Resource-መረጃ ምንጭ

Resources About Early Intervention in Speech Therapy

Over the past decade applied behavior analysis (ABA) has become widely-recognized as the most effective therapy for addressing the behavioral issues associated with autism. Thanks to the tireless efforts of applied behavior analysts and other therapists, along with the advocacy groups that work on their behalf, state legislators heard the appeals and responded overwhelming in support of autism insurance reform.

Disability Rights DC 

I want to share this announcement as this can have a big impact on individuals with autism in the District.  Disability Rights DC supports the extension of services to individuals with developmental disabilities (currently eligibility for services from the District’s Developmental Disability Administration are limited to those who have a diagnosis of intellectual disability) including those with autism who may not have an intellectual disability but need supports so they can live in and be an active part of our community.  We urge you to make your voice heard now.  If you want more information or have questions about testifying, please feel free to contact or call Sandy Bernstein in our office at (202) 547-0198 ext. 117 or sbernstein@uls-dc.org.

Monthly Caregiver Webinar Series

There is a new monthly Caregiver Webinar Series by Children's National specialty providers and community experts on the 3rd Wednesday of each month from 12-1:00pm via Zoom. Caregivers can register at the following link: 

https://childrensnational.org/departments/center-for-neuroscience-and-behavioral-medicine/programs-and-services/early-childhood-behavioral-health-program/caregiver-webinar

Children is willing to give interpreter during this webinar.
 
Topic: Promoting Early Language for Children
Date: October 20, 2021
Presenter: Colleen Morgan, M.A., CCC-SLP, speech-language pathologist 

FAQ about Disability Support

What is Autism?

Autism Spectrum Disorder (also known as autism or ASD) is a disorder classified by a set of specific behaviors related to social, communication, and behavioral differences. The word “spectrum” appreciates the fact that individuals with autism are all different and their symptoms of autism could be anywhere on a continuum from very mild to very severe in any of the areas of need that characterize the disorder.

What is Applied Behavior Analysis (ABA)?

Applied Behavior Analysis (ABA) is a therapy based on the science of learning and behavior.

Behavior analysis helps us to understand:

  • How behavior works
  • How behavior is affected by the environment
  • How learning takes place

ABA therapy applies our understanding of how behavior works to real situations. The goal is to increase behaviors that are helpful and decrease behaviors that are harmful or affect learning.

ABA therapy programs can help:

  • Increase language and communication skills
  • Improve attention, focus, social skills, memory, and academics 
  • Decrease problem behaviors

The methods of behavior analysis have been used and studied for decades. They have helped many kinds of learners gain different skills – from healthier lifestyles to learning a new language. Therapists have used ABA to help children with autism and related developmental disorders since the 1960s.

How does ABA therapy work?

Applied Behavior Analysis involves many techniques for understanding and changing behavior. ABA is a flexible treatment:  

  • Can be adapted to meet the needs of each unique person

  • Provided in many different locations – at home, at school, and in the community
  • Teaches skills that are useful in everyday life
  • Can involve one-to-one teaching or group instruction
  • Positive Reinforcement

    Positive reinforcement is one of the main strategies used in ABA.

    When a behavior is followed by something that is valued (a reward), a person is more likely to repeat that behavior. Over time, this encourages positive behavior change.

    First, the therapist identifies a goal behavior. Each time the person uses the behavior or skill successfully, they get a reward. The reward is meaningful to the individual – examples include praise, a toy or book, watching a video, access to playground or other location, and more.

    Positive rewards encourage the person to continue using the skill. Over time this leads to meaningful behavior change. 

    Antecedent, Behavior, Consequence

    Understanding antecedents (what happens before a behavior occurs) and consequences (what happens after the behavior) is another important part of any ABA program.

    The following three steps – the “A-B-Cs” – help us teach and understand behavior:

    1. An antecedent: this is what occurs right before the target behavior. It can be verbal, such as a command or request. It can also be physical, such a toy or object, or a light, sound, or something else in the environment. An antecedent may come from the environment, from another person, or be internal (such as a thought or feeling).

    2. A resulting behavior: this is the person’s response or lack of response to the antecedent. It can be an action, a verbal response, or something else.  

    3. consequence: this is what comes directly after the behavior. It can include positive reinforcement of the desired behavior, or no reaction for incorrect/inappropriate responses.                         Looking at A-B-Cs helps us understand:
      1. Why a behavior may be happening
      2. How different consequences could affect whether the behavior is likely to happen again

      EXAMPLE:

      • Antecedent: The teacher says “It’s time to clean up your toys” at the end of the day.
      • Behavior: The student yells “no!”
      • Consequence: The teacher removes the toys and says “Okay, toys are all done.”

