Department of Applied Behavior Analysis
Program Director: Matt DeLaney, MSW, BCBA
About Our Program
The mission of the Department of Behavior Analysis is to provide consultation and intervention to caregivers of children with a wide variety of developmental disorders (pervasive development disorders spectrum, intellectual disabilities). Intervention focuses on empirically based approaches to behavior management and addresses both behavioral excesses (aggression, self-injury, tantrums) and behavioral deficits (compliance, self-help skills, toileting). For children with language delays and behavior disorders, strong emphasis is placed on providing training to develop verbal behavior (vocal and/sign language/augmentative communication devices). Sessions are conducted primarily in the clinic, but also take place in the school and home, when indicated. Education of the caregivers is also considered an integral function of the program.
The program emphasizes working with your child as part of a team. The “team” may include as few people as your child and you as the parents/caregivers, or it may extend to a group of behavior therapists and other interdisciplinary providers such as speech and language pathologist, occupational therapist, feeding therapist, etc.
Applied Behavior Analysis (ABA) therapy is a systematic teaching approach based on B.F. Skinner’s analysis of behavior and the subsequent contributions of other behavior analysts. ABA focuses on changing behavior in socially significant ways to improve the lives of the children and families who seek ABA services.
We offer ABA therapy for children in a variety of settings including in the home, clinic, community and schools. Therapy is individualized to each child based on an initial assessment (ABLLS-R, VB-MAPP, AFLS, essentials for living, functional assessments of problem behaviors, etc.) and continually modified based on the child’s progress.
Our Professional Team
All of Keystone’s therapists hold at least a bachelor’s degree and have completed specialized training in ABA training. Therapists continuously receive training in techniques that reflect best practice for the field through Keystone’s customized competency-based training system. Ongoing supervision is provided by a master’s- or doctoral-level Board Certified Behavior Analyst® for your child’s initial assessment, skill acquisition programming, behavior plan development and programming/plan updates.
We have clinicians specializing in early intervention, behavior management, social skills programming, verbal behavior programming, adaptive living skills, parent coaching and school consultation.
Early intervention focuses on children from infancy to kindergarten age with special needs affecting their development. The purpose of early intervention is to take advantage of these critical years in a child’s development. Using ABA principles, early intervention aims to help your child in reaching goals created specifically for their needs to gain developmentally appropriate language and learning skills. Early intervention programs prepare your child for the transition to school-based learning with the objective of entering into the least restrictive environment possible.
Behavior management focuses on reducing dangerous and/or disruptive behaviors. Children may attend regular sessions or day treatment for more intensive cases. This program addresses behavioral concerns that are affecting school placement, as well as challenging behaviors that are significantly impacting the child’s ability to function in the home or in community settings. The following challenging behaviors are frequently addressed:
- Self-injurious behavior
- Disruptive/dangerous behaviors
- Property destruction
- Elopement (running away from caretakers)
- Pica (ingesting inedible objects)
- Inappropriate sexual behavior
The goal of treatment is to identify the environmental variables contributing to the challenging behavior in order to reduce the frequency/severity/magnitude of the challenging behavior. Clinicians focus on determining socially appropriate replacement behaviors for the challenging behavior(s). Treatment strategies are determined on an individual basis depending on your child’s needs, assessment results and any other environmental variables that effect treatment decisions (family structure, classroom structure, medical concerns, etc.). Once the treatment team determines appropriate and effective interventions for the challenging behaviors, caretakers are trained to use the interventions in a variety of settings.
Day treatment intensive services are typically provided for a minimum of four to five hours a day due to the ongoing safety concerns that result from a child’s challenging behaviors. Your child may require a physician’s note that outlines the necessity of these services in order to maintain eligibility for Florida’s McKay scholarship program, especially if a modified school day is deemed to be clinically necessary.
Social skills services provide treatment to children and adolescents who have deficits including, but not limited to, establishing peer relationships, sharing items, reciprocating conversations, appropriately using non-verbal cues receptively and expressively, difficulty with receptive and expressive use of non-verbal clues, engaging with toys appropriately, initiating peer interactions, understanding humor/jokes and predicting and understanding emotions. Teaching pro-social behavior is linked to positive developmental outcomes such as peer acceptance, academic achievement and reduction in problem behaviors in social settings. Treatment provides children and adolescents opportunities to learn skill sets necessary to navigate the social world.
Verbal behavior programs are frequently a critical component of an ABA program and incorporate current research combined with the functions of language to assess and teach verbal milestones. Verbal behavior (VB), a term introduced by B.F. Skinner in his 1957 book, Verbal Behavior, is defined as “any behavior mediated by a listener.” In other words, language is behavior and can be taught and reinforced using highly effective teaching procedures, such as error-less teaching, prompting and discrete trial training. Keystone’s verbal behavior programming focuses on teaching your child to realize that appropriate functional language will get your child what your child wants when your child wants want it.
