Tag Archives: early intervention

Lessons from a Lost Balloon: Growth, Safety, and Kindness

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A blue balloon is inflated and resting in a bathtub, with a towel nearby.

In this story about small town stranger appreciation, a mom learns lessons while her little kid grows up a little more, making kind decisions about safety, cats, and personal capabilities. Let’s nurture our relationships and read on. To begin, why is this balloon in the bathtub?

Short answer: to protect our cat (Rolo, who can open every door except a shower door) from GI distress caused by eating the string.

Long answer: My 4-year old son is building resilience, self-discipline, confidence, and communication skills. Today, he acquired a balloon from a Habitat for Humanity kiosk at the local Berthoud farmer’s market (which makes up for its well-known lack of vegetables by being located at the new splash pad park, bringing multiple sourdough purveyors, and hosting the beloved Wildfire Arts kids art table. Today there were even dancing local ladies and a massive drum circle. And it’s really not the town’s fault about the veggies. We have a notoriously short growing season, etc etc).

My kids love balloons. Yes, I know they’re dangerous… a family I know had a child fall from a large mylar one at his own party and get seriously injured. In our family we aren’t allowed to put them up to our mouths, and so on. Mine play with them a few times a year under supervision…. STRONG supervision. This is partly because we have a large cat who loves to eat that curly, delicious, devilish shreddable balloon string. He gets very sick from eating it, and he just can’t stop. If it’s in the house, he’s gonna find it and have it for his own.

So we got a balloon anyway. They were gleeful, knowing this was rare. The kids ran to the playground, clutching their strings. Enter some sort of spinning playground equipment and a spill. No scrapes, no blood, no bump… but snap! My son’s balloon was gone like that, soaring to the sky as if we’d meant to poison nature. I’m so sorry, birds. I really should have known.

Well, there was another family observing. I’m not going to say they caused the disaster, but they sure fixed it. (In truth, a park dad had been giving all the kids massive pushes on this spinning piece of park equipment, which led to riotous laughter and a moment for me to call my own father to check on him after some difficult health issues early this month). I saw the spill, the cut string, the loss all play out in slow motion and was ready when my 4 year old sprinted to me screaming as I slammed my finger down on the phone fast to spare my dad the screams in his phone ear. Are you hurt? “No.” Are you ok? “NO!”

That darn balloon. I went into triage mode. The kids were given some options from which to pick (stay here and play a little but we have to use nature friendly voices again; taste a pickle and calm down with mom; go home right away, etc). Kid opted for a pickle and kid 2 went on spinning, her balloon much more securely attached to her hat band. It’s a pink cowgirl hat and she is NOT taking that thing off. But her 4-year old brother was SO SAD.

You know those moments, parents? You know when you COULD go get another (whatever spilled-melted-dropped-broken-ruined) thing, but it’s a long way away, and isn’t there a lesson here crammed in there that you don’t want to miss and don’t want your kid to miss? (And what about the voice from your past reminding you that when you were a kid and that lady next to you at Disney broke your balloon with her 1980’s cigarette and she didn’t apologize and your parents did not buy you a new one and how will he learn a lesson if you don’t inflict on him the pain you felt when you were 6… just me? To be fair, I didn’t remember it. My dad reminded me about it later as I recounted the blue balloon story.)

“OK but mom, it was not his fault!” my brain argued. “He fell and the string broke and he. is. SO. SAD!”

Yet I stuck to my proverbial guns. I wasn’t mean, I was soft and sympathetic, walking with my crying kid back to the car as he suffered loudly and his sister bounced along with her balloon. And guess what happened before we left the parking lot? If you live in Berthoud maybe you already guessed.

The stranger family re-appeared. One of the kids was clutching a lollipop- Oh please don’t let my kids notice that, I prayed. Too late, my daughter instantly said the quiet part out loud. But that didn’t matter, because… the stranger-family-dad (sorry kind sir, this is what my children have dubbed you) was holding out a balloon. “He took a pretty big spill back there,” he said apologetically. “We decided we didn’t want him to have to leave without a balloon.”

