Tuesday, April 14, 2015

Family involvement

We always say that when parents and other caregivers get involved in the interventions, their children show the most gains and progress. Parents become the therapist and thus, the intervention is in place 24-7.

The question is what it means to be involved. Here are my recommendations regarding the necessary steps of family involvement:

Phase 1: Look, listen, and learn

·       This is the introductory phase where the parent observes the behaviorist working one to one with the child. The parent will observe different segments in a variety of domains including independent living skills, functional communication, play, and behavior. Verbal instruction as well as modeling will be used throughout this phase to familiarize the family with common strategies and techniques.  

·       20 - 25% of the session will be devoted to observation. 

Phase 2: Working together

·       The parent has now observed all of the segments and is given a choice of what segment they would like to work on. During this step the parent and provider are both actively involved in the segment. The parent begins to give instructions, redirect inappropriate behavior, and use reinforcement contingencies.

·       The behaviorist is collecting data on the consumer’s interactions with the parent as well as with herself/himself.

·       20 – 25% of the session the parent and behaviorist will work together on achieving the consumer’s goals.

Phase 3: Parent lead

·       The parent is now leading the segment with the support of the provider. Instructions, redirections, and opportunities are all directed by the parent.

·       The behaviorist is taking data on the interaction and is only stepping in when necessary to give feedback to the parent.

·       25 – 30% of the session will be parent lead.

Phase 4: Independence

·       In the fourth and final step the parent is working with the consumer one to one and the provider has been completely faded. The parent is responsible for handling difficult behaviors, following through with demands, and employing environmental modifications.

·       The parent and behaviorist are both taking data that will be compared during the debriefing session to check for reliability.

·       25 – 30% of the session will include parent participation.

All this take and investment in terms of work and commitment. But it is worth it because you are investing in your family quality of life.
Daniel Adatto, BCBA

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