FAQ

Autism, or autism spectrum disorder, is a range of developmental conditions that affect how a person processes information and interacts with the world. In other words, people with autism learn, think, and problem-solve differently. There’s a wide variation in the type and severity of symptoms. Some individuals may require significant support for daily tasks, while others can live independently. Although there’s no cure for autism, interventions like ABA therapy can improve communication, social skills, and underlying brain development.

While symptoms vary greatly, people with autism may:

• Have difficulty communicating and interacting with other people
• Struggle to understand how other people think or feel
• Be overwhelmed when their senses are overloaded (like bright lights or loud noises)
• Become anxious or upset in unfamiliar situations
• Take longer to understand information
• Do or think the same things over and over

While some children show signs from birth, they usually appear by 12-18 months of age. In other cases, a child may develop normal communication skills and then regress, typically between 12 and 24 months. If you notice any loss of speech, babbling, gestures, or social skills in your child, this is a red flag for autism. You should talk to your pediatrician right away.

If your child hasn’t reached the milestones below, tell your pediatrician. Keep in mind that not all children with autism show all the signs. And in some cases, children who don’t have autism show a few. In other words, these milestones aren’t definitive; they’re simply a starting point for further screening.

• By 6 months – Few or no big smiles or other engaging expressions; limited or no eye contact
• By 9 months – Little or no back-and-forth sharing of sounds, smiles, or other facial expressions
• By 12 months – Little or no response to name, babbling, or back-and-forth gestures (such as pointing, showing, reaching, or waving)
• By 16 months – Very few or no words
• By 24 months – Very few or no meaningful, two-word phrases (not including imitating or repeating)

Autism Speaks has a helpful 20-question assessment called Modified Checklist for Autism in Toddlers (M-CHAT-R), meant for toddlers between 16-30 months. The results will let you know if you should talk to your child’s healthcare provider.

At present, there is no known single cause for autism. Research suggests that autism develops from a combination of genetic and environmental influences. While there’s still much to understand, a few factors may increase the risk. Just remember, falling into one of these categories doesn’t mean your child will definitely develop autism.

• Your child’s sex: Autism is four times more common in boys than girls.
• Family history: Families with an autistic child have an increased risk of having another child with autism.
• Other disorders: Children with certain medical conditions such as fragile X syndrome, tuberous sclerosis, Tourette syndrome, and Rett syndrome may have a higher risk.
• Extremely preterm babies: Children born under 26 weeks may have a higher risk.

Where can I learn more about autism?

See Our Recommended Resources for national and regional autism organizations, parent advocacy groups, and books we recommend.

Start with your pediatrician. The American Academy of Pediatrics (AAP) recommends that all children be screened specifically for autism during regular well-child doctor visits at 18 and 24-month well-child visits. However, that doesn’t mean you can’t request a screening at any time if you have concerns. Make a list of the early warning signs you’ve noticed to share with the doctor. While the screening won’t provide a formal diagnosis, it will help your pediatrician determine whether your child should have a formal developmental evaluation.

If your pediatrician conducts a developmental screening, and the results warrant further evaluation, you’ll see a specialist who’s trained in diagnosing autism. The specialist might be a developmental pediatrician, child psychologist, speech-language pathologist, or occupational therapist. They typically employ The Autism Diagnostic Observation Schedule (ADOS-2), which is a standardized assessment of communication, social interaction, play, and restricted and repetitive behaviors in children. During this assessment, a specialist interacts directly with the child in social and play activities. Ultimately, an autism diagnosis is a combination of your child’s development, plus careful observations of certain behaviors by your pediatrician, autism experts, medical tests, and your child’s history.

As a parent, you might be concerned that your child is too young to get an accurate diagnosis. You don’t want them to get labeled. Or maybe you want to “wait and see,” because someone said your child will catch up on their own. However, any parent with concerns about their child’s development should consider an evaluation. Autism diagnostic tools are much more precise than in the past. And if your child does have autism, early intervention is critical. In this dynamic period of a child’s growth, the brain demonstrates the greatest potential to alter the course of development.

