Introduction

ABA (Applied Behavior Analysis) therapy is one of the leading therapies in treating children with autism spectrum disorder (ASD). A child on the spectrum can benefit from ABA therapy in various ways including encouraging positive behaviours, life skills, communication, and social skills. For a long time, traditional ABA therapy has been in person, and the lack of accessibility of services in rural areas started the need for virtual services. The pandemic, however, created a drastic change to health services everywhere with a need for tele-health counselling, therapy, and much more.

With the growing need for Autism Services, there is a need to ensure that ABA services can be provided to children on the spectrum or with ASD through virtual means. With the need for services and a wide waitlist continuing in Ontario, virtual ABA therapy is a growing trend. It is important to explore how accessible and effective virtual ABA Therapy is in Ontario and what challenges need to be overcome.

What does ABA therapy involve?

ABA therapy looks at the principles of behavioral science, and focuses on understanding how behavior works, how it is affected by the environment, and how learning takes place. ABA therapy includes working with you, your child, and different professionals such as Board Certified Behavior Analysts (BCBAs) and Registered Behavior Technicians (RBTs) to achieve the treatment goals of the child.

If your child is working on social skills, independence skills, and communication skills, then the BCBA, the family, the child, and other professionals can come together, track behaviours, and understand the child a little more. ABA is important to the autism community as not only is ABA therapy scientific and evidence-based, but it also teaches these children beneficial skills.

Traditional in-person ABA therapy

Traditional in-person ABA Therapy involves:

1. Assessments done by professionals: These assessments are used to understand the strengths, challenges, and needs of your child. This can include interviews, observations, and standardized assessments to create an individual and personalized treatment plan. Talk to the BCBA in the clinic about what assessments are being used to assess your child.
2. Places where ABA therapy occurs: Traditional ABA therapy can be provided at home, in a school setting, at clinics, or in various community areas in a naturalist setting. The point of traditional ABA therapy involves your child having one-on-one sessions with the Instructor or therapist, in small groups, or within their regular routine. Typically, ABA therapy is provided in person at a center or clinic. 
3. A Goal-oriented Treatment: The most important thing about ABA therapy is setting goals. This can be about creating skills for being more social, developing communication, or even independent skills. Strategies are then provided to help achieve these goals, by prompting, reinforcing positive behaviors, collecting the data, and breaking down tasks to help your child complete them without assistance.
4. Family Involvement: As each child has their own needs, the parent, caregiver, or guardian usually knows most about their child. With ABA therapy it is important to be a part of the treatment planning and understanding of how to treat your child. Being involved and asking to be trained in teaching your child those skills can help with generalizing these skills at home, at school, and in the community beyond therapy sessions.
5. Having access and Funding for services: The Ontario government provides funding options for ABA therapy through programs like the Ontario Autism Program (OAP). This funding gives access to in-person and now tele-health services as well. The OAP provides funding in different areas to support you and your child. As the waitlist for the OAP grows there are also private clinics that offer ABA therapy, these places also may have waitlists due to the high demand for services. Researching is the best way to find what services can be offered to you and what services are the best fit for you and your child. 
6. Standards and Regulations of Services: ABA therapy in Ontario is guided by standards set by professional bodies such as the Ontario Association for Behavior Analysis (ONTABA), and the certification standards of the Behavior Analyst Certification Board (BACB). These regulations ensure professional and ethical standards for giving your child the best services possible. With the shift of regulation, BCBA’s and BCBA-D are the ones that have to register for their professional standings. Registered Behavior Technicians and BCaBAs are no longer under the provided credentials of the Ontario provisions. 

