Tips to Find the Best ABA Center for your Autistic Child

Introduction

ABA stands for applied behavior analysis. It’s a form of therapy that’s based on the principles of behavioral psychology. It’s one of the most common therapies used to treat autism and it’s endorsed by the surgeon general. ABA is widely popular due to its proven effectiveness in improving the lives of individuals with autism. An ABA center is where individuals with autism can go to receive ABA therapy.

Customized Therapy Programs

 

No two children are exactly the same, right? Since this is true, it makes sense that no two children will have exactly the same therapy needs. They will have different behavior problems and will be behind in different developmental milestones. Therefore, ABA centers should never be offering cookie-cutter therapy programs.

In designing a therapy program, the ABA center should be performing a deep assessment of your child’s needs. An analysis of your child’s current skills will be produced from this assessment. Then, a board certified professional will design a therapy program tailored to your child and their current skills. Additionally, the ABA center should be asking for the parent’s input in the initial and ongoing assessment. Parents add value to the assessment by providing information about behaviors the child is having and skills they are lacking. This is also a chance for parents to communicate the goals they have for their child. Goals can range from basic life skills like toilet-training to more sophisticated skills like vocal communication.

Any worthwhile ABA center should be willing to create a unique therapy program to meet your child’s and families needs.

Formal Assessment Tools

Formal assessment tools, such as the VB-MAPP and AFLS should be used to evaluate the skill sets of an individual diagnosed with autism. They should be part of the foundation and structure of any great ABA curriculum.

The VB-MAPP is an assessment tool used to determine an individual’s social and early learner skills. VB-MAPP stands for Verbal Behavior Milestones Assessment and Placement Program. Quality ABA centers use the VB-MAPP, or something similar, to assess a child’s skills and then guide the design of that child’s goals.

The AFLS is another assessment tool that could be used by an ABA center to assess your child’s needs. AFLS stands for Assessment of Functional Living Skills. AFLS assesses the more practical, functional skills like toileting, dressing, basic communication and self-management.

There are even more tools that ABA centers could be using like the ABLLS and the Essentials for Living. These tools not only allow the therapy team to do an initial assessment of a child, but they are also designed for continued monitoring and measurement of your child’s progress. The therapy team uses these tools to re-evaluate the effectiveness of the therapy program.

Consider asking an ABA center if they are using these tools to initially evaluate and continually monitor their children. Without these tools and the data they provide, an ABA center would have far less visibility into your child’s needs and progress.

Based on Data

Data is the lifeblood of any quality ABA program and guides the decision-making about your child’s therapy programs.

For example, when your child first comes to a center, they may spend 60 minutes of every day flopping on the floor and screaming. A proper ABA center should be tracking the amount of time your child engages in this behavior. Over time, it will become possible to see a trend in the frequency of problem behaviors from one day to the next. The therapy program supervisors will then use this daily/weekly trend to decide how well the intervention is working. Eventually, they’ll want to see the 60 minutes of daily tantrums become 30 or 15 minutes. This declining trend in tantrums could indicate that the program is working. On the flip side, if that 60 minutes of daily tantrums consistently stayed at 60 minutes over the course of several months, this might indicate that something about the therapy program wasn’t working. In the case of a program not working, the program supervisors should be able to re-examine the child’s behavior and shift the therapy program accordingly.

Consider asking the ABA center “what kind of data do you use to track my child’s progress?” and “can I see the data?”

Social Skills, Natural Environment Training and Table Work.

Every ABA therapy program should be based on 3 different components of ABA.

1.) Social Skills – The child should be learning social skills by communicating with the therapist, working on eye contact improvements and socializing with other children at the center. To make sure your child is getting the right social skills training, you want to know that they will have appropriate peer groups of the same age. A 10 year old will not gain as many social skills interacting with only 5 year old children as opposed to if they were interacting with children of their own age.

2.) Natural Environment Training – Natural environment training involves using the principles of ABA therapy in natural environments or “the real world”. If your child only learned at a table in a therapy room, then they would have a harder time applying their teachings to other situations. By integrating therapy into “natural environments” like a kitchen, a bathroom, or even a playroom, your child becomes more equipped to use their new skills in the rest of the world and in your home.