      How could ABA help the student learn a more appropriate behavior in this situation?

      • Antecedent: The teacher says “time to clean up” at the end of the day.
      • Behavior: The student is reminded to ask, “Can I have 5 more minutes?”
      • Consequence: The teacher says, “Of course you can have 5 more minutes!”

      With continued practice, the student will be able to replace the inappropriate behavior with one that is more helpful. This is an easier way for the student to get what she needs!

      What Does an ABA Program Involve?

      Good ABA programs for autism are not "one size fits all." ABA should not be viewed as a canned set of drills. Rather, each program is written to meet the needs of the individual learner.

      The goal of any ABA program is to help each person work on skills that will help them become more independent and successful in the short term as well as in the future.

      Planning and Ongoing Assessment

      A qualified and trained behavior analyst (BCBA) designs and directly oversees the program. They customize the ABA program to each learner's skills, needs, interests, preferences and family situation. 

      The BCBA will start by doing a detailed assessment of each person’s skills and preferences. They will use this to write specific treatment goals. Family goals and preferences may be included, too.

      Treatment goals are written based on the age and ability level of the person with ASD. Goals can include many different skill areas, such as:

      • Communication and language
      • Social skills
      • Self-care (such as showering and toileting)
      • Play and leisure
      • Motor skills
      • Learning and academic skills

      The instruction plan breaks down each of these skills into small, concrete steps. The therapist teaches each step one by one, from simple (e.g. imitating single sounds) to more complex (e.g. carrying on a conversation).

      The BCBA and therapists measure progress by collecting data in each therapy session. Data helps them to monitor the person’s progress toward goals on an ongoing basis.

      The behavior analyst regularly meets with family members and program staff to review information about progress. They can then plan ahead and adjust teaching plans and goals as needed.

      ABA Techniques and Philosophy

      The instructor uses a variety of ABA procedures. Some are directed by the instructor and others are directed by the person with autism.

      Parents, family members and caregivers receive training so they can support learning and skill practice throughout the day.

      The person with autism will have many opportunities to learn and practice skills each day. This can happen in both planned and naturally occurring situations. For instance, someone learning to greet others by saying "hello" may get the chance to practice this skill in the classroom with their teacher (planned) and on the playground at recess (naturally occurring).

      The learner receives an abundance of positive reinforcement for demonstrating useful skills and socially appropriate behaviors. The emphasis is on positive social interactions and enjoyable learning.

      The learner receives no reinforcement for behaviors that pose harm or prevent learning.

      ABA is effective for people of all ages. It can be used from early childhood through adulthood!

      Who provides ABA services?

      A board-certified behavior analyst (BCBA) provides ABA therapy services. To become a BCBA, the following is needed:

      • Earn a master’s degree or PhD in psychology or behavior analysis
      • Pass a national certification exam
      • Seek a state license to practice (in some states)

      ABA therapy programs also involve therapists, or registered behavior technicians (RBTs). These therapists are trained and supervised by the BCBA. They work directly with children and adults with autism to practice skills and work toward the individual goals written by the BCBA. You may hear them referred to by a few different names: behavioral therapists, line therapists, behavior tech, etc.

      To learn more, see the Behavior Analyst Certification Board website.

      What is the evidence that ABA works?

      ABA is considered an evidence-based best practice treatment by the US Surgeon General and by the American Psychological Association. 

      “Evidence based” means that ABA has passed scientific tests of its usefulness, quality, and effectiveness. ABA therapy includes many different techniques.  All of these techniques focus on antecedents (what happens before a behavior occurs) and on consequences (what happens after the behavior). 

      More than 20 studies have established that intensive and long-term therapy using ABA principles improves outcomes for many but not all children with autism. “Intensive” and “long term” refer to programs that provide 25 to 40 hours a week of therapy for 1 to 3 years. These studies show gains in intellectual functioning, language development, daily living skills and social functioning. Studies with adults using ABA principles, though fewer in number, show similar benefits.

      Is ABA covered by insurance? 

      Sometimes. Many types of private health insurance are required to cover ABA services. This depends on what kind of insurance you have, and what state you live in.

      All Medicaid plans must cover treatments that are medically necessary for children under the age of 21. If a doctor prescribes ABA and says it is medically necessary for your child, Medicaid must cover the cost.

      Please see our insurance resources for more information about insurance and coverage for autism services

      You can also contact the Autism Response Team if you have difficulty obtaining coverage, or need additional help.

      Where do I find ABA services? 

