Skills for Autism CARD Skills Elearning

Leading the Way in the Successful Treatment of Autism
The Center for Autism and Related Disorders (CARD) is one of the world's largest organizations using applied behavior analysis (ABA) in the treatment of autism spectrum disorder.
CONTACT US TOLL FREE (PARA AYUDA EN ESPAÑOL): 1-855-345-CARD (2273)

CARD: INTRODUCTION

ABA RESOURCES: INTRODUCTION

What is ABA Therapy

What is ABA?

Behavior Analysis is the scientific study of behavior. Applied Behavior Analysis (ABA) is the application of the principles of learning and motivation from Behavior Analysis, and the procedures and technology derived from those principles, to the solution of problems of social significance. Many decades of research have validated treatments based on ABA.

The Report of the MADSEC Autism Task Force (2000) provides a succinct description, put together by an independent body of experts:

Over the past 40 years, several thousand published research studies have documented the effectiveness of ABA across a wide range of:

  • populations (children and adults with mental illness, developmental disabilities and learning disorders)
  • interventionists (parents, teachers and staff)
  • settings (schools, homes, institutions, group homes, hospitals and business offices), and
  • behaviors (language; social, academic, leisure and functional life skills; aggression, selfinjury, oppositional and stereotyped behaviors)

Applied behavior analysis is the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree, and to demonstrate that the interventions employed are responsible for the improvement in behavior (Baer, Wolf & Risley, 1968; Sulzer-Azaroff & Mayer, 1991).

CARD: DISCRETE TRIAL TRAINING

DISCRETE TRIAL TRAINING

Discrete trial training (DTT) is a particular ABA teaching strategy which enables the learner to acquire complex skills and behaviors by first mastering the subcomponents of the targeted skill. For example, if one wishes to teach a child to request a a desired interaction, as in "I want to play," one might first teach subcomponents of this skill, such as the individual sounds comprising each word of the request, or labeling enjoyable leisure activities as "play." By utilizing teaching techniques based on the principles of behavior analysis, the learner is gradually able to complete all subcomponent skills independently. Once the individual components are acquired, they are linked together to enable mastery of the targeted complex and functional skill. This methodology is highly effective in teaching basic communication, play, motor, and daily living skills.

Initially, ABA programs for children with Autism utilized only (DTT), and the curriculum focused on teaching basic skills as noted above. However, ABA programs, such as the program implemented at CARD, continue to evolve, placing greater emphasis on the generalization and spontaneity of skills learned. As patients progress and develop more complex social skills, the strict DTT approach gives way to treatments including other components.

Specifically, there are a number of weaknesses with DTT including the fact the DTT is primarily teacher initiated, that typically the reinforcers used to increase appropriate behavior are unrelated to the target response, and that rote responding can often occur. Moreover, deficits in areas such "emotional understanding," "perspective taking" and other Executive Functions such as problem solving skills must also be addressed and the DTT approach is not the most efficient means to do so.

Although the DTT methodology is an integral part of ABA-based programs, other teaching strategies based on the principles of behavior analysis such as Natural Environment Training (NET) may be used to address these more complex skills. NET specifically addresses the above mentioned weaknesses of DTT in that all skills are taught in a more natural environment in a more "playful manner." Moreover, the reinforcers used to increase appropriate responding are always directly related to the task (e.g., a child is taught to say the word for a preferred item such as a "car" and as a reinforcer is given access to the car contingent on making the correct response). NET is just one example of the different teaching strategies used in a comprehensive ABA-based program. Other approaches that are not typically included in strict DTT include errorless teaching procedures and Fluency-Based Instruction.

At CARD all appropriate teaching approaches based on the well grounded principles of applied behavior analysis are utilized.

References

Baer, D., Wolf, M., & Risley, R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1, 91 - 97.
Baer, D., Wolf, M., & Risley, R. (1987). Some still-current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 20, 313 - 327.
Maine Administrators of Services for Children with Disabilities (MADSEC) (2000). Report of the MADSEC Autism Task Force.
Myers, S. M., & Plauché Johnson, C. (2007). Management of children with autism spectrum disorders.Pediatrics, 120, 1162-1182.
National Academy of Sciences (2001). Educating Children with Autism. Commission on Behavioral and Social Sciences and Education. 
New York State Department of Health, Early Intervention Program (1999). Clinical Practice Guideline: Report of the Recommendations: Autism / Pervasive Developmental Disorders: Assessment and Intervention for Young Children (Age 0-3 years).
Sulzer-Azaroff, B. & Mayer, R. (1991). Behavior analysis for lasting change. Fort Worth, TX : Holt, Reinhart & Winston, Inc.
US Department of Health and Human Services (1999). Mental Health: A Report of the Surgeon General.Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.

CARD: RELIABLE MEASUREMENT

RELIABLE MEASUREMENT

Reliable measurement requires that behaviors are defined objectively. Vague terms such as anger, depression, aggression or tantrums are redefined in observable and quantifiable terms, so their frequency, duration or other measurable properties can be directly recorded (Sulzer-Azaroff & Mayer, 1991). For example, a goal to reduce a child's aggressive behavior might define "aggression" as: "attempts, episodes or occurrences (each separated by 10 seconds) of biting, scratching, pinching or pulling hair." "Initiating social interaction with peers" might be defined as: "looking at classmate and verbalizing an appropriate greeting."

ABA interventions require a demonstration of the events that are responsible for the occurrence, or non-occurrence, of behavior. ABA uses methods of analysis that yield convincing, reproducible, and conceptually sensible demonstrations of how to accomplish specific behavior changes (Baer & Risley, 1987). Moreover, these behaviors are evaluated within relevant settings such as schools, homes and the community. The use of single case experimental design to evaluate the effectiveness of individualized interventions is an essential component of programs based upon ABA methodologies.

This process includes the following components:

  • selection of interfering behavior or behavioral skill deficit
  • identification of goals and objectives
  • establishment of a method of measuring target behaviors
  • evaluation of the current levels of performance (baseline)
  • design and implementation of the interventions that teach new skills and/or reduce interfering behaviors
  • continuous measurement of target behaviors to determine the effectiveness of the intervention, and
  • ongoing evaluation of the effectiveness of the intervention, with modifications made as necessary to maintain and/or increase both the effectiveness and the efficiency of the intervention. (MADSEC, 2000, p. 21-23)

As the MADSEC Report describes above, treatment approaches grounded in ABA are now considered to be at the forefront of therapeutic and educational interventions for children with autism. The large amount of scientific evidence supporting ABA treatments for children with autism have led a number of other independent bodies to endorse the effectiveness of ABA, including the U.S. Surgeon General, the New York State Department of Health, the National Academy of Sciences, and the American Academy of Pediatrics (see reference list below for sources).

CARD: SOCIALLY SIGNIFICANT BEHAVIORS

SOCIALLY SIGNIFICANT BEHAVIORS

Brushing Teeth"Socially significant behaviors" include reading, academics, social skills, communication, and adaptive living skills. Adaptive living skills include gross and fine motor skills, eating and food preparation, toileting, dressing, personal self-care, domestic skills, time and punctuality, money and value, home and community orientation, and work skills.

