Many ABA therapy providers in Southwest Florida share similar approaches and philosophies with respect to evidence-based methodologies and evaluation standards. That said, there are different schools of thought when it comes to the optimal treatment setting – whether that’s in-clinic, at school, at home, or some hybrid combination. At FOCUS Therapy in Fort Myers, we prefer in-clinic ABA therapy for our patients – and there are tons of good reasons why.
ABA stands for Applied Behavior Analysis. It’s widely recognized as one of the most highly-effective, child-oriented, results-driven therapy for kids diagnosed with autism spectrum disorder. It’s also proven very helpful for kids with traumatic brain injuries, oppositional defiant disorder, obsessive compulsive disorder, attention deficit/hyperactivity disorder, and Down syndrome. These conditions don’t have a “cure,” per se. What ABA therapy does is teach appropriate/safe/expected behaviors while minimizing and extinguishing inappropriate/unsafe/unexpected behaviors. Individual target goals may differ, but most long-term goals involve improving kids’ independence, safety, social skills, academic participation, and community engagement.
Although the skill of the therapist is certainly important, so too is the setting where therapy is provided.
Among the many upsides to Southwest Florida in-clinic ABA therapy:
- Easier transitions to (pre)school. For most families, the goal is for their child to ultimately transition to a mainstream learning environment. In-clinic ABA therapy can better prepare kids for that transition, structuring environments that more closely mirror their experience in school so that their skills are more easily generalized.
- More opportunities to teach and learn social skills. When our registered behavior technicians (RBTs) and board-certified behavior analysts (BCBAs) are working with children in the clinic, there are going to be inherently more opportunities for social interactions – both with peers and adults. We can practice key skills like turn-taking, recognizing social cues, and self-regulation/coping skills.
- Better quality of care and supervision. This is not to say at-home ABA therapy providers don’t provide adequate care. But when we have multiple RBTs, BCBAs, speech therapists, occupational therapists, physical therapists, and support staff on-site, there are simply more eyes, ears, and hands if challenges arise. Plus, it gives supervisors the opportunity to regularly observe, make recommendations, and ensure treatment is on-track. They can see what’s happening in real time (rather than relying on RBT notes after the fact) and are able to make immediate modifications as necessary.
- Multi-disciplinary setting. Lots of the kids we treat at FOCUS require numerous therapy interventions. If your child needs ABA therapy, speech therapy, occupational therapy, and/or physical therapy, you can get all of that in one location. But parent convenience is just part of this benefit. When you have highly-skilled pediatric therapists in a broad range of disciplines all working in close proximity to each other, it creates opportunities to learn from each other. A speech therapist might notice an issue in passing that an RBT wouldn’t have immediately identified – and offer possible solutions. Those kinds of interactions and collaborations happen all the time – and we encourage them because kids get optimal benefits when we approach treatment from the “whole child” perspective.
- Tons of positive reinforcers. Every parent can recall at least one time their child was super into something – and then just suddenly decided they were ALL SET with it. Like, all they want to eat every single morning is a strawberry Pop-Tart, so you eventually go all-in and buy the Costco size – only for them to decide two packages in, they never want to see another strawberry Pop-Tart for as long as they live. Reinforcers in ABA therapy can be like that too. These are the unique-to-each-child incentives used to encourage interactions and activities that allow us to target behavior goals. But what a child was willing to work for one day might no longer interest them the next. With in-clinic ABA, the therapist has immediate access to TONS of alternative reinforcers – games, puzzles, books, sensory gym, etc. We can quickly find the “next best thing” and go from there.
- Easier transitions when there are staff changes. As much as we love and value our amazing ABA therapists, they don’t always stay forever. For these kids, transitioning from one therapist to another can be a major challenge. But when kids receive behavior therapy in a clinic setting, there’s a good chance that their new therapist is a friendly face they’ve already seen and directly interacted with.
- In-clinic ABA therapy works. Like, really well. While there’s no one-size-fits-all approach that works for every kid in every therapy, it’s been our experience that in-clinic ABA provides the most “bang for your buck” in terms of results – and a conclusion solidly backed by research. Just one example: A National Institute of Health study analyzed the effectiveness of at-home ABA therapy vs. in-clinic ABA therapy. They controlled for variations in individual child skill sets by treating the same group of kids in both settings at different times, and then tracking their progress during each. Kids treated in-clinic mastered 100 percent more skills-per-hour compared to those treated in their homes.
With in-clinic ABA therapy at FOCUS, we’re able to provide the best quality therapy in a setting that is welcoming and fun as well as structured and safe. If you have questions about our therapy services or Fort Myers ADOS testing, reach out!
FOCUS offers ABA therapy and ADOS testing to children in Lee County, Florida. Call (239) 313.5049 or Contact Us online.
