Meaningful Behavior Change

Applied Behavior Analysis (ABA) is a therapy rooted in the science of learning and behavior. Using principles of ABA, children and adults can learn to improve their communication skills, social skills, and daily living skills while also addressing problematic or challenging behaviors. The primary goal of ABA therapy is to teach helpful skills that promote independence and reduce harmful behaviors. Here's our complete guide to everything you need to know about ABA therapy.

It's a big decision to make for your family! Applied behavior analysis (ABA) seeks to improve communication skills, introduce productive habits, and reduce harmful behaviors. Watch out for ABA providers who look to "cure" autism.

High quality ABA therapy does exist where the goal is not to “fix” children, make them appear “less autistic”, or change who they are. The goal is to help people learn all that they can so they can live to their potential while embracing their unique, individual personality traits. Here's our complete guide to start and end ABA therapy.

ABA is usually covered by insurance if you have an autism diagnosis. Autism is typically the only diagnosis insurance will authorize for ABA services since its benefits have been researched extensively.

Always check with your specific insurance plan to confirm that ABA is covered for your child’s diagnoses and that the provider you are seeking care at is in-network. Here's our complete guide to everything you need to know about ABA therapy.

Even if a provider offers parent training, it may look different from one provider to another. For example, an in-home provider might conduct a parent training session directly following a therapy session with your child to help explain what they’ve been working on with your child. At larger organizations, you might have a support group of families who are dealing with similar issues.

More research is needed to understand the link between sleep disturbance and autism, but there are a few possible reasons why autistic children have difficulty sleeping.2

• Co-occurring conditions. Coexisting medical conditions like ADHD, anxiety, or sleep apnea (when you stop breathing multiple times throughout the night), environmental allergies, and gastrointestinal upset (like constipation), can negatively impact sleep.
• Sensory sensitivities. Sensitivity to lights, sounds, and touch (think textures of blankets and clothing) can disrupt sleep.
• Medications. Often autistic children are prescribed medications to address various concerns like hyperactivity, anxiety, or aggression. Many of these medications may contribute to sleep problems. Adderall, Focalin, and Vyvanse are examples of stimulants prescribed to children on the spectrum to treat hyperactivity, impulsivity, and inattention, that can cause insomnia. Abilify and Risperdal (medications commonly prescribed for autistic children who have severe irritability, aggression, and/or self-injurious behaviors) may cause some children to become very sleepy.  However, each person responds differently to medications. (Pro tip: Keep channels of communication open with your doctor so that you can find the best medication to help your child that least affects sleep.)
• Neurobiological differences. Some research suggests autistic people may not produce the same levels of neurotransmitters (such as serotonin) or hormones (melatonin) important for sleep regulation, and may also experience disruption in circadian rhythms.3 In addition, low muscle tone can contribute to sleep-breathing disorders, such as sleep apnea, which also affects the quality of sleep and can lead to increased inattentive and hyperactive symptoms during the day. These behaviors, in turn, make it more challenging for the child to participate in therapies and activities. 

For more information, read our comprehensive sleep guide.

Like anyone else, when children on the spectrum don’t get adequate sleep, they may find it difficult to self-regulate during the day. But there’s another consequence – autistic kids who don’t get enough sleep can experience an increase in stimming, irritability, inattention, difficulty socializing, and keeping up in school.3 They may also face challenges with increased hyperactivity and lack of impulse control. In short, lack of sleep can intensify your child’s existing challenges.

The same goes for parents, too. It’s hard for you to keep your cool and be fully present when you aren’t well-rested.5 As you’ve already found out, good sleep is crucial for everyone in the home.

Speak with your doctor if you have concerns – especially if you notice your child snores or gasps in their sleep, grinds their teeth (bruxism), sleeps with their mouth open/drools, or is very sweaty during sleep, as these are potential signs of sleep apnea. It can be helpful to keep a log of concerns, including when the child falls asleep, how many times they wake up, when they wake for the day, and any unusual behaviors (e.g., an unusual number of sleep terrors, recurrent nightmares, sleepwalking, sleep talking, unusual hand movements, lip-smacking).

Research shows that pediatricians are sometimes unaware of the severity of sleep issues in autistic children, so please continue to advocate for your child if you have concerns.

Your doctor may recommend feeding therapy to help your child with their negative feelings and behaviors towards food. Feeding therapy can be a part of your existing speech and language, behavior, or occupational therapy. For example, a speech and language pathologist (SLPs) can help with chewing and swallowing related issues and an occupational therapist (OT) can help with fine motor skills related to eating. Applied behavior analysis (ABA) is a type of behavior therapy that will aim to improve behaviors with mealtimes and increase dietary variety and decrease unwanted behaviors such as food refusal.