Our Services

We offer several services for the development and growth of children diagnosed with Autism and other comorbid disorders. We define “disability” as a mismatch between a person’s skills and environmental demand. The purpose of our services therefore, is to teach the skills necessary for your child to participate in his/her home, school and community environments. We are committed to excellence and high standards of clinical care of the participants we serve. Our program is designed to advance according to the developmental progress of the child, such that simpler skills are taught first and more complex ones will follow only when the child has grasped the core skills and knowledge. Since each skill is used to build the next skill, this ensures that maintenance of previously acquired skills continues throughout the child’s program. Participant individualized behaviors reduction plans and skill-building lessons are designed to meet the following criteria:

  • Child-centered, strengths-specific, family-focused, community-based, and culturally-competent
  • Clearly define specific target problem behaviors and replacement skills
  • Use of objective measures to record baseline levels
  • Establish quantifiable criteria for progress
  • Describe intervention techniques appropriate to the target skill, reinforcers selected, and strategies for generalization and maintenance of learned skills
  • Document the plan for transition through the continuum of interventions, services, and settings, as well as fade-out criteria

Early Intensive Behavioral Therapy

The focus of Intensive ABA services is on skill building through direct one-on-one intensive intervention programmed by a Board Certified Behavior Analyst (BCBA) and provided to the person needing assistance by an ABA-trained professional (Registered Behavior Technician, RBT). For young children, we focus on teaching critical skills such as, developing and enhancing language, eye contact and joint attention, following directions, initiating interactions with peers, play skills, toileting and grooming, positive affect, and social pragmatics. For school-aged children, we remain attentive to important language and social skills but additionally focus on academic development, independence, self-management, and adaptive skills. We use a variety of data-driven teaching methodologies, including Discrete Trial Training (DTT), Naturalistic Environmental Training (NET), employing procedures based on Verbal Behavior analysis, and incidental teaching. In dealing with challenging behaviors, we implement the least intrusive and most natural technique that is effective. The aim is to reduce unwanted behaviors and to increase desirable replacement skills by encouragement and positive reinforcement. Generalization is a goal of our program from the very beginning, during the acquisition process of each concept and skill. In general, concepts and skills are taught via discrete trials and/or within a sequence of behaviors via chaining. Once the learner has mastered a broad spectrum of skills/concepts, the focus of programming is to bridge these concepts and skills in the learner's natural learning environment. Services are provided several days a week, depending on the individual needs of each participant, as determined by the outcome of a behavioral assessment. Day to day routines are established in each participant's repertoire to encourage the generalization of concepts and skills as they are taught within our program’s generalization framework. The program curriculum covers all relevant domains, includes behavior programs and procedures, specifies a variety of teaching settings, and includes natural environment training as well as work on individual skills in isolation. Decisions on programming and treatment recommendations consider the level of need, age, hours of other intervention(s) in the person’s life, and the family’s ability to participate. Services are ended when target behavioral and skills goals are achieved. Transition planning to public education is an important part of this service.

Functional Behavior Assessment

A complete assessment for intensive ABA programs includes a functional analysis of behaviors and may require 1-3 months to complete. A full functional behavioral assessment for intensive ABA programs includes a functional analysis of behaviors and may require 1-3 months to complete. Parents are encouraged to actively participate in the assessment process (and in the development of goals) to assure that the assessment is reflective of the child’s functioning within the family setting or from the parent’s perspective. During the assessment process, we offer support in understanding Autism and by sharing and providing information and program options available for the child and family. Parents are strongly encouraged to be full partners in the collaborative process.

Functional Behavior Assessment (FBA) or Functional Analysis Assessment (FAA) are research-based assessments that provide a systematic method for determining the function of a problem behavior that is targeted for reduction. We conduct a thorough FBA/ FAA for each participant in order to investigate the relevant setting events, antecedents, and consequences that play a role in the presence and persistence of the problem behavior(s). Truly understanding why a child behaves the way he or she does is the first, best step to developing strategies to stop the behavior. Following an initial interview with parents/caregivers and prior records review, we perform a direct assessment that includes observing the participant, objectively defining, and coding behaviors and contiguous environmental events. Once all baseline data is collected, we proceed to interpreting the gathered data and formulating hypotheses about the function and reinforcement paradigms of problem behaviors. Whenever circumstances permit and if required, we may also empirically test the hypotheses using functional analysis.Information from the FBA/FAA is generally used to develop an individualized Behavior Treatment Plan that outlines the procedures for systematically reducing targeted behavioral excesses and teaching functionally equivalent replacement behaviors.