ABA methods are used to support persons with autism in at least six ways:

  • to increase behaviors (eg reinforcement procedures increase on-task behavior, or social interactions);
  • to teach new skills (eg, systematic instruction and reinforcement procedures teach functional life skills, communication skills, or social skills);
  • to maintain behaviors (eg, teaching self control and self-monitoring procedures to maintain and generalize job-related social skills);
  • to generalize or to transfer behavior from one situation or response to another (eg, from completing assignments in the resource room to performing as well in the mainstream classroom);
  • to restrict or narrow conditions under which interfering behaviors occur (eg, modifying the learning environment); and
  • to reduce interfering behaviors (eg, self injury or stereotypy).

ABA is an objective discipline. ABA focuses on the reliable measurement and objective evaluation of observable behavior.

CARD: THERAPY/SUPERVISION

THERAPY/SUPERVISION

Lesson Areas and Sample Targeted Skills
Following the principles of Applied Behavior Analysis, we developed a treatment approach for children with autism, up to age eight, that focuses on minimizing challenging behaviors and maximizing skill acquisition. Once new behaviors are mastered, we focus on generalization with the goal of transitioning each child into the mainstream educational system. If necessary, we also provide school shadowing services so children have the support they need in the classroom.

Challenging Goals; Trackable Progress
We teach self-help and safety skills, build language and communication, as well as an array of advanced skills such as theory of mind, social skills, and executive functioning. With the input of parents and the child’s caregivers, we set challenging goals for our team and the child and track progress on each skill domain carefully.

The program is developed and managed by a highly trained CARD supervisor who tailors the program to each child’s needs. A team of therapists implements the plan and participates in training and team meetings to ensure consistency. The entire treatment team, including all caregivers (mom, dad, grandparents, and siblings) is invited to participate in regular “clinic meetings” designed to review the child’s progress, train on new techniques and add lessons to the program.

The CARD Goal
While each student will come to us with unique needs, we have developed a set of long-term goals that are important for all students to work toward achieving. The CARD goal is to teach independence skills, appropriate social activities and relationship building, as well as many other skills.

For more information about the CARD program for your child, please call us at 1-855-345-2273.

ASSESSMENT: OVERVIEW

ASSESSMENT: OVERVIEW

The CARD Assessment Center provides developmental assessments and consultations for children, adolescents, and young adults. Developmental evaluations provide useful diagnostic and prognostic information for a wide variety of suspected and confirm neurological and psychiatric disorders that can then be used to develop tailored treatment programs, if necessary. Through the use of standardized tests and procedures, developmental assessments are used to evaluate many areas of functioning. They can test intelligence (e.g., IQ) and achievement, as well as areas of functioning that impact performance in school, relationships with family and friends, and behaviors in the home and community.

Why Get an Evaluation

One of the most common reasons to get an evaluation is that someone is experiencing difficulty in one or more areas functioning (e.g., school, peers). Typically, assessments are administered to diagnose or rule out developmental disabilities or to establish a baseline from which educational programs can be derived.

Conditions for which assessments may be necessary:

  • Autism Spectrum Disorders
  • Gifted Assessment
  • Memory Disorders
  • Language Disorders
  • Learning Disabilities
  • Attention Deficit Disorder
Payment Policy

While the CARD Assessment Center will provide the necessary documentation for billing of third parties, including insurance companies, it is the responsibility of the client or client's guardian to ensure timely payment of all services.

ASSESSMENT: ASSESSMENT TESTS

ASSESSMENT: ASSESSMENT TESTS

In an assessment battery, measures are selected based on each child's unique needs. Below is a list of measures that may be used during an assessment. Please note that this list is not inclusive of all assessment measures that may be used with your child. Additionally, the administration times listed are estimates and may not be representative of the actual time it takes for your child to complete testing measures.

Achievment Assessments

WOODCOCK - JOHNSON III TESTS OF ACHIEVEMENT (Woodcock, Mc Grew, & Mather, 2001)

The Woodcock-Johnson III Tests of Achievement is one of the primary diagnostic tools used by evaluators to determine whether a student has learning disabilities. It is an individually administered battery of 22 achievement tests that covers 10 achievement areas such as reading, spelling, knowledge of science, mathematics etc. Not all of the tests are administered at the youngest age levels.

Age Range: 2 - 90+ years
Administration Time: Varies, about 5 minutes per subtest

Adaptive Behavior Assessments

VINELAND ADAPTIVE BEHAVIOR SCALES - SECOND EDITION (Vineland-II)(Sparrow & Cicchetti, & Balla, 2005)

Vineland Adaptive Behavior Scales - Second Edition (Vineland-II) aids in diagnosing and classifying mental retardation and other disorders, such as autism, Asperger Syndrome, and developmental delays. The content and scales of Vineland-II were organized within a three domain structure: Communication, Daily Living, and Socialization. This structure corresponds to the three broad Domains of adaptive functioning recognized by the American Association of Mental Retardation (AAMR, 2002): Conceptual, Practical, and Social. In addition, Vineland-II offers a Motor Skills Domain and an optional Maladaptive Behavior Index to provide more in-depth information about your child.

Age Range: 0 - 18 years
Administration Time: 20 - 60 minutes

Developmental Assessments

BAYLEY SCALES OF INFANT AND TODDLER DEVELOPMENT - THIRD EDITION (Bayley-III) (Bayley, 2006)
This tool's primary purposes are to identify children with developmental delay and to provide information for treatment planning. The Bayley-III assesses infant and toddler development across five domains: Cognitive, Language, Motor, Social-Emotional, and Adaptive.
Age Range: 1 - 42 months
Administration Time: 50-90 minutes


Brigance DIAGNOSTIC Inventory OF Early Development - REVISED (Brigance, 1991)
The Brigance Inventory is intended for informal assessment of several aspects of child development and is for children functioning at developmental levels from birth to seven years of age. The BDIED-R assesses children on their performance across over 200 skills within the following 11 developmental domains: preambulatory motor, gross motor, fine motor, self-help, speech and language, general knowledge and comprehension, social and emotional development, readiness, basic reading skills, manuscript writing, and basic math.
Age Range: 0 - 7 years
Administration Time: 3 hours

The Developmental Profile II (dp-II)(Alpern, Boll, & Shearer, 2000)
The Developmental Profile II is a comprehensive assessment of motor, language, personal/self-help, social, and intellectual development. The format is a 186-item inventory designed to assess a child's functional, developmental age level. The test may be administered either in interview format to the parent, as a combination of parent interview and direct testing of the child, or as a self-interview completed by a teacher.
Age Range: 0 - 7 years for typically-developing children and for developmentally-delayed children of any age when their skills are not expected to extend beyond the 9 year ceiling.
Administration Time: 20-40 minutes

 

Diagnostic Evaluations

AUTISM DIAGNOSTIC INTERVIEW, REVISED (ADI-R) (Rutter, LeCouteur, & Lord, 2003)
The Autism Diagnostic Interview-Revised (ADI-R) is useful for formal diagnosis as well as treatment and educational planning. To administer the ADI-R, an experienced clinical interviewer questions a parent or caretaker who is familiar with the developmental history and current behavior of the individual being evaluated. Composed of 93 items, the ADI-R focuses on three functional domains:

