March 2022 - Hidden Talents ABA

Discrete Trial Training: An ABA Therapy Technique

If an ABA therapist is engaged in teaching your child emotions, they may break the concept of emotions into individual emotions. Each emotion will be broken down into specific lessons.
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Discrete Trial Training: A Powerful Tool for Children with Autism

Autism Spectrum Disorder (ASD) is a developmental disability that can cause significant social, communication, and behavioral challenges. For parents and educators of children with autism, finding effective ways to teach skills and engage these children can be challenging. One method that has shown significant success is Discrete Trial Training (DTT).

What is Discrete Trial Training?

Discrete Trial Training is a teaching technique simplified and structured steps. Instead of teaching an entire skill in one go, the skill is broken down and “built-up” using discrete trials that teach each step one at a time (Smith, 2001).

Each trial or teaching opportunity has a definite beginning and end, thus the descriptor “discrete trial.” Within each trial, the teacher presents a task, the child responds, and the child’s response is followed by a consequence such as a reward or correction.

The Power of DTT

The beauty of DTT is its simplicity and structure, which are often beneficial for children on the autism spectrum. The clear beginning and end to each trial can help to focus a child’s attention and make learning more manageable and less overwhelming.

DTT can be used to teach a variety of skills, including social skills, academic skills, self-help skills, language skills, and play skills. It is particularly effective in teaching new material and behaviors (Smith, 2001).

How DTT Works

DTT typically follows a five-step process:

  1. Antecedent: This is the instruction or question given to the child. For example, “What is your name?”
  2. Prompt: If needed, the teacher gives the child a hint or guide to help them respond correctly. For instance, the teacher may point to themselves and say their name.
  3. Response: The child’s behavior following the antecedent and prompt. This could be the child saying their name.
  4. Consequence: The teacher gives feedback based on the child’s response. If the child responded correctly, they would receive praise or a small reward. If they responded incorrectly, the teacher would provide a gentle correction.
  5. Inter-trial Interval: A short break between trials to help the child process and prepare for the next trial.

Discrete Trial Training and ABA therapy

Applied Behavior Analysis (ABA) therapy is a scientifically validated approach to understanding behavior and how it is affected by the environment. One of the most critical instructional methods within ABA therapy for children with autism is Discrete Trial Training (DTT).

The Value of DTT for ABA Therapy

DTT is not only an excellent method for teaching academic and self-help skills but also for imparting social skills and other positive behaviors. By breaking down tasks into manageable parts, DTT makes learning more accessible for children with autism, fostering their confidence and independence.

The Process of DTT in ABA Therapy

In DTT, an action is divided into small, bite-sized pieces. Each step is taught separately, using positive reinforcement as a reward for correct responses. This helps children associate positive experiences with learning, motivating them to engage more fully in the process.

The Intensity and Duration of DTT in ABA Programs

What sets ABA programs using DTT apart is the intensity and duration of the training. The primary role of the discrete trial method for instruction ensures that each child receives focused, individualized attention. This intensive approach often leads to significant improvements in the child’s skills over time (


DTT is a powerful tool in ABA therapy for children with autism. Its structured, step-by-step approach coupled with the use of positive reinforcement, makes learning more accessible and enjoyable for these children. By focusing on individual skills and promoting positive behaviors, DTT can help children with autism reach their full potential.

Discrete Trial Training is not a one-size-fits-all solution. Like any teaching method, it should be tailored to the individual child’s needs and abilities. However, its structured, step-by-step approach can make learning more accessible and less daunting for children with autism.

By breaking down complex tasks into manageable parts, DTT can empower children with autism to learn new skills and gain confidence in their abilities. With patience, consistency, and the right approach, DTT can be a powerful tool in helping children with autism reach their full potential.

Does Medicaid Cover ABA Therapy in Texas?

Medicaid is a government health insurance program that helps low-income individuals and families pay for medical care. Many people with autism spectrum disorder (ASD) qualify for Medicaid services, including ABA therapy.

In this article, we will explore the requirements for qualifying for ABA therapy under Texas’s Medicaid program.

But first let’s get a better understanding about ABA therapy.

