CATCH Team - Chester County Intermediate Unit

Transcripción

CATCH Team
(Childhood Autism Team CHeck)
GUIDEBOOK
“The CATCH Team works to bring the medical, educational, and behavioral health systems together to
create a single point of entry to develop a plan of care for a child suspected of having autism that
encompasses intake, evaluation, diagnosis, and recommendations for interventions with one case manager
to coordinate with families.”
FUNDING PROVIDED FOR THE DEVELOPMENT OF THIS GUIDEBOOK IS THROUGH DEPARTMENT OF
PUBLIC WELFARE / BUREAU OF AUTISM SERVICES
Development of the CATCH Team Guidebook through the Chester County CATCH Team and
through facilitation of the Luzerne County CATCH Team:
Brenda Eaton-Shadie Developer/Administrator
Angela Conser- Case Manager
Suzanne Muench- Case Manager
Sarina Sweeney- School Psychologist
Jackie Bryant- School Psychologist
Kristy Van Campen- School Psychologist
Denise White- School Psychologist
Michelle Davis- Service Coordinator Manager, Chester Co. Early Intervention
Nicole Cartwright- BHRS Case Management Supervisor, EAS Clinician
Questions: Contact Brenda Eaton at 484-237-5354 or e-mail at CCIU, [email protected].
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Table of Contents
I.
WHAT IS THE CATCH TEAM?
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page 2
II.
DEVELOPMENT OF A CATCH TEAM
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page 5
III.
WHAT IS THE REFERRAL PROCESS FOR THE CATCH TEAM? .
page 8
IV.
EVALUATION OF CANDIDATES FOR THE CATCH TEAM
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page 10
V.
OBSERVATION
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page 13
VI.
HOW TO DISCUSS THE CATCH TEAM REFERRAL
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page 15
VII.
ROLE OF THE CASE MANAGER .
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page 17
VIII.
DAY OF ASSESSMENT AND MEMBERS OF THE CATCH TEAM
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page 18
IX.
WHAT IS THE ADOS?
X.
XI.
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page 19
WHAT HAPPENS AFTER THE ASSESSMENT?
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page 20
FEEDBACK SESSION
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APPENDIX .
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page 21
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page 22
1
~I~
WHAT IS THE CATCH TEAM?
With this concept being a recommendation from the Early Intervention Sub-committee Report from the
PA State Autism Task Force, Brenda Eaton, the facilitator of the Early Intervention Sub-committee
report, approached Dr. Levy from CHOP and the Administrators with-in Chester County to discuss the
concept. As a result of these discussions, meetings were held to discuss system issues, regulations, and
how to blend and braid systems. A plan was formulated, and we began to see children in Chester County
in August of 2005. Today, we have refined out process, and have had over 100 children referred to the
CATCH Team, with an approximate rate of 80% being identified with an Autism Spectrum Disorder. The
Administrative Team included the following members:
Administrative CATCH Team
Regional Autism Center and Children’s Hospital of Philadelphia (CHOP)
•Developmental Pediatrician, Dr. Susan Levy
Chester County Dept. of Mental Health/Mental Retardation
•Birth to 3 years Early Intervention
Mental Health Department Chester County Dept. of Human Services of Chester County
Chester County Intermediate Unit
•Three to 5 years Early Intervention
Chester County Dept. of Human Services
Community Care Behavioral Health
Chester County Behavioral Health Providers
Through county-wide collaboration in Chester County, meetings were held by the Administrative
CATCH (Childhood Autism Team CHeck) Team to discuss the possible process and procedures
necessary to make the CATCH Team a reality.
In light of the increasing incidence of autism, (current rate 1-150 from the CDC 2007) there is a growing
need to address the concerns of families and children affected by this disorder. Issues with early
identification, coordination of services, and meeting the needs of families with children on the autism
spectrum have become a major focus of many serving systems. The Pennsylvania Autism Task Force
Report, the Early Intervention Sub-committee report, as well as other Sub-committee Task Force reports
2
highlighted the fact that several systems serve children with autism, but none are coordinated to work
together. Too often, families are on their own to seek out professionals to make a diagnosis and then left
to sort through the various agencies and systems that could provide support and services. Once parents
find their way into the various systems, they were left to be the coordinator for their child’s services,
negotiating the maze of medical, educational, and behavioral health systems.
The CATCH Team was designed to increase the rate at which children are identified at an early age, and
to provide a streamlined and family friendly evaluation process. With this method for coordination of
services for families and for the children suspected of having an Autism Spectrum Disorder, the CATCH
Team can function as a single point of entry to all serving systems. The CATCH Team works to bring the
medical, educational, and behavioral health systems together to create this single point of entry to develop
a plan of care for a child that encompasses intake, evaluation, diagnosis, and recommendations with one
case manager to coordinate with families.
The CATCH Team was developed to address the following barriers and obstacles:
-
To develop a multi-disciplinary system of care diagnostic process to involve medical/physical
health, Early Intervention, education and behavioral health. All systems to participate in a
streamlined process to share information, communicate more effectively, and participate in
pediatric diagnostic evaluation and creation of an initial single comprehensive plan of care.
-
Families have identified the strong preference to have diagnostic evaluations conducted by
developmental pediatricians. It is a known fact that families can wait upward of one to two
years for an initial appointment for a diagnosis.
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Families continually identify the difficulty of relaying “their story” to numerous agencies,
doctors and providers, often repeating the same demographics and course of treatment/history
over and over.
-
Families and agencies often feel that treatment goals, plans, interventions and outcomes are
not coordinated or shared across systems.
-
Families often express being overwhelmed by the various systems logistics, requirements, next
steps and insurance issues.
3
The goals of the CATCH Team:
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To identify children between the ages of 0-5 years old who may be at risk for a diagnosis of
autism.
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To implement standardized practices for children identified with developmental delays
through Early Intervention for autism using the M-CHAT, and dialogue with families about
the results of the screening.
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To implement a referral process to the CATCH Team to reduce the wait time for a
developmental pediatrician to conduct an evaluation at a site convenient for families.
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To use a standardized and research based evaluation tool, the ADOS (Autism Diagnostic
Observation Schedule), administered by trained staff.
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To have cross systems representatives (medical, education, Early Intervention and behavioral
health) participate in the observation of the evaluation and engage in a post-evaluation
discussion with the evaluators.
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To have such representatives discuss and agree upon an initial single plan of care following
the evaluation.
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To ensure timely feedback to the families regarding the results of the evaluation and review
of the recommendations for the next steps in the plan of care.
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To provide the family with direct face-to-face contact with the CATCH Team Case Manager
and representatives from the behavioral health system to increase the likelihood for followthru and continuity of care.
-
To identify case management practices, roles and responsibilities to assist families accessing
the necessary resources and appointments.
Responsibilities can include follow-up and
coordination of the initial plan of care, including applying for MA.
4
~II~
DEVELOPMENT OF A CATCH TEAM
The CATCH Team being comprised of several serving systems, having buy-in from each system’s
representatives locally is a necessity. It is also suggested that the development of an Administrative
CATCH Team be established made up of system administrators, as was developed in Chester County,
working in the same fashion, to address the same barriers and obstacles, and to address the same goals.
NOTE: Please keep in mind that the material contained in this Guidebook is specific to systems and
processes found with-in Chester County, and the processes and procedures may need to be adapted
based on the county, and the local system dynamics.
The identification of a facilitator who is familiar with county dynamics would be a benefit, but someone
with good facilitation and organizational skills would also be ideal to take the lead. Systems and
administrators have to be open and willing to discuss their processes and regulations with the group and
facilitator in order to identify how to blend and braid a process for the CATCH Team with-in the county.
A “Team Approach” is required and defined as, “a number of people organized to function cooperatively
as a group” and should be the tone of the meetings. Discussion needs to focus on regulations, mandates,
and difficulties encountered with each system, and how they can be addressed. As this discussion takes
place, gathering information on paperwork, forms, releases and staffing should be considered and noted.
Systems, departments and agencies to include in an Administrative CATCH Team can mirror the
members of the Chester County Administrative CATCH Team from the list provided.
A forum for discussion of the development of a CATCH Team could take place at a variety of meetings
such as the LICC (Local Interagency Coordinating Council) which is a joint meeting of the Early
Intervention Infant and Toddler Program and the Preschool Special Education Program. Another
possibility is at the county office where stakeholders may meet to discuss children services. Also, some
counties have autism specific work groups, Coalitions or Alliances.
As consensus is reached, and processes and procedures are being identified, and forms and releases are
considered, the following checklist will be helpful to complete the process to set up the CATCH Team
with-in the county. (See CATCH Team PowerPoint and Algorithm for the CATCH Team attached for
more information.)
5
CATCH Team Planning Checklist
_____ Identification of an Administrator, or lead coordinator to oversee the process and deal with issues
and concerns that come up, as needed, as the CATCH Team develops.
_____ The identification of a Masters Level Caseworker (check credentials to bill Medical Assistance)
_____
Location, such as an assessment room with one-way mirror with observation room with a
conference room that has internet access, printer and copy machine available.
_____ Developmental Pediatrician
_____ Behavioral Health Rehabiliation representatives
_____ Determine in-kind (sustainable funding) and what will need to be funded and by which system
_____ Start-up costs for trainings such as the ADOS, ADOS kit, Manuals, ADOS Modules, computer,
camera if taping, Polaroid camera to take intake photo, secure file cabinet, and assorted office supplies.
_____ Training and Meeting location(s).
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~ III~
WHAT IS THE REFERRAL PROCESS FOR THE CATCH TEAM?
Ideally, the point of entry should be when a child is screened at a pediatric visit, and then referred to Early
Intervention if delays are noted, but 70% of our children with developmental disorders are not detected by
primary care providers (Palfrey et al. J PEDS. 1994). The National American Academy of Pediatrics’
(AAP) current Policy Statement recommends developmental screenings at 9-, 18-, and 30-month visits
with an autism specific screen, such as the M-CHAT. (Modified Checklist for Autism in Toddlers) to find
the M-CHAT and other helpful screening tools, go to www.firstsigns.org.
To access the full Policy statement see the following website:
Site: http://pediatrics.aappublications.org/cgi/content/full/118/1/405
The CATCH Team point of entry is through Early Intervention (EI) or the Preschool Special Education
(PSE) Program depending on the child’s age. Many times, children who may present with signs of autism
are delayed in several areas. Even if a family is not currently in EI, we ask the family to call Early
Intervention or Preschool Special Education first, so the child can begin to receive services as soon as
possible, and have them do their Intake.
In Chester County Early Intervention (0-3years), all children are screened with the M-CHAT. The MCHAT is a parent driven screening tool with 23 questions to tease out concerns and behaviors that can
indicate the child may be at risk for an Autism Spectrum Disorder (ASD) diagnosis.
At the Chester County Intermediate Unit, (3-5 years) Preschool Special Education Program, a child who
is 4 years and under, the M-CHAT can be used as a screening tool although some professionals express
concern of false negatives you may get due to the age of the child. If the child is 4 years old or older the
evaluator should consider the use the Social Communication Questionnaire (SCQ) or other type of screen
that can be found on the National AAP website given above or, the PA Autism Assessment and Diagnosis
Expert Workgroup provides a list of autism screeners as well.
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NOTES:
9
~IV~
EVALUATION OF CANDIDATES FOR THE CATCH TEAM
When working with a family and the topic of screening comes up, explaining the AAP’s
recommendations for children to receive an autism specific screener at 18 months could be a viable
explanation if parents are concerned why the evaluator is using an autism screener with their child.
If the child passes the M-CHAT or SCQ and there are no other red flags, then the evaluator should
continue their Early Intervention evaluation. If the child passes the M-CHAT or the SCQ, and there are
considerable red flags, or if the child fails the M-CHAT, or the SCQ, the evaluator should further
interview the parents.
The first question to the parents might be to ask what made them seek Early Intervention. Some parents
might already have concerns that their child is on the Autism Spectrum while other parents do not really
know what characterizes a child with Autism Spectrum Disorder.
Determine if the parents have
expressed their concerns to their pediatrician or if their pediatrician has expressed concerns to them. At
this time, the evaluator might want to discuss their concerns with the parents. It may be helpful to
mention a concern and ask the parents if they have ever been concerned about that same thing. For
example, if the evaluator observes a child flapping, the evaluator might say to the parent, “Have you seen
Billy do that before?” or “How often does Billy make that movement with his arms?” If the evaluator is
not ready to address the concerns with the parents the evaluator could discuss weather or not the parents
have been referred to a Developmental Pediatrician.
If the parents have contacted a Developmental Pediatrician, it is important to determine how far away
their appointment is. If the parents have not contacted a Developmental Pediatrician, or will be waiting
for more than a couple of months to be evaluated by the Developmental Pediatrician, consideration should
be taken when discussing the CATCH Team. Providing the option for an earlier date through the
CATCH Team is often a welcome alternative, as our wait time is from 10 weeks to 2.5 months. In Chester
County, our Developmental Pediatrician is from CHOP (Children’s Hospital of Philadelphia), and
provides the same assessment as would be done at CHOP but through the CATCH Team Process here in
Chester County. CHOP also monitors their intakes and will not schedule with a family if they already
have an appointment with the CATCH Team. We advise families to cancel their initial evaluation with
CHOP if they are on a waiting list and schedule a 6-month follow-up instead. Through the CATCH Team
a 6-month follow-up is recommended.
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When interviewing with the parents the evaluator may want to start out with what the evaluator has
observed. To further investigate whether or not there are other concerns that the evaluator had not
observed or that the parents have not discussed, the evaluator may want to consider the items listed below
or may want to use some of the probes from the Autism Diagnostic Interview (ADI).
1) Social Interaction
Has little or no eye contact
Does not gesture, wave bye-bye, point, finger to lips for shh
Does not respond to name
Does not initiate play with peers
Do not respond to peers attempts to play with them
2) Communication
Does not appropriately indicate needs and wants
Answer questions
Uses language when playing appropriate to their age
Echoes words or repeat words or phrases over and over
Makes sounds just to self stimulate or self soothe
Repeats verbatim conversations from movies or books
3) Stereotyped Patterns of Behavior
Has unusual motor behaviors or motor planning- pacing back and forth, clumsiness
Odd hand and finger mannerisms- flapping
Is preoccupied with certain toys or games, such as Thomas the train
Lines up toys or
objects and becomes upset if the order is disturbed
Do they seem preoccupied with parts of objects
4) Behavioral Concerns
In addition, the evaluator should investigate if the child is exhibiting behavioral concerns. Some concerns
of particular importance that would warrant behavioral intervention would be safety, task avoidance and
aggression. Safety concerns could include, eloping in dangerous places, such as a parking lot, not
responding to their name, not responding to stop, climbing on unsafe objects, or mouthing unsafe objects.
Task avoidance concerns could include tantrums when asked to do something that the child does not want
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to do. If the child tantrums, then the evaluator should determine how frequent, intense and the duration of
the tantrums. Acts of aggression include aggression toward others as well as to self. If a parent has any
of these behavioral concerns, this child would be a candidate for Behavioral Health services and may be a
good candidate for the CATCH team.
The evaluator may determine priority of who goes to the CATCH team based on their need for a
diagnosis, a developmental pediatrician and the severity of their behaviors. Evaluators might give priority
to the children who need 2 or 3 of the 4 things mentioned above rather than just one.
If the evaluator has determined that the child would be appropriate for the CATCH team based on the
information collected they should discuss these findings with the parents of the child, explain the CATCH
team and determine if the family is interested. The evaluator should also call the CATCH team case
manager to determine available appointments.
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~V~
OBSERVATION
When possible, observe the child in different environments. Many very young children are in the home
and may not be in other settings. But for those in daycare and preschool, these different environments can
provide important information. Observation has the advantage of tapping into behaviors within natural
contexts. It is important to schedule the observation at a time when the target behaviors are more likely to
occur.
It is best to see the child in a setting such as a preschool or daycare where you can see
communication skills, behaviors and social skills. Seeing the child in only one setting may not be
sufficient, the observer may want to see the child at home and also in the preschool/daycare setting to get
a complete observation across settings.
Observers should be non-intrusive and neutral as possible. Use a running record type of observation, in
which the observer records all the events as they occur naturally during the observation period. Highlight
or make special note of behaviors that are related to the referral concern. These behaviors can be either
positive behaviors or negative behaviors to rule in/rule out the question of autism spectrum disorder.
It may be helpful to look for the following behaviors during the observation:
Eye contact
Non-verbal gestures
Showing/Bringing
Sharing things of interest
Pointing out things of interest
Repetitive or stereotyped language/phrases
Repetitive play/preoccupation with objects
Play (near peers, with peers or alone)
Play skills (cause and effect, pretend, imaginative)
Watching/observing peers and adults
Imitating peers/adults (immediate or delayed)
Initiating interaction with peers/adults (appropriate or inappropriate)
Compliance with adult directions
Repetitive motor movements
13
Some may find it helpful to develop a checklist, along with the running record, to help structure the
observation and organize notes.
Evaluators are required to gather a language sample to determine where a child falls with language skill
development. This may partly be done previously if a Vineland Adaptive Behavior Rating Scale –
Second Edition was completed, or by observing the child before the day of assessment, or within the first
few minutes of administering the ADOS by the school psychologist.
NOTES:
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~VI~
HOW TO DISCUSS THE CATCH TEAM REFERRAL WITH PARENTS WHEN THEIR CHILD
SCREENS POSITIVE TO BE AT RISK FOR A DIGNOSIS OF ASD (AUTISM SPECTRUM
DISORDER)
When enough red flags have been identified, an observation has taken place, and history of the concerns
have been discussed, it is time to discuss with the parents the CATCH TEAM. This is best done in person,
rather than over the phone. The most important thing to have in mind is monitoring where the parents are
in the grieving process of having a child with developmental delays. Some parents may have done their
own research and are aware of the red flags for ASD, some may have a family member with the disorder,
some may have heard about or seen a show on autism, but the majority of parents don’t know what the
disorder is. This discussion is to inform them a little about what Autism Spectrum Disorders are and how
their child is presenting with red flags. It should be emphasized that up to this point, no diagnosis is being
made and that information is being collected. The parent should be made aware of the red flags that have
been identified, and that their child has not been found to have the disorder at this time, but further
evaluation from trained professionals is needed and that can take place with the CATCH Team.
The professional meeting with the parents can introduce the CATCH packet and explain to them what is
inside that should be filled out and what is needed for the evaluation to take place. This packet includes:
- a letter explaining the CATCH Team
- permission to evaluate
- medical assistance application
-medical history form
-HIPPA form if not already signed (For the agency that will be holding the CATCH file.)
Give an overview of the CATCH Team. Parents often find it comforting to have step-by-step details of
what happens on the day of evaluation.
SAMPLE CATCH EVALUATION DAY OVERVIEW
1. You will arrive and tell the secretary at the front door that you are here for the CATCH Team.
2. Someone from the team will come and get you and bring you downstairs where you will meet the
evaluator.
3. The evaluator will explain how the assessment will be conducted and you will join him/her in the
assessment room.
15
4. There will be a one way mirror and behind it the rest of the team of professionals will be
watching.
5. When the evaluator is finished conducting the assessment, the Developmental Pediatrician will
meet with you for sometime and conduct his/her interview to gather additional information.
6. At this point, you are finished for the day and go home.
7. The team of professionals gather to score the assessment and if appropriate make a diagnosis and
recommendations, as necessary.
When all of the preliminary information is gathered, it can be sent to the CATCH Team Case Manager
should be added into the database for all to see.
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~VII~
ROLE OF THE CASE MANAGER
The case manager serves a supportive role for families and an organizational and facilitative role for the
Team. The case manager is an integral person in bringing systems together. This person needs to have a
knowledge base in education and Behavioral Health services. Strong organizational skills, the ability to
adapt to change, and counseling skills are also needed assets for the person in this position. A case
manager solely, designated to facilitate an autism evaluation and also to support the family in receiving
the appropriate services, after evaluation, is a unique feature of the CATCH Team.
First and foremost, the case manager serves as a vital source of support for families whose children are
evaluated by the CATCH Team. From the point of referral to questions related to their children, even
years after evaluations, the case manager is available. The case manager is a person knowledgeable about
educational, behavioral and community resources. The case manager supports and checks in with the
family on regular intervals after the diagnosis, to help with follow- through of team recommendations and
also serve as an information resource. She is also someone who keeps current on trends and recent
findings in autism research. The case manger creates and facilitates workshops on topics of interest for the
parents of children newly diagnosed with autism.
The case manger is also the scheduling and resource manager for the team. She is the contact person with
the office manager at the Regional Autism Center, who helps coordinate the CATCH team days with the
developmental pediatrician’s schedule. Referrals from Early Intervention and from pre-school Special Ed.
are all sent to the case manager. She reserves rooms, and resources for the day of the evaluations. As, well
as copies and prints needed reports and materials. The case manager keeps on top of updating resource
lists and materials for the families’ information packet to be given at the feedback meeting.
The case manager attends all of the CATCH evaluations, feedbacks, and family trainings, to serve as a
constant “friendly face” for families. For more information, including a “Timeline of Tasks, Processing
Referrals, and Logging into the Database”, please see the “CATCH team processes” section of the
guidebook, followed by the “CATCH Team Forms” section to understand data entry and timelines.
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~VIII~
DAY OF ASSESSMENT AND MEMBERS OF THE CATCH TEAM
The CATCH Team is comprised of the many stakeholders that provide services to children and their
families across systems including Birth to Three Early Intervention and their providers, Preschool Special
Education, representatives from Behavioral Health Rehabilitation Services, and a Developmental
Pediatrician.
Participating in the evaluation is the CATCH Team Administrator, CATCH Team Case Manager, a
Developmental Pediatrician, a School Psychologist from Preschool Special Education, a representative
from a behavioral health agency, and Birth to Three providers (Occupational Therapy, Speech Therapy,
teacher that works with the child) when appropriate. The ideal location would have a one-way mirror
assessment room with an observation room. After introductions, the School Psychologist will facilitate
the ADOS (Autism Diagnostic Observation Schedule) with the child and parents in the room, while the
Developmental Pediatrician, Behavioral Health Staff and other CATCH Team Members observe and
score the ADOS. This provides for a wonderful opportunity for the cross-system observers to have a
discussion about the child as the assessment takes place.
Once the ADOS is complete, the Developmental Pediatrician will meet with the family and ask any
questions that may not have been answered in the Medical History, or through other questions and
information provided from the MDE (Multidisciplinary Evaluation) or the IFSP (Individualized Family
Service Plan) from 0-3 Early Intervention or ER (Evaluation Report) from 3-5 Preschool Special
Education. The Developmental Pediatrician will also do a brief physical exam and discuss any medical
concerns with the family. Once the Developmental Pediatrician has finished, the Case Manager will give
the family an appointment to come back in two weeks for a feedback session.
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~IX~
WHAT IS THE ADOS?
The Autism Diagnostic Observation Schedule (ADOS) is the gold standard for assessment of autism, and
is used as an evaluation tool in the CATCH Team Process. The ADOS is a semi-structured, standardized
assessment of communication, social interaction, and play for children who have been referred due to
concerns about autism or other pervasive developmental disorders. The ADOS consists of standard
activities that allow the examiners to observe behaviors that have been identified as contributing to the
diagnosis of autism at different developmental levels and chronological ages. Structured activities and
materials provide standard contexts in which social interactions, communication, and other behaviors
relevant to autism spectrum disorder are observed. The ADOS is not a diagnostic tool by itself, and
should be used in combination with others, such as the DSM-IV-TR, CARS(Childhood Autism Rating
Scale) and other tools the Developmental Pediatrician and team are comfortable using.
For more information on the ADOS, go to Western Psychological Services website:
http://portal.wpspublish.com/portal/page?_pageid=53,70384&_dad=portal&_schema=PORTAL
19
~X~
WHAT HAPPENS AFTER THE ASSESSMENT?
When the evaluation is complete, and the family leaves, the rest of the team meets to review their
observations and discuss overall ratings that are used to formulate a diagnosis through the use of the
ADOS diagnostic algorithm. Each member of the team provides input for this process and helps develop
the recommendations. The results of the ADOS as well as a rating scale completed by the Developmental
Pediatrician are examined in light of the diagnostic criteria for autistic disorder outlined in the Diagnostic
and Statistical Manual of Mental Disorders-IV-TR.
The Behavioral Health clinician will assist in scoring the ADOS and provide a clinical impression during
the formation of the evaluation report on whether the child requires behavioral health services and how
quickly these services are needed.
Children that exhibit strong elopement, self-injurious, or other
potentially physically harmful behaviors can be recommended to be “fast-tracked,” meaning that the
evaluation is written in a way that prescribes behavioral health services to occur within 60 days of the
report.
A report is generated with diagnostic information as well as recommendations for educational and
behavioral health services with information on any medical follow-up if necessary. All of the information
is entered into the database and is ready to be signed by the Developmental Pediatrician for the Feedback
session in 2 weeks.
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~XI~
FEEDBACK SESSION
The case manager schedules a follow-up meeting for the family at which time the results of the report are
discussed with the evaluation team. The Developmental Pediatrician explains the medical diagnosis and
concerns to the family, while the School Psychologist reviews the ADOS with the family to discuss what
impressions where observed.
Typically, the Behavioral Health clinician who attended the assessment would also attend the feedback
session. The clinician will explain what behavioral health services are, how the services could be
provided to the child and family for that child’s situation, and how to obtain the services. The clinician
will discuss Medical Assistance, how it pays for behavioral health and other supplemental services, and
how to apply. An application will be provided to the family and specific directions on how to apply for a
child with a disability will also be provided during the feedback session.
Parents are provided with the information needed to access systems and services and follow-up through
the Case Manager who can assist with completing paperwork, providing resources and supports to the
families. Through the CATCH Team process, parents of children with autism are provided with a timely
and efficient system for evaluation and access to services.
21
Appendix
22
CATCH Team processes
1. Timeline of Tasks
2. Processing Referrals
3. Logging onto the Database
23
Catch Team-- Timeline of Tasks
• Two Weeks Prior to CATCH Team
o Information should be received from both Birth-3, and 3-5. If not,
call the referring source for the child and request the information.
You will need this no later than one week prior to the evaluation
date.
o Enter into database any information already received: medical
history, IFSP evaluation results, etc.
o Assure you have reserved the meeting room and testing rooms.
• One Week Prior to CATCH Team
o If information is not yet received for 0-3, email contact person.
o If information is not yet received for 3-5 children, contact
psychologist and ask them to enter the information. If medical
history is still not received for 3-5 child, contact family again and
inform them the information is critical. If they have lost the form,
offer to email or fax a new form to them.
o Email Dr.
and the information for all kids. Inform them if
information is not available and when you feel it might be.
o Assure you have adequate copies of blank ADOS forms. If not, put
request through copy center for more.
o Make 5 copies of the completed report for the children who were
previously evaluated. Copies go to EI, Pediatrician, Behavioral
health, and 2 copies go to the family. (CATCH keeps original)
o You can make up their feedback packets to include resource
information, medical assistance application, copies of reports, “How
to get follow-up” (see CATCH Team CD) , “What’s next?”(see
CD), and any other applicable information. Put the feedback packet
into the child’s file.
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• Several days Prior to CATCH Team
o Contact families to confirm appointment time and date and answer
questions as needed.
o Assure all information is included in database.
o From the database, print out for Pediatrician copies of the “CATCH
Team report”, “Developmental Pediatric Report”, and “Medical
History” for each child. Even though it may not be complete, the
doctor can take notes on these. Have copy of IFSP for 0-3 child
available for Dr.
, or MDE information from 3-5.
o Gather copies of previous CATCH Team kid’s reports for the
pediatrician and place all in a folder.
o Email psychologists, other trained professional to find out who will
be conducting the ADOS
o Develop schedule for the day and email to team (BHRS, EI, Doctor
and administrative support staff
(see file on cd “samplescheduleCATCH.doc”)
• Day of CATCH Team
o Assure that cameras and laptops (if applicable are ready for the day)
o Make sure a file box is stocked with blank ADOS forms, the files
for the children being evaluated, and the file for the child who is
having their feedback session in the afternoon.
o The file box should also have in it pens, the camera, Ethernet cord,
blank ADOS form, a few blank CARS, and the files.
o Set up computer and phone in the conference room, and make sure
someone in the reception area knows where to reach you when
families and professionals arrive.
o Put the file you made for Dr.
containing the information
for that day’s kids, as well as copies of reports from previous day’s
evaluations for feedback at her place and include a copy of the
schedule for the day.
o Once the family has arrived, bring them to the assessment room and
take a Polaroid photo of the child. Briefly explain the course of
events for the day-1. ADOS, 2. Dr.
, 3. team meeting to
formulate report. Case manager should go back to speak with the
25
family after the evaluation to give appointment card (see file on
CD) with feedback time.
o Repeat x2
o Print out all reports when completed and be sure Dr.
signs
reports before she leaves.
o Disconnect computer and bring all items back to desk. Secure files.
• 2 weeks to One Month after CATCH Team Feedback
o Follow up with families via phone call to check in with them about
how things are going. Have they… completed the MA form… met
with BHRS if applicable… met with IEP or IFSP team, begun
follow-up process with Dr.
?
• Three Months after CATCH Team Feedback
o Send to families from the previous three months a CATCH Team
survey with a self-addressed stamped envelope. “CATCH Family
Surveys.doc”
26
Processing Referrals
Birth-3 Referrals
• Referrals come from support coordinators
• Send email to director of Early Intervention for the county a few days before
information is due if referral is not received
• Coordinator should call to let you know that referral is being faxed, and you confirm
with them that information is received, as well as who will be attending the
evaluation. This should be limited to 2 outside people.
• They will send the IFSP, consents, HIPAA form for agency holding CATCH
information, medical history, and summary paragraph.
• Generate letter to families with assessment time if referral is received at least 10
days prior to the evaluation-if not, call parents and introduce self and answer
questions as needed.
• Once information is received, it can be entered into the database.
o Summary paragraph is typed into first text box in CATCH report
o Testing results-found in the IFSP- are typed into the text boxes on the first
DPR page (you may click “set results template” to enter IFSP info.)
o Medical history information is put in the medical history section under the
drop down box
o You can begin the basic information for the medical history section of the
DPR page one (Dr. will complete on day of eval)
• Save copies of the CATCH report, Developmental Pediatrics report-page 1, and
medical history as .pdf for Dr. and email to her as an attachment. It may be helpful
to make a folder on your computer to save these files in.
• For the day of evaluation, Dr.
reviews copy of the IFSP, and a print out of
the medical history form, CATCH report and Developmental pediatric report for her
to take notes on.
• Give the family the feedback appointment time/date before they leave for the day.
• For the feedback session, you should make 5 copies of the report-2 for the family, 1
for Dr., 1 for EI, and 1 for Behavioral health. Keep the original in the file for future
reference or for copies as needed. (Appointment cards found in “record keeping”
folder on the CATCH CD).
• At feedback, parents get their reports in a folder with information on how to obtain
follow-up and what’s next after the CATCH Team. Additional reading material may
be given as appropriate. We use: “Autism Overveiw: What We Know” by the NIH
(www.nichd.nih.gov) and “ASD, PDD” by the NIMH (www.nimh.nih.gov)
27
3-5 Referrals
• Referrals come from school psychologists
• Once the psych has talked to the family about CATCH team and they have agreed to
an evaluation, the psych will forward you contact information for that child
including name, parents’ names, DOB, address, and phone number.
• Contact families to introduce self and let them know you are going to send out a
packet that contains information they need to send back to you and information
about the CATCH Team process.
• In this packet, Preschool Permission to evaluate form, Release form medical history
form, HIPAA form for agency holding CATCH info. and CATCH Team
Descriptions and Algorithm forms(all available in the Intake Folder on CATCH CD,
except for the HIPAA). Include a self-addressed stamped envelope for them to send
back the releases and medical history back to you.
• Also in this packet you will include letter to families with assessment time and
instructions about the day.
• Once information is received, it can be entered into the database.
o Medical history information is put in the medical history section under the
drop down box
o You can begin the basic information for the medical history section of the
DPR page one
• The school psychologist is responsible for entering into the database the following
information at least one week prior to evaluation:
o Summary/referral information in first text box on CATCH report
o Testing results in boxes on page one of Developmental Pediatrician’s Report
(DPR)
• Save copies of the CATCH report, Developmental Pediatrics report-page 1, and
medical history for Dr.
and email to her as an attachment. Each child has a
folder in the CATCH Team Kids folder
• For the day of evaluation,
receives a print out of the medical history,
CATCH report, and Developmental pediatric report for her to take notes on.
• On the day of eval, check in with families about when a good time would be for
follow-up and let them know the school psych will schedule this with them.
• For the feedback session, you should make 5 copies of the report-2 for the family, 1
for the Dr.
, 1 for EI, and 1 for Behavioral health. Keep the original in the
file for future reference or for copies as needed.
• Parents get their reports in a folder with information on “How to get up follow”-up
with the developmental pediatrician and “what’s next” after the CATCH Team.
Additional reading material may be given as appropriate. (all found in the Feedback
Folder on the CATCH Team CD)
28
Logging onto the CATCH Team Database
• You must have File Maker Pro 8 on your computer.
• The icon looks like this
• Once this is installed and available, open the program.
• At the top of the screen you will see the FileMaker tool bar. Click on File and go
down to “Open Remote”
• You will then get the following screen
• Be sure the “View” field says “Local Hosts” and select File Maker Server 1
• From there select CATCHTeam from the list and click Open
• The log in screen will then appear (This may vary depending on the location of
your server_.
29
• Your login is your First and Last name
• The password is “ catchdb “
• Once you fill in this information and login, you will get the main screen of the
database.
• Once on the main screen, you will have the option to search for a specific
child or see the complete list of children.
• It is recommended that you be connected to the database via an Ethernet
connection versus wireless as the wireless has been known to cut out and
unexpected quitting of the program will render un-stored information lost.
30
Entering information
• To add a new child to the database, you must click on “Complete Child Listing”
and then choose any child and select “Go to info”
• Once you have this child’s information up, go to the open box in the top right
hand corner above the green box that says “Go” and place cursor in box. This
should bring up a drop down menu and you can select “Add new child” You will
be given a blank entry to begin to add information.
• That same box above the green box that says go will allow you to move between
the reports needed. Simply click on the report needed and hit “go”
Example of where to find the green GO box 
31
Example of the drop down box choices.
• There is no way to “save” the information per se on the database, but clicking out of
one area into another will automatically store the information in the database. You
should click out of the page you are working on periodically to assure information is
being stored and to avoid losing work.
32
Medical History Form
• From the drop down box, you can select Medical History Form
• Once the information is given to you from the School Psychologist, or from EI, you
can enter the information in. Take note to write exactly what the family writes.
Example of the Medical History Form 
33
• Some of the information entered on the Child information page will appear here in
an effort to reduce entering duplicate information.
• Once completed, this form will get saved and sent to the Pediatrician.
34
CATCH Report
• This is the form in which the reason for referral is entered. If the child is a Birth-3
referral, enter the paragraph that EI sends. If the referral is for Preschool3-5
services, the school psychologist will enter this information. This is entered into this
first large box.
• The rest of the information on this page will be filled in once subsequent forms are
filled in. The CATCH Team report in meant to be a compilation of all testing
conducted on the day of valuation.
35
Developmental Pediatrics Report
• The Developmental Pediatrics report has two pages-or fields-to it. Once you click
on Developmental Pediatrics from the drop down box in the top right hand corner,
you will see the main screen, which contains several large text boxes.
• The first text box is to enter birth history of the child. Information gathered ahead of
time is used to begin this, and the Pediatrician will help fill this out as the report is
generated.
• The second text box is for developmental history and the Pediatrician will fill this
out.
• The remaining text boxes are to record testing scores for the child
o If the child is a Birth-3 referral, use the IFSP test results and enter in the Date
of eval, age at eval, eval used, and results.
o If the child is Preschool 3-5 referral, the school psychologist will enter this
information.
• This information is entered prior to the evaluation and saved and sent to the
Pediatrician prior to the evaluation for her review.
• When the report is being generated, the second page of the Developmental
Pediatrics Report is used. In order to access this, click on the blue box in the upper
right hand corner that says “Ped Report Page 2” This will bring up the next screen.
36
•
On this page 2 the physical exam and testing results will be recorded
37
Example of the Testing Results
38
Example of Impression and Recommendations
• In the recommendations section, there is a Yellow box that says “Set
Recommendation Template” This is a pre-printed template with recommendations
that can be edited and changed as needed. When you first arrive at this screen, the
box will be blank until you click this box. It will ask you if you want to use the
template and you must click yes. If you click this box a second time it will rest the
template and not save any changes you may have made.
• The information entered in here will be carried over to the CATCH Team report and
will not need to be re-entered there.
39
Mental Status Exam
• The Mental Status Exam is a check box form that needs to be filled out upon seeing
the child for the evaluation, if they are being fast tracked..
40
Initial Care Plan
• The initial care plan is a document that incorporates the social history information
for the child. It is also used when fast tracking.
• The first text box will contain the Medical History information that was entered
previously. You will see a yellow box next to the two text boxes. Once clicked the
information from the appropriate place will be imported. You can add/delete from
this information without it changing the text from the original location.
•
Here you will also enter the Diagnosis and Recommendations. The recommendation
is cut and pasted from the Behavioral Health section of the recommendations on
page 2 of the Developmental Pediatrics Report form.
41
Printing Reports
• You can print reports in one of two ways
o To print individual reports you can go to the page you want to print, then in
the drop down menu above the green Go box, click on “Print Current Page”

