ABA Therapy Treatment Planning Overview
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What is one key component to include in a written discharge plan?

  • A detailed description of the initial assessment
  • A plan for monitoring and follow-up (correct)
  • A list of all previous interventions used
  • Families' feedback on the overall treatment

    • What must patients continue to demonstrate for discharge under insurance funding?

  • Independence from all therapies
  • Full mastery of every targeted skill
  • Meaningful progress on socially significant goals (correct)
  • Compliance with all previous treatment recommendations

    • Whose involvement is emphasized in the planning of desired outcomes for services?

  • Only the clients themselves
  • Parents and other professionals (correct)
  • Supervisors only
  • Medical staff exclusively

    • What is a crucial aspect of discharge criteria as mentioned in the content?

    <p>Individualized criteria for each patient</p> Signup and view all the answers

    How should BCBAs approach the decision-making process for discharge?

    <p>Using the same scientific process applied to teaching skills</p> Signup and view all the answers

    What is a reasonable expectation regarding a patient's behavior and skill deficits?

    <p>They may improve significantly over time.</p> Signup and view all the answers

    What could be a consequence of withdrawing treatment from a patient?

    <p>Loss of the progress made by the patient.</p> Signup and view all the answers

    According to the BACB’s Ethics Code, what should behavior analysts consider when designing interventions?

    <p>Risks, benefits, and side effects.</p> Signup and view all the answers

    What is a comprehensive ABA model as per CASP's practice guidelines for ASD?

    <p>30-40 hours per week targeting multiple skill domains.</p> Signup and view all the answers

    What does the conventional view state about the relationship between dosage and patient progress?

    <p>More hours of treatment are correlated with better outcomes.</p> Signup and view all the answers

    Why might the belief that 'more is better' in treatment hours be problematic?

    <p>It underestimates the importance of individualized treatment.</p> Signup and view all the answers

    What is the recommended dosage for a focused model of ABA as per CASP’s guidelines?

    <p>10-25 hours per week.</p> Signup and view all the answers

    What should behavior analysts advocate for according to BACB's Ethics Code?

    <p>The appropriate amount of behavioral service to meet client goals.</p> Signup and view all the answers

    What is the average duration of Max's tantrums?

    <p>20 minutes</p> Signup and view all the answers

    How does Sebastian currently communicate?

    <p>In 1-2 word phrases</p> Signup and view all the answers

    Which of the following therapies does Sarah receive?

    <p>Both A and B</p> Signup and view all the answers

    What is the range of hours for therapy recommended for Amara?

    <p>12-20 hours/week</p> Signup and view all the answers

    What behavior does Sebastian engage in that indicates echoing or repetition?

    <p>Toe-walking</p> Signup and view all the answers

    At what age was Amara diagnosed with autism?

    <p>3 years old</p> Signup and view all the answers

    What commitment do parents of these children show regarding ABA methods?

    <p>They are open to learning and being present</p> Signup and view all the answers

    What co-occurring condition is Carlos known to have?

    <p>Seizure disorder</p> Signup and view all the answers

    What is suggested about the therapy hours required for optimal progress for most patients?

    <p>Very few patients require more than 20 hours of therapy per week.</p> Signup and view all the answers

    What is emphasized regarding the delivery of therapy services to children?

    <p>Children should receive education in the least restrictive environment.</p> Signup and view all the answers

    What approach does Kyo adopt concerning clinical recommendations?

    <p>Recommendations aim to optimize patient outcomes and respect family resources.</p> Signup and view all the answers

    In the context of interventions, why is understanding the full suite of evidence-based interventions important?

    <p>It provides a holistic view of a child's treatment options.</p> Signup and view all the answers

    What is one of the key beliefs held by Kyo regarding school-aged children?

    <p>Children should receive necessary supports in educational settings.</p> Signup and view all the answers

    What is a common barrier to language development in children with ASD and intellectual disabilities?

    <p>Limited motivation for social interaction</p> Signup and view all the answers

    What is indicated as common for patients seeking services at Kyo?

    <p>Patients typically need a lower intensity of therapy for progress.</p> Signup and view all the answers

    Which of the following strategies is likely to be less emphasized by Kyo?

    <p>Providing as much therapy as possible regardless of individual need.</p> Signup and view all the answers

    Which co-occurring conditions might negatively affect treatment outcomes for children with ASD?

    <p>Physical health issues</p> Signup and view all the answers

    Which statement best describes Kyo's view on evidence-based interventions?

    <p>There is a variety of interventions that can contribute to effective treatment.</p> Signup and view all the answers

    What is an example of a maladaptive behavior that may be observed in children with ASD?

    <p>Echolalia</p> Signup and view all the answers

    Which factor is considered when assessing dosage for treatment in children with ASD?

    <p>Caregiver commitment</p> Signup and view all the answers

    What should be evaluated to determine relevant interventions for a child with ASD?

    <p>Evidence-based activities</p> Signup and view all the answers

    What is likely to be a significant challenge for children with ASD when developing social competence?