3.) Table Work – Table work is the initial teaching arm of the therapy program. Table work provides an environment that is engineered to reduce distractions. The reduced-distractions environment of table work creates focused learning experiences for your child.Through table work, they will become more accustomed to the kind of setting they will experience in a regular classroom as well as at a desk job.

One-on-One Therapy

An intense ABA therapy program means there will be a lower ratio between therapists and children. Additionally, an intensive ABA therapy program should strive for a 1:1 ratio between therapists and children as much as it can.

A 1:1 ratio has a positive impact on teaching the therapy. With a 1:1 ratio, the therapist can be fully aware of all your child’s behaviors, struggles, triumphs and skills.

Furthermore, the 1:1 ratio also has benefits beyond the learning part of the therapy program and impacts the general operation of the center. Even small amounts of time where therapists must manage multiple children can result in behaviors going unnoticed and safety becoming increasingly at risk.

Ask the ABA center how often your child will be 1:1 with a therapist. If it’s possible, try to find a center that provides 100% 1 on 1 ABA therapy. This means that at NO point during the therapy program will your child be without a 1 on 1 setting with a therapist.

Contact Lighthouse Autism Center to learn more about finding a quality ABA center for your child.

Anthem Insurance Cos. Inc. will pay almost $1.63 million to end
claims that it violated federal benefit laws by placing certain
caps on the coverage of therapy treatments for children with
severe autism disorders.

Anthem also agrees to stop using guidelines that base coverage
of applied behavior analysis therapy for autism solely on an
individual’s age, according to a motion seeking approval of a
class action settlement filed March 23 in the U.S. District Court
for the Southern District of Indiana.

If approved, the settlement will provide relief for at least 201
children and allow class counsel to seek fees of up to $508,345.
The estimated average payment to class members will be
$5,052, with payments ranging from $2.02 to more than $36,000,
according to court documents.

The proposed deal would end a three-year lawsuit that accused the insurance giant of violating federal mental health parity law when it limited coverage for a 13-year-old boy’s autism treatment to 20 hours per week. The settlement comes one year after a federal judge held that Anthem satisfied Indiana’s autism mandate, which requires insurers to cover treatment for autism spectrum disorder, by covering 20 weekly hours of treatment instead of the 40 hours requested. Anthem joins a growing list of companies that have settled claims over coverage of ABA therapy for autism, including United Healthcare Services Inc., T-Mobile USA Inc., and Applied Materials Inc.

To read the full article, please visit https://bit.ly/2Een9XG

Prenatal multivitamins linked to lower autism risk

A new study suggests prenatal multivitamins may reduce a child’s risk of developing autism. The study analyzed more than a quarter-million mother-child pairs in Sweden and found a link between multivitamin use and risk of the neurological disorder.

It’s estimated that 1 in ever 68 people in the United States has a form of autism, boys more than girls. And since mothers-to-be are already advised to take prenatal vitamins, this could be an added benefit.

“Multivitamin use with or without added iron or folic acid was associated with a lower likelihood of having a child with an intellectual disability, compared with mothers who did not use supplements,” said lead researcher Elizabeth DeVillbiss, a Ph.D. graduate in epidemiology and biostatistics at Drexel University’s Dornsife School of Public Health. In fact, the odds of autism in the multivitamin group were 30 percent lower.

Autism, experts believe, is caused by genetic and environmental factors. It most likely starts in the womb, and the mother’s diet during pregnancy might have an influence, said DeVillbiss.

However’, it’s too early to recommend multivitamins specifically for lowering autism risk. The study couldn’t yield definitive cause and effect proof. It was observational and didn’t keep track of specific supplements taken, timing, and the doses. Plus, the results of other studies have been inconsistent.

Even so, it’s recommended that pregnant women take multivitamins- before and after pregnancy while they are still breast-feeding.

To read the full article, please visit https://drexel.edu/news/archive/2017/october/multivitamin-use-during-pregnancy-linked-to-lower-risk-of-autism-with-intellectual-disability

A Guide to Health Insurance for Children with Autism

Health insurance has changed dramatically in the last year, with many companies, like Anthem Blue Cross Blue Shield and IU Health, leaving the individual market in Indiana. This means there are fewer choices for 2018 making it important to begin shopping early.

