ABA In-Home vs. Center vs. Special Needs School Placements: How Do You Choose What is Best?

Our children and their care are one of our top priorities, and when they have autism making that choice for where a child receives ABA services can be even more difficult. 

The Factors in Choosing Child-Care and School

Everyone’s needs are vastly different when it comes to choosing in-home versus center-based placements. For one consider the age and health of the child. What would be the choice for a typically developing child? And what limits does their health put on their surroundings? Additionally, consider financials and time availability. Are both parents working? How much time will the parents be away from the home? Are there relatives or caregivers who are willing and able to give the right support if you choose home care? There is a long list of individual specifics that will contribute to you making the best decision for your child.

Appropriate Placement

What does it really mean for child care or school to be appropriate? Ask yourself, are they safe and happy, and are their needs being met? Safety is always my top priority and even the best ABA center isn’t right for you if it isn’t safe for your child, from the minute they leave your door to the minute they arrive home. You can tell if your child will be happy at a center from the moment you walk in, you need a positive environment. Additionally, what skills are they working on? Be sure they aren’t teaching skills that aren’t relevant to your child and their needs.

Choosing child care whether it’s in-home ABA or at a center is difficult, and it’s something I get questions about every day. Be sure to check back next week, when I cover this topic again with our TOP 5 frequently asked questions. 

ABA In-home vs. Center vs. Special Needs School Placements : How Do You Choose What is Best?

Mary Barbera – Turn Autism Around Podcast Transcript

Transcript for Podcast Episode: 215

ABA In-home vs. Center vs. Special Needs School Placements: How Do You Choose What is Best?

Hosted by: Mary Barbera

Mary: You're listening to the Turn Autism Around Podcast Episode number 215. Today I am sharing something that I recorded actually a few years ago, but it's all about home versus school ABA programs. The differences, how to know as parents and professionals what individual kids need, whether they are diagnosed with autism or toddlers showing signs. We talk about different placements and different options based on the child and the family's needs. One thing that we've created since this podcast was released was a new digital assessment. It is actually free right now. You can go to freeautismassesment.com, get scores in three areas: self-care, language and problem behaviors. Freeautismassessment.com. This will really help you and other professionals you're working with know the areas of strengths and needs of your child. So if you haven't taken that yet, you may want to do that. Let's get to this really important solo show about home versus school ABA.

Intro: Welcome to the Turn Autism Around podcast. For both parents and professionals in the autism world who want to turn things around, be less stressed and lead happier lives. And now your host, Autism mom behavior analyst and bestselling author, Dr. Mary Barbera.

What are the factors? Age, Health, Financials.