No. You’ll need an autism diagnosis first. Contact your child’s doctor to start the process.

See Our Recommended Resources for national and regional autism organizations, parent advocacy groups, and books we recommend.

Applied Behavioral Analysis (ABA) therapy is an individualized autism treatment program based on proven theories of learning and behavior. It’s considered an evidence-based best practice treatment by the US Surgeon General and the American Psychological Association. ABA aims to increase positive, helpful behaviors and decrease harmful behaviors that affect learning and social interactions. Sessions focus on breaking down tasks into manageable steps, practicing positive reinforcement, and documenting progress closely.

While every child’s goals are different, in general, ABA therapy often results in:

• Improved communication and language skills
• Strengthened social skills
• Better focus, attention, and memory
• Reduced problem behaviors like self-harm
• Fewer tantrums or angry outbursts

The earlier, the better. ABA therapy should begin as soon as your child receives an autism diagnosis. Clinical research has shown that children who receive early intervention (around two years old) make the most significant improvements. That being said, it’s never too late to begin.

We strongly encourage a minimum of 20-25 hours of direct therapy per week to start. Studies have shown that intensive intervention is most effective. Children come into our center for up to six sessions per week. Each session is typically two to four hours.

Our center-based programming allows for treatment with high intensity (20 to 30 hr a  week). As your child makes progress, there’s less need for high intensity. Instead, we shift the focus to generalizing their skills across different settings. When your Board Certified Behavioral Analyst (BCBA) decides your child is ready, they’ll discuss transitioning services into the home and the community. This occurs no later than age 11 and typically takes three to six months.

When we provide home-based services, a parent or a caregiver over the age of 18 must be present in the home. Siblings can participate in session activities if considered appropriate by the BCBA. However, you must be present to supervise them. BCBAs will regularly attend sessions to provide supervision to the therapist as well as monitor treatment progress and implementation.

We begin with various assessments to evaluate the social, affective, cognitive, and/or environmental factors associated with your child’s behavior. The assessments gather feedback from parents, teachers, and any other adults working with your child. Next, we determine your child’s learning objectives and create concrete treatment goals. Objectives and goals are critical to measure progress and make adjustments. Finally, we create specific behavioral interventions that build on your child’s strengths and specifically address the underlying “why” for any problem behaviors.

Parents are an integral part of the treatment team. BrightBloom provides supportive parent training to make sure you feel confident in your role. Here are two primary ways we encourage parents to boost their child’s success in ABA therapy.

1. Reporting behaviors – What changes have you noticed? Are they improving? Regressing? What do you think is causing behaviors? This context helps your therapist tweak the treatment plan to make it more effective.
2. Carry on the lesson – You’ll spend far more time with your child than the therapist will. Through parent training, we’ll provide a step-by-step plan to reinforce targeted behaviors in the home and community through conversation, modeling, rewards, and other techniques.

Verbal behavior therapy is a form of ABA therapy.  This intervention helps people with autism learn language by connecting words with their purposes. The student learns that words can help them get what they need or want, rather than focusing on words as labels only. At its most basic level, verbal behavior therapy begins by teaching requests (also referred to as mands). For example, a child with autism learns that saying “juice” can produce a juice box.

See Our Recommended Resources to learn more about how ABA works, what to expect, and how you can help your child get the most out of treatment.

Most insurance companies will require your child to have a medical diagnosis of Autism Spectrum Disorder before they’ll authorize coverage. We ask that you submit:

1. a copy of your child’s diagnostic report
2. a referral letter for ABA
3. back and front copies of all active insurance cards
4. complete parent agreement packet

ABA therapy requires time and consistency to be effective, which is why our program also requires a commitment of 10 hours per week minimum availability to begin.

