Sunday, April 19, 2009

A Good Autism Consultant

I have people contact me from across the country and share awful stories about how their Autism Consultants has been running their children's programs. The saddest part about it is the fact that most parents don't realize there is better service out there.

*You never know which private agency your child's case will be contracted out to for services and you often cannot choose whom to work with when granted a contract through the Regional Center (or other state-regulated agency). Unfortunately, state-regulated agencies do not have the time to routinely audit the companies they provide contracts, and some companies become so driven by the monetary benefit of having contracts and renewing contracts when adequate progress is not met, that they begin to fail the families they serve. The following is a list of three of the most common issues associated with service providers:
  • Your Service Provider and/or your Program Supervisor are not Board Certified Behavior Analysts (BCBA) or cannot provide evidence they are actively pursuing certification.
-While having a PhD or PsyD is definitely impressive on an educational level, it does not necessarily mean the professional you are working with has had experience with children on the Autism Spectrum. Companies will often hire such individuals in order to justify charging higher fees. Dr. Robert W. Montgomery, BCBA, of Reinforcement Unlimited explains: "Being a licensed psychologist does not mean that the person has ever had any coursework or supervision in ABA or Behavior Analysis at all. Very few licensed psychologists are in fact qualified by training or experience to develop, supervise, or implement an ABA program." The person to look for is a Board Certified Behavior Analyst (BCBA). Since this is a fairly new certification, it is possible to find many professionals currently in the program. Unless your Program Supervisor is already certified, or actively pursuing certification, you should be weary of the techniques they are using. All professionals in the field of Autism must obtain the BCBA certification eventually in order to be considered qualified to work with your child. As a matter of fact, the California Department of Education already requires that "the IEP team shall include [a] behavioral intervention case manager with documented training in behavior analysis," under Title 5, CCR 3052. -You have a right to request such documentation.
  • Another note: Applied Behavior Analysis is a specific, scientific based approach to managing behaviors and educating a person with an ASD/PDD. Your Case Supervisor should routinely show you graphical representations of your child's progress. If you have not seen data collected for graphical analysis, you are NOT being provided with ABA services. Dr. Jose Martinez-Diaz of the Behavior Analyst Certification Board describes graphs as "the fundamental tool for organizing, summarizing, interpreting, and communicating the results of ABA."

  • Your Program Supervisor fails to observe your child at least once every two weeks.
-Ideally, your Case Supervisor will develop a relationship with your child just as your child's tutors will during the course of his program. This means she will need to be making face-to-face contact with you at least once a week. Unfortunately, with the average caseload thrown at Program Supervisors, a weekly consultation is not always realistic. But, how can the Supervisor adequately assess the progress (or lack of progress) that your child is making without seeing it for herself? For example, California's Department of Education states that in order to appropriately evaluate a Behavior Intervention Plan, "Measures of the frequency, duration, and intensity of the targeted behavior shall be taken at scheduled intervals across activities, settings, people, and times of the day" and be compared with original baseline data that was also collected " across activities, settings, people, and times of the day." This obviously requires a significant amount of initial direct observation in order to collect baseline data, as well as regular hours of observation in order to evaluate the effectiveness of the program. The final report of your Program Supervisor has a great impact on the continuation of your services. The report cannot possibly be accurate if the Supervisor has not taken the time to observe your child along the course of the services contract.

  • Your Program Supervisor cannot/will not answer your questions.
-In all fairness, the course of Autism and other PDD's involves constant discovery and is a learning processes for everyone involved. However, your Program Supervisor should be experienced enough to answer most of your questions, especially regarding the development of your program and behavior intervention strategies implemented. According to David Celiberti, a Board-Certified Behavior Analyst and leading advocate in the profession for Applied Behavior Analysis, unqualified case managers will "act defensively when parents ask questions about services, service provider competencies or recommendations." If your Program Supervisor is unable to answer your questions, you have reason for concern! Allow her a chance to find the answers you are looking for, but be sure she follows through and gets back to you in a timely manner.
The certification granted by the Board of Behavior Analysts is currently the only nationally recognized program that assures the professional has had specialized education, training, and supervision applicable to Applied Behavior Analysis. You can learn more about this certification and qualifications by going to the website of the Behavior Analyst Certification Board and looking under "consumer information."