Educational-Behavioral Therapies: Overview

November 3rd, 2015

Applied Behavioral Analysis (ABA)

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

"Applied Behavior Analysis (ABA) is the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree." (Baer, Wolf & Risley, 1968/1987; Sulzer-Azaroff & Mayer, 1991). 

ABA takes a systematic approach to the assessment and evaluation of behavior and the application of interventions that alter behavior. A program binder is created specifically for each child, which includes teaching procedures and data collection sheets for the child’s in-home program. ABA training is provided for paraprofessionals and parents regarding teaching skills and behavior management. A BCBA provides ongoing program consultation, which includes recommendations and changes to the in-home program based on the child’s progress.

Who pays: Insurance (where available), school, private pay

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

Assistive Technology or Augmentative Communication

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

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

Who Pays: School, Medicaid, Medwaiver, private pay

More info: Helping Non-Verbal Kids to Communicate

Floortime

Who and where: A specially trained Floortime therapist, an early intervention therapist, or a parent; in home.

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

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

Who pays: Insurance, private pay, Medwaiver (some states), early intervention programs

More info: The Interdisciplinary Council on Developmental & Learning Disorders

Itinerant Therapies/Services

Who and where: School therapists; in school

Students who do not attend public school may still receive related services (PT, OT, or speech, for example) either at school or at home or day care. This includes Homeschooling families.

Who pays: School

Occupational Therapy (OT)

Who and where: Licensed occupational therapist; in school, in a private clinic or home.

An occupational therapist works to improve your child’s motor development, activities of daily living (ADL), and sensory integration. Fine motor skills include small movements, like the way your child’s hands pick up or manipulate an object; color or write; and perform self-care activities.
Activities of daily living include manipulating toys in play, writing, dressing, feeding, bathing, and working. An OT will also evaluate how your child perceives the environment through his/her senses. Additionally, an OT may evaluate your child’s trunk and upper body strength, joint range of motion, muscle tone, skin integrity, and eye-hand coordination. The therapist, with parent input, will develop a treatment plan. Therapy sessions are typically geared towards functional activities that your child should be performing, such as playing, dressing, self-feeding, bathing, coloring, writing, craft projects, and work activities.

Occupational therapists sometimes use assistive devices to perform ADLs, as well as big therapy balls, bolsters, wedges, and swings for motor development and sensory integration.

Who pays: Schools, Insurance, Private Pay, Medwaiver

More info: American Occupational Therapy Association

Physical Therapy (PT)

Who and where: Licensed Physical Therapist; In school or in private practice.

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

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

Who pays: Schools, Insurance, Private Pay, Medwaiver

More info: American Physical Therapy Association

Social Skills Training (SST)

Who and where: Contracted agency; school, in-home, or in private clinic

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

You can also incorporate social skills into your child’s IEP. Some Medwaiver programs cover this too. There is no certification for this job.

Who Pays: School, private pay, Medwaiver

More info: A Model for Social Skills Instruction

Speech Therapy (ST)

Who and where: Licensed speech-language pathologist; in school, in private practice or in home.

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

A speech-language pathologist evaluates your child’s understanding of language and ability to communicate through non-verbal and verbal gestures; cognitive status (thought and learning process); and your child’s ability to chew and swallow food and liquids. The therapist, with your input, will develop a treatment plan.

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

Who pays: Schools, Insurance, private pay, Medwaiver

More info: American Speech-Language-Hearing Association

Relationship Development Intervention (RDI)

Who and where: A trained RDI consultant and parents; in-home

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

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

Who pays: Private pay,Insurance*

More info: RDI Connect

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

Verbal Behavior (VB)

Who and where: A Board Certified Behavior Analyst (BCBA) typically leads a team of paraprofessionals working 1:1 with child at home or at school.

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

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

A VB program will focus on teaching children that language will get them what they want, when they want it. Requesting is often one of the first verbal skills addressed. Children are taught to use language to communicate, rather than just to label items. Learning how to make requests often leads to improved behavior. Some consider VB to be a more natural form of ABA.

Who pays: Insurance, school, private pay

More info: Autism Teaching Methods: Applied Behavior Analysis and Verbal Behavior

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3 Responses

  1. […] like Floortime/DIR/Play therapy and RDI (Relationship Development Intervention) both combine social skills training in their […]

  2. […] about the traditional therapy options. Use your insurance to see a behaviorist, speech therapist, occupational therapist, and physical […]