Interns in the Treatment Track complete two six-month major clinical rotations (4.5 days per week), one year-long minor rotation (½ day per week) and a brief rotation in diagnostic assessment (≈16 hours). Interns are matched with a clinical area of primary interest through the national internship match, and then they are assigned to other clinical areas, based on interest and availability.
Skill Acquisition - Language and Learning Clinic & Community Autism Program (1 position)
The Language and Learning Clinic (LLC) at The Marcus Autism Center serves children diagnosed with autism and related developmental disabilities between the ages of 2 and 21 years (average 4 years of age) who are exhibiting significant language and social communication delays. A central goal of the LLC is to work with families to identify areas of strength, areas in need of remediation, and barriers to intervention that can be addressed through direct and indirect intervention services.
Interns in the LLC have the opportunity to gain a diverse set of experiences that include working directly with children, providing consultation, and delivering caregiver training. They learn to conduct and utilize comprehensive language assessments to aid in the development of intervention programming that focuses on improving language skills, play skills, social skills, adaptive skills, school readiness skills, and addresses barriers that may interfere with learning. They learn how to integrate child development and evidenced-based practice, which includes ABA, as well as an arsenal of other tools to produce meaningful outcomes in the daily life of the children they work with.
Understanding and Treating Severe Behaviors (2 positions)
The Severe Behaviors Program provides a continuum of services for individuals with developmental disabilities between the ages of 2 and 21 years who display severe destructive behavior such as self-injurious behavior (SIB), aggression, property destruction, noncompliance, tantrums, elopement, pica and toileting deficits. The primary goals of the program are to: (a) serve as a model for the evaluation and treatment of destructive behavior displayed by persons with developmental disabilities, (b) foster the development of new therapeutic procedures through systematic research on the nature and management of destructive behaviors, and (c) promote the effective application of currently available treatments through training and consultation.
The goal for each child is to decrease the occurrence of his/her problem behavior and generalize gains made in treatment to the child’s home environment, community, and school. Social and ecological validity of interventions is a significant area of emphasis in all Severe Behavior treatment programs. Four clinical services are available, with level of care matched to child and caregiver characteristics to provide the services warranted for each child. Training opportunities within the Severe Behavior Program include:
RUBI-Parent Training Program (minor rotation) is an outpatient program developed and shown to decrease challenging behaviors in children with Autism Spectrum Disorder (ASD) between the ages of 3 and 10. The program involves teaching parents a number of strategies to prevent, manage, and reduce occurrences of problem behaviors of mild to moderate severity while promoting skill development.
The Brief Behavior Intervention (BBI) Program (minor rotation) is a weekly outpatient program. Children have a variety of problem behaviors of moderate to high severity, including aggression, self-injury, noncompliance, disruptive behavior, elopement, and pica. Targeted treatment goals are achieved through the therapist coaching the caregiver in completing a functional analysis and implementing treatment. There is a heavy emphasis on parent training, with the caregivers rehearsing skills both during the appointment as well as between appointments.
The Behavioral Day Treatment Program (major rotation component) is the most intensive treatment format available at the Marcus Autism Center. Individuals are referred to this program if their problem behavior is placing their family in a state of crisis (e.g., problem behavior is causing significant injuries or the family is considering residential placement for the individual) or if their problem behavior cannot safely be managed by the staffing ratio available in the intensive outpatient program.
Two-week Intensive Urine Training Program (major rotation component) focuses on urine training through interventions that use consistency and reinforcement.
Two-week Intensive Bowel Training Program (major rotation component) focuses on bowel training children through interventions that use a combined medical/behavioral approach.
Pediatric Feeding Disorders (3 positions)
The Pediatric Feeding Disorders Program provides services for children who do not consume enough volume or variety of food to maintain adequate growth or nutrition. The multidisciplinary team consists of behavioral psychologists, nutritionists, occupational therapist, speech pathologist, nurses, nurse practitioner, pediatric gastroenterologist, and social worker. The psychological portion of care includes a heavy emphasis on applied behavior analysis, although some cognitive behavioral strategies and consideration of family systems issues may also be incorporated. The two rotations within the feeding program are in the day treatment program and in the outpatient program. Interns would participate in each rotation as well as participate in multidisciplinary assessments.
Based on the information obtained through a multidisciplinary assessment, the team meets and agrees upon general and specific recommendations and develops a treatment plan for the child. The child then is referred to the Day Treatment or Outpatient Program or to appropriate providers elsewhere in the community. Throughout the child's course of treatment, the team works together closely to provide comprehensive assessment, treatment, and follow-up.
Interns in the Intensive Day Treatment Program provide treatment for children whose feeding problems require daily intensive therapy (e.g., failure to thrive, nasogastric or gastrostomy tube dependence, food or texture selectivity, and food refusal), but who do not need around-the-clock medical supervision. The goals of the program are to increase appropriate and decrease inappropriate mealtime behaviors. Goals also may include increasing volume of food consumed, increasing texture of food consumed, decreasing dependence on alternative forms of nutrition (e.g., G-tubes), and increasing variety of foods consumed.
The Outpatient Feeding Program is for children who graduate from the day treatment program or for children whose feeding problems could be treated through less intensive therapy. During these sessions, the caregiver reports on the child’s progress at home. Relevant team members provide feedback. The caregiver and child also may practice the feeding techniques recommended by the team.
Interns also complete a brief minor rotation in the Clinical Assessment and Diagnostics Clinic.