ABA for Toddlers: What ABA Therapy Should Look Like for Early Learners
Written by Christina Cox, PhD, BCBA, LABA
Starting ABA therapy can feel overwhelming for parents, particularly for parents of young children who may also be newly diagnosed with ASD. There is a lot of information out there that may have left you with more questions than answers. What therapy options are out there for my child? Will they get the attention and support they need? Will these professionals work with my family to help us succeed in the home as well? Is ABA therapy right for my child?
If you have been asking yourself these questions about your toddler, let’s talk about it. Toddlers learn differently than older children, teenagers, and adults. They have BIG feelings, and need professionals who understand that working with them. High quality ABA should be individualized, evidence-based, developmentally appropriate, and relationship-based. In fact, ABA with your toddler might not look like what you would imagine “therapy” to be at all.
Hot take: ABA with a toddler should look different than ABA therapy with other age groups.
So, what should ABA for toddlers look like?
Play focused: Play is your child’s main occupation right now, therapy should reflect that. Learning happens through toys, movement, sensory activities, books, songs, and everyday routines. RBTs and BCBAs will often be on the floor playing with your child, and working in learning activities through play.
Connection first: We want your child to WANT to play with us! The RBTs/BCBAs will spend time getting to know your child’s favorite toys, activities, and interests before learning opportunities occur.
Functional communication: Helping your child communicate their wants and needs will be prioritized.
Developing meaningful and age-appropriate skills: Goals might include play skills, communication, imitation, tolerating everyday routines, and social engagement. Developmentally appropriate and individualized goals will be targeted during sessions.
Movement and Variety: A toddler shouldn’t be expected to sit still for long periods of time-a good ABA program will find ways to get them moving through music, play, obstacle courses, and other activities.
Caregiver Involvement: Parents should understand what is being taught and how ABA strategies can fit into everyday family life. Conversations with the RBT and BCBA should feel collaborative, and align with your vision for your child.
What ABA for toddlers should not look like:
Hours of repetitive work
Expecting a 2-3 year old to sit at a table for developmentally inappropriate periods of time
Prioritizing eye contact
Teaching compliance as the primary goal
Ignoring reasonable requests to be “all done” or “no”
Trying to eliminate harmless behaviors that simply look different
Using the exact same goals or programs for every child
Continuing an activity simply to obtain compliance when the child is clearly distressed
What about challenging behavior?
Challenging behavior is often one of the reasons families first seek ABA services. Tantrums, aggression, self-injury, throwing, running away, or other intense behaviors can put stress on the entire family, especially when these behaviors can make everyday activities more difficult. One thing that is important for you to know: you don’t need to feel embarrassed about your child’s behaviors, and you don’t need to apologize for it. ABA professionals are trained to understand and respond to challenging behavior-its what we do! We view all behavior as communication-its up to us to figure out what information, want, or need the child is trying to convey. In ABA, the goal isn’t to completely stop the behavior from happening, it's to find out why the behavior is occurring. Once we know that, we can teach safer and more effective ways to communicate, or adapt the child’s environment when appropriate. Families should be able to open up about the hard moments without fear of being judged. You and your child are welcome here, including on the hard days.
What is assent and what does it look like with toddlers?
Assent at this age means the practitioner pays attention to whether a child is willing and comfortable participating in ABA sessions, even if they are too young or cannot formally give or remove consent. A toddler might show they are comfortable and willing to participate by approaching the ABA team members, reaching for activities, smiling and engaging, or returning a social interaction. Removal of assent in a toddler might look like turning away from the person or activity, saying “no” or “all done”, or becoming increasingly upset. Respecting assent doesn't mean your child will never have to do something they don’t like. Toddlers still need to engage in important activities and daily routines for hygiene and safety, and experience reasonable boundaries and demands to learn. However, clinicians should be taught to thoughtfully consider assent in the therapeutic process and make determinations on when to stop, when to persist, and when to modify the approach or demand.
Parents should have a voice
Parents know their child in a way that the ABA team, and other professionals, cannot. You are the expert on your child, we are here to ensure treatment goals align with your family’s priorities. Families should understand why goals are being targeted, feel comfortable asking questions and questioning recommendations, and feel like an integral part of their child’s therapy team. Caregiver consultation with the BCBA should happen often, and should feel collaborative rather than judgmental. ABA has to work outside of ABA sessions-you are a part of the team and your voice matters too.
Questions a parent can ask an ABA provider:
What will the first two weeks of sessions look like?
What will your RBTs do if my child says, or seems to say, “all done” to an activity?
How will you ensure my child wants to engage in therapy sessions?
How often will I be able to observe the session and talk with the BCBA?
How will we ensure skills carry over outside of therapy?
The purpose of early ABA should be to give a child more ways to communicate, means to self-advocate, build rapport and therapeutic relationships, and to better navigate their world with greater confidence and independence-the goal is not to make them act or appear more neurotypical. A good ABA program at its core doesn’t ask “How can we make this child more manageable?", it asks “What tools and supports can we put in place, and what skills can we teach, to help this child thrive?”. At BBLC, family-centered ABA is at the heart of what we do, and we would be honored to be but a small part of your child’s journey.
If you have further questions about ABA service with BBLC, please reach out to info@bostonblc.org.