Our Enrollment Process

We will take you and your family through a few key steps in order to get you the care that you need:

Step 1: Initial Contact & Paperwork

Contact the location closest to you and discuss your situation. The center will review some initial information, schedule your tour, and send over some information on next steps.

Find a Close Location

Step 2: Tour and Reports

Visit your closest location and meet with the team, and provide any diagnostic or insurance information that the center will need for an assessment.

Step 3: Initial Assessment

During this time, a certified BCBA will conduct an assessment with both you and your child. You’ll be asked to fill out the Vineland Adaptive Behavior Scales (an assessment tool that uses a semi-structured interview to measure adaptive behaviors and support diagnoses) along with other approved assessments.

The BCBA will also ask additional questions as well as trial skills with your child. If you’re seeking Speech or OT, our SLPs and OTRs may attend the session.

If they are not present, your child’s SLP and OTR will perform an assessment once services start.

When all three providers are present at the initial assessment, the process may take three hours to complete. Otherwise, the session will take one or two hours to complete.

Step 4: Evaluation & Treatment

Following the assessment, our providers will spend the next few days evaluating your child’s assessment and creating a treatment plan. Once completed, the provider will share a copy with you for review.

Here, you’ll be able to ask questions, comment on goals, and send the plan to your insurance.

Step 5: Insurance Approval

Once the treatment plan is approved by your insurance, our staff will meet with you to discuss services. If your insurance denies hours or services, our providers will appeal on your behalf to ensure coverage for your child. Once the hours are approved, services will start.

Step 6: Service Initiation

Officially begin services!

Please note that 90% attendance of authorized hours are required. This is due to five key reasons:

Understanding Clinical Recommendations

Hours & Productivity

Treatment plans are similar to any other prescription; you should abide by the hours of service recommended! If a doctor prescribes a certain medication daily, and you only take it weekly, the outcomes will differ. The same goes for ABA! If a client spends fewer hours in ABA than recommended, some children may experience worsening symptoms.

For example, if a client spends 20 hours at ABA per week instead of a clinically recommended 40 hours, the child might become resistant to all therapy techniques. As a result, a child might feel that they can “wait out” their therapists instead of engaging in new learning opportunities. Learners on the spectrum often require several re-presentations of task demands to help them learn skills, more often than neurotypical learners.

Financial

If less intensive services are provided, families will spend more money on their child’s treatment while seeing fewer beneficial outcomes. This is because out-of-pocket costs and deductibles are met faster when pursuing full-time services. Pursuing part-time services can be harmful to families as they will likely see less progress for their child while spending a similar amount to full-time services.

Continued Coverage

When a provider recommends a certain number of hours per week, they outline a set amount of goals for the children to achieve. For example, if the provider recommends 40 hours of ABA per week, they may propose 20-30 goals over 6 months. If a learner attends only 20 hours instead, they will generally only achieve 50% of their targeted goals.

When insurance sees this at the six-month follow-up, they will reduce the number of hours covered. Once hours are cut, it is nearly impossible to increase those hours in the future if it becomes necessary to do so.

Research

Although 30-40 hours may seem like a lot for young children, intervention occurs early when children soak up intervention more readily and have less of a learning history to compete with. At Essential Speech and ABA Therapy, we train our practitioners to utilize naturalistic interventions. This means intervention is generally implemented into play. With this approach, goals can be targeted through joyful and personalized engagement. Children are less likely to burn out on treatment with this approach, and still make maximized progress.