Glory be! Is this the small town feeling creeping up my arms, a mix of chill bumps and gratefulness and humanity and embarrassment (my toddler was just about to leave without one and darn it I was going to make sure he was ok with that)?

We humbly and gratefully said big thank yous. My little guy’s eyes were dazzling blue worlds of gratitude staring up at this family, accepting his balloon. He clutched the string like I clutch his hand at Trail Ridge Road overlooks while we stare over the edge.

There were so many lessons today. First, the amazement of my son: “I didn’t realize a stranger would be so kind to another stranger!” Then, the detailed discussion of situations when it is ok, versus not ok, to take things from strangers. We discussed the role of my presence, of the dad asking me “can I give this to him?”, and other nuanced questions only a 4- and 6-year-old can generate. We rode home happy.

And now it was nap time. Here’s where his character development really comes into the story. “Mom,” he said sleepily, “I really, really love playing with the balloon. So I think we better work together to find a safe place that is not inside my room. Especially for Rolo. Can you help?”

Yes, son. I got your back on this one. He’s asleep now, napping after all the excitement, while the cat lies in wait outside the bathtub and I take in the wonder that is 4-year-olds growing up.

Oh… and I love other families as well. I provide mentoring to families, therapists and teams that gives them the tools to transcend trauma. See my courses at www.cuspemergenceuniversity.com, join a group with me, book an appointment, or just email me any time.

Part 9 in Trauma-Informed Behavior Analysis: On intervention for fetal alcohol exposure

18 Monday Sep 2017

Posted by in adults, Behavior Analysis, children, Early Intervention, Education, enriched environment, FAS, FASD, Fetal Alcohol Spectrum Disorders, risk assessment, self injurious behavior, Social Interaction, teaching ethics, trauma, Uncategorized

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Early intervention after an unfair start in life: Fetal exposure to alcohol

Those of us who work with people who have lived through adverse childhood experiences are familiar with the importance of individualizing treatment. We can do a lot of harm if we don’t consider what someone went through in life, or if we assume that one child’s preferences and needs are similar to those of another person.

Of course, this series about trauma has emphasized that it is the responsibility of ANY behavior analyst to individualize treatment, to consider the history of a client before moving forward with treatment, and to treat more than the “local” functions of behavior. Unfortunately, it is easy to miss the importance of this component of assessment and treatment, especially for new behavior analysts who have gained their “hours” working with highly similar clients, working without supervisors experienced in a diverse clientele, of without any supervisor or instructor who appreciates experimental as well as applied behavior analysis. One of the ways we find out more, is to go to the literature. This may be easier said than done, and an example of successfully data mining for this topic is provided toward the end of the article.

Today’s discussion involves clients who have been affected by what’s known as “Fetal alcohol syndrome”, or exposure to alcohol in the womb.

This is more than adverse childhood experience, for it goes back further in development, perhaps even as early as the neural tube (which will give rise to the spinal cord) and other important structures were being formed. This kind of exposure can affect an individual for their entire lifetime.

So we can consider it an adverse experience, although it happened even earlier than what we think of as “childhood”, and it has long lasting consequences, altering the way someone will learn and interact for the rest of their life.

Can we treat behavior after this condition? Continue reading →

Learning more each year about autism

03 Wednesday Apr 2013

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Just in time for Autism Awareness Day yesterday, a new article highlighted ten things we didn’t know last year about autism. At Cusp Emergence, much of our contact is with families of young children who are either newly diagnosed, are in the early stages of treatment, or are transitioning to school placements. We are challenged by these findings daily, and we need to find new ways to help families and providers make the most of early years. You can link to the original article here. Below are some of the findings, with links to the source article for each. 

“1. High-quality early intervention for autism spectrum disorder (ASD) can do more than improve behaviors, it can improve brain function. Read more.” 

