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SECTION 5: Key Terms, Definitions and Acronyms

Key Terms and Definitions

Applied Behaviour Analysis (ABA): An applied science, based on the principles of learning and behaviour, which uses specific methods to change behaviour. ABA uses these principles to assess, understand, and teach behaviours that are important to individuals, their families, and their communities. ABA interventions are based on scientific research and direct observations and measurement in order to increase or decrease existing behaviours under specific contextual conditions. ABA may be used to teach communication, social, and adaptive skills (among others), promote independence, and treat challenging behaviour. An important feature of ABA is that the skills learned are maintained and generalized to other settings and with other people.

Autism Spectrum Disorder (ASD): A life-long neurological disorder that affects the way a person communicates and relates to the people and world around them. ASD can affect behaviour, social interactions, and one’s ability to communicate. ASD is a spectrum disorder, which means that while all people with ASD will experience certain difficulties, the degree to which each person on the spectrum experiences these challenges will be different.

Board Certified Behaviour Analyst (BCBA): Professional in the area of applied behavior analysis with a valid certification from the Behaviour Analyst Certification Board. In the context of the Independent Clinical Review process, BCBAs are one of two Clinical Reviewers on the Review Committee, working alongside psychologists/psychological associates to render decisions on Ontario Autism Program (OAP) Behaviour Plans.

Case File Materials: In the OAP, service providers keep a record for each child receiving services and supports. Case files include all Family Service Plans, clinical reports and data, notes, the OAP Behaviour Plan(s) etc., but can also include materials that are not clinical in nature (for example, feedback or concerns noted by the family, or observations by someone who is not a clinician such as a daycare worker). Review Committee Clinical Reviewers conduct a careful review of a child’s case file materials in order to make their decision, and Family Representatives review the case file to have a good understanding of the family’s perspective.

Child: The term ‘child’ or ‘children’ is used throughout the ICR Guidelines, and includes children and youth ages 0 to 18 years who are receiving OAP services.

Clinical Review Meeting: In the context of the review process, the meeting of two Review Committee Clinical Reviewers to discuss the child’s case file, with the goal of achieving consensus on their decision.

Consensus: In relation to the ICR, a decision-making process in which the Review Committee Clinical Reviewers commit to working together to develop a decision they can both agree to support. Consensus can be reached to either accept OAP Behaviour Plans as is, or direct them back to the OAP Clinical Supervisor to address areas of concern in the Behaviour Plan and/or to provide more information. Decisions reflect the views of both Review Committee Clinical Reviewers.

Direct Funding and Direct Service Option: Families of children in the OAP have a choice between receiving direct services or receiving funding to purchase services:

  1. The Direct Funding Option (DFO) gives families funding to purchase their child’s OAP services and supports directly from a private provider;
  2. Through the Direct Service Option (DSO), families can receive OAP services and supports directly from one of Ontario’s nine regional service providers.

Family: Refers to families of children/youth in the OAP, and can include but is not limited to parents, primary caregivers, guardians, grandparents, siblings, and other relatives or individuals who offer an enduring commitment to care for the child in the OAP, related either biologically, legally or emotionally. In relation to the Independent Clinical Review process, only parents or guardians can request a review of a child’s OAP Behaviour Plan, and must consent to other people submitting information on the child’s behalf.

Family Perspective: In the context of the review process, the portion of the Family Request Form that details which aspects of an OAP Behaviour Plan a family wishes to have reviewed and why. The family perspective can include both the family’s and the child’s perspectives. The Family Representative consults with the family as part of the review process to confirm and verify that the family perspective is complete and accurate. This process enables the Family Representative to capture the family’s perspective as it will be formally presented, in writing and verbally, to the Review Committee Clinical Reviewers.

Family Representative: Parents, guardians or primary caregivers of children with ASD who are hired and trained by the Independent Clinical Review Coordinator to help provide a clear understanding of families’ perspectives in the review process. The ICR Coordinator assigns Family Representatives to families that are located in a different region of the province than their own (Appendix 6.1). While Family Representatives are Review Committee members, they are not involved in making the decision in an independent review as they are not clinicians, and do not attend stage two of the Clinical Review Meeting.

Family Support Worker (FSW): An individual employed by the OAP, assigned to a family to assist with needed service and program navigation, supports and planning, including the development of the OAP Family Service Plan.

Review Committee: Committee responsible for the review process in the ICR. A Review Committee is assigned to each family requesting an independent review of their child’s OAP Behaviour Plan. The committee is composed of:

  1. One Family Representative who works with the family to provide a clear understanding of the family’s perspective throughout the Independent Clinical Review process; and
  2. Two Clinical Reviewers (one Board Certified Behaviour Analyst, and one psychologist or psychological associate) who conduct a clinical review of case file materials and render decisions on OAP Behaviour Plans.

Independent Clinical Review (ICR): Process through which a family can request a clinical review of key elements of their child’s Behaviour Plan in the OAP (Behaviour Plan). The Independent Clinical Review is not a review of decisions about the funding for, or the implementation of, behavioural intervention.

Review Committee Clinical Reviewer(s): Refers to any/all clinicians who are a member of the ICR Review Committee. The Review Committee for each review includes two Clinical Reviewers, a psychologist or psychological associate, and a Board Certified Behaviour Analyst. Their role is to render a decision about a child’s OAP Behaviour Plan based on a clinical review of the child’s case file.

Ontario Autism Program (OAP): The OAP provides evidence-based behavioural services, as well as family services and training that are individualized, coordinated, family-centred and responsive to the needs, strengths, goals and unique potential of children with Autism Spectrum Disorder.

OAP Behavioural Clinician: General term used that encompasses any behavioural clinician of the OAP. Further information is provided in the OAP Guidelines.

OAP Behaviour Plan: A component of a child’s case file materials in the OAP. It provides a detailed description of the recommended behavioural intervention developed by an OAP Clinical Supervisor and approved by a Clinical Supervisor. Behaviour Plans share common components but can vary considerably depending on the nature of the behaviours being addressed and the intervention modality.

OAP Clinical Supervisor: In the OAP, Clinical Supervisors are accountable for overseeing all aspects of a child’s OAP Behaviour Plan, in close collaboration with families, therapists, and inter-professional partners. See the OAP Guidelines for more information on qualifications for OAP providers of behavioural services.

OAP Internal Review Process: Encompasses any and all internal review processes established and administered by OAP providers to address disputes that arise with their clients. This can include, but is not limited to, complaint, grievance and conflict resolution processes related to the implementation of an OAP Behaviour Plan.

OAP Provider: Direct service and direct funding service providers offering OAP services and supports.

Peer-review process: In relation to the Independent Clinical Review Process, refers to the review of the OAP Behaviour Plan by others working in the same field (psychologists and BCBAs).

Psychologist / psychological associate: Psychologists/psychological associates are registered with the College of Psychologists of Ontario or comparable regulatory body in the jurisdiction where they practice. In the context of the Independent Clinical Review process, psychologists/psychological associates are one of two clinicians in the Review Committee, working alongside BCBAs to render decisions on OAP Behaviour Plans.

The Ministry: Refers to the Ministry of Children and Youth Services which funds the OAP and the Independent Clinical Review process Coordinator.

Acronyms

ABA
Applied Behaviour Analysis
ASD
Autism Spectrum Disorder
BACB
Behaviour Analyst Certification Board
BCBA
Board-Certified Behaviour Analyst
DFO
Direct Funding Option
DSO
Direct Service Option
FSW
Family Support Worker in the OAP
ICR
Independent Clinical Review
MCYS
Ministry of Children and Youth Services
OAP
Ontario Autism Program

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