Severe Behavior Program Track

The Severe Behavior Program at the Marcus Autism Center provides a continuum of services for individuals with developmental disabilities between the ages of 2 and 21 years who display severe destructive behavior such as self-injurious behavior (SIB), aggression, property destruction, noncompliance, tantrums, elopement, pica and toileting deficits. The primary goals of the program are to: (a) serve as a model for the evaluation and treatment of destructive behavior displayed by persons with developmental disabilities, (b) foster the development of new therapeutic procedures through systematic research on the nature and management of destructive behaviors, and (c) promote the effective application of currently available treatments through training and consultation.  The goal for each child is to decrease the occurrence of his/her problem behavior and generalize gains made in treatment to the child’s home environment, community, and school. Social and ecological validity of interventions is a significant area of emphasis in all Severe Behavior treatment programs. Four clinical services are available, with level of care matched to child and caregiver characteristics to provide the services warranted for each child.  Interns in the full-year severe behavior program will lead at least one case at a time in our Intensive Outpatient Program, working with the most severe and complex cases of problem behavior in the region.  Clients are served 5-hours a day, 5-days a week, for an average of 3 months.  Individuals are referred to this program if their problem behavior is placing their family in a state of crisis (e.g., problem behavior is causing significant injuries or the family is considering residential placement for the individual) or if their problem behavior cannot safely be managed by the caregivers.  Common treatment courses include detailed functional analysis, teaching of adaptive behaviors (e.g., functional communication training), reinforcement for appropriate behaviors on a dense schedule, schedule thinning, caregiver training, and generalization. 

Interns in the full-year track will gain experiences providing short-term follow-up to clients after discharge from the Intensive Outpatient Program to build skills in the area of maintenance of behavioral interventions and caregiver training. Interns in the full-year program will also have opportunities to increase the variety of clients they see through the minor rotation options in the severe behavior program.  These minor severe behavior rotations will occur throughout the year, but with a heavier emphasis on in the second six months. In addition to the severe behavior minor rotations, interns will also be given the opportunity to conduct a minor rotation (1/2 day a week) in a clinic outside of the severe behavior program throughout the entire year. Minor rotations may be available in the Clinical Assessment and Diagnostics Department or Feeding Department.

Severe Behavior Minor Rotations

RUBI-Parent Training Program (minor rotation) is an outpatient program developed and shown to decrease challenging behaviors in children with Autism Spectrum Disorder (ASD) between the ages of 3 and 10. The program involves teaching parents a number of strategies to prevent, manage, and reduce occurrences of problem behaviors of mild to moderate severity while promoting skill development.

The Brief Behavior Intervention (BBI) Program (minor rotation) is a weekly outpatient program. Children have a variety of problem behaviors of moderate to high severity, including aggression, self-injury, noncompliance, disruptive behavior, elopement, and pica. Targeted treatment goals are achieved through the therapist coaching the caregiver in completing a functional analysis and implementing treatment. There is a heavy emphasis on parent training, with the caregivers rehearsing skills both during the appointment as well as between appointments.

Long-term Follow Up (minor rotation) is a service provided to children after completion of day-treatment and short-term follow-up.  Clients are transferred to long-term follow-up approximately 6 months after discharge and most clients are seen every 1-3 months.  This program provides experiences in maintenance of behavioral interventions.  

Possible Minor Rotations Outside of Severe Behavior

The Clinical Assessment and Diagnostic Department (minor rotation) is a multidisciplinary clinic that provides diagnostic assessments of individuals with a wide range of neurodevelopmental disorders with a possible autism spectrum disorder. Children seen in the CAD clinic range from infancy to late adolescence with a focus on children ages 16 months to 6 years.

The Pediatric Feeding Clinic (minor rotation) offers interns the opportunity to work with children ages 9 months to 21 years who do not consume enough volume or variety of food to maintain adequate growth or nutrition. Children with this level of feeding disorder fall under the broader psychiatric diagnosis of Avoidant-Restrictive Food Intake Disorder (ARFID).

The Early Intervention Program (minor rotation) is an outpatient parent coaching program designed to support families of toddlers with or at-risk for autism spectrum disorder (ASD) in developing play, communication, social engagement, and imitation skills. The program uses the Project ImPACT curriculum, which has been shown to build skill in young children with ASD and other developmental delays through integrating behavioral and developmental treatment strategies. The program emphasizes active parent participation within and between sessions.

The Cognitive-Behavioral Therapy for Anxiety program (minor rotation) is an outpatient therapy program. The program is aimed to treat youth diagnosed with autism spectrum disorder and co-morbid anxiety disorders. This program is currently offered in an individual context via telemedicine. The clinic utilizes the Facing Your Fears Program, which uses cognitive behavioral principles to help youth develop their awareness and insight into their anxiety and/or fears and learn ways to effectively manage their symptoms. The program actively involves parents via a parent education component. This minor rotation is for persons with graduate practicum experience in delivering individual/group therapy to any child/adolescent with or without ASD.