FOCUS Therapy ABA therapy

ABA Therapy & Occupational Therapy Helps Kids Self-Regulate Big Emotions

FOCUS Therapy Fort Myers

FOCUS Therapy Only Schedules Evaluations if We Have Space to Treat Your Child

Evaluations are an important step in the process of securing speech, occupational, physical, and/or ABA therapy for your child. But parents and caregivers should be wary of facilities that offer these evaluations while lacking capacity to immediately treat the child.

FOCUS Therapy Owner/Founder Jennifer Voltz-Ronco explains that unless her team is being called on for a second opinion of an initial evaluation, they refrain from conducting formal assessments if unable to promptly provide treatment once the evaluation is complete.

“A standardized assessment is only a snapshot in time during the child’s development,” Voltz-Ronco said. “It’s like taking a picture of a child now, and then expecting it not to change in a few months. … If your child cannot access therapy within 1 or 2 months of that evaluation, the results are no longer going to be accurate. Kids develop new skills every few months. But the longer the child goes without therapy, the more significant that standard score comparison/discrepancy to same-age peers is going to be.”

Jennifer Voltz-Ronco FOCUS Therapy Owner
Jennifer Voltz-Ronco, FOCUS Therapy Owner/Founder

Beyond this, families who rely on insurance to cover the cost of these evaluations (and they aren’t cheap) should be aware that insurers typically only cover one evaluation every six months or so. Even though clinics can utilize standardized assessments administered by another, it’s not ideal.

“Your child gets the most benefit when the team that directly observed your child’s abilities and deficits are the ones who ultimately formulate a plan of care and follow through with treatment,” Voltz-Ronco said. “In my opinion, it’s unethical for a clinic to profit from an evaluation that reveals a child is delayed or needs intervention – without providing that help.”

Types of Pediatric Evaluations FOCUS Therapy Offers

Children are usually referred to FOCUS Therapy and other therapy specialists by their primary care physician. Evaluations are typically ordered when a child is showing some developmental deficit, such as not sitting up or crawling, not talking or making regular eye contact, or red flags for a possible cognitive deficit. They could also be diagnosed with a condition that we can pretty well say for certain is going to require some combination of therapy services (such as cerebral palsy, down syndrome, vision impairments or hearing deficits).

Depending on the child’s condition and identified areas of concern, qualified therapists will be scheduled to conduct age-appropriate assessments to determine the need for therapy intervention services.

The specifics of the evaluation may vary, but they are generally going to include:

  • A look at case history, including medical status, education, socioeconomic, cultural, and linguistic backgrounds, and information from other providers.
  • Child and/or parent interview.
  • Review of the child’s auditory, visual, motor, and cognitive status.
  • Standardized and non-standardized assessments of specific aspects of speech, non-spoken language, swallowing function, cognitive communication, etc.
  • Assessment of self-care and/or self-awareness.
  • Skilled observation. This is where we keenly observe an accurately record a child’s abilities and behaviors.

There are several different types of standardized tests (including the ADOS test for autism screening, which FOCUS Therapy also provides).

“If a parent wants a second or third opinion after their child has been evaluated by a school or another provider, that’s one thing,” Voltz-Ronco. “But they’re most likely going to pay for that out-of-pocket – and they’re going to understand the purpose upfront. But if parents are looking for action, to get the ball rolling on the therapy interventions that a child needs, then the clinic conducting the assessment should be able to provide that.”

Not all of them do. Therefore, it’s incumbent on parents to ask the question before scheduling the assessment.

“We’ve gotten calls from parents of children who were evaluated other clinics, only to be told after the fact that the clinic did not have the ability to treat their child,” Voltz-Ronco said. “They were told to just call around and see what other clinics may be able to use the report generated from their assessment. That, to me, is not ethical.

“It’s a situation where parents need to be aware of this issue, and make sure they are asking the question upfront: ‘If I schedule this assessment and my child needs treatment, do you have the capacity to provide that treatment?’ If not, I would advise parents to move on and find a place with the capacity and willingness to do both.”

FOCUS offers ADOS testing and other standardized assessments in Fort Myers and throughout Southwest Florida for children who may need speech therapy, occupational therapy, physical therapy, or ABA therapy. Call (239) 313.5049 or Contact Us online.

Additional Resources:

Assessment and Evaluation of Speech-Language Disorders in Schools, American Speech-Language Hearing Association

More Blog Entries:

ADOS Testing, FOCUSFlorida.com

sensory meltdown

Tantrum or Sensory Meltdown? Fort Myers ABA Therapists Explain

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:

  • Screaming
  • Kicking
  • Name-calling
  • Hitting
  • Crying
  • 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.

Additional Resources:

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

Fort Myers ABA therapy

5 Fort Myers ABA Therapy Techniques

Behavior therapy – specifically, applied behavioral analysis, begins with understanding the science of behavior. At our Fort Myers ABA therapy clinics, we use this understanding to employ specific strategies proven to help children with autism and other conditions achieve their goals – ultimately allowing them to gain greater independence and engage more fully with the world around them and people in it.

As explained by the American Psychological Association, ABA therapy is an evidence-based practice, meaning it’s supported by peer-reviewed literature. It identifies the motivation behind the behavior before addressing it with one or more proven strategies.

Each Fort Myers ABA therapy plan of care must reflect what reinforcements are most effective with that specific child, with clear goals we want to see them meet within a set time frame. Our ABA therapy team then works with kids one-on-one with them – day after day, week after week, and month after month, and sometimes year after year. We want to see them thriving in all environments – from home to school to play dates to community events – to the fullest extent of their capabilities.

Most all strategies involve some use of the ABC’s of behavior. That is, we study the Antecedent, then the Behavior itself, then the Consequence. By studying each element, we can determine what is the motive or what’s being communicated by that behavior – and then change either the antecedent or the consequence with the goal of altering the behavior.

Top Fort Myers ABA Therapy Techniques

Fort Myers ABA therapy
ABA Therapy Fort Myers

Understanding ABA Therapy

Understanding ABA therapy is critical for anyone whose child has been recently diagnosed with Autism Spectrum Disorder, or ASD.

As our Fort Myers ABA therapy team can explain, ABA is short for “applied behavioral analysis,” and it involves utilizing the science of behavior to help children with autism in producing socially significant improvements in behavior. We apply proven behavioral science principles to increase or decrease targeted behaviors, with the ultimate goal of bringing about meaningful change to the child.

We work to identify behaviors that are observable and measurable, and then use empirically-validated, research-based strategies to help them make strides in overcoming challenging behaviors and increasing those that are helpful in daily life. We also teach and and help them practice critical life skills, such as social communication, emotional regulation, sensory integration, and executive functioning.

At FOCUS Therapy, we have two Fort Myers clinics where we provide both ADOS testing and ABA therapy for children in Southwest Florida.

FOCUS offers pediatric ABA therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

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 4, 2022, Fort Myers ABA Therapy Blog

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.

 

 

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

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.

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.