It Takes a Team: 4 Steps to Building a Stronger Therapy Team

For students on the Autism spectrum, having a strong and reliable therapy team to support individual needs can be an important factor in student success. When members of a therapy team are collaborating seamlessly, a student is more likely to have high quality support across all areas of development (communication, social, cognitive, play, motor, and adaptive skills).

mixed working group looking at laptopThe pervasive nature of ASD across these areas means that multiple disciplines are necessarily involved in effective intervention (Donaldson and Stahmer, 2014). When we work together and have a narrow focus, we can help our students make a great deal of progress. Gone are the days of a Speech Language Pathologist, Physical Therapist or Occupational Therapist taking a student away for traditional pull out therapy and leaving no time for debriefing with the classroom team.

Who comprises the therapy team is determined on a case-by-case basis. You may be wondering where to start with this sometimes daunting task of building a strong and supportive team. Below I will discuss some strategies that are evidenced-based and the ways that I incorporate them into my busy life as a speech language pathologist.

Pairing
One of the first things that I always try to do is build rapport with staff, which is known as a behavioral principle called pairing. It is important to build rapport and/or pair with team members, especially if you are new to the team or if other new members have joined. It may sound like very basic advice, but as clinicians we are very busy and sometimes we feel that we do not have time for this piece. I am urging you to put this time with staff on the top of your priority list. Once you have a good rapport with team members, it allows you to share ideas and collaborate more easily and more effectively.

Sharing
The next tip I have is to share the goals your student is working on. If you are the teacher, share the student’s IEP goals with the paraprofessionals and explain why you are teaching particular tasks. Knowledge is power! If you are the occupational therapist, please share your student’s therapy goals with the team. Therapy takes place all day, across settings and across instructors. If the team does not know what the goals are, they will have no idea how to address them across the school day.

Reinforcement
Students and professionals benefit from reinforcement! People feel good about the work at hand when they receive positive reinforcement. Let the paraprofessional know that they are doing a great job with their student(s). Everyone likes to get praise for a job well done!

Data
Another way that we can assure that our collaboration is helping the student is by collecting daily data on skills from all domains (i.e. behavior, academic, communication). When we, as a team, create a data sheet that captures the skills and specific targets we are addressing, we can use this across the student’s day. When we take this data and analyze the progress, we can all make informed decisions about a student’s programming needs. I have included a free team-based daily data sheet from Stages Learning. You can use this data sheet to track a variety of skills.

In my 14 years practicing in the field, the majority of people that I encounter are driven by a desire to see their students. However, even with the best intentions, we may face barriers in collaborating with other staff members. Follow the tips mentioned above and reach out to colleagues who seem to need additional support. I try to continually assess the needs of the teams I work with throughout the year. Maybe the team needs a refresher on a certain skill area – see if you can work this into your yearly professional development time. When we work together as a team, we can help so many students achieve their goals!


ABOUT THE AUTHOR

rosemarie-griffin-headshotRosemarie Griffin, MA, CCC-SLP, BCBA is a licensed speech language pathologist and board certified behavior analyst. Currently she splits her time between a public school system and a private school for students with autism. She is passionate about lecturing on effective communication services for students with autism and has done so at the local and national level. Rosemarie also enjoys spending time with her family, playing the harp and shopping.

Article originally posted on Stages Learning Materials Blog.

“Underwater Basket Weaving Therapy for Autism: Don’t Laugh! It Could Happen…” by David Celiberti, PhD, BCBA-D & Denise Lorelli, MS

This month’s featured article from the Association for Science in Autism Treatment (ASAT) is by Executive Director David Celiberti, PhD, BCBA-D and Denise Lorelli, MS on the abundance of so-called “therapies” available for children with autism, why some fall trap to these “therapies,” and how to assess what therapy is right, and most importantly, effective in the long run. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!


Underwater Basket Weaving Therapy for Autism: Don’t Laugh! It Could Happen…
by David Celiberti, PhD, BCBA-D and Denise Lorelli, MS

Yes, sadly it can happen. With 400+ purported treatments for autism, there is no shortage of such whose name begins with an activity, substance, or favorite pastime and ends in the word “therapy.” A cursory internet search would reveal such “therapies” as music therapy, art therapy, play therapy, sand therapy, dolphin therapy, horseback riding therapy, bleach therapy, vitamin therapy, chelation therapy, and helminth worm therapy joining the list of the more established habilitative therapies such as physical therapy, occupational therapy, and speech-language therapy (this is by no means an exhaustive list of the array of “therapies” that are marketed to consumers). Touted therapies can involve all sorts of things. I recall sitting on a panel at Nova University in the late ‘90s with another provider boasting the benefits of llamas and lizards as well.

What concerns us are the assumptions – made by consumers and providers alike – that promoted “therapies” have legitimate therapeutic value, when, in fact, there is often little-to-no scientific evidence to support them. Some might rightfully say that many of these touted methods are “quackery” without such evidence. The focus on such unproven methods or “therapies” may result in financial hardship and caregiver exhaustion, further exacerbating the stress levels of participating families. What is most alarming is that these “therapies” may be detrimental because they may separate individuals with autism from interventions that have a demonstrated efficacy, thus delaying the time of introduction of effective therapy.

