As a Behaviour Interventionist (member of the BC RASP) I am often asked about what services I provide for children and teens with autism spectrum disorder and what was formerly called "Asperger's Disorder."
Of course, many of my patients come for initial assessments of autism spectrum disorder. Additionally, many people see me for significant/severe behavioural issues they are experiencing, that their regular behaviour interventionist can't deal with. This often involves behaviour management consultation, parent training and sometimes working with the schools and classroom teacher to develop specific positive behavioural support programs for an individual student (PBIS). This often involves observations, interviews and sometimes means writing a formal FBA or Functional Behaviour Assessment. Any behaviour plan a school writes should start with a formal FBA. If your child doesn't have an FBA, but is having behavioural problems at school, ask for someone to complete an FBA.
To learn EVERYTHING you need to learn about functional behavioural assessments you could start at the California State webpage: http://www.pent.ca.gov/frm/forms.html
This is by far the most comprehensive site for FBAs available, and I often use these materials exclusively when providing training in behaviour management to school districts. And it's all FREE!
Often parents of children or teens see me just for psychoeducation. They are trying to implement a behaviour plan, a token or other reinforcement system, and need to know exactly how it's done. This, by the way, is covered under your provincial funding for children with autism.
But one place parents often fall down is keeping a child or teen connected with a behavioural therapist or psychologist over the long term, someone they develop a relationship with, feel free to talk to, and who can teach social learning skills over a long period of time. Often I see children or teens, after an initial emergency is over, for an extended period, but only sporadically. We stay in touch to make sure things are going well, and so that I can continue to monitor school programs and deal with issues before they become major problems again.
Some of this takes ppace within the context of what might be called "play therapy," as we play, and talk about feelings, emotional issues and work through them as we engage in activities that are distracting enough to make the child comfortable with the process.
Usually we try to also follow a structured curriculum such as Michelle Winner's "Superflex" curriculum, or one of her other books that are addressed to older teens and young adults.
While I am familiar with ABA, Floor Time and many other behavioural interventions, high functioning teens and young adults with Asperger's or Autism Spectrum Disorder have a high rate of co-morbid disorders such as depression, anxiety or learning disabilities. And...ADHD. These are issues we address together.
CBT or "Cognitive Behavior Therapy" is one of the many wys we teach skills and address issues successfully. CBT is very similar to therapies and skills children with autism spectrum disorder are exposed to in many school programs, such as The Incredible 5-Point Scale and other emotional regulation programs.
For more information please visit my webpage at www.relatedminds.com or http://www.relatedminds.com/autism/
Feel free to contact me to discuss the services I provide. I am happy to answer any of your questions.
Showing posts with label Behaviour Interventionist. Show all posts
Showing posts with label Behaviour Interventionist. Show all posts
Thursday, June 9, 2016
Monday, March 7, 2016
Behaviour Interventionist Burnaby / Vancouver
I provide behaviour interventionist services in my Burnaby office for individuals with autism spectrum disorder (ASD and Asperger's disorder. I am a member of the ACT (Autism Community Training) RASP list and my services are covered under minsitry funding programs for children and teens.
Most of my services are focused on specific behavioural problems which parents and consultants are having a hard time dealing with. I provide parent training, consultation and some school based training and consltation. I have workd as the behaviour management specialist for several school districts and as a provincial autism consultant through the Provinical Outreach Program for Autism and Related Services (POPARD). I am deeply familiar with school based programs and have supervised and cnsulted with many professionals in local districts.
Two other things that I provide in my pracritce:
First, I provide autism diagnosist services. If you suspect your child has autism an appointment can usually be set up within 10 days to 2 weeks. I prioritize my cases with individuals with autism spectrum disorder because I am aware how few services there are here in BC. Please visit my website for more information on arranging an appointment for an autism diagnostic consultation. I require an initial 1 hour session to discuss current symptoms and history. The cost of this session is $175.00 and this is part of the overall costs if we decide to move forward with testing.
I also see children and teens in my office for individual therapy. This therapy usually is focused on issues of communications and follows the structure of interventions you will find in the work of Michelle Winner ( Social Thinking). Often these sessions include a period of play therapy, some didactic training and skills development, and then a period of feedback with parents so that they will understand the process and be able to impliment supportive skills trainng in the home.
In addition to diagnosising and providing therapy for autism spectrum disorder / Aspegers disorder, I also focus much of my practice on ADHD and executive dysfunction issues. These are often co-morbid with a diagnosis of ASD.
Finally, I not only provide autism spectrum disorder services to children and teens, but also to adults as well, and see patients from across the lifespan.