1. Our Intake Specialist will contact your insurance provider to confirm your eligibility for ABA services and benefits. Often an authorization is required to start the process.
2. Once we have the green light from your insurance and all documentation is on hand we will schedule the initial assessment.
3. Once the on-site assessment is complete, a Board Certified Behavior Analyst (BCBA) will discuss recommended treatment dosage and create a plan based on your child’s needs.

The length of the intake process can vary. On average, it takes between one to two weeks. However, our dedicated Intake Specialist will work with you to ensure it’s as quick and seamless as possible.

Visit the Start Here page, and we’ll guide you through the process.

We currently work with children between 2 and 13 years old.

The BrightBloom team has two levels of clinical professionals, each with an important role.

• BCBA – We have several master’s level Board Certified Behavior Analysts (BCBA) who develop behavior programming and supervise ABA therapists. To receive BCBA certification, applicants must hold a graduate degree in a relevant field, fulfill relevant coursework, complete supervised experience, and pass an exam with the Behavior Analyst Certification Board.
• Registered Behavioral Technicians (RBTs) – Our behavior therapists must obtain their certification from the Behavior Analyst Certification Board after completing 40 hours of training in relevant coursework, periodic competency assessments, and passing the RBT exam. Each RBT operates under the regular supervision of a BCBA.

Collaboration and communication are critical to your child’s success. Therefore, parent/caregiver participation is an expectation of service – and we welcome your questions at any time.

You’ll be actively involved in your child’s treatment plan through team meetings, data review, and the implementation of recommended strategies. We’ll also provide formal quarterly progress reports and semi-annual treatment plan reviews.

Your BCBA will communicate progress to school and daycare staff as well. The BCBA will participate in IEP meetings, provide consultation and training to school and daycare staff, and invite them for a guided observation in the clinic.

We have three center-based locations. Visit our Contact page.

• Wilmington
  510 Philadelphia Pike, Wilmington, DE 19809
• Middletown
  200 Cleaver Farms Road, Suite 400, Middletown, DE 19709
• Milford
  1010 Mattlind Way, Milford, DE 19963
• Swedesboro
  545 Beckett Road, Swedesboro, NJ 08085

Our centers are open Monday through Friday 9 am to 6 pm. Please contact our office for availability.

Naturally, you want the best for your child. A third-party accreditation gives you confidence that your provider is operating in alignment with industry best practices. The Behavioral Health Center of Excellence® (BHCOE®) Accreditation recognizes behavioral health providers that excel in the areas of clinical quality, staff qualifications, and consumer satisfaction. These areas are measured with a wide-ranging audit, including interviews with agency clinical leadership, in-depth on-site observation, a detailed staff qualification review, an anonymous staff satisfaction survey, and an anonymous consumer satisfaction survey.

Yes, depending on what you need, our team can review your child’s IEP, assist in writing the plan, and/or attend IEP meetings. We welcome the opportunity to work with all the adults/professionals in your child’s life, so parents, teachers, and therapists are all working toward the same goals.

If necessary, we can provide a trained paraprofessional to assist your child with behavioral challenges and reinforce ABA therapy, one-on-one in the classroom. Learn more about our school-based services.

Once a child reaches school-age, we adjust the amount of center-based ABA therapy to accommodate their new school schedule, shifting to evenings or weekends.

We currently accept Aetna, Cigna, Highmark (BCBS), TriCare-Humana, United Behavioral Health-Optum, and Delaware Medicaid plans.

It’s important to know exactly what your behavioral benefits are since they may be different than your medical benefits. To learn more about your specific behavioral health benefits, contact your insurance company by calling the number listed on your insurance identification card. If you’re unsure, our staff can also help you identify what’s covered under your benefit plan and arrange the appropriate referrals.

Every insurance plan is different. Once we receive your insurance information, a representative from our facility will contact your insurer to verify your eligibility and benefits information. Then, they’ll contact you to review.

This depends on your insurance plan. Some are a co-pay, while others may require a deductible before coverage. Be sure to speak to your insurance carrier before starting services.

Some states have laws to ensure that Medicaid recipients diagnosed with autism receive specific benefits or coverage.

