What is The Center for Autism Treatment?
The Center for Autism Treatment, Inc. (The Center) is a company created in 2007 to meet the needs of families who have children with autism. Our mission is to provide the best possible services for children with autism spectrum disorders using methods and procedures that have been proven effective through research and real world application. The Center provides highly trained Behavioral Treatment Therapist (Senior) and Behavioral Treatment Technicians (Line staff), all of whom are supervised by a Board Certified Behavior Analyst (BCBA) Licensed Supervisor.
What services does The Center provide?
The Center provides Applied Behavior Analytic (ABA) therapy services with emphasis on Skinner’s analysis of verbal behavior to children who have been diagnosed with autism spectrum disorders. ABA therapy services include Intensive and Non-Intensive services funded through private insurance, and Comprehensive and Focused services funded through ForwardHealth/Medicaid. The Center also provides specially designed Social Opportunities, Consultative Services, Individualized Workshops, and Specialized Trainings including Toilet Training.
The Center also provides individualized workshops and trainings for schools, families, and other agencies.
What is ABA?
Applied Behavior Analysis is the science of studying behavior and applying data-supported techniques to increase and/or decrease behaviors that are meaningful to the client and the client’s social environment. The field of ABA seeks to:
Ø Define behavior in objective and measurable terms
Ø Examine the relationship between a behavior and its controlling variables
Ø Analyze socially significant behaviors that are in need of improvement
Ø Study behavior through a three-term contingency
Why do we use ABA?
Ø ABA-based approaches for educating children with autism and related disorders have been extensively researched and empirically supported.
Ø Application of behavior analytic strategies for treatment of children with autism is the most highly documented effective treatment.
Ø The Surgeon General of the United States of America noted that thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior in children with autism.
Ø The following agencies state that ABA-based procedures represent best practices for individuals with autism and mental retardation (Hagopian and Boelter, 2006):
o National Institute of Mental Health
o National Institute of Child Health and Human Development
o National Academy of Sciences (Committee on Educational Interventions for Children with Autism)
o American Psychological Association (Division 33; “Guidelines on Effective Behavioral Treatment for Persons with Mental Retardation and Developmental Disabilities”)
o Association for Science in the Treatment of Autism
o California Department of Developmental Services
o Florida State Department of Children and Families
o Maine Administrators of Services for Children with Disabilities
Ø Current research demonstrates that eclectic approaches are less effective. Several studies (Ditza Zachor and colleagues, 2005; Svein, Eikeseth and colleagues, 2002; Janet Howard and colleagues, 2005) compared the use of ABA-based procedures to ‘‘eclectic’’ treatment. At follow-up, the children receiving the non-eclectic Applied Behavior Analysis program scored higher and had made more progress than the children in the other groups in areas of language, communication, social skills, independence, and reduction of problem behaviors.
What is verbal behavior programming?
Verbal behavior programming places focus on the principles of ABA and uses proven teaching procedures within the field of ABA based on:
Ø B.F. Skinner’s Verbal Behavior as a guide to the classification of language
Ø The application of Skinner’s work by Michael, Sundberg, Partington, Carbone, McGreevy, and others
Ø The following conceptual frameworks:
o Functional Assessment: Treatment of problem behavior is based on identifying the causes and consequences of behavior. By looking at what happens before and after a child demonstrates a behavior, it is possible to understand why a behavior continues to occur and to develop a plan to change the situation and thereby change the behavior.
o Motivative Operations: Careful attention is given to the environmental situations and actions of others that encourage or discourage a child in his or her learning and behavior.
o Matching Theory: The child’s learning is our responsibility, and we need to use teaching methods that promote cooperation and learning so that the child enjoys learning and wants to stay in the teaching environment with us.
o Functional Communication Training: Emphasis is placed on teaching the child to communicate effectively in his or her environment.
What is the ABLLS? What is the ABLLS-R?
The ABLLS is The Assessment of Basic Language and Learning Skills developed by Mark Sundberg and Jim Partington. It has been revised by Jim Partington and is called the ABLLS-Revised. The ABLLS/ABLLS-R is an Assessment, Curriculum Guide, and Skills Tracking System that:
Ø Assesses child’s level in 25 different areas
Ø Documents progress
Ø Aids in development of treatment goals
How does verbal behavior programming differ from “Lovaas Therapy”?
