Focused ABA

Focused ABA refers to treatment provided directly to the client for a limited number of behavioral targets. It is not restricted by age, cognitive level, or co-occurring conditions.

Focused ABA treatment may involve increasing socially appropriate behavior (for example, increasing social initiations) or reducing problem behavior (for example, aggression) as the primary target. Even when education of problem behavior is the primary goal, it is critical to also target increases in appropriate alternative behavior, because the absence of appropriate behavior is often the precursor to serious behavior disorders. Therefore, individuals who need to acquire skills (for example, communication, tolerating change in environments and activities, self-help, social skills) are also appropriate for Focused ABA.

Focused ABA plans are appropriate for individuals who (a) need treatment only for a limited number of key functional skills or (b) have such acute problem behavior that its treatment should be the priority.

Examples of key functional skills include, but are not limited to, establishing instruction-following, social communication skills, compliance with medical and dental procedures, sleep hygiene, self-care skills, safety skills, and independent leisure skills (for example, appropriate participation in family and community activities).

Examples of severe problem behaviors requiring focused intervention include, but are not limited to, self-injury, aggression, threats, pica, elopement, feeding disorders, stereotypic motor or vocal behavior, property destruction, noncompliance and disruptive behavior, or dysfunctional social behavior.

When prioritizing the order in which to address multiple treatment targets, the following are considered:

  • Behavior that threatens the health or safety of the client or others or that constitute a barrier to quality of life (for example, severe aggression, self-injury, property destruction, or noncompliance);

  • Absence of developmentally appropriate adaptive, social, or functional skills that are fundamental to maintain health, social inclusion, and increased independence (for example, toileting, dressing, feeding, and compliance with medical procedures).

When the focus of treatment involves increasing socially appropriate behavior, treatment may be delivered in either an individual or small-group format. When conducted in a small group, typically developing peers or individuals with similar diagnoses may participate in the session. Members of the behavior-analytic team may guide clients through the rehearsal and practice of behavioral targets with each other. 

As is the case for all treatments, programming for generalization of skills outside the session is critical. When the focus of treatment involves the reduction of severe problem behavior, the Behavior Analyst will determine which situations are most likely to precipitate problem behavior and, based on this information, begin to identify its potential purpose (or “function”). This may require conducting a functional analysis procedure to empirically demonstrate the function of the problem behavior. The results enable the Behavior Analyst to develop the most effective treatment protocol.

When the function of the problem behavior is identified, the Behavior Analyst will design a treatment plan that alters the environment to reduce the motivation for problem behavior and/or establish a new and more appropriate behavior that serves the same function and therefore “replaces” the problem behavior.

PARENT& CAREGIVER TRAINING

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  • Functional behavioral assessment (FBA) to identify why the behaviors are occurring

  • Development of a Behavior Intervention Plan (BIP) to address persistent challenging behaviors

  • Family and caregiver training, to enable you to manage the behaviors at home and in the community

  • Sessions take place in the environment that the behavior is most likely to occur, to promote rapid behavior change


School Support

Advocating for your child's education is a challenge for any parent.  When your child is in need of special education services, parents must work closely with school staff to determine the best plan of action for their child.  

If your child is displaying repeated challenging behaviors at school, a Board Certified Behavior Analyst (BCBA) may be able to help.  Our BCBAs work with parents, teachers, and school administrators to develop an individualized Positive Behavior Support Plan (PBSP) that focuses on increasing attention, on-task behavior, following group directions, being punctual, completing assignments and appropriate social behavior, among others.

Our consultation-based school services are designed for school-age children, who are struggling to reach their potential in the classroom.

Our Board Certified Behavior Analysts will:

  • conduct a Functional Behavioral Assessment (FBA) in the classroom

  • Develop a Positive Behavior Support Plan (PBSP)

  • If necessary, develop a Behavior Intervention Plan (BIP) to address persistent challenging behaviors

  • Work with school SENCo to develop IEP goals

  • Provide training for management of challenging behaviors in the classroom

  • School placement evaluation and recommendations


Supervision of Paraprofessionals

It is not always financially feasible to afford comprehensive ABA therapy without insurance coverage.  We recognise this reality, and are actively working to lower our rates so that services can be accessible to all families.

However, in the meantime, some families may elect to hire their own behavior technicians, who can work with a child intensively in the home or school environment.  

Considering that Registered Behavior Technicians are not independent practitioners, and must be supervised by a Board Certified Behavior Analyst (BCBA) in order to provide ABA therapy, Cayman ABA offers assessments, treatment plan development, and BCBA supervision to families participating in the "workshop model."  

This model ensures quality ABA services are provided, while lowering the cost of therapy to meet your family's needs.

Board Certified Behavior Analysts (BCBAs) are bound by a Professional and Ethical Compliance Code.  The provision of Behavior Analytic supervision by a BCBA to paraprofessionals implementing ABA treatment plans is regulated and controlled by the Behavior Analysis Certification Board, as well as local laws in the Cayman Islands.

With these regulations in consideration, Cayman ABA offers the workshop model of supervision to families looking to contract our supervision to their own hired Registered Behavior Technician. If an individual is not a Registered Behavior Technician (RBT), but has experience working as a behavioral technician in ABA, we can still provide supervision, under the condition that the home-therapist attains their RBT qualification within the first three months of starting under our supervision.

We require this level of certification for anyone we supervise, in order to protect the integrity of your child’s ABA program. Training and certification within the international licensing body of ABA practitioners, ensures consistency in service delivery and promotes best practices.

OUR WORKSHOP AGREEMENTS WITH FAMILIES INCLUDE THE FOLLOWING GUIDELINES:

1.     Paraprofessionals employed by families must enroll in 40-hour online RBT training, approved by the BACB. This training can be completed entirely online.

2.     The paraprofessionals must pass the Competency Assessment conducted by a Board Certified Behavior Analyst.

3.     The paraprofessional must pass the RBT examination. The examination is administered at Pearson Vue Testing Centers; the closest testing centre to Cayman is in Miami.

4.     This must be completed within the first three months of signing on to contracting services with Cayman ABA for supervision. During this time, the Cayman ABA supervisor can conduct the intake/assessment process with your child, so that the treatment plan is set up and ready to go when your paraprofessional returns with the RBT credential.

5.     Families must consult with Immigration about the work permit title of their Behavior Technician. RBT cannot—by BACB ethical codes—engage in any dual relationships, including nannying/babysitting.  As such, the work permit title “Caregiver/Nanny” should not be used. If nannying/babysitting activities are expected to be carried out by the RBT, families must make arrangements to ensure that these activities stop and are replaced by a person who is only employed as a nanny/babysitter, to avoid the RBT engaging in any dual relationships.  

7.     A person over the age of 18 must be present during all sessions conducted by the paraprofessional; we do not allow the RBT and child to work together alone, for your child’s safety.

9.     Paraprofessionals must complete Darkness to Light training (available online for US $25.00), in accordance with child protection regulations in the Cayman Islands.