A new trend in ABA is happening. This blog is not intended to discuss the merits of ABA, as there have been many arguments for and against ABA, and just as in any field, there are good ABA practitioners and then there are not. This blog does not seek to debate those merits but merely to make people aware of a new questionable practice that seems to be happening in some ABA clinics throughout the United States.
Originally, ABA found that because pre-school was not a mandatory attendance grade in most states, they could bill insurance companies for services for pre-school aged children and the child would receive anywhere from 30-40 hours per week paid services. ABA facilities began to create “clinic” type settings, where children with ASD (Autism Spectrum Disorder) would be dropped off by their parent and stay at the clinic as if they were attending pre-school. In fairness, many independent pre-school programs do not or did not at the time, take children with ASD so for working parents, this alternative was a viable solution for their child.
In some states, kindergarten is a mandatory attendance grade and in other states kindergarten is not. This meant that in states where kindergarten was not mandatory, ABA practitioners could continue to bill insurances for ABA services, but this also began a slippery slope trend. In states where kindergarten was a mandatory attendance grade, it has been reported by many parents, that ABA practitioners convinced parents that their child still needed ABA services and that they could continue at the “clinic” if the parent registered the child for “homeschooling.” Instead of the child being at home and being “homeschooled” by the parent, their child could come to clinic and the ABA facility could continue to bill the insurance company for the 30-40 hours a week.
As some ABA practitioners began to see that this “homeschooling/clinic” system was financially lucrative, those clinics began encouraging parents that they could continue to do the same for their child in first, second, and older grades. Because of the shut down during COVID, more and more parents became aware of what was happening in their child’s classroom because teaching online gave the parent a window into their child’s education. Many parents became disgruntled, and so the idea of sending their child with ASD to an ABA clinic while saying their child was being “homeschooled,” became a popular trend. To be clear, this article does not judge parents for making this decision, it merely seeks to give the historical perspective on a controversial trend happening now.
As insurance companies became cognizant of what was happening or merely because there was an uptick in parents who were “homeschooling” their children, insurance companies began reducing the number of hours per week the child received as he or she got older. Seemingly, the logic behind the reduction in hours was that the child who was now at an age for mandatory school attendance, should be enrolled in school, so there would not enough hours in the day for the child to receive 30-40 hours a week of ABA plus attend school full time. Parents have now reported that they have been left scrambling to figure out where to place their child who now only qualified for 10-20 hours a week of ABA. As an educator, the biggest issue that I have seen is that children who were in this type of clinic setting, were not being prepared for a school setting. Skills in a clinic setting are very different than skills in a school setting. My experience has shown that many children coming out of clinic setting were not coming into a school setting with school readiness skills (skills generally found in most pre-schools) such as: plays cooperatively with peers, follows simple directions, uses restroom independently, washes hands properly, sorts by colors, shape, and size, pays attention to a task for several minutes, and completes tasks, just to name a few. School readiness skills are key to helping your child succeed in school. They are the foundational skills for what your child needs in order to learn in a school setting.
My recommendation to parents who find themselves in this situation is to either find a pre-school that is willing to allow your child’s RBT to come onto their school campus, or ask the ABA practice what school readiness skills they will be working on with your child during those pre-school years and then have your child begin kindergarten on a school campus with RBT support if needed or without an RBT.
*This article reflects my perspective as an educator who has worked with students transitioning from ABA settings into schools. It is not intended to criticize ABA as a therapeutic intervention but to encourage parents to consider how educational and therapeutic services can best work together to support their child’s long-term development.
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