Suggestions for Ethically Fading Out ABA Services
While ABA is generally a long term commitment that a client and his or her caregiver makes, oftentimes before the child reached his or her third birthday, it is still important to have a fade-out policy in place in for when the client reaches their treatment goals or the provider is no longer able to provide services. Unlike many professions, behavior analysts want our clients to reach a point where they no longer need our services! Here are some tips for developing an effective fade out policy that is supportive of your client’s transition out of services.
1. Clearly outline eligibility, timeline and fade out procedure
The fade-out policy should explicitly state the conditions that qualify a client for fade out of services (e.g. client is no longer benefitting, client no longer requires the services, client requests discontinuation, client violates terms of client-services agreement, etc.). In addition, a fade-out should provide the family with a transition plan detailing when caregivers will be notified of anticipated discharge date, rate of fade out (e.g. Decreasing frequency of sessions from once per week to once every two weeks) and resources provided for addressing remaining areas of deficit. Having a clear plan takes the guesswork out of the process of transitioning out of services for both clinicians and caregivers.
2. Communicate your fade-out policy to caregivers at the onset of treatment
Include your fade-out policy as part of the initial intake process. This informs caregiver expectations and prevents them from assuming the myth that formal ABA therapy is going to be part of the rest of their child’s life.
3. Planning ahead for at least 6 months prior to termination of services
Structure treatment plans to account for and support transition out of services to ensure that fade out does not feel sudden or disruptive. Treatment should always maximize opportunities to utilize natural teaching strategies and caregiver training and support. It is recommended that the provider adequately train caregivers to support generalization of mastered programs as well as provide training so they have the necessary skills to know how to prompt, reinforce, and adjust the environment when necessary. In addition, work with any new provider who will be supporting the client to ensure a smooth transition and continuity of services.
4. Support client independence and teach functional skills
The long-term goal of ABA therapy is to help clients learn functional skills that can help them integrate into an inclusive environment. Thus, treatment plans should address functional skills first in order to ensure that the client can achieve maximum independence if services are no longer available.
5. Develop a network of professionals and community partners to assist in transition of care beyond scope of practice
Collaborate with ABA-friendly providers to provide resources for clients after they transition out of formal ABA services to maximize skill maintenance and continuity of care. Some BHCOEs partner with adult transitional programs that assist in job-placement into sites that utilize ABA-strategies to ensure success.
6. Include an aftercare plan with follow-up consultations when possible
Schedule follow-up consultations with caregivers after transition out of services to troubleshoot issues that may have arisen.
This piece was written by the Behavioral Health Center of Excellence and has been shared with their permission. For more information, please visit www.bhcoe.org.
