Access to Applied Behavior Analysis (ABA) therapy for children with Autism Spectrum Disorder (ASD) is crucial for their development and well-being. However, one significant challenge is providing this therapy to children in rural areas where specialized services may be limited. In recent years, advancements in technology have opened up new possibilities, including telesupervision or virtual telehealth appointments, to overcome geographical barriers and increase access to ABA therapy. Leveraging technology to provide ABA therapy to children in rural communities has several benefits and implications.

The Challenge of Access

Children with ASD often require intensive, specialized therapy to help them develop communication, social, and behavioral skills. ABA therapy, which is evidence-based and highly individualized, has been shown to be effective in improving outcomes for children with ASD. However, many rural areas lack the trained professionals required to develop treatment plans and oversee the care, making it difficult for families to access these services. ABA treatment plans are developed by a masters level, board-certified clinician, who then provides ongoing supervision for the case. Families may face long waitlists, travel long distances, or even relocate to urban areas to access ABA therapy, placing significant financial and emotional burdens on them. 

The role of technology in ABA therapy

Technology has revolutionized various aspects of healthcare, and ABA therapy is no exception. Telehealth, which involves delivering healthcare services remotely via audio and video technology, has emerged as a promising solution to bridge the gap in access to ABA therapy for rural children. Telesupervision, a subset of telehealth, allows behavior analysts to remotely supervise and monitor therapy sessions conducted by trained paraprofessionals or therapists in the child's home or local community. Throughout the COVID-19 pandemic, ABA Therapists relied heavily on telehealth to keep services consistent for clients while minimizing exposure to the virus. One benefit of the pandemic is that companies were able to develop methods and systems for leveraging telehealth to keep children in service and offer services to those who may not have previously been able to access them, even today.

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What are the benefits of telesupervision?

  • Increased Access: Telesupervision eliminates geographical barriers, allowing children in rural areas to receive ABA therapy without the need for long-distance travel.
  • Flexibility: Telesupervision offers flexibility in scheduling therapy sessions, making it easier for families to incorporate therapy into their daily routines.
  • Quality Assurance: Remote supervision allows behavior analysts to monitor therapy sessions in real time, ensuring that interventions are implemented correctly and effectively. It also allows them to observe sessions more consistently.
  • Professional Development: Telesupervision provides opportunities for professional development and mentorship for therapists in rural areas, ultimately improving the quality of ABA therapy services and retention of these staff.

Telesupervision challenges and considerations

While telesupervision holds great promise, it also presents challenges and considerations that must be addressed by companies and professionals who use it:

  • Connectivity:  Reliable internet connectivity and access to necessary hardware and software are essential for successful telesupervision, which can be difficult to obtain in rural areas.
  • Regulatory and Licensing Issues: Regulations surrounding telehealth and licensure vary by state and country and may impact the delivery of telehealth in ABA therapy. Each insurance company has its own stance and requirements for telehealth. 
  • Privacy and Security: Ensuring the privacy and security of sensitive patient information transmitted during telesupervision sessions is paramount. Companies must invest in and utilize HIPAA compliant software for conducting meetings with clients and caregivers. 
  • Training and Support: Proper training and ongoing support for therapists and families are crucial to the success of ABA therapy.

Here at Powerback Pediatrics, we utilize a hybrid approach to therapy. We offer telehealth assessment, supervision, and parent training and guidance when appropriate for the client. We evaluate each case individually to determine if they would benefit from support via telehealth and then assign a team that consists of a Behavior Analyst and a Behavior Technician. The Behavior Technician works one-on-one with the client in the home or school setting daily. At the same time, Behavior Analysts use a combination of in-person and telehealth to ensure the case is appropriately supervised and supported. Additional clinical support (PT/OT/Speech therapy) may be required in certain cases, which we are happy to provide accommodations for.

Every Case Needs a Team: Family, Behavior Tech, Client Advocate, Additional Clinical, BCBA

We continue to advocate for the extended approval of telehealth services from insurance companies and state Medicaid plans because we see the benefit to our clients and the impact it can have on their access to services. 

If you are interested in learning more about ABA therapy services at Powerback Pediatrics, call us today at 888-269-9876 or visit our website:

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