Please visit my website at www.relatedminds.com or http://www.relatedminds.com/autism and contact me if you have any questions I can help you with.
Most of my services are focused on specific behavioural problems which parents and consultants are having a hard time dealing with. I provide parent training, consultation and some school based training and consltation. I have workd as the behaviour management specialist for several school districts and as a provincial autism consultant through the Provinical Outreach Program for Autism and Related Services (POPARD). I am deeply familiar with school based programs and have supervised and cnsulted with many professionals in local districts.
Two other things that I provide in my pracritce:
First, I provide autism diagnosist services. If you suspect your child has autism an appointment can usually be set up within 10 days to 2 weeks. I prioritize my cases with individuals with autism spectrum disorder because I am aware how few services there are here in BC. Please visit my website for more information on arranging an appointment for an autism diagnostic consultation. I require an initial 1 hour session to discuss current symptoms and history. The cost of this session is $175.00 and this is part of the overall costs if we decide to move forward with testing.
I also see children and teens in my office for individual therapy. This therapy usually is focused on issues of communications and follows the structure of interventions you will find in the work of Michelle Winner ( Social Thinking). Often these sessions include a period of play therapy, some didactic training and skills development, and then a period of feedback with parents so that they will understand the process and be able to impliment supportive skills trainng in the home.
In addition to diagnosising and providing therapy for autism spectrum disorder / Aspegers disorder, I also focus much of my practice on ADHD and executive dysfunction issues. These are often co-morbid with a diagnosis of ASD.
Finally, I not only provide autism spectrum disorder services to children and teens, but also to adults as well, and see patients from across the lifespan.
Please visit my website at www.relatedminds.com or http://www.relatedminds.com/autism and contact me if you have any questions I can help you with.
Sunday, April 27, 2014
Behavioural Interventionist and Visual Supports for Children with Aserger's Disorder
So, parents are always arguing for classroom aide, a paraprofessional, to work with their child. And they often want that assistant there ALL the time. But there is a problem with this, actually a few. See if you can tell what the problem will be from the old cartoon I often show parents to explain the issue.
Heres number 1: Your child should be getting his or her cues from a couple of places in the classroom environment. Often teacher aides become the only place they look. Where should the social cue come from? First, the classroom teacher. And second, other students. When I do my observations in a school I pay close attention to the number of cues a child picks up, and usually the number from the teacher, other students or the white board or classroom schedule is near zero. Almost all of the social cues, what to do when, are obtained from the teacher aide.
This is why as a behavioural consultant I push the use of visual prompts and cues over verbal prompts and cues. Verbal prompts end up being requested, they end up being waited for, and students end up reliant on verbal prompts. "Use visual prompts - point, and stop talking so much," is my usual advice. Yes, I know we want students with ASD and Aspegers to talk more and give eye contact, but you need to be careful. The eye contact becomes a prompt for the teacher aide to tell the student what to do. Look at the cartoon. Got it?
Here is an example: The bell rings for recess (environmental cue ...a big one!), the teacher says, "Let's get our desks cleaned up and line up..." (another Massive prompt here, but regretfully not from where the student is use to looking. He or she usually looks to his classroom aide for prompts!) At this point the other students all start to put their coats on for recess. (a GIANT social cue). But what is this a prompt to do? The student sees the other students getting their coats on and turns ......to his aide!!!!!! At that point she says, "Now lets get your coat on."
READ THE CARTOON. See what happened?
This is why its necessary to occasionally have your behavioural interventionist go to the school and observe what's going on. In most professions observation and feedback is a critical part of quality control, but who is doing that for the teacher aide? The teacher? I don't think most teachers have the behavioural expertise to take on that task.
So, that's that. All of this could have been avoided by using the classroom aide (the schools behavioural interventionist) use visual supports to guide the student, not to getting things done, but to learning how and where to find social prompts as to what is going on and what I should be doing. The aim of a support person is to teach skills that lead to independence, not get todays math done or your child's coat put on. Independence comes through learning to use environmental and social prompts to navigate the world.
Besides that, the cartoon is funny. Just so typical, right?
For information of behavioural interventions services, autism diagnosis and treatment that Dr. Roche provides please visit his website at www.relatedminds.com
Friday, March 7, 2014
Asperger's Disorder, Autism and Visual Supports
One of the key features of autism interventions for children, adolescents and adults are visual support systems. These range from visual schedules to visual prompts and cues, hand signals and reminder notes. Visual supports are critical to success with young people with autism, but regretfully they are one of the first things that teachers, aides and parents want to drop because they feel their student or child no longer needs such supports. This, most of the time, is a mistake.