The study above examined ESDM (Early Start Denver Model) at 20 hours per week of therapy. Earlier this year we linked to additional evidence showing effects of pivotal response therapy, another set of behavioral interventions, on brain activity.

“2. Being nonverbal at age 4 does NOT mean children with autism will never speak. Research shows that most will, in fact, learn to use words, and nearly half will learn to speak fluently. Read more.”

Many students whom we have been fortunate to support, have gained language after intervention, after histories involving long-term periods of nonverbal communication.

More importantly, virtually ALL learners can make progress in functional communication, when the functions of their difficult behavior are carefully examined in the context of a strengths-based assessment. For an individual student, we discover what she needs and wants to communicate, and therapy then expands her access to, and engagement with, the world around her.

Why is it so important that we understand ALL learners can make progress with functional communication? Because it is so important to keep trying, to not give up. Years ago in a robust metroplex school district, I was an undergraduate, un-schooled, interventionist level trainer assistant for special education teachers participating in an ABA training. My first task seemed daunting: approach a student in the corner, sitting in a wheelchair alone, to discover whether she had a communication system at school, how she used it, and determine how to support teachers moving forward. This beautiful high school student remained belted in her chair looking vacantly off to one side most of the time, without a PECS system or vocal or verbal repertoire that the teachers knew of. As I built rapport with her, pairing myself with her favorite songs as we sat together in her loud classroom, I noticed she moved her hands a few seconds after I moved mine. I was practicing some basic signs as I attempted to establish communication with her. After a few minutes I noticed she was moving her hands “intentionally”, and that the signs she was making looked sort of like mine! At least, they were shape-able. We began to teach her basic signs for “music” and “eat”, and within the first week of our summer training, her teachers and paraprofessionals were struggling to grasp that this whole time, after years of sitting in her wheelchair not using expressive language, this 15 year old student was capable of sign language to communicate at least 5 basic requests. Was she capable of this the whole time? She had not used much problem behavior and, the teachers readily admitted, was not “a squeaky wheel” and did not demand much attention. 

“3. Though autism tends to be life long, some children with ASD make so much progress that they no longer meet the diagnostic criteria for autism. High quality early-intervention may be key. Read more.”

All students can learn. And when learning starts early, we often get farther!

How do you meet diagnostic criteria? By acting and behaving in ways that are consistent with the diagnostic criteria. Currently, there are no reliable biomarkers or blood tests that denote “having autism” or show where someone is “located” on a spectrum.

But while this fact is indisputable—that some children with ASD do make so much progress as to be “distinguishable” from other children who never met the diagnostic criteria—it is important to support families to understand the true life long path through supporting a family member who may have autism.

It is important to understand that there may always be new challenges that come with development, exposure to new social environments, and learning. As a parent of an 18 year old expressed to me recently, being able to plan for transitions requires being realistic and supportive even when we hoped it would all be over by now. 

“4. Many younger siblings of children with ASD have developmental delays and symptoms that fall short of an autism diagnosis, but still warrant early intervention. Read more.” 

One of the most pressing questions may be, if the delays and symptoms of younger children fall short of a diagnosis but warrant intervention, how do you fund it?

Recommendations:

  • Insure all families and practitioners in your practice or community understand that having an older sibling with autism is a risk factor for the younger siblings. Younger siblings can be referred to early intervention (in some cases, funded by a state fund in which the child can access ABA (sometimes under the label Social Emotional Support), OT, SLP, and other services to prevent falling behind in language development and social interaction.
  • Often, having an older nonverbal model in the home can prevent younger children from using skills that would otherwise emerge sooner. For example, a younger child may imitate the behaviors that result in meeting his older sibling’s needs. The younger child may imitate pulling parents around by the hand, tantruming to access food, toys or attention. The younger child also may not have adequate verbal models. So it is recommended to use powerful strategies for increasing language, with younger siblings of children with autism, even if those siblings  have no diagnosed delays.
  • Families can attend a workshop and learn skills to arrange their home environment to promote language and insure they respond consistently to behavior.
  • When families begin providing expansions and elaborations on every utterance, and using contingent access to help their children learn social interaction as a basic part of getting needs met, younger children who have been slow to develop speech, often start to talk more. 
  • If a family is considering preschool, younger siblings may benefit from a stimulating environment where language promotion and appropriate social interaction is built into the daily lives of the students. Integrated preschools for children with autism and their typically developing peers may be good options for siblings of students with autism, as the skills they practice daily at school, will be useful and powerful in their daily home lives. 

