There is no doubt about the level of stress that a diagnosis of autism, or other developmental disabilities, can place on a family, as well as the individual diagnosed. However, there are numerous service providers educated and trained to be able to assess and provide intervention for those people and their families.
Many people stare in bewilderment when one presents themselves as a “behavior analyst,” where in truth such a lofty title can be broken down as someone who assesses the behavioral excesses and deficits of an individual and, if tasked to, designs interventions to help support that individual, as well as their families and caregivers. In today’s society, behavior analysts have come to be known as those who work with children diagnosed with autism, although this can be expanded to include individuals diagnosed with a variety of developmental disabilities, and broadened even further to people with behavioral needs of any kind.
While some may have misconceptions about what the field of Applied Behavior Analysis (ABA) actually aims to accomplish, others aren’t clear about what a behavior analyst or behavior therapist actually does. This process begins when an assessment of the individual is referred to the behavior analyst, typically through a funding source such as an insurance company, a Regional Center, a school district or privately. There are several objectives of a behavioral assessment, that may vary depending on the person’s level of deficit and living situation. However, in general, although age, gender and diagnosis are vital factors to take into account during the assessment process, the behavior analyst is looking for the following:
- What behavior excesses are present, such as aggression, self-injurious behaviors or stereotypic behaviors;
- What behavior deficits exist, such as a lack of communication, daily living or social skills;
- What the family or caregiver’s primary areas of concerns are;
- In some cases, what the individual themselves deems to be his or her areas of need.
Each of these tasks are accomplished through a variety of means including, but limited to, the following:
- Interview with primary caregivers;
- Interview with additional service providers such as teachers, speech therapists, occupational therapists etc.;
- Direct observations of the individual in their natural environment, including home, school, play groups, job site, group home etc.;
- Direct interactions with the individual in their natural environment, either through interview, play or probing of current skill set;
- Assessment tools and surveys to measure areas of need, such as adaptive skill level and language development;
- Record review of previous and current service providers.
While this may seem like a broad list of objectives, in reality the assessment process follows a comprehensive rubric that must be adapted to each individual and their caregiver’s specific needs. An assessment of a non-vocal, 4-year old girl with autism is going to be approached differently when compared to an assessment of a 25-year old man with Down’s Syndrome, even though in both cases the assessor will be following each of the tasks outlined above.
The difference ultimately lies with what information the assessor gleans from interviews with the caregivers and service providers to ascertain what the major concerns in the present day are and what their long-term goals for their child may be. For example, in the case of the hypothetical, non-vocal, 4-year old girl with autism, a parent’s top goals may be to decrease levels of physical aggression towards her mother, increase functional communication skills and prepare her for integration into a school setting. On the other hand, the top goals for the 25-year old man with Down’s Syndrome may be to improve his self-care and hygiene skills, teach him money exchange in community settings and to ultimately prepare him for employment at a local library.
The assessor will then attempt to determine where the individual’s current skill level, or baseline, lies for each of the goals specified by their caregivers, as well as potential other goals for that individual. All of this information will then be outlined in a report including background information on the individual, an overview of information and data garnered from the assessment process, results of any assessment tools utilized, a list of goals for both the individual and their caregivers and a recommendation of service hours, or how many direct and indirect hours of therapy and supervision are deemed necessary to achieve the goals listed in the report, if applicable.
Approximately 500,000 children diagnosed with autism will be turning 21 and thereby legally entering adulthood in the next decade, and with the renewal of the Autism CARES Act in 2014, more and more individuals diagnosed with special needs, from childhood to adulthood, are gaining access to personalized care and support that used to be a feat to attain. The most vital goals of the assessment and therapy process are to help provide the needed support for people diagnosed with special needs and collaborate with families and caregivers in order to foster independence, decrease dependence, improve quality of life for all involved and facilitate integration into society as a whole.