  • Language and Communications
  • Reciprocal Social Interactions
  • Restricted, Repetitive, and Stereotypes Behaviors and
  •  
  •  
  •  
  • Interests
  • Age Range: Children and adults with a mental age above 2 years
    Administration Time: 1.5 hours - 2+ hours AUTISM DIAGNOSTIC OBSERVATION SCHEDULE (ADOS) (Lord, Rutter, DiLavore, & Risi, 1999)
    This semi-structured assessment can be used to evaluate almost anyone suspected of having autism--from toddlers to adults, from children with no speech to adults who are verbally fluent. The Autism Diagnostic Observation Schedule (ADOS) consists of various activities that allow you to observe social and communication behaviors related to the diagnosis of pervasive developmental disorders. These activities provide interesting, standard contexts in which interaction can occur.
    Age Range: Toddler - adult
    Administration Time: 35 - 45 minutes C.A.R.D. AUTISM SYMPTOMS QUESTIONNAIRE (C.A.R.D. ASQ)(Granpeesheh, Talei, & Yoo, 2007)
    The C.A.R.D. Autism Symptoms Questionnaire (ASQ) was developed to assist healthcare practitioners efficiently and correctly diagnose Autistic Disorder (299.00), Asperger's Disorder (299.80), or Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS) (299.80). Specifically, the ASQ aids in determining if an individual presents symptoms that are characteristic of and adequate to meet the diagnostic criteria for the aforementioned disorders. The ASQ is divided into three categories to complement the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV). Specifically, children with Autistic Disorder have difficulties and/or delays in Social Interaction, Communication, and Stereotyped Behaviors.
    Age Range: 2 years - adultAdministration Time: 15 minutes C.A.R.D. SKILLS Index (2007)
    Before beginning to provide therapy, your child may be assessed using the C.A.R.D. SKILLS Index to determine what the child needs to learn during ABA-based intervention. The SKILLS Index is a compilation of developmental skills organized by age level and listed in chronological order of one year ranges of development (e.g., 0-12 mos, 1 -2 yrs.) across eight domains (Language, Motor, Adaptive, Cognition, Executive Functions, Social Skills, Play, and School Skills). The SKILLS Index is administered by asking a parent of each child to answer whether his/her child exhibits each skill listed. The parent can answer "yes," "no," or "unsure" into a computerized database. Then, the child's supervisor begins probing skills based on the answers given by the child's parents and continues to update the database as information is obtained from probing and as the child masters skills through his / her ABA-based program.
    Age Range: 0 - 7 years, 11 months
    Administration Time: 8 - 10 hours CHILDHOOD AUTISM RATING SCALE (CARS)(Schopler, Reichler, DeVellis, & Daly, 1980)
    This scale is used to assess children suspected of having an autism or PDD diagnosis. This scale evaluates 15 dimensions of behavior on a scale of 1-4, 1 being age appropriate and 4 being severely abnormal. Listed below are the 15 dimensions.
  •  
    1. Relationships with people
    2. Imitation (verbal and motoric)
    3. Affect
    4. Use of body
    5. Relation to non-human objects
    6. Adaptation to environmental change
    7. Visual responsiveness
    8. Auditory responsiveness
    9. Near receptor responsiveness
    10. Anxiety reaction
    11. Verbal communication
    12. Non-verbal communication
    13. Activity level (motility patterns)
    14. Intellectual functioning
    15. General impression


  • Age Range: 24 months of age and up
    Administration Time: 30-45 minutes CHECKLIST FOR AUTISM IN TODDLERS (CHAT) (Baron-Cohen, Allen, & Gillberg, 1992)
    This test focuses on five key types of behavior at 18 months of age. These behaviors are: pretend play, protodeclarative pointing, joint-attention, social interest, and social play. Later research predicted that children who failed three items (protodeclarative pointing, gaze monitoring, and pretend play) would be at risk for receiving a diagnosis of autism and that those children who failed one or two key items (either pretend play or protodeclarative pointing and pretend play) would be at risk for a diagnosis of developmental delay without autism.
    Age Range: 18 months and up
    Administration Time: 30 minutes GILLIAM ASPERGER'S DISORDER SCALE (GADS) (Gilliam, 2002)
    Based on the most current and relevant definitions and diagnostic criteria of Asperger's Disorder, the Gilliam Asperger's Disorder Scale (GADS) is useful for contributing valuable information toward the identification of children who have this disorder.
    Age Range: 3 - 22 years
    Administration Time: 45 minutes GILLIAM AUTISM RATING SCALE - SECOND EDITION (GARS-II) (Gilliam, 2006)
    Gilliam Autism Rating Scale - Second Edition (GARS-II) is a diagnostic tool helpful in estimating the severity of the child's disorder, based on the definitions of autism adopted by the Autism Society of America and the DSM-IV-TR (2000). The GARS-II consists of 42 items describing the characteristic behaviors of persons with autism and includes three subscales: Stereotyped Behaviors, Communication, and Social Interaction.
    Age Range: 3 - 22 years
    Administration Time: 45 minutes
    PERVASIVE DEVELOPMENTAL DISORDERS BEHAVIOR INVENTORY (PDDBI) (Cohen & Sudhalter, 1999)
    The PDDBI is a tool for assisting in diagnosis and treatment recommendations and for assessing change over time in follow-up assessments. Specifically, the items aim to measure both problem behaviors and social skills relevant to autism. In order to address the issue of generalization, it includes separate questionnaires for parents and teachers.
    Age Range: 18 months - 12 years, 5 months.
    Administration Time: 20 - 30 minutes

Executive Functioning/Neuropsychology Assessments

BEHAVIOR RATING INVENTORY OF EXECUTIVE FUNCTION - PRESCHOOL VERSION (BRIEF-P)
(Gioia, Espy, & Isquith, 2003)

The Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P) is specifically designed to measure the range of executive functioning in preschool aged children. Parents, teachers, and day care providers complete the 63-item form to rate a child's executive functions within the context of his or her everyday environments (home and preschool). It measures the following aspects of executive functioning: inhibit, working memory, shift, plan/organize, and emotional control.

Age Range: 2 years - 5 years, 11 months
Administration Time: 10 - 15 minutes


BEHAVIOR RATING INVENTORY OF EXECUTIVE FUNCTION (BRIEF)
(Gioia, Isquith, Guy, & Kenworthy, 2000)

The Behavior Rating Inventory of Executive Function (BRIEF) assesses executive function in children and adolescents. The BRIEF is useful in evaluating children with a wide range of developmental and acquired neurological conditions such as learning disabilities, Attention-Deficit/Hyperactivity Disorder, Traumatic Brain Injury, low birth weight, Tourette's Disorder, and Pervasive Developmental Disorders/Autism. The BRIEF consists of two rating forms—a Parent questionnaire and a Teacher questionnaire—designed to assess executive functioning in the home and school environments.

Age Range: 5 - 18 years
Administration Time: 30 minutes


Children's Color Trails Test (CCTT)
(Llorente, Williams, Satz, & D'Elia, 2003)

The Children's Color Trails Test (CCTT) assesses sustained attention, sequencing, and other executive functions while reducing reliance on language and diminishing the effects of cultural bias and parental verbal report. The CCTT is appropriate for testing children within cross-cultural contexts and with children with special needs.

Age Range: 8 - 16 years
Administration Time: 5 - 7 minutes


Developmental Neuropsychological Assessment (NEPSY)
(Korkman, Kirk, & Kemp, 1997)

The Developmental Neuropsychological Assessment (NEPSY) is a battery of tests designed to identify neuropsychological deficits that interfere with learning. The NEPSY measures 5 complex cognitive functional domains: attention/executive, language, sensorimotor, visuospatial processing and memory & learning.