o To Print the final report once all information is entered and report is ready to
be signed, in that same drop down box you can click on “Print Final Report”
and it will print the CATCH Team Report, Developmental Pediatrics Report,
Mental Status Exam, and Initial Care Plan.
42
Saving Reports in PDF format (only for individuals who need
electronic access to information but do not have filemaker pro, i.e. developmental
pediatrician)
• When preparing to send information to pediatrician, you will need to save the
CATCH report, the developmental pediatrics report, and the medical history as a
PDF file that you can attach to an email to the doctor.
• To do this, you must go to each of the three reports and once in a report, go to the
toolbar at the top and under “File” click on Print. Once you click on print you will
see the following screen.
• Once open, click on the button that says “PDF” when you click on it you will get
a drop down box, and you should select “Save as PDF”. It will then ask you
where you want to save it and give you the option of naming the file. Name each
file according to what it is:
o for instance if it is a CATCH report for Suzy Sample, title it
“S.Sample-CATCH.pdf” or “S. Sample-MEdhx.pdf”
o The .pdf is added to the end to help those who are not working on Apple
computers be able to recognize the file. So adding that at the end of the file
name assures they will be able to open the file on a PC.
• It is helpful to create a folder for that child under a “CATCH Team Kids” folder
so that when you save these documents you can place them right into their folder.
43
CATCH Team Timeline – Desktop Guide
About 4 weeks prior to CATCH team evaluation
1. Referring Source (Birth to 3, or 3-5 E.I.) notifies CATCH Case Manager of intent to refer.
2. Consents, Release, Agency Privacy Notice (HIPPA) and Medical History are acquired from
the family. (Currently birth to 3 does this themselves, and 3-5 has the CATCH case manager).
The family is also provided the CATCH algorithm and CATCH summary.
3. An intro. letter is mailed to families reminding them of their appointment date/time and an
providing an overview of the days event for the evaluation
About 2 weeks prior to CATCH team evaluation day
1. The child’s information is entered into the database (including demographics, reason for
referral, medical history, Early Intervention Assessments go in the developmental pediatrician
report page 1).
2. Contact Referring Source, if all information is not returned by family.
3. Assure that the resources (rooms, staff, materials, computer etc) are reserved for the day.
One week prior to the CATCH team evaluation day
1. Email the Developmental Pediatrician and notify her that the information for each child is
available in the database, or fax pertinent info. to the doctor .
2. Print the CATCH Report, and Developmental Pediatricians Report from database, for the
doctor to take notes on during the evaluation. (This will mostly be blank at this time)
3. Make sure an adequate number of ADOS protocols are available for the assessments.
4. Print reports for children receiving feedback (if not done on evaluation day) for pediatrician to
sign. (6 copies are needed for the feedback session).
44
Day of the CATCH team evaluation
1. Make sure that files and blank reports are accessible for the developmental pediatrician in the
assessment room.
2. Have extra ADOS forms, pens, and CARS (or other assessment) available.
3. Set up computer to be used during report writing.
4. Greet family and assessment team. Take a picture of family and explain course of events. Give
family an appointment card for their feedback at the end of assessment and contact
information.
5. After the ADOS and medical exam, guide team to conference room to score instruments and
input data in report. Case manager and pediatrician take turns typing. Completed report is
printed and signed by doctor.
6. Repeat steps 1-5 for each evaluation.
7. Greet family arriving for feedback.
8. Provide each team member with a copy of the final report (doctor, early intervention,
behavioral health, and parent (2). Retain one signed copy for the child’s CATCH file.
Developmental Pediatrician leads feedback discussion.
9. Give the family a feedback packet containing information on the diagnosis, recommendations,
follow-up instructions, and the medical assistance application.
Two weeks after the CATCH team
1. Evaluation families from the previous team day come back for feedback.
2. Case manager calls families who received their feedback previously to investigate the status of
follow-through on recommendations and determine the type of follow-up needed.
Three months after CATCH team evaluation
1. Send families a CATCH team Family Survey with a self-addressed stamped envelope.
Ongoing Endeavors of the CATCH team case manager
1. Send families CATCH team Newsletter, or other relevant resources.
2. Develop ongoing trainings for families (Overview of Systems, Potty-training,
Autism Intro, etc).
2. Keep on-going data on family follow through with recommendations.
3. Remain available to answer questions and support families.
4. Participation in interagency and family community partnership meetings at the county level to
advocate for families and the program in general.
5. Participate in ongoing education to stay informed on current trends in diagnosis and treatment
of autism
45
CATCH Team
Childhood Autism Team Check
Name: _________________________________
Date
Referral received from:
Demographic information entered in database
Family contacted to set up evaluation
Packet mailed to family w/ intro letter
Intro letter emailed to referring source
Summary/paragraph entered into database
Medical history received
Releases received
Medical history entered into database
Information sent to Developmental Pediatrician
Assessment attendance form signed
Picture taken and put in file
Family given feedback time/date
Pediatrician report printed and signed
Catch team report printed
Feedback packet made w/ reports
Feedback attendance form signed
Packet given to behavioral health
Packet given/sent to referring source
46
Schedule for CATCH Team
May 22, 2007
Parkersville Conference Room 9:00 – 3:30 p.m,
Testing Room 143
8:45 0-3 Family arrives
9:00-9:45 ADOS for Steven (testing room)
9:45-10:15 Medical Evaluation (testing room)
10:15-10:30 Scoring ADOS (conference room)
10:30-11:00 Formulate report for Steven (conference room)
10:45 3-5 family arrives
11:00-11:45 ADOS for Zachary
11:45-12:15 Medical evaluation
12:15-12:30 Scoring of ADOS
12:30-1:00 Formulate report for Zachary
1:00- 1:30 Lunch
1:15 3-5 Family Arrives
1:30-2:15 ADOS for Hailey
2:15-2:40 Medical evaluation
2:40- 3:10 Scoring ADOS
3:10-3:15 Formulate report for Hailey
3:30 Feedback for Jason (conference room)
Have a good day!
47
CATCH Team
CATCH Team
Your feedback session with the CATCH
Team is scheduled for:
Day
Date
If you have questions, call
Your feedback session with the CATCH Team
is scheduled for:
Day
Time
name
Date
Time
at xxx-xxx-xxxx
CATCH Team
CATCH Team
Day
Date
Time
Day
Date
48
Time
CATCH Team
CATCH Team
Your feedback session with the CATCH Team Your feedback session with the CATCH Team
is scheduled for:
is scheduled for:
Day
Date
Time
Day
Date
CATCH Team
CATCH Team
Time
is scheduled for:
is scheduled for:
Day
Date
Time
Day
Date
CATCH Team
CATCH Team
Time
is scheduled for:
is scheduled for:
Day
Date
Time
Day
Date
49
Time
CATCH Team Process
Childhood Autism Team CHeck
Intake for 0-3 & 3-5
Early Intervention
M-Chat done by EI
18 months - 48 months
Not at risk, continue
on regular process EI
At risk- Talk with familyCATCH Team option, while
continuing regular process EI
Release to share info.
MA Application,
Audiological, HIPPA
Video release
Intake processIntake Packet of Info
Doctor/Developmental Ped.
0-3 Early Intervention
3-5 Early Intervention
Behavioral Health Intake
Assessment for DX
CATCH Team
Doctor Report and
Recommendations
Team meets/discuss
recommendations
Report and Feedback
to the family with Dr.
develop IFSP/IEP or revisions
with CATCH Team
recommendations
B. Eaton 6/24/05
50
CATCH
Proceso de Equipo CATCH
Revisión en Equipo de Autismo Infantil (Childhood Autism Team Check)
Ingresos para Programas de
Intervención Temprana
Entregas
Información respecto de
CATCH
Cuestionario Médico
Consulta programada
ndada
MCHAT completado 0-3 EI
Con riesgo / sin riesgo
En proceso regular en
Conversación con familia –
Opción de Equipo CATCH
Proceso de ingreso –Paquete
de Información de Ingreso
Doctor / Pediatra de
Desarrollo
Psicólogo realiza ADOS
Personal 0-3 y 3-5 disponible
Conclusión BHRS
Evaluación para DX de
Equipo CATCH
Informe y
Recomendaciones
IFSP / IEP desarrollado o
modificado por Informe
Intervención
Temprana
Informe y Retroalimentación
con familia y equipo
Solicitar MA
Acceder a servicios BHRS
Seguimiento por Coordinador
de Caso de Equipo CATCH
B. Eaton 13/07/2006
51
CATCH Team
- A Pilot Program The CATCH Team is made of the many stakeholders that provide services to families and their children
in Chester County and contracted professionals to round out the lineup.
Birth to 3 years Early Intervention / Mental Retardation Office of Chester County
Three to 5 years Early Intervention / Chester County Intermediate Unit
Office of Mental Health/Mental Retardation of Chester County
Office of Human Services of Chester County
Community Care Behavioral Health
Chester County Providers
Developmental Pediatrician
Chester County has been aware of the need to address the growing concerns for families and individuals
with autism for many years. The County offices that run and support the behavioral health services
through Chester County’s Managed Care Organization (MCO), Community Care Behavioral Health
(CCBH), serve hundreds of children. Of these children, 80-90% have an autism spectrum disorder.
Early Intervention in Chester County that includes 0-3 Early Intervention and 3-5 Early Intervention come
together to meet as the Local Interagency Coordinating Council (LICC). The LICC’s autism
subcommittee as well as the public awareness subcommittee, see the difficulties with early identification,
the difficulties with coordinated services and meeting the needs for families and their children on the
Autism Spectrum.
In February of 2002, the Intermediate Unit hired an Autism Network Coordinator, Brenda Eaton, to work
full time in Chester County to build bridges and develop networks to improve communication and
services for families and children dealing with an Autism Spectrum Disorder. Along with this focus, the
Autism Network Coordinator facilitated the Early Intervention Subcommittee for the Pennsylvania
Autism Task Force.
Within the PA Autism Task Force Report, it was very clear in the Early Intervention Subcommittee
Report, as well as many of the other reports, that there were several systems serving autism, but none of
them coordinated and working together. Too often, families were left to find out about the diagnosis, seek
out information about the various serving systems, leaving them confused and frustrated. Once they had
found their way in the different serving systems, they were left to be the coordinator for their child’s
services between medical, school and behavioral health care.
From an Early Intervention recommendation of the Pennsylvania Autism Task Force Report, Chester
County as a whole, is now working to bring the medical system, the education system and the behavioral
health system together to create a single point of entry to develop a plan of care which will encompass
intake, evaluation, and recommendations with one case manager to coordinate with families.
52
Equipo CATCH
Revisión de Equipo por Autismo Infantil
(Childhood Autism Team Check)
- Un Programa Piloto El Equipo CATCH está compuesto por las diversas partes interesadas que proporcionan servicios a
familias y sus niños en el Condado de Chester y profesionales contratados para completar el equipo.
Nacimiento a 3 años Oficina de Intervención Temprana / Retardo Mental del Condado de Chester
Tres a 5 años Intervención Temprana / Unidad Intermedia del Condado de Chester
Oficina de Salud Mental / Retardo Mental del Condado de Chester
Oficina de Servicios Humanos del Condado de Chester
Cuidado Comunitario de Salud Conductual
Proveedores del Condado de Chester
Pediatra del Desarrollo
El Condado de Chester ha estado consciente por muchos años de la necesidad de atender la creciente
preocupación por familias e individuos con autismo. Las oficinas del Condado que realizan y apoyan los
servicios de salud conductual a través de la Organización de Cuidado Administrado (MCO), Cuidado
Comunitario de Salud Conductual (CCBH), atienden a cientos de niños. De estos niños, del 80 al 90%
tienen un desorden de espectro autista.
La Intervención Temprana en el Condado de Chester que incluye Intervención Temprana de 0 – 3 e
Intervención Temprana de 3 – 5 se unen para tener sesiones como el Comité Local de Coordinación
Interagencias (LICC). El subcomité de autismo de LICC así como el comité de conciencia pública,
enfrentan las dificultades para una identificación temprana, las dificultades con servicios coordinados y
con cumplir las necesidades de las familias y sus niños en el Espectro del Autismo.
En febrero de 2002, la Unidad Intermedia contrató una Coordinadora de la Red de Autismo, Brenda
Eaton, para trabajar tiempo completo en el Condado de Chester creando lazos y desarrollar redes para
mejorar la comunicación y servicios para familias y niños que enfrentan un Desorden de Espectro Autista.
Junto con este enfoque, La Coordinadora de Red de Autismo posibilitó el Subcomité de Intervención
Temprana para el Grupo de Trabajo de Autismo de Pennsylvania.
Dentro del Informe del Grupo de Trabajo, fue muy claro en el informe del Subcomité de Intervención
Temprana, así como en muchos de los otros informes, que había varios sistemas atendiendo al autismo,
pero ninguno de ellos coordinando y trabajando con otros. Con demasiada frecuencia, las familias eran
abandonadas a buscar por si mismas un diagnóstico, buscar información respecto de los varios sistemas
de servicios, dejándolas confundidas y frustradas. Una vez que hubiesen logrado orientarse en los
diferentes sistemas de servicio, se les dejaba como coordinador para los servicios de su hijo entre cuidado
médico, escolar, y de salud conductual.
En base a una recomendación de Intervención Temprana del Informe del Grupo de Trabajo de Autismo de
Pennsylvania, el Condado de Chester en su totalidad está ahora trabajando para unir el sistema médico, el
sistema educacional, y el sistema de salud conductual para crear un único punto de entrada para
desarrollar un plan de cuidado que incluya recepción, evaluación y recomendaciones con un
administrador de caso para coordinar con las familias.
53
CATCH Team
Date:
Dear
:
Welcome to the CATCH Team at the
scheduled on
at
.
. This letter confirms that
has an evaluation
We ask that you come to your appointment no later than
so that the evaluation can begin on
time and that you will have enough time with Dr.
, the developmental pediatrician who will be
evaluating
. At times there are other professionals watching the evaluation behind a one-way
mirror. This may include behavioral health clinicians, early intervention staff, case managers, and other
CATCH Team members. This is done in an effort to minimize the number of assessments and intakes
by the various systems that will serve you and your family. It will also help us to provide the most
thorough and comprehensive evaluation of your child.
will be given a test called the ADOS (Autism Diagnostic Observation Schedule) by the CATCH
Team school psychologist. This is a play-based test that will look at your child’s play, communication,
and social skills. You will be in the room with
at all times, although we ask that you do not
prompt your child’s behavior or direct their play while in the room—for example, hold back and see
what they do with the bubbles on their own instead of saying ”Look at the bubbles.”. We also ask that
you bring two small finger food type snacks that your child likes (examples include: goldfish, cookies,
M&M’s, fruit puffs). We will put them into little containers to use as part of the testing.
After the ADOS, Dr.
will come into the room to go over the medical history form you filled out
for us, and talk with you about your child’s development and growth. She will do a brief physical exam,
after which time you are free to leave.
The team members who observed
will then meet to go over observations, concerns, and
recommendations. A report will be generated and shared with you when you return for your feedback
session, which is tentatively scheduled for
at
.
Should you have any questions about the evaluation, please feel free to call me at
.
Sincerely,
CATCH Team Case Manager
54
Equipo CATCH
Revisión por Equipo de Autismo Infantil
Fecha:
Estimado
:
Bienvenido al Equipo CATCH en el
programada para el
en
. Esta carta confirma que
tiene una evaluación
.
Le solicitamos llegue a la cita a más tardar a las
para que la evaluación pueda comenzar a
tiempo y tenga suficiente tiempo con el Dr.
, el pediatra de desarrollo que evaluará a
.
A veces hay otros profesionales observando la evaluación tras un espejo unidireccional. Esto puede
incluir especialistas clínicos de salud conductual, personal de intervención temprana, coordinadores de
caso, y otros integrantes del Equipo CATCH. Esto se hace en un esfuerzo por minimizar el número de
evaluaciones e ingresos en los diferentes sistemas que le atenderán a Ud. y a su familia. También nos
ayudará a proporcionar una evaluación completa y profunda de su hijo.
recibirá una evaluación llamada el ADOS (Autism Diagnostic Observation Schedule) por parte
del psicólogo escolar del Equipo CATCH. Esta es una prueba en base a juegos que evaluará las
habilidades de juego, comunicacionales y sociales de su hijo. Ud. estará en el cuarto con
en
todo momento, aunque le solicitamos que no intervenga en el comportamiento de su hijo ni dirija su
juego mientras esté en el cuarto – por ejemplo, manténgase alejado y observe lo que hace con las
burbujas por su cuenta en vez de decir “Mira las burbujas”. También le solicitamos que traiga
alimentos que se puedan comer con la mano que a su hijo le gusten (ejemplos incluyen: galletas,
M&Ms, fruta). Pondremos estos alimentos en pequeños envases para ser usados como parte de la
evaluación.
Después del ADOS, el Dr.
entrará al cuarto para revisar el formulario de historial médico que
Ud. llenó y hablará con Ud. respecto del desarrollo y crecimiento de su hijo. Le realizará un breve
examen físico, después del cual podrán retirarse.
Los integrantes del equipo que observaron a
se reunirán para revisar las observaciones,
preocupaciones, y recomendaciones. Se generará un informe que será compartido con UD. cuando
vuelva para sus cita de seguimiento programada en forma tentativa para el
a las
.
Si tiene alguna pregunta respecto de la evaluación, por favor llámeme al
.
Sinceramente,
Coordinador de Caso de Equipo CATCH
55
CATCH Team
Medical History
Today’s Date:______________________
Child’s name:________________________________________
Date of birth:______________________
Sex: M F
Age:_________ years _________months
School District: ______________________________________
Physician Name:___________________________________Phone number: _______________________
Physician Address:_____________________________________________________________________
Person completing this form:____________________________ Relationship to child:_______________
Has your child been diagnosed with any medical or developmental conditions?  Yes
If yes, please complete:
Condition
Date of Diagnosis

