Service Stages

GENERAL STAGES OF INTERVENTION

(Please note that this is a general sample of events – each child may follow a different service delivery course depending upon their individual needs and the needs and resources of families.)

STAGE A: INTAKE, PLAN OF CARE & ASSESSMENT

1. PRE-INTAKE

Prior to scheduling an intake meeting, interested new families must submit initial paperwork. These 3 documents can be found on our Forms Page. Once received, the paperwork will be reviewed and our Intake Coordinator will call to set up an intake meeting and supply the remainder of the paperwork needed to begin services.

2. INTAKE MEETING – A.P.P.L.E. OFFICE

Intake meetings are designed to accomplish 3 main goals:
  • To complete an interview assessment to assess the strengths and needs of your child
  • To discuss together the A.P.P.L.E. Pre- Intake Questionnaire and other assessments and to identify family needs and priorities
  • To draft an initial plan (including provider matching, assessments to deliver, timelines, etc.)

3. ASSESSMENT

The A.P.P.L.E. Direct Service Team that has been matched with your child [any combination of Lead Tutors (LT), Program Manager (PM), & Clinical Supervisor (CS)] begins rapport building sessions and administers the assessment(s) in your home. A visit to your child's school (or other observations) may also be a component of the assessment process.

Examples of Some Assessments Used:
  • ABLLS-R (Assessment of Basic Language & Learning Skills—Revised; Partington, 2006)
  • BRIEF (Behavior Rating Inventory of Executive Function; Gioia et al., 2000)
  • CASL (Comprehensive Assessment of Spoken Language; Carrow-Woolfolk, 2005)
  • OWLS-II (Oral & Written Language Scales - II; Carrow-Woolfolk, 2011)
  • PEP-3 (Psychoeducational Profile - 3rd Edition; Schopler, 2005)
  • SSIS (Social Skills Improvement System; Gresham & Elliott, 2008)
  • TOPL-2 (Test of Pragmatic Language - Second Edition; Phelps-Terasaki & Phelps-Gunn, 1992)
  • TOPS-3 (Test of Problem Solving—3; ¬Huisingh, Bowers & LoGuidice, 2005)
  • VB-MAPP (Verbal Behavior Milestones Assessment & Placement Program; Sundberg, 2008)
  • Vineland Adaptive Behavior Scales—II (Sparrow, Cicchetti & Balla, 2006)
  • WJ-II Test of Achievement- III (Woodcock, McGrew & Mather, 2001)

Once assessments are completed and scored, a Treatment Plan is developed with programs designed to address your child's specific needs, learning style as well as your priorities. Particular focus is placed on identifying criterion for each skill across The Four Levels of Learning. The Four Levels of Learning are critical to skill longevity and functionality.

STAGE B: INITIAL PROGRAM IMPLEMENTATION & REFINEMENT

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1. INTERVENTION: CURRICULUM INTRODUCTION

Initial sessions focus on the collection of baseline data to record how your child responds to specific program target and early implementation of those programs given techniques specified. In this phase the A.P.P.L.E.. Direct Service Team conducts team meetings as often as needed in order to review data, facilitate consistency and collaborate with “outside” providers to refine program. We also focus on understanding and refining the unique communication needs - including style and frequency - for each family and team.

STAGE C: ONGOING IMPLEMENTATION & SUPERVISION

1. INTERVENTION

Intervention Schedule: Session schedules may be revised according to your child’s response to initial session schedule.

Intervention Sessions: The Lead Technician (LT) and the Program Manager (PM) are the providers that focus on ongoing direct implementation of programs with your child in sessions. LTs and PMs fulfill certain duties during each session. While LTs focus on direct intervention as primary goal, the PM also provides regular oversight as well direct intervention. As a result of each direct intervention session, the PM provides a Session Feedback Form for the team to review regarding strategies/changes.

2. FAMILY SUPPORT

Family Support & “Training” Sessions: These sessions focus on providing families with tools to work on current programming skills, generalization and maintenance of skills. Also general support is provided for incidental teaching opportunities and for any particular skill or issue by which the family requests support.

3. MEETINGS & COMMUNICATION

A.P.P.L.E.. Direct Service Team meetings are conducted regularly as permitted by insurance. During the meeting, interventions are modeled, techniques are practiced, and data are reviewed. Other providers, such as school staff, SLPs, and OTs, are always welcome to join. Coordination with others who work with your child help to create a consistent and cohesive daily environment and assist in skill generalization. Team meeting notes are also taken and delivered to the team complete with "to-do" lists. Additionally, the specific modes and frequency of communication are finalized to meet the specific needs of parents, team and the monitoring needs of the student.

4. SUPERVISION/OVERLAPS.

The Clinical Supervisor provides supervision on a regular basis to behavior technicians. In that supervision session, the Clinical Supervisor observes programming in action, demonstrates programs with your child, reviews data and also provides opportunitiesto communicate with parents regarding your child's progress.

Stage C & Beyond: The “Keys” To Success:

The A.P.P.L.E. Progress Monitoring System

The progress monitoring system allows us to measure progress on an ongoing basis as demonstrated by the following periodic activities (as permitted by insurance):

1. MONTHLY

Progress Charts: There are two main components to this activity.

  • Development: A member of the A.P.P.L.E. Direct Service Team compiles progress for the month and places on a 6 month comparison matrix called the Progress Chart.
  • Analysis: Progress charts are thoroughly reviewed with feedback given each month. The progress chart data are also graphed to track month-to-month cumulative progress across various components include the Four Levels of Learning.

2. QUARTERLY

Executive Director (ED) Progress Chart Analysis & Feedback: Dr. Apple reviews your child’s progress chart and graph and provides written feedback to the team from her thorough analysis of current status of programming just prior to a Quarterly Home Meeting/Session with the Clinical Director and your Clinical Supervisor

3. SEMI-ANNUAL OR ANNUAL

Plan Update Meetings with the A.P.P.L.E. Directors Team: Prior to this meeting [scheduled with both the Executive Director (ED) & Clinical Director (CS) along with your A.P.P.L.E. Direct Service Team] a video of your child engaging in intervention (when given permission) is reviewed by A.P.P.L.E. Directors Team. At the meeting your child’s assessments updates are presented and your child's program thoroughly reviewed. This review also includes analysis of rates of progress across various points including the levels of learning and assessment progression & comparison of growth. At this time, priorities are updated, new goals and directions defined in the form of an updated treatment plan, and any overall program modifications discussed.