Age Range: 3 - 12 years
Administration Time: 2 - 3 hours


The Auditory Sequential Memory Test
(Wepman & Morency, 1973)

The Auditory Sequential Memory Test is designed to assess ability to repeat from immediate memory an increasing series of digits.

Age Range: 5 - 8 years
Administration Time: 20 minutes


TEST OF AUDITORY DISCRIMINATION (ADT)
(Reynolds, 1987)

This test is used to measure the child's ability to hear spoken language accurately. The test consists of 40 word pairs matched for familiarity, length, and phonetic category. Ten of the words do not differ, whereas 30 pairs differ in a single phoneme. The examiner reads each pair, and the child must indicate whether the words are the same or different.

Age Range: 4 years, 0 months - 8 years, 11 months
Administration Time: 5 - 10 minutes


The Stroop Color and Word Test
(Golden, 1978)

The Stroop Color and Word Test targets inhibition, mental vitality, and flexibility by measuring the speed and accuracy of reading single words (blue, green, yellow), recognizing and naming blocks of color (red, yellow, green), and naming the color that a word is written in regardless of the content of the word (e.g., "green" is presented and the answer is "yellow" - the color that the word is written in).

Age Range: 5 - 14 years (children's version) and 15 years and up (adult version)
Administration Time: 5 minutes


Test of Problem Solving, Elementary & Adolescent-Revised (TOPS-R)
(Bowers, Huisingh, Barrett, Orman, & LoGiudice, 1994)

The Test of Problem Solving, Elementary & Adolescent - Revised (TOPS-R) assesses how children use language to think, reason, and solve problems. It uses age-appropriate tasks to determine strengths and weaknesses in a number of areas: clarifying, analyzing, generating solutions, empathizing, affective thinking, using context cues and vocabulary comprehension.

Age Range: 6 - 11 years (elementary), 12 - 17 years (adolescent)
Administration Time: 35 - 40 minutes


Wisconsin Card Sorting Test
(Grant & Berg, 1993)

The Wisconsin Card Sorting Test assesses perseveration and abstract thinking. It allows the clinician to assess the following frontal lobe functions: strategic planning, organized searching, utilizing environmental feedback to shift cognitive sets, directing behavior toward achieving a goal, and modulating impulsive responding.

Age Range: 6 years, 5 months - 89 years
Administration Time: 20 - 30 minutes

 

Intelligence Assessments

DIFFERENTIAL ABILITIES SCALES (DAS)(Elliot, 1990)
The DAS measures conceptual and reasoning abilities. It includes a preschool level and a school age level and comprises 17 cognitive and 3 achievement subtests. It measures General Conceptual Ability, Verbal and Nonverbal Ability for the Preschool subsets, and Verbal, Nonverbal Reasoning, and Spatial Ability for the School-Age subtests. For language-impaired and non-English-speaking children, a Special Nonverbal score may be obtained. The DAS is also a measure of basic academic skills. Achievement subtests are Basic Number Skills, Spelling, and Word Reading.
Age Range: 30 months -17 years
Administration Time: 3 hours


LEITER INTERNATIONAL PERFORMANCE SCALE - REVISED (LIPS-R) (Roid & Miller, 1997)
The goal of this instrument is to construct a non-verbal measure of intellectual ability, memory, and attention that could be used to assess children, adolescents, and young adults who could not reliably and validly be assessed with traditional intelligence tests.
Age Range: 2 years - 20 years, 11 months
Administration Time: 2 hours

Merrill Palmer Scale of Mental Tests(Stutsman, 1948)
The MPSMT is widely used as a nonverbal test instrument for assessing visual-spatial skills. MPSMT enables a more detailed assessment of visual-perceptual functioning than is provided by some other instruments.
Age Range: 1 year, 6 months - 6 years
Administration Time: 1 hour

WECHSLER INTELLIGENCE SCALE FOR CHILDREN - FOURTH EDITION (WISC-IV)(Wechsler, 2003)
This is an individually administered clinical instrument for assessing the cognitive ability of children. The Full Scale IQ (FSIQ) includes the following four composite scores:
* Verbal Comprehension Index (VCI)
* Perceptual Reasoning Index (PRI)
* Working Memory Index (WMI)
* Processing Speed Index (PSI)
Age Range: 6 years, 0 months - 16 years, 11 months
Administration Time: 2 - 3 hours

WECHSLER PRESCHOOL AND PRIMARY SCALE OF INTELLIGENCE - THIRD EDITION (WPPSI-III) (Wechsler, 2002)
The Wechsler Preschool and Primary Scale of Intelligence - Third Edition (WPPSI-III) assesses the cognitive ability of children. It contains various subtests which yield a Full Scale IQ, Verbal IQ, Performance IQ, Processing Speed Quotient, and General Language Composite.
Age Range: 2 years 6 months - 7 years 3 months
Administration Time: 2-3 hours

 

Other Assessments

Aberrant Behavior Checklist (ABC)
(Aman, Singh, Stewart, & Field, 1985)

The Aberrant Behavior Checklist (ABC) is a 58-item rating scale developed for persons with developmental disabilities. It is designed to be used with clients living in the community, often used to assess medication effects on persons with developmental disabilities.

Age Range: 5 - 54 years
Administration Time: 10 - 15 minutes


Behavior Assessment system for children - second edition (basc-2)
(Reynolds & Kamphaus, 2004)

The Behavior Assessment System for Children - Second Edition (BASC-II) is a tool used to evaluate the behavior and self-perceptions of children and young adults. It is multimethod in that it has the following five components, which may be used individually or in any combination:

  • Two rating scales (parent and teacher)
  • Self-report scale (ages 8-25)
  • Structured Developmental History (SDH) form
  • Student Observation System (SOS)

Age Range: 2 - 25 years
Administration Time: rating scales (parent and teacher) 10-20 minutes; self-report 20-30 minutes; SDH varies;
SOS 15 minutes


Clinical Global Impression (CGI)
(Guy & Bonato, 1970)

The Clinical Global Impression (CGI) scale is a 3-item scale designed t to assess global severity, improvement, and side effects. It is widely used in clinical drug studies.

Administration Time: 5 minutes


Parenting Stress Index (PSI)
(Abidin, 1995)

The Parent Stress Index (PSI) is a 36-item measure of parents' self-reported stress along several dimensions: parental distress, parent-child dysfunctional interaction, and difficult child. The instrument has established reliability and validity across ethnic/cultural groups representative of the U.S. population.

Age Range: parents with children between the ages of 1 month and 12 years
Administration Time: 30 minutes

 

Pragmatic Language Assessments

TEST OF PRAGMATIC LANGUAGE - SECOND EDITION (TOPL-2) (Phelps-Terasaki & Phelps-Gunn, 2007)

The Test of Pragmatic Language - Second Edition (TOPL-2) is an individually administered test for a comprehensive assessment of a child's ability to effectively use pragmatic language. Pragmatic language is language that is used socially to achieve goals, involving not only what is said, but also why and for what purpose something is said.

