Safely Conducting ABA Sessions in Home Settings as A Result of COVID-19: Part 1- Preparation and Discussions

Returning to behavior analytic services in homes can be both exciting and scary with everything going on in the world and the uncertainty of a cure. There should be a great deal of preparation prior to entering into homes again. The behavior analysis community has put a lot of effort into the consideration for services to address the safety for all and ethics within the field (Cox, Plavnick & Broadhead, 2020; Colombo, Wallace & Taylor 2020; Leblanc, Lazo-Pearson, Pollard & Unumb, 2020). The suggestions listed below are some considerations and topics of conversation that should be held while preparing to safely conduct ABA sessions in the home setting.

Speak with your employer regarding current rules and regulations that are in place for re-entering homes.

• Are ongoing risk assessments being conducted across clients individually to determine if working in the home is safe?
• Is your employer requiring daily health screenings in the form of temperature checks and health screening questions prior to entering the home across both families and clinical staff?
• Does your company offer personal protective equipment (PPE) and cleaning supplies that can be utilized during the sessions?
• How is your company staffing cases to reduce the number of people you may come in contact with?

The families you work with should also be a part of the preparation conversation to ensure agreement and safety.

• How can we reduce the number of people in the rooms during the session?
• How can the family support a clean and safe environment?
• Are they willing to wear PPE?
• Is there anyone in their home that is immune-compromised that the clinical staff should be aware of?
• Is the family willing to participate in daily health screenings?
• Is the family willing to discontinue unnecessary visitors immediately during sessions?
• Due to physical distancing, and minimizing physical contact, is the family willing to assist with physical prompts that may be needed?
• Can some of the sessions be held outside (as appropriate) or in a room with minimal human traffic with the windows open?
• Are there any socially significant goals the clinical team should add to programming to help the client with safety concerns such as hygienic challenges and physical distancing?

There are some measures you will want to consider when setting up for the in-home sessions.

• Do you have clean PPE available with you?
• Do you have enough effective cleaning material to clean the equipment and stimuli you interact with?
• Do you have only the necessary equipment present with you for the session?
• Does the family have stimuli that can be utilized in lieu of what you would have typically brought?
• Have you prepared lessons to teach the client the rules of the session (e.g., behavioral skills training to practice physical distancing)?
• How will you pair yourself with the client?

It is important to continue following safety protocols during sessions, even if it reduces the amount of clinical time you are in session.

• Wash your hands (and encourage your client to do so) throughout the session, but also use non-scented lotion to reduce the likelihood of your hands drying out and cracking, which may cause other complications.
• Always monitor the health of yourself and others (e.g., frequency of coughing or sneezing, after sneezing, ensuring handwashing, etc.)
• Wear your PPE to help you eliminate touching your face.
• Clean any surfaces or stimuli that may have been exposed to body fluids.

Safety and health risks may still exist at the offset of sessions and those should be accounted for as well.

• At the end of the session, clean all equipment and stimuli that were utilized during the session.
• Wash your hands prior to touching your personal transportation (e.g., car steering wheel, etc.)
• When arriving home, immediately place your clothing in the laundry and take a shower prior to touching anything in your home or interacting with your family members.
• Place clothes in the laundry and immediately shower

Guidelines have been established by the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) which you should continue to keep up with as new information is available. Do you have any other ideas regarding ways we can maintain safety for everyone involved in ABA sessions while also ensuring effective treatment for our clients?

Ready to start the RBT or ABAT Course? Click here to get started.

Resources:

Centers for Disease Control and Prevention. Coronavirus (COVID-19).  https://www.cdc.gov/coronavirus/2019-nCoV/index.html

World Health Oganization. Coronavirus disease (COVID-19) pandemic. https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Columbo, R. A., Wallace, M. & Taylor, R. (2020). An essential service decision model for applied behavior analytic providers during crisis. Behavior Analysis in Practice. DOI: https://psyarxiv.com/te8ha

Cox, D. J., Plavnick, J. B. & Broadhead, M. T. (2020). A proposed process for risk mitigation during the COVID-19 pandemic. Behavior Analysis in Practice. DOI: https://psyarxiv.com/buetn/

LeBlanc, L. A., Lazo-Pearson, J. F., Pollard, J. S. & Unumb, L. S. (2020). The role of compassion and ethics in decision-making regarding access to applied behavior analysis services during the COVID-19 crisis: A response to Cox, Plavnick & Broadhead. Behavior Analysis in Practice. DOI: https://psyarxiv.com/ma23n?fbclid=IwAR3AN00HFcfNroPpAoZB5olmCJPg1snhK_Lenmmrv_Dwxn6iiY80m0k3CGc