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Downlo ism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first two years of life.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a guide created by the American Psychiatric Association that health care providers use to diagnose mental disorders, people with ASD often have:
Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience.
People of all genders, races, ethnicities, and economic backgrounds can be diagnosed with ASD. Although ASD can be a lifelong disorder, treatments and services can improve a person’s symptoms and daily functioning. The American Academy of Pediatrics recommends that all children receive screening for autism. Caregivers should talk to their child’s health care provider about ASD screening or evaluation.
What are the signs and symptoms of ASD?
The list below gives some examples of common types of behaviors in people diagnosed with ASD. Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below.
Social communication and social interaction behaviors may include:
Restrictive/repetitive behaviors may include:
People with ASD also may experience sleep problems and irritability.
People on the autism spectrum also may have many strengths, including:
What are the causes and risk factors for ASD?
Researchers don’t know the primary causes of ASD, but studies suggest that a person’s genes can act together with aspects of their environment to affect development in ways that lead to ASD. Some factors that are associated with an increased likelihood of developing ASD include:
Not everyone who has these risk factors develops ASD.
How is ASD diagnosed?
Health care providers diagnose ASD by evaluating a person’s behavior and development. ASD can usually be reliably diagnosed by the age of 2. It is important to seek an evaluation as soon as possible. The earlier ASD is diagnosed, the sooner treatments and services can begin.
Diagnosis in Young Children
Diagnosis in young children is often a two-stage process.
Stage 1: General Developmental Screening During Well-Child Checkups
Every child should receive well-child checkups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics recommends that all children receive screening for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits, with specific autism screenings at the 18- and 24-month well-child visits. A child may receive additional screenings if they are at high risk for ASD or developmental problems.
Considering caregivers’ experiences and concerns is an important part of the screening process for young children. The health care provider may ask questions about the child’s behaviors and evaluate those answers in combination with information from ASD screening tools and clinical observations of the child. To learn more about ASD screening tools, visit the Centers for Disease Control and Prevention (CDC) website .
If a child shows developmental differences in behavior or functioning during this screening process, the health care provider may refer the child for additional evaluation.
Stage 2: Additional Diagnostic Evaluation
It is important to accurately detect and diagnose children with ASD as early as possible, as this will shed light on their unique strengths and challenges. Early detection also can help caregivers determine which services, educational programs, and behavioral therapies are most likely to be helpful for their child.
A team of health care providers who have experience diagnosing ASD will conduct the diagnostic evaluation. This team may include child neurologists, developmental behavioral pediatricians, speech-language pathologists, child psychologists and psychiatrists, educational specialists, and occupational therapists.
The diagnostic evaluation is likely to include:
Because ASD is a complex disorder that sometimes occurs with other illnesses or learning disorders, the comprehensive evaluation may include blood tests and a hearing test.
The outcome of this evaluation may result in a formal diagnosis and recommendations for treatment.
Diagnosis in Older Children and Adolescents
Caregivers and teachers are often the first to recognize ASD symptoms in older children and adolescents who attend school. The school’s special education team may perform an initial evaluation and then recommend that a child undergo additional evaluation with their primary health care provider or a health care provider who specializes in ASD.
A child’s caregivers may talk with these health care providers about the child’s social difficulties, including problems with subtle communication. These subtle communication differences may include problems understanding tone of voice, facial expressions, or body language. Older children and adolescents may have trouble understanding figures of speech, humor, or sarcasm. They also may have trouble forming friendships with peers.
Diagnosis in Adults
Diagnosing ASD in adults is often more difficult than diagnosing ASD in children. In adults, some ASD symptoms can overlap with symptoms of other mental health disorders, such as an anxiety disorder or attention-deficit/hyperactivity disorder (ADHD).
Adults who notice signs and symptoms of ASD should talk with a health care provider and ask for a referral for an ASD evaluation. Although evaluation for ASD in adults is still being refined, adults can be referred to a neuropsychologist, psychologist, or psychiatrist who has experience with ASD. The expert will ask about:
The evaluation also may include a conversation with caregivers and other family members to learn about the person’s early developmental history, which can help ensure an accurate diagnosis.
Obtaining a correct diagnosis of ASD as an adult can help people understand past challenges, identify personal strengths, and find the right kind of help. Studies are underway to determine the types of services and supports that are most helpful for improving the functioning and community integration of autistic transition-age youth and adults.
What treatment options are available for ASD?
Treatment for ASD should begin as soon as possible after diagnosis. Early treatment for ASD is important because proper care and services can reduce individuals’ difficulties while helping them learn new skills and build on their strengths.
People with ASD may face a wide range of issues, which means there is no single best treatment for ASD. Working closely with a health care provider is an important part of finding the right combination of treatments and services.
