Important Questions (and answers)

Autism spectrum disorder (ASD) is a neurological and developmental condition that impacts people differently.  It is characterized by social and communication deficits (or differences) along with restrictive or repetitive behaviors. If someone is diagnosed they often also get a severity label to help identify the level of supports that may be needed for that person.  People are born autistic and are autistic throughout their life.

It is important to remember that "if you have met one Autistic person, you have met ONE Autistic person".

ABA stands for applied behavior analysis.  

(Great, so what does that mean!?!)

Behavior analysis is a scientific field that focuses on principals that explain how living things behave and learn.   It requires observing specific behaviors and the environments in which they occur.  ABA takes that science and applies it to real people (or in some cases animals) to develop necessary skills.

Payment options may vary depending on the ABA provider, the region, and the client.

At Behavior Balance Point we are working hard to join insurance networks and we also accept private payments.  Currently we are in-network with Colorado Health First (Medicaid), Aetna, Anthem, and Optum.  If your insurance provider is not listed here please reach out and we will do our best to figure out options to get services covered!

All members of Behavior Balance Point have, at minimum, a high school degree or equivalent, have passed a background check, and receive on-going training.  Below is a breakdown of our care teams:

• Board Certified Behavior Analysts (BCBA) oversee all of the services provided at Behavior Balance Point.  BCBAs have a Masters degree, completed coursework specific to behavior analysis, completed supervised experience hours, and complete continuing education.  These are the folks to chat with if there are concerns about what is being taught and how.
• Board Certified Assistant Behavior Analysts (BCaBA) work closely with BCBAs to assist in overseeing cases as well as providing supports to staff and caregivers.  They have taken coursework or have a degree that is accredited by the Association of Behavior Analysis International or they have completed coursework and they have passed a credentialing exam.  To maintain their credentials they complete continuing education, and receive ongoing supervision.
• Registered Behavior Technicians (RBT) implement a large portion of direct care and services.  Eligibility requirements include: being at least 18 years old, having a high school diploma, passing a background check, completing 40 hours of training,  showing competence through an assessment, and passing an exam.  They must recieve ongoing supervision from a BCBA or BCaBA and must also renew their credential annually.  These are the folks to ask for simple daily updates and to communicate specifics about your child's care. 
• Behavior Technician -  Work closely with other team members and provide direct services to clients.  These folks are trained in-house to work with your child and are working toward becoming an RBT.  These are the folks to ask for simple daily updates and to communicate specifics about your child's care. 

For additional information about credentialing requirements please visit the Behavior Analyst Certification Board

At Behavior Balance Point, LLC we want learning to be natural and fun.  Our team uses materials that learners are likely to interact with on a daily basis to contrive opportunities to practice play, communication, social, self-help and other foundational skills.

Depending on what a learner needs and wants help with, their day may look slightly different from another learner's.  One learner may spend time at a table so they can tolerate a "typical" classroom experience or dining at a restaurant with family members.  Another learner may spend their day playing with sets of toys learning how to play with others and expand their language (colors, shapes, sizes, prepositions, etc.).  Another still may spend sections of their day focusing on daily living skills such as independently brushing their teeth, washing their face, putting deodorant on, etc.  All learners have a somewhat structured day that includes targeted skills, movement, and social opportunities (when available with scheduling).

We do not FORCE any learners to do anything.  If a learner seems as though they do not want to be in session, we will take a step back and look at what is going on.  Some things we'll look at (and if possible, talk to the learner about) are:

• Is there a prerequisite skill that may help the learner to be more successful?
• Can we change the timing or sequence of our activities?
• Can we modify some of the materials used to be more interesting?

The creation of goals is a group effort.  During intake Behavior Balance Point will discuss learner/family priorities, complete a review of any diagnostic or school documents that are shared, and will also complete an interactive observation to help in assessing skill.

As much as is possible, Behavior Balance Point aims to utilize preventative ABA (see  Ala’i-Rosales, S., et al. 2019) in which we focus on prosocial behaviors and skills that, when absent, often result in dangerous or maladaptive behavior.  

