Treatment Plan Development

At The Center For Social Dynamics, we implement Applied Behavior Analysis (ABA) plans that are designed to reduce your child’s inappropriate behaviors and increase equivalent functional behaviors. This helps your child learn to function independently while achieving his or her personal goals. Our Board Certified Behavior Analysts (BCBAs) develop treatment plans based on the data gathered through direct interaction, questionaires and observations across different environments. The objective is to address behaviors on the autism spectrum that are socially significant and that will have a profound impact on your child and on your family.

Applied Behavioral Analysis

ABA is a discipline devoted to the understanding and improvement of human behavior. It focuses on objectively defined, observable behavior of social significance; it seeks to improve specific behaviors while demonstrating a reliable relationship between the procedures used and the change in that specific behavior. ABA uses the method of science; description, quantification and analysis. In 1968 Baer, Montrose and Risley published a paper that outlined seven defining characteristics of ABA, this paper has become the most widely cited publication in ABA and serves as the standard description of ABA.

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Applied: is determined by the social significance of the target behavior (what we teach a student). The behavior must have immediate importance to the student/family
Behavioral: the behavior chosen has to be a behavior in need of changing (teaching a 2 year old to tie shoes), and the behavior must be measured reliably and precisely.
Analytic: this simply means that we can demonstrate that the change in behavior is due to our teaching procedures. There has to be a functional relationship between the manipulated events and the behavior of interest.
Technological: Procedures are considered technological when all of the procedures used to teach are completely identified and precisely described; we often refer to this as “objectively defined.” Can someone else carry out your program/behavior plan without you there?
Conceptually systematic: behavior change procedures should be described in terms of the behavioral principle from which it was derived. There are many tactics we use to change a behavior (i.e. teach) however they all come from just a few principles of behavior.
Effective: did the behavior of interest change to a meaningful/practical degree? Did a physical prompt teach a student to touch her head?
Generality: does the behavior last over time? Can your student go to play group and sing “twinkle twinkle?” Once the teaching procedure is finished does the student really “know” his/her colors? Generality also occurs when a behavior that was not the focus of teaching changes as well. This is a good thing but not always automatic. We have to program for generality aka generalization.

Pyramid Educational Consultants (PECS)

PECS was developed in 1985 as a unique augmentative/alternative communication intervention package for individuals with autism spectrum disorder and related developmental disabilities. First used at the Delaware Autistic Program, PECS has received worldwide recognition for focusing on the initiation component of communication. PECS does not require complex or expensive materials. It was created with families, educators, and resident care providers in mind, so is readily used in a range of settings

Pyramid Educational Consultants

Pivotal Response Treatment (PRT)

Regarded as one of the top state-of-the-art treatments for autism in the United States*, Pivotal Response Treatment (PRT) is a naturalistic intervention model producing positive changes in critical behaviors, leading to generalized improvement in communication, social, and behavioral areas. Rather than target individual behaviors one at a time, PRT targets pivotal areas of a child’s development, such as motivation, responsivity to multiple cues, self-management, and social initiations. By targeting these critical areas, PRT results in widespread, collateral improvements in other social, communicative, and behavioral areas.
The underlying motivational strategies of PRT are incorporated throughout intervention as often as possible, and they include child choice, task variation, interspersing maintenance tasks, rewarding attempts, and the use of direct and natural reinforcers. The child plays a crucial role in determining the activities and objects that will be used in the PRT exchange. For example, attempts at functional communication are rewarded with a natural reinforcer (e.g., if a child attempts a request for a stuffed animal, the child receives the animal, not a piece of candy or other unrelated reinforcer). Pivotal Response Treatment is used to teach language, decrease disruptive/self-stimulatory behaviors, and increase social, communication, and academic skills.

* National Research Council of the National Academy of Sciences, 2001

SCERTS

The SCERTS® Model is a research-based educational approach and multidisciplinary framework that directly addresses the core challenges faced by children and persons with ASD and related disabilities, and their families. SCERTS® focuses on building competence in Social Communication, Emotional Regulation and Transactional Support as the highest priorities that must be addressed in any program, and is applicable for individuals with a wide range of abilities and ages across home, school and community settings.

