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A basic premise of health care, dating back several thousand years, is to first do no harm. Autism and the related spectral disorders have come onto the scene rapidly. In addition it affects an increasing number of children and is ripe for exploitation by any number of self-proclaimed experts.
Parents are frustrated by traditional medicine and often turn to any program that sounds even remotely helpful. While many of the programs offer guarantees of success and offer evidence that they "do no harm", any time effective therapy is delayed... harm is occurring.
Our goal at Threshold is to ensure that we use and endorse only outcome-based, research validated therapy and treatment procedures and protocols.
Behavior Modification is the basic science from which Applied Behavior Analysis (ABA) is derived. In the early days of the profession behavior modification seemed to be too associated with animal training or the manipulation of people to gain general acceptance. Thus the term behavior analysis was created. Behavior analysis sounds less intrusive than behavior modification. Performance management is an offshoot of behavior analysis and uses the same techniques and methodologies to improve the performance of workers.
Therapy is about behavior and learning. Disabilities related to disease and/or injuries often results in impaired social interaction, communication difficulties, and physical activities.
People with neurological disabilities often exhibit abnormal responses to sensory stimulation (e.g., touch, sound, light) and usually have moderate to severe physical abilities. The use of performance improving behavioral programs with these disabilities should be thoroughly explored and documented that that all patients have the best opportunity for an optimal outcome.
Performance Management is based on the laws of behavior and applied to the therapist. Because behavior that is reinforced is more likely to reoccur we can use preferred reinforcers to aid in refining the skills of the therapist. Through other behavioral techniques we can teach therapy related behavior that encourages patients to use discretionary effort that might otherwise not be used. What is absolutely key for therapists to understand is that if a behavior is not within their patient's ability, years of training, medications, and other therapies will not make that behavior occur.
If a patient is paralyzed from an accident, walking is probably not in his or her repertoire. While we never discount the opportunity for a miracle to occur, months or years of therapy chasing the improbable take away from therapies that has a higher probability of enhancing skills that is within the existing repertoire. It is equally important that therapists understand why people behave the way they do. Performance really is about the consequences from the performers point of view. Therapist may see the value of treatment but unless the patient does, then the outcomes will be less than optimal.
Computer based simulation training programs will soon be available for use by therapists and parents for improving the outcomes of both inpatient and outpatient therapy. Central Florida is home to the National Simulation Center and Threshold has partnered with the Harrington Group to develop 21st century training programs. Occupational therapists and physical therapists will be among the first professionals to beta test these programs. The additional behavioral skills obtained through these unique interactive programs are designed to take solid therapists and make them significantly better.
The application of behavior analysis has been effective in treating children and adults with autism for more than forty years. For at least the last thirty years behavioral psychologists such as Dr. Aubrey Daniels has used ABA in the business world effectively to improve worker productivity and discretionary effort. Simulation training has been used since prior to World War II with the historical "LINK" trainers and over that half century, with the advent of computers, simulation training has moved into every facet of our lives. Threshold strongly believes that in combining simulation with ABA, physical and occupational therapies we can improve the outcomes of thousands of patients with their various disabilities.
Threshold's Behavior Simulation Training (BeST®) Virtual Behavior for Professionals (VBP®) is designed to take professionals in Occupational, Speech, Physical and other therapies and introduce them to ABA techniques. These behavioral techniques allow the therapist to look at therapy from the patient's perspective and then design programs with consequences that are positive immediate and certain (PICs®). PICs® represent powerful reinforcers that can be used to achieve consistent therapeutic outcomes. Threshold's therapists will be trained using the BeST® programs and compared with therapists without BeST® training. We believe that BeST® training can take therapists to a higher level of success with patients who are having compliance issues. Family members will be trained in the family edition of the BeST® program (Virtual Behavior for Families - VBF®) to ensure consistency in therapy once the patient has been discharged from direct care.
For more information regarding Threshold's innovative training programs please contact Kylene Beard, Vice President for Extramural Programs at 407-671-7060.
PICs® Are a registered trademark of Aubrey Daniels International.
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