No
Given by whom
***If you need more room, please use other side of this page.
Does your child receive any of the following services?
Service
When did it start?
How often per week or month?
Occupational Therapy
 Yes
 No
Physical Therapy
 Yes
 No
Speech Therapy
 Yes
 No
Behavioral Therapy
 Yes
 No
Early intervention/IU
 Yes
 No
Where:
Who provides services
Prenatal History
• Is child  adopted  in foster care If so, from what age? ___________________
•
How old was mother when she became pregnant? ______________
•
Did the mother have any health problems during pregnancy?  Yes
o
•


N/A
No
If yes, explain:____________________________________________________________
Did the mother use any prescription or non-prescription drugs during pregnancy?  Yes

No
o If yes, explain:_____________________________________________________________
56
Labor and Delivery
•
Where was the child born?
______________________________________________________________
•
Was the delivery:  Vaginal
•
Were there any complications?
•
If yes, explain:____________________________
•
Was the baby full term?  Yes
•
Baby’s birth weight: _______lbs, ________oz
•
Were there any of the following problems in the nursery?

C-section


Yes
No
 Breech


Don’t know
No
If no, early late by _____ weeks
Baby’s length at birth: ______ inches
Please explain if checked

Was in NICU
_________________________________________________________

Breathing problems

Low oxygen

Infection

Needed ventilator _________________________________________________________

Feeding/sucking problems _________________________________________________

Tube feedings ____________________________________________________________

Jaundice ________________________________________________________________

Needed light therapy _______________________________________________________

Apnea _________________________________________________________________

GER (reflux) ____________________________________________________________

Other: ___________________________________________________________________
_____________________________________________________
___________________________________________________________
______________________________________________________________
Review of Systems
Normal
Abnormal
Comments
•
Head, eyes, ears, nose, throat
!
 !_______________________
•
Vision Screening (date:_________)
!
 !_______________________
•
Hearing screening (date: ________)
!
 _______________________
•
Heart
!
 ________________________
•
Lungs
!
 ________________________
•
Stomach/Intestinal/Constipation
!
 ________________________
•
Skin


_______________________
•
Sleeping/Snoring


_______________________
•
Muscles/joints/bones
!
 !
_____________________
!
!
57
•
nervous system
•
!Nutrition/Diet
!
•
!

_______________________
!

_______________________
!
Please list any medications your child is currently taking (including vitamin supplements) 
None
Medication
•

Dose
Frequency
Has your child ever been hospitalized or required surgery?  Yes
If yes, please complete:
Date
•

No
Reason
Does your child have any allergies?  Yes
_____________________

No If yes, what are they?
Behavioral History
•
Activity level of child:
!  Normal
•
Emotionality: !  Happy !  Angry
!
High
!  Low
!  Moody ! Depressed
! other:
_______________
•
Sociability with other children:
! Initiates play
!  Ignores children
! Joins play
!  Observes them
! Parallel play
! Intrudes on play !  Prefers adult
interaction
•
What does your child like to do for play? ________________________________________
____________________________________________________________________________
•
Does your child have difficulty with any of the following behaviors (currently or past—please
Behavior
explain)
How does child display this
behavior
(ie: hits, scratches, runs away)
Aggression
Hyperactivity
Impulsivity
Mouthing objects
58
Frequency
Duration
(How often does this happen# of times daily, weekly,
month)
(when did behavior
begin/how long does it last
when occurs)
Non-compliance/not
obeying
Obsessive behavior
Self-injury
Self-stimulation
Sleep difficulties
Tantrums
Family/Social History
Name
Age
• Child’s Father
____________________
• Child’s Mother
___________________
o Marital Status:
Single
Occupation
Employed
_______ __________________________
_______
Married
__________________________
Separated
Divorced
Y
N
Y
N
Partner
o
• Please list all of mother’s pregnancies and the outcome of each
*Please use another sheet of paper if more space is needed**
Year
Outcome
Name
Sex
!Living !Miscarriage
Present Age
! Male
Any developmental concerns
! Yes ! No If yes, what?
! Female
! Male
! Female
! Male
! Female
•
Is there a history of developmental concerns or medical concerns in the mother?  Yes

No
If Yes, please explain:
_________________________________________________________________
•
Is there a history of developmental concerns or medical concerns in the father?  Yes
If Yes, please explain:
________________________________________________________________
•
Who lives at home with the child?
_______________________________________________________
59

No
_______________________________________________________________________________
•
Does the child attend daycare/childcare?  Yes

