Archive for FAQs – Page 2

How and where are the ABLLS-R, VB-MAPP, or ESDM assessments conducted?

The assessments are conducted by a qualified Program Manager or a Program Supervisor, who has been assigned by the ABA Learning Centre to work with the child. The assessments are conducted at the ABA LC Clinic in Richmond or at the child’s home with the caregivers present. The location will depend on the kind of program you are receiving from ABA Learning Centre. The parents can choose to be present at the time of testing. The assessments involve direct observation of the child’s skills, thus it is important to first establish rapport with the learner. ABA Learning Centre provides a child-friendly environment and if your assessment is to take place at our centre, the rooms in which the assessor will work with the child are spacious, bright, colourful and contain numerous toys, board games, books and videos which the child is free to explore during testing. The PM/PS will evaluate the child’s skill level using both academic materials and various toys and games in which the child shows high interest. Skills are examined at the table by giving specific instruction and also by more natural method, such as structured and purposeful play.

How long does it take to conduct an assessment for program planning?

The typical assessment is conducted over two to three sessions which are each about two hours long but this may vary based on the level of the child’s cooperation and present skills. During the first two sessions the Program Manager/Supervisor assesses child’s current skill level in the area of referencing, joint attention, language, basic learning skills, academic and motor abilities. Interview is conducted with parents and caregivers who can often provide information about the child’s self-help skills, preferences and strengths. Parents are encouraged to share their concerns and to identify their priorities regarding the objectives for intervention. When appropriate, caregivers will be asked when they would like the assessment of their child’s social skills. This assessment is conducted in the student’s preschool or school where the Program Manager/Supervisor observes how the child interacts with peers and follows group or individual instruction.

What is ABLLS-R, VB-MAPP, or ESDM assessment?

The ABLLS-R is the Assessment of Basic Language and Learning Skills- Revised, VB-MAPP is the Verbal Behavior Milestones Assessment and Placement Program and ESDM is the Early Screening Denver Model. All are curriculum guides, and skills tracking system for children diagnosed with autism and other developmental disabilities.  These assessments provide the opportunity to investigate many skills necessary for a unique child to communicate with others and to gain new functional skills for independence and academic learning. The appropriate assessment tool is chosen based on the individual learner’s current skills, age and any barriers that may be interfering with learning. Skills for the following areas are investigated:  Referencing, Joint Attention, Cooperation and Reinforcer Effectiveness; Basic Language skills; Social skills; Academic; Self-Help and Motor Skills.

How can I find out more about Verbal Behaviour?

You can go to various websites to find out more about verbal behaviour.  To start with, go to:

www.abacentre.ca         then, try:
www.drsjacobsen.com
www.christinaburkaba.com

Do you use a strict Lovaas approach?

No, we don’t.  Our intervention is contemporary applied behavior analysis (ABA) based on Skinner’s Analysis of Verbal Behaviour, and we use intensive teaching (IT which means discrete trial teaching) and Natural Environment Teaching (NET).  Children do not learn when they are unhappy, bored or stressed. It is our job to make sure that your child has good reasons to want to try new and difficult tasks so we will consider your child’s motivation and interests in planning specific activities to help your child learn language, play skills and skills for independence.

How long is your waiting list?

We attempt to provide service to everyone in a fair and timely fashion, but “first-come, first served” cannot always be implemented. Your child is an individual and your family and circumstances will not be the same as anyone else’s. It is our job to put together a team who will work well within your family dynamic, your goals for your child, your child’s needs and temperament and your budget. We have staff members serving the needs of families all over the lower mainland.  How long you wait for service depends on if we have a Program Manager working in your area and if they have enough room in their caseload to fully serve your child’s needs. We understand that the rules and regulations surrounding your funding make it difficult to wait, however the needs of your child are paramount, and we will not do anything less than our best for your child.

Once you have met with ABA LC’s intake team, met your Behaviour Consultant and signed your contract with ABA LC, the average time to implementation of a program is around 4-6 weeks depending on: the completion of the ABLLS-R, VB-MAPP or ESDM assessment; the number of programs required to address the objectives for your child; and the hiring and training of BIs (behaviour interventionists).

I need a behaviour consultant. Do you have availability?

The Behaviour Consultants for ABA Learning Centre, even those that are Board Certified Behaviour Analysts, are supervised by Dr. Suzanne Jacobsen, Founder, and Dr. Elizabeth Athens, Clinical Director. ABA Learning Centre has a number of Program Managers, and Program Supervisors, Student Program Supervisors who are in the process of completing the requirements to become certified. All ‘Program Managers’ are Board Certified Behaviour Analysts. All ABA LC Program Managers and Program Supervisors have education in behaviour analysis and supervised experience in providing intervention programs. Program Managers are assigned as a ‘case manager’ for each child’s program. Dr. Athens is kept informed about each child’s program and his or her progress through direct consultation and monthly team meeting minutes. Dr. Athens acts in a consultative capacity to support, advise, educate, supervise and facilitate the Program Managers and Program Supervisors to ensure the best possible service for a child and his/her family. This allows ABA LC to serve many more families than we otherwise could. Our Program Managers and Program Supervisors are extremely well-qualified, and in other organizations could call themselves behaviour consultants. We feel it is important for you to have access to the combined skills and experience which our team approach can offer. Our Program Managers and Supervisors can perform ABLLS-R, VB-MAPP and ESDM assessments and updates, prepare BPIs (Behaviour Plan of Intervention), monitor and update programs, and provide training and supervision to behaviour interventionists.

