goals
4. Personalized and Tailored approach

Holistic, tailored care is more important than ever as when parents are better prepared, the goals of treatment are more achieved by working with the child at home. This can have a positive effect on the child, the family, and caregivers. This equips families to better understand and develop the participation of caregivers in the therapeutic process.

Local organizations and initiatives supporting family-centered approaches include:

1. The Ontario Autism Program
2. Autism Ontario
3. The Geneva Centre for Autism 
4. The Ontario Association for Behaviour Analysis (ONTABA)
5. Toronto Autism Services Network
6. Family Services of Ontario
7. Child Development Institute 
8. Autism Support Network

What are the Benefits of Family-Centered ABA Therapy?

It is important to know that the benefits of Family Centred ABA Therapy allow for communication between parents and therapists. Evidence has shown that family has the most influence on the child’s development and that family involvement is the basis for children’s progress.

Key benefits of family-centered therapy include:

1. Teaching skills and generalization of skills.
2. Empowering families to help children and strengthen communication 
3. Confidence in parents and families to train and be involved in the treatment process
4. Greater long-term effects as well as greater outcomes for treatment

In improving the consistency and effectiveness of interventions, family-centered therapy also supports the emotional and practical needs of families and creates lasting positive changes for the children and their families. Following this approach, long-term success can be achieved through empowerment and collaboration.

Challenges and Considerations

Potential challenges faced by parents who start family-centered ABA include challenges based on different circumstances can include:

1. Family dynamics and stress – sometimes not all families communicate, so ensuring that as a family you communicate what has been working with each other and the therapist can help your child and family pressures as well. Working collaboratively can reduce that stress. It may seem hard to manage the daily responsibilities of the family and meet the needs of therapy as well. 
2. Children’s needs – Sometimes a child’s needs are not being met, such as children with complex dynamics. It is important to stay as consistent as you can be. Children with challenging behaviours, can make it harder for transitions and come to therapy. 
3. Financial Struggles – With varying costs of services and discrepancies between services, therapy may be hard for some families to do consistently. This could be where looking at cost-effective options such as telehealth services could come in handy.
4. Accessibility – qualified providers are not always available, and access to services may not always be present as in rural and remote communities access to these services is seen as quite a challenge. Telehealth can be an area to alleviate these challenges as well.

The need for ongoing support and training for parents and therapists as it is underutilized, it has been shown to be effective in the community settings for generalization skills. It is important for those who care for children with ASD to be provided pieces of training, as well as providers and organizations to all have the same knowledge to help with consistency throughout the child’s life. This can determine the success and outcome of treatment goals.

The Future of Family-Centered ABA Therapy

There are predicted outcomes that to tailor children’s and family needs, the Ontario Government would provide family-centered therapy to meet equitable needs for ABA therapy. This could help develop training and support for family members to generalize skills obtained both in the community and at home.

Policy and funding changes empower families to play a more active role in their child’s therapy in Ontario. Increasing access to ABA therapy provides more:

• Funding  
• Flexibility
• Caregiver training

Not only will this create a more holistic approach, but this can also create areas for telehealth and virtual care to help access these therapies remotely. This can help with some of the challenges such as minimized costs, accessibility in rural and remote areas as well as fewer transitions to reduce challenging behaviours.

As we look to the future research and evidence must be collected to see the importance and how family-centered therapy looks over time. The natural teachings are shown to support children in various settings that can provide overall success for the treatment goals. The future need for family-centered ABA therapy ensures integration in the community and at home, which minimizes stress for families and encourages continued learning for parents and children.

Conclusion

It is important to explore the growing trend in Ontario towards family-centered ABA therapy plans that cater to the unique needs of each child. With understanding the structure of ABA therapy in the past, it is clear that tailored treatment plans for children on the spectrum are required for the child’s unique needs, and incorporating parents and families in interventions creates and reduces stress for families, reduce behaviours, and help children with ASD as a whole. Family-centered interventions are important to provide empowerment to families and give families a say in the treatment of their children. It is important to take into account that there is a need for holistic services to help children grow in their natural environments.

Call to action

The Insight Clinic has many therapists who can help you manage stress and anxiety, and treatment plans for yourself, your child, or your family. At The Insight Clinic, we can help you manage burnout, depression, anxiety, and financial burdens as well as provide resources for Autism & ABA therapy. If you are a parent struggling with managing the behaviours of a child with autism, are anxious, or are struggling with finding options, The Insight Clinic can provide you with a therapist to cope with the anxieties and struggles by using Acceptance and Commitment Therapy as well Mindful Based Practices, Cognitive Behavioural Therapy, and Family Therapy as well.

You can reach out today to book an appointment with our skilled and trained therapists to help you gain understanding and develop healthier coping strategies when you are feeling anxious, or developing these maladaptive thought patterns.

In collaboration with The Insight Clinic, ABA Academy leads with a focus on excellence and focuses on providing individual ABA Interventions for your child’s growth in social, cognitive, emotional, and physical developmental growth and milestones. ABA Academy provides high-quality, individualized & personalized treatment plans that involve you in the process of creating effective services to help your child grow and learn. These services are provided by a fully licensed and qualified BCBA. Reach out today to see if ABA Academy is the right fit for your child’s ABA services and allows better transitions in schools.