Age Range: 6 - 18 years
Administration Time: 60 minutes

Psycho-Educational Assessments

Psychoeducational Profile - Revised (PEP-R) (Schopler, Reichler, Bashford, Lansing and Marcus, 1990)

The Psychoeducational Profile - Revised (PEP-R) assesses skills and behaviors of children with autism and communicative disabilities who function between the ages of 6 months and 7 years. The PEP-R administration graphically represents uneven development, emerging skills, and autistic behavioral characteristics. This instrument evaluates the learning problems of children with autism spectrum disorder and related communication disorders, and it provides data that can be used to plan behavioral interventions and education programs. It also assesses developmental functioning in the areas of imitation, perception, fine motor, gross motor, eye-hand integration, cognitive performance, cognitive verbal, and behavior.

Age Range: 6 months - 7 years
Administration Time: 2 hours

Social Skills/Play Assessments

Social Behavior Assessment Inventory (SBAI) (Stephens & Arnold, 1992)

The Social Behavior Assessment Inventory (SBAI) is a 136-item curriculum-based teacher rating instrument that measures the performance level of social behaviors of children in a classroom setting. Four areas of social behaviors are assessed: Environmental Behavior, Interpersonal Behaviors, Self-Related Behaviors, and Task-Related Behaviors.

Age Range: Grades K - 9th
Administration Time: 30 - 45 minutes


Social Skills Rating SYSTEM (SSRS)(Gresham & Elliot, 1990)

The Social Skills Rating Scale (SSRS) allows for a comprehensive evaluation of teacher report, parent report, and child of social behaviors. It includes the areas of social skills (cooperation, assertion, responsibility, empathy, self-control), problem behaviors (external, internal, hyperactivity), and academic competence.

Age Range: 3 - 18 years
Administration Time: 25 minutes
Social Responsiveness Scale (SRS)(Constantino & Gruber, 2005)
The Social Responsiveness Scale (SRS) measures the severity of autism spectrum symptoms as they occur in natural social settings. It is a quantitative measure of a child's social impairments, assessing social awareness, social information processing, capacity for reciprocal social communication, social anxiety/avoidance, and autistic preoccupations and traits.

Age Range: 4 - 18 years
Administration Time: 15 - 20 minutes

Symbolic Play Scale (Westby, 1991)

The Symbolic Play Scale provides an overview of the development of symbolic play in children.

Age Range: 18 months - 6 years
Administration Time: 1 hour

Speech & Language Assessments

CLINICAL EVALUATION OF LANGUAGE FUNDAMENTALS - FOURTH EDITION (CELF-4)
(Semel, Wiig, Secord, 2003)

The Clinical Evaluation of Language Fundamentals - Fourth Edition (CELF-4) is used to identify individuals who lack the basic foundations of content and form that characterize mature language use. This instrument evaluates language and determines whether or not a language disorder is present. Once it is determined that the child has a language disorder you can choose from several paths in order to evaluate:

  • The nature of the disorder (strengths/needs, affected modalities, content areas, conditions that enable the student to perform well)
  • The underlying clinical behaviors (working memory, automaticity of speech production, phonological awareness)
  • How the disorder affects the student's classroom performance (authentic assessment with the Observational Rating Scale and Pragmatics Profile)

Age Range: 5 - 21 years
Administration Time: 30-45 minutes


CLINICAL EVALUATION OF LANGUAGE FUNDAMENTALS - PRESCHOOL
(CELF-P)

(Wiig, Secord, & Semel, 1992)

Clinical Evaluation of Language Fundamentals - Preschool (CELF-P) is a measure a broad range of expressive and receptive language skills in preschool and early elementary-aged children.

Age Range: 3 - 6 years
Administration Time: 2 hours


GOLDMAN-FRISTOE-WOODCOCK - TEST OF AUDITORY DISCRIMINATION
(Goldman, Fristoe, &Woodcock, 1970)

The Goldman-Fristoe-Woodcock - Test of Auditory Discrimination was designed to provide measures of speech-sound discrimination ability, relatively unconfounded by other factors. It provides a measure of auditory discrimination under ideal listening conditions plus a comparative measure of auditory discrimination in the presence of a controlled background noise. This test is used for Fast ForWord Assessments.

Age Range: 2 - 21 years
Administration Time: 15 minutes


PEABODY PICTURE VOCABULARY TEST - THIRD EDITION (PPVT-III)
(Dunn & Dunn, 1997)

This is a non-verbal, multiple-choice test designed to evaluate the hearing, vocabulary, or receptive knowledge of individuals from age 2 years, 6 months through adulthood. This test is not timed and requires no reading ability. The
physical abilities required are adequate hearing and the ability to indicate yes/no in some manner. Neither a pointing nor an oral response is necessary.

Age Range: 2 years, 6 months - 90 years
Administration Time: 15 minutes
PRESCHOOL LANGUAGE SCALE - FOURTH EDITION (PLS - 4)
(Zimmerman, Steiner, & Pond, 2005)

The Preschool Language Scale (PLS-4) was developed as a diagnostic instrument of language development for young children. This tool screens for a broad spectrum of speech and language skills.
Age Range: birth - 6 years, 11 months
Administration Time: 15 to 30 minutes


ROSSETTI INFANT-TODDLER LANGUAGE SCALE
(Rossetti, 1990)

The Rossetti Infant-Toddler Language Scale was designed to assess preverbal and verbal areas of communication and interaction including: interaction-attachment, pragmatics, gesture, play, language comprehension and language expression. The results from this assessment tool reflect the child's mastery of skills in each of the areas assessed at three-month intervals.

Age Range: 0 - 3 years
Administration Time: 10 - 30 minutes

TEST OF LANGUAGE DEVELOPMENT: INTERMEDIATE - THIRD EDITION (TOLD-I:3)
(Hammill & Newcomer, 1997)

This test aims to assess the understanding and meaningful use of spoken language and aspects of grammar. This test is used for Fast ForWord Assessments.

Age Range: 8 - 12 years
Administration Time: 60 minutes


TEST OF LANGUAGE DEVELOPMENT: PRIMARY - THIRD EDITION (TOLD-P:3)
(Newcomer & Hammill, 1997)

The Test of Language Development: Primary - Third Edition (TOLD - P:3) was designed to measure language from a linguistic frame of reference. This test is used for Fast ForWord Assessments.

Age Range: 4 - 8 years
Administration Time: 40 minutes

Treatment Evaluation Tests

Autism Treatment Evaluation Checklist (ATEC)
(Rimland & Edelson, 1999)

The Autism Treatment Evaluation Checklist (ATEC) is a one-page form consisting of 4 subtests. The ATEC is designed to assist parents, physicians and researchers to evaluate various treatments for autism.

Age Range: 5 - 12 years
Administration Time: 10 - 15 minutes

Visual-Motor Assessments

BEERY-BUKTENICA DEVELOPMENTAL TEST OF VISUAL-MOTOR INTEGRATION - FIFTH EDITION (BEERY VMI-5) (Beery, Buktenica, & Beery, 2004)

The Beery-Buktenica Developmental Test of Visual-Motor Integration - Fifth Edition (BEERY VMI-5) helps assess the extent to which individuals can integrate their visual and motor abilities. The Short Format and Full Format tests present drawings of geometric forms arranged in order of increasing difficulty that the individual is asked to copy.

