AdvanceableABA blogs

  The first call about ABA coverage for a military-connected family often starts with a mix-up. A parent says "military insurance," and the person on the other end assumes TRICARE. Sometimes that's right. Sometimes it's CHAMPVA, and the conversation has to start over. Two programs that get confused TRICARE is the health program for active-duty service members, retirees and their families. CHAMPVA, run by the Department of Veterans Affairs, is a separate program. It generally covers the spouses and children of veterans who are permanently and totally disabled from a service-connected condition, or who died from one, when those family members aren't eligible for TRICARE. North Carolina has plenty of both. Families near Fort Bragg or Camp Lejeune may be on TRICARE. A family in Raleigh whose parent is a disabled veteran may be on CHAMPVA. The rules, the forms and the people you call are different. Why it matters for ABA TRICARE covers ABA for eligible beneficiaries th...

  For eleven minutes the technician does nothing. She has put a bin of cars on the rug, sat down about six feet from the dining table, and started building a track by herself. Under the table a five year old is lying on his side watching her, having made it extremely clear on arrival that he was not coming out. At minute twelve a car rolls towards him and he pushes it back, which is the first thing that has happened all afternoon and is also, in the notes written later, the beginning of the session. Refusal is the most ordinary thing in home based therapy and the most alarming to parents, who tend to interpret it as evidence that the whole arrangement is wrong. Occasionally it is. More often it is information that nobody has read yet. What the refusal is saying Behavior that avoids something is doing a job, and the job is usually escape. The question is escape from what. Demands pitched slightly too high. A reinforcer that stopped meaning anything three weeks ago. A particular pers...

  A mother spent months treating her son's grocery store meltdowns as a discipline problem, something to correct with firmer boundaries, before a BCBA reframed the whole situation for her in a single sentence: he is not misbehaving, he is telling you something in the only way he currently can. That reframe changed how she approached almost everything that followed. Understanding behavior as communication rather than defiance is one of the more useful shifts a parent can make early in this process, and it tends to change how a family responds to hard moments long before any formal goal shows measurable progress. Reading behavior as a message Every behavior, including the ones that look disruptive on the surface, is typically serving a function, escape from a demand, access to something wanted, a sensory need, or a bid for attention. A functional behavior assessment exists specifically to identify which of these is actually driving a given behavior, since guessing wrong tends to prod...

  A mother in Raleigh spent her first month of services convinced she'd have to choose between her son's school day and his therapy hours, since both seemed to need the same after-school window and neither felt negotiable. The scheduling turned out to be less of a standoff than she expected, once she understood how in-home and school-based support are actually meant to fit together rather than compete for the same hours. Families new to ABA often picture therapy as an add-on stacked awkwardly onto an already full school day. In practice, a well-built schedule treats school and therapy as complementary parts of the same overall plan, each addressing different environments and different kinds of goals rather than duplicating the same work twice. Where After-School Hours Actually Fit Most in-home sessions happen in the after-school window precisely because that's when a child is home and available, but the content of those sessions is shaped by what happened at school that day...

  A father spent an entire Saturday on hold, transferred four times between a managed care organization, a state Medicaid line, and a billing department that kept insisting he needed a reference number nobody had given him yet. By the end of the day he had learned more about Virginia's Medicaid system than he ever expected to, and still had two more calls to make before he understood whether his son's ABA hours were actually authorized for the following month. Medicaid coverage for ABA therapy is not confusing because the underlying system is unusually complicated. It is confusing because it involves several parties, the state program, a managed care organization if the family is enrolled in one, and the provider, each of whom holds a different piece of the picture, and none of whom is necessarily positioned to explain the whole process from start to finish. How Medicaid coverage for ABA actually works in Virginia Virginia Medicaid covers ABA therapy as a service under its beh...

  Bedtime in a house outside Richmond starts at eight and finishes somewhere near eleven. There is a bath, then a negotiation about the bath, then pyjamas that come off twice, then a stretch of stair traffic nobody logs because everyone is too tired to log anything. By the time the house is quiet the parents have forty minutes before they need to sleep themselves. Families rarely raise this at intake. Sleep and meals get filed as domestic problems rather than things a behavior program would touch, so they go unmentioned while the assessment focuses on communication and school. They belong in scope, and they happen in exactly the rooms where an in-home team is already standing. Bedtime is a chain, not a moment What looks like one event is a sequence of eight or ten steps, and the trouble is never spread evenly across them. One family's problem is the bath ending. Another's is the gap between lights out and sleep. Another's is a cheerful child beside the bed at four in the mo...