Applied Behavior Analysis (ABA)
It’s What We Do.
Attentive Behavior Care provides cutting-edge, comprehensive and compassionate ABA treatment to individuals who have been diagnosed with an autism spectrum disorder (ASD) and referred for ABA treatment by a qualified physician
Research has shown that ABA is an effective science that addresses some of the following concerns:
Destructive Self-Injurious Behaviors
Social Skills And Pragmatic Language
Toilet Training And Personal Care Skills
ABA is a science which involves the application of the principles of behavior (i.e., reinforcement, motivation, extinction, punishment, stimulus control, conditioned reinforcement, and schedules of reinforcement) to build socially significant behavior in real world, every day settings in order to improve the lives of our patients and their families. ABA involves defining target behaviors, recording data on those behaviors, and analyzing the data to make changes to treatments that are not effective.
The field of ABA is well-established with a large supporting body of scientific research and standards for evidence-based practice. ABA treatment for individuals with ASD has been endorsed by the US Surgeon General (1999) and the New York State Department of Health (1999).
In addition, many professional associations have published statements reporting the effectiveness of and endorsing ABA treatment such as the American Academy of Pediatrics (2001). In addition, the National Autism Standards Report (2009, 2015) has found that treatment rooted in the principles of ABA have the strongest research support as established, effective treatment for individuals with ASD.
Attentive Behavior abides by the Behavior Analyst Certification Board’s Professional Ethical Compliance Code and Guidelines for Responsible Conduct (BACB, 2014) as well as all local, state, and federal laws with regards to the provision of services.
Our services begin with an intake with a member of our administrative team. This is a time where the family may discuss primary areas of concern and determine if ABC can meet those needs. During this process our team will determine eligibility for services and navigate the insurance process. The family will be asked to fill out an enrollment form, provide proof of medical diagnosis of ASD, provide a prescription/referral for ABA treatment, and provide proof of insurance.
The next step is to assess your child’s skill level which is necessary to guide the development of an individualized treatment plan. The assessment will be conducted by a licensed Board Certified Behavior Analyst (BCBA) and will include the use of various assessment tools. Typically assessments are conducted in the home setting; however, arrangements can be made to conduct the assessment in an area that best suits your family’s needs.
Assessment of Basic Language and Learning Skills- Revised (ABLLS-R)
Assessment of Functional Living Skills (AFLS)
Essential for Living (EFL)
Functional Behavior Assessment (FBA)
Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP)
The ABLLS-R is an assessment, curriculum guide, and skills tracking system for children with language delays that provides criterion referenced information about a child’s skills which can be used as the basis for selecting objectives and monitoring progress (Partington, 2010).
The AFLS is an assessment, skills tracking system, and curriculum guide for skills that are essential for independence. It assesses the basic abilities as well as more advanced skills of the child which are broken down into six assessment modules: Basic Living Skills, Home Skills, Community Participation Skills, School Skills, Independent Living Skills, and Vocational Skills (Partington& Mueller, 2012).
EFL is a communication, behavior, and functional skills assessment, curriculum, and skill-tracking instrument for both children and adults with moderate-to-severe disabilities, particularly those with limited communication repertoires, minimal daily living skills, and/or severe problem behavior. It is based on the concepts, principles, and empirically-validated procedures from ABA and Skinner’s (1957) analysis of verbal behavior. The focus of this assessment is to identify, assess, and target skills and behaviors which are essential for effective daily living and result in an improved quality of life by categorizing skills into must-have skills, should-have skills, good-to-have skills, and nice-to-have skills (McGreevy, Fry, & Cornwall, 2012).
The FBA is an assessment used to determine the function (i.e., purpose) of problem behavior in order to select protocols for reduction (e.g., access to tangibles, attention, escape/avoidance, sensory, etc.). It includes various forms of data collection and procedures.
The VB-MAPP is a criterion referenced assessment based on B.F. Skinner’s analysis of Verbal Behavior (1957), which, in addition to his work in behavioral psychology and learning, led to the field of applied behavior analysis (ABA). The VB-MAPP contains five components (i.e., Milestones Assessment, Barriers Assessment, Transition Assessment, Task Analysis, and Curriculum Placement Guide) that are designed to assess a child’s existing skills, determine appropriate treatment plans and placement, and to assist in developing treatment goals and objectives. The Milestones Assessment is designed to provide a sample of the child’s existing verbal and related skills, containing 170 measurable learning and language milestones that are sequenced according to typical development and balanced across 3 developmental levels. The Barriers Assessment provides an assessment of 24 common learning and language acquisition barriers children with autism are faced with. The Transition Assessment contains 18 assessment areas to help identify whether a child has made meaningful progress and has acquired the skills necessary for reducing and/or withdrawing treatment. This assessment tool can provide a measureable way for the child’s team to make decisions and set priorities regarding reduction of treatment and/or discharge (Sundberg, 2007).
