FOCUS Therapy evaluations

Why FOCUS Asks Parents to Stay in the Waiting Room During Evals, Sessions

FOCUS Therapy in Fort Myers conducts a range of in-depth evaluations for children who have been referred for speech, occupational, physical, or ABA therapies as well as ADOS testing. During our evaluations and therapy sessions, we rarely allow families to directly participate – but we have evidence-based reasons for our position.

During evaluations, we want to ensure every child receives an assessment that is as accurate as possible because that is what is going to allow us to:

  • Determine whether the child needs therapy.
  • Calculate the frequency/level of therapy that might be recommended.
  • Make a strong case to the relevant insurer(s) about the medical necessity of the therapy.

Parents, when present in the room during FOCUS evaluations, can unwittingly stand in the way of those goals. Why? Mainly because children rely on their caregivers when things get tough – to help them, to comfort them, to make it better. When a child is struggling in a certain area, such as communication or independence with self-care skills, our clinicians need to independently observe the particulars.

Parent input is a key aspect of our evaluations, but we need to see for ourselves, too. Jennifer Voltz-Ronco, MS-CCC/SLP and FOCUS Therapy Owner/Founder, explained that when a child is accompanied by a parent during the direct observation portion of the assessment, parents often interfere without intending to do so or even realizing it.FOCUS Therapy

“For example, in speech evaluations, parents might talk to the child or give clues to help their child ‘get the right answer’,” Voltz-Ronco explained. “We might ask the child to point to an object out of an array of 3-4 items by saying, ‘Show me the cup.’ Standardized testing requires that we be very specific in how we present these items – and with the requirement that we wait. And while we wait, we’re looking to see how long it takes them to process the directive and what they do. Will they look at us to see if we’re looking at the object? Will they point to it or make a face if they’re unsure? They might associate a cup to mealtime and instead point to a cookie. If the child looks to our face to get a clue, that would indicate social awareness and joint attention – key pre-linguistic communication skills. If there is a delay in their response, there may be an auditory processing issue. If they grab the first thing in reach, they may have impulsivity issues. Watching a child while they’re thinking tells us so much. But parents in the room might think the evaluator presumes the child doesn’t know the answer, so they interject. They say to the child, ‘You know what a cup is, like the blue sippie cup you have at home.’ Unfortunately, what that does is give the child numerous opportunities to hear the word, ‘cup,’ and in many standardized tests, we aren’t allowed to repeat the word or give a description or synonym. So with that, we lose the opportunity to see what we needed to see, and must in turn score the response incorrectly – which impacts the overall results.”

She went on to explain that often the key responses FOCUS therapists are looking for aren’t necessarily what an untrained observer may presume.

What’s more, some children can become what we call “prompt dependent.” That means the child looks to the parent to prompt them (to take an action, answer a question, etc.) – even if they don’t necessarily need the prompt. Many of our team members are parents ourselves, so we wholeheartedly understand how difficult it is to wait for your child to “do it themselves.” It is actually instinctual to intervene when we see or sense our child needs help. But during these evaluations, this intervention – however slight – can actually prove more of a hindrance when what we’re seeking are accurate results.

We DO Want Parents Involved in Their Child’s Therapy Journey

Although it is important for parents to remain outside the room during evaluations, this does not mean we lack transparency or that we don’t want parents involved at all in the therapy process. In fact, we get the best results from therapy when parents are fully engaged!

But we discourage direct engagement during the evaluation process and therapy sessions because we want to ensure our findings are accurate and that your child gets the true level of support they need.

While we want parents to be involved in consultation, goal-setting, education, and carryover, we strongly advise parents against sitting in during therapy sessions for the following reasons:

ABA Therapy

Top 4 Benefits of In-Clinic ABA Therapy

There’s more than one way to do ABA. Also known as Applied Behavior Analysis or behavior therapy, ABA therapy involves the study of behavior and the use of positive reinforcements to fade out unexpected/unhelpful behaviors and promote expected/helpful behaviors.

At FOCUS Therapy, we’re strong proponents of in-clinic ABA. There are many reasons for this, but it really boils down to the fact that: It works.

In fact, as we reported previously on our blog, a study published by the National Institute of Health revealed that when controlling for individual differences by analyzing the progress of the same kids but in different settings, those who received ABA therapy in-clinic demonstrated far higher rates of learning during treatment compared to in-home therapy services. The kids who received ABA therapy in-clinic mastered 100 percent more skills per hour than those who received home-based treatments.

