FAQ

What is an interdisciplinary team?

An interdisciplinary team is a treatment team composed of therapists from different disciplines, who work together collaboratively to provide assessment and treatment.  At CLC, our interdisciplinary team is composed of behavior analysts/specialists, speech therapists, occupational therapists, physical therapists and developmental specialist/direct staff who come together to understand the individual differences and needs of each child, and provide assessment and treatment in a supportive and caring environment.  In addition, parents are considered to be respected members of the team and believed to be their child's best advocate.

All interdisciplinary team members are involved in the development of each child's treatment program.  Each team member takes the time to ensure they understand and are able to implement the goals developed by the other team members.  A functional example of the interdisciplinary model would be the speech therapist who implements an attending to task program designed by the behavior therapist, or the behavior therapist who implements a gross motor activity designed by the occupational therapist before implementing a seated task.  Each team member is not working in isolation, but implementing all the goals that have been designed.

What does each team member do? 

The Role of the Parent(s)

In all CLC programs, parents are considered to be an integral part of the team.  Parents are needed in order to improve the prognosis of the children that we serve.  Without appropriate parental involvement your child's prognosis will be affected.  Parent education is heavily emphasized, to empower parents to be able to make a true difference in their child's life. 

Each member of the interdisciplinary team will request your involvement in the treatment process.  On average, parents will participate in at least one session per week per discipline.  In addition, it is typical to have one parent training session per week with the behavior analyst/specialist.  This session may take place in the home or community environment and the focus of the session is on parent education.  CLC strongly encourages a hands-on approach so parents feel effective at teaching and playing with their child, as well as handling behavioral challenges in multiple environments.  Parents may utilize these sessions to present a challenge they are experiencing with their child.  The behavior analyst/specialist then follows a step-by-step training process: 

·        Determine, with the parent, the function of the behavior.  In other words, why is the behavior occurring?  What are the antecedents that trigger the behavior?  What consequences are following the behavior that may encourage the child to continue the behavior? 

·        Determine a solution(s) to the challenge.

·        Agree on a plan to deal with the behavioral challenge and write out the plan for all parents and caregivers to follow.     

·        Demonstrate the plan through role playing.

·        Have the parent role play the plan.

·        If appropriate, have the parent implement the plan while the behavioral therapist or other staff members are available.  It is important to talk about the plan but it is more important to be an active participant in the implementation of the plan. 

The Role of the Behavior Analyst/Specialist

The behavior analyst/specialist will often provide the foundation for a child's program.  This may vary depending on the child's needs.  During the assessment period of a child's program, the interdisciplinary team will determine the primary focus of treatment for that child.  Frequently, that primary focus is determined to be learning readiness.  When this is the case, the behavioral therapist will lay the foundation for the team.  (There are other cases were the child is more challenged in the area of fine and gross motor skills, or speech skills.  In such cases, the occupational therapist or speech therapist would lay the foundation for the team.)  It is important to state that the interdisciplinary team will often change the primary focus of treatment from one discipline to another as the child progresses and needs change.  However, whatever the primary focus, good therapy is always based on sound behavioral principles. 

The primary role of the behavior analyst/specialist is the following:

·        Conduct ongoing behavioral assessment to determine what behaviors are interfering with learning as well as design programs to address the identified behaviors. 

·        Provide parent training on a regular basis.

·        Develop and implement goals and objectives in the areas of cognition (e.g., problem solving and play skills) and social-emotional-behavioral development (e.g., social skills, perspective taking and behavioral feeding challenges)  

·        Provide supervision to developmental specialist/direct staff on the team

·        Provide written data after each session.

·        Collaborate with all other team members. 

·        Attend monthly team meetings for each child. 

