Sponderwrks Program Description
The SCS Philosophy of Integrated Intervention

 Sadly, in the past, parents have been led to believe that parents must choose treatment for their child based on one single methodology or another - and to the exclusion of others.  This caused parents to worry whether or not they have chosen the "right" approach.  There has always been a robust body of solid evidence supporting a variety of effective approaches - and no single intensive treatment has ever proven to be more effective than any other. 

 In recent years, top experts in the field of Early Autism Intervention have begun to recommend combinations of behavioral and developmental methods to provide balance and thoroughness in treatment.  Increasingly, the field is recognizing that no single approach is equipped to provide an answer to every intervention need.
 

Clinically and empirically validated methods available for intervention today fall on a continuum of structure, ranging from adult-controlled approaches such as Discrete Trial Training, Special Education, and TEACCH, to those that offer more in the way of child choice such as Contemporary ABA, Visual/Augmented Communication, and Pivotal Response Training, to those who offer the most in the way of child-control such as the Hanen, Relationship Development and Floortime techniques.  Each of these approaches when used alone can be expected to have their strengths and weaknesses.

SCS has always offered a "Prescriptive" Approach towards program development.  What that means is that we select methodologies and combinations of techniques based on an assessment of your child's unique development, personality, and learning style.  This is much different than the more common practice of offering a program based on a philosophical bias towards a single approach.

Description of Approaches 
 The Continuum of Structure: From Adult-Controlled to Child Centered

Behavioral Approaches: These approaches consider the child's learning environment as an essential tool for teaching and changing behavior.  An analysis is done of the environment, and a program is developed to use the environment to change or teach new behaviors.  "Structure" in the form of lesson plans is used to direct the child through learning exercises.  Teaching may include the use of tangible rewards to motivate the child, but most of the time, approval and other types of social rewards are used.
 
Contemporary Applied Behavioral Analysis:  CABA treats all behavior as purposeful and meaningful.   It focuses on the child's innate characteristics and needs, and how effectively [or ineffectively] they interact with the environment.   An assessment of the child's typical responses within his or her environment is conducted, and aspects of the child's environment (aspects of routines, natural and logical consequences for behavior, teaching steps, etc.) are systematically changed to in order to teach specific

Special Education is frequently used as an adjunct to ABA techniques.   These consist of a body of teaching techniques developed over 30 years, which are meant to teach a wide variety of learning styles.  A necessary part of ABA assessment is an analysis of the child's natural learning style.   Once this is done, Special Education techniques are prescribed to teach the child new skills or skills meant to replace maladaptive behaviors.

Pivotal Response Training:  PRT is an improvement over traditional Discreet Trial Training approaches, developed by DTT pioneers Lynn and Robert Koegel.   PRT incorporates more child autonomy and control, which increases motivation naturally - without the need for artificial rewards.   It also focus on the teaching of "pivotal" skills, which when learned by the child, enable her to learn a much wider array of skills on her own - even in unplanned or un-programmed situations.

SCERTS: (Social Communication, Emotional Regulation and Transactional Support) was developed out of 25 years of research and clinical/educational practice by a multidisciplinary team of professionals trained in Communication Disorders, Special Education, Occupational Therapy, and Developmental and Behavioral Psychology.  It focuses on building a child's capacity to communicate with a conventional, symbolic system from preverbal to conversational levels of communication. It also focuses on the development of emotional regulatory (i.e., self and mutual regulatory capacities to regulate attention, arousal and emotional state). Transactional supports are designed and implemented across settings to foster more successful interpersonal interactions and relationships, and more productive learning experiences across school, home and community settings.

Hanen Language: Children learn to communicate during typical, daily situations such as going to the park or having a snack. Everyday situations are considered opportunities for language learning.  Speech-language therapy for children in need is suddenly no longer limited to one or two hours per week with a speech-language pathologist.  Language learning is integrated into the many routines and activities that occur every day in these settings. The Hanen approach focuses on children's social and language development for the most part.

