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.

ABA therapy Fort Myers kids

The Importance of Pairing in ABA Therapy

Those trained to provide ABA Therapy will understand well the concept of “pairing.” Play and pairing is the foundation of instructional control in any behavioral therapy session. Simply put, pairing is a way for ABA therapists and technicians to help build a rapport with a child by finding out what interests them and then linking whoever is working with the child to that interest/activity/object so that we can facilitate positive reinforcements in each session. It’s a means of letting the child guide us to what motivates them. When we know what that is, we use it as a positive reinforcer for expected behaviors.

So for example, a child who is new to ABA therapy will begin with a few “pairing” sessions with their ABA therapist/RBT (registered behavior technician). This is a time when we simply play together, we’ll let the child lead, allowing free access to toys, games, songs, and other stimuli. It may look like we’re just “playing,” but remember two things:

  • Play is how kids learn.
  • By discovering what they love to play with, we can help motivate them to learn important skills and promote helpful behaviors.

Let’s say the child falls in love with a toy train set. We then restrict play with that train set to only our sessions. The child earns play with the trains as a positive reinforcer for expected behaviors.

Speech therapy uses a similar technique in motivating kids to talk. Such toys are so-called “communication temptations,” something we’ve written about extensively in prior speech therapy blog posts.

Pairing is also important because it lets the child and therapist establish a positive, trusting relationship where they come to understand that even when learning can be challenging at times, it’s also fun and ultimately benefits them (by giving them what they want). Parent input during pairing is very important too! We will spend time interviewing caregivers about what their child is really into, and we can then build on those ideas.

From there, we’ll work on trying to teach mands/requests. (Think of a mand as short for “demand.” It’s how a person requests something. For example, we may hold a piece of that toy trainset or car until he/she asks for it or a turn with it.

FOCUS Therapy child development

Boost Child Development While Playing in Nature

As the weather cools in Southwest Florida, it’s the perfect time to get outside and play with your child! It’s not just about enjoying the day and making some memories (though these are worth it in itself). Our speech, occupational, physical, and ABA therapists know that spending time outdoors is great way to boost child development.

Being in nature has been proven to boost kids’ academic achievement, physical health, mental health, and overall well-being. One analysis of hundreds of studies on the subject found that nature boosts learning in eight distinct ways. Those include:

  • Improves attention.
  • Relieves stress.
  • Boosts self-discipline.
  • Increases physical activity and fitness.
  • Promotes self-motivation.
  • Increases enjoyment.
  • Improves engagement.

As pediatric therapists dedicated to helping disabilities and delays make strides, we have found that nature provides a calmer, quieter, and safer setting for learning. It can also help with:

  • Motor skills
  • Communication
  • Social-emotional skills
  • Speech and language skills
  • Executive function
  • Sensory integration
  • Relaxation and emotional regulation

Spending time outdoors creates opportunity for more creative, exploratory forms of play – and play is how children learn best!

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.”

Fort Myers ABA therapy

Finding the Function of Behavior: ABA Therapy Insight

In the field of behavior science, we commonly use the phrase “function of behavior.” As behavior analysts at the Fort Myers ABA therapy team at FOCUS, figuring out the “function” of a child’s behavior is hands-down one of the most mission critical parts of the job.

As parents or caretakers, it will be so helpful for you and your child too if you’re able to determine why a behavior occurs. When we don’t know what truly causes a behavior and respond reactively, we may be unintentionally reinforcing that behavior. Why is my child facedown on the floor screaming when I told him we were eating tacos tonight? Why is he nonstop kicking the back of his sister’s car seat even though I’ve begged, cajoled and yelled at him to stop?

All behavior has a reason. A function. If you’re looking for a different outcome or response, it’s imperative to find out why it’s happening in the first place. And understand that, for example, if the answer is attention (a common incentive), yelling or having an otherwise big response to it may be having the opposite effect.

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

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.

FOCUS Therapy

Join FOCUS Therapy for FOCUS POCUS Trunk-or-Treat!

FOCUS Therapy in Fort Myers is hosting its first ever FOCUS POCUS Trunk-or-Treat event of socially-distanced Halloween fun for all our patients & families!

We’re welcoming everyone to dress up, bring a treat bag and join us for games, candy, prizes and more!

Our Southwest Florida speech, occupational, physical and ABA therapists are committed to providing enriching experiences for our young patients while encouraging the kind of inclusion we want to see at all events. That’s why we’re opening our FOCUS POCUS Trunk-or-Treat fun to our patients as well as their siblings and family.

From 6 p.m. to 7:30 p.m. on Thursday, Oct. 29th, FOCUS Therapy staffers and therapists will park their decorated vehicles a full vehicle-length apart in the parking lot outside our clinic, 4997 Royal Gulf Circle, Fort Myers, FL 33996. Parents will be encouraged to park to the west end of the office plaza, and we’ll have a carefully directed flow of trunk-or-treaters, with only one family allowed in front of a vehicle at a time.

FOCUS Therapy Fort Myers
One family per trunk: Map of foot traffic flow for safe social distancing at FOCUS POCUS Trunk-or-Treat.

“Halloween and trick-or-treat are such special events that kids look forward to all year long,” said FOCUS Therapy owner/founder Jennifer Voltz-Ronco. “We know a lot of families this year may be wary of the traditional door-to-door trick-or-treating, but we don’t want anyone to miss out on the fun. It’s also great for our kiddos with disabilities and delays who could use some practice before venturing out door-to-door over the weekend.”

Some of our therapists will have fun, engaging activities and games at their “trunk stop” for children to play and engage, while still remaining socially-distanced.

“For many of our patients, traditional trick-or-treat can be tough anyway, whether because of sensory issues, language deficits or physical challenges,” Voltz-Ronco explained. “Trunk-or-treat events in general have sort of always been the perfect opportunity to allow for both tradition and accessibility. And now this year, as families with children of all abilities in our community are expressing concern about safe trick-or-treating, our team is excited to be involved in making that happen for them.”

For more information, contact FOCUS Therapy at (239) 313-5049 or e-mail Jennifer.Voltz@FOCUSFlorida.com.