What is ABA therapy?

ABA therapy is a type of behavior therapy that uses positive reinforcement to encourage desired behaviors and discourage undesired behaviors.

ABA therapy has been shown to be an effective treatment for ASD, providing significant improvements in social, communication, and behavioral skills.

ABA therapy is usually provided by a therapist in a one-on-one setting, and can be adapted to meet the unique needs of each individual with ASD.

Does Medicaid cover ABA therapy in Texas?

Historically ABA therapy was not covered under Texas Medicaid; however, in 2019, the Texas Legislature passed a bill that requires Medicaid to cover ABA therapy for children with ASD. Due to COVID-19, coverage for ABA therapy was delayed until its implementation in February 2022.

Now, over 50,000 children with ASD in Texas will have access to this life-changing therapy.

Now that we know that Medicaid covers ABA therapy in Texas, let’s look at the requirements to qualify for coverage.

How can my child qualify for ABA therapy under Texas Medicaid?

In order to qualify for ABA therapy under Texas Medicaid, your child must meet the following criteria:

  • Your child must have been diagnosed with ASD within the past 3 years.
  • Your child must be under 21 years old.
  • You will need to have a current prescription for ABA therapy from a licensed physician or other healthcare professional.

If you think your child may qualify for ABA therapy under Texas Medicaid, the best way to find out is to contact your local Medicaid office. A caseworker will be able to help you determine if your child qualifies and what steps you need to take next.

How can Hidden Talents help with ABA therapy?

At Hidden Talents, we are passionate about helping children with ASD reach their full potential.

Our team of highly trained and experienced therapists provide individualized ABA therapy that is tailored to meet the unique needs of each individual.

If you would like to learn more about our ABA therapy services, or if you have any other questions, please contact us today. We would be happy to answer any of your questions and help your child get started on their journey to discover their hidden talents.

Sample Letter of Medical Necessity for ABA Therapy

A letter of medical necessity is a document that is used to justify the need for certain treatments or services. It can be used to get insurance coverage for services like ABA therapy, or to prove to a school that a child needs special education services.

In this article, we will discuss how to write a letter of medical necessity for ABA therapy to send to an insurance provider, and what to include in it. We will also provide a sample letter of medical necessity.

How do you write a letter of medical necessity for ABA therapy?

There is no one-size-fits-all answer to this question, as the letter will be tailored to the specific needs of the individual. However, there are some general things that should be included in any letter of medical necessity for ABA therapy.

Some key points include:

State the nature of the illness

The letter should state that the individual has been diagnosed with autism spectrum disorder (or another condition that warrants ABA therapy).

Outline the treatment plan

The letter should list the specific goals of ABA therapy that will be addressed, and how they will benefit the individual.

Duration of treatment

The letter should state how long the treatment plan is expected to last.

Summary of letter

The letter should provide a brief overview of the main points that have been discussed.

Some other key aspects for a letter of medical necessity include:

  • The letter should be on letterhead from a licensed health care professional such as a doctor.
  • The letter should include contact information for the doctor.
  • The letter should have a professional tone.

Sample letter of medical necessity for ABA therapy

Here is an example letter of medical necessity for ABA therapy:

To whom it may concern:

I am writing this letter on behalf of my patient, (Patient Name), to document the necessity of ABA therapy treatment. This letter offers information about their medical history, diagnosis, and an explanation for the necessity of treatment.

(Patient Name) has been diagnosed with ASD and currently exhibits symptoms that warrant ABA therapy. The most appropriate treatment here will be operant conditioning and positive reinforcement, which will help to program desired actions.

The rationale behind this treatment is that it’s totally safe. It is simply a positive reinforcement approach. It is just a method of rewarding patients for acting in a manner that is natural to them.

The patient will be left to engage in desirable behavior or else reinforcement incentives will be withheld unless there is a behavioral shift. This is about giving rewards or praise as the need arises.

The treatment plan will last for a total of 36 weeks, and will be supervised by myself or one of my associates. This will be repeated as necessary.