Today on my way to the office I checked my fridge for any notes from family members, checked my calendar (yes, in spite of the fact I have a Mac and every program know for schedules etc I use a paper calendar to maintain my daily schedule) and then checked a short to do list at the office, a list of things I didn't complete yesterday. On the way to work there were road signs telling me to switch lanes, and someone actually holding a bright orange and yellow sign, waving it, tell me and everyone else to "slow down."
Amazingly there seems to be an attitude that as soon a a student begins to write, or as soon as they speak fluently they no longer need these visual support systems you and I seem to need every day. I often urge parents to maintain visual prompts and cues because when a problem does come up, and having had several teenagers myself I know problems come up, you need a system to use to correct the problem, to teach new skills and to reinforce those skills. If you already have a system in place you are using you don't need to invent a new support/intervention method while addressing the new crisis. And childhood, teen years and early adulthood are full of these crisis moments!
My answer to parents who wonder when to give up visual supports is: Never! You change them, make them more age and socially appropriate and rework them and focus on using them to generalize new behaviours, but don't give up a good tool that you could use later on.
Schools especially seem to give up visual supports, especially when an aide is assigned to a student. Often the aide will say, "Well, he talks to me and asks questions so I don't think we need those. Besides, he needs to learn to ask questions and talk more." This is not true. Children who use visual supports use more language, and when it comes to a choice of a visual support or a verbal prompt from a classroom aide I would usually suggest sticking to the visual support." The visual support should be reminding the student to look to his or her environment to get social cues as to what is going on, and what we are doing next. An aide often stands in the way of that behaviour by providing constant verbal cues or prompts. I can't tell you how many times I've gone into a classroom and seen a student with a high IQ, very aware, sitting while other students get their coats on...waiting for the prompt of cue from the aide rather than looking at the schedule, looking at and listening to the teacher or simply watching what all the other students are doing - putting on their coats. The behavioural process becomes - other students are putting on their coats to go to the playground - that means I should turn to my aide and wait for her to tell me to - "put on your coat!" Students become overly reliant on verbal prompts, and maintaining visual prompts can help avoid that.
Visual supports remain a critical part of any person's life, and it sometimes seems odd that we withdraw these supports so quickly from individuals with Asperger's and autism. Some places to find information on visual supports are:
http://autismdigest.com/visual-strategies-valuable-support-at-any-age/
POPARD, the Provincial Outreach Program for Autism and Related Disorders also has several great handouts and videos on using visual supports: http://www.autismoutreach.ca/assets/30visual.pdf
This article: 30 Reasons to Use and Keep Using a Visual Schedule or "Please don't take my visual schedule away," is a great resource for teachers, or parents who have to convince a teacher to maintain visual supports.
Finally, a lot of times visual supports are stopped because they seem to stop working, things get complicated and confusing for staff who don't have a lot of training in behavioural interventions, and rather than fix something that doesn't seem to work they just stop using the system. This sometimes happens with very young children as teachers or parents become frustrated as students seem to object to using the visual supports or seem to work against them. Well there are two great manuals on this issue EVERY teacher or parent of a child with Aspergers or autism should have:
Visual Strategies for Improving Communication and Solving Behavioural Problems in Autism by Linda A Hodgdon. These are the best books I've seen in this area in years. There are also video training programs and other support materials that go with this comprehensive program. My favourite part of these books is the chapter on using your body, hands, face, posture and so on as a visual support to get the meaning of what you are saying across to the student with Asperger's or autism, and to help them with issues such as anxiety and stress. Great book!
To sum this up - don't stop using visual supports. Learn more about them, get creative, make them more age and environmentally appropriate. We all use them and they can make a huge difference in how well anyone with Aspeger's or autism navigates the world.
For information about my practice and services I offer for children with Autism, adolescents and young adults with Asperger's and High Functioning Autism, please visit my website at: http://www.relatedminds.com or http://www.relatedminds.com/adult-autism-and-aspergers-disorder/
Today on my way to the office I checked my fridge for any notes from family members, checked my calendar (yes, in spite of the fact I have a Mac and every program know for schedules etc I use a paper calendar to maintain my daily schedule) and then checked a short to do list at the office, a list of things I didn't complete yesterday. On the way to work there were road signs telling me to switch lanes, and someone actually holding a bright orange and yellow sign, waving it, tell me and everyone else to "slow down."
