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Program Intensity
Program intensity and number of treatment hours are determined by many
factors. The child's age, nature of their deficits and their daily
schedule should be determining factors when one considers the intensity
of intervention. In addition to the number of hours of one-to-one
therapy, the quality of therapy and the degree of follow-though and the
level of structure during "non-treatment hours" must also be
considered. TLC is always open to draw correlations to the number of
treatment hours to the rate of progress during TLC's mandatory
bi-weekly team meetings.
Team Structure
A
team of 1 to 4 trained behavioral therapists, a senior behavioral
therapist and a case supervisor provide the direct instruction. Each
therapist may provide between 4 and 12 hours of one-to-one instruction
per week. This is ample time to establish procedural competence and a
positive rapport, while not spending so much time that the child
becomes dependent on any one member. Parents are an integral part of
the instructional team. The TLC model requires parents to provide a
minimum of 2 or 3 hours per week of additional natural environmental,
incidental instruction or generalization. This will enable parents to
maintain a consistent approach across their child's waking hours, as
well as to establish contingencies in the child's everyday environment.
Parents are also required to attend all staff meetings (i.e., clinical
meetings), participate in selecting new goals, offer observations,
provide feedback for staff evaluation purposes, and are required to
approve all procedures implemented.
Applied Behavioral Analysis Therapy Sessions
Therapy
sessions typically last between 1.5 and 3 hours. The length of the
therapy sessions is adjusted to meet the needs of the clients served.
The sessions maintain a positive ratio between intensive one-to-one
discrete trials and less intensive structured activities. The less
structured activities include preferred activities, self-help, fine and
gross motor skills, play activities, natural and incidental teaching
methods. In an effort to promote a fluent session, one-to-one
instruction is interspersed with the other activities. This allows the
Behavioral Therapists to target all areas of development (.i.e.,
acquisition of receptive and expressive language, communication, toy
play, peer play, socialization, abstract concepts, self-help skills,
fine, gross, and visual motor integration, behavioral reduction, etc.)
Time away from the structured teaching setting provides the child with
breaks that facilitate the generalization of mastered skills into the
child's everyday living environment.
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Progression of Program
As the child acquires new skills, therapy progresses through different
stages. New programs are constantly being created as the child's
individual needs are the driving force for programs identified,
modified and implemented. As such, there is never an all inclusive
program, rather an always-changing program created to meet the dynamic
needs of the children that receive our services. The child's
progression or rate of acquisition may also warrant the incorporation
of other treatment elements as deemed mutually necessary by parents,
schools and our Case Supervisors (see the Our Program section).
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School Placement
Once a child learns appropriate foundation behaviors and skills, and
interfering behaviors have been reduced in frequency, the child is
gradually integrated into an appropriate nursery, preschool, or
classroom while protecting the integrity of least restrictive
environment. The particular setting is chosen based on the child's
success in the preceding period of one-to-one instruction in the home.
In all cases, the goal is to provide a child with a setting conducive
to maximizing success and minimizing failure, with appropriate peers to
model social behaviors and language. A behavioral therapist accompanies
the child in order to facilitate integration into the classroom,
participation in group activities, interaction with peers and to assist
the child in acquiring new skills in a group setting. Deficits that
exist in the child's behavioral repertoire in school are targeted in
one-to-one instruction at home and are then generalized to the school
environment. The duration of school attendance will vary as each child
is unique. The goal is that eventually a child will attend school for
the entire school day with additional services provided after school if
required. These additional services are designed to target social
skills during peer sessions, pre and post teaching of academic skills,
and to continue to target any remaining areas of deficits that may
exist.
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