Contact us online or by calling (239) 313-5049. FOCUS offers ABA therapy to kids at two clinics in Fort Myers, Florida.

ABA therapy

How Behavior Chaining Works in ABA Therapy

ABA therapy, short for applied behavior analysis or behavior therapy, focuses on studying behaviors – understanding them – and then incorporating techniques that promote expected behaviors and modify unexpected behaviors. One of the strategies our Fort Myers ABA therapy team employs is called “chaining.”

Chaining is a type of evidence-based technique that we can use to teach kids basic skills like handwashing or waiting their turn to more independent life skills.

The basic idea is that you’re breaking down each task into a series of mini-tasks. Many of us take for granted that skills like using the restroom or engaging in a conversation require numerous steps. We don’t give a second thought to every single step needed to complete everyday tasks – but there are, in fact, many. It takes some kids with developmental delays and disorders lots of practice to master each individual step.

Let’s take handwashing, for instance. It’s considered a single, simple task. But in ABA therapy, we recognize that there are many smaller steps to it. We break it down into little, teachable bits. These include:

  • Turning on the sink.
  • Adjusting the water temperature.
  • Getting your hands wet.
  • Pressing the soap dispenser (or grabbing the soap).
  • Moving the soap around in your hands.
  • Scrubbing your hands.
  • Rinsing off the soap.
  • Turning off the water.
  • Drying your hands.

We teach this series of tasks as one “behavior chain.” Once they have the first step down, we move onto the next step in the behavior chain. As the child gets comfortable with each “mini-task,” we add or “chain” new behaviors/tasks that are linked to it, so that it all becomes synched. The child learns what is expected – and what is not expected – as they move through the steps of each task.

Fort Myers ABA therapy

How ABA Therapy Can Help Fort Myers Kids

ABA therapy (short for applied behavioral analysis) is an evidence-based therapy that focuses on studying the “ABCs” of behavior to learn the function of it. From there, we can use positive reinforcement to create an environment that helps promote expected behaviors and minimize unexpected behaviors,  We start with A, the antecedent, (what comes before the behavior), then B, the behavior itself, and then C, the consequence (what comes right after the behavior).

All behavior has a function. At its core, behavior is a means of communication. We work to understand what the child is gleaning from the behavior (avoidance? sensory input? a reaction?). We also find out what really interests or motivates them. We then use scientifically-proven strategies that will help us tailor a unique treatment plan to promote helpful behaviors and fade/extinct unhelpful behaviors.

When ABA therapy is successful, it can help with skills key to independent function. Learn more about FOCUS Fort Myers ABA Therapy services here.

FOCUS offers pediatric behavior therapy, occupational therapy, speech therapy, and physical therapy in Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

What is Applied Behavior Analysis? Autism Speaks

More Blog Entries:

FOCUS Therapy ABA Talks: Hosted by Our ABA Team! July 31, 2021, Fort Myers Behavior Therapy Blog

Fort Myers ABA therapists

Why Our Fort Myers ABA Therapists Use Countdowns for Transitions

Change is an inevitable part of life. But for children on the autism spectrum, transitions can be TOUGH. Our Fort Myers ABA therapists have strategies to help make this easier. One of those is a countdown.

But first, it’s important to understand the why of transition triggers.

What makes transitions so difficult? For a lot of kids, it’s because transitioning from one activity or focus to another can seem sudden. It can also mean leaving an activity that is preferred for one less preferred. Plus, many kids on the spectrum have an inherent need for predictability. Not knowing what is coming next can also set off one’s anxiety, elicit big emotions, and trigger a seemingly outsized response.

As ABA therapists, we are always studying the ABC’s of behavior. That is Antecedent (what comes before the behavior), Behavior (what exactly is the behavior) and Consequence (how is the behavior reinforced). In altering big reactions to transitions, we can alter the antecedent, teach replacement behaviors and reinforce with positive consequences when kids transition calmly.

The idea is to prepare the individual before the transition occurs and support them during the transition.

FOCUS ABA Therapy Talks

FOCUS Therapy ABA Talks: Hosted by Our ABA Team!

FOCUS Therapy ABA Talks

At FOCUS Therapy, we offer speech, occupational, physical, and ABA therapy. For that last one, "ABA" stands for "Applied Behavioral Analysis." It also sometimes goes by the name, "behavior therapy." It involves the study of behavior and ways it is reinforced. ABA therapy is considered the gold standard for treatment of children with Autism Spectrum Disorder and other conditions that make it difficult to communicate and behave in ways that are expected.