Age Range: 3 years to adult
Administration Time: 20 - 30 minutes

What to Expect

ASSESSMENT: WHAT TO EXPECT

Contact CARD Assessment Center:

(855) 345-2273

What should you expect during an assessment:

In order to facilitate a better understanding of our clients’ strengths and weaknesses, the CARD Assessment Center team’s evaluation process consists of the following steps:

  • Initial Paperwork/Background Info Collection - Initial paperwork, including medical and educational history, will be completed.
  • Testing Session(s) - The number and type of tests administered is are dependent on the individual's needs. There is no set battery of tests for all. When establishing a testing schedule, CARD assessors will also take into consideration that the individual's age, attention span, and issues related to fatigue.
  • Written Report - A formal report is generated and distributed to parents and authorized individuals.
  • Feedback Session - Test results are discussed and recommendations are made.

ASSESSMENT: FUNCTIONAL BEHAVIOR

ASSESSMENT: FUNCTIONAL BEHAVIOR

Ginny is known in her classroom to hit and push the other children. She then takes their toys while they tell the teacher.

Samuel is also known to hit his peers. The adults note that he seems to enjoy provoking the other children.

Inappropriate behavior both in and out of the classroom can lead to problems for the child and his/her family. When intervention is planned, it is important to look at the function of the behavior rather than the topography (what a behavior looks like). The topography of Ginny and Samuel’s behavior looks similar - they are both hitting their peers. However, the function may be drastically different. Focusing on the topography yields little information regarding effective intervention. However, by understanding what causes the behavior, more effective intervention can be discovered.

Functional behavioral assessment (FBA) is an approach that uses a variety of methods to define a target behavior and determine the underlying causes of it. Biological, social, affective, and environmental factors are taken into consideration. The assessor moves beyond the "symptom" (the behavior) in order to find the true motivation or function that maintains the occurrence of the behavior.

The functions of behavior are not usually considered inappropriate. Rather, it is the behavior itself that is deemed socially appropriate or inappropriate. For example, bringing home a test with an “A” and ripping up assigned homework may have the same function (i.e., getting attention from adults). However, the first behavior is significantly more appropriate than the second.

FBAs can be conducted in many ways. Traditionally, there are three basic assessments:

  • Indirect functional assessment - Interviews, standardized questionnaires, and discussions with the child, parents, and other involved caregivers
  • Direct functional assessment - Observation of the child by the assessor in the natural environment. Data on the behavior will be collected, as well as environmental factors. This produces a descriptive correlation between behavior and function.
  • Experimental functional analysis - Empirically test suspected functions by systematically altering the environment contingent upon the child’s behavior

CARD SOS has qualified staff to perform comprehensive functional behavior assessments for children with and without autism at the request of a family or the school system. Depending on the behavior, severity, and individual situation, one or more of these assessments may be conducted. The results from the assessment used are then summarized in a report and discussed with the family.

ASSESSMENT: INTERNSHIP INFORMATION

ASSESSMENT: INTERNSHIP INFORMATION

pre doc program CARD

Organization: The Center for Autism and Related Disorders, Inc. (CARD) is among the world’s largest and most experienced organizations effectively treating children with autism and related disorders. With US and international reach, CARD touches the lives of hundreds of children and their families. Through a network of trained therapists, supervisors, assessors, and researchers, we develop and implement superior quality comprehensive and individualized treatment programs.

CARD was founded in 1990 by renowned psychologist and early researcher of autism, Dr. Doreen Granpeesheh. She designed a unique treatment curriculum based on the principles of Applied Behavior Analysis (ABA) and built an organization of dedicated and trained staff. Currently, CARD has 18 US-based offices serving California, Texas, New York, Arizona, Illinois, and Virginia, as well as international offices in Australia and New Zealand. CARD’s goal is to become the worldwide leader of top-quality autism treatments.

Description: As part of our commitment to training, CARD provides practicum placements in the field of psychology. Practicum students work in the CARD Assessment Center and provide diagnostic and psychological assessments and consultations for children, adolescents, and young adults with developmental, learning, and behavioral disorders. Comprehensive assessments provide valuable information related to the treatment of a variety of suspected and confirmed neurological and psychiatric disorders.

Primary Population: Individuals ranging in age from 12 months to Adult with suspected and confirmed pervasive developmental disorders.

Hours & Compensation: Students are required to work 2 full days per week (i.e., 18 hours per week); Monday is a mandatory training day while the second day is flexible. Training begins the 2nd Monday of August and ends the 2nd week in August of the following year. No stipend is provided.

Responsibilities: Students will perform psychological assessments and report writing assignments on a weekly basis. Assessment measures include the ADOS, ADI-R, Bayley-III, WPPSI-III, WISC-IV, Leiter-R, PLS-4, TOLD-3, NEPSY-II, and CELF-4, as well as a variety of rating scales (e.g., Vineland-II, BRIEF, SSRS). A typical assessment schedule will consist of testing the client, scoring the protocols, and initial report writing on the first day. Students will complete the remainder of the report on the second day. Students will also have the opportunity to participate in feedback sessions.

Qualifications: Students are required to have some clinical experience with children. It is preferred that the student has completed course work in psychological assessment and/or has prior assessment experience as well as report writing experience. We require excellent writing skills. Good Interest and/or experience working with children with developmental disorders also preferred. We also require some light traveling and/or commuting to our local CARD offices from time to time. A driver’s license and a reliable mode of transportation are also required.

Supervision: 1 hour of individual supervision and 1 hour group supervision as needed.

Application Procedure: Interested students should submit a letter of interest, current CV, 2 letters of reference (preferably current or previous supervisors) and a sample report by March 1, 2013. Students will be contacted for an interview. CARD operates in accordance with SCAPTP guidelines. Students will be notified on the UND (2nd Monday in April).

Dowload the Program Flyer

Dowload the CARD Practicum Description

CENTER-BASED SERVICES: Overview

Center-Based Services are regular one-to-one sessions for your child that take place at a CARD center rather than in your home.

There are many benefits to Center-Based Services, both for you and your child:

  • Children and teenagers can be matched by age and level of functioning for socialization opportunities and peer play dates
  • A perfect setting for generalization, allowing children to use acquired skills in a new way, at a new place
  • Engagement with new toys and materials
  • Free time for parents to work, attend meetings, or run errands–all while your child is learning at the center
  • Variation in your weekly schedule (you can do some sessions at the center, some at home)

 

Your CARD center provides a fun and welcoming atmosphere, where your child can interact with a number of staff members and other kids, all while learning the same lessons, behaviors and skills they would at a home session.

To schedule your Center-Based Services, contact your local CARD office.

SPECIALIZED OUTPATIENT SERVICES

SOS: SPECIALIZED OUTPATIENT SERVICES

ELIMINATE YOUR CHILD'S CHALLENGING BEHAVIOR - FAST.

CARD SOS provides services to individuals with and without developmental disabilities.

What is S.O.S.?

CARD's Specialized Outpatient Services (S.O.S.) is a unique service that targets a child's more extreme behavior which can make daily life difficult for a family. These services are a short-term intervention meant to fill any potential gaps not covered by other therapies. Our goal is to make the home lives of our clients as enjoyable and productive as possible.

The behaviors addressed by CARD S.O.S. tend to be more severe in nature. Often other providers have attempted unsuccessfully to address these behaviors. Utilizing the principles of Applied Behavior Analysis, the CARD S.O.S. team provides consultation and direct one-to-one intervention to reduce inappropriate behaviors and increase socially appropriate behaviors.