 

The SCERTS® Model

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Though some autistic children have little or no problem with the pronunciation of words, most have difficulty effectively using language. Even those children who have no articulation problems exhibit difficulties in the pragmatic use of language such as knowing what to say, how to say it, and when to say it as well as how to interact socially with people. Many who speak often say things that have no content or information. Others repeat verbatim what they have heard (echolalia) or repeat irrelevant scripts they have memorized. Some autistic children speak in a high-pitched voice or use robotic sounding speech.
Two pre skills for language development are joint attention and social initiation. Joint attention involves an eye gaze and referential gestures such as pointing, showing and giving. Children with autism lack social initiation such as questioning, make fewer utterance and fail to use language as a means of social initiation. Though no one treatment is found to successfully improve communication, the best treatment begins early during the preschool years, is individually tailored, and involves parents along with professionals. The goal is always to improve useful communication. For some verbal communication is realistic, for others gestured communication or communication through a symbol system such as picture boards can be attempted. Periodic evaluations must be made to find the best approaches and to reestablish goals for the individual child.

TEACCH

TEACCH (Training and Education of Autistic and Related Communication Handicapped Children) is a special education program that is tailored to the autistic child’s individual needs based on general guidelines. It dates back to the 1960s when doctors Eric Schopler, R.J. Reichler, and Margaret Lansing were working with children with autism and constructed a means to gain control of the teaching setup so that independence could be fostered in the children.

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What makes the TEACCH approach unique is that the focus is on the design of the physical, social, and communicating environment. The environment is structured to accommodate the difficulties a child with autism has while training them to perform in acceptable and appropriate ways. Building on the fact that autistic children are often visual learners, TEACCH brings visual clarity to the learning process in order to build receptiveness, understanding, organization, and independence. The children work in a highly structured environment which may include physical organization of furniture, clearly delineated activity areas, picture-based schedules and work systems, and instructional clarity. The child is guided through a clear sequence of activities and thus aided to become more organized.It is believed that structure for autistic children provides a strong base and framework for learning. Though TEACCH does not specifically focus on social and communication skills as fully as other therapies it can be used along with such therapies to make them more effective.
While early educational intervention is key to improving the lives of individuals with autism, some parents and professionals believe that other treatment approaches may play an important role in improving communications skills and reducing behavioral symptoms associated with autism. These complementary therapies may include music, art, or animal therapy and may be done on an individual basis or integrated into an educational program. All of them can help by increasing communication skills, developing social interaction, and providing a sense of accomplishment. They can provide a non-threatening way for a child with autism to develop a positive relationship with a therapist in a safe environment.
Art and music are particularly useful in sensory integration, providing tactile, visual, and auditory stimulation. Music therapy is good for speech development and language comprehension. Songs can be used to teach language and increase the ability to put words together. Art therapy can provide a nonverbal, symbolic way for the child with autism to express him or herself. Animal therapy may include horseback riding or swimming with dolphins. Therapeutic riding programs provide both physical and emotional benefits, improving coordination, and motor development, while creating a sense of well-being and increasing self-confidence. Dolphin therapy was first used in the 1970s by psychologist David Nathanson. He believed that interactions with dolphins would increase a child’s attention, enhancing cognitive processes. In a number of studies, he found that children with disabilities learned faster and retained information longer when they were with dolphins, compared to children who learned in a classroom setting.
As with any therapy or treatment approach, it is important to gather information about the treatment and make an informed decision. Keep in mind however, as with most complementary approaches, there will be little scientific research that has been conducted to support the particular therapy.
If your child is younger than 3 years old, he or she is eligible for “early intervention” assistance. This federally-funded program is available in every state, but may be provided by different agencies.
This early education assistance may be available to you in two forms: home-based or school-based. Home-based programs generally assign members of an early intervention team to come to your home to train you and educate your child. School-based programs may be in a public school or a private organization. Both of these programs should be staffed by teachers and other professionals who have experience working with children with disabilities specifically autism. Related services should also be offered, such as speech, physical or occupational therapy, depending on the needs of each child. The program may be only for children with disabilities or it may also include non-challenged peers. Because no two children with autism have the exact same symptoms and behavioral patterns, a treatment approach that works for one child may not be successful with another. This makes evaluating different approaches difficult. There is little comparative research between treatment approaches. Primarily this is because there are too many variables that have to be controlled. So, it’s no wonder that as a parent you might be confused about what to do.
In an article titled “Behavioral and Educational Treatment for Autistic Spectrum Disorders” (Advocate, Volume 33, No. 6), Bryna Siegel Ph.D. suggests thinking about “each symptom as an autism specific learning disability . . . and a barrier to understanding.” Using this model, it is easier to evaluate what a child can and cannot do well. “Take stock of which autistic learning disabilities are present . . . then select treatments that address that particular child’s unique autism learning disability profile.” Understanding these learning differences is the first step in assessing whether a specific treatment approach may be helpful to your child. Understanding a child’s strengths is equally important. For example, some children are good visual learners, while another more advanced child may require written, rather than oral, learning tools.