In summary, ABA therapy is a necessary and safe treatment for (Patient Name) that will address their specific needs. I urge you to approve this request and provide the coverage needed for ABA therapy. Please contact me if you have any questions.

Thank you for your time and consideration.


(your doctor’s name)

How Hidden Talents can help you

At Hidden Talents, we believe that ABA is the key to helping children on the autism spectrum succeed. Combined with the expert care and guidance of our trained BCBAs, your child can achieve more than you thought possible.

We currently offer ABA therapy services in Houston and Atlanta.

Reach out to us to learn more about how we can help.

ABA Therapy in Texas: What You Need to Know About Insurance Coverage

If you are the parent of a child with autism, then you know that ABA therapy is essential for their development. ABA therapy can help children learn important skills and improve their quality of life.

But what happens if you can’t afford to pay for this therapy yourself? In this article, we will answer some common questions about insurance coverage for ABA therapy in Texas.

Give us a call if you want to work with the best ABA therapy provider in Houston. 

Is ABA therapy covered by insurance in Texas?

Texas law requires most insurance companies to provide coverage for autism treatment.

However, insurance companies are not required to cover the full cost of treatment. There are loopholes which enable certain companies to opt out or reduce insurance coverage for ABA therapy as a child gets older.

It is important to speak with your company’s human resources department to find out the details of the coverage your insurance offers for ABA therapy, and check if the plan is fully funded or self-funded.

If the plan is self-funded, ask if you have ABA therapy coverage. It is important to ask about information specifically on autism coverage; you might have to be in touch with the plan administrator and ask them about benefits for ABA therapy for children with autism.

Does Medicaid cover ABA therapy in Texas?

After a hard battle, Medicaid now covers ABA therapy for children with autism in Texas.

Beneficiaries must satisfy the conditions established in the Autism Services benefit description, and the treatment must be deemed medically required. Beneficiaries may obtain further information from their Medicaid insurance plan’s benefits representative as it becomes available.

Are there any caps on insurance coverage for ABA therapy?

In Texas, a law passed in 2013 which eliminated the previous age limit on insurance coverage for autism treatment (it was previously 10 years old). Currently, there is no limit.

However, plans can restrict ABA therapy reimbursement to $36,000 per year for children over 10 years old. Furthermore, to be eligible for coverage, a child must be diagnosed before age 10.

Some insurance plans also attempt to reduce coverage for ABA therapy as children ages. Insurers have their own standards for approving benefits for ABA therapy and do not always adhere to clinical recommendations.

Even though there is no formal cap on coverage for plans until age 10, obtaining insurance authorization for intensive ABA therapy can be more difficult as children get older.

Exceptions from insurance coverage in Texas

State of Origin

Check with your insurance provider to find out where your health insurance plan is based.

Some businesses, particularly those that operate in multiple states, may provide their employees with an insurance plan from a different state. Requirements and laws on ABA therapy insurance coverage differ from state to state.

Some states have limits on the amount of coverage, age caps, and other rules that might affect your child’s insurance.

Insurance plans are governed by the state law where the plan is issued, not the beneficiary’s location. So even if you live in Texas, Texas laws may not apply to your insurance plan.

Realizing that your plan is administered out of state is easy when it’s named something like “XYZ Insurance of Illinois.” Others may not be as recognizable.

If your plan is issued outside of the state, contact your human resources department or insurance provider to learn about rules and regulations in that state regarding covered autism therapies. Make sure you inquire about any restrictions or exclusions in ABA therapy insurance coverage.

Fully funded or self-funded?

Be sure to check if your company’s insurance plan is self-funded or fully funded. The Texas law only applies to fully funded (large and small) plans, not self-funded ones.

Options for families without employer ABA coverage

Consider these alternatives for obtaining an individual ABA therapy insurance plan if your family doesn’t have insurance through your employer:

Through the Affordable Care Act marketplace

In North Texas, there are two distinct insurance coverage plans accessible through the ACA (Affordable Care Act) marketplace. Some families may be eligible for tax credits for plans bought through the ACA marketplace, depending on their income.