Children with developmental delays may engage in problem behaviors because they have no way of expressing their thoughts, needs and wants. As a team, it is our priority to create an effective treatment plan that will develop the communication process and facilitate its growth. Our primary goal is to give children a way to communicate by devising programming that is individualized to each child’s unique learning style. For children who are less vocal, the Picture Exchange Communication System (PECS) protocol, American Sign Language (ASL), and even technological resources like Proloquo, DynaVox and ipads can be utilized for communication.
Upon completion of a verbal behavior assessment, learning objectives are selected based on your child’s current level of ability. Verbal behavior skills are identified through a variety of skills assessments, including:
- Assessment of Basic Learning and Language Skills – Revised (ABLLS-R)
- Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP)
- Early Start Denver Model (ESDM)
A child’s verbal behavior goals are then taught by utilizing both Natural Environment Teaching (NET) and Intensive Table Teaching (ITT) techniques. During each 1:1 therapy session, data is collected on skill acquisition and target behavior objectives. Behavior analysts work collaboratively with each child’s family, teachers and other team therapists through team meetings, school consultation and shadowing and parent collaboration meetings. This collaborative team approach ensures that a child’s goals are being met and generalized across school, home and community environments.
Adaptive Living Skills
Keystone offers adaptive living skill training for children in a variety of formats and settings to address a wide range of deficits. Adaptive living skills refer to those behaviors that are needed for an individual to function safely, independently and appropriately on a daily basis. Common adaptive living skills addressed in treatment include toileting, grooming, dressing, meal time behavior, kitchen and cooking, housekeeping and chores, safety, money management, community knowledge, shopping, meal time behaviors in public, phone skills, time skills, social awareness, time management, planning, study skills and organizational skills. Keystone utilizes a variety of assessments to evaluate adaptive living skills, some of which are questionnaires completed by parents, caregivers, teachers, therapists, other providers and/or the client; assessments completed by the therapist; and observations of adaptive living skills. The goal of adaptive living skills training is to increase independence, to increase caregiver knowledge and ability to help generalize skills and to apply adaptive skills across settings and caregivers.
Parent coaching is a unique part of the treatment package. Parent collaboration provides a way for your child’s therapists to directly coach you on how to utilize behavior analytic techniques in the home and community settings. These sessions not only allow you to have the opportunity to receive direct feedback from your child’s therapist, but also encourage you to take an active therapeutic role in your child’s progress. Similar to beginning a new fitness routine, you cannot expect to get ideal results from just one or two hours a week of hard work. Parent coaching provides the opportunity for consistency, treatment integrity and promoting generalization of important life skills. Our philosophy maintains that parents/caregivers are the primary therapists in a child’s life.
Keystone provides consultation services to school districts seeking assistance with Individualized Education Plans (IEP) and behavior management difficulties. Clinicians work closely with the school to select appropriate goals for students, as well as to provide assistance with writing and presenting IEPs. Keystone clinicians also assist the school by conducting Functional Behavior Assessments (FBA) and writing Behavior Treatment Plans (BTP). FBAs consist of indirect assessments and direct assessments. Examples of indirect assessments include parent/teacher interviews, standardized behavior rating scales and questionnaires. Examples of direct assessments include direct observations of the student in the classroom and ABC data collection. The results of the FBA are then used to write an individualized BTP. Teachers and aides are trained on the BTP by clinicians and then provided with supervision and feedback as they implement it. In addition, Keystone also offers district-wide trainings in applied behavior analysis.
Endorsement of ABA
Surgeon General Endorses Behavioral Intervention for Autism
United States Surgeon General David Satcher, MD, PhD, has endorsed intensive behavioral intervention for individuals with autism. “Mental Health: A Report of the Surgeon General” states, “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior.”
The report is available at National Library of Medicine’s Profiles in Science.
The report can also be ordered by calling 1-877-9MHealth, or by writing to Mental Health, Pueblo, CO 81009.
The following organizations endorse ABA as a scientifically proven approach for treating children with autism and related disorders: American Academy of Neurology, American Academy of Family Pediatrics, American Academy of Pediatrics, American Academy of Occupational Therapy Association, American Psychological Association, American Speech-Language Hearing Association, Society for Developmental and Behavioral Pediatrics, Autism Society of America, National Alliance for Autism Research, National Institute of Child Health & Human Development and the National Institute of Mental Health.
- What to Expect from ABA Therapy
- National Autism Standards
- Association of Professional Behavior Analysts
- Florida Association for Behavior Analysis
- National Dissemination Center for Children with Disabilities
- Integration of Resources for Families with Disabilities
- Children with Special Health Care Needs Knowledge Path
- American Psychological Association
- National Brain Injury Association
- The Association for Behavior Analysis
- American Association on Mental Retardation
- The Association for Advancement of Behavior Therapy
- Cambridge Center for Behavioral Studies
- The Journal of Applied Behavior Analysis
- ABA Guidelines for ASD