Research Article | Open Access

Experiences and Strategies of Competent Smart ABA Therapists in Treating Children with Autism

    Arneliza

    University of Persada, Indonesia

    Siti Rahmawati

    University of Persada, Indonesia

    Rudy Sutadi

    University of Persada, Indonesia

    Asmadi Alsa

    University of Persada, Indonesia

    Kuncono Teguh Yunanto

    University of Persada, Indonesia


This research aims to explore the experiences of Smart ABA therapists who possess the competencies to treat children with Autism Spectrum Disorder (ASD). This research uses a qualitative method with a phenomenological approach. Three Smart ABA therapists were selected based on the following criteria: they already have competency as Smart ABA therapists as determined by the KID-ABA Autism Center through training and internships, and have been Smart ABA therapists for approximately three years. In addition to the three informants mentioned above, five parents of children with ASD participated in sharing information about the success of their children who were treated by the informants. Data was collected through semi-structured interviews, observations, and documentation. Interview transcripts and other data were analyzed through data reduction, presentation, and conclusion. Based on the interviews and transcripts, five themes can be identified: interest, knowledge, skills, values and attitude. The findings of this research are important in uncovering various valuable aspects of the experiences of competent Smart ABA therapists. Implications of these findings will provide a deeper understanding of the role of competent Smart ABA therapists in interventions for children with ASD. The results of this study can be utilized by therapists, professionals, and policymakers in the field of autism to enhance therapist competencies and provide appropriate and effective therapy services for children with ASD.

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The prevalence of autism is increasing worldwide. In the United States, the Center for Disease Control and Prevention reported in 2018 that 1 in 36 children was diagnosed with Autism Spectrum Disorder (Maenner et al., 2023). The male-to-female ratio for ASD is approximately 4:1 (Bethin et al., 2019). In Indonesia, there is lack of precise data available on the number of children with ASD. According to Sutadi et al. (2022) as mentioned during World Autism Awareness Day in 2018, it was estimated that there were around 2.4 million individuals with ASD in Indonesia, with approximately 500 new cases being identified each year. This situation requires effective and timely interventions to improve their developmental outcomes.

Autism is a severe neurobiological developmental disorder that occurs in children and causes difficulties in communication and social interaction with their environment. This disorder usually appears in the first three years of life and persists throughout a person's life if not intervened properly. Autism is a neurodevelopmental disorder seen from a lack of communication problems, limited interest, and repetitive behavior (Appah et al., 2024; Bommangoudar, 2018; Chen et al., 2019; Hodges et al., 2020; Jones et al., 2014; Lord et al., 2020; Pickles et al., 2020; Sergi et al., 2021; The National Institute of Mental Health, 2018; Van Laarhoven et al., 2020). Proficient professionals are required to effectively manage this intricate disorder, thereby facilitating the independent integration of all individuals diagnosed ASD with society. ASD children should receive the proper treatment from professionals or therapists who have competence.

Competence is the ability, skill, and proficiency that someone can rely upon in accordance with the provisions in a particular field.  According to Edison et al. (2022), there are three aspects of the concept of competence: knowledge, Skill, and Attitude. Furthermore, according to Cooper et al. (2017), there are at least two components involved in assessing therapists' competence: an assessment of their knowledge of the treatment in question, including how and when to use its strategies and procedures, and an evaluation of their ability to apply that knowledge skillfully in practice. The role and availability of the therapist is critical to maximizing the chances of therapeutic success (Amichai-Hamburger et al., 2014; Castonguay et al., 2018; Dobson, 2022; Kazantzis & Dobson, 2024).

Therapists are the frontline to treat ASD children. However, in Indonesia, there are still few therapists who have competence in treating ASD children, so there are many complaints from parents of ASD children about this, especially the slow development of their children. A therapist is a person or group with expertise in a particular therapy field for a healing process. According to the Big Indonesian Dictionary, a therapist is a person who provides therapy (KBBI Kamus Besar Bahasa Indonesia, 2016). Smart ABA therapists are competent in using Smart ABA therapy for Autism (Sutadi et al., 2022).

According to Simatupang (2022), the lack of training received by therapists results in their inability to handle children with ASD. This leads to complaints and anxieties from the parents of children with ASD who are dissatisfied with the progress and development of their children being treated by therapists lacking competence. In addition, there are ASD children who receive poor treatment from therapists who conduct therapy for them, which can result in traumatic experiences, such as being teased, shouted at, pinched, hit, pushed, or verbally abused, as highlighted in research by Nurhasanah (2023) and Restina and Mardiawan (2017). This condition, apart from being incompetent, the therapist does not consider his work as a therapist as a mandate from God that will be held accountable late. It is important to address these issues immediately to ensure that children with ASD receive appropriate therapy from qualified professionals who are committed to their well-being.

Innovations are needed in terms of therapy for children or individuals with ASD, as well as the competence of therapists. One significant solution to solve the problem caused by the lack of therapist competence is appropriate and high-quality Smart ABA training. This is very important in preparing competent ASD child therapists. By strengthening training systems and providing better access to educational resources, therapists will be able to provide effective therapeutic services and help children with ASD make progress in their development through the application of Smart ABA techniques. Proper and quality Smart ABA training is essential in preparing competent ASD child therapists.
Smart ABA is a development of ABA (Anwar et al., 2022). Smart ABA aims to accelerate the improvement of various abilities in children or individuals with ASD.