·        Provide appropriate referrals to other professionals in the community

The Role of the Occupational Therapist

The occupational therapist will often play a key role in providing many foundational skills in a child's program.   Many children who enter our program lack the necessary sensory processing skills to learn from their environment.  In these cases, the occupational therapist would assist in the development of these skills, and ensure that all team members understand what skills the child needs in order to be a successful learner.  As previously mentioned, the interdisciplinary team will often change the primary focus of treatment from one discipline to another as the child progresses and needs change.  However, whatever the primary focus, good therapy is always based on sound behavioral principles. 

The primary role of the occupational therapist is the following:

·        Conduct ongoing assessments to determine what sensory processing issues are interfering with learning as well as design programs to address the identified behaviors.

·        Request parents to take part in therapy sessions.

·        Develop and implement goals and objectives in the areas of fine and gross motor skills, visual motor integration, motor planning, daily living skills, sensory or motor based feeding challenges, and reducing rigidity and increasing flexibility within daily living routines

·        Provide written data after each session.

·        Collaborate with all other team members. 

·        Attend monthly team meetings for each child. 

·        Provide appropriate referrals to other professionals in the community

The Role of the Speech Therapist

The speech therapist will often play a key role in providing many foundational skills in a child's program.  Many children are more challenged in the area of speech, language, communication or language learning strategies.  In these cases, the speech therapist would assist in the development of these skills, and ensure that all team members understand what skills the child needs in order to be a successful communicator.  As previously mentioned, the interdisciplinary team will often change the primary focus of treatment from one discipline to another as the child progresses and needs change.  However, whatever the primary focus, good therapy is always based on sound behavioral principles. 

The primary role of the speech therapist is the following:

·        Conduct ongoing speech, language, communication, and language learning assessments to determine the direction of the program and design programs to address the identified challenges. 

·        Request parents to take part in therapy sessions.

·        Conduct ongoing assessments to determine what communication issues are interfering with learning as well as design programs to address the identified behaviors.

·        Develop and implement goals and objectives in the areas of speech (e.g., to address articulation, childhood apraxia of speech), language (e.g., to address receptive and expressive language disorders), communication (e.g., social language/pragmatics) and cognitive skills.

·        Provide written data after each session.

·        Collaborate with all other team members. 

·        Attend monthly team meetings for each child. 

·        Provide appropriate referrals to other professionals in the community

The Role of the Physical Therapist

The physical therapist will be a part of an individual child’s team if that child demonstrates significant deficits in the areas of mobility, gait, gross motor development, motor skill performance, balance, postural control and alignment, strength, endurance, coordination, motor control, motor learning, flexibility and/or muscle tone.  In these cases, the physical therapist would assist in the development of these skills, and ensure that all team members understand what skills the child needs in order to be a successful learner. 

The primary role of the physical therapist is the following:

·        Conduct ongoing assessments in the area of physical development.

·        Request parents to take part in therapy sessions.

·        Develop and implement goals and objectives in the areas of mobility, gait, gross motor development, motor skill performance, balance, postural control and alignment, strength, endurance, coordination, motor control, motor learning, flexibility and/or muscle tone

·        Provide written data after each session.

·        Collaborate with all other team members. 

·        Attend monthly team meetings for each child. 

·        Provide appropriate referrals to other professionals in the community

The Role of the Developmental Specialist and Direct Staff

One of the most important roles on the team is that of the Developmental Specialist or Direct Staff .  These team members are trained ABA instructors.   They work under the direct supervision of the behavior analyst/specialist on the team.  They also collaborate with ST, OT and PT staff on the child's interdisciplinary team and are highly skilled at implementing goals across all areas of development. 

The developmental specialist or direct staff will provide the majority of the intervention hours.  Their services are often provided in the home, school and community settings.    

The primary role of the developmental specialist/direct staff  is the following:

·        Work under the supervision of the behavior analyst/specialist on the team

·        Provide written data after each session.

·        Collaborate with all other team members to help implement goals and objectives designed by the interdisciplinary team. 

·        Attend monthly team meetings for each child. 

What are your Staff Qualifications?

