Autism therapy is under the microscope.

• The New York Times did a big expose on ABA therapy (gift link) last week.
• Derek Thompson is tweeting about the exploding number of autism workers.
• Today’s Wall Street Journal talks about the explosion of the Autism-Therapy business.

I’m not a huge fan of those articles; they miss all the subtleties of a complex situation. There should be a rule — no reporter should write about autism or ABA unless they have a child with autism. As it turns out, I have a kid with autism. And I just spent a year helping families with Medicaid get access to ABA therapy. I must have talked to 500 families and 100 ABA providers in the past 16 months.

So, let’s chat.

What is ABA?

Applied Behavior Analysis (ABA) is a form of therapy for children with autism. It’s very time-intensive; it’s recommended that children with high support needs get about 40 hours per week of therapy.

BCBAs (lead therapists with Master’s Degrees) oversee a team of ABA technicians who go into people’s homes and reinforce good behavior and try to eliminate behaviors that are disturbing to others. Complex tasks are broken down into small, easily teachable steps (often called Discrete Trial Training).

When a child has a tantrum, they try to determine the root cause in the environment — are they hungry? Do they have a toothache? It’s really hard to figure out why a non-verbal child is having a meltdown. So, they keep data on when the child has a problem and hope the data will tell the full story.

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