Behavior Management Program

Services are intended for any child with behavioral problems and range from simple behavior interventions (e.g., potty-training, hitting, sibling rivalry) to more complex behaviors (e.g., related to diagnoses of autism, ADHD, PDD, etc.)

Our goal is to help a child be as successful as possible. To achieve this, we determine a child’s strengths and challenges, preferences and anxieties. We need to know how to motivate the child using areas of strength and preference; we work on overcoming challenges and anxieties—our mission is to motivate the child to want to learn and then teach them “how to learn.”

Unlike most programs, our approach is GLOBAL. We meet with the family to learn about the child’s natural environment, behaviors of concern, preferences, and challenges. We evaluate the child’s global development —cognition, language, gross and fine motor skills, social-emotional, and self-help skills. We assess sensory processing and regulatory status. We consult with the school staff to discuss concerns in a school setting, behaviorally and academically.

We set up an individualized plan for the family utilizing a variety of modalities and approaches, best suited to the child’s needs. Our program includes:

• ABA structure and program design (by experienced BCBAs)
• Floor-time / child-directed sessions (by DIR®-trained multidisciplinary line therapists)
• Play-based interactions with focus on learning through play
• Sensory profile conducted (by experienced OTs) with appropriate sensory strategies utilized
• Additional modalities utilized as needed (e.g., Therapeutic Listening, Interactive Metronome)
• Tailored individually to family needs
• Parent coaching and team participation
• Family support specialist assigned to each family for needs assessment, access to resources, and advocacy

WHERE?

A Behavior Management program can be implemented across multiple environments. The location of therapy is determined by the parent’s goals for their child and can include:

• Schools
• Home
• Clinic

If treatment sessions are held at school, teacher/principal approval and contact information is required. Meetings with school staff will be held periodically to ensure school-based intervention is successful and progress is observed. Home-based behavior intervention will also include parent training/parent modeling so that behavior protocols can be used throughout the day and the family routines. Parents or caretakers are required to be present during home-based sessions. Since this type of intensive intervention can be disruptive to home environments, family counseling is available to help families cope with and overcome stressors.

WHO?

Your behavior management team will consist of Team Leader (Board-Certified Behavior Analyst or Licensed Clinical Counselor), Level II ABA Therapist (certified in ABA, certified autism specialists, experienced ABA line therapists with degrees in child development, speech/hearing, or related field), Special Education Coordinator, and Family Support Specialist.

Team members will also include speech language pathology, occupational therapy, physical therapy, and developmental therapy to address specific areas of concern such as speech, motor planning, feeding, or sensory/regulatory status.

Who are Board Certified Behavior Analysts (BCBA)?

Board certified behavior analysts (BCBA) are professionals that have demonstrated the academic and practical requirements to practice behavior analysis. BCBAs monitor ABA programs consistent with the guidelines of the Behavior Analyst Certification Board.

WHEN?

The program can be as intensive as needed. Hours generally decrease as the client increases independent skills and generalizes behavioral changes to other critical settings. Research has concluded that children under 3 years of age with an ASD diagnosis have better outcomes when they receive 25-30 hours/week. However, it is important to realize that intensive hours need to be productive and effective, and also need to fit in within school and family routines as much as possible. For that reason, our program can be adjusted as per child and family needs and goals:

1. Flexible program: intended to target problem behaviors, the absence of appropriate behaviors, and those who need to acquire skills (i.e., communication, flexibility, tolerating change in environments and activities, self-help skills, social skills, etc.). Programming can run 5 up to 15 hours per week of direct therapy (plus direct and indirect supervision hours).
2. Comprehensive program: intended to address multiple targets across all developmental domains. Programming can range from 15-25 hours of direct treatment plus supervision per week.
3. Intensive program:  intended to change developmental trajectories to match that of typically developing peers. Research suggests 30–40 hours per week (6–7 hours daily, 5–6 days/week) of treatment.

Comparison of ABA and DIR Floor Time

We believe strongly in the benefits of using a combination of both approaches based on best practice for each individual child. ABA is task-oriented and focuses on changing negative behaviors and acquiring specific skills. Floor-time is child-directed and focuses on a child’s emotional interests and growth.

What is Applied Behavior Analysis (ABA) or Verbal Behavior Therapy (VBT)?

It is the real world application of behavior analysis to behaviors we encounter in everyday life.  ABA helps to modify human behaviors as part of a learning or treatment process.  It is NOT just one technique, but a scientific approach to understanding why people do what they do and ultimately change the behavior in a way that is beneficial to the growth and development of the individual.

ABA and VBT use objective and reliable data collection systems to monitor behavior change and individualized to each child based off his/her specific needs. Motivation and positive reinforcement are key factors in teaching the child socially significant behaviors—positive reinforcement is used to increase the duration and frequency of appropriate behaviors, while reduction procedures and replacement behaviors are put in place to decrease/eliminate maladaptive behaviors. Data collection procedures are put into place for each targeted behavior and analyzed by the team. The parents, therapists, and consultant work together as a team to discuss the data, current targets, and future targets.

What is ‘Floor-Time Approach’?

The “Floor-time Approach” is based on a system developed by the late Stanley Greenspan, M.D., a well-known and respected authority on clinical work with children with developmental and emotional problems. Floor-time focuses on building a child’s strengths and abilities by creating an interactive relationship with the child, following the child’s natural emotional interests and at the same time gradually challenging the child towards greater and greater mastery of the social, emotional and intellectual capacities.

The DIR^® / Floortime™ Model (DIR^® = Developmental, Individual Difference, Relationship-based Model) ) is a comprehensive framework which enables clinicians, parents and educators to construct a program tailored to the child’s unique challenges and strengths. The objectives of this model are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. This model emphasizes the critical role of parents and other family members because of the importance of their emotional relationships with the child.

D (Developmental) = building blocks of this foundation and describe the developmental milestones that every child must master for healthy emotional and intellectual growth.

I (Individual differences) = describes the unique biologically-based ways each child takes in, regulates, responds to, and comprehends sensations such as sound, touch, and the planning and sequencing of actions and ideas.

R (Relationship-based) = describes the learning relationships with caregivers, educators, therapists, peers, and others who tailor their affect based interactions to the child’s individual differences and developmental capacities to enable progress in mastering the essential foundations.

For more information, please call us at 312-458-9865 or email us at info@pediatricresources.org.