Our speech therapists, occupational therapists and physical therapists are fully licensed.  In addition, all ST, OT and PT staff are given ABA training.  Our behavior analysts/specialists typically hold a master's degree in psychology, special education, or a related field.  They all have extensive training in ABA teaching methodologies.  They may also hold certification as a Board Certified Behavior Analyst (BCBA) or may be working towards their certification. 

Our developmental specialists and direct staff have diverse educational backgrounds and goals. They are typically graduate or undergraduate students in speech pathology, psychology, special education, or occupational therapy. All developmental specialist/direct staff must successfully complete CLC's ABA training including lecture/workshop, hands-on training, and clinical practicums, and are cleared as behavioral intervention instructors through the Department of Education before being assigned to any cases. Developmental Specialists/Direct Staff work under the supervision of Behavior Analysts/Specialists as well as work in collaboration with Occupational Therapists, Speech therapists and Physical Therapists as part of interdisciplinary teams.  Additionally, they receive ongoing training in the form of lecture/workshops and clinical practicums throughout their time at Children's Learning Connection.  

What is an "intensive" program?  How does CLC determine how much therapy is right for an individual child?

The definition of intensity according to Webster's dictionary: Exceptionally great concentration, power, or force.

Many people feel that treatment "intensity" only relates to the number of hours per week a child is receiving therapies.  (Treatment intensity does indeed pertain to treatment hours, but also to the type and quality of treatment.  Behaviorally-based intervention, provided one-to-one, is an intensive TYPE of treatment.  The higher the QUALITY of the program, the more intensive the program.) 

The current body of research indicates most children with a diagnosis of autism three years or over need a minimum of 25 hours per week of intervention.  At CLC, our clinical experience has shown us that more hours are often needed.  However, there are many factors that must be considered before simply increasing the child's hours.  CLC takes into consideration several factors, a few of which are presented below:

·        How much treatment time does it take to meet established goals and objectives?  What types (disciplines) does it take?

·        What is the child's learning style?  Can the child learn through more typical learning strategies or are the child's learning strategies limited?

·        What types of activities does the child engage in when he or she is not in therapy?

·        How involved or what is the understanding the parent(s) have in providing the necessary intervention?

·        What is the age of the child?  (A child under the age of two years may not be able to tolerate a minimum level of 25 hours per week of intervention.  Children at this age need naps as well as lots of time with their parents.  As a result, requesting increased treatment hours for children this young may result in a negative association with therapy.) 

·        How is the child currently responding to treatment?

·        The team must determine if additional hours will be utilized effectively to meet current and/or additional goals and objectives for a child.  Adding large amounts of hours to be carried out entirely by paraprofessionals with supervision provided by a clinician that does not work directly with the child on a weekly basis DOES NOT equal intensity.             

CLC takes great care in recommending increased hours for the children that we serve.  Without careful consideration we are not designing programs that are individualized. 

What level of commitment is required from the family?

In all CLC programs, parents are considered to be an integral part of the team. Parents are encouraged to attend and actively participate in treatment sessions. Parent education is heavily emphasized and takes place on a weekly basis, allowing the parent to employ successful strategies to help their child make progress.

When a comprehensive program is being provided the parent(s) involvement is paramount.  Without their ongoing involvement it may affect their child's prognosis.  We recommend that parents overlap with each clinician one time per week in order to insure carryover of treatment goals outside of therapy time.  Additionally, we recommend parents do the following:  

·        Read program plans and session notes that are provided in your child's treatment log

·        Ask clinical staff any questions you may have during the last 10 minutes of their treatment session, or leave written notes in the treatment log

·        Attend all monthly team meetings

·        Attend all parent training sessions

·        Openly communicate with all staff members

·        Follow through with program recommendations in everyday interaction with your child

·        Set up play dates upon request

·        Provide developmentally appropriate toys and set up of the home environment to enhance play and communication development

·        Assist in the identification as well as the development of reinforcers for your child

·        One parent or caregiver MUST be in the home at all times when a therapy session is being provided in the home environment.

