We offer focused and comprehensive programs as well as early intervention services for children diagnosed with Autism and other special needs.
communication & language
We use the Verbal Behavior approach (based on Applied Behavior Analysis) to teach communication and language skills to children who are non-vocal, have language delays or struggle with communication disorders.
We work with children who struggle with problem behaviors by analyzing the behaviors in terms of function, and designing programs that focus on teaching the child replacement behaviors that are functional and age appropriate.
play and social skills
We teach play and social skills to children who struggle to connect to others, interact and communicate with peers or engage in age-typical play skills, including turn taking, pretend play and sharing.
daily living skills
We help children achieve independence with self-care skills and daily routines, including successfully getting a haircut, going to the dentist or doctor, or participating in family outings.
academic and pre-academic skills
We help prepare children for the academic setting and serve children who struggle with learning deficits or have difficulty learning to read, write or complete age-appropriate academic tasks.
We help children achieve independence using the toilet and completing the whole bathroom routine. We also help children who struggle with frequent accidents, bedwetting or other bladder and bowel control issues.
We help children who struggle with food refusal, food selectivity or a limited diet (picky eaters), so they can learn to accept a variety of foods and participate in meals independently and without problem behaviors.
We assist children who have struggles transitioning from one activity to another, or from one setting to another. We help prepare children for the school environment and help families prepare for big changes.
How we can help
We offer focused and comprehensive programs, including early intensive behavioral intervention, for children ages 18 month-old and up who are diagnosed with Autism and other special needs.
ABA is a well-founded science that has been proven to be effective for teaching children with autism. In fact, it is considered an evidence-based best practice treatment for Autism Spectrum Disorders, by the US Surgeon General and by the American Psychological Association. Here are some of the reasons why ABA is so effective in treating the impairments related to autism as well as other conditions:
The goal of ABA treatment is to make substantial gains in socially significant behavior. That means we teach skills that are useful and important, focused on helping children lead fulfilling and independent lives, develop meaningful relationships and participate in their community.
We use direct observation, measurement and functional analysis of behaviors. We are always collecting and analyzing data, in order to carefully select goals and adapt our teaching to each unique learner.
We use evidence-based strategies to systematically teach skills to each learner, sometimes breaking down skills into smaller, teachable steps to make sure the child is successful.
Which Program is Right for You?
Treatment for each child varies in terms of intensity and duration, setting, format (individual or small group), and complexity of goals, based on the individual child and their response to treatment.
The BACB has put forth specific guidelines for ABA treatment, which categorize treatment as Focused or Comprehensive depending on the intensity and complexity of treatment needed. You can read more about the two categories, here.
In order to know which program is right for your family, an extensive assessment needs to be completed by our team. This assessment process helps us carefully assess the best ways to produce practical and significant changes in behavior, whether it is skills to teach, problems behaviors to reduce, or most commonly, both.
Following the initial assessment, a treatment plan is developed to teach skills and reduce problem behavior. This plan is monitored consistently and data is collected and graphed to make sure that the child is always making progress. Depending upon the child’s progress and response to treatment, intensity and duration may be decreased or the program setting changed to allow for generalization and maintenance of what is learned in the more restrictive setting. For example, we might move from 1:1 therapy sessions to small group sessions, or transition to the home or community after mastering goals in the clinic setting.
Autism Speaks: Applied Behavior Analysis (ABA)
ATN/AIR-P: Parent’s Guide to Applied Behavior Analysis
ATN/AIR-P: Introduction to Behavioral Health Treatment
communication and language
We use the verbal behavior approach to teach communication and language skills to children who are non-vocal, have language delays or struggle with communication disorders.
Using the verbal behavior approach to language development, we look at communication in terms of function. Even non-vocal communication serves a specific function for the ‘speaker,’ in relation to their environment. Every communication exchange is considered a specific behavior, which can be shaped, taught and reinforced. The key to this approach is that verbal behavior is categorized differently based on its function, so that even if the behavior looks the same, it may be used for a different reason and under different circumstances. For example, the word ‘water’ may be used to request water in one situation, but it can also be used to label ‘water’ when seeing a water bottle, or used to answer the question ‘what is something you drink?’
Looking at communication and language from this unique angle allows us to assess a child and identify where ‘gaps’ in language development may be, and design programs to teach language across all verbal operants in a way that mirrors the way typical language development occurs. A child may be great at labeling, but have difficulty requesting for things spontaneously or engaging in conversation with friends. Or, a child may have a strong understanding of language (receptive language), but struggle with expressing their wants and needs, labeling and even repeating spoken words.
Non-vocal children usually need to begin with requesting for things they need and want and when that is addressed from a behavioral lens, we are able to use the principles of motivation, shaping and positive reinforcement to develop early communication behaviors. For some children, that may be in the form of signs, pictures or communication devices. It is fairly common for vocal language to emerge when using the verbal behavior approach, especially when the program is individualized to the child and carefully monitored through data analysis.
What about Speech Therapy?
Teaching communication and language through verbal behavior does not take the place of speech & language therapy. Rather, it complements it. Behavior analysis assesses and treats based on function, while speech therapy assesses and treats based on form (what language looks and sounds like). If you have speech therapists working with your child, we typically collaborate with them and work together as part of your child’s team.
