Frequently Asked Questions

Do you use Applied Behavior Analysis (ABA)?
What is Pivotal Response Training (PRT)?
What is the difference between Discrete Trial Training (DTT) and Pivotal Response Training (PRT)?
What is reinforcement?
Why do certain behaviors occur?
How do you determine the number of hours of   therapy my child should receive?
What are the staff positions at AST?
What are the qualifications of your staff?
How much and what type of supervision does the staff receive?
How will I be involved in my child’s program?
Who do I contact when I have concerns or questions regarding my child’s program?
Why do you collect data, and do I have access to the data?
What do you collect data on?
What does the process include between the referral from the Regional Center to the start of the in-home sessions?
Do you work with school districts?
Do you provide services on the weekends?
How do you assign a therapist and supervisor to my child?
How do I request changes in my child’s therapy schedule?
Will AST make changes in my child’s therapy schedule?
Who provides the materials required to conduct my child’s session?
What does a typical session look like?
How many therapists will be working with my child?
Do you provide make-up sessions?
How do you accommodate families who speak other languages?
Where can I look on the internet for further information?

Q. Do you use Applied Behavior Analysis (ABA)?
A. Yes, Autism Spectrum Therapies incorporates the major principles of Applied Behavior Analysis in all of its programs. ABA is a systematic process to study and modify observable behavior. Specifically, we first examine how a behavior looks, how long it lasts, how many times it occurs, among other attributes. Next, we apply principles of ABA such as reinforcement or extinction to increase appropriate behaviors or reduce inappropriate behaviors.

All treatments used at AST are empirically validated and fall under the umbrella of ABA. AST uses a blend of different ABA strategies individualized for each child’s program such as discrete trial training (DTT), Pivotal Response Training (PRT), Picture Exchange Communication System (PECS), Self-Management, and a range of social skills training techniques. These strategies are all critical in teaching children with autism. AST works closely with families in monitoring each child’s progress to decide on the right mix for the individual. Ultimately, the goal is to find a way of motivating the child using a number of different strategies and reinforcement techniques to ensure that the sessions are enjoyable, productive, and result in high rates of learning.

Q. What is Pivotal Response Training (PRT)?
A. One ABA approach is Pivotal Response Training. PRT incorporates principles of Applied Behavior Analysis (ABA) to teach behaviors that seem to be central to wide areas of functioning. It is expected that by teaching certain “pivotal” behaviors, we will see improvements in other areas of behavior. One pivotal behavior is motivation. A lack of social motivation is hallmark to autism. Children with autism typically lack the motivation to learn new tasks and participate in their social environment. A lack of motivation may be observed as temper tantrums, crying, noncompliance, inattention, fidgeting, staring, attempting to leave the teaching situation, or lethargy. PRT targets motivation by getting the child to respond to increasing expectations to communicate and socialize. The interventionist creates opportunities for the child to receive desired items and interactions, and gradually shapes more effective communication, play, and social skills. The use of PRT can increase the motivation of children with autism, therefore, significantly enhancing the effectiveness of the teaching environment. PRT uses turn-taking, child choice, modeling, shaping, and direct reinforcement to increase appropriate social and communication behaviors in children with autism. For some children with autism a blend of Discrete Trial Training (DTT) and PRT is necessary to maximize the child’s learning potential. The right proportions of intervention techniques are decided through data analysis and close supervision.

Q. What is the difference between Discrete Trial Training (DTT) and Pivotal Response Training (PRT)?
A. Both Pivotal Response Training (PRT) and Discrete Trial Training (DTT) incorporate the major principles of Applied Behavior Analysis to teach specified behaviors to individuals with Autism or other Developmental Disabilities. DTT approaches are highly structured and useful when acquisition skills are a major focus of a child’s program. PRT involves a structured, play-based format, to target skill development. Most Pivotal Response Training programs utilize discrete trials as needed. AST’s model is flexible enough to allow for the benefits of both types of ABA approaches, thus individualizing each child’s program. This process of fitting the program to the child’s needs is discussed with each family, so that parents understand the benefits of PRT and DTT and how each will be applied.