Treatment of ADHD

Behavior modification is the only nonmedical treatment for AD/HD with a large scientific evidence base. Behavioral treatment for AD/HD is important for several reasons. First, children with AD/HD face problems in daily life that go well beyond their symptoms of inattentiveness, hyperactivity and impulsivity, including poor academic performance and behavior at school, poor relationships with peers and siblings, failure to obey adult requests, and poor relationships with their parents. These problems are extremely important because they predict how children with AD/HD will do in the long run. How a child with AD/HD will do in adulthood is best predicted by whether his or her parents use effective parenting skills. We offer treatment for children with AD/HD and similar disorders that includes parent training in effective behavior-management techniques aimed at reducing the problem behaviors associated with AD/HD. With behavior treatment, parents and children learn specific techniques and skills that will help improve children’s behavior. Parents then use the skills in their daily interactions with their child, resulting in improvement in the child’s functioning in the key areas noted above. In addition, children use the skills they learn during sessions in their interactions with other children. Important strategies include being consistent, using positive reinforcement, and teaching problem-solving, communication and self-advocacy skills. Treatment is tailored to the unique needs of each child and family.

Curriculum-Based Skills Assessment

To gather information about the child’s developmental level and repertoire of existing skills, we rely on evidence-based criterion-referenced assessment tools such as, the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) and Essentials for Living (EFL) which are designed to provide a representative sample of a child’s existing skills. An assessment using the Assessment of Basic Language and Learning Skills - Revised (ABLLS-R), the Behavior Rating Inventory of Executive Function (BRIEF), and the Revised Brigance Inventory of Early Development may also be completed to gain additional information. Assessment domains may differ as a result of an individual’s age, developmental level, diagnosis, and areas of need. The domains may include, but are not limited to the following: cognition/developmental levels, social/emotional skills, sensory regulation, motor skills, communication skills, play/leisure-time activities, pre-academic/academic skills, prevocational/vocational skills, self-help, safety skills, and community-based skills. The assessment contains an individualized program curriculum for each client that is comprehensive in scope, appropriate to the age and the needs of the client, and reflects continuity with the baseline evaluation. We conclude the assessment with comprehensive written report within one-three months of the assessment date.

Consultation

Consultation services are typically provided during weekly meetings, addressing targeted behavioral goals by educating parents and other key social agents to use applied behavior analytic techniques. Consultation services can be provided in the home or school. The focus of intervention is typically on a few targeted problem behaviors or skill deficits. Services are ended when behavioral goals are achieved.

Child Psychological Testing & Diagnostic Evaluation. In order for a child to access a range of services that are available through the health insurance finders and the school district, eligibility may have to be established through the presence of a specific diagnosis. Children who have been previously diagnosed with Autism Spectrum Disorder can also be referred for review assessment sat times of transition and for cognitive or developmental assessments. Dr.Nikolova offers comprehensive diagnostic assessments for suspected Autism Spectrum Disorder, AD/HD or similar developmental disorders in children. Once an appointment for assessment is made, parents will be sent forms via email for themselves to complete. The completed forms are to be brought to the diagnostic intake appointment. The diagnostic intake takes place during 1 hour at our clinic or client’s home where one or both parents are present to go over the developmental history of the child and to discuss the current concerns. The child should not be present at this appointment. After this, an appointment will be scheduled for the assessment. The assessment is usually conducted in the clinic, child’s home and/or school over a course of 2-3 days. As part of the assessment, Dr. Nikolova administers a series of parent questionnaires, conducts formal cognitive testing with the child, and performs informal observation in natural settings (home, preschool,school). A feedback session outlining the assessment outcomes,including an opportunity for questioning and clarification, recommendations for intervention and follow-up, and comprehensive written report are provided within one-three months of the assessment date. The entire diagnostic assessment process generally takes 20 to 30 hours to complete (includes a formal diagnostic assessment report), depending on individual assessment needs. Much appreciated!