In Delaware, your child may qualify for Medicaid coverage based on your financial needs and/or their diagnosis. Please visit the Delaware Medicaid Program website for more information about eligibility and enrollment.

In New Jersey, families can access mental and behavioral health services through PerfromCare.

Autism Speaks

Autism Speaks is dedicated to promoting solutions, across the spectrum and throughout the lifespan, for the needs of individuals with autism and their families. They do this through advocacy and support, increasing understanding and acceptance of people with autism, and advancing research into causes and better interventions for autism spectrum disorder and related conditions.

Autism Society of America

The Autism Society of America has been improving the lives of all affected by autism for over 50 years and envisions a world where individuals and families living with autism are able to maximize their quality of life, are treated with the highest level of dignity, and live in a society in which their talents and skills are appreciated and valued. They provide advocacy, education, information and referral, support, and community at national, state and local levels through our strong nationwide network of Affiliates.

National Autism Center

The National Autism Center is a nonprofit organization dedicated to disseminating evidence-based information about the treatment of autism spectrum disorder (ASD), promoting best practices, and offering comprehensive and reliable resources for families, practitioners, and communities. Their National Standards Report is the most comprehensive analysis available to date about treatments for children and adolescents with ASD. It’s a single, authoritative source of guidance for parents, caregivers, educators, and service providers as they make informed treatment decisions.

Autism NOW

A division of The Arc, a national organization serving people with intellectual and developmental disabilities, Autism NOW is a central point of quality resources and information for individuals with Autism Spectrum Disorders (ASD) and other developmental disabilities, their families, and other key stakeholders. All resources and information that Autism NOW posts go through a formal review process.

Organization for Autism Research

OAR’S mission is to apply research to the challenges of autism. They strive to use science to address the social, educational, and treatment concerns of self-advocates, parents, autism professionals, and caregivers. The mission of “applying” research to answer questions of daily concern to those living with autism defines our goals and program objectives and shapes our budget. They define applied research as research that directly impacts the day-to-day quality of life of learners with autism.

Autism Delaware

Our center is a proud sponsor of Autism Delaware. Their mission is to be the leading resource for expertise, advocacy and raising awareness of autism in Delaware. Their goal is to continue expanding creative and innovative services, resources and support to individuals and families, while using evidence-based methods to become a model for others. Contact their family navigators for help, attend their educational opportunities, participate in parent coffees, or join an online support group. They also have an extensive Delaware-specific resource directory.

ASCEND Group

ASCEND Group Inc., the Asperger and Autism Alliance for Greater Philadelphia, is a nonprofit organization launched by parents of children with Asperger Syndrome (AS) as a means to create a community of people who are concerned about the many ways that AS and other Autism spectrum disorders (ASD) affect children and adults and their families in the home, at school, and in every area of their lives.

Delaware Medicaid

In Delware your child qualifies for Medicaid coverage based on a diagnosis of Autism Spectrum Disorder.

National Autism Resources

This online company has a broad array of classroom tools, visual aids, calming products, sensory items, and toys for children and adolescents with autism.

The Reason I Jump: The Inner Voice of a Thirteen-Year-Old Boy with Autism

(Higashida, 2016)

Written by Naoki Higashida, a very smart, very self-aware, and very charming thirteen-year-old boy with autism, it is a one-of-a-kind memoir that demonstrates how an autistic mind thinks, feels, perceives, and responds in ways few of us can imagine.

Thinking in Pictures: My Life with Autism

(Grandin, 2006)

Originally published in 1995 as an unprecedented look at autism, Grandin writes from the dual perspectives of a scientist and an autistic person to give a report from “the country of autism.” Introducing a groundbreaking model which analyzes people based on their patterns of thought, Grandin “charts the differences between her life and the lives of those who think in words.”

More Than Words

(Sussman, 2012)

Updated to reflect the most current view on naturalistic models of communication, this beautifully illustrated guidebook provides a step-by-step guide for parents of children with Autism Spectrum Disorder and other social communication difficulties. Presented in a user friendly format, the book s research-based strategies show parents how to turn everyday activities with their child into opportunities for interaction and communication.

