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In-Home Autism Therapy Survey:

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QUESTIONS FOR IN-HOME AUTISM TREATMENT PROVIDERS

BBA- Beyond Boundaries of Autism (non-profit)
“ Fostering Independence and Community Participation”
A Partnership with Goodwill Industries of North Central Wisconsin, Inc.
A 501 ( c ) ( 3 ) organization
March 8, 2004

Serving: Milwaukee, Fond Du Lac, Waukesha, Outagamie, Brown, Waushara, Waupaca, Portage, Winnebago & Calumet Counties (others pending)
Vivian Hazell, LPC – Executive Director
Kristine Dunlap, Ph.D.- Clinical Director
Kari Barnes, M.A. – Director of Development
Sara Kaiser- Director of Business Operations
1(920)-795-4183

In-Home Autism Therapy Survey:
Questions for Autism Treatment Providers

 

A. Therapy

1. How would you characterize your therapeutic approach? Our therapeutic approach is built off of the foundation that every individual is unique and therefore has a unique set of needs and circumstances. The goal of the therapy is to improve the quality of life for the child through therapeutic interventions that are deemed most effective and appropriate after assessment of the child. Our philosophy allows for flexibility and utilization of a broad range of techniques and interventions. Some of these styles include, but are not limited to, Applied Behavioral Analysis, Verbal Behavior Therapy, as well as Sensory Integration Techniques. Our philosophy also maintains that the use of positive reinforcement as a core technique helps to enhance a child’s learning while simultaneously increasing his or her self-esteem. We recognize that a child who feels successful when attempting to learn new things is more likely to continue attempting to participate in new endeavors. This leads to increased independence and participation in the community, two core values of BBA and Goodwill Industries.

2. How do you work with children who are nonverbal? It is our experience that often children who are labeled as nonverbal possess a tremendous capacity for developing communication. Possession of an effective communication system is frequently correlated with decreased frustration and behavioral challenges. Nonverbal children are assessed as to what tools and techniques would most effectively and appropriately help them to develop communication skills. These skills are then focused on as part of the child’s therapy program. While verbal communication is frequently the most desired outcome, it can also be one of the most difficult to achieve for the nonverbal child. BBA works to establish an effective form of communication, allowing the child to express his or her needs and wants, while simultaneously working to develop speech. Whenever possible, BBA staff consults with appropriate speech and language professionals to assist in the child’s development of speech.

3. How do you accommodate the child’s sensory defensiveness? Sensory defensiveness is most often managed through the use of sensory diets. A sensory diet is a group of activities within the child’s program designed to assist the child with managing and overcoming sensory defensiveness. Some examples of activities that may be included in a sensory diet would be brushing followed by joint compressions, swinging, jumping, biking, deep pressure activities, and other activities designed to reduce tactile defensiveness (e.g. finger painting). Consultations with Occupational Therapists whenever possible also help to accommodate sensory defensiveness.

4. How do you deal with a child’s aggressive behavior? Members of BBA are firm believers that identifying the antecedent that precedes the aggression has a significant impact on decreasing the aggressive behavior. Most often, aggressive behaviors are exhibited due to a child’s lack of ability to access and utilize a more functional and appropriate behavioral response in the moment. If the moment leading up to the aggressive behavior can be identified, it becomes possible to see and understand what tool the child is missing for functional communication. A therapist will then use techniques such as modeling, shaping, extinction, social stories, and positive reinforcement to decrease and eliminate the aggressive behavior and replace it with a more functional behavior.

5. What services are offered in addition to the in-home therapy (i.e. social skills groups, speech therapy, etc.)? Currently, the focus of BBA is to offer in-home therapy services to intensive and ongoing children as determined by the 2004 waiver. BBA maintains a commitment to serving the needs of ongoing children and recognizes the need for and importance of ongoing treatment beyond the three year mark imposed by the waiver. Intensive children are offered intensive, in-home, behavioral therapy services. Ongoing children are offered more flexibility in their choices of services. These choices may include home therapy, home and school consultation, training for staff and families, as well as program development. In the future, we do hope to expand our scope of services to include social skills and other types of group therapy services for children.