      To get started, follow these steps:

      1. Speak with your pediatrician or other medical provider about ABA. They can discuss whether ABA is right for your child. They can write a prescription for ABA if it is necessary for your insurance.
      2. Check whether your insurance company covers the cost of ABA therapy, and what your benefit is.
      3. Search our resource directory for ABA providers near you. Or, ask your child’s doctor and teachers for recommendations.
      4. Call the ABA provider and request an intake evaluation. Have some questions ready (see below!)

      What questions should I ask? 

      It’s important to find an ABA provider and therapists who are a good fit for your family. The first step is for therapists to establish a good relationship with your child. If your child trusts his therapists and enjoys spending time with them, therapy will be more successful – and fun!

      The following questions can help you evaluate whether a provider will be a good fit for your family. Remember to trust your instincts, as well!

      1. How many BCBAs do you have on staff?
      2. Are they licensed with the BACB and through the state?
      3. How many behavioral therapists do you have?
      4. How many therapists will be working with my child?
      5. What sort of training do your therapists receive? How often?
      6. How much direct supervision do therapists receive from BCBAs weekly?
      7. How do you manage safety concerns?
      8. What does a typical ABA session look like?
      9. Do you offer home-based or clinic-based therapy?
      10. How do you determine goals for my child? Do you consider input from parents?
      11. How often do you re-evaluate goals?

Can Autism Be Cured?

Although it is a common (and the only scientifically-proven) treatment for autism, ABA is not a cure for the disorder. In fact, most professionals believe that there is no cure for Autism Spectrum Disorder (ASD).

Some experimental studies, like one published in 2017 covering stem cell transfusion therapy in a small group of ASD patients, show promise. And a 2016 lab experiment on mice showed that blocking production of a particular protein prevented autism-like symptoms from being expressed.

But such research is only exploratory and not definitive. Results take time and for millions of current ASD patients, such exotic treatment will never be an option even if they are proven to be effective.

How are IEPs Designed for Students with ASD?

Individual Education Plans came about as a result of the IDEA (Individuals with Disabilities Education Act) passed by Congress in 2004. The act calls for every public school district to provide a free and appropriate public education to all students, including those with special needs. In today’s environment, many of those special needs students have autism spectrum disorder (ASD).

In order to ensure that those children’s needs are being met, IDEA requires that an IEP must be separately designed and written for every qualifying student that outlines:

  • Present level of academic and functional performance
  • Measurable annual goals and the metrics used to quantify progress
  • Special-education and related services required to meet those goals
  • Modifications to equipment or other school programs that will be required
  • Other data regarding scheduling and attendance plans
  • Transition plans as the child progresses toward graduation

These documents can run to twenty pages and have up to thirteen different sections covering those aspects in excruciating detail. They can be a real challenge for parents of kids with ASD to understand and interpret, but they are designed to give those kids an equal opportunity to education with their peers. If you are one of those parents, understanding the process and purpose of individual education plans will give you real power to help your child navigate the school system and get the best possible education.

WHY SHOULD I GET ABA SERVICES FOR MY CHILD?

Applied Behavior Analysis (ABA) services are grounded in science and have been researched to prove their effectiveness. ABA services are effective in teaching many new skills including how to communicate, be social, and care for oneself. ABA also helps address behaviors that may be a concern by understanding the “function” that a behavior may serve.

How Can You Tell ASD from ADD/ADHD in a Young Child?

It is entirely possible for children to have both ASD and ADHD. In fact, it is actually quite common for the two disorders to co-occur. A National Institutes of Health study published in 2014 showed that 18 percent of children diagnosed with ADHD actually showed symptoms of ASD.

If you’ve found yourself here, reading this page, you’re asking yourself:

Which – if any- of these disorders does my child have and how can I tell?’

Early diagnosis and intervention of behavioral and neurological disorders is imperative. Proper treatment can actually reduce the severity of the symptoms, no matter what the diagnosis might be.

If you’re concerned your child may have one or both of these disorders, the earlier you voice these concerns to a doctor, the better. The young brain is an adaptable brain and early treatment options may help reduce the severity of symptoms as your child ages. In some cases, the faulty neural connections in the brain can actually be rerouted.

How is Autism Diagnosed?

The difficulties in conclusively diagnosing a person with Autism Spectrum Disorder (ASD) show up right in the name of the affliction: as a spectrum, it can represent a wide range of different degrees of severity and types of symptom, usually including:

  • Behavioral problems
  • Difficulties in forming bonds and engaging in social interaction
  • Communication and language difficulties
  • Sensory deficits

These different combinations of behavior and function have always been difficult to categorize. Since autism was first described as a distinct disorder in the early 1940s, it was joined by a handful of other similar syndromes and disorders, including:

  • Asperger’s Syndrome
  • Rett Syndrome
  • Pervasive Developmental Disorder
  • Childhood Disintegrative Disorder

Each of these attempted to describe a distinctive set of symptoms and degrees of disability, but each of them failed to fully capture the range of possible symptoms and behaviors.