According to Vuattoux et al. (2021), improving children's abilities is a challenge faced by individuals with ASD without intellectual impairment at any age. The effectiveness of Smart ABA in treating children with ASD has been reported in several studies (Savitri & Salam, 2020 ; Soedita, 2019 ; Sutadi et al., 2022 ). This development must continue to be carried out to improve various abilities in ASD children, one of which is through the competence of smart ABA therapists. However, researchers have not found studies on the experiences and strategies of competent therapists in treating autistic children. This study is urgent to conduct in order to fill the current research gap. The aim of this study is to explore the experiences of Smart ABA therapists who possess competence in providing therapy to children with ASD. The results of this research are expected to contribute to a deeper understanding of the challenges, effective strategies, and emotional impact experienced by the therapists. The experiences of being a competent Smart ABA therapist for children with ASD are reported for the first time in this study.

Method

Study Design

This study employs a qualitative method with a phenomenological approach. According to Husserl (1965) it is very important to understand the phenomenology of a person or group according to the actual situation, various assumptions must be eliminated to understand the true meaning. Furthermore, according to Creswell (2013) , phenomenological studies aim to interpret the experience of a society or individual regarding a particular concept established as a phenomenon. Alase (2017) explains that phenomenology is a qualitative methodology that allows researchers to apply their subjectivity and interpersonal skills in the exploratory research process. Creswell and Poth (2018) explain that the phenomenological approach provides valuable insights into the experiences shared by multiple individuals. Understanding these common experiences can be beneficial for groups such as therapists, educators, health workers, and policymakers. In this context, the experiences of Smart ABA therapists, who effectively provide therapy resulting in significant changes for children with ASD, are particularly relevant. This therapy enables these children to be accepted into regular schools (Arneliza et al., 2025). In this study, we identify this as a key phenomenon.

Participants

Three informants were selected based on the main criteria that they are Smart ABA therapists who have the competency as Smart ABA therapists as determined by the KID-ABA Autism Center through training and internships. In addition, they have experience as Smart ABA therapists treating children with ASD for approximately three years. With approximately three years of experience as a Smart ABA therapist, this means that the informant has received adequate training both during the training period and after being declared competent as a Smart ABA therapist by the KID-ABA Autism Center. Experienced therapists are more skilled at observing children's responses and adjusting intervention strategies, which is crucial for therapy effectiveness (Eikeseth, 2010; Hillman, 2006; Schenk et al., 2023; Symes et al., 2006; Wang & Yang, 2022). According to Creswell (2013). Informants in phenomenological research should be chosen carefully, that is, only those who have experienced the phenomenon themselves. In addition to the three informants mentioned above, five parents of children with ASD participated in sharing information about the success of their children who were treated by the informants. The demographic data of the included three females with age range of 28-35 years with experience of working as Smart ABA therapists from 3-6 years.

Instruments

Data was collected through semi-structured and open interviews with informants to be more flexible in collecting information. Interview techniques in phenomenological research are intended to draw conclusions from opinions and perceptions of the phenomenon being studied (Moustakas, 1994 ) . Before conducting the interview, the researcher created an interview guide to make it easier for the researcher to conduct the interview. The questions are as follows: 1. Why are you interested in becoming an ASD child therapist?: 2. What do you need to prepare to become a competent ASD child therapist?: 3. How do you gain the knowledge to become a competent therapist to treat ASD children?: 4. What are the challenges you experienced during your time in this profession: 5. How did you overcome these obstacles?; 6. What do you think if a therapist treats a child with ASD, but has not received adequate training? Apart from that, observations were made via CCTV monitors when the informant carried out therapy on children with ASD. The researcher also documented and recorded some information when the informant made a report after completing the therapy session.
Researchers have obtained permission from the KID-ABA Autism Center and all informants for interviews, observations and documentation. The informant also allowed the researcher to use a voice recording device during the interview to facilitate the data collection process and transcripts to facilitate data analysis.

In this study, competent Smart ABA therapists had the same training and internship standards. The training and internship are tiered after approximately three months for prospective therapists to be declared capable or competent to become therapists in therapy for children with ASD. This is in line with research conducted by Granpeesheh et al. (2010) , Julimet and Cholid (2017) , and Luiselli et al. (2008) that it takes a long time for ABA therapists to learn ABA principles to achieve the effective results.

Becoming a competent Smart ABA therapist involves not only initial training but also ongoing training to maintain skills and competencies. While therapists are in practice, they receive direct supervision from supervisors, program directors, and consultants. Cooper et al. (2017) highlight the significance of continuous training and supervision for therapists working with children with ASD, as it enhances their confidence and ability to deliver effective therapy. In this context, continuous quality training and expert supervision are crucial for therapists, helping them navigate any challenges that arise during therapy sessions.

Data Analysis Techniques

This study uses data analysis techniques from Miles et al. (2013), which consist of four stages: data collection, data reduction, data display, and conclusion drawing/verification. Data was collected through interviews, observations, recordings, and documentation from Smart ABA therapists. Data was reduced by entering relevant information and excluding irrelevant ones interview transcripts with coding and systematic descriptions. To ensure the validity of the data, triangulation of sources was performed through interviews, observations, and documentation. Cross-verification was further conducted by comparing the information obtained from interviews with the observations made during the informant's therapy sessions through CCTV monitoring, as well as the documentation created by the informant after the therapy sessions were completed. In this process, the researcher matched the findings from the interviews with what was directly observed during the therapy sessions and the interactions with the informant when the informant prepared reports after the therapy sessions were completed. This way, the researcher was able to verify that the obtained information was consistent and supportive of each other, providing a more accurate depiction of the phenomenon under study. This approach also helped identify potential biases or inaccuracies in the data. This approach was aimed at strengthening data reliability and ensuring consistency between different sources of information.

