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Each teaching session or shift is typically conducted by a single Instructional
Assistant and usually lasts for 3-4 hours. During this time frame, 10-20
different programs involving particular drills or stimuli are presented.
Typically, children receive between 400-800 learning opportunities or
trials each day of treatment. Children typically require several weeks
to develop the tolerance needed to participate in 25-40 hours of therapy
each week.
Ongoing training is provided to Instructional Assistants, school personnel,
and family members during weekly clinical staffings to update behavior
and language programs. At these meetings, data (discrete trial data, hours
of treatment, etc.) are reported, program modifications communicated,
and upcoming changes previewed. Occasionally, the child is brought to
the staffing in order to demonstrate programs or to better diagnose specific
treatment difficulties.
In order to promote generalization, treatment is varied from location
to location within the child's home, as soon as possible. Discrete trial
teaching also takes place "out-of-the-chair" and during "downtime"
where social skills and play skills are emphasized and incidental language
opportunities are structured.
Once a sufficient foundation has been established, the treatment program
begins to include procedures, which measure generalization and maintenance
of skills outside structured therapy contexts. In addition, social experiences,
beyond interacting with Instructional Assistants and family members are
integrated into the child's program. These include peer play dates, participation
in a group learning experience such as preschool or gymnastics, and community
outings.
Continuation of intensive behavioral treatment is driven by the IFSP/IEP
process and reviewed every 3-6 months. Data sources include results from
standardized testings, discrete trial summaries, direct observation in
a variety of environments, and videotape.
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