No
If Yes, where and how often?
___________________________________________________________
•
What do you feel are your child’s strengths?
______________________________________________________________________________
_______________________________________________________________________________
•
What are your concerns about your child?
_______________________________________________________________________________
60
Equipo CATCH
Historial Médico
Fecha de Informe: ________________________
Nombre del Niño: ________________________ Sexo: O Masculino O Femenino
Fecha de Nacimiento: _____________________ Edad al Momento del Informe: ____
Persona que Completa Informe: _____________ Parentesco con Niño: ___________
Proveedor de Servicios de Salud: ____________
Dirección del Proveedor de Servicios de Salud: ________________________________
Teléfono del Proveedor de Servicios de Salud: _________________________________
¿Ha sido diagnosticado su hijo con algún problema médico o de desarrollo? O Sí O No
Problema
Fecha de Diagnóstico
Diagnosticado por
¿Recibe su hijo alguno de estos servicios?
¿Cuando comenzó?
¿Con que frecuencia por semana o
mes?
Servicio
Terapia Ocupacional
Terapia Física
Terapia de Lenguaje
Terapia Conductual
Terapia de Alimentación
Intervención Temprana / UI
¿Donde?
O Si
O Si
O Si
O Si
O Si
O Si
¿Quien proporciona los
Servicios?
O NO
O NO
O NO
O NO
O NO
O NO
istorial de los Apoderados:
Su Hijo es: O Adoptado O Bajo Cuidado Tutelar O N/A Si es así, ¿Desde qué edad? _________
¿Qué edad tenía la madre cuando se embarazó? ___________
¿Tuvo problemas de salud la madre durante el embarazo? O Si
Si es así, explique:
O No
¿Usó la madre algún medicamento recetado o no recetado durante el embarazo? O Si O No
Trabajo de Parto y Nacimiento:
El nacimiento fue: O Vaginal O Cesárea
¿Hubo Complicaciones?
O Si O No
O Parto Invertido
61
O No Sabe
¿Cumplió el bebé el período completo de gestación? O Si O No Si no: O Temprano
O Tardío
¿Cuantas semanas? ___________
Peso del bebé al nacimiento: ___________ lbs. _________ oz. Largo: ____________
Hubo problemas en el pabellón de recién nacidos? O Si O No
(Explique cada una que marque)
__ Estuvo en NICU ______________________________________________________
__ Problemas de respiración: _______________________________________________
__ Poco oxígeno: ________________________________________________________
__ Infección: ___________________________________________________________
__ Necesitó Respirador: ___________________________________________________
__ Problemas de alimentación: _____________________________________________
__ Alimentación con sonda: _______________________________________________
__ Ictericia: ____________________________________________________________
__ Necesitó terapia de luz: _________________________________________________
__ Apnea: ______________________________________________________________
__ GER (reflujo): ________________________________________________________
__ Otro: _______________________________________________________________
Revisión de Sistemas:
Cabeza, ojos, oídos, nariz, garganta: O Normal O Anormal _______________________
Revisión Visual – Fecha: _______ : O Normal O Anormal _______________________
Revisión de Oídos – Fecha: _____ : O Normal O Anormal _______________________
Corazón
O Normal O Anormal _______________________
Pulmones
Estómago/intestinos/estreñimiento O Normal O Anormal _______________________
Piel
Sueño/ronquidos
Músculos/articulaciones/huesos
Neurológico (sistema nervioso)
Nutrición/Dieta
Por favor detalle cualquier medicamento que su hijo esté usando actualmente (incluyendo
suplementos de vitaminas). ___ Ninguno
Medicamento
Dosis
Frecuencia
62
¿Tiene su hijo alergias? O Si O No
¿Ha sido hospitalizado o ha requerido cirugía su hijo? O Si O No
Fecha
Razón
Historial Conductual
Nivel de actividad del niño: O Normal
O Alto
O Bajo
Emocionalidad: __ Feliz __ Enojado __ Melancólico __ Deprimido __ Otro
Si Otro: _______________________________
Sociabilidad con otros niños: __ Ignora a niños
__ Inicia juegos
__ Observa a niños
__ Se incorpora a juegos
__ Juega en paralelo
__ Invade juego
__ Prefiere Interacción con adultos
¿Qué le gusta hacer a su hijo para jugar?
Tiene dificultades su hijo con cualquiera de las siguientes (actualmente o en el pasado – por favor
explique si marca la casilla):
__ Agresión ____________________________________________________________
__ Hiperactividad _______________________________________________________
__ Impulsividad _________________________________________________________
__ Llevarse objetos a la boca _______________________________________________
__ No cumplimiento / no obediencia _________________________________________
__ Conductas obsesivas ___________________________________________________
__ Autoagresión _________________________________________________________
__ Autoestimulación _____________________________________________________
__ Dificultades para dormir ________________________________________________
__ Berrinches ___________________________________________________________
__ Otro ________________________________________________________________
63
Historial Familiar
Nombre
Padre del Niño: _________________
Madre del Niño:_________________
Año Resultado
Nombre
Sexo
Edad
______
______
Edad Actual
Profesión
_______________________
_______________________
¿Algún problema de desarrollo?
Problemas Médicos y/o de Desarrollo de los Padres:
Padre del Niño: _____________________________________________
Madre del Niño:_____________________________________________
64
Release Forms
When conducting evaluations using the CATCH team process please make sure you also use the
following agency specific forms. An administration meeting between the collaborating agencies to agree
on a protocol for consent s and releases may be helpful.
1. Permission to Evaluate (describing CATCH process and listing ADOS)
2. HIPPA form for agency that will retain the hard copy of all CATCH files.
3. Release forms for agencies not listed on the CATCH Team “Release form”
65
CATCH Team
Consent and Release Form
As part of the CATCH Team Pilot Program, a videotape of your child’s assessment is being done to secure the
evaluation session as a record for other professionals that may need to review the evaluation to make
recommendations for services from various serving systems.
As part of the CATCH Team Pilot Program, the observation of your child’s assessment will help to develop the
plan of care for your child by allowing the Team to observe, make comment to each other, and discuss your child’s
strengths, needs, and necessary supports.
Additionally, a photo of you and your family is taken at the evaluation, which remains in your child’s record for the
CATCH Team. After the feedback session, a copy of the final report will be given to the referring agency-either
County Early Intervention or
County Intermediate Unit Preschool program, and the behavioral
health agency.
The three items listed above will be used strictly for the use of the CATCH Team to develop a plan of care for your
child, and to further develop the CATCH Team Pilot Program. The information and video will not be shared or
reproduced in any way without your further permission. At times, information regarding the CATCH Team is
presented in internal education sessions, grand rounds trainings, and other clinical training forums. Should your
child’s information be considered for inclusion in those trainings, you will be contacted to sign further release
information.
Members of the CATCH Team that will observe may include staff from the following:
• Birth to 3 years- Early Intervention / Mental Retardation
County
• Three to 5 years- Early Intervention /
Intermediate Unit
• Office of Mental Health/Mental Retardation of
County
• Office of Human Services of
County
• Community Care Behavioral Health
•
County Providers
• Developmental Pediatrician
When the CATCH Team is finished reviewing the video, the tape will be kept as a part of the child’s CATCH
Team record.
I herby approve of the following (please circle):
YES
NO
Observation of my child’s assessment by CATCH Team Members
YES
NO
Videotaping of my child’s assessment for use by CATCH Team members
YES
NO
Taking a photograph of/with your child
YES
NO
Providing a final report to referring agency and behavioral health agency for inclusion in file
Parent/Guardian Name: ______________________Child’s Name: ______________________
Address: _____________________________________Phone #: ___________________________
______________________________________
Signature: _____________________________________
66
Date: _________________
Equipo CATCH
Formulario de Consentimiento y Liberación de Responsabilidad
Como parte del Programa Piloto del Equipo CATCH, se realizará una grabación de video de la evaluación de su hijo, para
conservar la sesión de evaluación como registro para otros profesionales que puedan necesitar revisar la evaluación para
realizar recomendaciones de los diversos sistemas de servicio.
Como parte del Programa Piloto de Equipo CATCH, la observación de la evaluación de su hijo ayudará a desarrollar el plan de
cuidado para su hijo al permitir al Equipo observar, comentar entre si y discutir las fortalezas, necesidades y apoyos necesarios.
Además, se toma una fotografía de Ud. y de su familia al momento de la evaluación, la cual permanece en el registro de su hijo
para el Equipo CATCH. Después de la sesión de retroalimentación, una copia del informe final será entregado a la agencia
referida – ya sea Intervención Temprana de
o el programa Preescolar Intermedio del Condado de Chester, y a la
agencia de salud conductual.
Los tres ítemes mencionados anteriormente serán usados estrictamente para el uso del Equipo CATCH para desarrollar un plan
de cuidado para su hijo, y para mejorar el Programa Piloto de Equipo CATCH. La información y video no serán compartidos o
copiados de manera alguna sin su consentimiento. En ocasiones, información respecto del Equipo CATCH es presentada en
sesiones internas de educación, rondas de entrenamiento, y otros foros de entrenamiento clínico. Si se considera incluir la
información de su hijo en estos entrenamientos, Ud. será contactado para autorizar la entrega de información.
Los integrantes del Equipo CATCH que observarán pueden incluir personal de los siguientes:
• Nacimiento a 3 años – Oficina de Intervanción Temprana / Retardo Mental del Condado de
• Tres a 5 años – Unidad de Intervención Temprana / Intermedia del Condado de
• Oficina de Salud Mental / Retardo Mental del Condado de
• Oficina de Servicios Humanos del Condado de Chester
• Cuidado Comunitario de Salud Conductual
• Proveedores del Condado de
• Pediatra del Desarrollo
•
Cuando el Equipo CATCH haya terminado de revisar el video, la cinta será guardada como parte del registro del Equipo
CATCH del niño.
Mediante la presente, apruebo las siguientes (por favor marque con un círculo):
SI
NO
Observación de la evaluación de mi hijo por Integrantes del Equipo CATCH
SI
NO
Grabar en video la evaluación de mi hijo para uso de integrantes del Equipo CATCH
SI
NO
Tomar una fotografía de / con su hijo
SI
NO
Entregar un informe final a la agencia que refiere y a la agencia de salud conductual para inclusión en
archivo.
Nombre de Apoderado / Tutor: _______________________________________
Nombre de Niño: __________________________________________________
Dirección Postal: __________________________
Teléfono: _________________
__________________________
Firma: ___________________________
Fecha: __________________
67
How to get a follow-up appointment with Dr. Kruger at
•
Your child should see Dr. Kruger for follow-up in approximately 6-8 months* through the
Regional Autism Center at The Children's Hospital of Philadelphia.
•
To get started, you will need to contact the Regional Autism Center's intake department
at 215/590-7500 and complete a telephone intake.
•
Please let the intake worker know that you have seen Dr. Kruger through the CATCH
team and need a follow-up visit in 6-8 months (from time of initial evaluation).
•
Please remind the intake worker to send out an intake packet and put your child on Dr.
Kruger's reminder list for King of Prussia in the month the follow-up should occur. (For
instance, if October is 6 months from evaluation, the reminder month would be October--there is no
guarantee the appointment will be scheduled in the reminder month as it may be 1-2 months behind)
•
You will be mailed an intake packet (parent questionnaire and Child Behavior Checklists) that
should be completed and returned with copies of IFSP/IEP and Dr. Kruger's report as
soon as possible.
•
An appointment with Dr. Kruger at CHOP cannot be scheduled unless they have your
intake packet and copies of report, education and behavioral plans, etc. returned. The
sooner you return the information to CHOP, the sooner they can schedule an
appointment.
Appointments are only scheduled 3 months in advance and fill up very quickly. You are advised
to begin this process soon after your CATCH Team evaluation.
If you have any additional questions about this process, please contact the Program Manger of
the Regional Autism Center at CHOP, Karla Varrell, at (215) 590-7649. You should also call
Karla if you have not received an intake packet from CHOP within one week of your phone
intake.
*Please note, appointments may be scheduled anywhere from 5-8 months after initial evaluation depending on availability and
scheduling.
Date phone intake completed: ___________________
68
Cómo obtener una cita de seguimiento con el Dr. Kruger en
•
Su hijo debe ver al Dr. Kruger para seguimiento en aproximadamente 6 – 8 meses* a
traves del Centro Regional de Autismo en The Children's Hospital of Philadelphia.
•
Para comenzar, deberá contactar al departamento de ingresos del Centro Regional de
Autismo al 215/590-7500 y completar un ingreso telefónico.
•
Por favor informe al encargado de ingreso que ha sido atendido por el Dr. Kruger vía el
equipo CATCH y que necesita una cita de seguimiento dentro de 6 – 8 meses (desde el
momento de evaluación inicial).
•
Por favor recuerde al encargado de ingreso de enviar un paquete de ingreso y poner a
su hijo en la lista de recordatorio del Dr. Kruger para King of Prussia en el mes en que la
cita de seguimiento debe ocurrir. (Por ejemplo, si octubre está a 6 meses de la evaluación, el mes
de recordatorio sería octubre – no hay garantías que la cita será programada en lo que resta del mes,
puesto que puede estar con un atraso de 1 o 2 meses)
•
Le enviarán por correo un paquete de ingreso (cuestionario de apoderado y Listas de Revisión de
Comportamiento de Niño) que deberían ser completados y devueltos con copias de IFSP/IEP
y el informe del Dr. Kruger lo más pronto posible.
•
Una cita con el Dr. Kruger en CHOP no puede ser programada a menos que los
paquetes de ingreso y copias de informe, planes de educación y comportamiento, etc.
sean devueltos. Mientras antes devuelva la información a CHOP, antes podrán
programar una cita.
Las citas son programadas con sólo 3 meses de adelanto y pueden llenarse con mucha
rapidez. Se le sugiere que comience el proceso pronto después de su evaluación del Equipo
CATCH.
Si tiene cualquier pregunta adicional respecto de este proceso, por favor contacte a la
Coordinadora de Programa del Centro Regional de Autismo en CHOP, Karla Varrell, al (215)
590-7649. También debería llamar a Karla si no ha recibido un paquete de ingreso de CHOP
dentro de una semana de su ingreso telefónico.
*Por favor tenga en cuenta, las citas pueden ser programadas entre 5 – 8 meses después de la evaluación inicial dependiendo
de disponibilidad.
Fecha en que se completó el ingreso telefónico: ___________________
69
After the CATCH team …What’s Next?
o Use the form titled “Application for Health Care Coverage”, and apply for
Medical Assistance (MA), if you have not already done so. Please be sure to
complete all sections, paying close attention to Section V. Special Qualifying
Information and indicate your child has a disability as diagnosed by the
developmental pediatrician. You can also apply at
http://www.compass.state.pa.us (click on “enter compass site” and then click
the box for “Apply online for social services” and click “continue” to apply for
“health care coverage”)
o Medical Assistance (MA) needs to be applied for within 60 days of the CATCH
team report. After 60 days, the evaluation is not valid for applying for services. Be
sure to include a signed copy of the report with your MA application. An extra
copy of the report has been included for you. You should then copy the
application and report in the event that it gets lost. We recommend delivering it
in person to the County Assistance Office in
, if possible. If not, an
envelope has been provided for you to mail it in. If you drop it off in person, ask
for a receipt to indicate that you filed the application.
o Once Medical Assistance (MA) has been approved, an intake must be
completed at a behavioral healthcare provider:
o
o
o
o
o
(insert providers from your county here)
70
o Once the intake has been completed by one of the providers listed above, you
may be approved for behavioral health services (wraparound). You can choose
to remain with that provider for wraparound services if they offer them, or you
can choose another provider of wraparound services. Some providers of
wraparound services in
County include:
o
o
o
o
o Schedule a 6-month follow up appointment with Dr.
at insert location for
follow-up Call
. **See “How to obtain Follow-up appointment at
”
Handout**
o If you have additional questions or need assistance with this process, or additional
resources please contact:
,
CATCH team Case Manager
000-000-0000 or
email:
.
71
Después del Equipo CATCH … ¿Qué Sigue?
o Use el formulario denominado “Application for Health Care Coverage”, y solicite
asistencia médica (MA), si no lo ha hecho ya. Por favor asegúrese de completar
todas las secciones, prestando especial atención a la Sección V. Información
Especial Para Calificar (Section V. Special Qualifying Information) e indique que
su hijo tiene una discapacidad diagnosticada por el pediatra del desarrollo.
También puede inscribirse en http://www.compass.state.pa.us (haga click en
“enter compass site” y luego haga click en la casilla de “Solicitud en Línea para
asistencia social”y luego haga click en “continuar” para solicitar “cobertura de
cuidado de salud”)
o Se debe solicitar Asistencia Medica (MA) dentro de los 60 días después de la
entrega del informe del equipo CATCH. Después de 60 días, la evaluación ya no
es válida para solicitar servicios. Asegúrese de incluir una copia firmada del
informe junto con su solicitud de MA. Una copia adicional ha sido incluída para
su uso. Debe, entonces, copiar la solicitud e informar en el caso que ésta se
extravíe. Le recomendamos entregarla en persona a la oficina de Thorndale, de
ser posible. Si no, se ha incluido un sobre para que la envíe por correo. Si la
entrega en persona, solicite que le entreguen un recibo indicando que entregó
la solicitud.
o Una vez que la Asistencia Médica (MA) haya sido aprobada, un ingreso debe ser
completado en uno de los siguientes proveedores de servicios completos:
72
o Una vez que el ingreso haya sido completado por uno de los proveedores de
servicios completos, estará aprobado para servicios de salud conductual
(completos). Puede elegir permanecer con ese proveedor de servicios
completos, si los ofrece, o puede elegir otro proveedor de servicios completos.
Algunos proveedores de servicios completos en el Condado de Chester
incluyen:
o Programe una cita de seguimiento en 6 meses con el practicante Dr. Kruger /
enfermera en CHOP vía el Centro Regional de Autismo. Llame al 215-590-7500.
**Lea el informativo “Cómo obtener una cita de seguimiento en CHOP”
o Si tiene preguntas adicionales o necesita asistencia en este proceso, por favor
contáctese con:
Angela Conser,
Coordinadora de Caso de equipo CATCH
484-237-5140 or
email: [email protected].
73
Family Resources
English and Spanish
Chester County, Pennsylvania has a large Hispanic population. In researching the types of
resources available to Spanish speaking families, we found that many of the resources were only
available online and on websites that are written in English. We wanted to work to make a variety of
resources on autism, readily available to families of children newly diagnosed with autism. Acquiring
services for a child with autism can be confusing to any parent. We found that parents of children with
autism who were Spanish speaking, were frequently frustrated about understanding the disorder and the
support systems that their children needed to be involved with (like early intervention and BHRS).
We hope that the published resources we have collected as well as our own resources that have
been translated, will aide in a smoother transition into services for Spanish speaking families of children
with autism.
74
Autism Library – Spanish Language
In order to better serve Hispanic families in the county, we have established a lending library of books on
autism in Spanish. We plan to use these resources to loan to families who have children evaluated by the
CATCH team. This library program was established to help eliminate lack of economic resources or
English language skills from interfering with a family’s ability to understand and respond to their child’s
needs.
The following is a list of the titles we currently have available for families in our Autism Library for
Spanish Speaking Families:
1. Autismo Un Guia Para Padres
by Simon Baron-Cohen and Patrick Bolton (1999)
This 150 page guide book for parents is written by the Director of Autism Research at Cambridge
University. The guide covers common questions about autism (what are the symptoms, causes, and typical
treatments?) It also includes a chapter on adolescence and adulthood.
2. Autism y Sindrome de Asperger: Guia para familiars, amigos y profesionales
By Jose Ramon Alonso Pena
Autism and Asperger’s Syndrome: Guide for Families, Friends and Profesionals .This book covers
topics from basic information to diagnosis, Apserger’s syndrome, neurology and autism, treatment,
education and effect of autism on the family. The book is 271 pages long, with over 50 pages devoted to
describing a wide variety of educational and other treatments.
3. Convivir con el Autismo: Una orientacion para padres y educadores by Mike Stanton (2002)
Learning to Live with High Functioning Autism is written by a professional educator and father
of a child diagnosed with autism. The chapters are as follows: “1. Introduction. 2. A parent's tale. 3.
Understanding autism. 4. Diagnosis. 5. Conflict and partnership. 6. Brothers and sisters. 7. Early years.
8. Childhood. 9. Adolescence. 10. Adult life. 11. Myths and insights. 12. Challenging behavior. 13. Mind
your language. 14. Difficulties at school. 15. The way forward. 16. Conclusion”
4. Los Trastornos del Espectro de Autismo de la A a la Z
by Emily Doyle and Barbara T. Doyle (2005)
Autism Spectrum Disorders from A to Z: Assessment, Diagnosis and More written by two
educational consultants from California. The Spanish translation of this book was named the 2006
Literary Work of the Year by the autism Society of America. The ASA praises “Autismo A-Z is the most
comprehensive book on autism available anywhere in Spanish.” If you do not speak Spanish, We
recommend purchasing the book in English and in Spanish to help you know which sections of the book
may be most helpful to the clients you serve.
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Medical assistance in PA
Take a screening test to see if eligible, apply on line, check benefits
https://www.humanservices.state.pa.us/compass/PGM/ASP/SC001.asp
Early intervention
•
First Signs
http://www.firstsigns.org
•
Checklist for growing children
http://www.dpw.state.pa.us/Child/EarlyIntervention/003670018.htm
Our organization aims to educate parents, healthcare providers, early childhood educators, and other
professionals in order to ensure the best developmental outcome for every child. Our goals are to improve
screening and referral practices and to lower the age at which young children are identified with autism and
other developmental disorders. The First Signs Web site provides a wealth of vital resources, covering a
range of issues: from healthy development, to concerns about a child; from the screening and referral
process, to treatments for autism spectrum disorders.
Find out what developmental milestones are appropriate for your child between the ages of 1 month -3
years
•
Planning for the IFSP
A family’s introduction to Early Intervention program planning
•
Early intervention contact numbers
Contact numbers to inquire about an intake/assessment with early intervention. This list is broken down by
County.
•
A Family's Introduction to Early Intervention in Pennsylvania http://www.pattan.k12.pa.us/regsforms/Resources2.aspx
This booklet explains how to request early intervention services; eligibility criteria; rights and
responsibilities; individualized family service planning for ages birth to three; and individualized education
planning for ages three to school age
76
Early Intervention Transitions
• Transitions for you and your child
Transitions occur in our lives all the time in many different ways. Changes in our jobs or homes are
examples. While receiving early intervention services, you and your child may experience transitions as
well. This site discusses how you can plan for and manage transitions.
• Early Intervention transition
http://www.pattan.k12.pa.us/teachlead/EarlyInterventionTransition.aspx
Information contained here relates to both the transition from the infant/toddler programs to
Preschool programs and the transition from Preschool programs to the school age district
programs.
School Age to Adult Transition
• Living beyond high school
http://www.autismsociety.org/site/PageServer?pagename=livinghighschool
Discusses the importance of transition planning and need to consider when a child is nearing graduation
from high school
•
Transition from Special Education to adult life
http://www.transitionmap.org/
•
Transition Health Care Checklist
http://www.dsf.health.state.pa.us/health/cwp/view.asp?q=243876
A Roadmap from school to the future for students ages 14 to 21 with developmental delay residing in
Pennsylvania and receiving special education services.
The Pennsylvania Department of Health Southwest Regional staff and their community partners recognized
a gap in health services for youth with special health care needs. When these youth leave school, they
transition from having different or no insurance coverage, from seeing pediatric specialists to searching for
adult medical specialists, and from good coverage for medications to having to understand new systems for
obtaining medicines.
•
Secondary Transitions http://www.pattan.k12.pa.us/teachlead/SecondaryTransition.aspx
Secondary transition is the process of preparing students for life after they leave high school,
including participation in post-secondary education or training, employment, and community
living.
77
Adult Issues
•
Planning for the future http://www.autismsociety.org/site/PageServer?pagename=livingplanning
•
Autism Living and Working http://www.autismlivingworking.org/
ALAW is demonstrating, through the Autism Pilot Program developed jointly with the Pennsylvania Department
of Public Welfare's Office of Social Programs, that adults with Autism/Pervasive Developmental Disorder can
be accommodated in order to live as valued neighbors, workers and full citizens of our Commonwealth.
Safety
•
Safety in the home http://www.autismsociety.org/site/PageServer?pagename=livingsafety
Resources and ideas for assuring the home is a safe environment for the child and family
•
Safety ID cards to print
http://www.leanonus.org/pages/11/index.htm
•
Police and Autism- http://policeandautism.cjb.net/avoiding.html
ID cards to print and put relevant information that would assist first responders and police should there ever
be an emergent situation requiring law
enforcement
Information on how parent and law enforcement can work together to provide a quick response in the event
that a child elopes or runs from the caregivers
• Medic Alert http://www.medicalert.org/Home/HomeEmblemCatalogs.aspx
MedicAlert provides comprehensive Kid Smart services that can safeguard and identify your child in an
emergency. With a single phone call, emergency response personnel can access medical history and
records, protecting your child against potentially adverse treatments or medication conflicts.
•
Child Locator -GPS Watches for kids http://childlocator.com/
•
Safety Harnesses http://www.the-baby-boutique.com/tottether.html
baby-boutique.com/harnessbuddy.html
Child friendly watches that serve as a GPS system
http://www.the-
Harnesses that help protect your child from danger by allowing close access of your child, but still allows
for exploration.

IonKids
http://www.ion-kids.com/
The ionKids system allows you to monitor up to four tagged objects at once. Children, seniors, pets or
anything you might lose and want to keep safe. The system consists of a base unit, a handheld device that
allows parents to monitor up to four tags simultaneously and a Wristag. Tag holders can be purchased
separately and can be clipped onto belt loops or lanyards; Wristags can be locked on children’s wrists.
ionKids lets you set a variable zone around the base unit so you will know when your child wanders to far.
If you can't find them, use the locating device and let it show you where to go to find them.
78
For medical professionals
• American Academy of Pediatrics http://www.aap.org/healthtopics/autism.cfm
•
First Signs http://www.firstsigns.org
•
AAP-The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum
Disorder in Children
http://aappolicy.aappublications.org/cgi/content/full/pediatrics;107/5/e85
•
Centers for Disease Control -Autism Information http://www.cdc.gov/ncbddd/autism/
•
Autism toolkit for Physicians
http://www.northshorelij.com/body.cfm?id=4726&oTopID=4725&PLinkID=2849
Our organization aims to educate parents, healthcare providers, early childhood educators, and other
professionals in order to ensure the best developmental outcome for every child. Our goals are to improve
screening and referral practices and to lower the age at which young children are identified with autism and
other developmental disorders.The First Signs Web site provides a wealth of vital resources, covering a
range of issues: from healthy development, to concerns about a child; from the screening and referral
process, to treatments for autism spectrum disorders.
Helpful informational topics for health care practitioners including special considerations for seeing patients
with autism, screening tools, research, and more.
•
National Institute of Mental Health
http://www.nimh.nih.gov/healthinformation/autismmenu.cfm
Information on Autism from the National Institute of Mental Health
For teachers/educators
•
Autism Education Network
http://www.autismeducation.net
The Autism Education Network's mission is to improve public special education programs and to
influence public policy that affects individuals with autism. We use new technology and the Internet to
connect and empower people in order to affect change. We provide free information about special
education rights and programs and our outreach efforts include seminars about special education law
and conferences regarding best practices in autism treatment and methodologies
•
PaTTAN http://www.pattan.k12.pa.us/teachlead/Autism.aspx
Offers information regarding current PA standards, teaching practices, effective assessments and
instruction. Training and workshop information for educators, as well as publications relevant to Autism
Spectrum Disorders are highlighted. Can also find publications such as Introduction to Early Interventions,
Providers guide to Early Intervention
79
•
PDE Special Education
http://www.pde.state.pa.us/special_edu/site/default.asp?g=0&special_eduNav=|978|&k12
Nav=|1141|
Mission, role, and function of special education in PA schools are defined and addressed. Links to other
reference materials on standard practices and procedures.
•
Adapted Books
http://schools.nycenet.edu/D75/academics/literacy/adaptedbooks/catalog.htm
Provides PECS and other visual materials to adapt books for children. Requires Adobe Acrobat reader
and/or Boardmaker
•
IDEA Regulations
a. http://www.wrightslaw.com/idea/art.htm
b. http://www.pde.state.pa.us/special_edu/cwp/view.asp?Q=111436&A=177
•
Wrightslaw http://www.wrightslaw.com/