Marketplace options are only accessible during open enrollment, which happens once a year (usually from November 15th to December 15th) or when a particular event occurs, such as a job loss or loss of insurance coverage from an employer. You can check out what plans are available on the marketplace by visiting

Individual plans can be purchased through a broker

There are also other kinds of individual insurance plans for ABA therapy available for children with autism. These alternatives may not be the same as those available through the Affordable Care Act insurance marketplace, and they do not qualify for the same tax credits.

There are brokers in the DFW area who are very experienced in finding insurance coverage for children with autism through ABA therapy.

How do I apply for ABA therapy?

To apply for ABA therapy, you will need to contact your insurance company and request an authorization for ABA therapy benefits. The insurance company will likely require a diagnosis and letter of medical necessity from a licensed psychologist or psychiatrist in order to process the authorization.

How can Hidden Talents help with ABA therapy?

Our focus is to help children grow and thrive by improving communication, social and adaptive skills. Hidden Talents ABA specializes in services for children from birth to age 12.

Our experienced team of BCBAs develops programs to fit each child’s specific needs. The dedication of our clinicians and our comprehensive, collaborative approach will allow our clients to truly shine and succeed.

Functional Communication

Functional Communication Training utilizes differential reinforcement to teach a child to replace one behavior with another. Through a series of steps, a child is taught to replace a problematic behavior with an appropriate phrase or some other way of communicating. Learn more about Functional Communication Training at

Daily Dose of Inspiration

“Like branches on a tree, we may grow in different directions, yet our roots remain as one.”

Daily Dose of Inspiration

“Like branches on a tree, we may grow in different directions, yet our roots remain as one.”

Shopping with an Autistic Child

It can be difficult to shop with an autistic child.

They may have trouble understanding what is happening around them, they may become overwhelmed by the noise and crowds, or they may have a meltdown in the middle of the store.

Here are some tips to help make shopping with your autistic child easier and ways to create a more autism-friendly shopping experience.

Why is it Difficult to Shop with an Autistic Child?

Autistic children don’t see shopping the same as their neurotypical peers. Some difficulties they face include:

Sensory processing disorder

For many autistic children, bright lights, loud noises, and strong smells can be overwhelming. A lot is happening around them which can make shopping a difficult and even painful experience.

Crowds and long lines

Large crowds of people can be overwhelming for anyone, but for a child with autism, it can cause a lot of anxiety.

Crowds also create noise which can be difficult for a child with autism to filter out.

Change in routine

Shopping is a deviation from the normal routine which can be difficult for a child with autism to handle. They may become agitated or have a meltdown because of the change in schedule.


Meltdowns are a common occurrence for autistic children. They may happen when a child with autism is overwhelmed, frustrated, or tired. Meltdowns can look different for every child but may include crying, yelling, hitting, or self-injurious behaviors.


Many autistic children experience high levels of anxiety. This may be due to the sensory overload they feel or from knowing that a meltdown is possible. Anxiety can make shopping an even more difficult experience.

Challenges children with autism face in a store

Children with Autism Spectrum Disorder (ASD) can face several challenges when visiting a store. These challenges can stem from sensory sensitivities, difficulty with social interactions, and the need for routine and predictability. Here are some of the key challenges:

  1. Sensory Overload: Many children with autism are sensitive to sensory stimuli. Stores can be full of bright lights, loud noises, and strong smells, which can overwhelm these children and lead to distress.
  2. Difficulty Understanding Social Norms: Social interactions can be challenging for children with autism. They might not understand the social expectations in a store setting, such as waiting in line or interacting with store employees.
  3. Changes in Routine: Children with autism often rely on routines and predictability. A change in the layout of the store or an unexpected event (like an item being out of stock) can be extremely disruptive for them.
  4. Trouble with Transitioning: Transitioning from one activity to another can be difficult for children with autism. This can make it hard for them to move from one section of the store to another, or to leave the store when shopping is finished.
  5. Difficulty with Motor Skills: Some children with autism may have challenges with fine motor skills, making it hard for them to handle small items or money.

Strategies like providing a schedule, practicing and building tolerance, and preparing the child for what to expect can help manage these challenges. Additionally, making retail environments more autism-friendly, such as reducing noise levels and providing quiet spaces, can also be beneficial.