Q. What is reinforcement?
A. Reinforcement is a consequence provided after the occurrence of a behavior that increases the possibility of that behavior occurring again. Reinforcement is not necessarily the provision of a desirable object or activity. In order for reinforcement to have occurred, the target behavior must be observed to increase. Contingent and natural reinforcers result in the child learning that his/her behavior impacts the environment (i.e. that it has meaning). Communication is typically rewarded by functional and natural responses. Requesting an item and consequently receiving that item, results in the likelihood that one will request the item in the future. Reinforcers can also be unrelated to the behavior. Getting something to eat, for example, would not be a natural reinforcer for clapping your hands. Research suggests that program goals are more generalized, and motivation is higher, when most of the reinforcement in the program is natural, and directly related to the child’s response.

There are two types of reinforcement: Positive and Negative. It is important to distinguish the two types, and to differentiate negative reinforcement from punishment. Positive reinforcement is the process of applying a consequence that results in the likelihood of a behavior increasing in the future. For example, giving a child a cookie when she asks, “Cookie please” is an example of positive reinforcement and results in the likelihood that she will ask for a cookie in the future. Negative reinforcement is the process of removing an aversive or undesired stimulus that results in the likelihood of a behavior increasing in the future. Removing a difficult task after a child cries and says they cannot do it is an example of negative reinforcement and increases the likelihood that the child will cry in the future when presented with a difficult task.

Q. Why do certain behaviors occur?
A. Behavior is often a form of communication. A behavior may occur in order to receive attention. For example, when a child says “Mommy,” his mother typically looks in his direction and smiles. In this case the child is saying “Mommy” in order to receive her attention. Since the mother looked at the child and smiled, (the desired outcome), the child will be more likely to say “Mommy” in the future. A child may engage in inappropriate behavior to receive attention. In the above example, the child may not be able to say “Mommy.” Instead, he may hit his mother until she looks at him and provides attention. Second, a behavior may occur in order to receive access to an activity, toy, or another desired item. For example, a child may say “Juice, please”. If the child receives access to the juice he will be more likely to repeat the phrase in the future. A child may engage in an inappropriate behavior to indicate desire for an item, activity, or toy. In the above example, the child may not be able to ask for juice, and may scream until his mother pours him the juice. Third, a behavior may occur to escape or avoid a particular situation. If a child no longer wants to play with a toy he may say “All done”. If that phrase is typically followed by the removal of the toy, he will likely repeat the phrase when he wants to escape something undesirable. A child may engage in an inappropriate behavior to escape or avoid a situation. In the above example, the child may not be able to request a break, or indicate that he is “all done.” He may throw the toy, or fall on the floor to indicate that he does not want to do the activity. Finally, a behavior may occur because it feels good to the child, otherwise known as a self-stimulatory behavior. For example, a child may sing the alphabet song repeatedly to himself because he enjoys the sound of the song. Before determining the purpose, or maintaining condition, for any behavior an individual must repeatedly observe its occurrence in the context of its environmental conditions.

Q. How do you determine the number of hours of therapy my child should receive?
A. AST is in agreement with the field of Applied Behavior Analysis that the literature supports the need for intensive ABA services for children receiving early intervention. For children severely impacted by autism this will require a weekly minimum of 25 hours of direct service, with services reaching as many as 40 hours per week. Each child requires an individualized program tailored to intervention needs in the area of language, play, behavior, social skills, and self-help skills. AST works with the family and other treatment providers to develop a program of appropriate intensity. We have clients who are currently receiving much more than the 25 hour minimum, as well as clients who have a broader range of services allowing for fewer than 25 hours of ABA.

AST believes that programming for appropriate intensity goes well beyond the consideration of hours. There is a range of ABA methods that fall across a spectrum of intensity. Other variables to consider are: 1) qualifications of the staff member providing weekly services, 2) quality of data collection procedures, 3) frequency of program modification, 4) amount of structure that is maintained within each session, 5) educational and experiential background of those overseeing the program. 6) parent involvement

Q. What are the staff positions at AST?
A. The staff positions include:
Directors: Oversee the overall operations and clinical services within AST.

Division Coordinator: Provides weekly supervision to program supervisors and works with supervisor to monitor program goals and child progress. Coordinators maintain contact with families within their division, and conduct periodic field visits to each child within their division. Coordinators oversee the professional growth and development of supervisors and therapists.