    <p>Impaired social skills</p> Signup and view all the answers

    Which activity is particularly important when planning interventions for a child with ASD?

    <p>Evidence-based interventions based on interests</p> Signup and view all the answers

    What type of imitational skills might children with ASD exhibit?

    <p>Weak or impaired verbal operants</p> Signup and view all the answers

    What is the initial recommended weekly dosage at Kyo for patients?

    <p>12 hours</p> Signup and view all the answers

    What is a treatment goal for young patients in ABA therapy?

    <p>Dramatically change developmental trajectory</p> Signup and view all the answers

    Which age group may have a history of plateauing with ABA therapy?

    <p>Older patients</p> Signup and view all the answers

    Which factor is indicated to correlate with patient response to ABA therapy?

    <p>Language skills</p> Signup and view all the answers

    What is an obstacle to learning identified in the content?

    <p>Strong, persistent negative behaviors</p> Signup and view all the answers

    At what age range are neural circuits found to be most adaptable?

    <p>First 3 years of life</p> Signup and view all the answers

    What may not always correlate with treatment outcomes?

    <p>Patient's age</p> Signup and view all the answers

    What is a key consideration when assessing a patient's imitation skills?

    <p>Co-occurring diagnoses</p> Signup and view all the answers

    Which age group may not have other interventions available or started yet?

    <p>Infants</p> Signup and view all the answers

    What may be an important factor in determining dosage considerations for patients?

    <p>Patient's maladaptive behaviors</p> Signup and view all the answers

    Study Notes

    ABA Therapy Treatment Planning

    • The presentation is about ABA therapy treatment planning, dosage, duration, and discharge.
    • The agenda includes a 3D view of treatment planning, a 3D review process, case examples, and critical conversations and managing disputes.
    • The 3D view involves dosage, duration, and discharge.

    Treatment Planning the Kyo Way

    • Services are prescribed based on each client's profile.
    • Treatment dosage is continuously tuned.
    • Services are provided until medically necessary.
    • Technology monitors patient progress at individual, regional, and company levels.

    Conscientious 3D Treatment Planning

    • Thoughtful and iterative treatment planning is essential for optimized outcomes.
    • Patient progress is optimized.
    • Family time and priorities are respected.
    • Health plan and member costs are considered.
    • Access is ensured for children who need treatment.
    • Kids, families, payers, agencies, and society all benefit.

    Definition of Applied Behavior Analysis (ABA)

    • ABA is a science that systematically applies behavioral analysis principles to improve socially significant behaviors.
    • Experimented-based analysis is used to identify the factors that influence behavior change.
    • The process involves 6 components, one of which is meaningful improvements to crucial behaviors.

    Definition of Medical Necessity

    • Guidelines vary by payer but share common principles.
    • Standardized assessments must demonstrate measurable and ongoing improvement in targeted behaviors and skills.
    • Continued improvement in behavior and skills are expected.
    • Cessation of treatment should result in a decline in progress.

    BACB Code of Ethics for Behavior Analysts

    • Behavior analysts consider factors such as risks, benefits, side effects, and client preferences when developing interventions.
    • Interventions are designed and implemented with the goal of maintaining positive results under typical conditions.
    • Appropriate levels of oversight and behavioral service provision should be provided to reach client goals.

    Dosage: Individualized, Tuned Approach to "How Much"

    • The amount of ABA therapy should be individualized based on client needs
    • Guidelines suggest a range of 10-25 hours per week (focused model) to 30-40 hours per week (comprehensive model) for children with autism spectrum disorder (ASD).
    • Dosage research indicates that more hours doesn't always equal more progress

    Dosage Research

    • In fee-for-service (FFS) models, more therapy hours often lead to greater reimbursement for agencies.
    • There is contemporary research that indicates that higher hours doesn't necessarily equate to better outcomes.
    • Standardized measures have shown that more hours doesn't always lead to better progress.

    JAMA Pediatrics Article on ABA Dosage

    • A meta-analysis found that the research on ABA doesn't support more than 20 hours/week of treatment being effective.
    • There are limitations to the study.
    • Clinicians need to carefully assess which of their clients would benefit from intensive services (20+ hours/week).

    Understanding Evidence-Based Interventions

    • Evidence-based interventions include ABA delivered by therapists or parents, Speech Language Pathologists (SLPs), Physical Therapists (PTs), Occupational Therapists (OTs), and social skills groups.
    • There is a wide range of evidence-based interventions available for children.

    Kyo's Clinical Culture Aligns with Recent Research

    • Kyo prioritizes clinical recommendations that respect family time, payer dollars, and patient outcomes.
    • Children require comprehensive support services, including appropriate education and least restrictive settings possible.
    • High-dose ABA therapy is exceptional, not the norm, at Kyo.

    Dosage Considerations: Sweet Spot of Therapy

    • Common dosage ranges for ABA in Kyo are 12-21 hours/week for all but advanced cases.

