Why 10-15 hours of ABA per week is likely enough.
The number on everyone's mind is “40”. For years, the ABA magic number was 40 hours per week. I have even received a Doctor’s prescription that specified this number without direct support as to why it was recommended, and without the doctor having a background or understanding of ABA.
After years in this field, it would be a very rare occasion that I would actually recommend this in a home-based or center-based program, especially if the child is in school or another service.
We need to compare this to a full-time job for a child. As adults, we make money by going to our 40 hour a week job. It is typically something that we are good at or independent with. We have sick days or the ability to manage our schedules in a way that is beneficial for us. We have the words and physical abilities to communicate or change the environment to support ourselves. We might get a little treat in the middle of the day to reward ourselves or listen to our favorite music while we respond to emails. Even with all of this, we are exhausted mentally and physically after a 40 hour work week.
Balance is important. Rest is important. Even for our kids.
The move towards play-based ABA has been great for helping with natural motivation with and interest in ABA sessions but that balance is still important. The 40 hours should not be thought of as 40 hours of ABA - it should be 40 hours of evidence based practices per week maximum. Many kids will not even require 40 hours of evidence-based practices per week. This is for some of the most impacted learners and even then, it should not be an automatic 40 total. Take into account the child's age, physical ability, any medical factors, other diagnoses, nap schedule, or other factors.
What should count in the total evidence-based practices for the week?
School!
School is very important to a child’s development and in general, the child should go to school when they are able.
The IEP assessment process can support needs that interfere or slow learning in public schools and private schools may be able to provide some support.
Some children will not need specific services or accommodations in the classroom and some will.
Some children will function best in a general education classroom and some will be best in a smaller class with a lower adult:student ratio.
Homework should also be factored into the school total.
If the child is in school for 5 hours per day (25 hours per week), then typically a 15 hour per week ABA program would be the max. And again, this is for the most impacted learners and if they are not attending speech, OT, or other services. So a child in school for 25 hours per week may only need 10 hours or 3 hours of additional services to be able to make meaningful progress.
If the child is in school or preschool for 3 hours per day (15 hours per week), then a maximum for all other evidence based practices would be 25 hours per week for the most impacted children.
Speech
1:1 and group therapy classes, online or in-person, count towards the total for the week
Additionally, using strategies the SLP has taught you to implement throughout the childs routine or activities also counts
Occupational Therapy and/or Feeding Therapy
1:1 and group therapy classes, online or in-person, count towards the total for the week
Additionally, using strategies the OT has taught you to implement throughout the child’s routine or activities also counts
Social Skills Groups
These can take place online through Zoom or in games, like Minecraft.
They may also take place at an ABA office, speech therapy office, or in the community.
Typically, there is an adult facilitator who helps as needed. Depending on the group, it may be entirely child-led or there may be structure. If it is an older or more independent group of children or teenagers, then there may not need to be an adult facilitator.
Psychology or Counseling Appointments
1:1 and group therapy classes, online or in-person, count towards the total for the week
What Else Should Count?
Is your child doing something that is not specifically evidence based but is working on group skills, social skills, or implementing already learned skills in a new setting or with new people?
This counts.
Things like soccer practice, horse therapy, scouts, play dates with peers from school at home or meeting new friends at the park are all important and can support the skills learned in other evidence based practices. The majority of the child’s time should be with evidence based practices but again, balance is important. If your child is really into gymnastics, awesome! They can practice following directions with new people in new settings, learn how to imitate complex sequences of steps, get sensory input, practice waiting and taking turns, and learn to communicate wants and needs with new peers or adults.
With good services, the SLP, OT, and BCBA should be giving you strategies to implement during these times.
Did the BCBA work with you so you can implement a task analysis each morning to help your child get ready for school?
Did the speech therapist give you suggestions on how to work on a program at home?
Did your OT suggest that you implement some sensory strategy at the same time everyday?
These all count towards the total
Time to eat dinner as a family without the BT awkwardly sitting by, time to go on vacation or spend time with extended family, time to cheer on a sibling at their soccer game, time to be with your child to connect. These are just as, if not more, important to a child's overall wellbeing and development. As with all things, life is about balance.