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, Asperger's syndrome, PDD-NOS, and other related disorders.

CONTACT US TOLL FREE (PARA AYUDA EN ESPAÑOL): 1-855-345-CARD (2273)

ABA RESOURCES: INTRODUCTION

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).

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.

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).

SOCIALLY SIGNIFICANT BEHAVIORS

"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.

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.

ANALYTICS MISSION

Mission Statement

The mission of the Analytics Department of the Center for Autism and Related Disorders is to improve the lives of people with ASD and their families by facilitating the highest level of research, development, assessment, and treatment through the collection, analysis, and dissemination of relevant data to ensure that all CARD departments operate in a data-enriched environment.

ABOUT CARD ANALYTICS

General Overview

Analytics is about using data intelligently to answer questions that matter. For us at CARD, the questions that matter center on improving outcomes for the children we serve. One of our primary goals is to identify the factors that influence outcomes within ABA treatment programs, collect data on these factors, and provide data-based recommendations and expectations for individual response to treatment.

We work closely with our Research & Development and Technology departments to collect, store, extract, and analyze information from numerous sources. Our primary focus is on clinical application, specifically acquiring and analyzing clinical data to enhance treatment outcomes. Additionally, the Analytics Department supports all CARD departments and clinical offices in their endeavors to provide optimal results for CARD clients.

ANALYTICS PROGRAMS

Data Analysis

• Identify, implement, and disseminate best practices based on results of data analysis.
• Maximize efficiency of all CARD departments by facilitating data-driven decisions in treatment, research, and development.
• Identify predictors and trends that influence research and treatment decisions.
• Develop and refine algorithms for the prediction of clinical outcomes.

Clinical Support

• Utilize data analysis to optimize client results by identifying severity, establishing anticipated mastery rates, and individualizing treatment plans.
• Use relevant data to document client progress.
• Identify client strengths and weaknesses through comprehensive data analysis, and convey findings to clinicians.
• Assess client satisfaction and areas of concern through analysis of survey results.

Research Support

• Provide statistical analysis and research design support for research projects.
• Ensure ongoing fidelity of active projects by analyzing data, identifying irregularities, and interfacing with project managers to resolve issues as they arise.
• Monitor data of active projects to ensure safety of project participants.
• Maintain data in multiple accessible formats to enable broad-based sharing throughout all CARD departments.

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 confirmed 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.

STANDARD FEES
Diagnostic Assessment: $1500 to $2000

Comprehensive Testing: (diagnostic, cognitive, language, adaptive, social skills, and executive functioning): $3500 to $4500

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.

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

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).

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Dowload the CARD Practicum Description

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.

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

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.

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.

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.

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.

SCHOOL CONSULTATIONS

The 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 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 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