Description of Service Providers
Individuals with autism often receive services from multi-disciplinary teams. In addition to educators and early interventionists, you will find descriptions of many of these service providers below.
Board Certified Behavior Analysts (BCBAs)
Board certified behavior analysts conduct behavioral assessments and provide interpretations of the results of such assessments. They design and supervise behavior analytic interventions to address both the acquisition of skills and the reduction of challenging behaviors. Many board certified behavior analysts also hold licenses or certifications in other disciplines (e.g., psychology).
Counseling/Psychological Service Providers
These individuals may include clinical psychologists, counseling psychologists, marriage and family counselors, social workers, psychiatric nurses or related professionals, as well as certified behavior analysts. They may provide parent training or support, social skills groups, clinical behavior therapy, play therapy. In some cases, the involvement of these providers may be restricted to conducting evaluations and making recommendations.
Early Intervention Providers
Early intervention providers seek to address the needs of children suspected of disabilities from birth to three years of age. In some states, early intervention is defined as birth to five years of age. As is the case with special education services, children in this age group must meet eligibility criteria in order to qualify for services. Priorities in early intervention often include addressing deficits in cognitive, language, motor, social, play, and self-care skills, reducing the gap between the child's skills and those of his/her typically developing agemates, and preparing the child for public school. Early intervention providers deliver an array of services to both the child and the family and these should be clearly delineated on a child's Individualized Family Service Plan (IFSP).
General Education Teachers
General education teachers work with students in preschool, elementary, and secondary schools. They provide services to large groups of students although class sizes range from school to school. Given the federal mandate that children participate to the fullest extent possible in least restrictive settings, children with autism and related disorders often have considerable contact with general education teachers. This may involve an all day placement or parts of the day (selected carefully by the team). A child with autism may participate in a general education classroom or classrooms with or without the support of a paraprofessional. Since general education teachers have tremendous experience with typically developing children and the vast array of learning potentials, their input and perspectives on age appropriate skills can be invaluable.
Occupational Therapists (OT)
Occupational therapists provide training in daily living skills such as dressing and hygiene, as well as fine motor skills related to holding objects, handwriting, cutting, and other activities. Their treatments rely on the use of specific tasks or goal-directed activities designed to improve the functional performance of an individual as it relates to the smaller muscle groups. They may also work on sitting, posture, and perceptual skills (i.e., recognizing differences in color, shape, and size) and many occupational therapists specialize in feeding and swallowing. Some occupational therapists emphasize or restrict their treatment to sensory integration therapy (described elsewhere on website).
The goal of paraprofessional teaching staff is to support the efforts of teachers. Their involvement varies widely with respect to both the amount and nature of contact. For example, paraprofessionals may be involved in one to one teaching, small group instruction, and shadowing and supporting the child with autism in a general education classroom. Given the role that they serve and the amount of direct contact that they have with their students, it is imperative that they receive the training, mentorship, and supervision necessary to maximize their skills and competencies. Some schools assume their responsibility in supporting these key members of the team; unfortunately, this is not always the case.
Physical Therapists (PT)
As is the case with occupational therapists, physical therapists are also concerned with improving or restoring physical function; however, they focus upon the larger muscle groups. They also use therapeutic exercises to reduce pain or improve posture, locomotion, strength, endurance, balance, coordination, joint mobility and range of movement and flexibility. Exercises may be active or passive (i.e., performed by the individual or performed on the individual by the therapist or by specialized equipment) and are based upon biomechanical and neurophysiologic principles. Physical therapy does not include adaptive physical education or dance therapy.
Special Education Teachers
In contrast to general education teachers, special education teachers focus upon meeting the unique educational needs of children with identified disabilities such as autism. They provide an array of services which should be clearly delineated on a student's Individualized Education Plan (IEP). Many special education teachers either work with students with autism in self contained classrooms or in resource rooms with the distinction related to the amount of time the child spends with the special education teacher. Please be aware that not all special education services have to be delivered within a special education classroom. In many cases, special education teachers work closely with general education teachers in adapting and supporting the general education experience to make it more meaningful for the child with autism. In addition, the special education teacher typically supervises the efforts of paraprofessionals. Having a disability does not automatically qualify a student to have access to the services of a special education teacher as the child must also meet eligibility criteria for special education and related services. When a student is determined to be eligible for special education services, the special education teacher often assumes a case management role to help coordinate the services of the various providers on the multidisciplinary team.
Speech and Language Pathologists (SLPs)
Speech and language pathologists are involved in the treatment of communication and speech impairments. Treatment areas may include muscle control related to speech production, articulation, prosody, vocabulary development, receptive and expressive language skills, conversation skills, and social pragmatics. When working with individuals who struggle significantly with spoken communication, speech pathologists are also involved in the selection and implementation of augmentative communication systems (see description elsewhere on website).
Providers vary widely with respect to their commitment to scientifically validated treatments for autism. Some providers rely exclusively on scientifically validated treatments, others emphasize such treatments but do not restrict their practice to them (i.e., they may also use procedures that remain untested and lack any scientific evidence), and still others appear to be providing services without consideration of scientific support or lack of support for the methods they use.
Furthermore, some providers collect data to objectively assess whether their interventions are leading to positive outcomes, whereas other providers do not use data and rely exclusively on subjective impressions to assess progress. These differences exist across all disciplines so consumers should assume their right to ask questions.
Please note that a license or certification is no guarantee that an individual: 1) possesses adequate, or even any, experience working with individuals with autism; 2) uses scientifically validated methods when providing their services; and 3) relies on data to guide their assessment of progress and decision making.