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QUESTIONS FOR IN-HOME AUTISM TREATMENT PROVIDERS
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Autism Behavioral Network
J. Jeffrey Crisco, Ph.D., Director
Christopher Wiebusch, Ph.D., Associate Director
333 N. Mayfair Road, Suite 113
Wauwatosa, WI 53222-3219
414-476-9755
A. Therapy:
1. How would you characterize your therapeutic approach? The Autism Behavioral Network uses Applied Behavior Analysis (ABA) procedures and methods for intervention.
2. How do you work with children who are nonverbal? A major emphasis for all children is development of effective communication. In the case of non verbal children we have found that a Picture Exchange Communication system (PECS) is generally the most effective in helping the child develop communication skills. It is often an intermediatry step while efforts are also employed to assist in development of verbal expressive abilities.
3. How do you accommodate the child's sensory defensiveness? Consultation with Occupational Therapists (OTR's) specializing in Sensory Integration (SI) to assist in modification of applied behavioral analysis procedures.
4. How do you deal with a child's aggressive behavior? First, by significantly increasing the density of positive reinforcement for appropriate responses incompatible with aggression. If the aggression is not severe then ignoring procedures are employed. If warranted a modified Time-Out/Quiet Room procedure (TO/QR) or Overcorrection methods may be employed.
5. What services are offered in addition to the in-home therapy (i.e., social skills groups, speech therapy, etc.)? Are these services also covered by Medicaid? The Autism Behavioral Network is a Division of Pediatric Psychology Associates, a certified and State of Wisconsin mandated mental health facility providing psychological assessment/treatment, family therapy, speech/language therapy and social skills intervention to young children with developemntal and other mental health challenges. There services are not covered by Medicaid.
B. Entering and Exiting the program:
1. Do you accept all children under the current Medicaid age limit who apply? If not, what are your entrance requirements, such as age or IQ? Yes. There are no mental age or IQ requirements. All children with a diagnosis of Autistic Disorder or any other of the Pervasive Developmental Disorders (with the exception of Retts) are considered for entry into the program.
2. What testing do you require initially? Evaluation of current status in the major developmental pathways is obtained using report procedures such as the Child Development Inventory, Scales of Independent Behavior - Revised (SIB-R) and/or the Vineland Adaptive Behavior Scales (Parent/Teacher). The Psychoeducational Profile Revised (PEP-R) may be administered to identify uneven and idiosyncratic learning patterns so as to better develop an initial Treatment Plan. "Formal" psychological testing (e.g., WISC-III) are not required since results are generally not a true reflection of the child's potential and data is not useful in developing a treatment plan.
3. Under what circumstances will you accept testing by other agencies, such as schools or private therapists? Consideration is given to all previous testing completed by other qualified professionals if the have been completed within six months of our initial contact with the child. However, PEP-R and ovservational data must be completed by the Autism Behavioral Network so that we may develop a direct first hand knowledge of the child and his/her learning patterns.
4. What are the current out-of pocket expenses that a parent must pay for the entrance testing? Approximately $200.00 to $250.00.
5. Can parents arrange to have these expenses spread out over a longer time period? Initial evaluation fees have been kept at a minimum so as not to be a burden to families. Since these fees are considered reasonable payment is required at time of service either by check or credit card. In many cases private insurance will cover the majority of the fee which is then reimbursed to the family..
6. How is the number of therapy hours determined? It is the intent of the program to be "intensive." The expectation is that the child will receive on the average between 25 - 35 hours of intervention/week. Families must be willing to commit to the intensive nature of the intervention in order to be accepted into the program..
7. Do you require that the child may not be in any other educational program when he begins therapy? If so, for how long? No, so long as the child receives the 25 - 35 hours/week intervention in our treatment program. Most school districts have welcomed developing a working relationship with the Autism Behavioral Network and our therapists work with the child in the school to assist translating curriculum into discrete trial procedures. Working within the school and community has enhanced the children's generalization of skills.
8. How is a child's progress evaluated, and how often is this done? As a behaviorally based intervention program a child's progress is constantly monitored through data collection and evaluation of the results. significant progress must be noted every six months in order for a subsequent prior authorization to be approved by the Department of Health and Social Services. Assessment of developmental status is completed as part of the child's program each year. There is no charge for the developmental updates.
9. What are your criteria for a child exiting the program? Mastery of programs developed and implemented; and, generalization of skills/behaviors to the school and community. Also, the child no longer meets diagnostic criteria for an Autism Spectrum Disorder or displays developmental skills consistent with his/her chronological age.
10. Under what circumstances can a child be dismissed from your program? If the child fails to show skill development or improvement during a six month interval. A child may also be dismissed from the program if the family undermines intervention by consistently failing to have the child available for treatment, failing to follow agreed upon treatment goals or does not take seriously the intensive nature of the program.
Therapists:
1. What are the minimum educational requirements for line therapists? Must have completed at least one year of college.
2. What kind of training are the line therapists given? Who provides the training and what are their qualifications? All newly hired line therapists must first attend a six hour orientation where they begin to learn the basics of applied behavior analysis. the new line therapist then receives 30 hours of overlap by the senior therapist and supervising senior therapist on the case they are assigned. They are not allowed to work alone with the child until this 30 hours of overlap has been completed and a positive evaluation given. The line therapists are also required to attend 6 four hour workshops conducted by our behavior treatment and educational specialist on a yearly basis. Further training occurs at weekly team meetings conducted at the child's home.
3. What should parents do if they have a complaint about a line or senior therapist? Initially discuss their concerns with the supervising senior therapist. If the problem cannot be satisfactorily solved then to contact the Lead Therapist.
Parents:
1. What kind of training is given to parents and other family members? How much training is provided? The Autism Behavioral Network conducts 6 to 8 four hour workshops per year on various aspects of applied behavior analysis and discrete trail learning. There workshops are attended by teachers, aides and other professionals. Parents of children in the program can attend free of charge. The Autism Behavioral Network publishes a monthly newsletter and parents are encouraged to observe the strategies and processes employed by therapists with their child.
2. Must one parent be in the home during therapy sessions? What alternate arrangements are acceptable? No. However, a responsible family member of legal age (18 years) must be available during therapy in the event of an emergency. Availability may be in person, by telephone or pager.
3. What, if any, support services, such as respite or counseling, are offered to families by your organization? How are these services paid for? Mental health services (e.g., counseling, family therapy, medication evaluation/monitoring) are offered through Pediatric Psychology Associates. There services are not covered by medicaid but most are by private insurance.
4. Do you provide prospective families a list of families who have used your services and have agreed to be contacted? Yes.
Other Agencies 1. How do you coordinate with area school districts that the children you are supporting attend? Attend school staffings and help develop IEP's. Work directly with child in classroom. Provide in-service to school personnel on applied behavior analysis. Invite school personnel to attend our workshops.
2. How do you coordinate with private therapists that the family employs who are not a part of your organization? Invite to weekly team meetings. have our therapists ovserve child in alternative therapies (e.g., OT, Speech) to develop common intervention goals strategies.