Focused puts dignity at the forefront. We put attending above eye contact, engage in stims along with the children, and are not intending to take away the Autism or individual characteristics, but to merely help individuals be the best they can be while retaining the essence of who they are, as Temple Grandin says. We work with clients with Autism, Developmental Delay, Sensory Processing Disorder, ADHD/ADD, and more! The principles of client dignity and understanding applies to all, and ABA is evidenced-based to increase skills and decrease challenging behaviors no matter the diagnosis!
We do have a clinic in Spokane, WA and the Panhandle of Nebraska, and soon Lincoln, NE. We also offer in-home services. Our owner was born and raised in Nebraska!
What is ABA?
Applied Behavior Analysis: the process of systematically applying interventions based upon the principles of learning theory to improve behaviors to a meaningful degree, and to demonstrate that the interventions employed are responsible for the improvement in behavior (Baer, Wolf, & Risley, 1968).
ABA is a scientifically valid approach to understanding behaviors (in ABA terms, discovering the "function"), hence, understanding equals the ability to change!
ABA focuses on observable, and measurable behaviors. Yes, this includes "private events" (thoughts, memories, emotions)
ABA uses the principles of learning to increase or decrease behaviors (think about it for a second. . . a "behavior" includes a lot!), and it generalizes learned behaviors (meaning that the learner can use new skills with multiple individuals, in different situations, and in many different environments)
ABA utilizes research-based interventions to teach skills and increase/decrease behaviors.
ABA relies on data collection and analysis to determine the best intervention in teaching new skills/behaviors, and reducing challenging behavior.
How much and how long do children need ABA therapy?
Research supports "focused" and "comprehensive" ABA which consists of 15-40 hours per week of ABA. Please click HERE for more information on the dosage and benefit of ABA. ABA is an on-going therapy that can change and grow with your child to cater to their ever-changing needs as they continue to grow older. It can be as little as 6-months, but as much as 3+ years.
How can I get services in school?
We love to collaborate to the best of our ability! Although Focused does not intervene on legal matters, it is useful to know the following information as a member of our services:
The following information is not legal advice, simply a summary of previous court rulings, and law summit education.
For behavioral health treatment services, the location, such as a school or community setting, may be an integral part of the treatment plan and may be necessary to ensure treatment goals are met, especially generalization of skills across settings. Medically necessary autism treatment may be provided in a school setting
(a) to ensure that skills acquired in the home and community generalize to
the school setting;
(b) when the behavior occurs in the school setting;
(c) or simply as a matter of logistics to ensure that a child’s full treatment hours are delivered.
Moreover, services provided by a school under an IEP do not preclude medically necessary services that are being provided across all natural settings, including the school. Schools do not typically provide medically necessary treatment; they may provide supports pursuant to a different standard (some educational benefit), for different purposes (to access the educational curriculum) with differently credentialed providers (special education teachers and aides). Such services do not supplant medically necessary treatment. Useful language to articulate some of these points may include:
• The location is often an integral part of the treatment plan and is necessary to ensure that treatment goals are met. That is, for treatment to be effective, it must be generalized across all natural environments, and the school is a natural environment for a school-age child.
• These services target goals in the treatment plan, which addresses the deficits and behaviors associated with your insured’s autism diagnosis.
• The location of services is part of the medically necessary treatment of the child’s autism diagnosis.
To summarize, an ABA funded by insurance is treating autism as a medical diagnosis. The ABA therapist is letting the funding source treat the core deficits of autism as a medical diagnosis. The curriculum side should solely be the responsibility of the school staff. The RBTs/BCBAs should be responsible for teaching the prerequisite foundation skills to access the curriculum without by addressing the skills per the DSM-5 criteria for ASD. Unless the school has equal to what is required per state and insurance requirements to render medically necessary ABA, the school is denying medical care based on disability, thus you may want to bring up things such as Discrimination, ADA Americans with Disabilities Act, and 504 Rehabilitation Act.
An example from the perspective of an insurance company and the court: a child is diabetic and needs their blood sugar levels taken 3 times per day and insulin is administered as needed.
In this example:
Blood sugar levels = behavior (functional or maladaptive)
Insulin = ABA treatment
When this issue has been litigated, the Court has consistently determined that insurance carriers are responsible for funding of medically necessary treatment, regardless of the location where it occurs, including school settings.
The duty as the insurance carrier to provide coverage for medically necessary treatment is a much higher standard than the duty of the school under IDEA to provide Free Appropriate Public Education.
Please note: When an insurer authorizes services, but a school prohibits the ABA provider from providing the services on campus, it may be helpful to update the IEP to include an agreement to allow the ABA provider on campus and into the classroom to provide medically necessary treatment. Additionally, parents may want to raise the school’s required compliance with ADA, which includes an integration mandate. That is, providing services in natural settings in which the child functions, such as a school, is not only considered best practice but is also required under the integration mandate of the Americans with Disabilities Act (Olmstead v. L.C., 527 U.S. 581, 1999). Finally, parents may want to raise Section 504 of the Rehabilitation Act which prohibits discrimination against students with disabilities. Since it is commonplace for schools to administer prescription drugs for students with medical ailments and to provide access to speech therapy on campus, a school that refuses to accommodate an ABA provider on campus is discriminating against a child who has a disability.
How Does Funding Work?
Nebraska Medicaid covers up to 25 hours/week of therapy in clinic or in-home. Private insurance covers up to 40 hours/week. We are in-network with Medicaid Heritage (United, Wellcare, Total Care), as well as most private insurances. Hours recommended are based off research, previous ABA, age, diagnosis criteria, and our assessments.
Is my child eligible?
A Medical diagnosis of Autism is required for ABA coverage if you have private insurance. Nebraska Medicaid covers Autism, Developmental Delay, and more diagnosis'.
What is a typical schedule?
We use a multi-domain treatment approach, thus we do not provide limited ABA services. Our service options include half-day and full-day options. Hour dosage recommendations are based off of research of treatment utilization/learn-gain scores. Please click HERE to learn more about the benefit of ABA. We offer a block schedule for in-home and clinic. Please see below for our block schedule options.
I find some interesting information about ABA when I look it up on Google.
We are aware that there is some negative views of ABA. While some is VALID, we simply encourage a lot of questions! Here is a great video on the Misconceptions of ABA. Here is one of our Orientation Courses that we cover that also gives a great deal of information and our philosophy as a company.