A Day in The Life (Respite Plus Service)

Upon initial consultation with AHSS, a master’s level ABA certified professional completes a Pre-Assessment.  From this information, an individualized Care Plan is developed with goals,  preferred activities and objectives. This plan and its data is reviewed weekly by the BCBA and a quarterly meeting in person with the parents or guardians.  Care plans focus on the functional life skills necessary for the child to participate in family and community life to the best of their ability.

For example, we work on social skills, self help skills, and positive behavior improvement strategies, etc. Our Care Team Members utilize ABA principles.  Parent coaching is also available to ensure that effective strategies are being utilized across all caretakers.  Session notes are taken on a daily basis and reviewed weekly by the BCBA.

Sample Schedule for After School Care

Sally (Autism Home Support Services Respite Aide) works the pre-dinner shift with Johnny (3:15PM to 7:15PM).

3:15PM

Johnny, a seven-year-old boy on the autism spectrum continuum, gets off the school bus in front of his house and is greeted by Sally. Sally takes Johnny by the hand, goes inside the house.  Sally promps Johnny to remove his shoes and put them away in the closet.  She prompts him to put his backpack on the table and remove his homework.

• One of the key goals in Johnny’s program is to manage his time and work on his homework skills.
• Sally reflects Johnny’s progress in these areas in her session notes.

3:30PM

Sally carries her glass to the sink and by telling Johnny “we are both going to carry our glasses to the sink,” she encourages him to do the same. She and Johnny both wash and dry their hands. Johnny is being encouraged to wash and dry his hands after every eating experience.

3:40PM

They both go to Johnny’s room and sit down on the floor and Sally orchestrates a Lego building activity with Johnny. Legos are one of Johnny’s favorite toys and Sally leverages that to educate Johnny in the areas of counting and colors. She asks Johnny for three blue Legos. She and Johnny pursue independent but parallel building activities on the floor with each other. She does not interfere with Johnny’s independent building structure, but rather periodically asks him for a specific-colored Lego, or a specific number of Legos. Per Johnny’s care plan, over the next several weeks as Johnny progresses, she will be asking for more complex combinations, such as four blue Legos and then four blue and two green Legos.

5:00PM

Johnny loves playing Legos, but it is a “hyper” activity for him, so he must be slowed down. In preparation for a quiet, peaceful eating experience, Sally starts a new activity that will slowly calm Johnny down and prepare him for a more quiet and peaceful hour over dinner. Referencing his PECS system, she asks him what book he would like to have read to him. Once Johnny chooses, she starts reading while encouraging him to physically slow down whatever his physical activity is (shaking, spinning, rocking). By 5:45 p.m. he is sitting quietly on the floor looking at a book with Sally and being responsive to her questions or comments about the book.

6:00PM

Sally has timed the story to end just before 6 p.m. and now takes Johnny (by the hand, if appropriate) down to the dining room table where the rest of the family is already seated. Everyone around the table, in a pre-agreed upon order, greets Johnny and (on a good day) he responds to each person appropriately in turn. An example of how to make this successful would be to have him join the family at the table a few minutes after they have started eating (i.e., Johnny is a fast eater), so they all finish at the same time.

Alternate Scenario

5–6PM

Johnny and Sally are working together to prepare a simple meal or a portion of the family meal together.   She uses ABA strategies such as simplifying tasks, prompting, and using reinforcers to help Johnny  make his own macaroni and cheese.

7:00PM

The family finishes dinner and everyone, including Johnny, carries their plate to the kitchen sink.

7:15PM

Sally says goodbye to Johnny and hands him over to a parent for the rest of the evening and bedtime preparation.

Alternate Scenario

7:15PM

Sally says goodbye to Johnny and hands him over to Barbara, the second shift (7:15PM until 10:15PM) Autism Home Support Services Respite Aide.

7:30PM

Barbara and Johnny sit down at the chair and table in his room and start another one of Johnny’s favorite activities, working in his coloring book. Using his PECS she offers him a choice of what coloring book to use. Again Barbara parallels Johnny’s activities and works in her coloring book alongside Johnny. Periodically she asks Johnny to hand her a specific color crayon. When appropriate, she will ask Johnny to name the color of the crayon he is using. She may also try to engage him in describing aspects of his picture. For example, questions like: Is there a dog in the picture? What is the dog’s name? Do you like dogs? Barbara will typically plan to divide her evening shift into three discrete activities each lasting between 45 minutes to an hour and a quarter. She will have preplanned up to six activities. (Examples may include coloring books, Legos, taking a walk, playing a two-person interactive computer game, etc.) If appropriate, Barbara will facilitate incorporating Johnny’s siblings in play.

9:00PM

Barbara will start slowing the pace down again and preparing Johnny to take a bath, brush his teeth and change into his pajamas.

Notes and Comments on the Day

Any time a parent feels willing and comfortable to either observe or participate in working with Johnny on a particular task or game, it is encouraged.  We understand that parents are often fatigued by the phenomenal pressures that an autistic child can bring to a family setting and therefore look for respite whenever possible. Specific exercises from speech therapy, occupational therapy and/or physical therapy can often be the focus of the afternoon shift’s activities. Sally or Barbara would, following the care plan and specific instructions for that week by the speech therapist, guide Johnny through his “tongue thrusting exercises” with a banana.

Autism Home Support Services is also working with off-the-shelf video/internet technology to improve availability and accessibility of support for parents and for our team.  The use of internet video communication technology allows for professionals to be “at your finger tips” and therefore reduces the need to bring them physically to the home or to bring the child to the professional. This use of technology will differentiate us from other providers of these services. We will also be rigorous in our data collection methodologies, eventually using automated data collections devices; this again would make us “a stand apart” service from the others.