The concept of what ABA therapy is and how it works is often unfamiliar to families who first seek our services on the basis of a physician referral. In an effort to help parents and families better understand ABA and how it works, Dr. Dean Funk, M.D./B.S. Biological Science and the rest of our FOCUS Therapy ABA team have created a series of in-depth videos we hope will better explain it all.

Insight is provided by invaluable members of our FOCUS Therapy ABA team, including Ignacio Fernandez, BCBA.

Watch the videos below!

telling your child he has autism

My Son Has Autism… When – and How – Should I Tell Him?

Your child has autism. You know it. The rest of the family knows it. His teachers and therapists know it. Maybe even a few of his classmates know it. But when should HE know it? And how should you tell him?

It’s something many of our FOCUS Therapy families grapple with at some point, and answers really depend on the individual. Some parents opt to tell their child when they’re very young, hoping an early understanding of why they struggle more with certain things might make it all less confusing. Other parents wait until their child becomes aware of their differences and starts asking questions. A few parents wait until their child is older with a better ability to fully grasp what their diagnosis means. Our FOCUS speech, occupational and ABA therapists know there isn’t a singular right answer, but we’re here to support our patients and help guide families in these discussions.

Recently, a patient’s mother asked about the best way to handle some of the questions her 7-year-old son on the spectrum was asking. Christie Lawrence, a registered behavior technician (RBT) with our Fort Myers ABA therapy team and herself the mother of a teenager with autism, offered her thoughts.

“I would say the most important part of informing your child of their autism diagnosis is to empower them,” Lawrence said. “Autism can bring many gifts, and it’s so important to teach our children to find and focus on their strengths and build confidence from their success.”

ABA therapy

Benefits of Clinic-Based ABA Therapy vs. In-Home Treatment

Applied Behavior Analysis (ABA therapy) is considered the most effective, early-intervention treatment for kids on the autism spectrum. It can take place in several settings: Clinic, home or some combination of the two. At FOCUS, we have chosen the clinic-based model for a number of reasons that benefit our patients.

One of the primary reasons is that we believe children benefit from being in a multi-disciplinary setting. It’s not just that it’s convenient for parents of children who need multiple therapies to have a single, physical location for all of them. (Families in Southwest Florida may find it very difficult to arrange all of the therapies their child needs in a home-based setting.) It’s the fact that in a clinic-based setting, supervisors are more available to provide additional direct observation and guidance compared to in-home services.

This point was underscored in a recent study published by the National Institute of Health. In that analysis, researchers controlled for individual differences by comparing and contrasting at-home and clinic-based ABA therapy treatment for the same kids. What they found was that kids demonstrated far higher rates of learning during treatment provided in-clinic compared to in the patient’s home. In fact, they mastered 100 percent more skills per hour while receiving in-clinic treatment compared to home-based treatment.

FOCUS Offers ABA Therapy at Our Fort Myers Clinic

Our clinic-based ABA therapy at FOCUS is designed to optimize your child’s growth in numerous areas of development, including:

  • Social interactions.
  • Play skills.
  • Adaptive skills.
  • Communication.
Fort Myers ABA Therapy

Study: Social Skills Genes Heritable, But Influence Shifts as Children Age

A new study has found that some social behaviors and reciprocal social skills associated with autism are inherited. But as children get older, their environment takes on a growing influence in how the child develops, researchers concluded.

This reinforces something our Fort Myers ABA therapy team has known for some time: The minds of children are incredibly resilient, and with appropriate early intervention, new neuropathways can be forged to help them overcome many of the deficits they face.

Fort Myers ABA therapy

FOCUS ABA Therapy Tips to Tackle Problem Behaviors

All parents struggle with problem behaviors with their children at some point. This is especially true for families with children diagnosed with Autism, ADHD, behavior challenges or related disorders. FOCUS ABA therapy promotes “expected behaviors” (and discourages “unexpected behaviors”) through consistent, positive reinforcement over a period of months or years. These methods are most effective when we have consistent parent carryover of our strategies.

We understand that lack of compliance, transition trouble and meltdowns can be incredibly frustrating for parents. Although we work on self-regulation and other skills in behavior sessions, our Fort Myers ABA therapy team have some helpful tips for how to handle these situations at home to reduce unexpected behaviors and increase positive behaviors.