Results

The results of interviews, transcripts, and data analysis produced five themes. These themes include interests, knowledge, skills, values, and attitudes. These five themes reflect the experiences of Smart ABA therapists who are competent in treating children with ASD. Personal interests, the depth of knowledge they possess, the specific skills they possess, the values ​​they uphold in their practice and their overall attitude toward therapy are all included in these themes. The following is an explanation of each theme:

Interest

A key interest for Smart ABA therapists in working with children with ASD, driving increased skills and effectiveness of therapy. Interest also increases therapists' awareness of continuing to improve their competencies (Attwood, 2020; Dover & Le Couteur, 2007; Hurt et al., 2013). Just like therapists, the teachers for children with special needs are professionals in treating ASD. They must recognize the importance of personal development to enhance competencies for effectively identifying and supporting ASD students in their learning (Sakarneh et al., 2023). The success of the intervention depends on the therapist's awareness and interest in the child's specific needs. Bruns and Mogharreban (2007) understanding the characteristics of children with special needs and effective teaching strategies is crucial for acceptance.  Second and third informants from the start had an interest and enthusiasm for working with children with ASD, while first informant fone initially had no special interest. However, after training and deepening the knowledge of ASD child therapy, the interest has been reported to grow. A strong interest in employment as an ASD child therapist can be the impetus that encourages therapists to develop their competence in providing effective services for ASD children. This is according to the following interview excerpts.

At first, I didn't like children, but after training, I became interested in children with ASD (Informant 1). Since college, I have started teaching children (Informant 2).  I love teaching work (Informant 3).

Knowledge

 Informants agreed that ongoing training and internships are essential for understanding Smart ABA methods. These enhance their knowledge, skills, and effectiveness in providing therapy for children with ASD. A lack of knowledge about effective instructional strategies may result in negative attitudes (Sze, 2009). Ongoing training and internships from KID-ABA Autism Center keep therapists updated with the latest ASD therapy methods. During the pandemic, they also received online seminars and discussions to enhance their skills. The study's results explain that Behavioral skills training for prospective ASD therapists between In-person training and Telehealth using communication technology is equally effective and efficient in increasing knowledge (Sump et al., 2018). Here is an excerpt from an interview with an informant:

"Wow, it is interesting to know about Smart ABA (Informant 1)."It is essential to know how to equip myself to train ASD children in the future. (Informant 2). It's really important, if I don't have the knowledge, how can I be able to teach the students” (Informant 3).

Skills

Informants highlighted that quality training and internships are crucial for developing ASD therapy skills in Indonesia, ensuring effective use of the Smart ABA method and adherence to SOPs. Ongoing training and internships are essential to enhance the therapist's skills (Ingersoll et al., 2020). Support from the KID-ABA Autism Centre helps them keep up with the latest developments and improve the quality of therapy services. The skills obtained by therapists are not only from face-to-face training but also through long-distance communication media such as the method developed by Sump et al. (2018). According to Canon and Gould (2022), training beyond standard technical skills is essential for trainers and supervisors to enhance practitioner performance using efficient and socially acceptable methods.

Training

Smart ABA therapists undergo structured training, starting with theory exams and progressing to simulations and practical exams as assistants. According to Sump et al. (2018), a therapist's competence will be improved by training in maintaining and using the skills gained. Proper technique in Smart ABA training is essential, as incorrect methods can lead to children mastering wrong concepts, making corrections harder (Anwar et al., 2022). Continuous training enhancing therapist skills is critical to ASD teaching strategies.

Stages of Training to Become a Smart ABA Therapist

Smart ABA therapist training follows structured stages. It begins with memorizing 27 theory questions-answers for an oral exam, followed by three days of material, simulation, and practice. Trainees then enter simulator sessions, observe senior therapists, and participate in guided simulations. They progress through stages of assessment, prompting, and assisting therapy under supervision. The final stage involves independently conducting graded therapy sessions over 30 days. During each stage of training, prospective therapists were accompanied by two senior therapists and Smart ABA trainers (Sutadi, 2018). Graduated therapists can conduct Smart ABA therapy sessions independently with other therapists on duty at the time. The key to success is equal ability between therapist and assistant therapist. The time it takes to reach therapist status varies for everyone, and interview excerpts can be seen in Table 2.

Obstacles During Training

During the training, one informant encountered obstacles due to a lack of collaboration from senior therapists but remained determined to improve the situation for others. The other two informants had smoother experiences, reflecting improved conditions. These experiences underscore the importance of the training environment in preparing therapists to work with children with ASD. Smart ABA training should be provided to parents of children with ASD, as they spend more time with their children than therapists do. According to Ingersoll et al. (2020) ABA service owner with more years of experience working with children with ASD were likelier to use parent training. Parent training faced challenges, including difficulty engaging working families and a lack of skills among parents to support ASD treatment. Additionally, not all ABA services offer training for parents. Collaboration and knowledge sharing among therapists are essential for enhancing training quality and preparing competent professionals to treat children with ASD (Sutadi et al., 2022). Interview excerpts can be seen in Table 1.

