Letter to therapists

To "Independent" ABA/DTT Consultants and Therapists:

This is an open letter to all of you in the field working with children with autism. There are lots of people out there who, after working with an agency providing ABA programs for children with autism, are striking out on their own as independent consultants.

As a parent of an autistic child and an advocate for children and families I have had a lot of contact with people in this field and I have some advice/requests for all of you.

Here goes:

Provide the specifics of your education, training and experience. This is a challenging and ever-changing field and it takes a lot of training and study to be effective. Working for 1-2 years in an agency supervised program, as an undergraduate does not qualify you upon graduation to develop and supervise programs and curricula. It is not appropriate to call yourself a consultant or senior therapist after having only worked with a few preschool age children.

If there is any formal certification, licensing or credentials in your area pursue them. This could be a teaching credential, certification as a behavior analyst, licensing in psychology, speech therapy, OT etc. These are the tickets that allow access to working with the school systems and also show a commitment to making this a "real" career.

You only have your professional skills and integrity to carry you in this field. Many parents can be described as desperate when they are trying to get a program started for their child. You may indeed have the skill to get them started, but if you don't know what to do 6 months or a year or 2 years down the road, people are going to find out about it. Word gets out quickly when families are not satisfied.


It's okay to specialize. You may have had some really great success with older kids or working kids into the mainstream or non-verbal kids or whatever. By specializing you can really focus you efforts and education on supporting that specialty. Building a reputation as a professional who has been successful with a particular segment of the autism population can really boost your demand and your standing in the community.

Be sure to assess each child that you work with.  You should use specific tools and standardized methods, as well as observation and parent interview. You will not be able to adequately develop a program for a child unless you have done an assessment.  These take some time but really add to your professional credibility. Even though many children have similar needs at the beginning of a program you can't just start all kids out with the same boilerplate program.

Work directly with the kids! I can't emphasize this enough. Initially you need to spend a fair amount of time getting to know and assessing the child. As a program progresses, you need to stay in contact with the child, not just in the context of team meetings, but actually working with him. I would like to see each consultant work with a child at least 3-4 hours a month not just talking about it in a team meeting, but getting down there in the trenches and working face to face with him/her.

If you did not have the opportunity to, go back (your local junior college has classes..) and take the BASIC Child Development classes. There is NO way you can do ANY programming for a non-typically developing child without knowledge of how "typical" development (social, emotional, language, physical) occurs. In addition to that, whenever you can, observe typically developing peers.

Admit it when you don't know or aren't sure what to do. Every child is different. We don't expect that you will have all the answers, but we do expect that your experience and education will help you to solve problems you haven't faced before.  Admitting that you don't know what to do next saves a lot of time and frustration in the long run. Working on something for 6 months or a year that a kid just isn't getting no matter what you try shouldn't happen very often. Find someone else in your field that you can consult with to help solve a difficult problem. Set your ego aside, we just want what's best for the kids.

In the specific details of your program, be prepared to answer the question "Why?" Why is this skill important? Why do we need to do this? How does it serve this child in the long run? Is there another way we could approach teaching this same skill?

Understand what functional and meaningful really mean to a kid and his/her family. We all want our children to be as independent and successful as they possibly can be. For some that may mean full, independent employment and living, for others that may mean much more basic survival and self care skills. One component that is important to all of our kids, as they grow older is for them to be pleasant and easy to be around. I don't care how high or low functioning a child is, if they are difficult or unpleasant to be around people will not want to be around them or help them and their life
will be more challenging as a result.

NEVER hold a family hostage for more money. If you are given a pay
increase by one family or agency it does NOT give you the green light to go around to all the other families or school districts and ask them for the same increase. I have seen areas where there are almost bidding wars for qualified therapists. I understand that everybody likes to make more money when they can, but this sets up a very difficult pattern.  Decide what you think is an appropriate rate to be paid, based on your experience, education, training, comparable professionals in the field and stick with it. It may
be very tempting to raise your rates based on the demands of the market, but it is my hope that money is not your primary motivator in this business.

This is not just a job. It is much more than that, when you are working with a child with autism you must develop a personal relationship with the child and his family.  Whether you think it's appropriate or not, families will be dependent on you to help them with their child. Treat them with kindness and respect and listen to their concerns.

Be reliable and punctual. Most of the time sessions are only a couple of hours long and families are pretty tightly scheduled with other tutors and appointments.  Being 15 minutes late can really throw the whole thing off.

This is also a business and you are the business owner.  Be professional and prepared. Many of the school districts with whom you may work are vast, multi-million dollar operations with lots of rules and regulations on how they must conduct their business. Make up some business cards; get a business license (how about a non-profit?), if appropriate. If you have contracted with agencies or school districts in the past, be prepared to discuss how those arrangements were made, how your services were classified,
etc. This helps to smooth the process out.

Don't take on too many clients. Really assess how many children you can effectively serve at one time. How many hours do you plan to work in a week? What are the paperwork and administrative requirements for each child? Your caseload can quickly overwhelm you if you don't plan ahead. I know it's hard to say no sometimes, but if you have too many kids you will serve none of them well.

This is not about you; it's about the kids. This is a challenging,
exciting, sometimes frustrating field that you have chosen to work in, if you are in it for the kids you will always do well.

Thanks for taking the time to read this and thanks for choosing to work with our kids.

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