Ø Training is initiated by teaching functional communication-requesting (manding)
Ø Early skills are taught in natural settings (natural environment training)
Ø The following teaching procedures are utilized:
1. Pair teaching environments with reinforcement (make them fun)
2. Start with easy responses
3. Use errorless teaching (reduce the number of errors the child makes when learning)
4. Intersperse easy and difficult responses
5. Work quickly
6. Mix and vary responses
7. Teach until fluent (the child can perform quickly and correctly)
How many hours a week will I have therapists in my home? How is the therapy time divided?
The Center’s goal is to maximize direct intervention hours while maintaining quality supervision. A clinical recommendation is made by the lead therapist regarding the appropriate number of treatment hours for each child.
Each therapy shift will typically last 2-3 hours. This time is divided between teaching around the house (natural environment training-NET), structured teaching (intensive table teaching-ITT), and community practice. During each shift, the therapist will also need time to review notes, set up the teaching environments, and document progress toward goals.
What information do I need to provide to the Center?
In order to be able to secure authorization for your child’s treatment, The Center requires the following documentation:
Ø The most recent diagnostic report for you child and any other previous diagnostic reports.
Ø Results of age-normed, standardized testing of your child’s cognitive ability, language skills, and adaptive skills. This testing may have been conducted as part of your child’s diagnostic evaluation or a part of an IEP or IFSP evaluation.
Ø Current IFSP (birth-3) or IEP (school)
Prescription for treatment from your pediatrician and medical evaluation that has occurred within the last 12 months. The prescriber must be a Medicaid provider. The Center will provide the forms for these requirements.
Everyone coming into my home has a different title. What do these all mean?
Each child in the program will receive the services of the Board Certified Behavior Analyst (BCBA) Licensed Supervisor, a Behavioral Treatment Therapist (Senior), and 2-5 Behavioral Treatment Technicians (Line Staff).
The Licensed Supervisor consults to you and the team, directs treatment, assists in the development of goals, assesses and tracks progress, helps the team problem solve and refine direction and approach, and maintains accountability. The Licensed Supervisor confers with the Treatment therapist at least weekly and works with the child, treatment therapist, and one or more treatment technicians at least every two months.
The Treatment Therapist is an extension of the Licensed Supervisor and works with your child, family, and other team members 2-5 hours per week. The Treatment Therapist conducts the ABLLS/ABLLS-R Assessment, develops and implements a treatment plan, establishes and maintains the treatment book,
assists with scheduling, assists in the development and maintenance of house rules, facilitates team meeting, tracks progress, and serves as communication liaison between parents and The Center’s staff.
Treatment technicians are trained and directly supervised by the Licensed Supervisor and Treatment Therapist. They will provide the bulk of your child’s treatment hours. Treatment technicians implement therapy protocols as directed by the Licensed Supervisor and Treatment Therapist and document progress toward those goals.
What can I expect from an intensive in home program?
Ø This work will be time consuming.
Ø I will be an active participant in my child’s growth.
Ø My child may have therapy for up to 40 total hours a week.
Ø I may need to prioritize my child’s treatment.
Ø Initially, therapists will spend time on fun activities with my child with very few teaching trials (pairing).
Ø My child will improve his ability to communicate.
Ø My child may sometimes cry.
Ø I will learn ways to respond to my child’s problem behavior.
Ø Sometimes I will need to confront behaviors rather than avoid them.
Ø A lot of people will be in my house.
Ø Therapists will be working with my child at a table and around the house and yard.
Ø There will be community outings involving therapists, my child, and me.
Ø Despite the best laid plans, people cancel.
Ø Progress takes documentation.
Ø I will be expected to follow through on behavior intervention plans, self-help skills, contriving opportunities to request, etc.
Ø My child will be more independent in daily routines.
Ø My child may not “recover” in three years.
Ø My child will learn.
Ø I am my child’s most important teacher.