Different Roads to Learning http://www.difflearn.com/
Parents, educators, advocates, and attorneys come to Wrightslaw for accurate, reliable information about
special education law and advocacy for children with disabilities. Wrightslaw includes thousands of articles,
cases, and free resources on dozens of special education topics.
For 10 years, Different Roads to Learning has been striving to meet the needs of families and professionals
working with children diagnosed with autism spectrum disorders. Our product line contains over 250
products, including books, flashcards, and videos, along with other materials critical to Applied Behavior
Analysis and Verbal Behavior programs. We have always sought out products that meet the unique
learning style and educational needs of the children in our community.
•
HandRighting, Ink. http://www.handrightingink.com/index.html
We specialize in teaching handwriting to children and adults of all ages. We provide seminars for teachers
and parents, and are happy to provide school-based intervention. Please see the linked pages for more
information, and do not hesitate to contact us if we can provide any further information.
Support Systems/Resources
•
Grandparents
• http://www.udel.edu/bkirby/asperger/grandparents.html
Answers common questions grandparents of children who have autism may have.
The OASIS (online aspergers syndrome information and support)
•
Religion and Autism
• http://www.autism-society.org/site/PageServer?pagename=Religion_and_Autism
Provides both a Christian and Jewish perspective on children with ASD and how
the church can provide an inclusive environment
•
http://gbgm-umc.org/disc/autism.stm
Information on autism for religious educators
80
•
Autism Information www.autismlink.com
•
Accessible PA www.accessiblepa.state.pa.us
•
Children’s Education and Resource Center http://www.frs-inc.com/
•
Family Village www.familyvillage.wisc.edu
•
ARC of Chester County http://www.arcofchestercounty.org/
•
Access Services http://www.accessservices.org/index.php
•
Autism Spectrum Resource Center http://www.autismsrc.org
•
Child and Family Focus
•
Parents involved Network www.pinofpa.org
•
National Alliance for the Mentally Ill http://namipa.nami.org
•
Pa Training and Technical Assistance Network
•
Special Kids Network
Welcome to the Family Village! We are a global community that integrates information, resources, and
communication opportunities on the Internet for persons with cognitive and other disabilities, for their
families, and for those that provide them services and support.
Since 1952, The Arc of Chester County has been there, helping to meet challenges and empowering
individuals to reach toward their full potential; successfully weaving their everyday experiences into the
rich fabric of Chester County.
Our mission is to empower and serve persons with cognitive, emotional and behavioral disabilities through
innovative services which enable them to live rich and fulfilling lives with positive family and community
relationships.
Our mission is to provide therapeutic services and educational resources to individuals within the
autism spectrum and their families. We recognize the special challenges that they confront in
everyday living and respect their unique approach to life. Our goal is to provide an environment
where they will find a sense of belonging with like-minded individuals. We seek to promote a
positive self-image that reflects their strengths, potential for growth, and unique contribution to
our world.
http://www.childandfamilyfocus.org/
It is the mission of Child and Family Focus to provide a continuum of mental health services that will
enhance the quality of physical, emotional, intellectual, spiritual, and relational well being of youth and their
families. Through our commitment to excellence, we endeavor to provide and advocate for least-restrictive,
family- and community-based settings as the most conducive for effective growth and positive change. CFF
Autism Family Based Services offer a unique approach to helping the child and the family of the child, who
has been diagnosed with a developmental disability within the Autism Spectrum Disorder (ASD).
Parents Involved Network of Pennsylvania (PIN) is an organization that assists parents or caregivers of
children and adolescents with emotional and behavioral disorders. PIN provides information, helps parents
find services and will advocate on their behalf with any of the public systems that serve children. These
include the mental health system, education, and other state and local child-serving agencies.
NAMI PA offers the Family to Family Education course for members who have adult children and an
educational program specific to the needs of families of children and adolescents. The NAMI-CAN, for
young families, and NAMI-CARE, for consumers, models of support are also available.
www.pattan.k12.pa.us
http://www.dsf.health.state.pa.us/health/cwp/browse.asp?A=179&BMDRN=2000&BCOB=0&C=35825
It is information and referral to services that children with special health care needs and their families may
need. It is available Monday through Friday from 8:00 a.m. to 8:00 p.m. and Saturdays 8:00 a.m. to 6:00
p.m.
81
•
Parent to Parent of Pennsylvania http://www.parenttoparent.org/

Local support groups
o ASCEND – West Chester - third Wednesday each month. Grove United Methodist
Church, West Chester. Networking and Support. Info: Barbara at 610-701-0466,
[email protected]
Parent to Parent of Pennsylvania matches parents and family members of children and adults with
disabillities or special needs, on a one-on-one basis, according to condition or concerns.
o ASCEND – West Grove - 3rd Tues of every other month. 11/21- 7pm at Avon
Grove Charter School
Info: Jane 610-345-1156, [email protected]
o ASCEND – Delaware County - 10/10, 7:30pm - HANDLING BULLIES 101 with
Brad Norford, PhD. at Grace Chapel, Darby and Eagle Roads, Havertown Info:
Deirdre 610-449-6776, or [email protected] or www.ascendgroup.org
o Autism Alliance Meeting - Monthly at the CCIU, Boot Road, Downingtown. Call for
date/time: Brenda Eaton, Autism Network Coordinator, [email protected] 484237-5354
Advocacy
•
Pennsylvania Department of Education Consult Line
www.pde.state.pa.us/special_edu/cwp/view.asp?a=177&Q=61680
The ConsultLine is designed to assist parents and advocates of children with disabilities or children thought
to be disabled. If you have any questions concerning your child's special education program or the laws
relating to the provision of services in your child's IEP (Individualized Educational Program), the special
education specialists at ConsultLine may be able to assist you.
•
Parent Education network (PEN) http://www.parentednet.org/
•
Education Law Center http://www.elc-pa.org
•
Pennsylvania Health Law Project (HLP)
PEN is Pennsylvania's statewide Parent Training and Information Center. Much of the information included
in this site is designed to support Pennsylvania parents of children with special needs, but information and
links are included on Federal Special Education, National Disability Issues and Resources, Special
Education Legal Links, Transportation, and Travel that will also pertain to parents and individuals with
disabilities in other states.
The Education Law Center (ELC), a non-profit legal advocacy and educational organization, dedicated to
ensuring that all of Pennsylvania's children have access to a quality public education.
http://www.phlp.org
HLP provides free legal services and advocacy to Pennsylvanians having trouble accessing publicly
funded health care coverage or services.
82
Sibling issues
•
Autism Society article on sibling issues http://www.autismsociety.org/site/PageServer?pagename=livingsiblings
Discusses some strategies on addressing the needs of the siblings of children who have autism.
• Sibling groups
•
Second Sat/month. 8:45-10am for 4-6 yr olds and 10-12pm for 7-11 year olds.
Cost $35
Wayne at 987 Old Eagle School Rd., Suite 712, Wayne, PA 19087.
Facilitators: Dale Fisher, LCSW , Deirdre Miller, MA.
Info: 610-668-8890, [email protected]
• Sibshops http://www.thearc.org/siblingsupport/sibshops-about#
Support groups for siblings of children with have special needs. Provides a listing by state of available groups.
Website also has a listserv for siblings as well as a pen-pal program
o SIBSHOPS, for 8-to-13-year-old brothers and sisters of children with
emotional/behavioral disorders.
Mixture of new games, discussion and guest speakers. Info/Regis. 610-9173010 x223, [email protected]
o SIBSHOPS - Pottstown. 2nd Sat of month (Sept thru May) Info: Jaime,
Creative Health Services, 610-326-2767, [email protected]
Newly diagnosed
•
Familial Stress
http://www.autism-society.org/site/PageServer?pagename=livingfamily
This article from the Autism Society of America discusses and outlines the unique stressors experienced by
families who have recently received a diagnosis of autism for one if their children.
Communication Resources
•
Do 2 Learn http://www.dotolearn.com/
•
Picture Exchange Communication System (PECS) http://www.pecs.com/
A web site providing activities to promote independence in children and adults with special learning needs. Free
teacher and parent materials.
Lori Frost and Andy Bondy pioneered the development of The Picture Exchange Communication System
(PECS) beginning in 1985 within the state of Delaware. It is a unique augmentative/ alternative training
package that allows children and adults with autism and other communication deficits to initiate and develop
functional communication.
• Boardmaker-Mayer-Johnson http://www.mayer-johnson.com
83
Our mission is to enhance learning and human expression for individuals with special needs through symbolbased products, training and services. To facilitate the creation of symbol-based communication and
educational tools, Mayer-Johnson offers a family of powerful, yet easy-to-use Boardmaker software products
each designed for specific needs: Boardmaker is symbol-based desktop publishing software used for the
creation of printed materials.
•
Assistive Communication Links
http://prekese.dadeschools.net/PRIMETime/PTlinks.htm
•
Adapted Books
http://schools.nycenet.edu/D75/academics/literacy/adaptedbooks/catalog.htm
Complete catalog of books with pictures files in order to adapt and make them more interactive. Uses
boardmaker and Adobe PDF
Spanish

INFORMACION GENERAL SOBRE EL AUTISMO
society.org/site/PageServer?pagename=autismo
http://www.autism-
Kids
•
Just for Kids- Autism Fact Sheet http://www.njcosac.org/cosacautism
Article explaining autism to kids in simple language with pictures
National Organizations
•
Autism Speaks http://www.autismspeaks.org
•
Autism Society of America http://www.autism-society.org
•
Cure Autism Now
•
Autism National Committee www.autcom.org
Autism Speaks aims to bring the autism community together as one strong voice to urge the government and
private sector to listen to our concerns and take action to address this urgent global health crisis. It is our firm
belief that, working together, we will find the missing pieces of the puzzle
ASA is dedicated to increasing public awareness about autism and the day-to-day issues faced by individuals
with autism, their families and the professionals with whom they interact. The Society and its chapters share a
common mission of providing information and education, and supporting research and advocating for programs
and services for the autism community.
http://www.cureautismnow.org
Cure Autism Now (CAN) is an organization of parents, clinicians and leading scientists committed to
accelerating the pace of biomedical research in autism through raising money for research projects, education
and outreach.
This is the only autism advocacy organization dedicated to "Social Justice for All Citizens with Autism" through
a shared vision and a commitment to positive approaches. Our organization was founded in 1990 to protect
and advance the human rights and civil rights of all persons with autism, Pervasive Developmental Disorder,
and related differences of communication and behavior.
84
•
Center for Excellence in Autism Research (CeFAR)
http://www.wpic.pitt.edu/research/CeFAR/default.htm
The Pittsburgh-based Center of Excellence, under the direction of Nancy J. Minshew, MD, an internationally
recognized expert in autism, is among the top three CPEA’s in the country. Dr. Minshew is working with a team
of scientists from Carnegie Mellon University as well as the University of Illinois at Chicago, to search for the
genetic, cognitive, and neurological basis for autism.
•
Centers for Disease Control -Autism Information http://www.cdc.gov/ncbddd/autism/
•
OASIS www.aspergersyndrome.org
As parents of children who are diagnosed with AS, we understand how essential is it that families of children
diagnosed with Asperger Syndrome and related disorders, educators who teach children with
AS, professionals working with individuals diagnosed with AS, and individuals with AS who are seeking
support, have access to information.
Behavioral Health
•
Child Guidance Resource Center http://www.cgrc.org/child_bhrs.html
•
Holcomb Behavioral Health Service
•
Chester County Intermediate Unit
•
Creative Health Services http://cstmont.com/creative_health.htm
•
Community Services of Devereux
http://www.devereux.org/site/PageServer?pagename=ben_csd
Multiple locations that provide a full range of therapy and support services
http://www.cciu.org/Departments/StudentServices/Assessment/homecommunityservices.html/view?searcht
erm=home%20and%20community%20services
Home and Community Services serves children diagnosed with mental/behavioral health disorders and
allows them to remain in the least
restrictive setting possible.
Creative Health Services are a Core provider for Chester County BHRS system. Families can have initial
behavioral health assessments and intakes done at this location.
Community Services of Devereux (CSD) is dedicated to providing high quality, therapeutically intensive,
coordinated and community based services to children, adolescents and adults. CSD's continuum is
designed to serve the needs of the Philadelphia and Chester County community as well as to be integrated
into and complement the over-all range of care and level of services provided by all Devereux Centers
providing services to Philadelphia and Chester County residents. As a result, collaborative partnerships
between CSD staff, community resources, referral sources and payors are inherent in all services provided.
Services are also monitored and evaluated by oversight agencies and funding sources, and through
internal on-going and planned performance improvement activities. CSD conducts client, teacher and
employee satisfaction surveys proactively and monitors client outcomes through a variety of mechanisms,
including the Devereux Scales of Mental Disorders.
•
Institute for Behavioral Change http://www.ibc-pa.org/
We deliver in-home and/or in-school behavior support to address troublesome behavior of all sorts in
children of all ages who receive Medical Assistance benefits and need these services, at absolutely
no cost whatsoever regardless of family income.
•
Integrated Behavior Solutions http://www.integratedbehaviorsolutions.net
Integrated Behavior Solutions strives to provide targeted rehabilitation services to persons from 2
to 30 years of age with behavior deficits and/or developmental delays. Utilizing the skills and
styles of of vast network of professionals, we seek to provide and apply holistic approaches to
resolve problems across the behavioral health spectrum.
85
Interventions

Applied Behavior Analysis
o Discrete Trial Therapy http://kathyandcalvin.com/manuals/aba_train.htm
Good overview of DTT with examples

o Lovaas Therapy www.lovass.com

o Verbal Behavior http://www.autismusaba.de/lovaasvsvb.html
Discusses the differences between Lovaas and Verbal Behavior. While the Lovaas-based
approach uses ABA to teach language skills based on the premise that receptive language
should be developed prior to expressive language… The Verbal Behavior approach
focuses on teaching specific components of expressive language (mands, tacts,
intraverbals, among others) first.

o Fluency Training http://www.autismteachingtools.com/page/bbbbfg/bbbbfz

A brief overview of fluency concepts is provided here for informational purposes, as well as
some fluency charts and examples of how we use them. As with all interventions, we
suggest you refer to the original source material before choosing how to apply these
teaching technologies with your learners.
o Precision Teaching
http://psych.athabascau.ca/html/387/OpenModules/Lindsley/introa1.shtml
•
o
A brief overview of fluency concepts is provided here for informational purposes, as well
as some fluency charts and examples of how we use them. As with all interventions, we
suggest you refer to the original source material before choosing how to apply these
teaching technologies with your learners.
Incidental teaching
http://www.spiesforparents.cpd.usu.edu/Modules/Module%203%20%20Incidental%20Teaching/Introduction.htm

Basic overview and explanation of incidental teaching and provides examples.
o Positive behavior supports

o DIR – Floortime: http://www.floortime.org/faqs.php?faqid=3

The DIR (Developmental, Individual-Difference, Relationship-Based)/Floortime approach
provides a comprehensive framework for understanding and treating children challenged
by autism spectrum and related disorders. It focuses on helping children master the
building blocks of relating, communicating and thinking, rather than on symptoms alone.
o TEACCH- http://www.teacch.com/