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? BBA is dedicated to serving the needs of all children and adolescents diagnosed with an Autism Spectrum Disorder who are likely to benefit from our therapy services and meet the waiver requirements.
  2. What testing do you require initially? Initial testing is not required. Formal, as well as informal, observational assessments are ongoing and take place throughout the duration of the child’s program with BBA.
  3. Under what circumstances will you accept testing by other agencies, such as schools or private therapists? It has been our experience that collaboration with other professionals enhances our ability to assist a child in reaching his or her full potential. If the family is willing to share information for the purpose of providing comprehensive, therapeutic services, BBA is open to receiving the information. BBA will not, however, replace their own assessment tools with testing performed by other agencies.
  4. What are the current out-of-pocket expenses that a parent must pay for the entrance testing? None.
  5. Can parents arrange to have these expenses spread out over a longer period of time? N/A
  6. How is the number of therapy hours determined? The number of hours is determined by the waiver requirements and what is deemed appropriate for the child.
  7. Do you require that the child may not be in any other educational program when he or she begins therapy? If so, for how long? No. In support of our mission and that of Goodwill Industries, fostering independence and community participation, we support the integration into educational and community settings and activities. We also strive to work in collaboration with theses agencies in order to help the child lead a full, productive, and satisfying life.
  8. How is a child’s progress evaluated, and how often is this done? Progress is charted and documented at a number of different levels and intervals. Daily session logs and data sheets are kept to track progress as well as monthly and bi-annual progress reports. Baseline data is also taken upon entrance into the program. Formal and informal assessments are regularly done throughout the program and final outcome measures are currently being designed.
  9. What are your criteria for a child exiting the program? Upon successful completion of program (treatment) goals a child will be recommended for exit of the program.
  10. Under what circumstances will a child be dismissed from your program? A child will be dismissed only when it is deemed appropriate due to a lack of progress, lack of participation or cooperation with program guidelines, when safety of client or staff is brought into question, or when legal reasons dictate dismissal. Dismissal can also occur if funding from the waiver program is terminated. All clients are at-will and have the right to terminate at any time.

 

Therapists:

  1. What are the minimum educational requirements for line staff? Line staff hired by BBA must meet the minimum educational requirements set forth by the State of Wisconsin. Currently, this includes a high-school diploma and 160 hours face to face experience working with individuals with autism while being supervised by a Senior Therapist. Line Staff with a high school diploma, but without 160 hours must participate in a 30 hour training program as designated by the State of Wisconsin. BBA offers this training to potential new Line Therapists.
  2. What kind of training are the Line Therapists given? Who provides their training and what are their qualifications? Line Staff are given the state required 30 hours of training if they do not come with the necessary number of hours. After this, training is ongoing and is provided in the form of consultation, observation, team meetings and overlap. Line Therapists are supervised by Bachelor’s and Master’s degreed senior staff members who meet requirements set forth by the state to become Senior Therapists. Line Staff are also indirectly supervised by the Lead Therapist, a Ph.D. responsible for supervision of Senior Therapists.
  3. What should parents do if they have a complaint about a line or senior therapist? Parents are encouraged to communicate openly with their staff. The team is dedicated to providing the best services possible to the child. If they feel that they have a complaint about their line staff, it can be addressed with their Senior Therapist. If their complaint is in regards to their Senior Therapist, it is advised to first speak with the Senior Therapist to see if the problem can be resolved. If this does not solve the problem, a meeting can be set up with the Lead Therapist, or Executive Director.

 

Parents:

  1. What kind of training is given to parents and other family members? How much training is provided? In conjunction with BBA’s and Goodwill’s philosophy of fostering independence, parental and familial training is recognized as a crucial component to success in this area. We strive to decrease the independence on therapists and to teach parents the skills that the therapists are utilizing in order to teach the child. Familial training is incorporated through team meetings and generalization of skills outside of therapy sessions. Parents are encouraged to speak frequently and openly with staff in regards to asking questions about ways to teach their child. BBA is receptive to these questions and will provide as much parental and familial training as is necessary and appropriate.
  2. Must one parent be in the home during therapy sessions? What alternate arrangements are acceptable? Yes. It is a policy of Goodwill that at least one adult or guardian for the client and his or her siblings remain in the home during therapy sessions.
  3. What, if any, support services, such as respite or counseling are offered to families by your organization? How are these services paid for? Currently, these services are not available and will be referred out as deemed necessary. Payment arrangements are made between the client family and the agency providing support. It is possible, that in the future, BBA will be offering these types of services.
  4. Do you provide prospective families a list of families who have used your services and agreed to be contacted? No. Due to the confidential nature of providing therapeutic services, we do not offer this type of information.

 

Other Agencies:

  1. How do you coordinate with area school districts that the children you are supporting attend? We offer to observe and consult in the schools and offer input during meetings and conferences as requested by parents and school and as deemed appropriate by the CLTS waiver. We strongly value the collaboration between home, school, and community agencies.