What Is Applied Behavior Analysis? June 23, 2021, Medically Reviewed by Jabeen Begum, WebMD
More Blog Entries:
Top 4 Benefits of In-Clinic ABA Therapy, April 2, 2022, Fort Myers ABA Therapy Blog
At FOCUS, all of our Fort Myers therapies are play-based therapy.
Of course, play can be a lot of fun for as adults too – but the real reason we use a play-based therapy model in our speech, occupational, physical, and ABA therapy sessions is simply because: It works.
Study after study shows that when we engage kids in a play-based model of therapy, they’re going to be more engaged, excited about therapy – and they’re going to better remember the skills we’re trying to teach them.
“We never say, ‘Ok let’s go back and do some therapy,'” explains FOCUS Therapy Owner/Founder Jennifer Voltz-Ronco. “No, we say, ‘Hey, are you ready to go play?’ Kids don’t even realize they’re doing ‘work’ – and that makes it more enjoyable – and ultimately more effective.”
FOCUS offers pediatric speech therapy, feeding/swallowing therapy, occupational therapy, behavior therapy, and physical therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.
Planning a Play-Based Therapy Session, Sept. 2, 2013, By Meredith Poore Harold, ASHA Wire
More Blog Entries:
FOCUS Therapy Take on New CDC Developmental Milestones Guidelines, Aug. 1, 2022, Fort Myers Play-Based Therapy Blog
When working with kids who have varying sensory struggles, it can be difficult to tell the difference between a tantrum or a sensory meltdown. Our Fort Myers ABA therapists recognize that it often takes some detective work to differentiate. But determining which is which is important when formulating the most effective response.
A sensory meltdown can be especially tough to identify because a child’s sensory thresholds can vary from day-to-day or even hour-to-hour.
Some behaviors that may be present in BOTH:
- Hiding or avoidance
Tantrums, however are typically a response to a child not receiving something they want or an anticipated outcome. Sensory meltdowns, meanwhile, stem from sensory overload, with reactions being to the big feelings that the overload can cause.
In the case of a meltdown due to sensory issues, parents may need to formulate a strategy that plans ahead, rather than simply react to the meltdown when it happens. That means meeting their sensory needs through a sensory diet (unique to each child) that can help them avoid feeling completely overloaded and overwhelmed.
We need to look carefully at the sorts of things that can trigger a sensory meltdown. Some possible meltdown triggers can include:
- Being overly tired or hungry.
- Generally not feeling well. (This can stem from illness, food sensitivity, overheating, etc.)
- Being expected to “hold it together” for long periods of time, such as going to summer camp, school, or on play dates.
- An abrupt change in routine – anything outside of the ordinary – can set off sensory overload.
Because the overload may not be immediate, it can sometimes appear like a meltdown “came out of nowhere.” But there is almost always a source when we look very carefully at the “antecedents,” or events that occurred prior to the meltdown. You may even have to go back a few days to pinpoint the cause.
Toddlers and preschoolers may be especially prone to tantrums because they do not have the motor, language, or problem-solving skills to work through some of their frustrations on their own. They may have an emerging desire to be independent, without having the skills to actually BE independent. They might have emerging language skills, and thus are unable to communicate what they actually want or need. They may have big feelings, but lack the prefrontal cortex development to emotionally regulate. They may have a growing understanding of the world around them, but also a lot of anxiety about how to move through it.
Tantrums usually only end when a child gets what they want or when they’re rewarded for better behavior.
Meltdowns, on the other hand, only end when the child tires out or the sensory input is altered. They stem from what we sometimes refer to as a “physiological traffic jam” in the central nervous system. There is too much overstimulation and feeling limited in your ability to “exit.” This can trigger a “fight or flight” response.
As parents, therapists, teachers, and caregivers, it’s important to recognize that the behaviors we’re seeing are not controllable behavioral reactions. Rather, they are physiological responses. This is why our Fort Myers ABA therapists and occupational therapists put such emphasis on identifying which is which so that you can appropriately respond.
With tantrums, you need to recognize the motivation or purpose, reinforce positive behavior, and build skills for success.
Meltdowns, however, can sometimes be avoided when we use visual schedules, social stories, and checklists to help kids know what is expected. There are no surprises or question marks. Reducing the unexpected changes in routine is going to reduce the overall stress that can trigger a meltdown.
We also recommend routine sensory diet activities, like scheduling quiet time or offering them breaks for sensory input.
Parents and teachers should also be able to recognize signs of a child’s distress. This could be covering their ears or rocking back-and-forth or humming or bolting from the room. Once you are able to quickly recognize the signs of overstimulation, you can respond to help them regulate before reaching the meltdown stage.
FOCUS offers pediatric ABA therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.
Expert Ways to Help Tame Tantrums and Manage Meltdowns, June 18, 2021, By Alescia Ford-Lanza, MS, OTR/L, ATP, Autism Parenting Magazine
More Blog Entries:
Study: Less than 1/2 Kids With Autism Undergo Early Intervention Therapy, July 30, 2022, FOCUS ABA Therapy Blog
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.