Coordinator of Staff Development: Provides intensive two week training to all new therapists, provides support to new therapists in the field, and conducts staff evaluations. Coordinators of Staff Development provide ongoing training and support to therapists and supervisors.

Program Supervisor: Provides weekly or bi-weekly field supervision for a program, provides ongoing support to the therapist and family, responds to family questions and concerns regarding program goals and child progress, analyzes program data, and maintains the effectiveness of the program.

Therapist: Conducts the in-home sessions and reports all data and other information to the supervisor.

Q. What are the qualifications of your staff?
A. AST hires highly qualified staff. All of our interventionists have at least a Bachelor’s degree in Psychology or a related field. Many of our interventionists have a Master’s degree or are enrolled in a graduate program. In addition to requiring experience working with children and providing ABA therapy, AST provides interventionists extensive didactic and experiential training prior to assigning their cases. Our program supervisors have advanced levels of training and experience. The majority of supervisors have obtained a Master’s degree or higher, and all of our supervisors are Board Certified Behavior Analysts or eligible to take the certification exam. All of our division coordinators and coordinators of staff development are Board Certified Behavior Analysts and hold Master’s or Doctoral degrees. Each coordinator has years of experience in the field of autism and developmental disabilities

Q. How much and what type of supervision does the staff receive?
A. AST provides an enormous amount of supervision to its interventionists. This is due to the complexity of our interventions, and the amount of data analysis required to maintain our programs. Every case receives weekly or bi-weekly supervision within the actual sessions depending on the number of direct intervention hours. Thus, depending on the program and the case, there may be anywhere from 2 to 5 hours of supervision provided within a given week. This includes in-home supervision, individual meetings between interventionist and supervisor, small group supervision meetings, full-staff meetings, monthly clinic meetings with the parents and supervisor, and AST staff presentations.

Q. How will I be involved in my child’s program?
A. There are a number of ways that parent collaboration takes place. The most important is the relationship between the parent and the supervisor. The program supervisor will meet with you weekly or bi-weekly in your home to review the program data, answer questions, ask for input, discuss your satisfaction with the program, and explain any changes that are being planned. A monthly clinic meeting will also take place in your home where the supervisor will formally discuss the child’s progress and review how the program is being extended to other home routines. Participation in parent education is expected, and parents collaborate with the interventionist and program supervisor to work on individualized goals based on their child’s needs.

Q. Who do I contact when I have concerns or questions regarding my child’s program?
A. You may contact your child’s program supervisor or your division coordinator. At the start of intervention you will receive your program supervisor’s and division coordinator’s contact information. You may also call the regional office for your area. Simply provide the receptionist with your child’s name and the supervisor or coordinator will be called for you. The phone numbers for each of our offices can be found on the home page of this website.

Q. Why do you collect data, and do I have access to the data?
A. Data collection is an integral portion of our program. The data allow us to keep an accurate record of the performance of the child. As we follow the child’s progress, AST can make changes as necessary to increase the intensity of the intervention, add goals, and incorporate new components as the child becomes ready for further challenges. Our ongoing evaluation gives us information regarding what the child knows and exactly when we can begin to increase demands to teach more to the child, and maintain the success of the program. You can review our data at the end of each session with your interventionist. Typically, the weekly visit from the supervisor allows for time to sit and review your child’s progress and program decisions. The monthly meeting that includes both the interventionist and the supervisor is a time for a more intensive discussion of program modification.

Q. What do you collect data on?
A. Data are collected on the individual goals that have been developed by the team as well as on challenging behaviors that occur during each of the targeted routines. Parents are often expected to collect data on their child’s progress throughout the week, as well, so that progress can be monitored across different people, places, and time (generalization). The specific behaviors for which data are collected change over the course of intervention as the child develops more advanced skills.

Q. What does the process include between the referral from the Regional Center to the start of the in-home sessions?
A. Depending on your local Regional Center the process may include:

1. A referral for services from the Regional Center
2. AST visits the home to conduct an assessment. This typically includes an interview with the family and observation and interaction with the child.
3. AST sends a report to the Regional Center making recommendations for services.
4. AST waits for the approval for funding from the Regional Center.<
5. Once the approval for funding is received, AST contacts the parents/guardians to schedule the first in-home session.