Obstacles During the Implementation of Therapy

Smart ABA therapists encounter challenges during sessions, such as managing complex behaviors and unexpected situations with children with ASD. Their ability to adapt, think creatively, and provide effective feedback is crucial for successful therapy outcomes. Parental involvement in home therapy is key to success for children with ASD, but many still don't understand it, this is in line with Ingersoll’s research (Ingersoll et al., 2020). Therapists overcome obstacles by combining training knowledge, practical experience, and evaluation as needed. Collaboration with a team of therapists, supervisors, program directors, physicians, and consultants also increases the effectiveness of therapy. Smart ABA therapists need to continue to develop skills through experience, reflection, and periodic training to improve effective therapy services for children with ASD.

Table 1. Themes Pertaining to the Experiences of Proficient Smart ABA Therapists in Conducting Therapy for Children with ASD

Value

Religiosity and competence are essential for Smart ABA therapists to implement Smart ABA therapy sessions. Religiosity provides strength and inspiration, while competence ensures effective and efficient understanding and application of Smart ABA therapy methods. The integration of religious values with the knowledge and skills of the therapist allows the provision of comprehensive therapy focused on the recovery of the child with ASD. Research conducted by Firdaus and Rasyidah (2022) to describe therapists’ work satisfaction for children with special needs shows that the greatest motivation of therapists is a sense of humanity and concern for children with special needs. The value that therapists have in carrying out this work involves quite a lot of emotion, a lot of patience, and having a good personality. The company provides freedom of worship and high rewards to Smart ABA therapists. It provides job satisfaction to informants and improves their performance in treating ASD children. Religiosity, competence, and reasonable compensation help them overcome challenges on the job and support the recovery of ASD children as well as the success of ASD children in attending regular schools. The above explanation is conveyed by the informant in the following interview excerpt:

"The key is religiosity and competence because these two values will be interrelated; competence without good religiosity, people will tend to be irresponsible; religiosity without competence, people will not work according to the rules.  And I will be accountable for my work to God" (Informant 1)". "Religiosity is very important so that I am trusted as a child therapist for ASD, as well as competence. This is work in addition to accountability in the world and my accountability to God later. Do not let me stumble later because I treat ASD children unkindly" (Informant 2). "Religiosity must also be competent; without good religiosity, someone cannot work responsibly; it could be just because of the money factor alone doing a job. Think about how we will be held accountable by God. Without the competence of Smart ABA therapists, it will be difficult to carry out therapy” (Informant 3).

Attitude Confronting Behaviors of ASD Children

In dealing with ASD children's behaviors such as tantrums, spitting, grabbing, hitting, yelling, and damaging Smart ABA therapists' belongings, informants apply systematic, structured, measurable, and consistent Smart ABA techniques to address the situation. The informants recognized the importance of maintaining their emotional balance when performing therapy on ASD children. Religiosity and support from fellow therapists, supervisors, program directors, doctors, and consultants help cope with stress and maintain mental well-being. Quality training facilities, material compensation such as salary, holiday allowance, incentives, housing, and daily necessities provided by the Company encourage Smart ABA therapists' motivation in carrying out therapy sessions. Interview excerpts can be seen in Table 2.

Inappropriate Treatment by Therapists Treating Children With ASD

Some ASD children receive poor treatment from therapists. This bad treatment includes children being ridiculed, shouted at, pinched until they are weak, hit hard, pushed, and even the child is scolded with bad words, as in research conducted  (2023) and Restina and Mardiawan (2017). Conversely, Smart ABA therapists do not tolerate physical or verbal abuse of children with ASD or other children with special needs. They have been trained with Smart ABA techniques to address the behavior of ASD children, and the main principle of Smart ABA is that there is no violence against ASD children. The KID-ABA Autism Center provides Closed Circuit Television as a control to supervise therapists and allow parents to view live therapy sessions. CCTV is also used to evaluate and take appropriate measures. The existence of CCTV shows the institution's commitment to maintaining the professionalism and quality of therapy services. Violence occurs in children with ASD or children with special needs, according to all informants, is due to a lack of religiosity, knowledge, competence, and skills in carrying out therapy in children with ASD.

Burnout is one of the reasons therapists exhibit poor treatment towards children with special needs. According to research conducted by Samsuddin (2013), one aspect of burnout visible from an emotional perspective is the emergence of annoyance or emotion. This can cause therapists to become irritable because they feel stressed and fed up with the monotonous work system. At the KID-ABA Autism Center, there are clear SOPs regarding therapist feedback on ASD children's responses during therapy sessions. This SOPs guarantees that therapists are non-violent. The therapist gives instructions in a neutral and flat tone, without emotion. In addition, therapists work in pairs with a therapist's assistant to maintain emotional stability. All informants also underlined that if a teacher or therapist mistreats our child, we will not accept it.

Table 2: Themes Concerning the Experiences of Smart ABA Therapists Adept in Providing Therapy for Children With ASD Pertains to Attitude
Themes Concerning the Experiences  of Smart ABA Therapists Adept in Providing Therapy for Children With ASD  Pertains to Attitude

Results of Smart ABA Implementation by Competent Therapists for Children with ASD

It is important for Smart ABA therapists to possess good competence and experience in treating children with ASD, as this can influence the success of therapy. Five parents of children with ASD who were treated using Smart ABA participated in providing information about the progress of their children, who were treated by the three informants.  Table 3 displays information from five parents of children with ASD who participated in this study.

Table 3: Results of Smart ABA Therapy Carried Out by Informants
Results of Smart ABA Therapy  Carried Out by Informants
Note. Com. = Communication; M = Month/s; W = Weeks.