“5. Research confirms what parents have been saying about wandering and bolting by children with autism: It’s common, it’s scary, and it doesn’t result from careless parenting. Read more.”

Recommendations:

  • Families can develop a basic family safety plan that includes preventative environmental arrangements (such as latches near adult height to prevent unlocking and opening doors), preventative teaching, responsive strategies, and the family’s emergency plan. They can follow up by educating community members on their family plan, including appropriate law enforcement agencies and a responsible party in any community environment (a school, a church, a grocery store) their family member frequents. Pre-teaching can include establishing high compliance with safety instructions such as “stop” and “come here”, by strengthening these skills when it is NOT a crisis, and pre-cuing, prompting, and reinforcing appropriate behavior at all times to keep the family member ready to use safety skills.
  • Talk to your behavior analyst about how to “bring safety behavior under instructional control” and develop a plan for teaching these skills, if you have not addressed them.
  • Even though schools often refuse to initiate a behavior plan for a student with an IEP until there has been demonstrated danger, learn your rights as a parent by consulting with an advocate or reading. If elopement or wandering has occurred in the home or community, demand your student has an appropriate safety and health plan, and behavior plan with preventative components. 

“7. One of the best ways to promote social skills in grade-schoolers with autism is to teach their classmates how to befriend a person with developmental disabilities. Read more.”

If number 5 was one of the more important points for safety, THIS point may be the most powerful one in terms of potential for social interaction.

At a recent IEP meeting, we listened with disbelief to our client’s school team insist a beautiful 3 year old child simply “didn’t enjoy” his peers’ interaction, so they had given up because it was quite difficult to promote interaction. Instead, they had decided to make his school day one that was filled with 1:1 interaction with an adult. In my experience, while it is true that many children diagnosed with autism do not initially “enjoy” interaction with peers, they begin to enjoy it almost immediately when the peer is the one doing the asking! Much research supports peer mediated instruction as one of the most powerful technologies for teaching students that it is fun, useful, and easy to interact with their peers.

Teachers and schools who would like to learn easy techniques for helping peers learn to initiate to their students with autism, can sign up for the School of Play or ask their local behavior analyst for help.

 

Don’t make me eat a broken hamburger in public!

29 Friday Mar 2013

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ImageWhen I read the poignant story of the broken hamburger, my eyes teared up for two reasons.

At first, they brimmed with gratitude– the collective sort of gratitude of the hundreds of thousands of Facebook users who “liked” the story about the kindness of a chain restaurant waitress.

Thank you, waitress, who heard a mom apologetically request a second hamburger for her young daughter affected by autism.

The original burger was “broken”, she had said, and her daughter could not eat it.

Consistent with the pattern discussed in diagnostic manuals and tools used to assess or document the presence of autism, or behaviors consistent with that label, the young girl in the story “preferred sameness”, and had difficulty participating when the environment contained a salient difference– even when that difference was presented in the context of a hamburger (usually a highly preferred, even a ‘favorite’, food).

The young girl has not yet learned to approach– and to enjoy– a hamburger different from how it appeared in her normal routine.

