Families ask all the time whether we provide services at our center in Austin. Most often, we use the Cultivate Learning Center with reluctance and I'll explain why. Katie and I started our careers as Pre-K ABA Teachers. This was a very controlled, structured, and engaging setting where children thrived. When transitioning into private-practice, we also started with center-based services in California. We had 3 Learning Centers, with the last one being 4600 glorious sqft of beautiful space for kiddos to play and engage. We had tons of space for younger clients, a Clubhouse with an Xbox, and a massive area for gross-motor activities and games. We had projectors and TVs and everything a child could dream of having at their ABA provider. Sounds impressive right? Not so much.
This is what we've learned in the years that we've done this work. Center-based services can be wonderful, yet most often they're not. I'll explain why below:
- Center-based services are contrived settings as opposed to being the natural environment where services SHOULD take place. This means that progress can be made in one setting without really making the necessary gains where it matters most (home and community). The technical reasons for this have to do with stimulus control and environmental factors, which we can discuss more in a different post.
- Typically there's a high-level plan for generalization yet that plan does not get communicated to Behavior Techs. Ask the individual that's actually working with your child what their plan is to generalize the skills to the home and community; I would predict that they'll not be able to articulate that plan. The BCBA assigned to the case may not even know what the plan should be. This clearly demonstrates why center-based work can be a misuse of valuable time.
These are just a handful of reasons why center-based work is difficult to do. Are there providers that do it incredibly well? Yes, absolutely. Autism Partnership was a huge part of my career and they certainly do this well yet a majority do not. This is important to us as a provider because we recognize how important it should be to you. Rather than setting up a contrived setting where things are perfect and lovely, we'd rather roll up the sleeves and go to HEB, or Target, or to the park, where the significant issues exist (and where the natural triggers are). Let's do meaningful work that actually has a purpose. What if a trigger for aggression is Timmy's little sister? How will I address that in my contrived setting where the sister is never present? What if going to Target and walking by the Legos evokes a tantrum? How will I help you if I only serve your child in the center? The point is, I wouldn't be able to serve you well at all and that's unacceptable.
To answer the question, sure, we do provide center-based services but it comes with a very well defined, intentional, and systematic plan for how those services can be effective.
Final Note: I'm only referring to ABA providers in this post. I think other disciplines have very good reasons why they do center-based work (ST, OT, PT). I also think center-based ABA can be excellent, if done right (it's just not commonly done properly). Ask questions in the comments section if you'd like to dialogue.
Rob @ Cultivate