•
Social Stories- http://www.thegraycenter.org/socialstories.cfm
o
A Social Story™ describes a situation, skill, or concept in terms of relevant social cues,
perspectives, and common responses in a specifically defined style and format. The goal of a
Social Story™ is to share accurate social information in a patient and reassuring manner that is
86
easily understood by its audience. Half of all Social Stories™ developed should affirm something
that an individual does well. Although the goal of a Story™ should never be to change the
individual’s behavior, that individual’s improved understanding of events and expectations may lead
to more effective responses
•
Picture Exchange Communication System (PECS) - http://www.pecs.com/
•
American Sign Language (ASL)- http://www.lifeprint.com/asl101/
•
Sensory Integration Therapies- http://216.194.201.208/terrytown/sensoryintegration.org/
o
The Picture Exchange Communication System (PECS) is an augmentative communication system
developed to help individuals quickly acquire a functional means of communication. PECS is
appropriate for individuals who do not use speech or who may speak with limited effectiveness:
those who have articulation or motor planning difficulties, limited communicative partners, lack of
initiative in communication, etc.
 Other treatment approaches:
o Gluten/Casien free diet
http://www.gfcfdiet.com
o Complimentary approaches http://www.autism-
society.org/site/PageServer?pagename=ComplementaryApproaches
Discusses art, music, animal therapies
o Biomedical and dietary approaches
http://www.autismsociety.org/site/PageServer?pagename=BiomedicalDietaryApproaches
Dentists
•
Dr. Sheldon Bernick http://www.childrens-dentistry.com/index_files/Page865.htm
General Pediatrics
•
Dr. Brad Dyer
Allstar Pediatrics
400 North Gordon Dr, Suite 702
Lionville, PA 19341
610-363-1330
•
Reading Pediatrics http://www.readingpediatrics.com/
All children with special health care needs (such as Down Syndrome, autism, cystic fibrosis) are
encouraged to participate in Reading Pediatrics’ Star program. Children enrolled in the Star Program will
have an updated list of medications, allergies, and specialty care they receive kept in the computer and on
their chart, ensuring their specific medical information will be known even in cases of an emergency visit,
when their paper chart may not be immediately available.
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Developmental Pediatricians
•
CHOP- Child Development Center
http://www.chop.edu/consumer/jsp/division/service.jsp?id=26666
34th St. and Civic Center Blvd.
Philadelphia, PA 19104
215-590-7500
•
Dr James Coplan www.ndepeds.com
919 Conestoga Rd.
Building 1, Suite 100
Rosemont, PA 19010
610-520-2130
•
Dr. Thomas Casey
937 E. Haverford Rd. Suite 103
Bryn Mawr, PA 19010
610-527-0147
•
Dr. Beth Parrish and Dr. Maureen Fee
http://www.stchristophershospital.com/CWSContent/stchristophershospital/ourServices/medicalServices/de
ptpeds.htm#developmental
St. Christopher’s Hospital
E. Erie Ave. and N. Front St.
215-427-5531
•
Shyamali Godboli, MD
Crozer Keystone Health Network
1 Medical Center Blvd # 326
Chester, Pennsylvania 19013
610-876-6898
•
Dr. Scott Meyer and Dr. Thomas Challman
http://www1.geisinger.org/patients/findadoc/docsearchresults.cfm
Geisinger Medical Center-Pediatric Subspecialties
100 N. Academy Ave.
Danville, PA 17822
570-271-6440
Developmental Optometry
•
Dr. Chaya Herzberg http://www.optometrists.org/herzberg/index.html
•
Dr. Mitchell Scheimann http://www.visiontherapy-online.com/index.html
Visual Rehabilitation for Special Populations, including Patients with Traumatic Brain Injuries,
Stroke, Whiplash, Developmental Delays, Cerebral Palsy, Multiple Sclerosis, etc.
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Speech Therapy
•
CHOP-Center for Childhood Communications
http://www.chop.edu/consumer/jsp/division/generic.jsp?id=77649
The Department of Speech-Language Pathology evaluates and treats children from birth to 21 years who
have difficulties with communication and swallowing. Services are provided across the continuum of care
from CHOP’s intensive care units, acute care units, rehabilitation programs, multiple specialty clinics, and
outpatient programs. Speech-language pathologists also teach families and professionals to work with
children with various communication and swallowing difficulties and participate in research to advance the
field of speech-language pathology.
•
Jody Seligson-Totally Sense-Sational http://www.totalysensesational.com/id17.html
•
A Total Approach http://www.atotalapproach.com/default.asp
•
Bryn Mawr Child Study Institute http://www.brynmawr.edu/csi/
•
Theraplay http://www.theraplayinc.com/
•
Fitz-All http://www.fitz-all.com/services/speech_therapy/index.html
The Therapists from Communication Imaging are dedicated to providing individualized communication
strategies and treatment plans for children of all ages. By emphasizing upon each child's strengths,
treatment techniques and goals will focus on facilitating communication and maximizing each
individual's potential. Our Speech Therapists will use such treatment techniques as PECS, oral motor
exercises, sign-langage, Floortime/DIR, etc. to help increase communication skills while in a therapeutic
naturalistic setting.
A trained masters level therapy program that works on specifically speech and communication through a
variety of methods, including oral-motor, speech, articulation, assistive technology, as well as work on
social and peer relationships.
The Child Study Institute of Bryn Mawr College provides a multidisciplinary approach to academic and
interpersonal difficulties experienced by children, adolescents, adults and families. Highly qualified
specialists in psychological assessment, educational support services, speech-language therapy, and
psychotherapy work together as a team, collaborate closely with parents, and consult with teachers to help
foster adjustment and competence in school, at home and in the community.
Speech and Language therapy helps people to develop specific communication skills and/or to
compensate for weaknesses in a specific area of ability. Speech/Language Pathologists serve all age
ranges and a variety of disorders: speech, language, hearing, voice, fluency and swallowing.
Occupational Therapy
•
•
Jody Seligson-Totally Sense-Sational http://www.totalysensesational.com/id1.html
In order for the child to develop higher order thinking and learning performance, the child has to develop
certain neuro-developmental pathways. Sensory Integration is mostly a "bottom up" approach, where we
attempt to assist the child in developing more efficient coping strategies inside his / her nervous system,
while also working at changing nervous system circuitry to develop a more functional adaptive response to
the environment in the child.
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•
Fitz-All
http://www.fitz-all.com/services/occupational_therapy/index.html
•
Collage http://www.collage-otp.org/
The occupational therapists at Fitz-All are very experienced in working with children with mild to moderate
developmental delays, learning differences/disabilities, sensory processing disorders and children on the
Autistic Spectrum.
OTP serves individuals with social skills deficits that intrude in day to day interactions in work, school,
family and leisure by providing regularly scheduled, social-skill-enhancing group activities supplemented
with therapeutic individual and group interventions and educational outreach.
Social Skills Groups
•
Prompt and Play http://www.promptandplay.com/
•
Autism Spectrum Resource Center http://www.autismsrc.org/
•
•
Center for Psychological Services http://www.centerpsych.com/
•
Fitz-All http://www.fitz-
Prompt & Play is a center designed for children ages 3 through 18 who are in need of social skills, life
skills, or individual counseling. The various groups at this center are designed to promote social and
developmental growth within children.
Our mission is to provide therapeutic services and educational resources to individuals within the autism
spectrum and their families. We recognize the special challenges that they confront in everyday living and
respect their unique approach to life. Our goal is to provide an environment where they will find a sense of
belonging with like-minded individuals. We seek to promote a positive self-image that reflects their
strengths, potential for growth, and unique contribution to our world.
The Center for Psychological Services proudly offers a range of art therapy groups designed to help
children, teenagers and young adults develop social skills and awareness. Existing strengths are reinforced
and new skills are taught to build self-esteem in a relaxed and fun environment. No art talent is necessary
to obtain maximum benefit from this program!
all.com/services/therapeutic_support/social_thinking/index.html
At Fitz-All, we have developed a range of groups for children pre-school through middle school who have a
need to develop and/or improve social interaction skills. Our small groups provide children the opportunity
to integrate their skills in a small, more typical play group. All children are screened to determine their
particular area of need and the best group and approach for them. Several approaches are used including
the cognitive approach based on the I LAUGH model, by Michelle Garcia Winner, to facilitate
communication skills for the development of social interactions.
•
Collage http://www.collage-otp.org/
•
Main Line Clinical Associates http://www.mainlineclinical.com/index.html
•
Theraplay http://www.theraplayinc.com/
OTP serves individuals with social skills deficits that intrude in day to day interactions in work, school,
family and leisure by providing regularly scheduled, social-skill-enhancing group activities supplemented
with therapeutic individual and group interventions and educational outreach.
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•
Wanna Play http://www.wannaplayprogram.com/
Wanna Play offers small social groups aimed at children of all ages and abilities, to help develop their
interactive social skills, using fun games and activities in both group and one-on-one settings.
Miscellaneous
•
Riverside Professional Development http://www.riversidepd.com/
•
Cognitive Learning Systems
•
Traci DiFrancesco, M.Ed ABA Consultant [email protected]
•
Residential Living Options http://www.residentiallivingoptions.org/
•
The Second Mile http://www.thesecondmile.org/welcome.php
Riverside Professional Development, LLC improves the performance of your professionals through
interactive, classroom style training and one-on-one consultations. Riverside facilitators have over 200
years combined experience. Our history of success with clients in private sector, academic, and human
service organizations along with State and City Government provide us a unique ability to assess your
specific needs and create customized training. We provide a monthly schedule of open registration events
at our training facility, The Riverside Center, while providing tailored workshops, either in-house or onlocation, for our contracting clients. Created in 1989 by G. David Smith, Ph.D., B.C.B.A. and incorporated in
2005 under majority owner, Erin E. Smith, Riverside Professional Development is a woman owned and
operated business headquartered in Harrisburg, PA.
http://www.coglearn.com/Default.aspx
Headquartered in Harrisburg, Pennsylvania, CLS is committed to the mission of developing and marketing
research-based student and teacher educational programs and content designed to facilitate
comprehension and enjoyment of learning. Cognitive Learning Systems believes this mission can be best
achieved by integrating proven, research-based learning methods with curriculum and training.
For 14 years, I have worked with children and adolescents with autism. I have been trained in ABA and
consult in homes and schools. I use functional behavior assessments. Once strengths and needs are
recognized, goals will be set. Some of the goals that will be addressed will be: activities of daily living,
academic, communication, social skills, community skills, fine and gross motor skills, play skills and
compliance issues. Data will be recorded daily, summarized and graphed. Interventions will be clear and
consistent. Modifications to the child's program will be adjusted according to the data collected. The skills
mastered will be generalized to different people, items, and environments. My goal is to teach children with
developmental disabilities to function and learn according to their true potential.
RLO is a non-profit organization that assists people with disabilities and their families with their individual
housing needs. Throughout the southeastern region of Pennsylvania, there are hundreds of people with
disabilities interested in developing housing of their choice. There is, however, limited funding to support
them in realizing their dreams. RLO is committed to doing something about it!
The Second Mile is a nonprofit organization serving the youth of Pennsylvania. At The Second Mile, we are
committed to helping young people achieve their potential as individuals and as community members and
providing education and support for their parents and youth service professionals.
Summer Programs/Camps
•
Aaron’s Acres http://www.udservices.org/aaronsAcres.asp
Aaron's Acres was founded as a day camp in 1998 by a group of parents who had children with special
needs. The purpose of Aaron's Acres is to provide ongoing supportive, educational and recreational
services to children with special needs and their families.
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•
5 to 6-week camps are offered every summer to children with developmental delays, including spectrum
disorders, and consists of heavy amounts of sensory integration work, DIR/Floortime, as well as
educational activities.
•
Camp Joy www.campjoy.com
•
Camp LeMar www.leemar.com
•
Keystone Pocono Camp www.campkey.com
•
Summit Camp and Travel www.summitcamp.com
•
Camp Jaycee http://www.campjaycee.org
We're a special needs camp for kids and adults with developmental disabilities: mental retardation, autism,
brain injury, and neurological disorders.
Camp Lee Mar is a private residential special needs camp for children and young adults with mild to
moderate learning and developmental challenges, including but not limited to the following: mental
retardation, developmental disabilities, down syndrome, autism, learning disabilities, Williams Syndrome,
Asperger Syndrome, ADD, Prader Willi, and ADHD.
Committed to offering novel as well as proven and meaningful programming to individuals with various
disabilities, ranging from developmental delays, ADHD, autism, and other related impairments. Ensuring
the proper degree of structure, supervision, and most importantly fun.
Camping for boys and girls with attention, social, or learning issues at Honesdale, Pennsylvania.
New Jersey Camp Jaycee is a collaborative effort between the New Jersey Jaycees and the Arc of New
Jersey , with a mission of providing quality camping experiences to persons with developmental disabilities.
Recreation
•
Island Dolphin Care http://www.islanddolphincare.org/
•
Cub Scout Pack 64- Chester County http://www.cubscoutpack64.com/
Island Dolphin Care is a 501(c)3 not for profit organization that provides dolphin therapy to children with
critical illnesses, disabilities and special needs from all over the world. We invite you to meet our therapy
staff, learn about dolphin assisted therapy, explore great resources for families, and meet our dolphins.
We are a Cub Scout Pack in the Chester County, PA Council, run by parents of boys on the autism
spectrum.
We are a group of about 20 boys that are having fun and enjoying activities that would be hard to involve
them in without their own special pack.
•
Upper Main Line YMCA-Open Doors
http://www.umly.org/UMLY/displayInfo.asp?branchID=1&progID=7504
Open Doors is a unique program at the heart of the YMCA mission for persons who are differently-abled. It
is ability, not disability that counts, and it is the possibilities that are most important!
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•
Camp Joy www.campjoy.com
Weekend Getaways occur throughout the fall and spring. Beginning Friday evenings and winding down
Sunday mornings, the sleep-over Getaway programs feature lots of camp fun: sing-alongs, storytelling,
pizza parties, talent shows, and occasional excursions. Most of the Getaway staff members are selected
from our Summer Camp counselor team.
Psycho-educational Testing
•
•
Margaret Kay http://www.margaretkay.com/
•
Neurodevelopmental Psychology Center at Widener University
http://www.widener.edu/Academics/Schools_amp_Colleges/School_of_Human_Service_Professions_/Institute_for_Graduate_Clinical
_Psychology/Neuropsychology_Assessment_Center/5338/
The Neuropsychology Assessment Center (NAC) specializes in neuropsychological evaluations for the
investigation of a variety of psychological conditions. These include conditions pertaining to learning
disabilities, brain injuries, epilepsy, autistic spectrum disorders, speech and language delays, and social
interaction problems. The center also provides personality assessments and intellectual evaluations.
•
Main Line Clinical Associates http://www.mainlineclinical.com/Testing.html
Psychologists
•
CHOP Department of Psychology
The Department of Psychology at The Children's Hospital of Philadelphia provides comprehensive
inpatient and outpatient psychological services for infants, children and adolescents with
pediatric conditions and their families.
•
Main Line Clinical Associates http://www.mainlineclinical.com/index.html
•
Autism Spectrum Resource Center http://www.autismsrc.org
Our mission is to provide therapeutic services and educational resources to individuals within the
autism spectrum and their families. We recognize the special challenges that they confront in
everyday living and respect their unique approach to life. Our goal is to provide an environment
where they will find a sense of belonging with like-minded individuals. We seek to promote a
positive self-image that reflects their strengths, potential for growth, and unique contribution to
our world.
93
Psychiatrists
•
CHOP Department of Psychiatry
The Department of Child and Adolescent Psychiatry offers an array of outpatient and emergency
services. We provide comprehensive evaluation and treatment of children and adolescents with
psychiatric conditions and behavioral or emotional difficulties. Our specialty clinics include the
Attention Deficit Hyperactivity Disorders program, the Mood and Anxiety Disorders clinic and the
Pediatric Psychopharmacology program. We are actively engaged in clinical research to support
state of the art patient care.
Opportunities for Financial Giving/Support
•
The Hearts and Smiles Foundation
PO Box 1253
Southampton, PA 18966
215-669-4221
Fax 215-997-7987
[email protected]
94
Autism Internet Resources: Información en Español
· El Autismo, hoja informativa de NICHCY.
www.nichcy.org/pubs/spanish/fs1stxt.htm
· Visite la Asociación Nuevo Horizonte.
www.autismo.com
Encuentre información de autismo en inglés y español, videos, libros, enlaces a otras organizaciones,
estadísticas y un ¡chat!
· Visite el "Indiana Resource Center for Autism" (IRCA).
www.iidc.indiana.edu/irca
El IRCA ofrece una variedad de materiales en español acerca del autismo y desórdenes relacionados.
Visite: www.iidc.indiana.edu/irca/fspanish.html
· NINDS es el Instituto Nacional de Desórdenes Neurológicos y Derrames Cerebrales.
www.ninds.nih.gov/disorders/spanish/autismo.htm
NINDS tiene disponible en español una hoja informativa extensa acerca del autismo. (En inglés, NINDS
es el "National Institute on Neurological Disorders and Stroke.")
· De la casa publicadora Woodbine.
www.woodbinehouse.com
La casa publicadora Woodbine ofrece Niños Autistas: Guía para Padres, Terapeutas y Educadores, un
libro que habla sobre cómo el autismo afecta los primeros seis años de vida de un niño. Comuníquese con
Woodbine a través del Internet o por medio de su línea libre de costo: 1.800.843.7323.
· Información general sobre el autismo.
www.autism-society.org/site/PageServer
Cortesía de Autism Society of America.
· AutismOnline.
www.autismonline.org
AutismOnline conecta a padres de niños que han sido diagnosticados recientemente y a profesionales que
trabajan con estos niños a recursos, grupos de apoyo e información sobre investigaciones. Los recursos en
español se encuentran disponibles en:
www.autismonline.org/bookspan.htm
· Información médica sobre el autismo.
www.nlm.nih.gov/medlineplus/spanish/ency/article/001526.htm
De la Libería Médica de los Estados Unidos, cortesía de Medline Plus en español, "Autismo." Discute
brevemente, desde una perspectiva médica, la definición de autismo y sus características, nombres
alternos, exámenes diagnósticos, tratamiento, prognosis y prevención.
· El niño autista.
www.aacap.org/publications/apntsfam/autistic.htm
Hoja informativa cortesía de American Academy of Child and Adolescent Psychiatry.
· "Cuando su niño/niña es diagnosticado con alguno de los desórdenes en la gama del autismo."
www.iidc.indiana.edu/irca/fspanish.html
95
Una publicación de Indiana Resource Center for Autism.
· La genética del autismo.
www.exploringautism.org/spanish/
· Un tesoro de materiales en español sobre el autismo.
www.autismo.com/scripts/articulo/slistaesp.idc?
Visite la Asociación Nuevo Horizonte y encuentre mucha información sobre los desordenes bajo la gama
del autismo (PDD). El enlace de arriba le llevará a diferentes artículos, tales como:
o Autismo: reconocer las señales en niños pequeños
www.autismo.com/scripts/articulo/smuestra.idc?n=humphries
o
El autismo: entender la mente y componer las piezas
www.autismo.com/scripts/articulo/smuestra.idc?n=happe
o Preguntas más frecuentes sobre autismo
www.autismo.com/scripts/articulo/slistafaq.idc?
o Discurso narrativo: pautas para la evaluación y la intervención
www.autismo.com/scripts/articulo/smuestra.idc?n=mgortazar2
o Bases de un programa de atención temprana para trastornos del espectro autista
www.autismo.com/scripts/articulo/smuestra.idc?n=mgortazar3
o Apuntes sobre la prevalencia del espectro autista
www.autismo.com/scripts/articulo/smuestra.idc?n=wingpotter
o Autismo, síndrome de Asperger y trastorno semántico-pragmático. ¿Dónde están los límites?
www.autismo.com/scripts/articulo/smuestra.idc?n=hfa2
o Síndrome de Asperger, autismo de alto funcionamiento y trastornos del espectro autista
www.autismo.com/scripts/articulo/smuestra.idc?n=smith1
o Diferencia entre el autismo de alto funcionamiento y el síndrome de Asperger
www.autismo.com/scripts/articulo/smuestra.idc?n=munro1
o Despúes del diagnóstico: empezando a actuar
www.autismo.com/scripts/articulo/smuestra.idc?n=despuesdiag
http://www.manitasporautismo.com/
http://www.njcosac.org/cosac2/espanol
Estrategias para sobrevivir a la integración de un niño autista en la escuela secundaria
www.autismo.com/scripts/articulo/smuestra.idc?n=secundaria
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Spanish pamphlets and manuals, Special education: Folletos en Español (all available at www.elcpa.org)
· El Derecho a la Educación Especial en Pennsylvania: Una Guía Para Padres (The Right to Special
Education in Pennsylvania: A Guide for Parents) - AVISO
· Como Obtener Ayuda Para Niños que Están Aprendiendo Inglés (How to Get Help for English
Language Learners)
· ¿Cuando Puede Ser Expulsado(a) Su Hijo(a) Por Armas a La Escuela? (Act 26) (When Can Your Child
be Expelled for Bringing Weapons to School?)
· Los Derechos de Estudiantes con Impedimentos Físicos, o de Salud o Salud Mental, Que No Necesitan
Educación Especial
(Rights of Students with Physical, Mental or Health Impairments Who Do Not Need Special Education –
Chapter 15)
· La Disciplina Escolar y Los Estudiantes Con Incapacidades (School Discipline and Students with
Disabilities)
· ¿Qué Puede Hacer Si Su Hijo(a) Está Siendo Hostigado(a) Por Otros Estudiantes En La Escuela?
(What Can You Do If Your Child with a Disability is Being Harrassed by Other Students?)
· Suspension y Expulsion en Pensilvania: Derechos del Estudiante (Suspension and Expulsion in
Pennsylvania)
· Transportación Para Estudiantes Con Impedimentos en Pennsylvania (Transportation for Students
with Disabilities in Pennsylvania)
· Carta al Departamento de Educacion Pidiendo Ayuda Para un Nino Sin Hogar (Letter to PA
Department of Education Seeking Help for Homeless Child)
For more information, please contact:
Emilio Pacheco, Vision for Equality, Inc.
Cast Iron Building
718 Arch Street 6N Floor
215-923-3349 ext 118, 215-923-3038 fax
97
Where to Order or Download Free Materials Online - Spanish
National Institute of Neurological Disorders and Stroke
National Institutes of Health
http://www.ninds.nih.gov/disorders/spanish/
Nation Institutes of Health Website (search for “autismo”)
http://salud.nih.gov/
DPW - Application for Health Care Coverage Spanish
http://www.dpw.state.pa.us/Resources/Documents/Pdf/FillInForms/Medical/PA600CH-S.pdf
98
Resources Created With Funding from DPW- Bureau of Autism Services Grant
The following materials were created with funding from DPW/BAS to better serve our Hispanic clients
and their families. The forms were compiled and created by master’s level educators, case managers,
psychologists, and nurse practitioners, all with several years working with children with autism.
99
The
CATCH
Team
Childhood Autism Team CHeck
A Collaborative Team Approach to evaluate children for autism spectrum disorders and
provide recommendations from a medical, educational and behavioral perspective for
children up to 5 years of age.
The CATCH Team
Discovering your child may have a developmental delay or disability can be the hardest
challenge a parent may have to face. Getting a diagnosis and finding out what to do to help
your child can be a daunting process. Families typically go through many assessments and
spend many hours trying to get a diagnosis and identify appropriate services within
systems.
The CATCH Team was developed to bring the 3 necessary systems together, education,
medical and behavioral health, to facilitate an evaluation that provides a diagnosis and
recommendations from all three systems to make it easier for families.
The CATCH Team includes:
-CATCH Team Administrator
-CATCH TEAM case manager
-Developmental Pediatrician
from Children’s Hospital of Philadelphia
-Early Intervention case Manager
-School Psychologist
-Rep from Behavioral Health
-and parents!
100
Answers to Frequently
Asked Questions
Who is eligible?
All children who are residents of Chester County School districts and are between the
ages of Birth-5 years old are eligible.
How much does it cost?
This program is free to all children who are residents of Chester County School districts.
Once I call Early Intervention, how does my child get referred to the CATCH Team?
Children in Early Intervention are screen with the M-Chat or other tool. If a child scores
at risk for autism, the child and family can be referred for a CATCH Team assessment.
How long will I have to wait to get a diagnosis for my child?
Once children are referred to the CATCH Team, the assessment and feedback is
scheduled with an average wait time of 3-months.
Early Identification is Key!
The optimal time for early identification is during your child’s well-child examination in the
primary care setting, as pediatric clinicians have regular contact with the majority of
children in this age range. For developmental milestones, go to www.firstsigns.org.
If you or your physician have concerns of a developmental delays or autism for your