The Shift to Virtual ABA Therapy in Ontario

In-person ABA therapy has been great for those who have access in their regions, However, virtual services are the response to the increased demand for ABA services, as the need for more flexible treatment options was developed through challenges posed by the COVID-19 pandemic. Ontario’s autism support landscape is becoming increasingly integrated with virtual ABA services as the waitlists grow longer and some regions remain under-serviced. Several factors have contributed to the growth of these services including:

1. Technological advances: Telehealth Platforms and video conferencing tools are now used to conduct therapy to help with behavior tracking, assessments, and monitoring the progress of your child. Data collection tools also help therapists to track behavior and the child’s progress remotely to track these behaviours and progress at that time, which can be shared with parents when needed. Advances in technology provide more accurate and fewer results that are affected by human error.
2. Increase in demand for ABA therapy:  As the awareness of Autism increases, the number of diagnosed children increases as well which creates longer waitlists. In rural areas with limited access to specialized ABA providers or long waitlists for in-person therapy, virtual services provide an option for families to have access and provide regions with access to these services.
3. Flexibility and availability: The availability of virtual services allows for greater scheduling flexibility through the reduction of travel, and making therapy more convenient for families. Families with varying schedules and parents juggling work and childcare responsibilities will particularly benefit from this. The research notes that due to the cost-effectiveness of tele-health services for ABA therapy, this can become more widespread in Regions that traditional ABA therapy is not placed. It is shared by Kinark,  that families from northern or eastern regions of Ontario, don’t have as much access due to location or physical limitations.

The Effectiveness of Virtual ABA Therapy

According to the Journal of Applied Behavior Analysis, telehealth interventions note that online therapy could achieve similar results to services for certain behaviors. A lot of research has stated that the quality of therapy is largely dependent on the therapist’s ability to adapt techniques for virtual delivery and the participation of the family or caregiver in supporting your child’s virtual services. The services that tele-health can provide include helping children increase their social communication and develop parent training packages.

According to Kinark, they see benefits in tele-health services due to reducing appointment wait times, collaboration among healthcare professionals, and having a low cost to families. It is shared that virtual services are comparable to in-person services and are just as effective. There needs to be more research done on the reliability and accuracy of virtual and tele-health therapy.

In some studies, it is shared how interventions and strategies in social communication targets (including requesting, labeling, social referencing, and joint attention) have varied results being achieved in telehealth ABA therapy. Compared to in-person techniques it is easier to have that control of variables.

Challenges of Virtual ABA Therapy

As virtual platforms and hybrid models continue to develop, virtual ABA continues to play a significant role in meeting the needs of families across the province, despite challenges in engagement and technology.

Technical barriers include access to technology, the internet, and devices as this is not always sustainable and accessible to everyone. This could affect services by poor connections in different regions or differences in understanding the technology or platforms being used. 

Along with that ensuring engagement and interaction virtually is a great question to ask as to whether or not engaging with the child is plausible. Working with a child across a screen can be difficult, especially for a child on the spectrum. Modelling behaviour or controlling the many competing variables which may exist in less structured environments are areas that can be the most challenging. Ensuring quality control and therapist training in virtual environments is key to engagement.

The Future of Virtual ABA Therapy in Ontario

There are emerging trends in AI, VR, and AR for ABA therapy. This can help in more accurate data collection and safe and controlled spaces to help your children with targeted skills with fewer variables to engage in. At Brock University, shaping skills are being tested within virtual environment formats or virtual reality in which teaching plans, setting up for a session, delivering reinforcement, and evaluating a session are all assessed. The studies have shown great encouragement and highly satisfied participants.

Looking towards the future of ABA and the technological advances of ABA therapy can help us see how hybrid models can be the most effective forms of treatment. With both data collection and the warmth of in-person treatment, hybrid models seem to be one of the greater options.

Conclusion

With the growing need for Autism Services, there is a need to ensure that ABA services can be provided to children on the spectrum or with ASD through virtual means. With the need for services and a wide waitlist continuing in Ontario, virtual ABA therapy is a growing trend. It is important to explore how accessible and effective virtual ABA Therapy is in Ontario as those in North and

Eastern Ontario do not have quite as much access to in-person services. This is where virtual services can help those regions who are underserved, Looking at the challenges of access to technology and internet access to families who cannot afford these services is an important area as well. Accessibility and equity of services are areas that need to be fought for, for your children with ASD.

Call to action

With the growing use of tele-mental health services, The Insight Clinic has many therapists who can help you through both in-person and virtual services. 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.

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, and effective services to help your child grow and learn from a fully licensed and qualified BCBA. Reach out today to see if ABA Academy is the right fit for your child’s ABA services.