Medication
A health care provider may prescribe medication to treat specific symptoms. With medication, a person with ASD may have fewer problems with:
Behavioral, Psychological, and Educational Interventions
People with ASD may be referred to health care providers who specialize in providing behavioral, psychological, educational, or skill-building interventions. These programs are typically highly structured and intensive, and they may involve caregivers, siblings, and other family members. These programs may help people with ASD:
📘 Download PDF Autism Spectrum Disorder
Credentials of the Medical Staff at Children’s Love CORP
The medical staff at Children’s Love CORP are required to maintain up-to-date certifications and credentials to ensure the highest standards of care and compliance. Below is a detailed list of the required courses, their renewal periods, and additional mandatory documents:
Mandatory Certifications and Renewal Periods:
1. RBT or Lead Analyst License
• Must be up to date.
2. HIV/AIDS Certification
• Renewal: Every 1 year.
3. HIPAA Compliance Certification
• Renewal: Every 1 year.
4. CPR and First Aid Certification
• Renewal: Every 2 years.
5. Zero Tolerance Training
• Renewal: Every 3 years.
6. DCF Child Care Credential (DCCC)
• Valid for life.
7. Security Awareness Training
• Renewal: Every 1 year.
8. Civil Rights Training
• Renewal: Every 1 year.
9. Domestic Violence Training
• Renewal: Every 1 year.
10. OSHA Certification
• Renewal: Every 1 year.
11. Physical Exam
• Renewal: Every 1 year.
Additional Mandatory Documents:
1. Police Record Check
• Renewal: Every 1 year.
2. Liability Insurance
• Must be up to date.
This ensures that all team members are qualified, well-trained, and compliant with both industry standards and legal requirements.
In the field of Applied Behavior Analysis (ABA), teams are typically composed of different roles, each with specific functions. Here’s an overview of the main roles and their responsibilities:
1. RBT (Registered Behavior Technician)
• Main Function: Directly implement behavioral interventions designed by a behavior analyst.
• Responsibilities:
• Work one-on-one with clients (usually children or adolescents) to teach skills and reduce challenging behaviors.
• Collect and record data on client progress.
• Follow the intervention plan developed by the BCBA or BCaBA.
• Maintain professional ethics and confidentiality as outlined by the BACB (Behavior Analyst Certification Board).
2. BCaBA (Board Certified Assistant Behavior Analyst)
• Main Function: Supervise and assist in the implementation of ABA programs under the guidance of a BCBA.
• Responsibilities:
• Design some intervention programs (always under the supervision of a BCBA).
• Supervise and train RBTs in their tasks.
• Assist in data collection and analysis to evaluate program effectiveness.
• Conduct periodic reviews of intervention plans to ensure their effectiveness.
• Collaborate with parents or caregivers to teach strategies and behavioral management techniques.
3. BCBA (Board Certified Behavior Analyst)
• Main Function: Independently design, implement, and supervise ABA intervention programs.
• Responsibilities:
• Assess the client to identify needs and behavioral goals.
• Develop personalized intervention plans based on ABA principles.
• Supervise BCaBAs and RBTs to ensure interventions are implemented correctly.
• Analyze the data collected by the team to adjust programs as needed.
• Provide training to parents, caregivers, and educators on ABA strategies.
• Ensure all practices adhere to the ethical standards established by the BACB.
Team Collaboration
• The BCBA leads the team, ensuring that programs are effective and ethical.
• The BCaBA acts as direct support for the BCBA and as an intermediate supervisor for the RBTs.
• The RBTs are on the front line, implementing the plans and collecting essential data to evaluate progress.
Together, they work to improve the client’s quality of life by using evidence-based interventions to promote skills and reduce problematic behaviors.
Advantages of Different Settings for Delivering ABA Therapy
ABA therapy is essential for developing skills in children, especially those related to academic, social, and emotional activities. Implementing it in various settings can maximize benefits and ensure the generalization of learned skills.
1. At Home (In-Home Therapy):
• Provides a familiar and comfortable environment, ideal for children who need a sense of security during therapy.
• Facilitates teaching daily routines and functional skills in a natural context.
• Promotes active involvement of parents and caregivers, strengthening support at home.
• Helps reduce challenging behaviors directly in the environment where they occur.
2. At School:
• Integrates therapy with academic activities, enhancing learning and behavior in the classroom.
• Supports the development of social skills through peer interaction.
• Collaborates with teachers to adapt strategies that foster the child’s educational progress.
• Assists the child in transitioning between activities and school environments, encouraging autonomy.
3. In Childcare Centers (Daycare):
• Introduces the teaching of functional and social skills in a group setting.