child, call Early Intervention in Chester County. If your child is 0-3 years of age,
please call:
1-800-692-1100 x 5948
or
610-344-5948 or 5949
If your child is 3 to 5 years of age, please call:
484-237-5150
The CATCH Team assessments take place at the
Chester County Intermediate Unit 455 Boot Road
Downingtown, PA 19335
101
What is Autism?
Autism is a neurobiological disorder that is present before the age of three and continues
through adulthood.
Autism is characterized by a delay in communication, socialization and the presence of
stereotyped behaviors.
The current rate of Autism is 1 in 150 children can have an Autism Spectrum Disorder.
(Center for Disease and Control 2007)
Autism is four times more common in boys then girls.
Autism knows no racial, ethnic, social boundaries, family income, lifestyle, or educational
levels and can affect any family, and any child.
Children with autism vary widely in abilities, intelligence, and behaviors.
The earlier a child is identified with autism, the better the long-term outcomes.
Red Flags
~No big smiles or other warm, joyful expressions by six months or thereafter.
~No back-and-forth sharing of sounds, smiles, or other facial expressions by nine months
or thereafter
~No babbling by 12 months
No back-and-forth gestures, such as pointing, showing, reaching or waving by 12 months.
~No words by 16 months
~No two-word meaningful phrases (without imitating or repeating) by 24 months
~ANY loss of speech or babbling or social skills at ANY age
Red Flags from First Signs & compiled from the following sources:Greenspan, S.I. (1999) Building Healthy Minds, Perseus Books
Filipek, P.A., et al. Practice Parameter; Screening and diagnosis of autism. Neurology 2000, 55:468-79
102
El
Equipo
CATCH
Evaluación de Equipo de Autismo Infantil
(Childhood Autism Team CHeck)
Un Enfoque de Equipo Colaborador para evaluar a niños por síndrome de espectro autista y
entregar recomendaciones desde una perspectiva médica, educacional, y conductual para
niños de hasta 5 años de edad.
El Equipo CATCH
Descubrir que su hijo puede sufrir de un retardo de desarrollo o discapacidad puede ser el
desafío más difícil que un padre pueda enfrentar. Lograr un diagnóstico y descubrir qué
hacer para ayudar a su hijo puede ser un proceso abrumador. Las familias tipicamente
recurren a muchas evaluaciones y gastan muchas horas intentando lograr un diagnóstico e
identificar los servicios apropiados dentro de los sistemas.
El Equipo CATCH fue desarrollado para unir los 3 sistemas necesarios, educación, salud
médica y conductual, para facilitar una evaluación que proporcione un diagnóstico y
recomendaciones de los tres sistemas para facilitar el proceso a las familias.
El Equipo CATCH incluye:
-Administrador de Equipo CATCH
-Encargado del Caso CATCH TEAM
-Pediatra del Desarrollo
del Children’s Hospital of Philadelphia
- Encargado de Caso de Intervención Temprana
-Psicólogo de la escuela
-Representante de Salud Conductual
-¡y los Padres!
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Respuestas a Preguntas Frecuentes
¿Quien es eligible?
Todos los niños que son residentes de los distritos escolares del Condado de Chester y cuya
edad sea de hasta 5 años son eligibles.
¿Cuanto cuesta?
Este programa es gratuito para todos los niños que son residentes de los distritos
escolares del Condado de Chester.
Una vez que llame a Intervención Temprana, ¿Como es referid mi hijo al equipo
CATCH?
Los niños en Intervención Temprana son evaluados con M-Chat u otra herramienta. Si un
niño es considerado en riesgo de autismo, el niño y su familia pueden ser referidos para una
evaluación del Equipo Catch.
¿Cuánto deberé esperar para obtener un diagnóstico para mi hijo?
Una vez que un niño ha sido referido al Equipo Catch, la evaluación y comentarios son
programados con un tiempo medio de espera de 3 meses.
¡La Identificación temprana es Esencial!
El periodo óptimo para identificación temprana es durante las evaluaciones pediátricas de
su hijo en el ambiente de atención primaria de salud, puesto que los pediatras tienen
contacto regular con la mayoría de los niños en este rango de edad. Para información
respecto de las señales de desarrollo, visite www.firstsigns.org.
Si Ud. o su pediatra tienen dudas respecto de retardos de desarrollo o autismo en su
hijo, llame a Intervención Temprana en el Condado de Chester. Si su hijo es de 0-3
años de edad, por favor llame al:
1-800-692-1100 x 5948
o
610-344-5948 o 5949
Si su hijo tiene entre 3 y 5 años de edad, por favor llame al:
484-237-5150
Las evaluaciones del Equipo CATCH se realizarán en la Unidad Intermedia del Condado de
Chester
455 Boot Road
Downingtown, PA 19335
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¿Que es Autismo?
El autismo es un síndrome neurobiológico que se presenta antes de los 3 años de edad y
continúa hasta la edad adulta.
El autismo se caracteriza por un retardo en la comunicación, socialización y la presencia de
comportamientos estereotipados.
La tasa actual de autismo es de 1 en 150 niños que pueden presentar un Síndrome de
Espectro Autista (Centro de Enfermedad y Control – CDC 2007)
El autismo es cuatro veces más frecuente en niños que en niñas.
El autismo no conoce límites raciales, étnicos, o sociales, ni ingresos familiares, estilo de
vida o nivel de educación, y puede afectar a cualquier familia, y a cualquier niño.
Niños con autismo presentan una
comportamiento.
gran variedad en habilidades,
inteligencia,
y
Mientras antes se identifique a un niño con autismo, mejores son los resultados de largo
plazo.
Señales de Advertencia
~Sin grandes sonrisas u otras expresiones cálidas y alegres a los seis meses o después.
~Sin compartir sonidos, sonrisas, u otras expresiones faciales a los nueve meses o
posterior
~Sin balbucear a los 12 meses
~Sin gestos recíprocos, tales como apuntar, mostrar, alcanzar, o agitar las manos a los 12
meses.
~Sin palabras a los 16 meses o después
~Sin frases de dos palabras con significado (sin imitar o repetir) a los 24 meses odespués
~CUALQUIER pérdida de lenguaje o balbuceo o habilidades sociales a CUALQUIER edad
Señales de Advertencia de Primeras Señales y compilado de las siguientes fuentes:Greenspan, S.I. (1999) Building Healthy Minds,
Perseus Books
Filipek, P.A., et al. Practice Parameter; Screening and diagnosis of autism. Neurology 2000, 55:468-79
105
Autism Spectrum Disorders
FACT SHEET
-The current rate of Autism from the CDC (Center for Disease and Control) is 1 in
150 children can have an Autism Spectrum Disorder (ASD).
-Autism knows no racial, ethnic, social boundaries, family income, lifestyle, or
educational levels and can affect any family, and any child.
- Autism is a lifelong neuro-biological disorder that affects communication, social
interaction skills and leisure and play activities.
- Autism is four times more common in boys than girls.
- Early diagnosis and intervention are very important for children with autism.
- Other features that may be present include difficulties in eating, sleeping and
toileting, unusual fears, lack of awareness of danger, and self-injury.
- Children with autism vary widely in abilities, intelligence, and behaviors.
-The Spectrum of disorders includes many diagnostic terms including: Autistic
Disorder, Asperger’s Disorder, Rett’s Disorder, Childhood Disintegrative
Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS)
- Some children with autism will receive a duel-diagnosis of Mental Retardation at
some point in life.
- Scientists believe that both genetics and environment play a role in the cause of
autism.
- Children do not “grow out” of autism but their symptoms improve with therapy
and intervention.
- The cause of autism is unknown but it is known that parents do NOT cause
autism.
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Desórdenes de Espectro Autista
HOJA DE DATOS
- La actual tasa de Autismo detallada por el CDC (Centro para Enfermedades y Control)
es de 1 en 150 niños con Síndrome de Espectro Autista (ASD).
- El autismo no conoce delimitaciones raciales, étnicas, o sociales, ni ingreso familiar,
estilo de vida o nivel de educación y puede afectar a cualquier familia y a cualquier
niño.
- El autismo es un síndrome neurobiológico crónico que afecta la comunicación,
habilidades de interacción social y actividades de diversión y juego.
- El autismo es cuatro veces más frecuente en varones que en mujeres.
- El diagnóstico e intervención tempranos son muy importantes para niños con autismo.
- Otros síntomas que pueden estar presentes incluyen dificultades para comer, dormir, ir
al baño, temores poco frecuentes, falta de percepción de peligro, y autoagresión.
- Los niños con autismo tienen habilidades, inteligencia, y conductas
variables.
ampliamente
- El Espectro de síndromes incluye muchos términos de diagnóstico, incluyendo:
Síndrome Autista, Síndrome de Asperger, Síndrome de Rett, Síndrome Desintegrativo
de Infancia, y Síndrome General de Desarrollo No Específico (PDD-NOS)
- Algunos niños con autismo recibirán un doble diagnóstico de Retardo Mental en algún
momento de sus vidas.
- Los científicos creen que tanto la genética como el ambiente juegan roles importantes
en la causa del autismo.
- Los niños no “superan” el autismo, pero sus síntomas mejoran con terapia e
intervención.
- La causa del autismo es desconocida, pero se sabe que los padres NO causan el
autismo.
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Getting a diagnosis of autism for your child…..
One of the most common things that families ask themselves during this time is… why?
Why is this happening to my child? Why is this happening to my family? What caused
this? Did I do something too much or too little? Did another family member do something
too much or too little? Being told that your child has autism may be the most difficult time
for parents of a child with an Autism Spectrum Disorder. Each family member will deal
with the diagnosis in his or her own way; most members will experience some or all stages
of the grieving process (denial, anger, bargaining, depression and acceptance). At this
time, scientists and researchers do not know exactly what causes autism but they are sure
that autism is not caused by the lack of loving a child enough or not spending enough time
with them. Research has indicated that genetic factors are the most likely cause of autism
and that environmental factors may play a role. But again, absolutely nothing indicates
that the home environment or experience provided by family members is a cause.
The second difficult step after accepting the diagnosis is families deciding on what
treatments and interventions to pursue for their child. There is no single treatment for
Autism Spectrum Disorders, but there are several intervention options that are available to
families. The most common delivery system for interventions that children with Autism
Spectrum Disorder receive is through Special Education from the Public Education
system. Special Education is available for children with Autism Spectrum Disorders from
birth to 21 years old and can involve Speech therapy, Occupational therapy and Physical
therapy in addition to academic and social skills. An intervention commonly used is
behavior management therapy, which is based on Applied Behavior Analysis, which uses
methods to reinforce desired behaviors and decreases unwanted behaviors. One other
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method of treatment to consider is medication though the medical system. There is no
medication specifically to treat an Autism Spectrum Disorder but there is medication
available that can treat symptoms and sometimes reduce severe unwanted behaviors.
There are also services provided through Medical Assistance. Sometimes, families can
find these treatments intrusive in their family’s life. They involve therapists coming into
the home and treating the child within the home with specific interventions. The positive
aspect to this treatment is doing interventions with the child, within the home. The
therapists can then educate the family about what techniques are successful with their
child. These services are called Behavioral Health Rehabilitation Services or Wraparound
Services and include TSS (Therapeutic Support Staff), BSC (Behavior Specialist
Consultants) or MT (Mobil Therapists). Children learn best when the people around them
are consistent, and children with autism respond very well when the people around them
are supporting the same interventions.
Finally, parents and families should feel comfortable talking to professionals, support
groups and each other about the struggles that their family is facing as a result of the child
being diagnosed with an Autism Spectrum Disorder. The more family members involved
in the child’s life, the harder it is to maintain consistency with the child. However, it is not
impossible for even large extended families to be consistent at home. Everyone handles
this difficult diagnosis differently, but keeping in mind the child’s needs and family
support will be meaningful for good long-term outcomes for the child and family.
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Lograr un diagnóstico de autismo para su hijo…..
Una de las cosas más comunes que las familias se preguntan durante este período de
tiempo es... ¿Por qué? ¿Qué le está pasando a mi hijo? ¿Por que le está pasando esto a mi
familia? ¿Qué causó esto? ¿Hice algo demasiado o demasiado poco? ¿Algún otro
integrante de la familia hizo algo demasiado o demasiado poco? Recibir la noticia que su
hijo tiene autismo puede ser el momento más difícil de manejar para padres de un niño con
Síndrome de Espectro Autista. Cada integrante de la familia enfrenta el diagnóstico en
forma diferente; la mayoría experimentará algunas o todas las etapas del proceso de duelo
(negación, enojo, discusión, depresión y aceptación). En este momento los científicos e
investigadores no saben exactamente cuál es la causa del autismo, pero están seguros que
no es causado por falta de afecto hacia el hijo o por no compartir suficiente tiempo con él.
Las investigaciones han indicado que factores genéticos son la causa más probable del
autismo y que los factores ambientales pueden jugar un rol.
Debemos enfatizar
nuevamente que absolutamente nada indica que el ambiente hogareño o experiencia
entregada por los integrantes de la familia sea una causa.
El segundo paso difícil luego de aceptar el diagnóstico es que las familias decidan qué
tratamientos e intervenciones seguir con su hijo. No hay un tratamiento único para el
Síndrome de Espectro Autista, sino que hay varias opciones de intervención disponibles
para familias. El sistema más común de entrega de las intervenciones que los niños con
Síndorme de Espectro Autista reciben es a través de la Educación Epecial en el sistema de
Educación Pública. La Educación Especial está disponible para niños con Síndrome de
Espectro Autista desde su nacimiento hasta los 21 años de edad y puede incluir terapia de
Lenguaje, terapia Ocupacional, y terapia Física además de habilidades académicas y
sociales. Una intervención que comunmente se usa es terapia de manejo de la conducta,
que se basa en Análisis Conductual Aplicado, que usa métodos para reforzar conductas
deseadas y disminuir conductas no deseadas. Otro método de tratamiento a considerar es
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medicamentos vía el sistema médico. No hay medicamentos específicos para tratar el
Síndrome de Espectro Autista, pero hay medicamentos disponibles que pueden tratar
síntomas y a veces reducir conductas no deseadas severas.
También hay servicios proporcionados a través de Asistencia Médica. Algunas veces, las
familias pueden sentir que estos tratamientos son invasivos de su vida familiar. Estos
incluyen a terapeutas que visitan los hogares y tratan al niño dentro del hogar con
intervenciones específicas.
El aspecto positivo de este tratamiento es realizar las
intervenciones con el niño, dentro del hogar. El terapeuta puede en esta instancia educar a
la familia respecto de las técnicas que son exitosas con su hijo.
Estos servicios se
denominan Servicios de Rehabilitación de Salud Conductual o Servicios Englobantes e
incluyen TSS (Personal de Apoyo Terapéutico), BSC (Consultores Especialistas en
Conducta) o MT (Terapeutas Móviles). Los niños aprenden mejor cuando las personas
que los rodean son consistentes, y los niños con autismo responden muy bien cuando las
personas que los rodean apoyan las mismas intervenciones.
Finalmente, los padres y familias deberían sentirse cómodos hablando con profesionales,
grupos de apoyo y entre sí respecto de las dificultadas que su familia enfrenta como
resultado del diagnóstico de Síndrome de Espectro Autista del niño.
Mientras más
integrantes de la familia estén involucrados en la vida del niño, más difícil es mantener la
consistencia con el niño. Sin embargo, no es imposible aún para familias extendidas ser
consistentes en casa. Cada uno maneja este difícil diagnóstico en forma diferente, pero
recordar las necesidades del niño y el apoyo familiar tendrán significado para obtener
buenos resultados de largo plazo para el niño y la familia.
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Frequently Asked Questions Regarding Potty Training
By Mary Barbera, RN, MSN, BCBA
The following are my answers to some Frequently Asked Questions regarding potty training.
What age should I start?
Consider the child’s developmental age. If a child with autism just turned 3 but has a developmental age
of 18 months, it is probably too early to start an official program. However there are some steps you can
do prior to potty training: 1) Keep the child dry and clean by changing diaper frequently; 2) Comment—
“your very wet;” 3) Place the child on a potty in the morning and at bath time—reward heavily if he is
successful; 4) Boys should sit on the potty for urination until they are fully bowel trained.
My child is 3 and just got diagnosed. Potty training is a priority as I am expecting our second child
next month. Should I start a program?
If a newly diagnosed child is starting a school or home program, you probably want to gain attention and
compliance with easy programs first. You also want to establish a good positive behavior program
(without any negative reinforcement or consequences) before attempting potty training. This is obviously
a very stressful time for you and your child so I would put it off for a several months if possible since
stressful times are not conducive to successful potty training. You have to be committed and have good
carry through for a program to work. You need at least 2 solid weeks to be home a lot and be committed
to working almost solely on potty training. Also, I would look at the 3 months that follow the start date of
your program and avoid planned events like the birth of a sibling.
My child urinates on the potty if I put him on at bath time but never shows interest throughout the day.
How can I motivate him to initiate using the potty?
A child is usually trained for urination using a schedule before he starts to initiate. Another key to potty
training is determining what will motivate your child. Choose a reinforcer that your child goes crazy
over. “Good job!” usually isn’t enough to motivate any child. If your child loves m&m’s, only give him
this special reinforce after a successful trip to the potty. Another option is to go to the Dollar Store and
fill a bag so your child can pick a toy after each success. I would not recommend using long-term
reinforcers for potty training for any child, especially those with autism (for example, “I’ll buy you a train
set when you go pee on the potty for one week”). Make sure rewards are immediate, tangible and
motivating to your child.
My child is 5 but I don’t think he has the verbal or cognitive ability to be trained. Are there some
cases when potty training is just not feasible?
Azrin and Foxx suggest that by 5 years of age, even severely retarded children (IQ of about 30) can be
successfully toilet trained.
Are there books or videos I should get to prepare myself and/or my child?
Yes, if your child likes videos there are many books and videos on the subject. My favorite is Once Upon
a Potty (for Him or Her). For parents, Toilet Training in Less than a Day by Foxx and Azrin is a great
place to start and is available for under $7 at amazon.com. Another great resource is Toilet Training for
Children with Severe Handicaps by Dunlap, Koegel and Koegel available for under $5 by calling 304696-2332. Finally, if you are attempting to train adults or children on the severe end of the spectrum, a
good resource is Toilet Training Persons with Developmental Disabilities: A Rapid Program for Day and
Nighttime Independent Toileting by Richard Foxx.
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Our Child has always worn diapers. Should he continue to wear diapers or pull-ups during training?
No. One of the keys to successful toilet training is for the child to wear regular underwear during the day.
The child needs to feel wet and you need to spot the accident promptly during the training. During the
initial weeks of training, if you prefer, the child can wear only underwear (no pants) and a shirt if you are
at home. You can get waterproof pants or use a diaper or pull-up to put over underwear if needed when
you take the child out. Unless the child wakes up consistently dry, putting a diaper or pull-up on at
bedtime is acceptable both in the short term and in the long term since many children with and without
autism have nighttime accidents. First thing after waking, the child should be taken to the potty and the
diaper removed. Of course, if the child wakes up dry he should receive lots of reinforcement.
OK, I think I’m ready. What are the components of a formal toilet training program?
There are five basic steps as outlined in both the Azrin and Foxx book as well as the one by Dunlap,
Koegel, and Koegel. Because of space limitations, I will only briefly describe each step.
1) Extra Drinks: The child should be given salty foods and extra drinks to allow more opportunities for
toileting during the training period.
2) Scheduled Toileting: This should happen at least 1-2 times per hour. Tell the child “Time to go to the
bathroom/potty?” Have them say or sign “toilet/potty” and take them. The child should be heavily
reinforced if he urinates or has a BM. Once the child starts initiating, the schedule should be dropped.
3) Dry Pants Checks: There are 2 purposes for this. One is to allow for detection of accidents. The other
is to reward the child for having dry pants. The child should be asked “Are your pants dry?” These dry
pants checks can be done at intervals of 5 minutes to an hour depending on the level of success. If you
notice an accident, a dry pants check should be done immediately.
4) Positive Practice (or at least a neutral tone) for Accidents: Some toileting experts such as Dr. Richard
Foxx suggest that Positive Practice is a very important step in the toilet training process. Positive
practice involves taking a child quickly from the spot of the accident to the toilet and back again 5-10
times. For more details on this step, read Toilet Training in Less than a Day by Azrin and Foxx. I usually
don’t recommend this step initially, especially if the child is larger or if he is in a setting outside the home
where the positive practice procedure can be stigmatizing. If you chose not to implement this step of the
procedure when you toilet train, make sure you are do not laugh, smile or give your child positive
attention after accidents. Have the child participate in the clean up procedure as much as possible and redirect him or her to a neutral activity.
5) Data Recording: You will need to record all successful trips to the potty as well as urine or BM
accidents. This will help indicate the length of time between urination as well as the usual times for
BM’s. Keeping data will also help you measure the success of you toileting program.
How long will the toilet training process take?
Some children with severe disabilities train completely in a week and some take months. If your child
regresses and starts having accidents after being trained, start implementing the steps of the formal
program to get him back on track. Some children and adults with disabilities who are very difficult to
toilet train or who regress with toileting need a toileting plan developed and coordinated by a medical
practitioner or behavior analyst. Don’t be afraid to seek assistance from a qualified professional if you are
having difficulties with toileting.
For more information on potty training, read Chapter 11 of my book: The Verbal Behavior Approach:
How to Teach Children with Autism and Related Disorders. The information in this paper is not intended
to serve as professional advice nor as a substitute for consultation with medical and behavioral
professionals.
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Preguntas Frecuentes Respecto del Entrenamiento Para Dejar los Pañales
Por Mary Barbera, RN, MSN, BCBA
Las siguientes son mis respuestas a algunas Preguntas Frecuentes respecto del entrenamiento para ir al
baño.
¿A qué edad debo empezar?
Considere la edad de desarrollo de su hijo. Si un niño con autismo acaba de cumplir 3 años, pero tiene
una edad de desarrollo de 18 meses, probablemente sea demasiado temprano para comenzar un programa
oficial. Sin embargo hay algunos pasos que puede realizar antes del entrenamiento para ir al baño: 1)
Mantenga al niño seco y limpio cambiando los pañales frecuentemente; 2) Comente —“estás muy
mojado;” 3) Lleve al niño al baño en la mañana y al momento de bañarlo – recompense fuertemente si
tiene éxito; 4) Los niños deben sentarse en el inodoro para orinar hasta que estén completamente
entrenados para ir al baño.
Mi hijo tiene 3 años y acaba de ser diagnosticado. El entrenamiento para ir al baño es una
prioridad debido a que daré a luz a nuestro segundo hijo el próximo mes. ¿Debo comenzar un
programa?
Si un niño recién diagnosticado está comenzando un programa escolar o en un hogar, probablemente
quiera lograr atención y cumplimiento con programas fáciles primero. También necesita establecer un
buen programa de comportamiento positivo (sin refuerzos negativos ni consecuencias) antes de intentar el
entrenamiento para ir al baño. Este es obviamente un tiempo de alto estrés para Ud. y su hijo, así es que
yo lo postergaría por varios meses de ser posible, puesto que los momentos de alto estrés no son
conducentes a un entrenamiento exitoso para aprender a ir al baño. Debe estar comprometido y tener
mucha dedicacón para que un programa funcione. Necesita al menos 2 semanas completas de
permanencia constante en casa y estar comprometido a trabajar casi exclusivamente en el entrenamiento
para dejar los pañales. Además, yo revisaría los tres meses siguientes a la fecha de inicio del programa y
evitaría cualquier evento planificado tal como el nacimiento de un hermano.
Mi hijo orina en el baño al momento de bañarlo, pero nunca muestra interés durante el día. ¿Como
puedo motivarlo a comenzar a usar el inodoro?
Un niño es normalmente entrenado para orinar usando un horario antes que comience a iniciar. Otro punto
clave del entrenamiento para usar el baño es determinar qué motivará al niño. Elija un refuerzo que
motive mucho al niño. “¡Bien Hecho!” normalmente no es suficiente para motivar a ningún niño. Si a su
hijo le encantan los M&M, solo entreque este refuerzo luego de que tenga éxito en el baño. Otra opción
es visitar una tienda de juguetes baratos y llenar una bolsa para que su hijo pueda elegir un juguete
después de cada éxito. No recomendaría usar refuerzos de largo plazo para entrenamiento para ir al baño