Priority is put on goals that will keep the learner and those around them safe.  Behavior Balance Point, LLC aims to help learners find ways to express themselves, quirks and all.  As Leaf, J., et al. (2021) state, "behavior  analysts also have an obligation to best prepare their clients  for the world in which they currently live, which is, unfortunately, less accepting than desired. Research has documented that engaging in stereotypic behavior often has a negative impact on the person engaging in the stereotypic  behavior (Bodfsh et al., 2000; Goldman et al., 2009; Koegel  et al., 1974) as well as negative perceptions from those  observing the person engaging in the stereotypic behavior  (Cook & Rapp, 2020a; Welsh et al., 2019)…ABA-based interventions should work toward empowering  and enhancing options rather than achieving conformity" for that reason, when "stimming" behaviors are targeted, it will be done with a focus on collaboration and care.

Behavior analysis is dependent on data!  At Behavior Balance Point, we review data every session so we can make decisions about how to proceed with goals.  Official reports are written, at minimum, every 12 months and caregivers are encouraged to reach out if they would like more frequent updates.  

During goal setting, caregivers will work with Behavior Balance Point to create a list of "up next" goals.

As a learner shows proficiency with a skill (which is determined per goal per learner - 100% of multiple opportunities would be required for something like crossing the street safely while a lower mastery criterion could be used for something like relinquishing a toy to a peer), goals are mastered out and new goals from the "up next" list are introduced.

If progress is not being made after a period of time (determined by the learner's acquisition pattern), procedures will be assessed and modified.  If, while assessing, it is determined that the learner could benefit from learning prerequisite or complimentary skills first, a goal may be put on hold or adjusted.

Caregivers will be notified at least conversationally during pick-up when new goals are introduced.

This depends on the learner, their skill level, and "why" they tend to engage in that behavior.  We work to learn a lot about our learners, what they like/dislike, what is easy vs. hard for them, what things may set them off and what they roll with easily.  This lets us set realistic expectations, recognize teaching opportunities within positive contexts, and set them up for success by creating a balancing act or dance with them in which we can teach perhaps without seeing the not-so-great stuff.

Learners all have plans that outlines how we should respond if we see not-so-great behavior.  Behavior Balance Point focuses on keeping everyone safe, remaining hands-off as much as possible, and helping the learner to get their needs met.  Sometimes this means helping them to say what they want/need (even just with a point or a glance), other times it may mean letting them leave the situation, sometime it means weathering the storm by remaining nearby and available.

There are two general ways to teach using prompts (or cues that tell a learner what to do): Most to Least Intrusive and Least to Most Intrusive.  The method selected often depends on the skill and the learner.

Often if a skill is emerging the least to most intrusive method will be utilized.  This means that they will be given an opportunity to try without assistance then if they are not successful assistance will be gradually offered.  Benefits of this approach may be that it can appear more naturalistic, it allows others to see what the learner can do independently each opportunity, and there is less likelihood of the learner depending on prompts. A main downfall of this approach is that it allows for errors which could slow learning or result in some "extra" behavior.  If a skill is longer, more complex, and never demonstrated by the learner it may be taught using most intrusive prompts first.  An example could be when writing a person my hold the learner's hand and guide them through the motions, then slowly move their hand back and away from the learner.  Benefits of this approach include that it allows errors to be avoided so mistakes are not practiced and the end performance is likely "clean".  However, it can lead to a degree of prompt dependence (less independence).  Preference is important here, some learners do not like to be wrong and get corrective feedback so they may prefer starting out with help and being successful every attempt while others like to figure things out on their own and add their flare to the activity.  

It is important to note, the most intrusive prompt does not always have to be physical (hand-over-hand or hand-under-hand), it could be a model, an instruction, or anything that is likely to result in a correct response.  At Behavior Balance Point we aim to teach using the learners' preferences.  We also strive to be hands-off and gain permission when providing physical assistance.  We do not use physical guidance for compliance.