    Additional Dosage Considerations

    • Factors that can impact dosage include age, language/imitation skills, potential barriers to treatment, co-occurring diagnoses, other therapies involved, and caregiver commitment.

    Dosage Considerations

    • The factors that may influence the dosage of therapy for a patient include the child's age, their language/imitation skills, potential treatment barriers, co-occurring diagnoses, other therapies being used, and the caregiver's input.
    • Research shows a correlation between pre-treatment language skills and imitation skills and the outcome of the ABA therapy.
    • Some factors that can impede learning include severe tantrums, aggression, limited communication skills, and a lack of motivation for social interaction.

    What other programs and activities is the child involved in?

    • What activities and programs are the child engaged in?
    • Are these activities evidence-based interventions?
    • Do the activities align with the child's special interests or bring them joy?

    How Might a Clinician Prepare a Family for Discharge?

    • Conversations about discharge should occur at the start of therapy.
    • Discharge should be treated as a celebration of the child's accomplishments.
    • Connect the family to other local resources.

    Resources for Families/Coordination of Care

    • Kyo provides specialized BCBA parent training.
    • Kyo offers behavior consults through CA Regional Centers.
    • The program provides support for transitioning from intensive ABA to other therapies.
    • Other agencies may also provide services.

    How Might a BCBA Respond to a Dispute?

    • Behavior analysts should prioritize patient care above everything else.
    • Conflict resolution should attempt to align with the best interest of the patient.
    • If conflict cannot be resolved, services may be terminated.

    When Disputes Arise Over Medical Necessity

    • It is crucial to turn to the research, looking at the current evidence for the specific level of service.
    • Seek guidance from regional clinical consultants or directors.
    • It is important to ascertain if other senior BCBA colleagues would concur with the recommended treatment.

    ###ABA Treatment Cycle

    • Dosage, duration, and discharge are all part of the larger treatment cycle.
    • BCBAs continuously monitor and adjust their approach to treatment, similar to skill teaching processes.

    How might the following recommendations conflict with Kyo’s clinical values?

    • Recommendations for extremely high doses of ABA therapy may conflict with Kyo’s values if the child already receives additional support.
    • Recommendations for high-dose ABA therapy may conflict with the family's choice of homeschooling if other therapies could better serve a child.

    Age at the Start of Treatment

    • Some studies show that starting ABA therapy earlier, before the age of seven, is associated with more positive and successful outcomes.

    Which baseline skills predict outcomes?

    • Pre-treatment verbal skills, imitation ability, and low severity of ABA symptoms (lack of self-injurious behavior, repetitive behaviors, and stereotypes) are predictive of positive outcomes.

    3D Review Process

    • The 3D review process has three levels.
    • Level 1 triggers when there's limited progress.
    • Level 2 involves a joint review of the treatment plan, potentially with a superior therapist involved.
    • Level 3 involves requesting a consultation with the Board to clarify the plan of action.

    Example Health Plan Criteria for Discharge

    • Criteria for discharge include showing improvement in targeted areas, caregiver refusal of treatment recommendations, exacerbation of behavioral issues from treatment, lack of progress after a certain point, and when care may be primarily for convenience and not benefit.

    Duration: Personalized, Outcomes Based Decision for "How Long"

    • The decision on how long treatment should continue should be based on individualized patient outcomes.

    Outcomes are Essential to Duration Decisions

    • Consistent progress as measured by standardized assessments, such as the Vineland, is essential for continued treatment.
    • Clinically significant progress (at least a two-point improvement) every six months, should be seen as the gold standard for ongoing ABA therapy.

    Some Patients will Not Demonstrate Meaningful Progress

    • Not all patients who receive ABA will demonstrate significant progress on standardized measures.
    • Some patients may transition to a less intensive method of care.

    Discharge: A Data-Based Approach

    • The process of discharge should be carefully documented with established criteria and timelines.
    • The clinical team must work closely with families and other professionals to facilitate the transition.
    • This process must follow specific guidelines.

    Kyo Also Provides Guidance on Discharge

    • Detailed discharge policies can be found in the clinical policy manual.
    • Services funded through insurance must meet the guidelines of the payer's criteria for medical necessity for continued treatment.
    • Patients must continue to show progress in socially significant areas, with specific criteria in mind.

    Discharge Conversations

    • Discharge discussions should start early in the treatment process.
    • Discuss the criteria for discharge up-front and often.
    • Use available data from standardized measures for guidance.

    How Might a Clinician Prepare a Family for Discharge?

    • Start dialog early in treatment about discharge criteria.
    • Treat discharge as positive and celebrate progress.
    • Connect families with community resources for potential continued care.

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    ABA Therapy Treatment Planning_ Dosage, Duration and Discharge PDF

    Description

    This quiz explores the fundamentals of ABA therapy treatment planning, focusing on dosage, duration, and discharge. It includes a 3D perspective on treatment planning, critical conversations, and managing disputes. Case examples are provided to illustrate the processes involved in effectively supporting clients.

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