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.
|
CLC Comprehensive Programs |
Traditional ABA Programs |
|
Applied Behavioral Analysis
(ABA) is the foundation of
the program. |
Applied Behavioral Analysis
(ABA) is the foundation of
the program. |
|
Utilizes an
interdisciplinary team
(speech therapy, behavior
analyst/specialist, occupational
therapist, and
developmental specialist/direct
staff) to provide
a comprehensive program
(cognition,
speech-language-communication,
social-emotional-behavioral,
fine motor, gross motor,
self-help and feeding). |
Utilizes clinical
psychologists as well as
other staff members who have
a background in psychology
and paraprofessional
staff to provide a
comprehensive program
(cognition, language,
social-emotional-behavioral,
fine motor, gross motor,
self-help). Typically only
has one discipline involved
in program development for
all areas. If the child
needs speech or occupational
therapy, the parent must go
other agencies to obtain
those services; the
additional agencies may or
may not collaborate to
develop curriculum, and
often work in isolation of
one another. |
|
Provides on average of seven
hours per week with
clinician level staff
(including direct treatment
with speech and occupational
therapy staff, as well as
direct treatment and
supervision with behavior
analyst/specialist staff) |
Provides on average of two
hours of supervision per
week provided by a
behavior program supervisor. |
|
All team members have been
trained in the methodology
of Applied Behavioral
Analysis and understand that
it is the foundation to a
successful program.
|
Team members from ABA agency
have been trained in the
methodology of Applied
Behavioral Analysis and
understand that it is the
foundation to a successful
program. Additional
agencies for speech and
occupational therapies may
or may not be supportive of
ABA teaching methodology.
|
|
Provides team meetings on a regular basis to review a child's program. |
Provides team meetings on a regular basis to review a child's program. |
|
Curriculum is
developmentally sequenced,
and based on the current
body of research in
behavioral intervention for
children with autism as well
as research on normal
development and research on
disorders in cognition,
speech, language and motor
planning. |
Curriculum is typically
skill-based rather than
following the normal
progression of development,
and based on the current
body of research in
behavioral intervention for
children with autism.
|
|
Curriculum adjusted and
advanced on a daily basis,
since clinicians do direct
therapy sessions with the
child rather than just
provide program supervision
|
Curriculum typically
adjusted or advanced
semi-monthly at team
meetings under diection of
behavior program supervisor. |
|
Use a positive and
systematic approach to
decreasing inappropriate
behaviors. |
Use a positive and
systematic approach to
decreasing inappropriate
behaviors. |
|
Discrete
Trial Teaching (DTT) is
considered a valuable
teaching strategy to rapidly
build skills but the child
is always assessed for the
ability to introduce other
strategies to learn
information in a more
natural manner. This
process is started shortly
after compliance is
established. |
Discrete trial teaching (DTT)
is typically the primary
teaching technique used in
the beginning stages of
therapy to rapidly build
skills. |
|
Teach the child a range of
cognitive and language
learning strategies used by
typically developing
children to learn new
information on their own;
teach information directly
only if child cannot learn
through more natural
strategies. |
Will typically use imitation
and rote learning to as
primary method for teach new
skills. Teach information
within skill/concept areas
directly. |
|
Teach to generalize the
skill from the beginning of
therapy. |
Teach a skill then at a later time will teach to generalize the skill. Often use "maintenance logs" to review skills learned through imitation and rote memory. |
|
| |