Mary: So Anna got me thinking this morning about home versus school programming. And Anna, I don't know how old her son is now, but he is in an ABA program approved private school or private ABA program that's funded by her district. And she's had involvement with a lawyer. And she is trying to make a decision about a non ABA school versus home program. She's wondering about using a completely different approach. May be a good thing, but may be a disaster. And on Friday, we have an IEP, and the district told us that home based instructions will be implemented if he's not accepted to the new school. It sounds like leaving him in the current ABA placement is not an issue. It sounds like now she has potentially a choice between a non ABA school versus a home, and I'm guessing the age is around 12. Okay, so this morning I started thinking about and this is a question I get a lot of which is better home ABA or school ABA central based and or should I homeschool. And there's so many variables, people from all over the world literally who have different circumstances, different funding streams, good options, bad options. I don't care what you call it, whether you're calling the center or the school, this program, ABA, non ABA, I don't care what you call it. I don't care if it's called life skills or artistic support or inclusion. I don't. It doesn't matter. Typical preschool. There are certain variables that make it so complicated for each individual. So that's why I decided this morning to write out some of the variables that can help us decide what the best situation is: home versus center or school. First of all, we have to look at the child's age. In most states, in the United States. Children first two, three are in. Serviced in their home or at daycares wherever they are naturally going. But then for really for funding reasons that switches 3 to 5 may switch. In the United States, the funding stream usually switches to center based school programming. Very few places really do quality ABA programming. And then you have in the United States, all 50 states now mandate insurance carriers to cover ABA. So then we got home, maybe a birth school, ABA, that's not through the education system. So that muddies the water, too. But we're not really going to talk about ABA versus non-ABA. We're going to talk about programming in general in the home or at a center slash school. We'll kind of put those together. So if you think about typically developing kids and we're talking about the whole day, we're talking about a six hour chunk. We're not talking about, you know, if we talk about a six hour chunk of time. If you think about the age that the child is at, where would he be? If he were typically developing, that's usually where I would start. So under age five, under eight, the age of kindergarten, a child would be mostly at home or in daycare. And or at home with preschool three mornings a week, three days a week, you know, very few like full time, 6 hours a day every single day. Preschools that would be an option if they're typically developing. So my thought is for kids under five, that's usually home and kids over five is usually school is where neurotypical kids would be placed. So the other variables and there's there's several variables. And then we're going to talk about after we talk about home versus school, we're going to talk about how to tell if a center school is appropriate. But in addition to the age of the child, we also have to think about the work status of parents, grandparents and other care providers. So if a parent works full time and their child were typical, he'd be in daycare. Or maybe they have siblings and siblings are in daycare or preschool, or maybe the grandparent watches the kids, the parents work with the grandparents, watch the kids. So what options are there? I know a couple of my clients, moms, all their dads, worked full time, and then their moms also worked between the commute and everything like 9 hours a day. And so in one case, the child was being watched. In both cases, the child was being watched by a relative. When I first started, in one of the cases, I trained the grandmother, Jacob's grandmother, to deliver the therapy and to be the center of the child's programing. And I also train mom to do it in the evenings and everything. And the other situation, the relative that was watching the child, not that they were a bad person or abusive or anything, but they just were not into anything extra that they would have to be delivering. So in that case, Mom decided to pull the child back to her home, stay working 9 hours a day, but hire a nanny to be the center and to have the speech therapist come in and have their behavioral therapist come in and have me come in to run the program. So I think that's a really important variable. Is there one parent or caregiver in a home situation that has the time but also has the interest in learning and being open and being the little boy that was being watched by a relative? This little boy was banging his head on soft and hard things. 