ABA Therapy

Applied Behavior Analysis (ABA) is an evidenced-based approach to addressing behaviors posing a barrier to a learner’s success. ABA employs an objective approach to behavior modification, catered specifically to each learner to address behavioral excesses (aggression, self-injury, tantrums) as well as deficits (communication skills, compliance, self-help skills, toileting). ABA interventions often consist of making changes to environmental variables (i.e., antecedents and consequences) determined to influence behaviors. Strong emphasis is placed on providing the learner with quality training to develop their communication skills (i.e., verbal behavior), because children with communication delays tend to rely on maladaptive methods such as aggression or tantrums to convey their needs and wants. By strengthening a learner’s communication skills, we provide them with more appropriate methods of expression and, therefore, reduce the need to engage in maladaptive behaviors in the future.

Sessions are conducted primarily in the clinic, but also take place in the school and home when indicated. Sessions conducted in 1:1 settings focus on developing communication while reducing behavior of excess. Sessions conducted in a classroom setting tend to focus on applying the communication skills learned in the 1:1 setting, while also ensuring learners possess or develop the classroom readiness skills required for academic success. Home sessions are also essential to learner success across settings, as they provide the parent/guardian the opportunity to observe the therapist and to receive coaching on strategies that have proven to be effective in both the school and clinic.

ABA Therapists

All of Mandala’s therapists hold at least a bachelor’s degree, and have completed specialized training in the methods of ABA. Therapists continuously receive training in techniques that reflect best practice for the field through our customized competency-based training system. Ongoing supervision is provided by a master’s- or doctoral-level Board-Certified Behavior Analyst for your child’s initial assessment, skill acquisition programming, behavior plan development, and programming/treatment plan updates.

Our clinicians have strong backgrounds and experience in early intervention, behavior management, social skills programming, verbal behavior programming, adaptive living skills training, parent collaboration, and school consultation.

Early Intervention

Early intervention focuses on children from infancy to kindergarten age with special needs that interfere with their development. The purpose of early intervention is to take advantage of critical years in a child’s development, allowing the benefits of targeted interventions to compound as they get older. Using ABA principles, early intervention aims to help your child reach goals created specifically for their needs, and to gain developmentally appropriate language and learning skills. Early intervention programs prepare your child for the transition to school-based learning with the objective of entering into the least restrictive environment possible.

Behavior Management

Behavior management focuses on reducing challenging behaviors. These programs address behavioral concerns that may adversely affect school placement, as well as challenging behaviors that significantly impact the child’s ability to function in the home or community settings. The following challenging behaviors are frequently addressed:

• Aggression
• Self-injurious behavior
• Disruptive/dangerous behaviors
• Property destruction
• Noncompliance
• Elopement (running away from caretakers)
• Tantrums
• Toileting delays
• Pica (ingesting inedible objects)

The goal of treatment is to identify the environmental variables contributing to the challenging behavior in order to reduce the frequency, duration, and intensity of the challenging behavior. Our clinicians focus on determining socially appropriate replacement behaviors for the challenging behavior(s), and determined treatment strategies based on your child’s specific needs. Assessment results and other environmental variables that may affect treatment decisions (family structure, classroom structure, medical concerns, etc.) are also taken into consideration. Once the treatment team determines appropriate and effective interventions for the challenging behaviors, caretakers are trained to use the interventions in a variety of settings.

Day treatment services are also available, and are typically recommended for a minimum of four to five hours a day due to the ongoing safety concerns that often result from the intensity of a child’s behaviors. Your child may require a physician’s note that outlines the necessity of these services in order to maintain eligibility for Florida’s McKay scholarship program, especially if a modified school day is deemed to be clinically necessary.

Social Skills

Social skills services provide treatment to children and adolescents who have deficits including, but not limited to: establishing peer relationships, sharing items, reciprocating conversations, appropriately using non-verbal cues both receptively and expressively, difficulty with receptive and expressive use of non-verbal clues, engaging with toys appropriately, initiating peer interactions, understanding humor/jokes, and predicting and understanding emotions. Teaching pro-social behavior is linked to positive developmental outcomes like peer acceptance, academic achievement, and reduction in problem behaviors across social settings. Treatment provides children and adolescents opportunities to learn skill sets necessary to navigate the social world.

