How many hours of ABA does my child really need?

A common mistake is to assume that only the hours that happen within the intensive programming with the ABA therapist count. Instead, intervention should be on-going - 24 hours a day, 7 days per week. This does not necessarily mean that programs are being run all day, every day, but instead that parents, teachers and students are always involved in maintaining and generalizing all of the skills that have learnt.

Research has consistently shown that positive effects can be achieved when ABA therapy is delivered via a comprehensive and intensive intervention program. Intervention should be provided for no less than 20 hours per week, with some studies recommending 30-40 hours.

A child’s access to long-term, comprehensive ABA services results in benefits across the developmental domains (Linstead et al., 2017).

Research has consistently shown that children receiving ABA services experience greater improvements over time in severity of diagnosis, IQ score and numerous skill domains, including but not limited to language comprehension, play and social skills and self-help skills, compared to children receiving eclectic or non-ABA services (Eldevik et al., 2006; Zachor et al., 2007). For children attending preschool or school, those receiving intervention from a team trained in ABA demonstrate greater improvements in adaptive skills and challenging behaviour than those receiving 1:1 support from support teaching staff supervised by a Special Education teacher (Eikeseth et al., 2012). ABA both meets good practice guidelines and is likely to be effective and beneficial for your child in comparison to alternative interventions for ASD.

Higher intensity (that is, hours per week) and duration (that is, length of treatment) engagement in ABA services are consistent predictors of higher skill acquisition (Linstead et al., 2017). Intensive ABA programs, providing a child with services for at least 25 hours per week, are evidenced to demonstrate the greatest improvement in a child’s language and adaptive skills, compared to non-ABA interventions (Makryganni & Reed, 2010).

It is important that your child receives the recommended hours as data from multiple studies of comprehensive ABA treatment for children with ASD show that:

• High-intensity treatment produces the largest improvements (Eldevik, Hastings, Hughes, Jahr, Eikeseth, & Cross, 2009, 2010; Klintwall, Eldevik, & Eikeseth, 2015; Virués Ortega, Rodríguez, & Yu, 2013). At least 36 hours of direct ABA treatment per week for at least two years is associated with clinically significant, reliable changes in cognitive and adaptive skills (Eldevik et al., 2010).

• Low intensity ABA treatment produces smaller improvements than high intensity ABA treatment (e.g., Eldevik, Eikeseth, Jahr, & Smith, 2006; Eldevik Hastings, Jahr, & Hughes, 2013; Green, 2011; Peters-Scheffer, Didden, Mulders, & Korzilius, 2010).

• Eclectic treatment comprising some ABA treatment plus a mixture of other therapies or methods, in particular non-evidence based therapies, is in- effective (at best) for most children with ASD, even when it is individualized and intensive (Eikeseth, Smith, Jahr, & Eldevik, 2002, 2007; Eldevik et al., 2009, 2010; Howard, Sparkman, Cohen, Green, & Stanislaw, 2005; Howard, Stanislaw, Green, Sparkman, & Cohen, 2014; Klintwall et al., 2015).

Also, age has not been shown to consistently predict a child’s treatment outcomes (Eikeseth et al., 2007). Research has demonstrated the positive impact of ABA services for children above 6 years old across multiple settings. Children commencing ABA services at an age above 6 years old continue to experience significant benefits to their adaptive rate of development (Blacklock, Perry & Dunn Geier, 2014). A study of 227 children aged 16 months to 12 years old indicated there was no significant difference in a child’s skill acquisition depending on their age, for children under 8 years old (Granpeesheh et al., 2009). The authors conclude that, for these children, “there was no point of diminishing returns from increased treatment hours” (Granpeesheh et al., 2009, pg. 1019).

At Super Kids, during your Initial Intensive period, the Behaviour Consultant will make a recommendation for what will be best for your child based on best practice research, your treatment goals and lifestyle.