3 hours out of the 9 hours a day. We didn't know that, but we did know that when I started, he had an open lesion on his head that we had to fix. And so when I was interviewing and assessing when was he banging, How hard was he banging what? You know, okay, he's in a high chair banging on the highchair. Okay, Can we get a shorter chair with a booster seat? Okay, we can do that. He was banging the pack in play in the crib because he was expected to take two naps a day and he was banging before he fell asleep. Banging when he woke up. Okay, we need to switch that. We can't have this child banging his head like he can't have two naps. He needs one nap, needs to be short, no banging. As soon as he's awake, he needs to be picked up and engaged. So those are two big things. Funding is another big, big variable. But just because something's funded like in Kelsey's situation on podcast number three MaryBarbera.com/3 Kelsey had funding to take her son Brantley an hour away driving him an hour away to an ABA center run by a behavior analyst. But even though that was funded, that was not what her child needed. So just because it's funded like when Lucas was supposed to go to the 3 to 5 program, that whatever was recommended was not appropriate. And we're going to talk about why that wasn't appropriate. So I'll save that. But just because something's funded doesn't mean it's right for your child. And then there's other factors. Are there siblings? What's the functioning level? What are the other diagnoses? I had a client once with autism. He was two. He also had severe diabetes with a pump. I've had kids with severe anaphylactic allergies. I've had kids with other syndromes, so they need a nurse. These are all factors that could make central base programing or something not in the cards. I do think that functioning level is something that I would consider as well. So if it's a matter of I remember when Lucas when I was in my second due process case, when Lucas was like nine or ten years of age, he had transitioned back from our approved private school to our public school. And the teacher went out on a pregnancy and nobody knew what they were doing. And like, I wasn't gunning for perfection. It was just like a disaster, like all of a sudden. And of course they didn't want me to see the disaster, so they didn't let me in the classroom and were rude. And so we ended up, you know, in due process anyway. But when I was in my due process, when he was about nine or ten, I remember another behavior analyst that knew me pretty well, was working with me in the Verbal Behavior project, said, You know what to do. Why don't you just homeschool Lucas? And I was adamant while I was already working as a behavior analyst, and I was like, No, I do not want to homeschool. I'm already working. I'm already becoming a leader in the field. There's a lot of kids to help, and I need Lucas to go somewhere for 6 hours a day so that I can do my life and have my goals and have, you know, it's a lot of time to have a child home. Now, if it meant Lucas was, you know, very high functioning and when he was ten, it would mean the difference between him going to college or being, you know, very disabled. And I knew it was like a shorter term thing where I could fix it and then I could get him somewhere else. Like, I would have probably considered it. But I knew by age ten that Lucas had moderate, severe autism, and had a mild intellectual disability. He was not going to progress to college to be fully conversational, most likely to. So if you've taken my intermediate learner course in module one, I will talk about the three profiles of intermediate learners. And for me, I'm not saying like I gave up on Lucas or anything, it's just a factor. If I have a profile, a kid who if I didn't think that I could really, you know, under age eight, I would blast as hard as possible, especially if you have a child that's making pretty good gains. And I did. When Lucas was under eight, I blasted full tilt. But when children get older, that was kind of my experience. I always wanted somewhere for Lucas to go for 6 hours a day, and it didn't have to be perfect, but it had to be appropriate. So those are the factors. Age, The work status of parents and caregivers, the funding streams, or whether parents are, you know, independently wealthy and can do whatever they want, hire nannies, hire around the clock care. You know, like there are differences between, you know, even hiring a lawyer, which I went through. Many of our parents have gone through, and then really thinking about is this going to be pivotal in changing the trajectory of where my child's going to be? So for Lucas, at age ten, is this really me home schooling? Is that going to change his trajectory of where he's going to be at 12 or 18 or 25? And I didn't think it would. And now he's 23. And again, he goes to a center 6 hours a day. And I have friends who don't have that. For whatever reason, their adult kids can't go to this center based program. And so you end up in a difficult situation where your kids are at home all day. It's a lot of hours filled with meaningful activities.

