• A child with severe problem behaviors significantly affects the quality of life of the entire family.
• Treatment procedures are often difficult to implement
• Treatment often works for a while, but does not maintain long-term.

• A clinic or home-based treatment program focused on eliminating problem behavior.
• Effective, fast, and safe treatment following principles based on the latest research in applied behavior analysis.
• A firm belief that our ultimate goal is to eliminate problem behavior for life.

To get on the waiting list for our program to treat problem behavior, click here.

POOGI is the Process of On-Going Improvement. The POOGI has informed my practice for many years. You can read more about how from my blog.

You can read more below, or contact us for more information.

Not every child with autism engages in serious problem behaviors. But for those children who do, sometimes almost nothing else matters. Much of the world has been trapped with nowhere to go for months during COVID-19. If you have a child with autism and significant problem behaviors, this might have been normal life for years.  Many parents have told me about their struggles of being home all the time.  They don’t go to restaurants, parks, museums, church or the movies. Sometimes they can’t even get a babysitter as their children’s behavior is too difficult for the average babysitter.

Just keeping the child safe can be a major issue. Or, a child might be fine for much of the time, but occasionally have significant tantrums that are extremely difficult to handle. In many situations, these problem behaviors lead to a wide variety of other problems like not sleeping properly throughout the night, toileting problems, difficulty learning basic skills, problems making friends, and nearly impossible-to-solve problems in school. If serious problem behaviors are occurring, no one is going to care if the child knows their multiplication tables or reads at grade level. The problem behavior usually (but not always!) needs to be addressed first before any other learning is likely to be successful.

When we are successful at treating problem behaviors, we can often make a huge difference in the lives of children with autism and their families.  In my experience, nothing matches the quality of life impact of successful treatment of problem behaviors.

“We’ve tried everything. The strategy suggested might help a little, for a while, but I have to go to work. I need to do the laundry, cook dinner, and take care of two other children. How can I possibly do all the things these professionals are asking me to do?”

The treatment process can sometimes feel overwhelming. Many times, parents tell me about all the professionals that have tried to help them with their child’s problem behavior.

Too often, families just give up hoping for successful treatment to occur. Many parents expect that this will just be a lifelong problem.

For decades, the field of applied behavior analysis has developed successful treatments for problem behavior. I have been working in the field for over 25 years, treated a tremendous number of children with problem behavior; I considered myself an expert in that area. Sure, there were many problems that came up with treatment. Sometimes staff or children got hurt when dangerous behaviors occurred. Sometimes the results didn’t last over time. Sometimes it didn’t generalize to all the situations we wanted it to. Sometimes what was required to be successful was so labor intensive it was hard to make practical. But this was just a hard obstacle. We were making a huge impact.

Then, in 2014, Greg Hanley and colleagues made (at least in my view) a breakthrough in the treatment process based on applied behavior analysis. His Practical Functional Assessment (PFA) and Skills Based Treatment (SBT) is still based completely on the principles of Applied Behavior Analysis (ABA), but it adds several new effective practices that are very different from what was often considered the best approach just a few years ago.  Numerous scientific articles have been published on this process, and I believe that it dramatically improves on what we were able to do before.

When I fully realized the impact that Hanley’s work could have, I decided to leave my job at a large company where I worked for a long time and open my own practice. That was a hard decision. I put in a lot of years with the company, but I knew it was time to move on. I wanted to use this process as it would make a huge difference in the lives of children and their families and it just wasn’t going to be possible without starting something new.

I love the values and goals I learned from Hanley’s team at FTF Behavioral Consulting. In training workshops, Greg Hanley argues convincingly that BCBA’s (Board Certified Behavior Analysts) need high goals for children with autism and other developmental disabilities. They need treatment that will provide them with a life free of problem behavior. But despite having very high goals, we also need to maintain high values. All of our decisions are based on the having high goals, but trying to fully live these values:

Safety

Too often treatment for problem behaviors can be dangerous to both children, family members, community members, and staff. Over the years, I have been hurt many times, I’ve seen staff hurt many times, and I’ve seen children hurt due to severe problem behaviors. We need to be completely committed to making a safe process for the treatment to occur.

Televisibility

In the past, sometimes the treatment seemed effective, but didn’t look very positive in the moment. We should be happy to have any treatment session occur on live television. It is possible.

Rapport

We want the children to have positive relationships with families, therapists, and teachers.

The benefits of PFA and SBT

The Practical Functional Assessment (PFA) and Skill Based Treatment (SBT) process adds a lot to the field of applied behavior analysis. I could write hundreds of pages on this topic, and I have been writing about it frequently on my blog, along with other topics about treatment of children with autism. But here, I will cover some of the key differences between PFA and SBT versus traditional applied behavior analysis:

Time to start treatment

The initial assessment process is very fast. Usually, we can begin treatment in 1-2 hours after meeting the child. Previously, I had spent numerous hours in observation and analysis before we had sufficient information to begin treatment.

Treat all the problem behaviors at one time

We used to assess each problem behavior one at a time. Sometimes, children would have lists of 10 or 20 different types of problem behavior--hitting, biting, fall to the floor, aggression, self-injury, etc. The new process allows us to assess and treat many problem behaviors all at the same time.

Step-by-step treatment process

The treatment moves consistently through a step-by-step process. The child is given a challenge that is (hopefully) at the just right level that the child can meet the expectation without engaging in problem behaviors. Then it moves slowly through baby steps so that the child is nearly always successful throughout the process.

Practicality

Reasonable expectations are set at first. There is no expectation that treatment will be implemented 24 / 7 right from the beginning. At the start of treatment, there is no expectation of carry over to home and school. It starts in therapy and slowly expands to other parts of the child’s day as the child is successful.

Why provide services at a clinic? I need help at home!

The treatment is based on a skills-based process. The idea is that the only long-term solution to the treatment of problem behaviors is developing the appropriate social skills, tolerance, and other appropriate alternative behaviors. While it is certainly possible, to teach those skills in a busy home environment, most of the time it is easier and faster to work on these skills at the clinic. Once your child learns the appropriate skills, intensive parent training is implemented to help generalize to the home setting, including home visits as needed.   Having said that, sometimes we do implement the start of the treatment in the home setting. But in general, we find it is better to work at the clinic.

What should I do while my child is learning the skills? I need help now!

We will provide some suggestions to minimize problems while waiting for the skills-based treatment process to be completed and the generalization phase of the treatment to begin.

How Likely is this to be Successful with My Child?

Of course, there are no guarantees of successful outcomes. The research and our own clinical practice suggest that it is usually (certainly not always!) highly effective. Over the last several years, the treatment process has been in a continuously improving. Our goal is to be in a continuous state of POOGI (Process of On-Going Improvement). We believe that no matter how good you are, there is always substantial room for improvement. We are constantly attempting to upgrade by staying abreast of the current research, getting regular training, seeking feedback from parents, and most importantly learning the lessons the children we work with are teaching us.

This sounds great, but there is no way I can get to the clinic in Ridgefield

Of course, we can’t help everyone – although we wish we could! In some cases, we will offer therapy through tele-health through video conferencing with parents. Contact Us to discuss whether this might be right for your family.

Want to Learn More?

Please contact us to learn more or get on the waiting list.