Educational-Behavioral Therapies: Overview

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Applied Behavioral Analysis (ABA)

Who & Where: Board Certified Behavior Analyst (BCBA) typically leads a team of paraprofessionals working 1:1 with child in the home or at school.

Applied behavior analysis (ABA) is the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree (Baer, Wolf & Risley, 1968/1987; Sulzer-Azaroff & Mayer, 1991). Specifically, ABA refers to a systematic approach to the assessment and evaluation of behavior, and the application of interventions that alter behavior. A program binder is created specifically for each child which includes teaching procedures and data collection sheets for the child’s in-home program. ABA training is provided for therapy assistants and parents regarding teaching skills and behavior management. Ongoing program consultation is provided which includes recommendations and changes to in-home program based on child’s progress.

Who Pays: Insurance (where available), School, Private Pay

More info: ABA Resources for Recovery from Autism/PDD/Hyperlexia

 

Assistive Technology or Augmentative Communication

Who & Where: Typically a highly trained speech therapist will assist your child with an augmentative communication device. Many schools and service agencies are now using Assistive Tech Specialists for augmentative communication.

An augmentative communication device can be anything from a simple picture board to an extensive computer system. There are many ways to communicate besides verbal language. Augmentative communication devices can be the answer to helping your child communicate with you. Augmentative communication does not eliminate the use of verbal speech. Both can be worked on as goals for your child. Make sure that different augmentative communication devices are tried to find the best one for your child.

Who Pays: School, Medicaid, Medwaiver, Private Pay

More info: Helping Non-Verbal Kids to Communicate

 

Floortime, aka Play Therapy

Who & Where: Specially trained Floortime therapist or Early Intervention therapist; in home.

Floor Time is a technique from the DIR model (Developmental, Individual-difference, Relationship-based) designed to help a child elaborate and expand on interactions with others through gestures, words, and pretend play. It is a way of relating to the child.

Floor Time was designed to strengthen individuals’ cognitive, emotional, social, and physical development. Emphasis is placed on facilitating two-way communication, expressing feelings, and developing logical thought.

Who Pays: Insurance, Private Pay, Medwaiver (some states), Early Intervention

More info: The Interdisciplinary Council on Developmental & Learning Disorders and www.polyxo.com

 

Itinerant Therapies/Services

Who & Where: School therapists, In school

This means for whatever reason your child does not attend the school itself for an educational program, but you still use the PT, OT and ST to deliver these services in an out-patient setting (on school campus but in a 1:1 situation). This includes Homeschooling families.

Who Pays: School

 

Occupational Therapy (OT)

Who & Where: Licensed Occupational Therapist; In school or in private practice.

An occupational therapist works to improve your child’s fine motor development. Fine motor means small movement, often it is how your child’s hands manipulate an object. It is how they pick up an object, color or write, perform self-care activities, and perceive their environment through their senses.

An occupational therapist assists your child to perform activities of daily living (ADL), such as manipulating toys in play, writing, dressing, feeding, bathing, and working. An occupational therapist will evaluate your child’s trunk and upper body strength, joint range of motion, muscle tone, skin integrity, fine motor milestones, eye-hand coordination, manipulation of objects within their hands, sensory (sight, smell, hearing, touch, taste) awareness, and activities of daily living. The therapist, along with your input, will develop goals for your child and a plan of how to achieve these goals. Therapy sessions are typically geared towards functional activities that your child should be performing, such as playing, dressing, self-feeding, bathing, coloring, writing, craft projects, and work activities.

Occupational therapists will sometimes use assistive devices to perform ADLs, big therapy ball, bolsters, wedges, and swings during therapy as a complimentary sensory integration strategy to reduce tactile defensiveness, sound sensitivity, photosensitivity, etc.

Who Pays: Schools, Insurance, Private Pay, Medwaiver

More info: American Occupational Therapy Association

 

Physical Therapy (PT)

Who & Where: Licensed Physical Therapist; In school or in private practice.

A physical therapist works to improve your child’s gross motor development. Gross motor means large movement, such as rolling, crawling, standing, walking, running, and playing on a playground. Physical therapy deals with mobility, which is how your child moves from one place to another, or how your child reaches to obtain an object.

A physical therapist facilitates your child to move. In order to achieve movement, the therapist will evaluate your child’s strength, joint range of motion, muscle tone, balance reactions, gait (how your child walks), skeletal integrity, skin integrity, endurance, gross motor milestones and active movement. The therapist, along with your input, will develop goals for your child and a plan of how to achieve these goals. Therapy sessions are typically geared towards functional activities, which for children is typically play, to achieve the established goals. Physical therapists will sometimes use big therapy balls, bolsters, wedges, bicycles, treadmills, swimming pools, playground equipment, and other equipment to facilitate movement. A physical therapist is also very involved with adaptive equipment such as splints, braces, seating devices, car seats, strollers, and wheelchairs.

