What is the difference between in-home vs. clinic-based ABA therapy?

This is one of the most frequently asked questions we get when we are talking with new families. How do you know if you are making the right choice when it comes to your child’s therapy?  Should therapy sessions be at home? In the clinic? Or should it be a combination of both? Sometimes the decision is made for you by your provider (they either only provide in-home or clinic-based therapy), but it still doesn’t quiet the voice that asks was there something different I could have done?

The answer is as unique as the individual needs of your child, but that doesn’t mean we don’t have some tools to help you wade through that decision to land at what fits perfectly for your child’s and family’s needs.

home vs. clinicIn-Home ABA Therapy

Are you looking for support that you can take and replicate immediately? In-home may be the answer! During in-home therapy the therapist is present in-home during the times that a parent is also at home. This allows for maximum parent involvement. Being in the home allows parents to observe all therapy and play an active role in implementing programs in real-time.

Is your child struggling to complete routines in the home such as putting away toys, brushing teeth, showering, making meals, or unloading the dishwasher? In-home may be the answer to focus on real-life functional skills that increase your child’s independent skills. We frequently frame these skills with the question “is your child contributing to the house? That is to say, does your child participate in household routines that make the home a better place to be? If the answer is no, then in-home may be great place to conduct therapy.

Have you ever struggled with your child performing a skill in one setting, but when you get in another setting the skill is magically gone? This may be due to a lack of generalization. If a child is able to generalize a skill it means they can perform that skill across a wide variety of people and environments. It’s great if we can do the skill in therapy, but if we can’t do the skill at home then we have not truly learned the skill. Working in the environment that we are living in the most may help with generalization.

The last major consideration we have for in-home therapy is where is the problem behavior occurring? Are you having meltdowns in the grocery store? In-home provides more opportunities to travel into the community and work in the real environment that frequently triggers the behaviors.

Clinic Based ABA Therapy

Is your family schedule so packed you can’t imagine being stuck at home for therapy? Clinic based ABA therapy may be the solution. Having the flexibility to attend therapy outside the home affords many busy families with the opportunity to access ABA therapy who wouldn’t otherwise have the time.

The clinic setting also allows kiddos who are preparing to enter school to stretch their social skills and work in a group setting with the careful guidance of a behavior therapist. Social skills such as sharing, cooperative play, greetings and reciprocal conversations can be taught in unison, but come to life when they can be generalized with a peer. A clinic setting may be just be the perfect opportunity to make social opportunity happen!

Is extreme behavior such as physical aggression or property destruction your primary concern? Intense behaviors may require environmental consistency that may be difficult to replicate at home. A clinic setting offers families a break to allow a professional to work through behavior without disrupting the whole home environment.

Clinic settings also offer teams the opportunity work closely without waiting for weekly or monthly meetings to touch base. A team approach is crucial to creating consistent skill acquisition. Therapy teams with multiple therapists can benefit from the camaraderie and collaboration that occurs when they see each other each day.

Still have questions about what would work best for your child and family? Contact us and we can help you create the perfect plan that fits your child’s unique needs!

We have been a family blessed with the help of the team at The Helm. Our son was diagnosed with autism spectrum disorder when he was 2.5 and The Helm was one of the places recommended by our developmental psychologist. I am a physician and still found it hard navigating this new medical problem and knowing what to do next. I called many places and from step one Lee Ann was the most helpful explaining the process with paperwork, assessment, available services, insurance, etc. we were able to start therapy quite soon after diagnosis and had sessions at home daily for 3 hours. The quality of staff, the system they have in place for the therapists, the coordination by the BCBA supervising therapist and early response put us at ease that we were on the right path. Ultimately the steady positive changes we saw with our son overcame any fears we had about autism holding our son back for the rest of his life.

We used many forms of intervention that we felt were individually tailored for our family – for potty training, anger management, dietary intervention and even let them know when we could not maintain something suggested in family training, and they would just take our request and implement another plan. Our son has now graduated/transitioned out of therapy and is currently in pre-K in a regular classroom with him on par with his class in academics, has friends and no behavior issues. Most important of all we have a happy son who loves to play with his big sister.

I know that I will always read all there is on autism and watch my son for any features. But I hope my review adds to positive aspects that I wish someone would have told me when I started the journey – start early, don’t put off your suspicions, get your child evaluated now! The label does not hinder,  in fact it falls to the side once you have the diagnosis to facilitate therapy. ABA intervention, especially done with the right people, makes a big difference. It does not pressure or upset the child at all, and you are not stuck in therapy for life! I know if any behavioral issues come up in the future I have The Helm, and they will help us and the outcome is going to be positive. Said with heartfelt thanks.

– Former Helm ABA Family

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