Parents of children under 18 months of age will be required to participate even more frequently in their children's treatment sessions.      

Where does therapy take place?

Therapy takes place in the clinic, home, school and community environments. Many of the clinical staff will provide services in the clinic environment with a great deal of the developmental specialist time in the home and community.  It is important to note that the location of treatment will depend on the child's individual needs.

How will you address social skills?

From the beginning of the therapeutic process the goal of each child's intervention program is to develop the necessary skills so they are able to interact with their peers and learn new skills in a social setting.  When a child is ready to begin treatment in the social setting, CLC helps the family look for appropriate opportunities and placements including play dates, playgroups, and classroom environments.  CLC is then able to work on more advanced goals and objectives by providing developmental specialist/direct staff and behavior analysts/specialist supervision in these settings.      

When do you introduce a social setting to the child's program? 

Many times a parent will seek to place their child in a social setting, such as preschool, early on in treatment because this is what looks the most typical to them.  In some cases, this is a mistake because the child does not yet possess the necessary skills to be truly successful in that environment. Often, 1:1 services need to continue for a period of time, in order for the child to learn necessary language and cognitive skills that he or she will need to be successful in a social environment.  In order for a child to be truly successful in a typical school setting, he must master these "learning to learn" language and cognitive skills before moving onto learning in a group environment. 

Some children appear ready to learn in a group environment because they can learn impressive pre-academic skills in a rote fashion, but the time must be taken to teach children truly how to learn from their environment.    

CLC programs are designed to teach children the language and cognitive strategies used by typical children to learn from their environment.  The following are some early developing language learning strategies that should be mastered before entry into a group or social setting to ensure success:      

·        Localizing to different sounds

·        Joint Referencing (foundational)

·        Visual and Auditory Attending Skills

·        Imitation (Nonverbal)

·        Imitation (Verbal)

·        Visual Matching (as it relates to vocabulary development)

·        Auditory Word Discrimination/ Initial Vocabulary strategies

·        Visual Memory (Visual memory, or visual recall, is necessary to talk about objects, events or people that are not present).

·        Auditory Memory (Auditory memory, or auditory recall, is necessary to talk about objects, events or people that are not present.) 

·        Gestalt Chunking (helpful in the social setting so the child is able to use phrases that will get his needs met) 

·        Observational Learning (critical--this is the child's ability to learn new information through observing others) 

·        Understanding others' communicative intent (very important)

The progression above shows how the team's goals in the beginning of therapy are to get your child to attend to the environment around him (localizing to sounds), then to reference objects, people and actions that are taking place around him, then onto observational learning and understanding others' communicative intent.  The relationships that he develops with people and objects in the 1:1 treatment setting will prepare him for treatment in the social setting.  Without these skills the child will not be an active participant in the social setting. 

Many programs wait until much later in their program development to advanced learning skills like observational learning.  Research on normal development shows these skills start to develop from infancy.  That is why CLC starts working on these skills as soon as the child's attending skills have increased to a point where more advanced skills are able to be taught. 

Your child's interdisciplinary team will focus on developing the above stated skills in order for your child to not only be enrolled in a social setting, but be successful!!!

How does CLC differ from other service providers?

CLC is different from most traditional speech and occupational therapy comprehensive programs in that we use ABA teaching principles and have behavioral specialists as part of our interdisciplinary team.  Many speech and occupational therapy service providers utilize a developmental teaching philosophy.  This means that a child is presented with tasks which are one step above his or her current level of development, and engages in those more difficult tasks at their own speed or pace.  In other words, the child "takes the next step" on his or her own terms.  CLC utilizes a behavioral teaching philosophy.  This means that a child is presented with tasks which are one step above his or her current level of development, and the adult provides the necessary prompting and contingencies to help the child take the next step.  In other words, the therapists set the pace. 

CLC is also different from traditional ABA programs.  The following chart outlines similarities and differences between CLC comprehensive programs and many traditional ABA programs.  Differences are presented in red.