Information from the five parents of children with ASD mentioned above aged between five and seven years, who have undergone Smart ABA therapy. One of the five children in the initial assessment (subject D) demonstrated the ability to imitate or repeat the therapist's speech. After undergoing Smart ABA therapy for 40 hours per week, there was an increase in the five children in indicators of speaking ability, including the ability to imitate words or sentences and answer simple questions. Additionally, all five subjects were able to sit independently without refusal, completed 80% of the therapy program, and then entered regular school. The time required for each subject to reach these indicators varied. By the 24th month, all subjects were able to be said to attend regular classes. This information shows that the supporting factors for the success of Smart ABA therapy are also backed by early diagnosis as the goal of intensive early intervention. If autistic children are treated too late, it will cause problems with language, cognitive and social functioning, which will result in autistic children being even further behind compared to children of a similar age (Soedita, 2019).

Discussion

Carrying out therapy for children with ASD is the same as teachers teaching children who are not ASD, starting with teachers who have competence, because if they do not have competence, what will they teach their students. Teachers who teach non-ASD children need competence, especially therapists for ASD children, of course, must have competencies related to how to teach ASD children. This is in line with the study of therapeutic competence conducted by Easden and Fletcher (2020), which states that improving the therapist's competence will increase the therapy's success. The competence of the therapist before carrying out therapy for children with ASD is imperative and very important for the implementation of therapy and its success (Linsao et al., 2023).

Interest in therapy for ASD children is also essential. However, in this study, one of the therapists was initially not very interested, but after following the training he became very interested and then carried out his role as a Smart ABA therapist. The knowledge and understanding gained through ongoing training and internships for Smart ABA therapists is very important for the basics of therapists in carrying out therapy later. In tiered training, knowledge and various techniques are given to teach ASD children to have competence as a basis or provision to become a therapist for ASD children, even though it takes a long time. According to Cooper et al. (2017), therapist training requires a long time; continuous training is also needed to maintain therapist skills and competencies. According to Hasanah and Alivia (2023), teachers of children with special needs should have skills gained from education and training, work experience, support and collaboration, physical and social environment, and availability of resources. If not, there can be unwanted things, such as violence against children (Nurhasanah, 2023; Restina & Mardiawan, 2017). Values in competence religiosity factors play an essential role for ASD child therapists, with the religiosity of Smart ABA therapists realizing that their work is Amanah (entrusted from God), supervised and seen by God, which will later be accounted for. Khaerunnisa et al. (2019), teachers who have memorized the Qur'an find it easier to carry out their emotional regulation and apply good emotional regulation strategies during teaching activities. Burnout in ABA practitioners is expected, so it is essential to know the cause and address this problem; environmental influences can be the initial factor that must be considered to reduce burnout symptoms (Brashear, 2023). Following emotion regulation without good emotional regulation, ASD child therapists will find it challenging to teach ASD children. In Restina and Mardiawan's research (2017), the findings indicate that educators in specialized educational institutions exhibited discourteous behavior when agitated with students, including instances of snapping, verbal outbursts employing profanity, physical interventions during tantrums, and assigning derogatory labels to students. Therapist dissatisfaction with children diagnosed with Autism Spectrum Disorder may stem from various factors, such as ambiguous job directives and obligations, lack of discernible progress in children's development, and feelings of being overwhelmed (Kurniawan, 2016; Otto et al., 2021; Situngkir, 2018).

Obstacles in the implementation of Smart ABA therapy are challenges faced by therapists. However, therapists can overcome such obstacles with good competence and support from supervisors, program directors, and consultants. One obstacle is parental non-compliance in therapy and following expert advice. The success of therapy and parental involvement brings happiness and eliminates fatigue for the therapist. According to Novack and Dixon (2019), good cooperation from parents in adherence to therapy and the result of therapy is an essential priority for therapists in overcoming burnout. Spirituality in the workplace has a good impact on the therapist’s performance and satisfaction. The company allows therapists to worship and facilitates them in worship. Smart ABA therapists are satisfied with income and facilities that exceed their expectations, which encourages their enthusiasm for dealing with children with ASD. Those ASD children, who successfully attend regular schools and can read the Quran for Muslims become evidence of the effectiveness of Smart ABA for ASD, be an encouragement for Smart ABA therapists. Quality training, supervision, salary, opportunities to advance, and praise enable therapists to work well, increasing job satisfaction (Kazemi et al., 2015). This research was only conducted on three Smart ABA therapists in Indonesia. Further research can be carried out with more therapists and from outside Indonesia. The implications of the research for enhancing therapist competence in practice and training for effective interventions for children with ASD.

Limitations and Suggestions

This study was conducted in Indonesia on three Smart ABA therapists. This study can be continued with therapists from various cultures. In addition, a more quantitative based investigation is appropriate in future studies to examine the interplay of diverse factors that could influence the efficacy of Smart ABA therapists.

Implications

This article shows that the experience and competent strategies of Smart ABA therapists are essential in treating children with autism. The main implication is the need for ongoing training and team support to improve the effectiveness of therapy. In addition, an adaptive approach can help overcome challenges faced in the therapy process.

Conclusion

This study highlights the effectiveness of Smart ABA therapists, whose skills resulted in significant progress in children with ASD. Key achievements included transforming nonverbal children into communicative individuals. Attributes such as knowledge and emotional regulation were critical to success, supported by strong supervision. These findings offer valuable insights for therapists, but further research is needed to address cultural variations.

References

Alase, A. (2017). The Interpretative Phenomenological Analysis: A guide to a good qualitative research approach. International Journal of Education and Literacy Studies, 5(2), 9.

