The telehealth industry is growing rapidly, allowing people to get therapy via video chat. ABA therapists, including BCBAs, can practice ABA therapy via telehealth sessions, though in-person sessions are still more common.
If you’re an ABA therapist and telehealth interests you, look for companies that offer telehealth options to clients. Since ABA therapy is primarily practiced in person, you may find that most positions require a combination of in-person and telehealth sessions.
Becoming a Telehealth ABA Therapist
The amount you can earn as a telehealth ABA provider varies based on your certification and level of education. As an overseeing board certified behavior analyst (BCBA), for example, you can make between $63,000 and $140,000. This will also vary based on where you live, your level of expertise, and what you or your clinic charges for your services.
Although telehealth is not a new field, establishing this option has been a recent transition for many ABA providers. Several places currently offer this option, including these:
* ABA Telehealth, based in Delaware, which is recommended by Autism Speaks
* Trumpet Behavioral Health, which is based in several states like these:
* ABA Telehealth Project, based in Connecticut, a service that has long provided telehealth services to people with autism and their caregivers
To work with any of these providers or others, you must be certified as an ABA therapist through the BACB.
What Is Telehealth ABA Therapy?
Demand for telehealth services increased dramatically due to the COVID-19 pandemic. However, more people living in remote areas, further away from experienced ABA therapists or educators, and those who need ABA therapy on a schedule that is not conducive to in-person sessions have pushed for telehealth therapists for years. This option is important for many people on the autism spectrum and for parents who have children on the autism spectrum, although working in person with clients is preferred.
The term telehealth covers methods of using communication technology like video chat, video conferencing software, and even phones to facilitate diagnosis and consultation, treatment, education of the client and their caregivers, and self-management skills.
Telehealth for ABA therapists is relatively new, so information on how to best work with clients with autism while at a distance, through a screen, is still limited. However, some approaches seem to work.
How Does ABA Telehealth Therapy Work?
Telehealth ABA therapy sessions are led by a licensed ABA therapist, but specific activities are implemented by the parent to support their child with autism. In some cases, a nurse or technician may implement these activities and skills-building exercises, guided by the ABA therapist.
This in-person support is vital to building social and language skills. However, in many cases, the treatment plan can be successfully implemented at a distance.
Using a computer or phone, a parent can be supervised by an ABA therapist to work directly with their child on specific sessions. The ABA therapist will observe the parent or a registered behavior technician (RBT) working with the child, and assess how the daily exercises show improvement and meet treatment goals. This can occur live, over a video feed through the internet, or the parent or technician can record the session and send it to the ABA therapist for later assessment.
The ABA therapist will watch the interaction between the child and the in-person treatment provider, be that a parent or an RBT. This helps the therapist watch which reinforcers work best, measure the changes in the child’s behaviors, and determine if the treatment provider is engaging with the child appropriately.
Telehealth also works very well for training staff or parents in ABA approaches. For example, many ABA professionals must get recertified every two or three years, so conducting training through video conferencing software can reduce travel and rental costs.
Parents who have children on the autism spectrum benefit greatly from training in some ABA techniques. This training can also be conducted over video conferencing software or through pre-recorded videos followed by assessments.
Live video calls or conferences between an ABA therapist, a parent or RBT, and the child also help with assessment and diagnosis. The ABA therapist can determine more about the child’s language proficiency, social skills, motor coordination, and other potential symptoms that need to be included in the treatment plan. The therapist can also determine how well the child is improving, and how they appear to interact with the RBT, to understand if this relationship is beneficial for the child.
Telehealth ABA Therapy Works as Well for Children as In-Home & Clinic Treatment
As long as the ABA therapist’s environment meets Health Insurance Portability and Accountability Act (HIPAA) requirements, telehealth therapy services can be provided from any location. During the COVID-19 pandemic, many services were available via telehealth options, with parents implementing guided treatment to their children in their homes.
Prior to 2020, telehealth ABA therapy was still widely used, with some parents bringing their children to clinics for supervision or recording via a verified computer or camera. Parents might still lead the session, but in a clinical setting, RBTs or other therapists and educators with ABA training were more likely to directly interact with the child.
Telehealth works well for children with autism, with some studies showing:
- 90% improvement in social functioning.
- 90% reduction in challenging behavior.
- 64% reduction in overall problem behaviors.
- Parent approval for the treatment plan.
- More time spent working with parents and children than on commuting between clients, allowing greater access to care and greater attention from therapists.
A medical study conducted in 2016 found that when compared to clinic-based therapy and in-home therapy, telehealth services showed a similar reduction in problem behaviors over the course of the research, regardless of implementation. Parents also reported that therapy in each setting was beneficial.
It is important, however, that children did not interact with the ABA therapist through video conferencing software and instead interacted with their parents. This shows that in-person implementation of the treatment plan is still a crucial component to ABA therapy.
The Importance of In-Person Treatment
Although telehealth is one way to lower the overall cost of ABA therapy, which makes this important treatment more accessible for more people, it is crucial to have an in-person component. Telehealth ABA therapy for parent training, functional assessments, and staff training all work very well.
Direct implementation of treatment programs should be conducted by someone working directly, in person, with the child with autism. Parents can fill this role, especially for young children, but it’s ideal if a registered behavior technician is working with the child.
The location of telehealth cannot be restrictive, meaning that the ABA provider does not have to show a geographical location like an office or clinic to provide these services to anyone across the United States. However, there may be some restrictions with specific insurance providers because companies will only work within certain locations.
Telehealth and the Practice of Applied Behavior Analysis (ABA). California Association of Behavior Analysists (CalABA).
Telehealth: Evidence-Based Practice in the Time of COVID-19. Behavioral Health Center of Excellence (BHCOE.org).
Increasing Access to Applied Behavior Analysis Through Telehealth. University of Iowa Children’s Hospital.
Telehealth and Autism: Treating Challenging Behavior at Lower Cost. (February 2016). Pediatrics.
$63k-$143k Remote BCBA Jobs (NOW HIRING). ZipRecruiter.
ABA Telehealth. Autism Speaks.
Access to Behavioral Health Expanding Through Telehealth. TBH.
ABA Telehealth Project. (February 2021). Psychology Today.