And it’s critically important not to judge. First, the list of what we don’t know is long. For example, we don’t know, but it may be progress just to sit with the family eating at a restaurant. We don’t know how hard they may already have worked, how far their family has already come, or whether tremendous problem behavior used to occur during dinner, and a request for ‘new hamburger, mom’ was a triumph. Learning to request a break, help, or the little things that ameliorate our daily troubles like a snack, a special blanket, or a teddy bear, takes lots of practice and shaping. Second, peculiarities of childhood eating are not so unusual; a family member diagnosed with nothing that I know of, used to refuse to eat the ‘handles’ on her french fries. That’s a lot of wasted potatoes, but I’m pretty sure her mom was choosing battles carefully.

How we address this situation depends in part on how we frame it.

Do we fight battles FOR our children, or WITH our children? Is food refusal a temporary battle to be won at each meal anew, or is food exploration and acceptance a new path to be walked with families?

Back to the story’s intent. Consider the perspective of the waitstaff, who is tasked with responsibility of honoring most appropriate customer requests. Upon reflection, I remain touched by the waitress’ readiness to honor the request so the child might enjoy the hamburger.

But my eyes also teared up for another reason.

Sometimes, children live in an environment indefinitely where most things in their food repertoire don’t change, and as a practitioner, I’ve observed students go for years not being challenged while families suffer in silence. How many dinners will she endure waiting until getting home to eat, because the favorite dish was not on the menu? How many times will her family go out without her, or select to not try going out, because there may be no appropriate foods for her on the menu? She may not have the opportunity to encounter (and eventually approach) diversity, and avoidance may be strengthened each time her parents’ requests to make the food a certain way, are honored in front of her. She may even avoid birthday parties or the community, because the food and setting is so different, and there has been very little practice to become comfortable in “different” situations.

As parents of neurotypical learners often point out to me, and as the little girl in my family illustrated, preferences don’t have to make sense, they may be comical at first, there is a broad range of “normal”, and it’s up to each family to decide how to, whether, and when to address the issue of food selectivity. Does the child have such a limited range of preferred foods, that a nutritionist and doctor are concerned?

Here is a good question to ask: how does the child handle being “challenged” or presented a challenge food? Does the child prefer something so much she will refuse (and refuse to try) every variant, to the point of disruptive behavior?

If the answer is “yes”, no matter the profile of your learner, it may still be helpful to address.

We can provide practice situations in supportive environments when sampling and practicing and trying differences is made comfortable, expected, familiar and do-able.

To families raising children with limited variety of food acceptance, or who eat very low volumes of foods or eat around only one or two family members:

  1. Practice eating with others before being shocked and disappointed that the child doesn’t eat the first cupcake she’s ever seen at a birthday party.

  2. Practice situations that teach us broken hamburgers taste the same as whole ones.

  3. Practice variants of seating arrangements, food that comes on different plates and with different utensils, and foods that arrive “contaminated” with a sauce (to use the phrase of one child in feeding therapy).

  4. Doing it for the first time in a familiar environment also makes it easier, and then practicing little by little in “the real world” helps.

Cusp Emergence hosts “snack parties” that provides practice for children learning to eat in community settings or eat with others before it is time for preschool or school lunches and snacks.

It is often helpful during the transition phase, as our clients transition away from early intervention to preschool, or change from weekly feeding support with a therapist to parent-only support 

Bottom Line:

You can do it, and we can help. Practicing the hard thing makes it easier. And practicing across multiple environments and situations makes the new skill stronger!

If your family member is in feeding therapy, ask the practitioner how they are programming for generalization.

Don’t just train and hope… program actively for generalization.

HELP- There’s a monster in my toybox!

06 Wednesday Feb 2013

Posted by in Autism, Behavior Analysis, Community, Early Intervention, Education, play, Rett's, Social Interaction

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Part 1 of Series: Helping caregivers and teachers support children to meet fearful challenges

Shannon’s Story

Shannon and Gina sat in a free play area near their preschool teacher. “SQUAWK!” came the loud animal sound when Gina pushed the button on a new toy. As the toy noise grew louder, Shannon’s eyes opened wider and wider until she froze, a look of sheer terror on her face. She started to back away and wailed, sinking onto the floor and crying.”Oh no,” gasped her teacher. “Put that toy away!” While Shannon cried, their teacher pulled Gina aside and said “I’m sorry, but Shannon is afraid of that toy. Next time we will remember to play with it when she’s in another room.”