WHAT WILL MY CHILD’S ABA SERVICES LOOK LIKE?

At ABI, we provide direct services at our Center, in your home, and in the community depending on the needs of your child. We complete comprehensive assessments to understand where your child is strong and where they need help. Parents and other caregivers are always involved in the assessment process. After assessment, we develop treatment plans that spell out how often your child will be seen, where they will be seen, and what skills will be taught. Behavior support plans are developed at this time too.

HOW DO I GET STARTED?

To get started, follow these steps:

  1. Speak with your pediatrician or other medical provider about ABA. They can discuss whether ABA is right for your child. They can write a prescription for ABA if it is necessary for your insurance.
  2. Check whether your insurance company covers the cost of ABA therapy, and what your benefit is.
  3. Search our resource directory for ABA providers near you. Or, ask your child’s doctor and teachers for recommendations.
  4. Call the ABA provider and request an intake evaluation. Have some questions ready (see below!)

DOES INSURANCE COVER ABA SERVICES?

Is Asperger Syndrome the Same As Autism?

Aspies, as many Asperger’s Syndrome patients call themselves, have long been a group apart from the general population of ASD sufferers.

Asperger’s is named after Doctor Hans Asperger, an Austrian physician and pediatrician. In 1980, English psychiatrist Lorna Wing acknowledged both that fact and his studies by naming a less severe strain of autistic spectrum disorder (ASD) after him

Is Autism Genetic?

When you get an incurable disorder that affects 1 out of every 166 children born in the United States, a number that has skyrocketed by nearly 700 percent in the course of a single decade, one thing you want to know right away is what is causing it.

With autism, the answer to that question has remained shrouded in mystery.

It’s a hard reality for the thousands of families afflicted with a child suffering from the disorder, as well as the ranks of doctors and applied behavior analysts who are on the front lines of treating ASD (Autism Spectrum Disorder) patients. Understanding the causes could lead to more effective treatments, better prevention efforts, and even a measure of peace for anguished parents forced to grapple with the question of whether or not they contributed in some unknowing way to their child’s struggles.

What are the Health Problems that Co-Occur with Autism?

The wide range of symptoms and behaviors associated with Autism Spectrum Disorder (ASD) are complicated enough to deal with on their own, but add in the vast array of other issues that often accompany it and it becomes a minefield to navigate.

If your child has been diagnosed with autism you already face special behavioral challenges. What makes ASD even more difficult are the many other medical health issues that often arise in conjunction with it. Sometimes these symptoms even mask ASD or vice versa.

Many of the issues outlined here can overlap each other. This makes it even more difficult for researchers to clearly determine how and why children with ASD are more likely to experience one or more of them. It is important that as a parent you keep very detailed notes on any areas of concern. This can aid in diagnosis and treatment options, giving you the best shot possible at reducing or eliminating these issues.

What Is High-Functioning Autism?

The use of the word spectrum in the condition Autism Spectrum Disorder (ASD) implies a wide range of severity levels. The most functional end of that range belongs to high-functioning autistics (HFA). Although diagnosed formally with ASD, people with HFA often lead remarkably normal lives and have less difficulty assimilating into society than other ASD patients.

There is no technical medical definition for high-functioning autism, so the term is sometimes—maybe even usually—applied unevenly. Many people believe that Albert Einstein was a high-functioning autistic; others apply the term to anyone with ASD who has an IQ over 70… a long way from Einstein’s caliber!

Nonetheless, most people consider HFA less an indicator of relative intelligence than one of social skill. HFA patients may present as neurotypical or nearly neurotypical people with some slight behavioral tics. Their social skills may be underdeveloped but not markedly so. Before autism became widely recognized as a distinct diagnosis apart from other mental disorders, many high functioning autistics simply would never have been diagnosed with any affliction, but rather regarded as simply odd or eccentric.

Why is Routine so Important to People with ASD?

One of the primary diagnostic criteria for autism spectrum disorder (ASD) as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is that the individual shows restricted, repetitive patterns of behavior, interests, or activities. And one of the key items of evidence to support the diagnosis is an insistence on sameness and an inflexible adherence to routines… extending down to minute details with things like the placement of toys, silverware, or bath towels… or into types of foods available at certain meals and the order in which they may be eaten… or the exact words and even tone of voice used in a bedtime story.

This insistence on routine and sameness can only be categorized as obsessive and compulsive

Any deviation from any of these particulars, even one almost undetectable to a neurotypical individual, can result in enormous anxiety and tantrums from an ASD patient. Adherence to routine becomes obsessively important and any sort of change is a major cause for alarm.