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A Symbiotic Partnership

 

More than 100 families with children with autism and developmental disabilities have received clinical services from a partnership between the College of Education’s Department of Special Education and Austin Travis County Integral Care (ATCIC). Andrew and his family are one example of the power of the partnership.
 
Photos: Christina S. Murrey
Narrated by: Taylor Rowland, special education graduate student and Applied Behavior Analysis (ABA) therapist
 

The Department of Special Education and Travis County join forces to help families with children with autism

When the College of Education’s Department of Special Education launched a modest partnership with Austin Travis County Integral Care (ATCIC) eight years ago, no one could have foreseen the robust, multi-faceted program it would blossom into by 2014.

“There’s a symbiotic relationship between us and ATCIC that’s been there from the beginning,” said Dr. Mark O’Reilly, chair of the Department of Special Education.

Under O’Reilly’s guidance, the department had recently established one of the first U.S. graduate training programs to specialize in preparing special educators, psychologists, and speech pathologists to work with children with autism and developmental disabilities and their families.

At the same time, ATCIC, a community-based behavioral health and developmental disabilities service provider, was struggling to provide enough board-certified behavior analysts (BCBAs) to serve its growing population of in-need families.

“An efficient and effective training program needs more than just ivory tower instruction. We have to link with those practices and we have to influence the community in positive ways.”

“We reached out to them and they reached out to us,” said O’Reilly. “We thought it would be essential as part of that curriculum to partner with community programs that actually deliver services to families who had children with autism. An efficient and effective training program needs more than just ivory tower instruction. We have to link with those practices and we have to influence the community in positive ways.”

At the outset the terms of the project were limited in scope: ATCIC would fund one University of Texas doctoral student to provide 20 hours a week of behavior supports for program families. Ten hours would be clinical services to families and the other 10 would fund student research.

This was a tall order, considering that challenging behavior and communication issues included potty training, eating difficulties, sensory issues, aggressive behavior, and self-injury.

“He came in and served as many people as he could, working in one little office downstairs,” said Maya Vega ATCIC Director of Intellectual and Developmental Services. “But the services that one UT Austin doctoral candidate was providing for this collaboration were of such high quality that we knew this was a relationship we needed to nourish and continue.”

Since then the Department of Special Education/ATCIC partnership has grown to include several separate and distinct branches that employ the skills of four to five doctoral students and about 10 masters students annually. In the eight years the program has been in place more than 100 children have received services.

“It’s basically four programs,” said Cindy Gevarter, a doctoral student in special education who supervises the program’s recently implemented Early Childhood Intervention (ECI) program. “Behavior supports is where the program initially started. Doc students would go out, write behavior plans and do short-term follow-ups. But now that we have more support we’re able to actually go in to a home setting and teach a family how to implement those behavior plans instead of just saying ‘Here you go.’” The ECI program provides in-home behavior therapy for children ages 0-3.

Now, in addition to the long-standing behavior supports program, the partnership features an Applied Behavior Analysis (ABA) autism program, the ECI program, and a social skills program that is geared up to start this spring.

Both the ABA and ECI programs provide children from low-income families with free or reduced-cost behavior services in the home. Both approach therapy in a naturalistic manner, although ECI tends to involve more on-the-go parental interaction.

“With the autism program we do a formal assessment and then put together individualized programs from that assessment,” said Laura Rojeski, a doctoral student in special education and manager of the ABA program. “We might have 10 to 30 goals for a kid depending on his level of functioning, and we’re working on those and taking data on those. We’re always trying to do things in a more naturalistic way, making sure we’re not just sitting at a table, but with our 3-6 year-old population it’s a bit more structured.”

“With the ECI program it’s mandated by law that the parents must be part of the training,” said Gevarter. “It has to be what’s called ‘vetted instruction.’ If the natural routine for mom is to play for 20 minutes, have snack time, and then go outside, we’re following that. We’re not saying to mom, ‘Hey, this is what we’re going to do.’ We’re figuring out how we can work within routines that are already happening.”

The success stories that stem from these programs are manifold.

“We used to not hear from families,” said Vega, “but now we hear from them all the time. We have individuals who are using zero ability to communicate verbally who start working with these clinicians and a few months later they have a vocabulary of 20 words.”

Cassandra Medrano is just one parent who has seen life-changing positive results. Her four-year-old son Andrew has been involved with the ATCIC program for more than a year, and in that time has progressed from being almost completely non-verbal to signing and talking more frequently. Thanks to the hands-on therapy his behavior issues have also quieted.
“He’s actually around other kids without temper tantrums,” said Medrano. “Now he’s side by side with them. He doesn’t lash out. He’s able to attend school and actually sit down for a good five to ten minutes and do activities.”

The relationship O’Reilly describes is beneficial to all involved. ATCIC’s stretched-thin staff gets much-needed support; doctoral students receive leadership and supervision opportunities; masters students gain learning opportunities and a chance to complete work toward their Behavior Analyst Certification; and the Department of Special Education builds research partnerships that help advance the field from an educational perspective. Most important, families struggling with the issue of autism are granted a ray of hope and a measure of success.

“We get excited to see the kids making progress, such as speaking their first word or using a communication device,” said Rojeski. “But sometimes parent’s reaction to that progress is the greatest thing. Seeing how excited the parent becomes when they watch their kid communicate, learn new skills and do something without behavior issues, that’s just incredible.”

In keeping with The University of Texas at Austin’s motto, “What starts here changes the world,” the unique Department of Special Education/ATCIC partnership’s influence has extended well beyond Travis County.

“It’s not just the here and now in terms of training,” said Dr. O’Reilly. “Doctoral students have flown out of here and have been very successful in terms of getting jobs at universities all around the nation and replicating this program.”


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