We work with children who struggle with problem behaviors by analyzing the behaviors in terms of the reason for the behavior, the function.
Through a detailed evaluation that includes direct observation of the problem behavior, we identify the common triggers, events that make the behavior most and least likely to happen, and common consequences to the behavior (may be negative or positive). A Functional Behavioral Assessment allows us to identify the reasons why the behavior is maintained, or why it continues to happen.
Following the evaluation and once we determine the specific function of the behavior, we also complete a brief assessment of the child’s skills. This helps us get a whole picture of where the child is and what their needs are, and is the basis for the development of an action plan that is completely individualized for each child. Every treatment plan has three parts:
· Prevention: This part focuses on providing necessary supports so that the triggers to the problem behavior can be avoided, where possible. This may include the use of visuals, giving detailed instructions or giving choices, for example.
· Intervention: This part focuses on managing the problem behavior when it occurs, in a way that minimizes reinforcement and keeps everyone safe. The intervention typically includes a step-by-step guide on what to do when the problem behavior happens.
· Replacement: This last part is the heart of the action plan and it focuses on teaching specific behaviors that meet the same need (have the same function) as the problem behavior and that are functional and age appropriate.
Problem behaviors are difficult for the child and also their whole family. We come alongside parents and involve them in the development of the action plan as much as possible so that it fits their family’s values, priorities and needs.
daily living skills
We help children achieve independence with self-care skills, daily routines and important routines like:
· Getting ready for school
· Washing hands
· Brushing teeth
· Participating in family outings (restaurants, parks, shopping)
· Going to the doctor or dentist
· Getting a haircut
· Taking medication
· Independent play/work routines (homework)
If this is an area of difficulty, we typically begin by carefully assessing the issue to determine whether it’s due to skills that the child needs to learn or barriers, such as problem behaviors, low motivation or need for specific supports.
The action plan is individualized to the child and their needs and skills, and usually addresses the issue from all three angles: Providing supports, teaching the specific skills and addressing barriers (including decreasing problem behaviors). We work with the whole family to ensure success in all settings.
ACADEMIC AND PRE-ACADEMIC SKILLS
We help prepare young children for the academic setting, especially when they struggle with problem behaviors or are not familiar with typical school routines, which require the child to know basic learning and language skills, including:
· Sitting for sustained periods of time
· Attending to instructions
· Participating in group activities
· Engaging in collaborative play with friends
· Completing 2-3 step routines
· Requesting for needs and wants (to adults and peers)
· Completing simple play activities independently
We can also help children who are already in a school setting and struggle with learning deficits or have difficulty learning to read, write or complete age-appropriate academic tasks.
We typically begin with a careful assessment of the skills the child has, and identify where the child needs specific supports, which pre-requisite skills they need to learn and how to teach the child so they can be successful at learning.
Using ABA to teach academic and pre-academic skills allows us to focus on building strong and fluent learners, helping them stay motivated and on-task and finding enjoyment in completing learning activities.
We help children achieve independence using the toilet and completing the whole bathroom routine. This includes: Going to multiple bathrooms on their own, using the toilet, wiping, flushing, pulling their pants up, washing their hands and leaving the bathroom.
Using ABA, we can help any child learn that chain of behaviors. We typically begin by completing a detailed assessment of the child to see what pre-requisite skills they know and whether they are developmentally ready to learn bladder and bowel control (this is not related to their chronological age). We also want to make sure the parents are ready!
We then develop an action plan to teach, typically over the course of a weekend! This can be done in the clinic or at the child’s home.
We come alongside the parents to teach toilet training using proven ABA strategies individualized to the child and family.
The key to the ABA approach to toilet training is that we collect lots of data so that parts of the program can be modified based on how the child learns. Sometimes that means including more supports, working on barriers (like problem behaviors), or isolating certain skills to teach them on their own before addressing the whole toileting routine
We help children who struggle with:
limited diet (picky eaters)
The purpose of our feeding programs is to teach the child to accept a variety of foods and participate in meals independently and without problem behaviors.
If feeding is an area of difficulty, we begin by completing a detailed assessment. This helps us determine if the issue lies in a behavioral issue, a sensory issue, a skill that needs to be taught or a need for specific behavioral supports.
Often, our team works together with an occupational therapist, speech therapist, pediatrician and other professionals who can help address the issue from all angles.
Feeding issues can cause a lot of problem behaviors and be difficult for the child and the whole family. When the barriers or problem behaviors are significant, the action plan will include a plan for reduction of the problem behaviors and a plan to teach specific skill deficits, which sometimes need to be addressed prior to addressing feeding.
Some children have difficulty transitioning from one activity to another, or from one place to another. Other children may have trouble adjusting to changes in routine. Typically, these difficult transitions can bring forth problem behaviors, which can affect the whole family and be very disruptive to the day-to-day family life.
Using ABA, we can address these challenges from a behavioral lens and teach the child to tolerate change, tolerate delays in access (learn to wait, learn to accept no) and successfully move from one thing to the next without problem behaviors.
The first step is always a detailed assessment of the issue, which helps us understand the root of the difficulty, skills that need to be taught, problem behaviors that need to decrease and supports that need to be in place for the child to be successful.
For some families, big changes can be burdensome and overwhelming. We can come alongside parents to prepare children for big life events, such as:
a medical procedure
the arrival of a new sibling
the start of a new school year