Description of the Treatment Team

Kate McKenna, MEd, MSEd, MS, BCBA
David Celiberti, PhD, BCBA-D
Association for Science in Autism Treatment

Description of the Treatment Team Individuals with autism often receive services from multi-disciplinary teams. Treatment teams work in partnership with the individual and their family. The members of a team, and their specialties, may depend on the individual’s current level of functioning, the nature of the needs and concerns, the age of the individual at the onset of intervention, and the type of school or community setting where services are provided. The composition of the treatment team may also change as the individual ages. Below we provide a brief description of the roles of those likely to be members of a treatment team. For more information see Ramirez and Pantelides (2019). Please note that these members are listed alphabetically.

Board Certified Behavior Analysts (BCBAs)

Board Certified Behavior Analysts work with families and other team members on a wide range of activities related to improving language, social communication, play, academic, and daily living skills. BCBAs will also work to teach functional communication and other replacement skills with the goal of reducing challenging behavior that negatively impacts the individual’s ability to learn in the least restrictive environment. BCBAs will, if necessary, conduct behavioral assessments related to, for example, language and social skills or challenging behavior. They then provide interpretations of the results of such assessments to families and team members. Many BCBAs also hold licenses or certifications in other disciplines, such as special education, speech-language pathology, or psychology. For more information about what to expect from a quality program designed by a BCBA, click here.

Depending on the state and the services mandated in the Individualized Education Plan (IEP), a Board Certified Assistant Behavior Analyst (BCaBA) or a Registered Behavior Technician (RBT) may be the person working with the individual. BCaBAs and RBTs receive training at institutions accredited by the Behavior Analyst Certification Board (BACB) and work under the supervision of a BCBA. If they are providing services to the individual, they may attend and contribute to team meetings. Before team meetings, it would be important to work on communication systems with the BCBA concerning whom to talk with about what, as some of your questions and concerns should be addressed directly with the BCBA.

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. Children in this age group must meet eligibility criteria, which differ from state to state, in order to qualify for services. Priorities in early intervention often include addressing deficits in cognitive, language, motor, social, play, and self-care skills. Focus in these areas seeks to reduce the gap between the child’s skills and those of their typically developing agemates and to prepare 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 the 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 spent in activities with same-aged neurotypical classmates. 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. In some states, the presence of a general education teacher at IEP meetings is required. In that role, they provide information about the grade level curriculum, prerequisite skills necessary for access to that curriculum, and the level of functioning typical of students at that age and grade. If the child receives shadowing support from a paraprofessional, the general education teachers will work closely with those individuals within their respective classrooms.

Occupational Therapists (OTs)

Occupational therapists (OT) providing early intervention (birth to age 3) may focus on gestures and actions critical for interacting effectively with the environment. This can involve functional and symbolic play with toys, coloring, stickers, play dough, and toy musical instruments. As children age and the focus shifts to preparation for school, goals related to fine motor skills such as handwriting, cutting, and the effective and efficient use of manipulatives may be targeted. Across the lifespan, occupational therapists work on daily living skills such as dressing and hygiene, as well as skills necessary for employment, leisure skill development, navigating the community, and living as independently as possible. For more detailed information about occupational therapy, click here.

Paraprofessionals

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 their contact with students. For example, paraprofessionals may be involved in one-to-one teaching, small group instruction, or shadowing and supporting the child with autism in a general education classroom. Paraprofessionals working in a classroom are typically supervised by a special education teacher. Despite the limits of their role, it is often the case that a paraprofessional may spend the most time with the student during the school day, compared with the other team members. Thus, their input at team meetings may provide important information about the student’s response to services, although they may not always be present at these meetings.

Physical Therapists (PTs)

Physical therapists (PT) are concerned with establishing, improving, or restoring physical function of large muscles in gross motor activities such as navigating stairs, riding a bike, safe use of park equipment, and muscle movements necessary to engage in age-appropriate physical games and activities. PTs use therapeutic exercises to improve posture, locomotion, strength, endurance, balance, coordination, joint mobility, and range of movement and flexibility. The goal of physical therapy is the development and improvement of gross motor and basic movement skills.

Psychological Providers

Depending on the setting in which services are provided, clinical psychologists, school psychologists, or family counselors, may be included as ongoing team members. Parent training, participation in social skill groups, or behavior therapy can be included in mandated services on a student’s IEP. In some cases, the involvement of these providers may be restricted to conducting evaluations and making recommendations as part of the diagnostic process.

Social Workers

In some states, a social worker who specializes in autism may be part of the treatment team. The training that social workers receive in counseling, problem-solving, and monitoring the well-being of individuals and families, allows them to bring a wider perspective to the work of the treatment team. Social workers support individuals and families in a variety of ways, including aiding in filling out and filing paperwork to obtain additional services, serving as a clearinghouse of information on support services available in the state or community, acting as an advocate in dealing with local and state government agencies, and providing individual or group counseling. In some cases, a social worker may serve as the case manager.

Special Education Teachers

Special education teachers focus on meeting the unique educational needs of children with identified disabilities such as autism. They provide an array of services that can be delineated on a student’s Individualized Education Plan (IEP). Special education teachers work with students with autism in a variety of settings, including inclusive co-taught classrooms (ICT), self-contained classrooms, or in resource rooms. Placement typically depends on the extent of the student’s needs for modifications and support. In ICT rooms, 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.

Special Education Itinerant Teachers (SEITs)

A special education itinerant teacher (SEIT) is a special educator who provides one-on-one educational support to students. The exact role of SEITs, the settings in which services are provided, and the ages of students served varies from state to state. In some states, SEITs work exclusively with children ages three to five, either in the home or in a preschool/daycare, spending all or part of the school day providing scaffolding and support to facilitate the student’s access to the curriculum and social interactions with peers. In others, teachers travel to different schools and work with students in elementary, middle, and high school. As members of the treatment team, SEITs provide updates on student progress, report on assessments they conduct, and suggest strategies to maximize student performance. If a student meets criteria, a SEIT provides a bridge from home to school if the student is unable to attend school in-person due, for example, to a prolonged illness.

Speech and Language Pathologists (SLPs)

Speech and language pathologists (SLP) are involved in the treatment of communication, language, and speech impairments. In addition, some speech and language therapists are educated in the treatment of swallowing and feeding disorders. SLPs respond to a variety of goals related to the muscle control necessary for 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 on website).

The Importance of Science-Based Treatment

Science and evidence-based strategies and techniques should be the core of a treatment plan. It is important to note that providers may 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 may not restrict their practice to them (i.e., they may also use procedures that remain untested and lack scientific evidence), and still others appear to be providing services without consideration of scientific 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 about how progress will be measured.

Finally, keep in mind 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, and 4) brings a strong sense of collaboration and compassion to the team.

For more information about science-based autism treatments or being a savvy consumer, click here.

Reference:

Ramirez, H., & Pantelides, M. (2019). Clinical corner: What does it mean to become an advocate for my child on multi-disciplinary teams? Science in Autism Treatment, 16(12).

Citation for this article:

McKenna, K., & Celiberti, D. (2023). Description of the treatment team. Science in Autism Treatment, 20(4).

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