The Affordable Care Act (ACA)’s open enrollment period allows individuals to enroll in a plan through the Health Insurance Marketplace. Any family who has a child with autism and wants access to therapy should have a healthy insurance plan covering ABA services. So, for those that do not currently have health insurance, or have group coverage not covering ABA Therapy, now’s the time to enroll.

To obtain insurance coverage in 2018, you mus purchase a policy between November 1 and December 15, 2017. While you may purchase a policy anytime during this period, the earliest the plan will be effective is January 1, 2018. The good news is ACA plans are fully funded and are mandated to include coverage of autism services. Plus, it doesn’t affect the cost of the plan in any way. The Insurance Department at Lighthouse Autism Center has been working diligently with an insurance broker to identify plans that will most benefit families with autism.

To learn more or inquire about purchasing a policy, you can contact Lighthouse Insurance Manager, Michele Rohyans, at 574-387-4313, or micheler@lighthouseautismcenter.com.

When asked how Lighthouse can help families, Sandy Maggioli said, “We will help families find a policy that is right for them and even help them apply for grants to cover their out-of-pocket expenses. It is our goal to help families in any way we can, starting with the insurance process.”

The Rutgers Center for Adult Autism Services (RCAAS) aims to be a national model, offering a mix of vocational and residential programs for adults with autism to work and live within a universal community.

An estimated 1 in 68 children nationally – and 1 in 21 in New Jersey – are diagnosed with an autism spectrum disorder (ASD). The RCAAS aims to address a gaping need for young adults with autism: Through high school, children with autism can get tutoring, mental health services, transportation and other resources to accommodate their needs. But, once they leave public school systems, services diminish greatly, leaving adults with little support outside of their families.

The center’s research will lead to creating a model for similar centers and training educated staff to work with adults with autism.

“Our aim is to make a difference in the lives of all adults with autism by creating a best-practices training program for students across all disciplines – business, medical, art – who work with adults with an autism spectrum disorder,” says Christopher Menente, the RCAA’s Executive Director.

The center has two phases – a $20 million facility for the workday program and a pilot residential program for 20 adults with autism who will work on campus and live alongside Rutgers graduate students in an apartment-style residence.

To read the full article, please visit https://bit.ly/2qPhnbB

What you need to know:

The landscape of health insurance has dramatically changed over the course of 2016, with many companies, such as Unitedhealthcare, leaving the individual market in Indiana. Unfortunately, there are fewer choices for 2017, which makes it more important to begin shopping early.

A health insurance plan covering ABA services is necessary for any family who has a child with autism and wishes to access therapy. For those that may not currently have health insurance, or have group coverage that does not offer coverage for ABA therapy, now is the time to enroll.

The Affordable Care Act (ACA) created a new way for families to enroll in insurance – it’s called open enrollment. This is a yearly period when individuals can enroll in a plan through the Health Insurance Marketplace. To obtain insurance coverage for 2017, you must purchase a policy between November 1, 2016 and January 31, 2017. While you may purchase a policy anytime during this period, the earliest the plan will be effective is January 1, 2017.

The Insurance Department at Lighthouse Autism Center has been working diligently with an insurance broker to identify plans that will most benefit families with autism. To learn more or inquire about purchasing a policy, you can contact Lighthouse Insurance Manger, Michele Rohyans, at 574-387-4313 or micheler@lighthouseautismcenter.com.

When asked how Lighthouse can help families, Sandy Maggioli said, “We will help families find a policy that is right for them and even help them apply for grants to cover their out-of-pocket expenses. it is our goal to help families in any way we can, starting with the insurance process.”

Genetic Research Could Lead to Earlier Autism Diagnosis

In an article published in Behavior Genetics, researchers at Ben-Gurion University of the Negeg (BGU) say they’re closer to understanding the genetic basis of autism. The researchers found distinct characteristics in genes associated with autism that distinguish them from other brain-specific genes. They believe this will allow the identification of additional autism genes, leading to an earlier diagnosis of autism.

“We are now a step closer to understanding the genes associated with autism and understanding the biological process involved in the disease,” says Dr. idan Menashe, who along with his colleagues, Erez Tsur and Professor Michael Friger, is a member of the BGU Department of Public Health in the Faculty of Health Sciences.

One particularly distinct characteristic of autism genes the researchers found is their exceptional genomic length, which is longer than other brain-expressed genes of closely related diseases such as Alzheimer’s and schizophrenia.