This concern is echoed by the American Academy of Pediatrics. In their guidelines focusing on the management of autism spectrum disorders, they state: “Unfortunately, families are often exposed to unsubstantiated, pseudoscientific theories and related clinical practices that are, at best, ineffective and, at worst, compete with validated treatments or lead to physical, emotional, or financial harm. Time, effort, and financial re-sources expended on ineffective therapies can create an additional burden on families” (p. 1174).

If a child diagnosed with cancer were prescribed chemotherapy, there is a reasonable expectation that chemotherapy would treat or ameliorate the child’s cancer. Parents of individuals with autism have that hope as well when their children are provided with various therapies. While this hope is understandable, it is often placed in a “therapy” for which there is an absence of any legitimate therapeutic value. We hope the following will help both providers and consumers become more careful in how they discuss, present, and participate in various “therapies.”

SOME FAULTY ASSUMPTIONS REGARDING “THERAPIES”

1. Anything ending in the word “therapy” must have therapeutic value. The word “therapy” is a powerful word and clearly overused; therefore, it would be helpful to begin with a definition. Let’s take a moment and think about this definition:

Merriam-Webster
Therapy: noun \ˈther-ə-pē\ “a remedy, treatment, cure, healing, method of healing, or remedial treatment.”

When a “therapy” provider or proponent uses the word “therapy,” he/she is really saying: “Come to me…I will improve/treat/cure your child’s autism.” The onus is on the provider/proponent to be able to document that the “therapy” has therapeutic value, in that it treats autism in observable and measurable ways or builds valuable skills that replace core deficits.

2. Providers of said “therapy” are actually therapists. It is not unreasonable for a parent or consumer to assume that the providers of particular “therapies” are bona fide therapists. It is also reasonable for a parent to believe that someone referring to him/herself as a therapist will indeed help the child. However, simply put, if an experience is not a therapy, then the provider is not a therapist. He or she may be benevolent and caring, but not a therapist.

Some disciplines are well established and have codified certification or licensed requirements, ethical codes, and practice guidelines (e.g., psychology, speech-language pathology, occupational therapy). Consumers would know this, as “therapy” providers will hold licenses or certifications. Notwithstanding, consumers can look to see if the provider has the credentials to carry out a particular therapy, and these credentials can be independently verified (please see http://www.bacb.com/index.php?page=100155 as an example). A chief distinction is that licenses are mandatory and certifications are voluntary. In the case of licensure, state governments legislate and regulate the practice of that discipline. It cannot be over-stated that just because a discipline has certified or licensed providers it does not necessarily mean that those providers offer a therapy that works for individuals with autism. This segues into the third assumption.

3. All “therapies,” by definition, follow an established protocol grounded in research and collectively defined best practices. Let’s revisit our chemotherapy example. Chemotherapy protocols have a basis in published research in medical journals and are similarly applied across oncologists. In other words, two different oncologists are likely to follow similar protocols and precise treatments with a patient that presents with similar symptoms and blood work findings. This is not the case with many autism treatments. Most therapies lack scientific support altogether and are often carried out in widely disparate ways across providers often lacking “treatment integrity.”

4. If “XYZ therapy” is beneficial for a particular condition, it would benefit individuals with autism as well. Sadly, this kind of overgeneralization has been observed and parents of children with autism are often misled. Suppose underwater basket weaving was demonstrated through published research to improve lung capacity. Touting the benefits of this as a treatment for autism would clearly be a stretch. Therapeutic value in autism must focus on ameliorating core symptoms and deficits associated with autism such as social challenges, improving communication skills, and reducing or eliminating the behavioral challenges associated with autism.

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Pick of the Week: NEW! Fidgets Kit

We’re thrilled to introduce this brand new Fidgets Kit, exclusively created and brought to you by Different Roads in conjunction with our Behavioral Consultant Stacy Asay.

Fidget toys can be a great and socially acceptable replacement for stereotypic or repetitive behavior in the classroom or community. Some students find the repetitive action of “fidgeting” to be calming and are then better able to focus on the task at hand. Additionally, some students who have a difficult time staying still are able to sustain sitting behavior for longer periods with less support or prompting when they are manipulating something repeatedly in their hands.

In honor of the arrival of this great new kit, this week only, take 15% off of the Fidgets Kit by entering in our promotional code FIDGETS at checkout!

We’ve assembled this Fidgets Kit to include an array of items that can provide a variety of sensory experiences: stretchy, chewy, spiky, twisty, bumpy, twisty, clicky, bouncy and smooshy! We’ve included a variety of items that vary in texture or are manipulated in different ways so that they can be rotated regularly. The components have also been chosen so that they can be worn on the wrist, clipped to a belt, handheld, or attached to a piece of clothing.

Remember, this week only, take 15% off* your order of the Fidgets Kit by applying FIDGETS at checkout!

*Offer valid through 01/28/14 at 11:59pm EST. Not valid with any other offer. Be sure there are no spaces or dashes in the code at checkout!