Focused/Functional Skills Programs: One on one help for real life challenges
As is the case with all our programs, our focused/functional skill programs start with asking you what your priorities are and what is doable for you. Typical issues we address include social skill deficits, pragmatic and general languae deficits, toileting, managing challenging behavior, sleep issues, daily living skills such as dressing, bathing and brushing teeth, tolerating hair cuts and hair brushing, getting out of the door in the morning without a meltdown, simple eating problems (drinking out of a cup without a lid, staying seated while eating, eating only their own food, etc.) tolerating the triggers the lead to challenging behavior, and the inevitable issues that are unique to each child. Unlike our parent coaching programs, focused/functional skill programs use one on one behavior technicians/RBTs to implement the strategies that are written by and supervised by Dr. Gifford. These programs are designed to give your child a head start to greater independence.
How we can help
At Utrecht Autism Services, just as we provide intensive programs with one on one support, we also provide focused programs for children and families who are a good fit for either an intensive program or parent coaching alone. Children older than 7, children with less severe challenges, and children whose deficits are primarily in the social and community skills domain can benefit greatly from these programs. Typically these are scheduled for after school hours for 10-15 hours per week. with an occasional Saturday session. However, children with severe challenges in language, social skills, functional skills such as toileting, brushing teeth, dressing, and appropriate play skills, as well as those with significant challenging behaviors including stereotypy (stimming) also benefit from these programs.
Uniquely designed programs
We know that no two children are alike. Every Utrecht Autism Services program is one of a kind. Skills teaching is targeted at the exact level demonstrated by the child. New skills are introduced immediately when prerequisite skills are mastered, and never on a predetermined schedule. Your child needs to learn at the fastest rate that he or she comfortably can, in order to make up lost ground whenever possible.
Expert supervision
We provide ongoing, in-person supervision for at least 10% of intervention hours by a doctoral-level board-certified behavior analyst for intensive and focused/functional skills programs. These are not only opportunities for the data to be reviewed, but also for new strategies to be coached. Often a child will demonstrate that he or she is ready move forward faster, or that a difficult skill needs to be broken down into more steps. Almost every supervision visit includes new skills to introduce as the children acquire the prerequisite skills needed. Every supervision visit produces written recommendations that are gone over with the parent and the team at regular meetings, to make sure everyone is aware of what is happening and in agreement with the recommended strategies.
Parent and caregiver coaching
All programs include parent and caregiver coaching by a doctoral-level board-certified behavior analyst, empowering you to support your child's progress. For intensive and focused/functional skills programs, this can be part of the regular meetings to go over supervision notes, or it can be separate to allow for an individual session with the parent.
What exactly happens during an focused/functional skills in-home program?
Focused/functional skills programs start with Dr. Gifford's in-person assessment of your child's skill levels and in depth interviews with parents to determine your priorities. Assessments typically also involve an RBT to assist (at no extra cost to the parent). Dr. Gifford also reviews any available relevant information (school and medical files, etc.). Standardized skill assessment tools such as the VB-MAPP, ABLLS-R, AFLS, and Vineland ae typically not included in these assessments, but they may be added at parent request. The assessment will look at the skills identified by the family as a priority, as well as any prerequisites to those skills that may be lacking. The entire assessment usually takes 8-10 hours spread out over 2-3 visits. The data and other information collected from those visits are used to design a one-of-a-kind program that addresses the child's needs in the domains that seemed to be the highest concern. Objectives are generated for each skill, including baselines and suggested goal levels. Typically, focused/functional skills programs address 10--15 skill deficit areas at any given time, as well as reducing behavior challenges. These findings are presented in an assessment report, which is reviewed with the family along with recommendations for intensity of treatment (number of hours per week). At that point, any additional parent input is requested and changes are made as needed. If the family decides to proceed with a program, the team is provided with additional training for the specific procedures recommended for your child. (Parents are welcome to attend these trainings). Behavior technicians/RBTs can be contracted directly with Utrecht Autism Services (UAS) or the family. A technician contracted directly with the family will need to complete and pass a specialized training program from us before they can be considered qualified to implement the program. UAS will provide basic teaching and data collection materials. Sessions involve the behavior technician/RBT working directly with the child. Dr. Gifford will provide supervision by watching the session, and going over the data from the previous week, as well as celebrating successes and trouble shooting any problem areas that many arise for at least 10% of the total session hours provided. Sessions are continued until the child meets all of their goals (goals are typically added and/or revised throughout the program) or the parents decide to end the program. These programs usually last about 1-3 years. All focused/functional skills programs also include parent coaching and collaboration with other professionals on your child's team such as speech and occupational therapists.
The focused/functional skills program experience
Just as with intensive programs, we know that it is a big change to have a person working with your child in your home for 2-3 hours per day, 5-6 days per week. We know we are there to help, not as guests, and we try to be as unobtrusive as possible. We will need a safe space to work with the child that is relatively free from distractions, and a space to store the session materials (especially reinforcers) when we are not there. As each child progresses, we may be working on learning in different settings such as outside and in different areas of the home and neighborhood. Many skills are best taught in the place where the child will use them - the table for eating, the bathroom for toileting and bathing, etc. We also can provide support in school and daycare settings if that is acceptable to all the parties involved.
