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SECTION 4: OAP SERVICES AND SUPPORTS

Scope of Services

The focus of all OAP services will be on increasing the capacity of the family and the OAP Family Team, should a family wish to have one, to maximize the child/youth’s functional skills within the context of their home and community. The OAP will deliver a continuum of evidence based behavioural services and family services and training for children and youth with Autism Spectrum Disorder (ASD) and their families based on their needs and strengths across all developmental stages.

Evidence Based Behavioural Services

The OAP Clinical Framework will guide clinicians in partnering with families to develop an understanding of each child’s/youth’s and family’s strengths, capacities and need for behavioural services and creating a Behaviour Plan with an evidence based approach to meeting those needs. Families can expect to receive services that actively engage them to acquire skills that support their child’s development and skill building.

Applied Behaviour Analysis (ABA)

Many of the effective behaviour interventions for children and youth with ASD are based on the principles of applied behaviour analysis (NAC, 2015). ABA is an applied science, based on the principles of learning and 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 is used to teach skills across developmental domains, including but not limited to communication, social and adaptive skills, 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.

ABA strategies range from highly structured, adult-led instruction (e.g., discrete trial teaching), to child-led interactions (e.g., incidental teaching, natural environment teaching).

There is an emerging body of research supporting the use of Naturalistic Developmental Behavioural Interventions (NDBI), which are typically used with children under the age of 3, at risk for, or diagnosed with ASD. These approaches follow the sequence of typical development, use the principles of developmental science, are relationship based, child centred and play based (Wagner, Wallace, & Rogers, 2014) and often include an intensive individualized approach to parent/caregiver coaching (Wetherby et al., 2014).

High quality, evidence based behavioural intervention for children/youth with ASD includes the following components that have been identified in the literature as being of key importance:

Family Services and Training

The involvement of parents/caregivers is essential to achieving maintenance and generalization of skills learned by children and youth with ASD. There is significant evidence of many positive outcomes associated with parent training and parent/caregiver implemented intervention (Drew, Baird, & Baron-Cohen, 2002; Ingersoll & Dvortcsak, 2006; Feldman et al., 2002; Lafasakis, & Sturmey, 2007; Stewart, Carr & LeBlanc, 2007; Seiverling, Williams, Sturmey, & Hart 2012; Fettig, Schultz, & Sreckovic, 2015). It has also been demonstrated that parents/caregivers who learn the specific techniques to support their children or youth have increased feelings of competence and report positive parent-child interactions (National Research Council, 2001).

The ability of the OAP to lead to improved outcomes for children and youth with ASD is dependent to a significant degree on the involvement of parents/caregivers in learning the strategies being taught to their children and incorporating these techniques into daily activities. This ongoing support is essential for children and youth to maintain the skills they have learned, and to apply these skills in other settings and with other people. As such, the involvement of parents/caregivers is a core component of the OAP, and will be clearly documented in the Family Service Plan.

OAP family services and training will support parents/caregivers to become:

Domains of Need

The OAP will address the needs that children and youth with ASD have across the following domains:

Social/Interpersonal

Individuals with ASD often have significant impairments in social/interpersonal skills, such as difficulties with initiating conversations or sharing emotions with others, use and understanding of nonverbal communicative behaviours, and difficulties establishing and maintaining friendships.

Communication

Communication difficulties or disorders are commonly associated with ASD, including difficulties using and understanding verbal and nonverbal communication. This may include joint attention, which is an early social-communicative skill in which gestures and eye gaze are coordinated and used to share interest in an object or event, and which may be impaired in children/youth with ASD. Other examples of communication difficulties include a total lack of speech, abnormalities in pitch, rhythm and intonation, stereotypical and repetitive language use, idiosyncratic word use.

Cognitive Functions

Cognitive abilities include problem-solving, reasoning, information processing, and executive functioning.

School Readiness

Learning/school readiness includes skills that are prerequisites for success in school, including acquiring new skills within a group setting, independent work, following routines, and self-help skills (e.g. dressing, toilet training).

Motor

Motor skills include gross motor movements (i.e., large movements of legs, arms, feet, or the entire body) and fine motor movements (i.e., fine movements of the hands, fingers and wrists).

Personal Responsibility/Adaptive

Adaptive and personal responsibility skills are practical skills required to function optimally in daily environments and routines, such as maintaining personal hygiene, using kitchen appliances, and community safety skills.

Play and Leisure

Many individuals with ASD lack effective play and leisure skills, including deficits in conventional engagement with play items/activities, engagement in cooperative or imaginative play, and interest in, and friendships, with peers.

Self-Regulation

Self-regulation includes the ability to identify and manage one’s behaviour, such as sustaining and shifting attention, self-management and self-monitoring.

Vocational

Vocational skills include practical skills and knowledge required for success in a trade, vocation or profession.

Challenging Behaviour

Challenging behaviours commonly occur in the ASD population. These behaviours may include aggression, self-injury, and restricted/repetitive or otherwise disruptive behaviours that interfere with skill development and prevent participation in social and community activities.

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