Is it appropriate? Safety, Skills, and Happiness.

Mary: Okay. So let's switch gears pretty quickly and then I'm going to get to the rest of the questions. I know this is kind of long. Let's switch gears to how to tell if a center or school is. Appropriate. No matter what you call it, they call it ABA, verbal behavior, Nana, ABA, floor time, whatever. Typical school. How do you tell if a school or center is appropriate? Those variables that I talk to about home versus center still absolutely apply the age, the funding, all that stuff. However, when I'm really looking at a school or center, I am mostly looking at my big three. Is a child safe? So let's talk about safety first, as I say in podcast one with my journey and I have a whole podcast episode on my legal battles over the years, and I have an interview with Gary Mayerson as one of my podcast interviews, both, you know, excellent podcast interviews and episodes. But when Lucas took three breaths, right when he got the diagnosis, I'm right when he was ready to go to the 3 to 5 programing, the program that was recommended was in the middle of the city. Lucas had just finished a year of two year old preschool at our, you know, neighborhood preschool that was, you know, had an excellent reputation. So he already had that. He already got the diagnosis of autism. I had developed a home program in my house in the suburbs and the program that was recommended with the 3 to 5 year old program was in the middle of the city in a gun zone, so they could not do any outside play ground time because it was in a gun zone. And then I had a choice to get him to the center. It was either I would drive him, but I also had Spencer, who was 18 months younger, so I would have to take my 18 month old and my three year old essentially non-verbal child, drive both of them into this gun zone, middle of the city, park, or I don't know what I would do. Maybe they would come and get Lucas out of the car and swiftly move him into the building. And then at the center that was proposed, I think it was 15 minutes a week of 1 to 1 time. I mean, we were talking about studies showing kids needed 40 hours a week of 1 to 1 time. And this was to give him 15 minutes a week in a classroom. He couldn't even go out to recess. And then every six weeks, because of funding, they would take like a two week break. So they didn't take summers off, but they had this scattered schedule. So right there, it wasn't a safe situation. Or he could stay at my home with this 40 hour week program, which was proven, we had a yard with a fence. He could go outside. He can return to his typical preschool with one of his behavioral therapists. Like which part of this would even make sense for him to go to this other option? So safety is huge. In Kelsey's Situation Podcast three, she was driving him. He was banging his head on hard surfaces 100 times a day. He was eloping from the center, running out of the door three blocks away when Kelsey was trying to drop him off. It's just not safe. So if it's a safety issue, then it's not appropriate. In addition to the center or school having safety and it doesn't. You might have to put things in the IEP to make it safe for your child, a 1 to 1 or a 1 to 1 during recess time, with the 1 to 1 being within arm's distance of your child the entire time. Because there's no fence. You may need, you know, whatever you need, but you have to make sure that the center of the school has enough safety considerations to make your child safe. You also want to make sure that the time during the school day is appropriate. They're going to be working on skills that your child needs, not skills he already has, not skills that are too hard, skills that are functional. And this is, again, depending on the age and the ability level. And I think as your child gets to be ten or 12 or 14, we have to be thinking no matter what the functioning level is, where are they headed, what skills are really going to be appropriate? I remember one, we had au pairs, which is how we kept Lucas safe and I got to work and earn a Ph.D. and travel, as we hired pairs for a good ten years of Lucas and Spencer's lives. And I remember one of our au pairs coming back after not seeing us for three or four years. And Lucas was probably eight when she was here and 12 when she came back. And she said, like his independent skills like chores and showering and all that stuff just really improved. She didn't see a ton of gains with language, and it wasn't because we weren't trying and we weren't working on that. It's just and like the other last week, Lucas answered his first why question spontaneously. We were walking in a parking lot of a restaurant after we ate, and I had been trying. I work with him a little bit. On why questions like "Why is the pool closed?" And he knows to say, because, but he is. And so I go, Oh, oh, be careful, It's slippery. It had snowed a little bit. I said, Be careful. It's slippery. And I go, Why is it slippery? And he's like, Because it snows and because he could see the snow. But it still was his first spontaneous answer to my question. So I don't want you to think like I'm not working on language. We teach him new people that he comes in contact with new tasks at work and all that stuff. But I think at this point, you know, his language, he's not fully conversational. I think it would. But we can work more and more on independence, keeping him safe, working on independence with everything and working on keeping him happy. So the other thing is, is your child happy to go to a center or a school, or do you think they'd be happy if it's just possible. What kind of things do they know? Do they know about pairing? Do they know about the power of manding or requesting? Is it set up so that the kids look happy? Like if I were picking a daycare just for a typically developing kid and I went into daycare A and this teacher was like, Johnny, stop that. All right. The jump rope is going away because you guys can't chair and blah, blah, blah, blah, blah. If that was, you know, stop, keep your hands yourself. I told you, you know, sit criss-cross applesauce like nobody's listening today or and then I went into daycare B and it was like. I like the way you're sharing. That's so awesome. You know, give me a high five. If it was like, all these 8 positive or negative. I don't care what you call it, I would pick the positive environment. So when you're assessing potential places for your child to be, whether that's a center or a school or a classroom, look for people that are positive. Look for people that know enough to talk to you about how they program for happiness, how they keep the child safe, and what kind of skills they work on, and see if they are in line with what you think your child needs.

Mary: If you're a parent or an autism professional and enjoy listening to this podcast, you have to come check out my online course and community where we take all of this material and we apply it. You'll learn life changing strategies to get your child or clients to reach their fullest potential. Join me for a free online workshop at MaryBarbera.com/workshop where you can learn how to avoid common mistakes. You can see videos of me working with kids with and without autism and you can learn more about joining my online course in community at a very special discount. Once again go to MaryBarbera.com/workshop for all the details. I hope to see you there.