Board-Certified Behavior Analysts help children learn important communication and life skills.
About 1 in 54 children in the U.S. have autism spectrum disorder, according to a 2020 report by the Centers for Disease Control and Prevention. The CDC also reported that about 1 in 6 children have a developmental disability, such as autism or ADHD, in a survey of parents. Applied Behavior Analysis is a scientifically validated therapy that has been shown to produce improvements in adaptive functioning and increase independence in children with autism. ABA also benefits children with ADHD and other related developmental disabilities.
Compass Counseling Services is a behavioral health agency that has been serving children and families throughout Virginia since 2004. Through its Connections program, Compass provides home-based ABA services to children under 21 who demonstrate significant impairment in adaptive functioning related to either developmental delays or other health conditions.
Lucia Morey is a board-certified behavior analyst for Compass who offers services in both English and Spanish. As our April Expert, Morey and the Compass team talk about how ABA works, and how families can benefit from the therapeutic tools Compass offers.
What is Applied Behavior Analysis?
ABA is a scientific approach to changing behavior in a very intentional and methodical way. We define behaviors as anything a person does that can be observed and measured. We are taking principles of behavior and applying them to everyday problems in everyday life.
A lot of the behaviors we work with stem from a lack of communication skills, so a lot of what we do is to build up communication skills that can replace the behaviors we want to see reduced so that children can interact more successfully with those around them.
Our work at Compass is mostly with children with autism and related diagnoses. However, even if you don’t have a child on the spectrum, ABA can be used to improve concentration, the ability to finish schoolwork, and reading, self-help and social skills.
How does this look in practice in the work you do at Compass with children who have an autism or ADHD diagnosis?
For a child with autism, they may not know how to speak words, but they do know how to get their needs met. Maybe they go to the kitchen and grab an item or maybe they have a tantrum. These might be behaviors we try to reduce by building up more positive communication skills.
One of the first things we do in these cases is look at what the child is getting when they throw that tantrum. We try to give them a better way to tell people what they want. This could be using sign language. It could be using a picture exchange system, where they point to a specific picture.
Sometimes we use a communication device such as an iPad, where they tap a button to make a specific request. If they are able to make and imitate speech sounds, we might be able to help them say words.
How are parents involved in the work you do?
One thing I really like about working with Compass is that we spend a lot of time working on our parent training and making sure that what we are suggesting is useful in the home. ABA can fail if the solutions are not doable and convenient for the family in their home setting.
We try to involve parents in every step of the planning process. We will do an assessment of the child’s skills, and then we will sit down with the parent and discuss our recommendations for treatment. It’s a back and forth and we hear from the parents about what is feasible, and what might be hard for them to do at home. We adjust the plan based on that feedback. We then try to involve them in some of the sessions so that they learn how to implement the interventions we are introducing.
We also recognize that we are working in people’s homes, and we try to be very aware that our outlook and perspective on certain behaviors may not be the same as that of the families, depending on their background and culture, even in deciding which behaviors we want to change. We try to establish very good relationships with our families so that they can feel confident helping us craft an intervention plan that is appropriate for them.
Does a child need to have a diagnosis to work with Compass?
Compass is a Medicaid-only provider, and we do need a diagnosis for services, but we are able to assist with getting a diagnosis if appropriate. We are able to provide provisional diagnosis for children who meet criteria and are waiting to obtain a full evaluation from a developmental specialist or psychologist in order to get services started.
What are some of the successes you see in your work with families
One of the most satisfying things I see happen is toilet training—it makes a huge difference in the parent and the child’s life. Not being toilet trained puts a child at risk for victimization and limits family activities. We have been able to make a lot of progress with clients on this front, and it makes such a huge difference in family life.
Another big area is communication. Seeing a child who previously had no way to say what they wanted have a lightbulb go off and be able to use a tool to talk to people is really life-changing. When the child can start initiating communication, we see tantrums going down and we see children realizing that the people around them can understand them.
How have your services evolved to respond to the COVID-19 pandemic?
Our leadership team adjusted within the span of a week or two. We were able to use telehealth services where appropriate, and for some clients, we kept seeing them in the home, with extra precautions taken, such as having dedicated toys and materials that were client-specific. We are back face-to-face with most of our clients now, and we are continuing to take every precaution to keep our staff and clients safe.
What would you want parents of children with developmental disabilities to know, especially as COVID-19 has put increased stress on these families?
Self-care for the caregiver is so important. Compass preaches this to its own employees: We can’t help anybody else if we are not taking care of ourselves. Also, keep your eye on the small successes. The scope of ABA is wide, but our area of focus is narrow. We are looking for small steps of improvement in the direction of overall health. I think for parents, remembering to celebrate and recognize those small, gradual improvements in a child’s behavior is important.
To learn more or to get in touch, visit compassva.com. Compass Counseling Services is a Medicaid-funded provider serving individuals in the Fredericksburg area, including Spotsylvania, Stafford Caroline and King George counties, and the city of Fredericksburg. Compass has also recently expanded to serve the Culpeper area.
Stay tuned in April for a video interview with Compass Counseling Services on the Fredericksburg Parent Facebook and YouTube channels.