In-Home versus Center-Based Services

December 30, 2013, TBH Blog
TBH Blog

As providers of evidence-based applied behavior analytic therapy, clinicians at Trumpet Behavioral Health know the importance of providing intensive behavioral intervention for young children recently diagnosed with autism and other developmental disabilities.

They also know that individualized plans are the key to pinpointing strengths and weaknesses in each person, leading to the establishment of programs that enhance skills and maximize each person’s potential.

An important question that’s often asked by parents and guardians is centered on that individualization and the location where it occurs.  When it comes to the care of your child, should you look to home-based or center-based services?

Fortunately for our client’s parents this question, while important, is not as important as the one that’s asked when a diagnosis first occurs: Can you help my child?

The answer is yes, and two of our clinical directors are here to explain the need for both in-home and center-based services when developing a comprehensive treatment plan that’s structured for success.

How it balances out

Making informed decisions is an essential element when choosing a behavioral therapy provider. The same scientific research and results that drive the services of Trumpet Behavioral Health have been tested with home- and center-based treatment, leading to extensively examined outcomes on a variety of skills and abilities.

As any parent of a child with autism can tell you, everyday distractions have a serious impact on the ability to help a child develop his/her skills, whether it be at home, in the car, grocery store; nearly anywhere.

One advantage of center-based treatment is an alleviation of distractions that a child is used to. From toys to pets and parents to siblings, the removal of these items and the subsequent decreasing of stimulation associated with them allows clinicians to have more control over a child’s attention span. That can equate to more concentration and better results.

Paige Raetz, Ph.D., BCBA-D, shares the following of center-based treatment services.

“Center-based services provide an environment that is more similar to school, allowing the learner to begin developing the necessary repertoire of focus and attention within an environment that is more like a classroom. Use of center services allows the learner to generalize skills to other people and other settings that can be limited while providing therapy in the home.”

Tyra Sellers, Ph.D., BCBA-D, reiterates that notion while adding that center-based services allow for skills to be assessed and worked on in settings that are similar to those where individuals will need to use the skills. This includes settings like a classroom, community, public environment and more.

Within the center setting, clinicians and therapists can remove things that might inadvertently support or weaken skills such as a familiar person and favorite objects. Those distractions can then be systematically added into the environment once the individual has learned the target skill.

Because balance plays an integral part to learning behaviors, it’s important to consider home-based therapies as well. Home-based therapies provide advantages for individuals who struggle with new places, settings and people. An individual who has a problem behavior might be more receptive to therapy within his/her own private setting.

An important part of treatment for ASD includes the family. With center-based services, family members can be brought in to test that a child is “generalizing,” or displaying behavior across different settings, with different people and at different times. This teaches them strategies that are effective for the child in the natural environment.

At times, in-home services are scheduled intermittently when individuals are not in a position to travel (such as elderly caregivers) or when physical situations are not replicable in the center (swimming pool, hot tub, dinner time, etc).

As our clinicians have identified here, a balance is certainly needed between in-home and center-based services. As children become more effective learners, it can be easier to move them to center-based services where they can apply their learning skills in a new environment.

So What Do I Do?

Work with your clinician and child to establish a detailed plan of action that outlines your child’s strengths, weaknesses and areas of greatest struggle. Then, align the plan with the environment that best suits your child for learning and maximizing their potential. Want advice or have a question on types of therapy? Click here to ‘Ask an Expert.’

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