Amichai-Hamburger, Y., Klomek, A. B., Friedman, D., Zuckerman, O., & Shani-Sherman, T. (2014). The future of online therapy. Computers in Human Behavior, 41(1), 288-294. https://doi.org/10.1016/j.chb.2014.09.016

Anwar, A., Barokah, A., Widiya, I., Jam’ah, M., & Siagian, S. B. (2022). Factors affecting religious and social life of the community and worship activities in Simonis Village, Aek Natas Sub-district, North Labuhanbatu Regency. Journal of Educational Psychology, 5(10), 4015-4019. https://doi.org/10.54371/jiip.v5i10.1001

Anwar, A., Sutadi, R., & Miranda, C. (2022). Development of discrete trial training procedure in smart applied behavior analysis for autism. Journal of Psychology and Behavior Studies, 2(1), 63-44. https://doi.org/10.3299 6/jpbs.2022.2.1.7

Appah, J., Senoo-Dogbey, V. E., Armah, D., Wuaku, D. A., & Ohene, L. A. (2024). A qualitative enquiry into the challenging roles of caregivers caring for children with Autism Spectrum Disorders in Ghana. Journal of Pediatric Nursing, 76, 23-29. https://doi.org/10.1016/j.pedn.2024.01.029

Arneliza, A., Adetya, S., Muti, R., Sutadi, R., & Rahayu, A. (2025). Experiences among doctors who have autistic children in obtaining diagnosis and therapy. Current Psychology Research.

Attwood, T. (2020). Working with individuals on the spectrum. In B. G. Englewood (Ed.). A Spectrum of Solutions for Clients with Autism: Treatment for Adolescents and Adults, (pp. 3-13). https://doi.org/10.4324 /9780429299391-1

Bethin, K. E., Kanapka, L. G., Laffel, L. M., Majidi, S., Chaytor, N. S., MacLeish, S., Adams, R., & Foster, N. C. (2019). Autism spectrum disorder in children with Type 1 diabetes. Diabetic Medicine, 36(10), 1282-1286. https://doi.org/10.1111/dme.14069

Bommangoudar, J. S. (2018). Management of autistic patients in dental office: A clinical update. International Journal of Clinical Pediatric Dentistry, 11(3), 219-227. https://doi.org/10.5005/jp-journals-10005-1515

Brashear, D. (2023). Causes and ways to combat burnout in ABA. https://manhattanpsychologygroup.com/finding-the-light-after-the-burnout/

Bruns, D. A., & Mogharreban, C. C. (2007). The gap between beliefs and practices: Early childhood practitioners’ perceptions about inclusion. Journal of Research in Childhood Education, 21(3), 229-241.

Canon, L. F., & Gould, E. R. (2022). A Preliminary analysis of the effects of clicker training and verbal instructions on the acquisition of relationship-building skills in two applied behavior analysis practitioners. Behavior Analysis in Practice, 15(2), 383-396. https://doi.org/10.1007/s40617-021-00555-x

Castonguay, L., Youn, S. J., Xiao, H., & McAleavey, A. (2018). The therapeutic relationship: A warm, important, and potentially mutative factor in cognitive-behavioral therapy. (pp. 157-179).

Chen, F., Wang, L., Peng, G., Yan, N., & Pan, X. (2019). Development and evaluation of a 3-D virtual pronunciation tutor for children with autism spectrum disorders. PLOS ONE, 14(1), e0210858.

Cooper, Z., Doll, H., Bailey-straebler, S., Bohn, K., Vries, D. De, Murphy, R., Connor, M. E. O., & Fairburn, G. (2017). Assessing therapist competence : Development of a performance-based measure and its comparison with a web-based measure corresponding author. Journal of Mental Health, 4. https://doi.org/10.2196/mental.7704

Creswell, J. W. (2013). Qualitative inquiry and research design: Choosing among five approaches. SAGE Publications.

Creswell, W. J., & Poth, Cheryl, N. (2018). Qualitative inquiry & research design: Chose among five approaches, (4th ed.). Sage Publications, Inc.

Dobson, K. S. (2022). Therapeutic relationship. Cognitive and Behavioral Practice, 29(3), 541-544. https://doi.org/10.1016/j.cbpra.2022.02.006

Dover, C. J., & Le Couteur, A. (2007). How to diagnose autism. Archives of Disease in Childhood, 92(6), 540-545.

Easden, M. H., & Fletcher, R. B. (2020). Therapist competence in case conceptualization and outcome in CBT for depression. Psychotherapy Research, 30(2), 151-169.

Edison, E., Anwar, Y., & Komariyah, I. (2022). Human resource management: Strategies and changes to improve employee and organizational performance. Sage Publications.

Eikeseth, S. (2010). Examination of qualifications required of an EIBI professional. European Journal of Behavior Analysis, 11(2), 239-246. https://doi.org/10.1080/15021149.2010.11434348

Firdaus, M. M., & Rasyidah, U. I. (2022). Job satisfaction of therapists for children with special needs. Happiness, Journal of Psychology and Islamic Science, 6(1), 21-28.

Granpeesheh, D., Tarbox, J., Dixon, D. R., Peters, C. A., Thompson, K., & Kenzer, A. (2010). Evaluation of an eLearning tool for training behavioral therapists in academic knowledge of applied behavior analysis. Research in Autism Spectrum Disorders. https://doi.org/10.1016/j.rasd.2009.07.004

Hasanah, U., & Alivia, B. (2023). Classroom teachers’ emotional regulation in dealing with children with special needs. Idea: Journal of Psychology, 7(1), 65-74.