Floor Time: FT is a body of techniques developed at the National Institutes of Health, Infant Research Center in Washington, D.C.  Following the child's lead, joyful play is used as the primary means of fostering development of emotional, cognitive, language, and play skills.   FT is "relationship-oriented," based upon the model of childhood development identified by Dr. Stanley Greenspan.   A great deal of emphasis is placed on the child's emotional well-being and her relationships with others.  FT is also concerned with remediation of the sensory integration dysfunction that is thought to be responsible for interfering with development, so we tend to work hand in hand with Occupational and Speech Therapists.

Developing a FT plan requires an extensive understanding of child development and parent-child relationships.   The parent is taught the principles of sensory perception and child development that pertain to their own child.  Once a plan is developed, the parent learns to do it with their child, as they are the primary relationship in the child's life.

Developmentally Based Behavioral Intervention: This approach focuses on dealing with specific behavioral challenges the child may present.  Combined with techniques of Applied Behavioral Analysis, this approach helps parents understand how the child understands the world, and once parents learn to understand their child in this new way, they are much better prepared to help their child change his behavior.   A primary focus is on improving the level of communication and understanding between parent and child, and changing a child's behavior through the use of rewards or punishers is rarely necessary using this approach.

Description of Services:

Regional Center Funded Behavior Intervention:  This service is designed to help families with specific problem behaviors a child may experience.   Assessment and Treatment usually take place in the family home, although it is common for us to help with behavior that occurs in community settings such as parks, shopping malls, grocery stores, etc.

Usually, Behavior Intervention begins with an assessment of the child's behavior.  This is to help us determine what kinds of services and treatment plans are necessary.   The assessment process involves interviewing the family and observing the child on 2 or 3 separate occasions, having parents keep a log or some sort of measurement of the child's behavior (can be done by videotape if appropriate) throughout the assessment period, and then developing treatment plans.   Treatment plans are individualized for each child, and discussed with the family prior to submitting the Behavioral Assessment Report to the Regional Center.   Once both the parents and the Regional Center agree that intervention is indeed necessary and treatment plans are approved, funding for treatment (intervention) is provided.  

Treatment is based on a Parent Education model.   The Consultant visits the family home or community setting where behaviors occur, at a rate of once per week (there can be more or less frequent visits if needed and approved), for about 3 or 4 months.   The Consultant provides examples or suggestions to the family that will help the child learn to better adapt to expectations.   At the end of this period, a report of progress is then required by the Regional Center.

Regional Center Funded Developmental Intervention:  This service is available to infants and toddlers under the age of 3.  Sometimes called "intensive," this service is different than standard behavioral intervention, in two main ways.  First, the focus of treatment is not only on the child's behavior, but also on their development of thinking, language, emotional, social, play, and motor skills.   Secondly, there is more direct work performed by the Consultant with the child, although ultimately, parents must learn to perform techniques themselves.  

Developmental Intervention is typically preceded by a recent diagnosis (from a Doctor or Independent Psychologist and an examination by a Clinical Psychologist at the Regional Center).   An assessment is performed in a similar manner to that described above, although the focus will be on behavior as well as developmental skills and readiness for school.

Developmental or Academic Assessment:  The Regional Center's own staff or vendors usually perform Developmental Assessment for eligible clients.  For children who are not eligible for Regional Center services, we offer assessment and treatment plans depending on the needs of individual families.  For the young child, developmental assessment is similar (or perhaps more in-depth) than the kind performed for the purposes of intensive intervention described above.  For older children, academic testing and evaluation is available.  All assessment services are provided directly or under the supervision of a Licensed Educational Psychologist.

Advocacy:  Parents may need help and advice regarding IEP, IFSP, or 504 services for their child.  Advocacy may or may not include formal evaluation of the child, or attending the child's IEP, but SCS offers a range of advocacy services to help parents deal with school districts.  Advocacy is not a Regional Center Funded service.

Play Groups:  We offer consultation to parents forming playgroups of their own, with an emphasis on improving social-play skills and inclusion in activities with typically developing children.