• Supports the child in adapting to daily routines, such as schedules, meals, and structured play.
• Encourages participation in group activities and the development of cooperative skills.
• Provides a safe and structured environment for early learning.
4. In After-School Programs:
• Reinforces academic and social skills in a relaxed and enriching environment.
• Offers opportunities to practice collaborative activities, such as sports or group projects.
• Provides a space to work on time management and self-regulation skills.
• Enhances social interaction in less formal settings than the classroom.
5. In the Community:
• Promotes the generalization of functional skills, such as communication and personal safety.
• Helps the child navigate public settings, such as parks, stores, or restaurants.
• Encourages independence through practical activities like shopping or using public transportation.
• Reinforces learned skills in real-life contexts, strengthening their everyday application.
The Importance of ABA Therapy in Academic Development
ABA therapy plays a crucial role in developing skills related to academic activities by:
• Improving the child’s attention and focus on school tasks.
• Encouraging communication skills that facilitate interaction with teachers and peers.
• Teaching emotional regulation and behavior management strategies for better classroom performance.
• Strengthening pre-academic skills, such as following instructions, recognizing patterns, and completing tasks.
Implementing ABA in diverse settings helps children develop essential skills not only for school but also for daily life, empowering them to reach their full potential.
ABA therapies are not free, but in many cases they are covered by health insurance, especially for children with a diagnosis of Autism Spectrum Disorder (ASD). However, it is important to note that coverage and associated costs depend on the health plan you have purchased.
Health Insurance Coverage
• Most health insurance plans in South Florida cover ABA therapies due to their effectiveness in treating ASD and other related conditions.
• Companies such as Oscar, Aetna, United Health Care, Blue Cross Blue Shield, Cigna, Magellan and more often include coverage for ABA in their plans.
• Florida laws require many insurance plans to cover ABA therapies as part of essential services for individuals diagnosed with ASD.
Copayments or additional costs
Although health insurance may cover most of the cost of therapies, in some cases, you may have to pay a copayment or a portion of the cost, depending on:
1. The insurance plan: Some plans have higher copayments or deductibles that must be met before insurance begins to pay.
2. The provider network: It is important to make sure that the ABA clinic or therapist is within your insurance network to minimize additional costs.
3. Other additional services: If specific assessments or additional support are required that are not included in your plan, they could incur extra costs.
Recommendations
• Carefully review your insurance policy to understand what portion of the cost is covered and if there are applicable copayments or deductibles.
• Check with the ABA provider and your insurer to make sure that all services are eligible under your plan.
• If you have Medicaid, ABA therapies are fully covered at no additional cost.
With this information, you can ensure that you are making the most of your insurance coverage and receiving the services necessary to support your child's development.
To access ABA therapies, be sure to gather the following essential documents, plus some additional ones that may be required depending on the provider and health insurance.
1. Referral for ABA therapies:
• Official document issued by a primary care physician, pediatrician, or specialist recommending ABA therapy as a necessary treatment.
2. Diagnosis or evaluation from a specialist:
• Formal diagnosis from a qualified professional, such as a:
• Neurologist.
• Psychologist.
• Psychiatrist.
• This must indicate a disorder treatable with ABA, such as Autism Spectrum Disorder (ASD) or another developmental disorder.
3. Health insurance:
• Valid insurance policy that includes coverage for ABA therapies.
• Check to see if there are any co-pays, deductibles, or network restrictions applicable to your plan.
4. Other documents that may be required:
1. Letter of medical necessity:
• Issued by the child's pediatrician, confirming that ABA therapies are necessary for the treatment of the diagnosis.
2. School evaluation (IEP):
• An Individualized Education Program (IEP) that reflects the child's specific needs in the educational setting and supports the need for ABA therapies.
Applied Behavior Analysis (ABA) works on a wide variety of behaviors across different areas of life. Some of the key behaviors targeted in ABA therapy include:
1. Problematic Behaviors
Physical Aggression
• Topography: Hitting others with fists, scratching, pushing, biting, kicking, throwing objects at people.
Self-Injurious Behavior (SIB)
• Topography: Hitting one’s head with hands or against surfaces, biting arms or fingers, scratching or pinching oneself to the point of injury.
Tantrums
• Topography: Crying loudly, yelling, throwing oneself on the floor, hitting the floor or walls, kicking objects or people.
Property Destruction
• Topography: Tearing books, throwing or breaking toys, hitting walls with objects, ripping papers.
Escape or Elopement
• Topography: Running out of a room or area, hiding, pulling away from an adult’s grasp, refusing to return when called.
Disruptive Behaviors
• Topography: Throwing objects, shouting out of turn, banging on desks or tables during activities.
Motor Stereotypies
• Topography: Repeated hand-flapping, spinning objects, walking on tiptoes, rocking back and forth.