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.”
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.
Early Intervention Speech, Occupational, ABA Therapy Preparing Wave of People With Autism for Workforce
As rates of autism diagnoses climb steadily, roughly 500,000 teens with autism are poised to enter the workforce over the next decade, according to advocates at Advancing Futures for Adults with Autism. Yet the majority of those people with autism struggle to land their first job, and 4 in 10 won’t work at all in their 20s. The spectrum is incredibly broad, so each comes to the table with their own strengths and challenges, but there is no question those who receive early intervention ABA therapy, speech and language therapy and occupational therapy fare much better long-term.
Last year, the U.S. Centers for Disease Control and Prevention updated autism prevalence rates by 15 percent to 1 in 59 children. That’s more than double what the rate was in 2000. Part of this has to do with improved awareness, earlier diagnoses and improved treatment models. Research published in the journal Frontiers in Public Health indicated early diagnosis (before 24 months, as early as 12 months) leads to earlier eligibility for intervention services (like ABA therapy), and other evidence-based research has indicated clear indication early intervention is causally related to better prognoses – including success in education and employment.
The AFFA reports that while most adults with autism want to work, fewer than 60 percent can land a job. The Americans With Disabilities Act prohibits employment discrimination on the basis of disability. Yet an adult deprived of early intervention therapies as a child has missed out on a critical development window to address significant challenges associated with everyday function and independence. This isn’t to say it’s ever entirely “too late” to initiate intervention strategies, but our ABA therapy team members know it’s most effective when it starts before age 5 (and the earlier the better).
Many of our FOCUS pediatric speech therapists were initially drawn to this field in part because we share a love of language. Sure, some of us are self-professed grammar nerds and logophiles, but in working with kids with special needs, we’ve seen that the real beauty of language is the way it facilitates communication and sparks connections. That’s a universal truth of language, but in helping children overcome speech delays, receptive language deficits or phonological disorders, we’ve come to appreciate language on a whole new level.
In stacking the developmental blocks for communication, social interaction and connection, one of the best (and easiest) things any parent can do: Read bedtime stories. This is especially true for kids with special needs, for whom language doesn’t come easily. Frequent storybook sessions help children learn new words, recognize the importance and subtle differences of tone, inflection and pitch, explore complex feelings and confusing interactions in a safe space and better grasp the intricacies of the world around them.
Most children – even if some have shorter attention spans – love bedtime stories. (Although story time can be anytime, bedtime is ideal – especially if you’re child is antsy – because you’re more likely to have a captive audience just before bed, as opposed to morning or mid-day, unless they still nap. Plus, many parents who work find it difficult to nail down a story time routine in the morning rush or simply can’t swing it on their lunch hour.) Making stories-and-snuggles part of the nightly groove works best for most, gives kids something to look forward to and a chance to wind down. And, as most parents of kids with special needs know, having a routine is a lifeline.
Even if your child doesn’t seem to understand the stories, follow along or pay much attention, research shows they still glean advantages from the one-on-one time, routine and mental exercise. Most speech, ABA and occupational therapists would argue children who struggle with expressive and receptive language skills may even need those bedtime stories more than most.
Parents of children with autism are acutely familiar with “meltdowns.” Over time, they grow attuned to them, gain a better sense of what and when to expect them and become increasingly adept at avoiding the most obvious triggers, reducing frequency and minimizing the effects.
FOCUS Fort Myers ABA therapists know that to outsiders, meltdowns and tantrums can seem analogous. The reality is they are very different. It’s not the result of a child or person who is trying to be difficult or disruptive (though many autism parents are familiar with the looks and judgments of people who assume so). Meltdowns occur when a child is utterly overwhelmed and often unable to express that in a way that is appropriate or easily understood.
Further, ABA therapists recognize meltdowns aren’t the only way someone with autism might express these intense feelings. It might also manifest with the person withdrawing from or avoiding a situation or interaction. It’s unique for every person, and often, recognizing these other indicators can signal to parents, teachers and caregivers when it’s time to intervene or remove someone from a situation.
The adjustment of starting a new school year is tough on everyone (parents included!). There are the earlier bedtimes and alarms, tighter schedules, new teachers, classmates and after school activities – all a bit jarring for many children. This is especially true for those with autism, for whom a change in routine can spur overwhelming anxiety.
Our Fort Myers ABA therapists at FOCUS know dislike of change is one of autism’s most common diagnostic symptoms, manifesting in a range of ways, including avoidance, distraction, negotiation, resistance – or a full-blown meltdown.
With federal health data now indicating 1 in 65 children in the U.S. has an autism diagnosis, more parents and caregivers are learning how best to navigate challenges with transitions – whether it’s something as seemingly small as moving from playtime to mealtime or as major as starting a whole new school. It’s important to understand both why transitions are so tough for kids the spectrum and also how we as parents, teachers and therapists can help it all go more smoothly.