Hillman, J. (2006). Supporting and treating families with children on the autistic spectrum: The unique role of the generalist psychologist. Psychotherapy, 43(3), 349-358. https://doi.org/10.1037/0033-3204.43.3.349

Hodges, H., Fealko, C., & Soares, N. (2020). Autism spectrum disorder: Definition, epidemiology, causes, and clinical evaluation, 9(8). https://doi.org/10.21037/tp.2019.09.09

Hurt, A. A., Grist, C. L., Malesky, L. A., & Mccord, D. M. (2013). Personality traits associated with occupational burnout in aba therapists. Journal of Applied Research in Intellectual Disabilities, 26(4), 299-308. https://doi.org/10.1111/jar.12043

Husserl, E. (1965). Phenomenology and the crisis of philosophy: Philosophy as a rigorous science, and Philosophy and the crisis of European man. Harper & Row.

Ingersoll, B., Straiton, D., & Caquias, N. R. (2020). The role of professional training experiences and manualized programs in ABA providers’ use of parent training with children with autism. Behavior Therapy, 51(4), 588-600. https://doi.org/10.1016/j.beth.2019.09.004

Jones, E. J. H., Gliga, T., Bedford, R., Charman, T., & Johnson, M. H. (2014). Developmental pathways to autism: A review of prospective studies of infants at risk. Neuroscience and Biobehavioral Reviews, 39(1), 1-33. https://doi.org/10.1016/j.neubiorev.2013.12.001

Julimet, N., & Cholid, S. (2017). Training for autism therapy using the Applied Behavior Analysis (ABA) method: A case study on the autism therapy training process at class I Tangerang Correctional Institution. Journal of Social Sciences, 16(2).

Kazantzis, N., & Dobson, K. S. (2024). Therapeutic relationships in cognitive behavioral therapy: Agreement in alliance, client factors, therapist factors, and CBT specific processes. Psychotherapy Research, 1-3.

Kazemi, E., Shapiro, M., & Kavner, A. (2015). Predictors of intention to turnover in behavior technicians working with individuals with autism spectrum disorder. Research in Autism Spectrum Disorders, 17(1), 106-115. https://doi.org/10.1016/j.rasd.2015.06.012

KBBI Kamus Besar Bahasa Indonesia. (2016). Têrapis. Badan Pengembangan Dan Pembinaan Bahasa. https://kbbi.kemdikbud.go.id/ entri/terapis

Khaerunnisa, E., Rafianti, I., Pamungkas, A. S., Pujiastuti, H., & Setiani, Y. (2019). Development of a Content management system for mathematics learning tools of mathematics pre service teachers. Formative: Scientific Journal of Mathematics and Natural Sciences Education, 9(2). https://doi.org/10.30998/formatif.v9i2.2978

Kurniawan, K. (2016). Job satisfaction for therapists in treating children with special needs. Scientific Journal of Psychology, 4(3), 414-421.

Linsao, A. W., McKiernan, P. M., & Morgan, S. M. (2023). Mental health providers’ perceptions of competency when working with autistic children with co‐occurring mental health diagnoses. Journal of Community Psychology, 51(5), 2026-2034. https://doi.org/10.1002/jcop.2 2994

Lord, C., McCauley, J. B., Pepa, L. A., Huerta, M., & Pickles, A. (2020). Work, living, and the pursuit of happiness: Vocational and psychosocial outcomes for young adults with autism. Autism, 24(7), 1691-1703. https://doi.org/10.1177/1362361320919246

Luiselli, J. K., Amand, C. S., Magee, C., & Sperry, J. M. (2008). Group training of applied behavior analysis knowledge competencies to community-based service providers for adults with developmental disabilities. Journal of Mental Health, 4(1), 41-47.

Maenner, M. J., Warren, Z., Williams, A. R., Amoakohene, E., Bakian, A. V., Bilder, D. A., Durkin, M. S., Fitzgerald, R. T., Furnier, S. M., Hughes, M. M., Ladd-Acosta, C. M., McArthur, D., Pas, E. T., Salinas, A., Vehorn, A., Williams, S., Esler, A., Grzybowski, A., Hall-Lande, J., … Shaw, K. A. (2023). Prevalence and characteristics of autism spectrum disorder among children aged 8 years: Autism and developmental disabilities monitoring network, 11 sites, United States. Surveillance Summaries, 72(2), 1-14. https://doi.org/10.15585/mmwr.ss7202a1

Miles, M. B., Huberman, A. M., & Saldana, J. (2013). Qualitative data analysis: A methods sourcebook. SAGE Publications.

Moustakas, C. (1994). Phenomenological research methods. SAGE Publications Ltd.

Novack, M. N., & Dixon, D. R. (2019). Predictors of Burnout, job satisfaction, and turnover in behavior technicians working with individuals with autism spectrum disorder. Review Journal of Autism and Developmental Disorders, 6(4), 413-421. https://doi.org/10.1007/s40489-019-00171-0

Nurhasanah, N. (2023). Emotional regulation in teachers of children with special needs. Da’wa: Journal of Islamic Guidance, Counseling & Guidance, 2(2), 212-228.

Otto, M. C. B., Van Ruysseveldt, J., Hoefsmit, N., & Van Dam, K. (2021). Investigating the temporal relationship between proactive burnout prevention and burnout: A four-wave longitudinal study. Stress and Health, 37(4), 766-777.

