Overview of Services
This clinic offers a 15-week program to determine why problem behavior is occurring, evaluate an effective treatment to reduce the problem behavior, and teach caregivers how to use the treatment at home and in the community. We ask that caregivers be present during all therapy appointments. We see each family once or twice per week for 1.5 hours each appointment. Therapy goals will be determined with each family individually. The program might be shorter than 15 weeks if goals are reached quickly. If more time is needed, we will determine if it will be beneficial to extend the program or refer the family to other service providers for more intensive therapy. This will be discussed with each family during their regular appointments. The following describes different parts of the assessment and treatment process; however, we will tailor this process to each family's needs and wishes.
Preference / Reinforcer Assessment
We conduct an assessment to identify a wide variety of things that the child enjoys, such as leisure activities and toys. A number of different items are placed within reach to determine if the child will approach them or indicate preference in some other manner (e.g., smiling or looking at the item, orienting toward the item).
We also give the child opportunities to interact with the items, and we evaluate how the child manipulates or plays with each item. In some cases, we might see if the child will perform a simple task more when the item is given for doing so.
Functional Analysis and Treatment of Problem Behavior
A functional analysis of problem behavior is conducted to determine why the child engages in problem behavior. This process is critical to determine which intervention strategies will work for a particular child.
During a functional analysis (FA), we examine how the child behaves in different situations that are tailored to the child. This process typically is completed in 1-3 appointments. Sometimes therapists will conduct the FA; however, when appropriate, we may coach caregivers to conduct the FA with their child. Results of the functional analysis are used to develop an individualized treatment to decrease the child's problem behavior.
During treatment, the child is taught to engage in adaptive (or appropriate) behaviors and/or to refrain from engaging in problem behavior. The therapists, caregivers, or both will conduct the treatment sessions with the child. The behavior management strategies typically involve delivery of things that the child appears to enjoy (e.g., praise, toys) when the child exhibits adaptive behavior (e.g., communication, waits appropriately for something they want) and not delivering things that appear to increase the child's problem behavior (e.g., attention, escape from work). This process can be very fast (1-2 appointments) or slow (more than 6 appointments), depending on the severity and history of the problem behavior for a particular child. We will keep families informed of progress and will discuss plans at the end of each appointment.
We use a combination of evidence-based assessments and interventions with the child, as well as some experimental procedures in the context of research. The experimental procedures will likely lead to additional information about effective strategies for decreasing severe problem behaviors for your child and others.
We also consult with the family before developing a treatment to ensure that the strategies we use will be feasible in the home and community. We want to make sure that any treatment recommendations we make will be valuable and useful to the family to meet their goals. This is very important, because once we identify a treatment that works, we begin teaching caregivers to implement the intervention. In this sense, caregiver training is one of the most important aspects of our work at the clinic.
Caregiver Practice with Coaching
After we identify an effective treatment for the child, we teach caregivers how to implement the procedures. We take a team approach to intervention and work with families to tailor the intervention to work best in the home and community.
Family involvement is critical to the success of the interventions developed at the clinic. Therefore, we ask that families plan to be present and participate during caregiver training appointments.
Without caregiver involvement, treatment will not be effective outside the clinic. With caregiver involvement, significant improvements in behavior can be seen over time and with continued practice!