Amazingly there seems to be an attitude that as soon a a student begins to write, or as soon as they speak fluently they no longer need these visual support systems you and I seem to need every day. I often urge parents to maintain visual prompts and cues because when a problem does come up, and having had several teenagers myself I know problems come up, you need a system to use to correct the problem, to teach new skills and to reinforce those skills. If you already have a system in place you are using you don't need to invent a new support/intervention method while addressing the new crisis. And childhood, teen years and early adulthood are full of these crisis moments!
My answer to parents who wonder when to give up visual supports is: Never! You change them, make them more age and socially appropriate and rework them and focus on using them to generalize new behaviours, but don't give up a good tool that you could use later on.
Schools especially seem to give up visual supports, especially when an aide is assigned to a student. Often the aide will say, "Well, he talks to me and asks questions so I don't think we need those. Besides, he needs to learn to ask questions and talk more." This is not true. Children who use visual supports use more language, and when it comes to a choice of a visual support or a verbal prompt from a classroom aide I would usually suggest sticking to the visual support." The visual support should be reminding the student to look to his or her environment to get social cues as to what is going on, and what we are doing next. An aide often stands in the way of that behaviour by providing constant verbal cues or prompts. I can't tell you how many times I've gone into a classroom and seen a student with a high IQ, very aware, sitting while other students get their coats on...waiting for the prompt of cue from the aide rather than looking at the schedule, looking at and listening to the teacher or simply watching what all the other students are doing - putting on their coats. The behavioural process becomes - other students are putting on their coats to go to the playground - that means I should turn to my aide and wait for her to tell me to - "put on your coat!" Students become overly reliant on verbal prompts, and maintaining visual prompts can help avoid that.
Visual supports remain a critical part of any person's life, and it sometimes seems odd that we withdraw these supports so quickly from individuals with Asperger's and autism. Some places to find information on visual supports are:
http://autismdigest.com/visual-strategies-valuable-support-at-any-age/
POPARD, the Provincial Outreach Program for Autism and Related Disorders also has several great handouts and videos on using visual supports: http://www.autismoutreach.ca/assets/30visual.pdf
This article: 30 Reasons to Use and Keep Using a Visual Schedule or "Please don't take my visual schedule away," is a great resource for teachers, or parents who have to convince a teacher to maintain visual supports.
Finally, a lot of times visual supports are stopped because they seem to stop working, things get complicated and confusing for staff who don't have a lot of training in behavioural interventions, and rather than fix something that doesn't seem to work they just stop using the system. This sometimes happens with very young children as teachers or parents become frustrated as students seem to object to using the visual supports or seem to work against them. Well there are two great manuals on this issue EVERY teacher or parent of a child with Aspergers or autism should have:
Visual Strategies for Improving Communication and Solving Behavioural Problems in Autism by Linda A Hodgdon. These are the best books I've seen in this area in years. There are also video training programs and other support materials that go with this comprehensive program. My favourite part of these books is the chapter on using your body, hands, face, posture and so on as a visual support to get the meaning of what you are saying across to the student with Asperger's or autism, and to help them with issues such as anxiety and stress. Great book!
To sum this up - don't stop using visual supports. Learn more about them, get creative, make them more age and environmentally appropriate. We all use them and they can make a huge difference in how well anyone with Aspeger's or autism navigates the world.
For information about my practice and services I offer for children with Autism, adolescents and young adults with Asperger's and High Functioning Autism, please visit my website at: http://www.relatedminds.com or http://www.relatedminds.com/adult-autism-and-aspergers-disorder/
Wednesday, January 29, 2014
Behaviour Interventionist Vancouver
Dr. Roche provides behavioural intervention services in both his Vancouver office, located near City Hall in Vancouver (corner of Yukon and 8th Ave West) and his Burnaby office. He is an approved behaviour interventionist with ACTBC (Autism Community Training - BC) and has over 20 years of experience providing behavioural interventions and treatment planning for children, adolescents and adults with autism spectrum disorder and Aspeger's disorder, as well as other cognitive dysfunctions. Dr. Roche specializes in providing behavioural training to parents and schools and has worked with parents, teachers and other professionals throughout the province as a provincial autism outreach worker. As an approved behavioural interventionist he is able to accept provincial payments for his services.
Dr. Roche also provides comprehensive diagnostic assessments for children, adolescents and adults who are suspected to have autism. This includes psychoeducational assessments for use in the schools to develop IEPs (Individual Education Plans) and behaviour management plans.
Please use the contact form on the home page of the website to contact Dr. Roche and make an appointment for assessment, counselling or therapy in either his Vancouver or Burnaby office.
Please visit my web page at www.relatedminds.com for more information.
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