Treatment Track

Interns in this track will spend 6 months in in the Language and Leaning Center program and 6-months in the Severe Behavior Program for a total of 2, 6 month major rotations. They will also complete a year-long minor rotation and complete a brief exposure experience in assessment.

The Severe Behaviors Program 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 with a 6-month major rotation in the severe behavior program will lead at least one case at a time in our day treatment unit, working with the most severe and complex cases of problem behavior in the region.  Clients are served 6-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 staffing ratio available in the intensive outpatient program.  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 this rotation will have one minor rotation (1/2 day a week) that can occur within the severe behavior department in one of the below options or in another clinic at Marcus.

The Language and Learning Clinic (LLC) at Marcus Autism Center serves children diagnosed with autism spectrum disorders between the ages of 2 and 12 years (average 4 years of age) who are exhibiting significant language and social communication delays. Services provided in the LLC focus on building communication and vocal skills, bolstering appropriate play and social skills, targeting foundational learning skills such as imitation and matching, and reducing barriers to learning (e.g., limited reinforcers, mild to moderate problem behavior). The goal for each child admitted to the LLC is to acquire the critical skills they need in order to thrive in a less intensive setting. Children receive services between 3 and 6 hours per day, 5 days per week. All services are provided in a 1:1 format that utilizes a combination of discrete trial training and natural environment teaching to meet each child’s individual and developmental needs. Intervention in the LLC also heavily involves caregivers via both didactic and in-vivo training in order to facilitate generalization and speed treatment progress.

Interns in the LLC have the opportunity to gain a diverse set of experiences that include working directly with children, providing consultation, and delivering caregiver training. They learn to conduct and utilize comprehensive language assessments to aid in the development of intervention programming that focuses on improving language skills, play skills, and adaptive skills and that addresses barriers that may interfere with learning. In addition, they learn how to integrate child development with evidenced-based practice in order to produce meaningful outcomes in the daily life of the children they work with. Interns will also have potential opportunities to participate in ongoing departmental research projects in the roles of designing and implementing research protocols, assisting with data collection and analysis, and manuscript writing.

Possible Minor Rotation Options

RUBI-Parent Training Program (minor rotation) within the Severe Behaviors Program 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) within the Severe Behaviors Program 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) within the Severe Behaviors Program 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.  

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 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 Pediatric Feeding Clinic (minor rotation) offers interns the opportunity to treat 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 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.