Pickles, A., McCauley, J. B., Pepa, L. A., Huerta, M., & Lord, C. (2020). The adult outcome of children referred for autism: Typology and prediction from childhood. Journal of Child Psychology and Psychiatry and Allied Disciplines, 61(7), 760-767. https://doi.org/10.1111/jcpp.13180

Restina, A. Z., & Mardiawan, O. (2017). Descriptive study regarding emotion regulation in teachers at slb abcd x bandung city. Psychology Proceedings, 3(1), 78-90.

Sakarneh, M. A., Ziadat, A. H., Almakahleh, A. A., Rababah, M. A., Alhassan, A. H., Al-Muhairat, L. A., & Al-Rababah, H. A. (2023). Socio-educational competencies required for teachers of students with autism spectrum disorder: Parents’ perspective. The Education and Science Journal, 25(5), 176-194.

Savitri, A. I., & Salam, N. E. (2020). Therapeutic communication between therapists and autistic patients using the smart aba technique at the brilliant autistic children’s therapy center in Pekanbaru. Journal of Communication Science, 9(2), 479-492.

Schenk, K., Weimer, A. A., & Warnell, K. R. (2023). Assessing child life specialists’ management of challenging behaviors in autistic pediatric patients. Journal of Autism and Developmental Disorders, 44(1), 68-80. https://doi.org/10.1007/s10803-023-06032-4

Sergi, L., Mingione, E., Ricci, M. C., Cavallaro, A., Russo, F., Corrivetti, G., Operto, F. F., & Frolli, A. (2021). Autism, therapy and covid-19. Pediatric Reports, 13(1), 34-42.

Simatupang, M., Muharsih, L., Barus, D. A., & Ratnaningtyas, A. (2022). Is job embeddedness able to mediate institutional support on employee performance? Prima Psychology Journal, 5(2), 222-230.

Situngkir, D. (2018). Description of work stress for autism therapists at the autism children’s therapy foundation in Medan Baru sub-district in Medan. Indonesian Scientific Forum, 15(1), 78-90.

Soedita, M. M. (2019). Report on handling autistic children using the smart-applied behavior analysis method at KID-ABA Bekasi. Early Childhood Education Teacher Education Proceedings, 5(2).

Sump, L. A., Richman, D. M., Schaefer, A. M., Grubb, L. M., & Brewer, A. T. (2018). Telehealth and in‐person training outcomes for novice discrete trial training therapists. Journal of Applied Behavior Analysis, 51(3), 466-481. https://doi.org/10.1002/jaba.461

Sutadi, R. (2018). Teaching and Training Speech and various abilities in people with autism with Smart ABA. PT Smart Medika Pro.

Sutadi, R., Anwar, A., & Miranda, C. (2022). Effectiveness of smart applied behavior analysis intervention in teaching non-verbal autism to speak and read. Journal of Psychology and Behavior Studies, 78-95. https://doi.org/10.32996/jpbs.2022.2.1.8

Symes, M. D., Remington, B., Brown, T., & Hastings, R. P. (2006). Early intensive behavioral intervention for children with autism: Therapists’ perspectives on achieving procedural fidelity. Research in Developmental Disabilities, 27(1), 30-42.

Sze, S. (2009). Learning style and the special needs child. Journal of Instructional Psychology, 36(4), 78-88.

The National Institute of Mental Health. (2018). Autism Spectrum Disorder. https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd

Van Laarhoven, T., Stekelenburg, J. J., Eussen, M. L., & Vroomen, J. (2020). Atypical visual-auditory predictive coding in autism spectrum disorder: Electrophysiological evidence from stimulus omissions. Autism, 24(7), 1849-1859. https://doi.org/10.1177/1362361320926061

Vuattoux, D., Castiglia, D., & Chabane, N. (2021). Considerations and perspectives on interventions to improve social cognition in adolescents with ASD and without ASD: Involving parents in social skills groups. Frontiers in Psychiatry, 12, 1-6.

Wang, M., & Yang, N. (2022). Observational therapy-assistance neural network for enhancing autism intervention quality. Proceedings of IEEE Consumer Communications and Networking Conference. https//doi.org/10.1109/CCNC49033.2022.9700714

Received 28 August 2023
Revision received 26 May 2024           

How to Cite this paper?


APA-7 Style
, A., Rahmawati, S., Sutadi, R., Alsa, A., Yunanto, K.T. (2025). Experiences and Strategies of Competent Smart ABA Therapists in Treating Children with Autism. Pakistan Journal of Psychological Research, 40(2), 351-372. https://doi.org/10.33824/PJPR.2025.40.2.21

ACS Style
, A.; Rahmawati, S.; Sutadi, R.; Alsa, A.; Yunanto, K.T. Experiences and Strategies of Competent Smart ABA Therapists in Treating Children with Autism. Pak. J. Psychol. Res 2025, 40, 351-372. https://doi.org/10.33824/PJPR.2025.40.2.21

AMA Style
A, Rahmawati S, Sutadi R, Alsa A, Yunanto KT. Experiences and Strategies of Competent Smart ABA Therapists in Treating Children with Autism. Pakistan Journal of Psychological Research. 2025; 40(2): 351-372. https://doi.org/10.33824/PJPR.2025.40.2.21

Chicago/Turabian Style
Arneliza, Siti Rahmawati, Rudy Sutadi, Asmadi Alsa, and Kuncono Teguh Yunanto. 2025. "Experiences and Strategies of Competent Smart ABA Therapists in Treating Children with Autism" Pakistan Journal of Psychological Research 40, no. 2: 351-372. https://doi.org/10.33824/PJPR.2025.40.2.21