en ningún niño, especialmente aquellos con autismo (por ejemplo, “Te compraré un tren de juguete
cuando orines en el inodor por una semana seguida”). Asegurese que las recompensas sean inmediatas,
tangibles y motivantes para su hijo.
Mi hijo cumplió cinco años pero no creo que tenga la habilidad verbal o cognitiva para ser
entrenado. ¿Hay algunos casos en que el entrenamiento para ir al baño simplemente no sea
factible?
Azrin y Foxx sugieren que para la edad de 5 años, incluso niños con retardo mental severo (CI cercano a
30) pueden ser entrenados exitosamente para ir al baño.
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¿Hay libros o videos que yo debería conesguir para prepararme yo y/o a mi hijo?
Sí, si a su hijo le gustan los videos, hay muchos libros y videos respecto del tema. Mi favorito es “Once
Upon a Potty (for Him or Her)”. Para padres, “Toilet Training in Less than a Day” por Foxx y Azrin es
un gran punto de inicio y está disponible por menos de US$7.00 en amazon.com. Otro gran recurso es
“Toilet Training for Children with Severe Handicaps” por Dunlap, Koegel y Koegel disponible por
menos de US$5 llamando al 304-696-2332. Finalmente, si está intentando entrenar a adultos o niños en el
extremo severo del espectro, un buen recurso es Toilet Training Persons with Developmental Disabilities:
A Rapid Program for Day and Nighttime Independent Toileting” por Richard Foxx.
Nuestro hijo siempre ha usado pañales. Debería seguir usando pañales o pañales “pull-up” durante
su entrenamiento?
No. Una de las claves para un entrenamiento exitoso para dejar los pañales es que el niño use ropa interior
normal durante el día. El niño necesita sentirse mojado y Ud. necesita observar el accidente prontamente
durante el entrenamiento. Durante las semanas iniciales de entrenamiento, si lo prefiere, el niño puede
usar unicamente ropa interior (sin pantalones) y una camisa si está en casa. Puede obtener pantalones
impermeables o usar un pañal o pañal “pull-up” sobre la ropa interior de ser necesario cuando salga con
su hijo. A menos que el niño despierte consistentemente seco, cambiar a un pañal o pañal “pull-up” al
acostarlo es aceptable tanto en el corto como en el largo plazo puesto que muchos niños con o sin autismo
tienen accidentes nocturnos. Lo primero que se debe hacer después de despertar es llevar al niño al baño
y retirar el pañal. Por supuesto, si el niño despierta seco, debería recibir abuntante refuerzo.
OK, Creo que estoy listo. ¿Cuales son los componentes de un programa formal de entrenamiento para
ir al baño?
Hay cinco pasos básicos que son detallados tanto en el libro de Azrin y Foxx como en el de Dunlap,
Koegel, y Koegel. Debido a limitantes de espacio, sólo describiré brevemente cada paso.
1) Bebidas Extra: El niño debe recibir comidas saladas y bebidas adicionales para permitir más
oportunidades de ir al baño durante el periodo de entrenamiento.
2) Programe las idas al baño: Esto debería ocurrir al menos 1 – 2 veces por hora. Diga al niño “Hora de
ir al baño ?”. Haga que diga “baño” y llévelo. El niño debe ser fuertemente reforzado si orina o hace sus
necesidades. Una vez que el niño comience a iniciar, el horario debe ser abandonado.
3) Revisión de Pantalones Secos: Hay 2 propósitos para esto. Uno es permitir la detección de accidentes.
El otro es premiar al niño por tener pantalones secos. Al niño se le debe preguntar “¿Están secos tus
pantalones?”. Estas revisiones de pantalones secos pueden ser realizadas a intervalos de 5 minutos a una
hora dependiendo del nivel de éxito. Si observa un accidente, se debe realizar inmediatamente una
revisión de pantalones secos.
4) Práctica Positiva (o al menos de tono neutro) para Accidentes: algunos expertos de baño tales como el
Dr. Richard Foxx sugieren que Práctica Positiva es un paso muy importante en el proceso de
entrenamiento para dejar los pañales. La práctica positiva involucra llevar al niño rápidamente desde el
lugar del accidente al baño o de vuelta 5 a 10 veces. Para mayores detalles respecto de este paso, lea
“Toilet Training in Less than a Day” por Azrin y Foxx. Normalmente no recomiendo este paso
inicialmente, especialmente si el niño es mayor o si está en un ambiente fuera de su hogar, donde el
procedimiento de práctica positiva pueda ser estigmatizante. Si elige no implementar este paso cuando
entrene para quitar los pañales, asegurese de no reir, sonreir, o entregar atención positiva luego de
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accidentes. Haga que el niño participe en el proceso de limpieza lo más posible y reorientelo a una
actividad neutral.
5) Registrar Datos: Necesitará anotar todas las idas exitosas al baño así como cualquier accidente. Esto
le ayudará a indicar el largo de tiempo entre idas al baño. Mantener datos también le ayuda a medir el
éxito de su programa de retiro de pañales.
¿Cuanto tiempo demorará el proceso de entrenamiento para dejar los pañales?
Algunos niños con discapacidades severas son completamente entrenados en una semana mientras que
otros requieren meses. Si su hijo retrocede y comienza a tener accidentes después de ser entrenado,
comience a implementar los pasos del programa formal para volver a enfocarlo. Algunos niños y adultos
con discapacidad que son difíciles de entrenar o que retroceden necesitan un plan de entrenamiento para
dejar los pañales desarrollado y coordinado por un practicante médico o analista de comportamiento. No
tenga miedo de buscar ayuda de un profesional calificado si está teniendo dificultades con el
entrenamiento para uso del baño.
Para mayor información respecto de entrenamiento para quitar los pañales, lea el capítulo 11 de mi libro:
“The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders”. La
información en este artículo no tiene por intención cumplir la función de consejo profesional ni como
sustituto de consultas con profesionales médicos y de comportamiento.
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Applied Behavioral Analysis (ABA): Myths and Facts
MYTH: ABA is only for extremely impaired children, who do not speak.
FACT: The principles of ABA can be used with children of all developmental and
cognitive levels. The types of interventions that will be helpful will vary with each child.
MYTH: ABA is rigid and must take place with a child sitting at a table.
FACT: Many teaching techniques based on ABA, such as verbal behavior, focus on
generalization and teaching a child skills in the environment in which they need to us
them. BHRS (Behavioral Health Rehabilitation Services) or wraparound providers can
implement ABA techniques while a child is in any natural environment (home,
playground, school, community settings).
MYTH: ABA creates children who are robotic and who only know the skills that you
teach them.
FACT: Generalization (using skills in real life scenarios) is a key component of a
successful ABA program. A good ABA program will include time and goals dedicated to
generalization, or helping children use skills naturally in their environments.
MYTH: ABA is expensive, costing families $30,000 to $50, 000/ year.
FACT: Many public school settings and private special education settings can
implement ABA techniques as part of a classroom. BHRS (wraparound providers) can
use ABA in a program that supports the child in a variety of environments. Public
education and BHRS services are provided at no cost to families. Please check with your
local school district and BHRS provider to find out what services are available and
appropriate for your child in your area.
MYTH: All children with autism need an intense, 40 hour/ week ABA program.
FACT: In the book Educating Children with Autism, the National Research Council
recommends: “ . . . that educational services begin as soon as a child is suspected of
having an autism spectrum disorder.” Those services should include . . . systematically
planned, and developmentally appropriate educational activities geared toward
identified objectives. These number of hours will vary according to a child’s
chronological age, developmental level, specific strengths, and weaknesses, and family
needs. (just keep in mind this is just for little kids-not school age)
MYTH: ABA will cure autism.
FACT: There currently is no cure for autism. There are many treatments and
educational techniques that can improve a child’s skills and decrease their symptoms
over time.
MYTH: ABA involves punishment, such as hitting or yelling.
FACT: ABA therapists and teachers that use ABA focus on reinforcing appropriate
behavior through positive reinforcement. In fact, some methods of ABA involve
“errorless teaching”. This is where the child isn’t even told “no” during teaching. The
teacher or therapist prompts the child at a level that allows them to respond correctly,
at any level of mastery.
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Análisis Aplicado de Comportamiento (ABA): Mitos y Realidades
MITO: ABA es sólo para niños con discapacidades muy severas, que no hablan.
HECHO: Los principios de ABA pueden ser usados con niños de todo nivel cognitivo y de
desarrollo. Los tipos de intervenciones que serán de ayuda variarán de niño en niño.
MITO: ABA es rígido y debe ocurrir con un niño sentado frente a una mesa.
HECHO: Muchas técnicas de enseñanza basadas en ABA, tales como comportamiento verbal, se
enfocan en generalizar y enseñar al niño habilidades en el ambiente en el cual necesita usarlas.
BHRS (Servicios de Rehabilitación de Salud Conductual) o proveedores englobantes pueden
implementar técnicas ABA mientras un niño se encuentra en cualquier ambiente natural (hogar,
patio de recreo, escuela, ambientes comunitarios).
MITO: ABA crea niños que son robóticos y que sólo conocen las habilidades que usted les
enseña.
HECHO: La generalización (usar habilidades en escenarios de la vida real) es un componente
clave de un programa ABA exitoso. Un buen programa ABA incluirá tiempo y metas dedicadas
a generalización o a ayudar a los niños a usar habilidades naturalmente en sus ambientes.
MITO: ABA es costoso, con valores por familia de US$30.000 a US$50.000 / año.
HECHO: Muchos distritos escolares y servcios de educación especial de escuelas privadas
pueden implementar técnicas ABA com parte de un salón de clases. BHRS (proveedores
englobantes) pueden usar ABA en un programa que apoya al niño en variados ambientes. La
educación pública y los servicios BHRS son proporcionados sin costo a las familias. Por favor
verifique con su distrito escolar local y proveedor BHRS para averiguar que servicios están
disponibles y son apropiados para su hijo en su área.
MITO: Todos los niños con autismo necesitan un programa ABA intensivo, de 40 horas
semanales.
HECHO: En el libro Educando Niños con Autismo (Educating Children with Autism), el Consejo
Nacional de Investigación (National Research Council) recomienda: “ ... que los servicios de
educación comiencen en cuanto se sospeche que un niño tenga un desorden de espectro
autista”. Esos servicios deberían incluir ... actividades educativas planificadas en forma
sistemática y apropiadas en términos de desarrollo orientadas a objetivos identificados. Este
número de horas variará según la edad cronológica del niño, su nivel de desarrollo, fortalezas
y debilidades específicas, y las necesidades familiares (recuerde que esto es sólo para niños
pequeños – de edad pre-escolar)
MITO: ABA curará el autismo.
HECHO: Actualmente no hay una cura para el autismo. Hay muchos tratamientos y técnicas de
educación que pueden mejorar las habilidades de un niño y disminuir sus síntomas con el
transcurso del tiempo.
MITO: ABA incluye castigos, tales como golpes o gritos.
HECHO: Terapeutas y profesores ABA usan el enfoque ABA de reforzar conductas apropiadas
via refuerzo positivo. De hecho algunos métodos de ABA incluyen “enseñanza sin errores”.
Esto es cuando al niño ni siquiera se le dice “no” durante la enseñanza. El profesor o terapeuta
trabaja con e l niño a un nivel que le permite responder correctamente, a cualquier nivel de
maestría.
118
What is Applied Behavior Analysis or (ABA)?
ABA refers to a systematic approach to the assessment and evaluation of
behavior, and the application of interventions that alter behavior. It is used as
the basic principle guiding many teaching methods for children with autism and
also the basis for the Behavioral Health Rehabilitation Services (Wraparound) that
are available for children in Pennsylvania.
Basically, ABA looks at all behavior (social, academic, adaptive, physical, etc.)
and breaks it down into 3 basic parts.
1. Antecedent – what happens right before the behavior (could be a
command, and environmental change, or an action by another person)
2. Behavior – exactly what the person does this is measurable, and tangible.
(examples: saying the word “home” more than 3 times in a row, standing
up and walking towards a doorway, scribbling on a worksheet, or pinching
someone.)
3. Consequence – what happens immediately following the behavior.
(examples: the teacher pointing at a schedule for the day, a parent
redirecting the child to the task, ignoring the behavior.
ABA works to decrease inappropriate behaviors, (like hitting, or spinning) by
either changing the antecedent to prevent the behavior from happening in the
first place or by changing the consequence to prevent the behavior from
happening again in the future.
ABA also works to increase appropriate behaviors (like using language to
request items, and following adult direction) by changing the antecedent to
create an opportunity for the appropriate behavior to occur or by changing the
consequence to make a child more likely to elicit a behavior again.
A (Antecedent)
The teacher asks the
child to clean up
their snack.
B (Behavior)
The child sits still
and says “home,
home, home”
A lawn mower begins The child stands up
to make noise in a
and runs towards a
neighboring yard.
closet door.
119
C (Consequence)
The teacher points at
a schedule to show
the child that it is
clean up time.
Parent takes the child
by the elbow and
guides them back to
the dinner table.
¿Que es Análisis Conductual Aplicado (ABA)?
ABA se refiere a un enfoque sistemático del diagnóstico y evaluación de la conducta, y
a la aplicación de intervenciones que alteran la conducta. Es usado como el principio
básico que guía muchos de los métodos de enseñanza para niños con autismo y
también en torno a la base de los Servicios de Rehabilitación de Salud Conductual
(englobante) que están disponibles para niños en Pennsylvania.
Básicamente, ABA observa todo el comportamiento (social, académico, adaptativo,
físico, etc.) y lo separa en tres partes básicas.
1. Antecedente – lo que pasó inmediatamente antes de la conducta (puede ser una
orden, un cambio ambiental, o una acción por otra persona)
2. Conducta – exactamente lo que la persona hace; esto es medible y tangible.
(ejemplos: decir la palabra “casa” más de 3 veces seguidas, pararse y caminar
hacia una puerta, escribir en forma ilegible en una hoja de trabajo, o pellizcar a
alguien).
3. Consecuencia – lo que pasa inmediatamente después de la conducta. (ejemplos:
el profesor apuntando a un horario para el día, un apoderado redirigiendo al
niño a la tarea, ignorar la conducta.
ABA trabaja para disminuir las conductas inapropiadas (como golpear, o girar) ya sea
cambiando el antecedente para prevenir que llegue a ocurrir la conducta, o cambiando
la consecuencia para prevenir que la conducta se repita en el futuro.
ABA también trabaja para aumentar las conductas apropiadas (tales como usar
lenguaje para solicitar cosas, y seguir instrucciones de adultos) al cambiar el
antecedente para crear una oportunidad para que ocurra una conducta apropiada o
cambiando la consecuencia para lograr que un niño sea más propenso a realizar una
conducta nuevamente.
A (Antecedente)
El profesor solicita al
niño que limpie los
restos de su
merienda.
B (Conducta)
El niño permanece
sentado quieto y dice
“casa, casa, casa”
Una máquina de
cortar pasto
comienza a hacer
ruido en un patio
vecino.
El niño se para y
corre hacia una
puerta de clóset.
120
C (Consecuencia)
El profesor apunta a
un horario para
mostrar al niño que
es hora de hacer las
limpieza.
El padre toma al niño
del brazo y lo guía de
vuelta a la mesa del
comedor.
Frequently Asked Questions Regarding Verbal Behavior
By Mary Barbera, RN, MSN, BCBA
As a lead consultant for the Pennsylvania Verbal Behavior Project as well as through my private practice, I have
found there is a need for some basic information about Verbal Behavior programming. In a question and answer
format, I will attempt to cover basic information for parents and professionals.
What is Verbal Behavior programming?
Verbal Behavior programming is guided by the principles of Applied Behavior Analysis (ABA). In addition to
using ABA principles, a Verbal Behavior (VB) practitioner also incorporates BF Skinner’s Analysis of Verbal
Behavior.
In 1957, BF Skinner published an important book entitled, Verbal Behavior. Skinner described language as a
behavior and illustrated how language could be taught using the principles of operant conditioning. He also
expanded the definition of verbal behavior to include any behavior mediated by a listener. A child using sign
language to make a request, saying a word to label an item, or having a tantrum because he didn’t get his way are
all considered Verbal Behavior according to Skinner’s Analysis.
Unfortunately Skinner’s book was largely ignored for decades until Dr. Jack Michael and his students, Mark
Sundberg and James Partington began to apply it with great success many years later.
What is the ABLLS and how does it relate to Verbal Behavior programming?
The ABLLS is an acronym for a book entitled, Assessment of Basic Language and Learning Skills. It was written
by Drs. Mark Sundberg and James Partington and published in 1998. This book is an assessment, curriculum
guide, and skills tracking system for children with autism or other developmental disabilities. VB practitioners
utilize the ABLLS to assess a child’s level in 25 different domains. A parent and/or a teacher who is very familiar
with the child can complete this assessment. The ABLLS can be completed every 3 to 6 months after the initial
assessment serving as an excellent tracking system of the child’s progress. Also in 1998, Drs. Sundberg and
Partington published Teaching Language to Children with Autism and Other Developmental Disabilities, which
gives an excellent overview of the VB terminology and techniques. These books, based on Skinner’s analysis of
Verbal Behavior, finally brought VB techniques into programs to educate children with autism.
How does a Verbal Behavior model differ from a Lovaas or discrete trial model?
A traditional ABA model such as the one pioneered by Dr. Ivaar Lovaas stresses compliance training, imitation
skills and building receptive language for young, non-vocal early learners. The VB model, on the other hand, looks
first at what the child wants and then teaches the child how to request (in VB terms, how to mand). Initially that
may involve only the child reaching for the item to indicate interest. The child quickly learns that if they use
“verbal behavior” or reaching in this case, to indicate interest in something, they get the item. Many VB
consultants also recommend the use of sign language for most non-vocal early learners while Lovaas consultants
rarely recommend signing as a first step. Another key difference is that VB is much more child-led. Also, early
skills, such as manding, are usually taught away from a table and in the natural environment as much as possible.
Both Lovaas programs and VB programs are based on the principles of ABA so there are many similarities as well
as a few key differences.
121
I keep hearing VB terms like manding, tacting, and intraverbals. My child can say 10 words, how does that
relate to the VB model?
While most traditional speech therapists and ABA practitioners break language into receptive and expressive
categories, BF Skinner and later Drs. Sundberg and Partington broke language down even further. They realized
that children with severe language impairments did not follow the normal developmental sequence for acquiring
language. Furthermore, they realized that many children with autism had very scattered skills. One child with
autism may be able to verbally label (in VB terms, tact) 100 items. That same child, who may be able to say
“cookie” when presented with a picture of a cookie, could not ask for (or mand) for cookie when she wanted one.
That child could also not say the word cookie or even point to a cookie if you said, “you eat a _______”. This fillin-the-blank is an intraverbal in VB terminology. The child could also not say “cookie” if you said, “say cookie”.
So his verbal imitation skills were also very poor. This child’s profile could be exactly opposite from the next
child’s ABLLS.
Getting back to your child who says 10 words, utilizing the VB model and the ABLLS, you would have to describe
the 10 words your child can verbally say. Can he make one-word requests or label items? Can he complete fill-inthe -blanks or can he imitate words or phrases? These are all-important skills and need to be assessed and
programmed for differently.
How can I learn more about Verbal Behavior programming?
My new book, The Verbal Behavior Approach: How to teach children with autism and related disorders gives an
in-depth overview of verbal behavior programming. For more information, and a list of web sites and resources
check my web site: www.vbapproach.com.
122
Preguntas Frecuentes Respecto de Comportamiento Verbal
Por Mary Barbera, RN, MSN, BCBA
Como consultora principal del Proyecto de Comportamiento Verbal de Pennsylvania así como en mi consulta
privada, he encontrado que hay una necesidad de información básica respecto de programación de Comportamiento
Verbal. En formato de pregunta y respuesta, intentaré cubrir la información básica para apoderados y
profesionales.
¿Qué es la programación de Comportamiento Verbal?
La programación de Comportamiento Verbal está guiada por los principios de Análisis de Comportamiento
Aplicado(ABA). Además de usar los principios ABA, un practicante de Comportamiento Verbal (VB) también
incorpora el Análisis de Comportamiento Verbal de BF Skinner.
En 1957, BF Skinner publicó un importante libro titulado, “Verbal Behavior” (Comportamiento Verbal). Skinner
describió el lenguaje como un comportamiento e ilustró como el lenguaje puede ser enseñado usando los principios
de condicionamiento operante. También amplió la definición de comportamiento verbal para incluir cualquier
comportamiento mediado por un auditor. Un niño usando lenguaje de señas para hacer una solicitud, diciendo una
palabra para identificar un objeto, o tener un berrinche porque no logró lo que quería son todos considerados
Comportamiento Verbal según el análisis de Skinner.
Desafortunadamente, el libro de Skinner fue en gran medida ignorado por décadas, hasta que el Dr. Jack Michael y
sus estudiantes, Mark Sundberg y James Partington comenzaron a aplicarlo con gran éxito muchos años después.
¿Que es ABLLS y como se relaciona con la programación de Comportamiento Verbal?
ABLLS es una sigla para un libro titulado, “Assessment of Basic Language and Learning Skills” (Evaluación de las
Habilidades Básicas de Lenguaje y Aprendizaje) . Fue escrito por los doctores Mark Sundberg y James Partington,
y publicado en 1998. Este libro es una evaluación, guía curricular, y sistema de monitoreo de habilidades para
niños con autismo u otras discapacidades del desarrollo. Practicantes VB usan el ABLLS para evaluar el nivel de
un niño en 25 dominios diferentes. Un padre y / o profesor que está muy familiarizado con el niño puede
completar esta evaluación. La ABLLS puede ser completada cade 3 a 6 meses luego de la evaluación inicial, y
sirve como un excelente sistema de monitoreo del progreso del niño. También en 1998, los doctores Sundberg y
Partington publicaron “Teaching Language to Children with Autism and Other Developmental Disabilities”, que
entrega una excelentevisión general de la terminología y técnicas VB. Estos libros, basados en el análisis de
Skinner del Comportamiento Verbal, finalmente lograron incluir técnicas VB en programas para educar a niños con
autismo.
¿Como difiere el modelo de Comportamiento Verbal de un modelo Lovaas o de ensayo discreto?
Un modelo ABA tradicional como el iniciado por el Dr Ivaar Lovaas enfatiza entrenamiento para el cumplimiento,
habilidades de imitación y la construcción de lenguaje receptivo para alumnos pequeños, no vocales. El modelo
VB, por otro lado, mira primero aquello que el niño desea y luego le enseña a pedirlo (en términos de VB).
Inicialmente esto puede involucrar sólo que el niño estire la mano para indicar interés. El niño rápidamente
aprende que si usa “comportamiento verbal” o estirar la mano en este caso, para indicar interés en algo, obtendrá
ese algo. Muchos consultores VB también recomiendan el uso de lenguaje de señas para la mayoría de los alumnos
pequeños no vocales mientras que consultores Lovaas rara vez recomiendan el uso de señas como un primer paso.
Otra diferencia clave es que VB es mucho más guiado por el niño. Además, habilidades tempranas, tales como
“manding”, normalmente son enseñadas alejado de una mesa y en el ambiente natural en la medida que sea posible.
Tanto los programas Lovaas como los VB se basan en los principios de ABA así es que hay muchas similitudes
además de algunas diferencias claves.
123
¿Escucho continuamente términos VB como “manding”, “tacting”, y “intraverbals”. Mi hijo puede decir 10
palabras, ¿Como se relaciona eso con el modelo VB?
Mientras que la mayoría de los terapeutas de lenguaje tradicionales y practicantes ABA desglosan el lenguaje en
categorías expresiva y receptiva, BF Skinner y luego los doctores Sundberg y Partington desglosaron el lenguaje
aún más. Ellos observaron que niños con discapacidades severas de lenguaje no seguían la secuencia normal de
desarrollo para adquirir lenguaje. Más aún, ellos notaron que muchos niños con autismo tenían habilidades muy
dispersas. Un niño con autismo podría ser capaz de nombrar verbalmente (en términos VB, “tact”) 100 cosas. Ese
mismo niño, que puede ser capaz de decir “galleta” cuando se le presenta una fotografía de una galleta, no puede
pedir (o “mand”) una galleta cuando quiere una. Ese niño tampoco podía decir la palabra galleta, ni siquiera
apuntar a una galleta si se le decía “tu comes una _______”. Este completar la oración es un “intraverbal” en
terminología VB. El niño tampoco podía decir “galleta” si uno le decía “di galleta”. Por ello sus habilidades de
imitación verbal también fueron muy pobres. El perfil de este niño podría ser exactamente opuesto al del ABLLS
de otro niño.
Volviendo a su hijo que puede decir 10 palabras, utilizando el modelo VB y el ABLLS, Ud. tendría que describir
las 10 palabras que su hijo puede decir verbalmente. ¿Puede hacer solicitudes de una palabra? ¿Puede completar
oraciones o puede imitar palabras o frases? Estas son habilidades cruciales y se necesita evaluarlas y programarlas
en forma diferente.
¿Cómo puedo aprender más respecto de programación de Comportamiento Verbal?
Mi nuevo libro, “The Verbal Behavior Approach: How to teach children with autism and related disorders” (“El
Enfoque de Comportamiento Verbal: Cómo enseñar a los niños con autismo y otros problemas similares”) entrega
una visión global en profundidad de la programación de comportamiento verbal. Para mayor información, y una
lista de sitios y recursos Web, visite mi sitio web: www.vbapproach.com.
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CATCH Team - Chester County Intermediate Unit

Transcripción

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