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Is ABA Therapy like babysitting?

Gretel Diaz, May 1st, 2021

As ABA providers, we have been asked this question or heard the remark many times. It is easy to see ABA as a type of babysitting service due to the daily number of hours the therapy usually takes (can range from 5 to 30 hours a week). But you'll only make that remark based on that superficial observation about the hours. Once you experience the therapy and understand all the moving parts behind it, you will see how it is nothing like babysitting and the reasons we request those hours.

First, let us start by talking about learning opportunities. How many learning opportunities does a child with a developmental disability need to learn a new skill? Every child is different. However, children with a developmental disability will need more learning opportunities than a neurotypical child to learn new skills. Repetition and consistency are key! Therefore, hours are requested based on the child's medical necessity. The greater the deficit of functional skills and the higher the frequency of challenging behaviors, the more hours the child will need. If the target is to teach to request items he/she wants, 30 minutes to 1 hour of therapy once or twice a week will limit the number of opportunities the child will be engaging in requesting behavior. It would not allow the child to close the gap and reach age-appropriate communication.

On the other hand, children with a developmental disability usually engage in challenging behaviors that can take minutes to hours in duration or frequently happen, which further interferes with acquiring appropriate skills. Now, that will also reduce the learning opportunities in a therapy session. Therefore, the treatment is structured to create abundant opportunities for the child to learn new appropriate skills, first with the full support until they can do it independently and spontaneously. In addition, we will also work with the parents and teachers so that what the child learns with the therapist is transferred to other people involved in the child's life.

A typical ABA session consists of building a successful relationship with the child by starting the session with fun interaction that usually involves playing with the toys or activities the child likes. Then therapy incorporates a mix of "work" and play as the therapist presents target skills for acquisition while rewarding the child's engagement with preferred items or activities. During this time, challenging behavior might be elicited, leading the therapist to apply the necessary strategies to reduce the challenging behavior by teaching the appropriate replacement behavior instead (this can take multiple learning opportunities just in that episode). At the end of the session, fun interactions are created again to maintain the successful client-therapist relationship. 

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