Q. Do you work with school districts?
A. AST works closely with over 30 school districts in the Los Angeles, Orange County and San Gabriel regions. Our services include developing individual programs, as well as training teachers, assistants, and school psychologists.

Q. Do you provide services on the weekends?
A. AST provides services Monday through Friday, 8:00am through 6:00pm. Our staff is not required to work on weekends, thus weekend sessions are subject to staff availability.

Q. How do you assign a therapist and supervisor to my child?
A. AST has created a model of intervention that is based on clinical teams. When you begin services with AST your child is assigned a “team”, consisting of your therapist(s), program supervisor, and division coordinator. This team generally stays with your family throughout the time your child receives intervention with AST. The clinical team model allows for close supervision and monitoring of your child’s program, as well as frequent and clear communication among team members regarding your child’s goals, program, and progress.

Q. How do I request changes in my child’s therapy schedule?
A. If you desire a change in the therapy schedule for your child, you must first discuss the change with the AST program supervisor. The discussion can take place when the supervisor visits your house or you can contact the supervisor for a phone meeting. Once the meeting regarding the changes has occurred, the supervisor will discuss your concerns with the division coordinator. During this meeting, the group will discuss the possible impact of the change on the individual therapist’s schedule and the therapy schedules of the other clients that we serve. Following the meeting, the supervisor will contact you with the decision regarding the schedule change for your child.

Q. Will AST make changes in my child’s therapy schedule?
A. Yes, AST may need to make changes in the time and days of your child’s therapy schedule during the course of intervention. Changes may occur due to your child’s current schedule, such as school or other therapy sessions, or due to changes in the availability of the AST therapist. During a weekly meeting, the impact of the necessary changes in your child’s schedule may be discussed with the division coordinator and program supervisor. AST reviews the impact of the change on the individual schedule of the therapist, and the schedules of other clients that we serve. Following the meeting, the supervisor will contact you with the decision regarding the schedule change for your child.

Q. Who provides the materials required to conduct my child’s session?
A. AST will provide the therapist with the majority of therapy materials, such as toys and games, to conduct the session with your child. However, AST may suggest additional toys for the family to purchase that will enhance your child’s session. The materials that are purchased by the family will remain at the family home when the therapist departs. AST strongly suggests that any materials that remain in the home are placed out of the reach of the child when the therapist is not providing services. Keeping the materials out of the reach of the child increases his/her motivation to play with them during the sessions.

Q. What does a typical session look like?
A. Each child’s program is individually tailored to meet the goals and needs of the client as well as fit within family routines. In an early intervention program, a session typically involves segments during which language, play and social skills are targeted in structured and/or unstructured formats. As children develop and the goals of the program become more advanced, the nature and format of the session change to accommodate the growing needs of the program. Our behavioral support programs focus on teaching the child appropriate skills as well as decreasing inappropriate behaviors. This can be done through a combination of direct instruction as well as through parent education and consultation. Please feel free to contact your supervisor or coordinator at any time if you have any questions regarding your program.

Q. How many therapists will be working with my child?
A. The number of therapists working with your child varies, depending on the number of weekly hours of service that your family receives. In programs of 15 hours or less, AST usually prefers to provide one therapist that will work with your child up to 5 days a week. AST will periodically rotate therapists to enhance generalization. In programs of 16 hours or more per week, your child will typically have two therapists. AST works closely with families and schools to ensure frequent and effective communication between therapists working with your child and between school and home staff members.

Q. Do you provide make-up sessions?
A. We make every effort to make up sessions canceled by AST staff within 30 days of the canceled session, or as stipulated by Regional Center and/or school district contracts. We are not obligated to provide make ups for sessions canceled by clients.

Q. How do you accommodate families who speak other languages?
A. AST actively hires qualified staff from diverse backgrounds, many of whom are bilingual. Although our intervention sessions are typically conducted in English, we make every effort to accommodate the individualized needs of each child and family to ensure communication and collaboration.

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http://rsaffran.tripod.com/faq.html#q4