Creating a Balanced and Happy Life While Raising a Child with Autism

(Senator, 2010)

Given the daily challenges of raising a child with autism, it’s easy for parents to lose themselves and for their overall quality of life to plummet. Susan Senator interweaves the voices of autism parents, researchers, and professionals to offer guidance and encouragement on how to find happiness and fulfillment in the midst of the struggles of raising an autistic child. Topics include: how to handle feelings of despair and hopelessness; finding fun, even during turbulent times; caring for your marriage; and finding a balance between accepting your child as he or she is and seeking new treatments.

The Verbal Behavior Approach

(Barbera, 2007)

This step-by-step guide provides an abundance of information about how to help children develop better language and speaking skills, and also explains how to teach non-vocal children to use sign language.

Teaching Language to Children with Autism and Other Developmental Disabilities

(Sundberg & Partington, 1998)

This is the original must have book for professionals and parents implementing a verbal behavior assessment and intervention program for children with autism or other developmental disabilities

ABA Visualized

(Van Diepen, 2019)

ABA Visualized is a parent training guidebook that uses step-by-step visuals to teach essential ABA strategies. Parents will learn how to build skills and reduce problem behaviors. In addition to the more than 60 visual strategies, templates & tools are included to accommodate the use of the techniques, making this book a comprehensive ABA resource for parents

Thriving with Autism: 90 Activities to Encourage Your Child’s Communication, Engagement, and Play

(Cook, 2020)

To guide your efforts to help your child flourish, this book has 90 playful, evidence-based activities. Thriving with Autism provides an easy, effective toolbox to supplement and support the developmental work parents and caregivers are doing with their children. These solutions are designed for kids with autism from ages 1 to 11.

Halloween can be an overwhelming start to the holiday season for children with autism and their families. The decorations can be terrifying for children, and here are helpful tips to help your children overcome their fears.

Decorations

• Use decorations in your home, setting them up slowly to allow your child to the changes.
• Show your children how the decorations work—understanding how they work can help them be less afraid.
• Remind your children that decorations aren’t real and can’t hurt them.
• If your family plans on attending a Halloween party, ask the host if you could show your child their decorations before the party to ease potential fears about the decorations.
• Avoid houses that you think will be too scary for your child. Overall, this will be beneficial for everyone!

Safety

• Before Halloween, have fun practicing trick-or-treating with your child.
• Come up with a game plan for Halloween, whether trick-or-treating with a friend or going to a party. Preparing the entire family for what to expect can be beneficial for everyone!
• If you plan on trick-or-treating, go early and plan to come home before it is dark out. Discuss this plan with your child in advance so they know that it is time to go home once it is dark out, no matter who is staying out.
• Bring a peer or sibling that your child feels comfortable with along for trick-or-treating.
• Wear clothing that stands out so your child can easily find you in a crowd of people.
• Review safety commands for walking on the street.
• Reinforce positive behaviors as they happen!

Making sure you have planned and are prepared for Halloween can go a long way for your child and your entire family. Putting your child’s needs first can help to ensure you all have the best day possible!

Thanksgiving can be a challenging holiday for families of children with autism–bringing new food, loud noises, new environments, and more. Here are tips to make Thanksgiving a fun and relaxing day for your family!

• Designate a quiet place that your child can go whether you are in your own home or traveling.
• Preparing your children for what to do if they feel overwhelmed will reduce stress for the entire family.
• Prepare food that your child will enjoy. Thanksgiving emphasizes eating certain foods, which may be a challenge for your child. Having foods on hand that your child enjoys can be helpful.
• Help your child become familiar with the environment and people they will spend time with on Thanksgiving.
• Ask your family and friends for help if you need it! Setting expectations for your family can help their stress as well as yours!
• Most importantly, give your child positive feedback when they deserve it. Overall, this will not only make you and your child happy, but it will help increase these positive behaviors!