ABA is not a curriculum, it’s a way of teaching, so it really depends on what you are focusing on for your child. It’s important to periodically review your Quality of Life vision and goals, as well as know the difference between working around autism deficits vs. addressing root issues for problem behaviors and cognitive challenges. If you know how to measure progress (i.e. independent spontaneous flexible communication, sharing with others, problem-solving) then you can have a good reference point for knowing when to stop. It all depends on what your goals are at the current level of your child’s development.
I would not recommend using what insurance will cover as the sole factor in deciding on what treatment to use – it’s a bit like saying “My child needs glasses but the state will pay for hearing aids, so I’ll just give my kid hearing aids”. People don’t equate that with behavioral/educational approaches, but it really does matter HOW the child is being taught, not just WHAT he is being taught. There is no solid right/wrong answer here, it’s something you can learn to evaluate for yourself if you know what questions to ask yourself.
That being said, there are some big indicators it would be a good idea to stop ABA and explore other educational approaches:
1. Your child is becoming avoidant of people, demonstrates new behaviors like self-injury or aggression (or such behaviors significantly increase upon initiating ABA), or loses motivation to initiate on his own. These can be unfortunate side effects of a child being treated at an inappropriate developmental level or becoming depressed or stressed as a result of the invasive nature of behavioral programming.
2. You are spending a significant amount of money on a program and seeing very little change or progress.
3. Therapists report gains in skills but you don’t see improvement in quality of life in your home life, and you are not receiving training on what you can do when you are with your child (leaving you dependent on therapists to do the work).
4. Your child is not progressing and therapists are unaware of neurodevelopmental foundations that may be impacting learning, including poor self-other awareness, limited ability to integrate a whole experience (i.e. the child perceives things in ‘parts’ and does not create meaning from experience), or lack of understanding of how to use tools and impact the environment in a meaningful way.
5. Your child becomes prompt dependent.
6. Activities that previously were enjoyable get used as rewards and subsequently become demotivating for the child, resulting in eradicating the child’s natural interests.
7. Your child’s therapists talk in front of him like he isn’t there, use intrusive methods to gain attention such as grabbing his face and forcing eye contact, and in general seem not to see him as a person first. All ‘behaviors’ are viewed through a lens of judgment. Lack of initiation or performance is viewed as willful, disobedient or manipulative. Children don’t thrive in this kind of environment, and while many therapists are caring and well-meaning, currently there is a culture of judgment and manipulation in behavioral autism treatment, stemming from attitudes passed down from trainer to trainee (often college students) over the past few decades. Attitudes are changing, but there is still a strong culture in behaviorism of judgment and manipulation.