Who Pays: Schools, Insurance, Private Pay, Medwaiver

More info: American Physical Therapy Association

 

Social Skills Training (SST)

Who & Where: Contracted Agency, School and in-home

Children on the spectrum usually do not naturally acquire the ability to interact with others. They have to learn these skills intellectually through deliberate treatments and interventions. There are a number of specialized curricula for Social Skills including “The Hidden Curriculum.”  Social stories and video modeling are useful tools for teaching social skills to children.

Some Easter Seals or UCP branches offer Social Skills training. You can also incorporate Social Skills into your child's IEP. Some Medwaiver programs cover this too. There is no certification for this job.

Who Pays: School, Private Pay, Medwaiver

More info: A Model for Social Skills Instruction

Social Stories info: An Introduction to Social Stories

 

Speech Therapy (ST)

Who and Where: Licensed Speech Language Pathologist; In school or in private practice.

A speech language pathologist works to improve your child’s ability to communicate and to manipulate food and liquids involved with feeding. Language development begins at a very early age. There is receptive language, which is the ability to understand language. And there is expressive language, which is the ability to produce communication through verbalization, or sign language, or a communication device. A speech therapist is also concerned with your child’s mouth mechanics, and, when possible, promotes the development of pragmatic language skills.

A speech language pathologist evaluates your child’s understanding of language and ability to communicate through non-verbal and verbal gestures. The therapist will also evaluate your child’s cognitive status, which is the thought and learning process. A speech language pathologist also evaluates your child’s ability to chew and swallow food and liquids. The therapist, along with your input, will develop goals for your child and a plan of how to achieve these goals.

Children with autism tend to have difficulty communicating with people due to the thought process of communication more than due to articulation problems (the mechanics of how the mouth works). If your child is having problems with communication, then a total communication approach should be in place, which consists of the promotion of language development through spoken language, picture boards, sign language and/or augmentative devices.

Speech therapy sessions are geared towards language development through pictures, books, singing, respiration activities, babbling, speaking and communication devices. Therapy can also focus on feeding skills and how to coordinate your child’s mouth musculature to chew and swallow food and liquids. For children who are speaking, SLPs can assist in teaching reading non-verbal cues, developing conversation skills, promoting perspective-taking and other communication language skills.

Who Pays: Schools, Insurance, Private Pay, Medwaiver

More info: American Speech-Language-Hearing Association

 

Relationship Development Intervention (RDI)

Who & Where: A trained RDI consultant and parents.  In-home program.

Relationship Development Intervention focuses on quality of life. RDI goes beyond teaching an autistic individual social and life skills. The foundations of the program include fostering genuine relationships, creating a desire and ability to live in a dynamic world, and self-empowerment.

The RDI Connect website states that the RDI program is “a parent-based intervention program where parents are provided the tools to effectively teach Dynamic Intelligence skills and motivation to their child.” Dynamic Intelligence skills consist of experience sharing, dynamic analysis, flexible and creative problem-solving, episodic memory and self-awareness, and resilience.

Who Pays: Private Pay,Insurance*

For more info: RDI Connect

* RDI's assessments, as well as follow-up consultations, are covered by insurance if the provider is a licensed mental health provider who is practicing within their scope of practice.

 

Verbal Behavior

Who & Where: Board Certified Behavior Analyst (BCBA) typically leads a team of paraprofessionals working 1:1 with child in home.  Sometimes in schools.

Verbal Behavior or VB is a form of ABA. It uses B.F. Skinner's 1957 analysis of Verbal Behavior to teach and reinforce speech, along with other skills. Skinner described categories of speech, or verbal behavior:

  • Mands are requests ("I want a drink.")
  • Echoes are verbal imitations,
  • Tacts are labels ("toy," "elephant") and
  • Intraverbals are conversational responses ("What do you want?").

A VB program will focus on getting a child to realize that language will get him what he wants, when he wants it. Requesting is often one of the first verbal skills taught; children are taught to use language to communicate, rather than just to label items. Learning how to make requests also should improve behavior. Some parents say VB is a more natural form of ABA.

Who Pays: Insurance, School, Private Pay

For more info: Autism Teaching Methods: Applied Behavior Analysis and Verbal Behavior