The following description of stages of service is a general roadmap, specifically for insurance funded services. Your journey will be additionally personalized to your child including but not limited to treatment goals and service dosage.
Stage 1: Intake, Assessment,
Treatment Planning & Program Development
When starting with APPLE Consulting, intake is a crucial step in the process. It occurs after all intake paperwork is submitted and is a meeting with the parents or guardians to discuss the strengths and needs of the child. During this meeting, we take the time to get to know each other and develop a foundation of rapport and trust.
One of the main components of intake is developing three initial pivotal goals that the parent prioritizes for the child. These goals are essential in guiding us towards the best course of action for your child's development. We also use the information derived from intake and records review to drive the type of direct assessment chosen for your child. These assessments can include but are not limited to: VB-MAPP, BRIEF, ABLLS-R, AFLS, SEE, ABAS, Vineland, SSIS, and the BASC.
During intake, we also take the time to explain our service model and provide opportunities for parents to ask questions. We believe that communication is key in providing the best possible service for your child, and we want to make sure that everyone is on the same page.
At APPLE Consulting, our direct assessment process is an essential part of our programming. During this 1-2 hour session, our BCBA will assess directly with your child in a variety of domains. These include but are not limited to social skills, communication, adaptive skills, motor skills, and cognitive skills. We understand that each child is unique and may require different areas of focus. That's why we tailor our assessments to meet your child's specific needs.
During the assessment, we also focus on building rapport with your child. This is the foundation of our first overall goal in programming - for your child to feel comfortable and what we call "Happy, Relaxed & Engaged (HRE)" per Greg Hanley. We believe that when your child feels comfortable with us, they will be more likely to engage in the programming and make progress towards their goals.
Once assessments are completed and scored, a treatment plan is developed. The treatment plan, developed with feedback from parents (and other providers as applicable), contains information about your child’s current levels of functioning across a variety of domains, recommended individualized goals, service delivery method and requested frequency.
Parents are actively involved in the treatment plan development by making suggestions, reviewing drafts, and ultimately signing the final treatment plan document (indicating agreement with the plan).
Based upon the treatment plan goals, individualized programs are developed to address specifically how goals will be taught. This includes but is not limited to: instruction given, response expected, how the skill is broken down into smaller, more manageable parts, how to respond to correct and incorrect (or prevent error) responses, specific prompting methods, generalization, mastery criteria (inclusive of the Four Levels of Learning), & data collection strategy.
The programs are combined into a program binder in our practice management system that includes each goal, individualized program instructions, graph for each program, data sheets, etc. This electronic binder serves as the “curriculum” book for your child and is regularly updated, modified and analyzed.
Stage 2: Ongoing Intervention, Supervision, Data Collection/ Analysis &
Our Certified Behavior Technicians receive rigorous training prior to initial delivery of services with your child. Additionally, they have reviewed and signed your child’s treatment plan and discussed areas of need with the Clinical Supervisor
The technicians deliver the direct care to your child at the frequency and intensity recommended (and authorized by insurance) following the treatment plan goals and individualized programs developed within your child’s program binder.
At the beginning of treatment, the main goal is development of rapport and the state of HRE (Happy, Relaxed & Engaged). When positive relationships are fostered, we have a foundation of trust and mutual respect, which increases the likelihood of your child "assenting" to intervention activities you have identified as a priority for you child.
We systematically introduce more goals as your child comfort level increases so we can provide a well-rounded, mutually agreeable approach to treatment.
Family guidance sessions are an important component of our services here at APPLE Consulting. These sessions occur on a regular basis, typically ranging from once per week to twice per month. We offer the flexibility of holding these sessions in the comfort of your own home, at our clinic, or via telehealth for added convenience.
The focus of our family guidance sessions is to extend treatment plan goals to generalize to the family unit. This means that we want to ensure that the progress made during treatment is carried over into the home environment. These sessions provide an opportunity for families to troubleshoot any issues they may be experiencing and ask questions about the treatment program.
Our family guidance sessions also provide an opportunity to share progress and data. This is important because it helps us to track progress and make any necessary adjustments to the treatment plan. We believe that involving the family in the treatment process is crucial to achieving long-term success.
Our Board Certified Behavior Analysts (BCBAs) or Clinical Supervisors oversee the work of our technicians to ensure that your child receives the highest quality care possible.
At APPLE Consulting, we provide at least 10% supervision of direct care hours worked with your child. This means that for every 10 hours of direct care, your child will receive at least one hour of supervision from a BCBA or Clinical Supervisor. This level of supervision allows us to follow your child's progress closely and make changes before goals become challenges.
During supervision, the supervisor observes the technician working with your child as well as works directly with your child to problem solve goals, check for maintenance and generalization, and to probe any possible goal additions to the program. This ensures that your child's program is tailored to their specific needs and is constantly evolving as they progress.
We cannot overstate the importance of supervision in monitoring your child's progress. It allows us to catch any issues early on and make adjustments to their program as needed. It also ensures that your child is receiving evidence-based treatment that is backed by research and proven to be effective.
Data Collection & Analysis
Data collection is the cornerstone of our practice, and we believe that it is essential to objectively measure progress. Our technicians collect data daily on goals, which are then automatically graphed for the supervisors to perform visual analysis and make changes based on trends in the data.
However, our data go beyond acquisition or "80% correct." We understand that after the acquisition phase, we must address fluency, maintenance, and generalization in a data-based manner. This means that we use data to guide our clients through all Four Levels of Learning. By mastering these levels of learning, our clients are more likely to produce meaningful outcomes.
Our data analysis process is thorough and comprehensive. We believe that analyzing data is the key to making informed decisions and driving positive change. By analyzing data, we can identify patterns and trends that might otherwise go unnoticed.
In conclusion, data collection and analysis are an integral part of the intervention process at APPLE Consulting. We believe that a data-driven approach is essential to achieving meaningful outcomes for our clients. By collecting and analyzing data on a daily basis, we can make informed decisions and drive positive change.
At APPLE Consulting, we take the re-assessment process very seriously. Our goal is to ensure that our clients are receiving the most effective treatment possible. Re-assessments are conducted every six months (or other frequency as dictated by insurance plan) to ensure that treatment plans are up-to-date and that progress is being made towards goals.
During the re-assessment process, treatment plans are updated to reflect any progress made towards goals. These updates include descriptive and data-based progress on goals, revision of any current goals, and new goals as applicable. Standardized and/or norm-based assessments are also administered to inform progress within the treatment plan. Specifically, we run the Vineland annually to measure a year's progress from a standardized perspective.
We understand the importance of including parents in the re-assessment process. Parents are requested to review draft re-assessment treatment plans, give their input, and sign the plan as are the behavior technicians. Family guidance sessions are often used to review the treatment plan draft with the parent for them to provide active feedback. This ensures that everyone is on the same page and working towards the same goals.