Nothing in ABA therapy history compares to what took place at the start of the Coronavirus pandemic. The entire world was brought to a halt, and every industry was forced to adapt to the new world reality. Healthcare and mental health organizations quickly switched to virtual visits as much as possible, and providers worked hard to meet the new standard of public health and safety. As the world begins to reopen, let’s take a few minutes to explore how our community handled the pandemic.
For ABA therapy providers, COVID19 created several obstacles for practices to overcome. Anyone in the field knows how important consistency is in this kind of therapy (or any therapy) and how prevalent school-based or in-home sessions are. So how have ABA practices addressed these issues during the pandemic? What efforts have been made to ensure their clients are still getting the best care possible? This answer varies from practice to practice, but the majority of ABA therapy providers worked hard to find solutions.
Issues the Pandemic Created
ABA Therapy in Schools
For RBT’s and BCBA’s employed by school districts, the pandemic threw a massive wrench in their routines. For children with an IEP, the transition to online learning was not a simple one. Many students were used to their ABA therapist working closely with them, in person, throughout the school week. The level of involvement might have been different from school district to district, but the in-person component became very important to the routine of many kids.
Schools were required to make sure their students still had access to their ABA providers during the school day, continuing to offer in-person interactions for what was categorized as necessary exceptions to the virtual learning rule.
The U.S. Department of Education (DOE) made a statement saying to ensure “compliance with IDEA [Individuals with Disabilities Education Act] should not prevent any school from offering education programs through distanced instruction.”
Most BCBAs and RBTs adapted their services to online learning or worked hard to create a safe public environment where they could work with students in person, depending on the rules of their district.
Safety regulations changed everywhere due to the pandemic to slow the spread of the virus. For in-person ABA facilities of all sizes, a few of the challenges that they have and continue to face included:
Most states have either required or strongly encouraged daily health screenings of their clients and their employees. Nothing like this has ever been necessary for ABA therapy history. Screenings usually include taking the temperature of everyone that enters the facility and asking a series of screening questions to rule out their exposure to the virus. Many practices have established standard health screenings.
Masks and Face Coverings
Early on in the pandemic, the CDC declared the effectiveness of masks in slowing the spread of the virus. For this reason, many states announced mask mandates under certain conditions, including within ABA practices. While this presented different problems for industries like restaurants or bars, ABA providers faced another problem when it came to mask mandates. A common experience for individuals with Autism Spectrum Disorder is a sensitivity towards textures. BCBAs had to find creative solutions for their clients that might struggle to wear face masks during their visits. For some facilities, this became one of the areas to work on in their sessions.
Social distancing, or keeping a distance of 6 feet, or the CDC also announced more between two individuals as an effective way to prevent the spread. For smaller facilities or facilities that serve a large number of clients at a time, figuring out how to social distance effectively was an early challenge of the pandemic. Some facilities set up marked socially distanced seating, spaced-out appointments, and more.
For facilities that offer meal or snack time, these are great opportunities for clients to engage with one another socially. ABA therapy providers faced the challenge of limiting contact between clients without sacrificing necessary social exposure and routine adherence. A way that some facilities dealt with this struggle was to keep children with their assigned providers.
The CDC listed effective cleaning procedures for facilities of all types early on in the pandemic. If ABA practices were not already meeting these standards, it meant increased staffing for facility cleaning or longer hours dedicated to such a task.
For both providers and clients, the pandemic completely disrupted their routines. For clients, this meant more instability in their life, which can quickly impact their progress. For providers, this meant adjusting every aspect of how they currently operated to create a safe environment for their clients and their team.
While some ABA therapy practices have a history of telehealth, many did not when new restrictions were set in place. This meant adopting technology that allowed them to visit virtually with their clients, which cost time and money.
Quality of Care
An unfortunate impact of the pandemic on many ABA therapists was a short drop in the quality of care they could offer their clients through the transition. The pandemic happened rather suddenly, pausing progress for many until the dust settled and solutions were found to some of the listed issues.
Some solo BCBA’s or small practices struggled to stay out of the red as their clients, and their caregivers battled the realities of the pandemic. With record job losses across the country, Some caregivers were forced to pause or terminate services until further notice.
How Practices Addressed these Issues
For small practices and solo providers that primarily work with one patient at a time, adjustments might have been slightly less complicated in some ways, but not in all. For example, solo providers who only work with a handful of clients might have been able to get away with regular testing, social distancing, and health screenings without having to adopt new technology or change too many of their procedures.
Some hygiene solutions that providers have found useful for shared spaces and toys have been to designate storage boxes for each client so that no cross-contamination occurs between children.
Larger facilities across the country quickly turned to software to solve the issues they were facing during the pandemic. Quality solutions were able to help them safely continue working with clients virtually, perfecting their time-management and productivity and so much more.
Enterprise ABA practices and school-based providers have followed strict guidelines for who is and cannot attend in-person visits. Facilities all over the country created rules regarding symptomatic children and families, saying if anyone in the household is sick, they are to stay home.
Ultimately, the transition from pre-pandemic to post-pandemic care was difficult for many providers and their clients. Creative ideas and technology came together to make sure clients were still getting the care they needed.
ABA therapy history is defined by how it has adapted and changed over time. ABA therapy had its problems in its early history, but it has adapted to best practices and ethical procedures over time. Today, thousands and thousands of individuals benefit from it.
As providers look forward, the question they must ask themselves is what adaptations they will have to make in the future to keep up with industry standards.