“Our findings suggest that ASD genes have evolved under complex evolutionary forces, which have left a unique signature that can be used to identify new ASD candidate genes,” the researchers add.

To read the full article, please visit sciencedaily.com/releases/2016/10/161006102944.htm.

Lighthouse Autism Center has recently completed the second episode of our Autism Minute series. The Autism Minute is a video series created by Lighthouse Autism Center to provide helpful tips and resources for parents and caregivers of children with Autism. Each series is led by one of our 10 full-time Board Certified Behavior Analysts, and covers a topic we believe to be relevant to caregivers.

The second episode of the Autism Minute is about Instructional Control and your child. The video discusses what Instructional Control is,  how to gain it with your child, and the benefits that come from having instructional control, including gaining respect from your child and forming a better relationship with them.

[youtube_sc url=”https://www.youtube.com/watch?v=aFx6bSxRiMI” autohide=”1″]

Hi, my name is Natalie Donkersloot. I’m a program manager at Lighthouse Autism Center at the Edison-Mishawaka location working with the early learners. I’ve been at Lighthouse for a little bit over a year. I’ve began having a passion for applied behavior and analysis in autism in my undergrad at Western Michigan University. Then I decided to pursue a master’s degree in applied behavior analysis while at Western. One of my favorite things about working at Lighthouse is that I get to make a difference in children’s lives every day. Thank you.

Today we are going to talk about the importance of earning instructional control between parents and children who have autism. So what is instructional control? It is pairing yourself with your child so that you have a positive working relationship and your child will want to follow your lead to listen and learn. What is pairing? It is the process of combining or pairing the learning environment, people, and setting with items that your child already finds rewarding. In other words it is very important to have a relationship with your child in which they respect you. Often when we have new kiddos start at Lighthouse, parents report that their child does not listen to simple demands or engages in problem behavior when they do not get what they want. While this is not uncommon for children who have autism, there are strategies to help you build and improve a relationship with your child. According to Robert Schramm, there are seven steps to earning instructional control with your child.

After implementing the seven steps of instructional control with your child, you will build a better relationship with your child, earn their respect, experience less problem behavior, and you will begin to see your child want to listen to you in order to get good things. You are not going to be able to teach your child everything you want him or her to learn, if you do not earn his/her willingness to follow your lead first.

Step 1: Clean the House of Toys. The first step is showing your child that you are the one in control of items that they want to hold or play with and that you will decide when they can have them. You should be in control of all of the toys in the house and the child has to go through you to get those items. This means that you need to clean the house of any toys, items or activities that your child likes to play with by putting all of the toys up out of access of your child.

Step 2: Play with your Child. The second step is showing your child that you are fun. This means interacting with your child when they are playing with their favorite toys and activities. You never want to manipulate the child, but manipulate the toy in order to get what you want. This means that the child can play with the toy, but only when it is with you. When the child leaves the area with you then they lose access with the toy.

Step 3: Show that you can be Trusted. The third step is showing your child that you can be trusted. It is very important to always say what you mean and mean what you say. This means following through with any and every demand that you give your child. You want to make sure to consider your words carefully. For example, do not ask questions that your child can answer “no” to when you would like them to do something. Do not ask, can you through your plate away? Instead say, throw your plate away.

Step 4: Provide Toys when your Child Complies. The fourth step of instructional control is showing your child that following your directions are to their benefit and that is the best way for them to obtain what they want. Give your child easy directions and if they comply then give them access to their favorite toys or activities. For example, if you ask your child to clean up the toys on the floor and they complete the task the first time you ask, then allow them to have five minutes playing with a preferred toy. However, if you give them unlimited time with that toy, the toy will lose its reinforcing value. Also it is important to have reasonable expectations of what you want your child to do based on his/her skill level.

Step 5: Provide Toys after every Appropriate Behavior. The fifth step of instructional control is making sure that you provide a reinforcer every time your child engages in good behaviors. You want to make sure to give attention to the good things that they do. This can be something as simple as telling your child what a nice job they are doing playing with one of their siblings.