Vocal Stereotypies
• Topography: Repeating sounds (e.g., humming, growling), repeating phrases or words out of context.
2. Social Skills
Lack of Social Interaction
• Topography: Avoiding eye contact, not responding when their name is called, not initiating or engaging in play with peers.
Turn-Taking Difficulties
• Topography: Interrupting others during games, refusing to wait for their turn, grabbing toys from peers.
Group Inappropriateness
• Topography: Talking during lessons without raising a hand, touching others without consent, standing too close to others.
Resistance to Change
• Topography: Insisting on routines (e.g., arranging items in a specific order), becoming upset or crying when routines are disrupted.
4. Daily Living Skills
Feeding Difficulties
• Topography: Refusing to use utensils, eating with hands, throwing food, stuffing too much food in their mouth.
Hygiene Skills
• Topography: Resisting handwashing, not brushing teeth without help, avoiding bathing, difficulty with dressing.
Toilet Training
• Topography: Not indicating the need to use the bathroom, having frequent accidents, refusing to sit on the toilet.
Household Tasks
• Topography: Ignoring requests to clean up toys, spilling items intentionally, not following basic instructions for chores.
5. Academic Skills
Attention Deficits
• Topography: Staring away from tasks, playing with unrelated objects, talking to themselves instead of focusing.
Following Instructions
• Topography: Not following verbal commands (e.g., “sit down”), ignoring gestures or cues, needing repeated prompts to respond.
Pre-Academic Skills
• Topography: Difficulty matching or sorting shapes and colors, not recognizing letters or numbers, confusion when asked to point to items.
Writing Challenges
• Topography: Avoiding holding a pencil, scribbling instead of writing letters, difficulty copying shapes or lines.
Reading Difficulties
• Topography: Inability to identify letters or words, guessing instead of reading, not associating sounds with letters.
6. Functional Skills
Play Skills
• Topography: Playing repetitively with toys (e.g., spinning wheels on a car), not engaging in pretend play, avoiding group games.
Imitation Skills
• Topography: Not copying simple actions like clapping, waving, or pointing when modeled by others.
Motor Skills
• Topography: Difficulty jumping, running, balancing on one foot, or manipulating small objects like puzzle pieces.
7. Emotional and Self-Regulation Skills
Expressing Emotions
• Topography: Failing to identify emotions (e.g., not saying “I’m sad”), not showing facial expressions that match feelings.
Frustration Tolerance
• Topography: Screaming, throwing objects, hitting themselves or others when frustrated.
Self-Regulation
• Topography: Pacing, crying excessively, or needing external calming (e.g., adult intervention) to recover from stress.
Why Are Topographies Important?
Topographies help describe observable behaviors without assumptions about intent or motivation. This clarity allows practitioners to:
1. Accurately assess behaviors.
2. Develop measurable goals.
3. Design targeted interventions.
An assessment in the context of ABA (Applied Behavior Analysis) is a structured process to gather information about a person's skills, behaviors, and needs. Its main purpose is to identify areas of strength and need, which allows for the design of a personalized and effective intervention program.
Types of Assessment in ABA
1. Functional Behavior Assessment (FBA):
• Identifies the function of problematic behaviors (e.g., gaining attention, avoiding a task, gaining access to something, or self-stimulation).
• It is done by observing the individual, analyzing antecedents and consequences, and conducting interviews.
2. Skills Assessments:
• VB-MAPP (Verbal Behavior Milestones Assessment and Placement Program):
Assesses language milestones and social skills in children.
• ABLLS-R (Assessment of Basic Language and Learning Skills-Revised):
Measures basic learning skills and functional language.
• AFLS (Assessment of Functional Living Skills):
Assesses daily living skills, such as personal hygiene, cooking, and money management.
3. Preference Assessments:
• Identify effective reinforcers for the person (e.g., toys, food, activities).
4. Developmental Assessments:
• Compare the individual's level of development with expected standards for his or her age.
What is an ABA assessment for?
1. Identify Skills and Deficits:
• Allows understanding what skills the individual already has and which ones need to be developed, such as language, communication, social skills, or self-care.
2. Design Personalized Intervention Plans:
• Based on the results of the assessment, analysts create a program tailored to the individual's specific needs.
3. Establish Measurable Goals:
• Helps define clear and achievable objectives that will guide therapy.
4. Monitor Progress:
• Initial assessments serve as a baseline to measure the individual’s progress during the intervention.
5. Identify the Function of Problem Behaviors:
• In the case of an FBA, determine the “why” behind a behavior to design specific strategies that address the root cause.
6. Determine the Level of Support Needed:
• Helps adjust the intensity of the intervention.
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