Who are the behaviour interventionists (BIs)?

BIs are the individuals who work directly with your child on a frequent basis implementing programs, lesson plans, and behavior procedures as designed by the Program Manager. The BIs are trained and supervised on an on-going basis by the Program Manager. They should possess a minimum qualification of a grade 12 diploma and have a strong interest in working with children. They must have a criminal record check (CRC). Their rates will vary based on their training, experience, skills and responsibilities.

What is the number of recommended hours of intervention per week?

Many research studies have documented the effectiveness of intensive behavior analytic interventions for autism. Howard, Sparkman, Cohen, Green, & Stanislaw, (2005) suggest that, “Findings from early intervention research indicate that intervention that is intensive, long in duration, and delivered directly to children (rather than caregivers) produces better outcomes than intervention that lacks those elements?. However, there is relatively little research on the effects of treatment intensity (hours per week) and duration (how many months or years intervention).

Ivar Lovaas (1987) demonstrated that children receiving 40 hrs per week (for at least 2 years) of intensive behavior analytic intervention made significantly larger gains than those receiving only 10 hrs per week. Furthermore, almost half of the children receiving intensive behavioral intervention achieved outcomes that placed them in the “normal” range of intellectual, communication, and adaptive functioning.

Eikeseth, Smith, Jahr, & Eldevik (2002) delivered behavioral intervention to 13 children with autism (ages 4-7 at beginning of study) for 28 hrs per week for 1 year. Seven of the 13 children (58%), at follow up, achieved scores in the normal range for functioning.

Howard and colleagues (2005) provided 25-30 hrs/week for children under age 3 and 35-40 hrs per week for children over age 3. They also included two control groups. One group received “eclectic”” intervention (i.e. TEACCH, some DTT, and sensory integration) in a non-intensive (15 hrs per week) community special education program and one receiving regular special education (30 hrs per week). After 14 months, various outcome measures were substantially and statistically significant for the behavior intervention group but not for either of the control groups. Therefore, the results of this study (and others) demonstrated significant improvements in intellectual functioning, communication skills, and adaptive behavior as a result of behavioral intervention. These gains were larger than those reported by Anderson, Avery, Dipietro, Edwards, and Christian (1987) for preschool children with autism who received behavioral intervention for 15-25 hrs per week for one year.

The intensity of behavioral intervention is important for accelerating a learner’s acquisition rate beyond the normal rate in order to close the gap between the learner’s skills repertoire and his/her typically developing peers. However, it is unlikely that this gap will be closed within one year’s time. This means the duration of intervention will often be 2-3 yrs or more. In the “best case” scenario, this gap will be closed and the learner will function at the same level as his/her peers. However, research indicates that fewer than half of children receiving a competently delivered behavioral intervention program will achieve this level of functioning. Regardless, for most children, the gap will continue to be closed as a result of behavioral intervention.

On the other hand, at least 2 published studies (Eikeseth et al., 2002 & Howard et al., 2005) have demonstrated that equally intensive alternative or eclectic treatments DO NOT yield comparable results. Worse yet, it is projected that learners in such programs would continue to lose ground to their same aged peers if they continue in such programs.

So, back to the question we started with… what is the recommended number of hours per week? Currently, we don’t have adequate research to answer this question on a student-by-student basis. However, the literature tends to supports intensive behavioral intervention (i.e. 20-40 hrs per week). In addition, certain learner characteristics need to be considered. For example, learners who are 2 yrs old and those who are 5 yrs old will have differences in the number of hours per week that they can successfully handle.

Generally, more seems to be better. But it is important to note that behavioral intervention continues beyond the number of 1-on-1 “therapy hours”. The goal is to create a 24 hr/day 7day/wk (24/7) therapeutic environment. This means actively including parents during “down time”. Assuming 12 hrs of sleep per day, there are nearly 90 waking hrs per week. This means more time with parents than interventionists, even if receiving 40 hrs per week of intensive intervention.

What is a home program?

Intervention plans are developed and ABA implemented for a child targeting specific developmental areas (e.g., imitative skills, receptive and expressive language skills, fine motor skills, etc.) which are derived from an assessment of those areas. The program is then implemented or taught within the home of that child. An individual trained to carry out program goals is known as a Behaviour Interventionist (BI).

For children under the age of 6 a home program will typically range between 8 to 40 hours per week depending on the goals developed for a particular child (and family budget). Guided by a Program Manager (Behaviour Consultant), BIs will work with a child for a set amount of time per day and week teaching the skills required to attain the goals outlined in the child’s program. A BI will use various techniques and teaching methods, guided by the science of ABA. They will be taught techniques empirically proven to be effective and for which they are trained and supervised by senior staff that are experienced and skilled.

In addition, a BI will work with other team members to support the overall implementation of a child’s program. The direct service intervention team consists of a Program Manager who develops and monitors the entire program, (may include a Program Supervisor) and who supervises and trains BI’s, and BI’s who teach the specific skills to achieve the goals. A team meeting typically occurs once per month and includes the child’s parents, PM/PS, and BIs. During the team meeting goals are developed and programs reviewed. It is at the team meeting where goals, objectives, strategies and problem solving are discussed to ensure the success of the child and to identify any appropriate changes needed so the child progresses successfully.