Duration of Services and Fees

CARD S.O.S. works with each family to determine particular needs. Our goal is to provide services in an effective and efficient manner. The duration and intensity of services are individualized. All assessment, treatment, and report-writing services are provided on a flat hourly rate. Please contact CARD S.O.S. to receive more information.

How to Get Started

CARD S.O.S. services families and individuals all over the world. However, because of staffing and logistical limitations, some services are only available in certain locations. For more information or to start the intake process, contact CARD S.O.S at  855-345-2273.Typically, after a brief phone consultation, we will schedule an initial evaluation and provide recommendations. Once accepted, services can begin.

CARD CLASSES

THERAPY PROGRAMS: CARD CLASSES

The Center for Autism and Related Disorders, Inc. (CARD) offers a variety of customized, hands-on classes and seminars that provide ongoing development for families, caregivers, professional educators, clinicians, and students with the opportunity to benefit from over 150 years of combined experience in Applied Behavior Analysis (ABA).

CARD Classes are held at a variety of CARD office locations, as well as community centers around the country. Please click on the links below to learn more about each opportunity and register today! If you have any questions, please contact: d.plump@centerforautism.com or 818.345.2345 x270.;


UPCOMING CLASSES
Social Skills Groups for Kids (Ages 6-12)

Ongoing classes
Fresno, California

Social Skills Groups for Teens (13-19)

Ongoing classes
Fresno, California

MORE DETAILS

CHALLENGING BEHAVIOR CLINIC

SOS: CHALLENGING BEHAVIOR CLINIC

CARD SOS: Challenging Behavior Clinic

Autism presents families with numerous hurdles to overcome on a daily basis.  Behavior problems are often one of the most cited concerns by parents. These issues not only inhibit the development of the child, but can curtail the activities of the family as a whole.

Common behavior problems seen within the autism spectrum that can cause significant harm to the child and others can include:

  • Self-injury (self-biting, scratching, pinching, hitting, etc.)
  • Aggression toward others
  • Property destruction
  • Pica (eating inedible objects)
  • Non-compliance

Although perhaps not as serious, there are other sets of challenging behaviors that our clients display that make the home environment more challenging. These include:

  • Sleep dysregulation
  • Inappropriate toileting
  • Inappropriate sexual behavior
Behavioral Intervention

Behavioral interventions have been utilized to address challenging behavior for decades. Between the years of 1960-1995, over 550 peer-reviewed studies were published documenting the effectiveness of Applied Behavior Analysis techniques in teaching skills to children with autism (Matson, et al, 1996). Currently, ABA-based interventions are considered to be the gold standard in intervention The CARD Challenging Behavior Clinic provides services for individuals with and without developmental disabilities, who display problem behavior in the home, school, and/or community setting. Utilizing the principles of Applied Behavior Analysis, the CARD S.O.S. team provides consultation and direct one-to-one intervention to reduce inappropriate behaviors and increase socially appropriate behaviors. Using state-of-the-art functional assessment procedures, presenting symptoms are identified and assessed. A function-based intervention is then developed to replace the challenging behaviors with newly-acquired, appropriate skills. Skills that are targeted for acquisition range from basic language and play skills to more complex social skills. Once new behaviors are mastered, CARD focuses on generalization of the newly-acquired skills to the home, school and community settings. Significant time and effort are invested in caregiver training to ensure that the child uses the new, appropriate behaviors with individuals besides the therapists.

FEEDING CLINIC

SOS: FEEDING CLINIC

For many children and adults, great joy can be found in the act of eating. However, for some children, this seemingly simple act can cause great strain on the individual and the family.

Pediatric feeding disorders occur when a child does not consume enough food or liquid to gain weight and grow as expected. On a whole, feeding issues are relatively common in children and even more common in children with developmental disabilities.  However, the severity of feeding issues can differ greatly from child to child.

CARD SOS CASE STUDY:

At the beginning of his services with the CARD’s SOS Feeding Clinic, Mitchell was small for his age, being within the 10th and 25th percentiles for height and weight for his age.  Upon discharge, Mitchell is 37.5 lbs (on the 50th percentile) and 38 inches tall (between the 25th and 50th percentiles).

MITCHELL
BEFORE
AFTER
Age 3 y 5m 3y 10m
Weight 30 lb 37.5 lb
Height 36" 39"
Texture of Food Mushy (i.e. porridge, mashed potato) Regular texture, bite size
Seating High chair, bath, tub In age appropriate booster seat
Feeding Style Mom fed him Self-feeder
Amount of Time Per Day Feeding Him 5 meals, each at least 1 hour 4 meals, each averaging 30 minutes
Variety Less than 10 foods eaten consistently, only water Anything we put in front of him. At least 40 different foods
Inappropriate Mealtime Behaviors Gagging, crying, throwing up, cough, giving back food Almost non-existent
Chewing Swallowed food whole Self-regulates chewing

A child with a feeding disorder may only eat a few foods, completely avoiding entire food groups, textures, or liquids necessary for proper development. As a result, children diagnosed with feeding disorders are at greater risk for compromised physical and cognitive development. Children with feeding disorders may also develop slower, experience behavioral problems, and even fail to thrive. Severe feeding disorders can cause children to feel socially isolated and often put financial strains on families.

There are many different types of feeding disorders, and they can take on one or more of the following forms:

  • Difficulty accepting and swallowing different food textures
  • Throwing tantrums at mealtimes
  • Refusing to eat certain food groups
  • Refusing to eat any solids or liquids
  • Choking, gagging, or vomiting when eating
  • Oral motor and sensory problems
  • Dependence upon high-calorie substances
  • Gastrostomy (g-tube) or naso-gastric (ng-tube) dependence

In most cases, no single factor accounts for a child’s feeding problem. Rather, several factors can interact to produce them.  Feeding disorders typically develop for several reasons, including medical conditions (food allergies), anatomical or structural abnormalities (e.g., cleft palate), and reinforcement of inappropriate behavior.  Unfortunately, at this time, the concise etiology of pediatric feeding disorders is still unknown.

While a wide variety of factors can contribute to feeding disorders, certain medical and psychological conditions may accompany feeding disorders more often, such as:

  • Gastroesophageal reflux disease
  • Gastrointestinal motility disorders
  • Failure to thrive
  • Prematurity
  • Oral Motor Dysfunction (dysfunctional swallow, dysphasia, oral motor dysphasia)
  • Food allergies
  • Delayed exposure to a variety of foods
  • Behavior management issues

Awareness of risk factors and clinical presentations of feeding disorders, combined with appropriate referrals at an early age, will produce the best outcomes for children and their families.

Feeding Disorders Within the Autism Spectrum

Although it has long been reported by parents, recent research has shown that there are significant differences in the eating patterns of children with autism and those who are neuro-typical. Children with autism are shown to be more selective in the types of food eaten, textures of food, and variety. Additionally, these children tend to need more specific environments and utensils (Shreck 2006). Nutritional intake is also seen to be lower for children on the autism spectrum (Bandini, 2010; Cermak, 2009).

Behavioral Intervention for Feeding Disorders

Behavior disorders (including feeding disorders) often involve an interaction of operant and biological variables. Behavioral psychology allows for systematic analysis of environmental variables. This allows the underlying function of the target behavior to be covered. Treatment intervention can then be developed fully when the function is known (Piazza 2003a).

