ABA Therapy during the Covid-19 Pandemic: Is it Essential?

Our lives have been disrupted in various ways by the current Covid-19 pandemic. For instance, many educational settings have transitioned to virtual instruction which means that children are home all day. In addition, many adults are now working remotely and, in many cases, juggling both work and childcare responsibilities at once. Furthermore, because of national and, in some cases, local guidelines to maintain social distance, many of us are spending the majority, if not all, of our times at home because only essential personnel and business are allowed to continue to operate.

Given differing shelter at home orders and definitions of essential personnel across states, some individuals no longer have access to ABA therapy whereas others either receive ABA services via telehealth or have continued to receive in-person therapy as done prior to this pandemic. This is because, in general, BCBAs are now charged with the responsibility of determining whether their service is “essential”.

A newly published article by Cox, Plavnick, and Brodhead (2020) appears to be the first to describe a process that BCBAs can use to determine whether to continue providing in-person ABA therapy to a client. That is, a process to determine for whom in-person ABA therapy is essential. In this article, the authors recommend that decisions about access to services be made on an individual basis by considering many factors such as whether the family wants to continue services, whether adequate services can be provided via telehealth (see CASP, 2020 for telehealth related resources) and whether in-person therapy is necessary to minimize risk of harm to the client or the community.  Furthermore, they recommend that ABA providers continue to assess the need for services on a regular, and individual, basis.

In addition to determining the necessity for in-person service delivery, in this article Cox, Plavnick, and Brodhead also highlight the importance of reviewing the risks associated with in-person service delivery (e.g., potential exposure to Covid-19) with all parties, including the client, their caregivers, and the therapists who would be interacting with the client, and attaining consent to continue providing in-person services. Consent is necessary because, as noted by the authors, although in person-therapy may decrease the risks associated with behavioral issues, it can also increase the probability of any of these persons (i.e., client, family, therapist) becoming ill with Covid-19.

It is thus imperative that ABA providers consider each individual client’s needs in assessing if, and when, in-person therapy is essential.z