Devon’s Mom’s Dilemma

Devon and his mom Jenny walked down the sidewalk with their next door neighbors. As they neared the playground, Devon suddenly grabbed his mother’s skirt tightly and shrieked. “NO BIRDIES! NO DOGGIES!” At this, Jenny’s face grew red as she picked up Devon and held him tightly. She looked at her neighbor helplessly and apologized: “I’m just so sorry… We can’t go any further with you. He’s been doing this every time. He has this issue with ducks and dogs and birds now. I think even if we don’t see one he’ll be afraid one might get him.”

Toward more supportive, long term strategies

At first, it may seem supportive to shield a child from their fears.

But both teachers and parents want and need solutions that will ultimately help children face and overcome challenges. So when there is a question, especially when a particular strategy feels good or soothing or produces relief in the short term, it’s a good idea to ask ourselves, “is this procedure also supportive in the long term?”

If not, how can Shannon’s teacher and Devon’s mom learn a more therapeutic approach? And why is that important? Let’s review these scenarios again, to better understand why and how to take a supportive long term approach. What might Shannon’s interaction with the toy, and Devon’s interaction with park creatures, have in common?

First, these scenarios are similar in how they are resolved.

In both interactions, a pattern is being established: the child first encounters a fear, or “fear inducing stimulus”, and then others respond by helping the child to escape or avoid it.

Second, these scenarios are similar in how they affect other people.

From the perspective of Shannon’s peers, her inability to play with that toy meant that they couldn’t either, at least not when she was around. From the perspective of Devon’s neighbor, the neighborhood kids couldn’t play with Devon in a park. This concept, the idea that Devon can’t play in the park, and that Shannon can’t play with toys that make animal sounds, limits interaction opportunities. It also risks changing the way peers think about approaching Shannon and Devon.

Third, these scenarios have similar “reductive” effects on the children’s “repertoire” or world. Have you ever met a family member or caregiver who says, “we used to love to do ___” but we can’t anymore”? Perhaps a family used to go to the movies, or out to dinner, or have friends over, or go to museums, or go hiking. During the initial conversation with families, that blank is filled in by all the things they need to avoid now because of fears of how people will react, fears that it won’t go well, fears that it will be too difficult, embarrassing, or noisy. Often those fears are REAL at the time! Perhaps people DID stare and talk at church when a family’s child loudly refused to stop standing on the pew. Perhaps all the teachers and mothers DID stare and talk in the parking lot as a child disrobed in public and threw a tantrum before leaving the store. Perhaps it WILL be difficult, embarrassing, or noisy. But keep reading. We can do this together.

Fourth, understand it’s a cycle: handling scenarios by allowing “fear habits” to persist, allows learners to skip learning opportunities and continue to repeat old harmful habits instead.

If Shannon and Devon can’t play with certain toys or in certain places, they have reduced opportunities to learn about those things and places, and no opportunity to learn that they are NOT scary.

Fifth, if these scenarios become habits, they make it more difficult for the child to handle or face similar or other fears in the future. These situations do not teach the child how to be more successful in coping with scary, new or different events.

Bottom Line: Instead of stopping or thwarting learning opportunities, we can expand them.

Come back Friday to learn how!

Build-Your-Own-Workshop

04 Tuesday Dec 2012

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Cusp Emergence is excited to offer a Build-Your-Own-Workshop feature to families, groups, and communities.

1. Consider what your workshop will address, and why you need a workshop.

  • Need to learn general ways to provide social, emotional, and behavioral support?

  • Need to practice behavior management for specific behavior challenges?

  • Need to teach your family or group about managing a particular behavior challenge?

  • Need to support a student or family or community member with cognitive or developmental challenges?