Step 6: Know your Child’s Favorite Toys. The sixth step of earning instructional control consists of demonstrating that you know your child’s priorities as well as your own. Make sure to keep a list of their favorite items and activities and then deliver the more preferred toys for harder instructions. If your child has never been able to independently get dressed, and they do one morning, then that would be a great time to provide a preferred toy or activity.

Step 7: Show your Child that choosing to NOT Listen to you will NOT Benefit Them. The seventh step of earning instructional control consists of showing your child that ignoring your directions or choosing inappropriate behaviors will NOT result in any good things like toys, for instance. This means that the ONLY way that they can get attention and toys is by engaging in appropriate behaviors. If they engage in inappropriate behaviors they will NOT get toys and attention.

So here are the “Take Away Points”. By implementing the seven steps of earning instructional control with your child, you could potentially improve your relationship with your child, earn your child’s respect, experience less problem behavior, and you will begin to see that your child wants to listen to you in order to get good things. You are not going to be able to teach your child everything you want him/her to learn if you do not earn his/her willingness to follow your lead first. Here are the seven steps one last time. First step, clean the house of toys and keep them out of reach of your child. Second step, play with your child when they are playing with their favorite toys and activities. Third step, show your child that you can be trusted. Fourth step, provide toys when your child complies. Fifth step, first provide toys after every appropriate behavior, and then once they’re engaging in those appropriate behaviors reliably, expect more out of them before you give them the same type of reinforcer. Sixth step, know your child’s favorite toys. Seventh step, show your child that choosing to not listen to you will not result in toys or good things.

No MMR-Autism Link in Large Study of Vaccinated vs. Unvaccinated

Despite repeated evidence to the contrary, there are those who continue to assert a link between the measles-mumps-rubella (MMR) vaccine and autism spectrum disorder (ASD), leading to lower vaccination levels.

In the largest-ever study of its kind, researchers again found that the MMR vaccine did not increase risk for ASD. This proved true even among children already considered at high risk for the disorder.

The April 21, 2015 issue of the Journal of the American Medical Association (JAMA) reported the results for the study, and an article appeared on the Autism Speaks website (autismspeaks.org).

For the study, researchers analyzed the health records of 95,727 children, including more than 15,000 children unvaccinated at age 2 and more than 8,000 still unvaccinated at age 5. Nearly 2,000 of these children were considered at risk for autism.

The study found no association between the MMR vaccination and increased ASD risk. It also found no evidence that the MMR vaccination was associated with an increased risk of ASD among children who had older siblings with ASD.

To read about this important study, please go to the article on the Autism Speaks website by using this link: https://bit.ly/1QfpH9P.

Autism-Friendly Amusement Parks in the Midwest

We recently came across an article in Indy’s Child that provided a list of amusement parks in the Midwest that provided unique supports for families with special needs. If you are looking for a family outing this summer, take a look at the list of parks below and see how these parks can accommodate your special needs family member to make the whole family experience better.

1.) Holiday World & Splashin Safari, Santa Claus, IN

They offer a Holiday World Ride Boarding Pass to individuals who are unable to wait in lines. It allows the individual and three guests to check in at a ride and return later without actually having to wait in line. For more information visit www.holidayworld.com/help-information/accessibility

2.) Kings Island and Cedar Point, Mason OH and Sandusky OH

Kings Island and Cedar Point both have a Boarding Pass Program which allows those who are unable to wait in ride lines and three guests to check in and return later to avoid the crowds. Visit Guest Services to request a pass once arriving at the parks. For more information visit www.visitkingsisland.com/plan-a-visit/guests-with-disabilities and www.cedarpoint.com/plan-a-visit/guests-with-disabilities

3.) Kentucky Kingdom and Hurricane Bay, Louisville, KY

Similar to other parks they offer an Attraction Boarding Pass at Guest Services that allows those who are unable to wait in ride lines and three guests the option to skip lines by going to the ride exit and speakign to an employee who will help them board the ride. Additionally, for those with sensory sensitivities, the park offers a quiet resting place for two people in the Carousel Courtyard and Health Services.

For more information visit www.kentuckykingdom.com/faqs-and-policies/rider-requirements/

4.) Six Flags Great America, Gurnee, IL
They offer an Attraction Access Program that allows those whoa re unable to wait in lines and three guests the option to “check-in” at a ride and return later. Unless you request before your trip, you will need to bring a doctor’s note to the park.

For more information visit