Behavioral interventions have been shown to be useful in reducing and even eliminating not only tantrums and non-compliance during meals but, also, even the use of tube feedings (Piazza 2003b; Matson, 2005; Linschield, 2006). Interventions of these types have been published in peer-reviewed literature dating back to the mid-1970s.

The CARD Feeding Clinic provides services for individuals (a) with and without developmental disabilities, (b) who display difficulties in self-feeding or have problems such as partial or total food refusal or food selectivity by type or texture, and (c) who do not have a feeding disorder of a biological basis (as determined by a pre-screened medical examination).

Trained clinicians design interventions based on the results of a systematic assessment of an individual’s feeding problem. Intervention cane be provided either in the clinic or home setting.

As individuals show consistent improvement in feeding skills, caregivers are trained to implement interventions with clinician support. Treatment goals have been met once individuals demonstrate generalization to novel foods, and are eating well with caregivers in the home setting, and caregivers feel confident implementing procedures independently.

MEDICAL FACILITATION CLINIC

SOS: MEDICAL FACILITATION CLINIC

There are many ways to compromise medical interventions.  One oft-cited reason is simply failure to comply with recommendations. This includes non-compliance with medication as well as regular testing, follow-up visits, and examinations.  For children on the autism spectrum, this failure to comply can be taken to an even greater level involving tears and tantrums due to possible difficulties with sudden changes in environments and routines.

The Medical Facilitation Clinic provides behavioral services to individuals to assist in assuring the individual’s adherence to medical procedures. Medical procedures include, but are not limited to, the administration of oral medication (capsules and tablets), capsule endoscopy, physical examinations, dental visits, obtaining vital signs, and IV procedures. Families are required to show documentation of a thorough physical examination by a licensed physician prior to intervention.

After a review of the client’s medical history, our staff is able to design a personalized behavioral intervention to teach the client necessary new skills and to desensitize him/her to medical procedures. Once the individual has shown mastery of the specific procedure, all caregivers are trained to implement the successful intervention.

CASE STUDY

9-year old Eli was required to take 9 pills each day to adhere to his medical regimen.  At the beginning of treatment, Eli willingly put the pill in his mouth, but was not able to swallow it.  Using size fading, Eli began his intervention using very small placebo pills (tapioca).  Once he was successful in swallowing that size, the size was increased systematically.  When he was able to swallow the biggest pill size (capsule size 0), his mother began to run the sessions with great success.

Case Study: CARD's SOS Medical Facilitation Clinic

SCHOOL CONSULTATIONS

SCHOOL CONSULTATIONS

SOS School ConsultationsThe staff at CARD S.O.S. is thrilled to provide our services and experience to school districts.

The Individuals with Disabilities Education Act (IDEA) requires that IEP teams address behavior problems that interfere with a child's ongoing learning. This includes conducting a functional behavior assessment to determine the underlying reasons that the problem behavior occurs. Once the function of the behavior is known, an intervention based upon that function can be constructed. Function-based interventions are shown to be more effective and long lasting in addressing problem behavior

Staff members are able to meet with school personnel, families, and the children in order to conduct a thorough functional assessment. This can include:

  • Indirect functional assessment
  • Direct functional assessment
  • Experimental functional analysis

All assessments are tailored to the individual child. Behavioral recommendations can be provided upon request to guide the formation of a child's Behavior Intervention Plan (BIP).

CARD: GLOBAL TRAINING AND CONSULTATION

CARD: GLOBAL TRAINING AND CONSULTATION

CARD offers expert training and consultation worldwide

  • Training and consultation available for schools and organizations
  • Supportive consultants offer professional guidance and support throughout the training process
  • In-person and web-based training provided by experienced consultants
  • Packages range from brief training on a single topic to in- depth training courses that prepare entire staff groups to effectively implement ABA-based interventions
  • Training topics, formats, and consultation packages are tailored to meet your specific needs

Contact us to discuss your particular training needs: 1-855-345-2273

You can also visit our training site: www.ibehavioraltraining.com

CARD: BCBA/BCABA MENTORSHIP

CARD: BCBA/BCABA MENTORSHIP

CARD provides expert supervision for professionals working to obtain their BCBA / BCaBA

CARD BCBA/BCaBA SUPERVISION BENEFITS:

  • One-to-one and small group supervision formats with an experienced clinician
  • Supportive supervisors offer professional guidance and support
  • Supervision from your home or work through video conferencing and other internet tools
  • Personally tailored supervision for your area of interest
  • Earn supervision hours from anywhere in the world
  • Over 50 BCBAs from a variety of backgrounds to assist you
  • Access to our extensive online assessment and curriculum, Skills, with over 4,000 lesson activities

Call us to get started: 858-278-6603 ext. 32

BCBA/BCaBA Supervision: $70 per hour

REMOTE CLINICAL SERVICES
Not near a CARD office? We can still help!

If there is no CARD office near you, our supervisors can travel to your family and provide the training your child needs. Remote clinical trainings include:

  • Understanding autism
  • ABA basics
  • Skills® assessments
  • Skill acquisition and maintenance
  • Behavior management
  • Demonstration/modeling/role-play
  • Practical training with child
  • Ongoing observation and specialized support for child and family

CARD is committed to providing top-quality therapy and supervision around the globe to families affected by autism spectrum disorder (ASD). With Remote Clinical Services, your family is individually matched with a CARD supervisor who travels to your home to meet with parents and caregivers. The supervisor initiates an in-depth and ongoing assessment to identify treatment goals and develop an individualized treatment plan for your child that fits your family’s needs. During the first visit, the supervisor puts behavior and skill acquisition plans in place specifically tailored to your child. Throughout the therapy process, your supervisor provides ongoing support to ensure the effectiveness and integrity of the treatment plan. Your CARD supervisor can also assist in school planning, report writing, and training additional staff. If requested, CARD can even hire and train therapists in your area to provide therapy in the home or out in the community.


CARD’s online assessment tools and training programs allow us to offer quality and consistency all over the world.


Assessment, curriculum, and behavior plans can be updated instantly with SKILLS®, the CARD online assessment tool based on 30 years of clinical research. For more information, visit www.skillsforautism.com.


CARD’s highly regarded training programing is also available online to train individuals in your community to become therapists. CARD’s eLearning™ program provides in-depth training on the principles and procedures of applied behavior analysis, an evidence-based approach to treating the challenges and delays associated with autism spectrum disorder. For more information, visit www.ibehavioraltraining.com.


The CARD Model is available to all autism treatment professionals through the CARD Affiliate Program, helping agencies worldwide address the needs of their local autism population. This unique partnership between CARD and other treatment providers produces exceptional clinical outcomes while building sustainable local businesses. Initially, clients, families, and affiliate staff receive direct supervision from CARD. As the program develops and the affiliate staff gain experience and training, clinical services may be provided independently. Affiliates work directly with a team of CARD clinicians who have extensive training and years of experience. Our CARD team designs the client treatment and supervision plans and teaches affiliate staff to develop and implement these plans themselves.


At CARD Remote Clinical Services, we work diligently to provide global access to top-quality, evidence-based treatment and to help small business owners build sustainable companies. For more information, contact us at (855) 345-2273 or email us.

 

© CENTER FOR AUTISM AND RELATED DISORDERS, INC. ALL RIGHTS RESERVED.