Once the assessment has been conducted, the assessor will evaluate the data collected to inform the development of a treatment plan. The assessor will comprise an extensive report of the assessment findings as well as a specific treatment plan.
A preliminary treatment meeting will be scheduled with the family and the treatment team in order to review the assessment results, proposed service type(s), treatment plan goals and objectives, recommended duration and length of treatment, and discharge plan. Upon discharge, recommendations will be provided as a way to support continued progress or address persisting concerns.
Authorization periods typically last for 6 months and a progress report and updated treatment plan will be composed for each authorization period.
Treatment dosage varies with each patient and reflects to goals of treatment, specific patient needs, and response to treatment. Recommendations for treatment dosage are made based on the results of the initial assessment and are continually monitored and updated for each authorization period.
Our treatment packages are based on the BACB’s Practice Guidelines for ABA treatment of Autism Spectrum Disorder and the Autism Special Interest Groups Consumer Guidelines. We utilize a tiered service-delivery model in which a qualified health care provider (QHCP) designs and supervises a treatment program delivered by a behavior technician. The effectiveness of this service delivery model has been documented in the peer-reviewed literature and has several advantages including increased access to services, permits sufficient expertise to be delivered to each patient at the level needed to reach treatment goals, and facilitates treatment delivery to patients in underserved areas and patients/families with complex needs.
Direct and Indirect Supervision
Team Meetings and Coordination of Care
Behavior technicians provide direct treatment based on the treatment plan designed and supervised by the QHCP. These services target increased adaptive skills and maladaptive behavior reduction.
ABA treatment also requires comparative levels of case supervision by a QHCP to ensure effective outcomes due to the following: the individualized nature of treatment, the use of a tiered service-delivery model, the necessity for frequent data collection and data analysis, and the need for adjustments to the treatment plan. Supervision includes both direct and indirect supervision in order to produce good treatment outcomes. Direct supervision occurs concurrently with the delivery of direct treatment and typically accounts for 50% of more of case supervision. Some examples of direct supervision activities include: directly observing treatment implementation for potential program revision, monitoring treatment integrity to ensure satisfactory implementation of treatment protocols, directing staff and/or caregivers in the implementation of new/revised treatment protocols with the client. Some examples of indirect supervision activities include developing treatment goals, protocols, and data collection systems, summarizing/analyzing data, evaluating client progress, adjusting treatment protocols based on data, coordination of care with other professionals, and reporting progress. The ratio of case supervision hours is adjusted based on the needs of every patient and take into account the complexity of the patient’s symptoms and the responsive, individualized, data-based decision making which characterizes ABA treatment. Some factors that may warrant an increase or decrease in case supervision include: treatment dosage/intensity, barriers to progress, issues of patient health/safety, the sophistication or complexity of treatment protocols, family dynamics or community environment, lack of progress or increased rate of progress, changes in treatment protocols, and transitions with implications for continuity of care.
If appropriate, patients may receive group treatment with a behavior technician and/or a QHCP in a group of 2 to 8 patients. These services may target social skills, adaptive skills, and/or behavior reduction.
Comprehensive treatment packages also include parent/caregiver training performed by a QHCP. The training of parents/caregivers involves a systematic, individualized curriculum on the basics of ABA and includes objective, measurable goals for parents/caregivers. The training emphasizes skill development and support so that parents/caregivers can become competent in implementing the treatment protocols. ABA treatment is only as effective as the tools the parents/caregivers are left with in the absence of the treatment team, and, for this reason, parent/caregiver training is a critical component of our program.
Finally, coordination with other professionals in the form of team meetings is critical to ensure patient progress and consistency. Treatment goals are most likely to be achieved when there is coordination among all professionals.
Attentive Behavior recognizes that the quality of services we provide is directly dependent on the quality of our providers. Your treatment team will include an administrative case coordinator who will assist with staffing, coordination, and authorization management; a qualified health care provider who will serve as the supervisor; and a behavior technician who will serve as the direct treatment provider.
Attentive Behavior uses an exclusive patient-provider matching process across 30 essential domains to ensure the perfect fit for your family. We carefully take into consideration the personality of your child, the behavior technician, and YOU. We trust that you will be thrilled with the team we have selected for your family.
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