Starting Together | Ages 2–4
Starting Together is a model program for naturalistic developmental behavioral intervention (NDBI) for families with children with autism, ages 2-4. The program is founded on the principles of Applied Behavior Analysis (ABA) and the Early Start Denver Model (ESDM).
The primary aim of the Starting Together program is to partner with parents to better understand how to support their child with autism and to practice evidence-based strategies during parent coaching sessions. Families then carry over these effective strategies and supportive interactions to family and community activities.
Focused behavioral treatment is offered through scheduled parent coaching sessions and individual treatment sessions for children as determined by their treatment plan. Parent coaching (with child present) is provided onsite or by Telehealth. Individual sessions for the child are provided at the Waisman Center. Families enroll for a six-month cycle, with progress review every 12 weeks. Many families continue with the program for 1-2 years, dependent on their child’s age at the start of treatment. Enrollment mid-cycle is an option when space is available.
Enrollment cycles: January – June and July – December
Service level options: Determined by current openings and behavior analyst recommendation after initial assessment
- Parent coaching plus 6 hours of individual treatment (ST 6)
- Parent coaching plus 1.5 to 3 additional hours of individual treatment (ST 3)
- Parent coaching only (PC)
At every service level parents attend a 60 or 90-minute parent coaching session for a dedicated schedule for a 6-month enrollment cycle. Session schedules are developed with the family’s behavior analyst, to best fit the parent’s goals for treatment and availability.
Parent coaching sessions focus on parents learning strategies to support their child’s development and learning. During sessions parents also identify other concerns and work with their provider toward solutions using positive behavioral strategies. Teaching and interaction strategies are based on “An Early Start for Your Child with Autism” (2012, Rogers, Dawson & Vismara). Progress toward parent and child outcomes is reviewed weekly by the treatment team with progress review meetings scheduled with the family every 12 weeks.
Children attend a 90-minute individual session for 4 days or 2 days each week scheduled between Monday-Thursday. Each child is paired with the same direct service staff for their sessions. Children participate in planned typical preschool activities and daily routines. Intentional session activities include play with toys, pretend play, building, sensory play, reading together, exploration, art projects, movement activities and outdoor play to practice specific skills. Children rotate to different play zones to practice transitions and different types of play. While other children are present at the same time, we do not provide small group or social skills instruction with peers.
Assessment (initial and ongoing),treatment planning, progress review, and staff training and direction are provided by licensed behavior analysts; two behavior analysts are also ESDM certified therapists.
Additional resource support for families is provided by a licensed clinical social worker. Bachelor’s level treatment specialists provide direct teaching and support during individual sessions. Treatment specialists may also join parent coaching sessions for child support and modelling of strategies. The family’s behavior analyst is also available to communicate with other providers, including Birth to 3 staff, speech or occupational therapists, preschool, day care or public-school teachers and therapists. .
Parents participate in assessment by identifying their priorities for treatment outcomes, observations of their child at home, and in treatment by practicing strategies at home during daily routines and family activities. Typically, families stay enrolled in the program until the end of the enrollment cycle when their child turns 4-years-old. Transition planning is individualized, most children graduate from the program around age 4. Based on their treatment goals some children continue until they are eligible for full day school at age 5. The treatment team supports families in planning for that transition.
Parents may attend one of their child’s sessions for parent coaching or schedule a Telehealth session at another time while at home with their child present. Sessions are scheduled Monday – Thursday, between 8:30 am – 2:00 pm, and Fridays, between 12:00 pm – 2:00 pm.
Individual Child Sessions
- Session 1: 8:30 am – 10:00 am
- Session 2: 11:00 am – 12:30 pm
- Session 3: 2:00 pm – 3:30 pm
Parent Coaching only
Sessions are scheduled based on a match of parent and provider availability and location of the session, Monday – Thursday between 8:30 am – 2:00 pm, and Fridays between 12:00 pm – 2:00 pm.