  • Want to know more about how social-emotional and behavioral wellness relate to physical health?

  • Want to learn a particular technique (for example, for teaching skills or shaping language, appropriate behavior, play, or social interaction)?

    2. Think about who will participate, where you’d like the workshop, and how long your group would like the workshop to be

    3. Contact Cusp Emergence!

CONTACT CUSP EMERGENCE:
720.263.CUSP

Social Emotional Support: Part 3 (How does it work?)

15 Thursday Nov 2012

Posted by in Autism, Behavior Analysis, Behavioral Cusp, Community, Early Intervention, Social Interaction, Uncategorized

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Social Emotional Support should be practical, and fit into a child’s family routine or team involvement.

How does Social Emotional Support work with other therapies? Does it replace Speech Therapy?
Social Emotional Support can complement, but does not usually replace, therapy by an experienced, licensed and trained speech therapist, especially if the child is diagnosed with an issue that would benefit from Speech Therapy. Instead, S/E can facilitate other therapies the child is already receiving, and brings a therapeutic perspective that can enhance the benefit of Speech, Occupational, Physical, or other supports. For example, some children may use dangerous or unsafe behaviors, or escape from unbearable or undesirable situations after inappropriate behavior. Other children benefit from learning how to “turn down” or “turn up” sensory stimulation, without using unsafe behavior. They can learn safe ways to express that there is too much, too little, or uncomfortable stimulation. We can help other therapists to integrate behavioral wellness into their sessions, and how to incorporate motivation and timing and behavior techniques into their strategies. Note: Some of the most powerful technologies in teaching children with autism (and diverse learners worldwide) have been generated by behavior analysts who collaborate with, or have backgrounds in, speech and language therapy. (PECS, or the Picture Exchange Communication System, is a good example of this.)

How do we do it?
Step 1: Assessment
A behavior analyst as S/E provider can assess a child’s strengths, challenging behavior, and family’s concerns, then generate individualized strategies to support the child’s growth. Often an assessment called an FBA, or Functional Behavior Assessment, is conducted over a couple of weeks to understand the reasons and ways that the environment is contributing to the child’s challenges. We learn what situations are most difficult and how to address them by strengthening more appropriate and successful alternative ways for learners to meet their needs.

Step 2: Collaborate
Next, we team with the child’s family and other providers or community members. We use a collaborative strength-based service model to determine measurable goals the child will meet by learning new skills, behaviors, and new ways to use their strengths. Then we discuss ways (strategies) that will be used to get there.

Step 3: Teach family and therapists to use consistent strategies; monitor strategy effectiveness
Collaboration results in setting measurable goals and developing a plan listing specific strategies families will use to meet the goal.

Families often ask whether we use individualized strategies or apply the same kind of support to every child.
We use individualized support. There are also many core “evidence-based” strategies that we use because research and practical application consistently shows they benefit children with autism and related challenges. Read more about the EI Colorado recommended strategies here.

Step 4: Support the child’s transition out of early intervention.
This step involves thoughtful planning for how the child and family will move to the next steps and environments as needed. Local agencies partner with schools to provide families with options for continued therapies in preschool if needed. Social emotional support providers can work with families to put the currently effective strategies in writing to share with important new people in the child’s life. Some families benefit from continued consultation from a BCBA, who can help teach preschool teachers and therapists how to keep making progress by providing continued individualized support based on the child’s needs. (Check out a previous related post on supporting a child’s transition).

Social Emotional Support and Intensity of Behavior Analytic Intervention
Although intensive intervention is recommended and effective for building skills and relationships with children with autism, the intensive aspect of intervention is not characteristic of the time-limited S/E support under Early Intervention Colorado’s guidelines. Instead, this model provides a brief assessment as needed followed by an hour or so of weekly therapy with the child that consistently includes caregiver education. By focusing on engineering change in families and team members, we set caregivers up to learn preventative successful techniques to support their child’s speech, motor, play, self-help and social skills.