Tips for Shopping with an Autistic Child

By understanding what is difficult for your child during a shopping trip, you can be better prepared to handle any challenges that may come up.

Here are some tips to make shopping with a child with autism easier:

Prepare your Child for the Change in Schedule

The day before the shopping trip , tell your child about your plans. Explain that they will be going shopping and tell them what time you will leave. This will help your child prepare for the change in routine.

Make a Plan with your Child

Before you leave for the store, sit down with your child and explain what will happen. Use words and pictures to help them understand the steps of the trip. This will help reduce anxiety and make the trip more predictable.

Include what will happen once you get home by creating a social story.

For example, say we will get into the car, drive to the store and park in the lot. Once we enter the store we will choose a wagon, collect all of the items on our list and head to the checkout line. Once we pay for the items we will bag them and place them in the car. Once we drive home, we will undo and put away the items and then play a game of your choice.

Applied Pressure Techniques

Applied pressure techniques can help an autistic child with sensory processing disorder. Things like weighted blankets, vests, or stuffed animals can provide deep pressure input which can help calm the nervous system.

Bring along a fidget toy

If your child becomes overwhelmed, having something they love to focus on can help calm them down.

Fidget toys can be a helpful distraction for a child with autism. They may help them focus and stay calm while shopping

Reward them for Good Behavior

If your child does well on the shopping trip, be sure to reward them. This could be a favorite food, toy, or activity.

Rewarding good behavior will help encourage your child to continue following the rules while shopping.

Keep Trips Short

Autistic children can become overwhelmed easily, so it is best to keep trips short. This will help reduce the chances of a meltdown occurring.

Start with two or three items. If you have to make a larger purchase, break it up into multiple trips.

This will help your child stay calm and avoid becoming overwhelmed.

How ABA therapy can help a child go shopping

Applied Behavior Analysis (ABA) therapy is a type of therapy that can be beneficial for children with Autism Spectrum Disorder (ASD), including when they go shopping. ABA therapy uses positive reinforcement to encourage desirable behaviors and reduce problematic ones. Here’s how ABA therapy can assist a child with ASD during a shopping trip:

  1. Planning and Preparation: ABA therapy helps children with autism to understand and follow routines. Before a shopping trip, parents or caregivers can use ABA techniques to prepare the child for what to expect, such as making a list or discussing the steps involved in shopping.
  2. Visual Supports: Visual schedules, which are often used in ABA therapy, can be incredibly useful for children with autism. They provide a visual representation of what will happen during the shopping trip, which can help the child understand the sequence of events and reduce anxiety.
  3. Skill Development: Shopping trips can be used as an opportunity to practice and develop skills. For example, younger children may help gather produce, while older children might learn to compare prices or pay for items. ABA therapy can guide this skill development.
  4. Behavior Management: ABA therapy can also help manage problematic behaviors that may arise during shopping. This can include using positive reinforcement to encourage calm behavior, or teaching the child strategies to cope with sensory overload.
  5. Real-World Application: ABA therapy isn’t just for the clinic – it can be applied in real-world situations like shopping. This allows children with autism to learn and practice skills in a practical context.

Remember, each child with autism is unique, and what works for one child may not work for another. It’s important to tailor strategies to the individual child’s needs and abilities.

To conclude

Shopping with a child with autism can be a difficult and frustrating experience. However, by following these tips, you can make the trip more manageable for both you and your child. Remember to be patient and understanding, and most importantly, have fun!

Recognizing Social Work Month

March is Social Work Month, a time that recognizes the dedication and empathy social workers deliver while providing services to those in need. Social workers provide support to people of all backgrounds, in our communities. They guide us through the obstacles and help lift us out of the potholes.

Social workers provide a voice for equal rights for the weakest of us and connect us to resources when we are in need. They touch millions of lives each day and it is likely a social worker at some time will assist you, a family member, or a friend.

Social workers continue to work on the frontlines throughout the pandemic, helping patients get the health care they need and helping loved ones overcome grief and loss. Take some time out this month to recognize social workers and the great things they do.