Verbal Behavior

Verbal behavior programs are frequently a critical component of an ABA program, and incorporate the use of proven techniques grounded in the functions of language to assess and teach verbal milestones. Verbal behavior (VB), a term introduced by B.F. Skinner in his 1957 book, “Verbal Behavior”, is defined as: “any behavior mediated by a listener.” In other words, language is behavior and can be taught and reinforced using highly effective teaching procedures, such as errorless teaching, prompting, and discrete trial training. Mandala’s verbal behavior programming focuses on teaching your child to realize that appropriate functional language will get your child what your child wants when they want it.

Children with developmental delays may sometimes engage in problem behaviors because at the time, they have no alternative way of expressing their thoughts, needs, and wants. As a team, it is our priority to create an effective treatment plan that will develop your child’s communication skills and facilitate their growth. Our primary goal is to give children a functional way to communicate by devising programming that is individualized to each child’s unique learning style. For children who are less vocal, the Picture Exchange Communication System (PECS) protocol, American Sign Language (ASL), and even technological resources like Proloquo, DynaVox and iPads can be utilized for communication.

Upon completion of a verbal behavior assessment, learning objectives are selected based on your child’s current level of ability. Verbal behavior skills are identified through a variety of skills assessments, including:

• Assessment of Basic Learning and Language Skills – Revised (ABLLS-R)
• Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP)

A child’s verbal behavior goals are then taught by utilizing both Natural Environment Teaching (NET) and Intensive Table Teaching (ITT) techniques. During each 1:1 therapy session, data is collected on skill acquisition and target behavior objectives. Behavior analysts work collaboratively with each child’s family, teachers and other team therapists through team meetings, school consultation and shadowing, and parent meetings. This collaborative team approach ensures that a child’s goals are being met and generalized across school, home, and community environments.

Adaptive Living Skills

Mandala offers adaptive living skill training for children in a variety of formats and settings to address a wide range of deficits. Adaptive living skills refer to those behaviors that are needed for an individual to function safely, independently, and age-appropriately on a daily basis. Common adaptive living skills addressed in treatment include toileting, grooming, dressing, mealtime behavior, kitchen and cooking, housekeeping and chores, safety, money management, community knowledge, shopping, mealtime behaviors in public, phone skills, time skills, social awareness, time management, planning, study skills, and organizational skills. Mandala utilizes a variety of assessments to evaluate adaptive living skills, some of which are questionnaires completed by parents, caregivers, teachers, therapists, other providers and/or the client, assessments completed by the therapist, and observations of adaptive living skills. The goal of adaptive living skills training is to increase learner independence, increase caregiver knowledge and ability to help generalize skills, and to apply adaptive skills across settings and caregivers.

Parent Collaboration

Parent collaboration is a unique part of Mandala’s treatment package. Parent collaboration provides a way for your child’s therapists to directly coach you on how to utilize behavior analytic techniques in the home and community settings. These sessions not only allow you to have the opportunity to receive direct feedback from your child’s therapist, but also encourage you to take an active therapeutic role in your child’s progress. These collaborative sessions offer you the opportunity to ask questions, troubleshoot protocols or procedures, and develop comfort and consistency with useful behavior management skills for working with your child.

School Consultation

Mandala provides consultation services to school districts seeking assistance with Individualized Education Plans (IEP) and behavior management difficulties. Clinicians work closely with the school to select appropriate goals for students by providing direct assistance with the writing and presenting of IEPs. Mandala clinicians also assist the school by conducting Functional Behavior Assessments (FBA) and writing Behavior Treatment Plans (BTP). FBAs consist of both indirect assessments and direct assessments. Examples of indirect assessments include parent/teacher interviews, standardized behavior rating scales, and questionnaires. Examples of direct assessments include direct observations of the student in the classroom and ABC data collection. The results of the FBA are then used to write an individualized BTP. Teachers and aides are trained on the BTP by clinicians and provided with supervision and feedback as the plan is implemented.