IBI Overview:
Intensive Behaviour Intervention Quick Overview. This is what you should be seeing within your program to some degree.
Supervision Requirements
10% of your child’s approved hours should be supervised by a Senior Therapist or CIC.
Therefore, if your child is approved for 20 hours of IBI per week then you should be seeing a senior therapist or supervising clinician on site AT LEAST 2 hours per week of therapy.
IT: Instructor Therapist - works directly with the child.
ST: Senior Therapist -
C-I-C/CIC: Clinician In Charge or Board Certified Psychologist
BCBA: Board Certified Behaviour Analyst
BCABA: Board Certified Associate Behaviour Analyst
Psych: Psychologist
I.S.P.: Individualized Service Plan
I.E.P: Individualized Education Plan
B.M.P.: Behaviour Management Plan
DFO: Direct Funded Option
S.O.: Service Option
ACFS: Algonquin Child & Family Services
TPAS: Toronto Preschool Autism Services
MCYS: Ministry of Children & Youth Services
MCSS: Ministry of Community & Social Services
CCAC: Community Care Access Centre
IBI: Intensive Behaviour Intervention
ABA: Applied Behaviour Analysis
VB: Verbal Behaviour
SLP: Speech & Language Pathologist
OT: Occupational Therapist
PT: Physio-Therapist
RT: Resource Teacher
TA: Teacher’s Aid
EA: Educational Assistant
SIB: Self Injurious Behaviour
ABLLS: Assessment of Basic Language and Learning Skills (often pronounced “Ables”)
ABLLS-R: Assessment of Basic Language and Learning Skills - Revised
The ABLLS is an assessment, curriculum guide and skills tracking system.
DTT: Discrete Trial Teaching (where skills are broken down into small components and taught individually before being incorporated into a whole skill.)
ITT: Intensive Teaching Time. This is the time spent, predominantly at a table, where individual target skills are worked on in a systematic format.
NET: Natural Environment Teaching and generalization of skills in a natural environment like the park or at the mall.
If the compliant protocol is not addressed in detail in your service contract then the regional agency should have some sort of written procedure in place and this should be followed. i.e. start with ST, ending with access being given to the board of directors.
With serious complaints, it would be in your best interest to bring a professional from another agency as a witness to any and all of these meetings or proceedings to ensure transparency and accountability.
The agency’s priority should be to serve and work with the families they are funded to serve and not to protect staff or employees of the corporate entity.
Red flags should go off if:
You aren’t seeing adequate supervision, the program has a close-minded nature, are defensive or exhibit protectionist behaviour instead of transparency, are unwilling to include or corroborate with other professionals within the community and team, or are unwilling to “put it in writing” or if the agency staff are not implementing family goals without clinical reasons (again should be given in writing).
These meetings should be held in a professional manner where you are not discouraged from bringing a pen and note pad or using “conversation summaries” when deemed necessary.
Data & Documentation
WITHIN 30 Days of starting the program your ST or CIC should have in place:
1) an ISP (Individualized Service Plan) and
2) BMP (Behaviour Management Plan)
Both of these plans should be detailed and extensive. They should also be signed by the family, the ST, the C-I-C.
Data should be taken on the items presented in both plans. i.e. you take data on a verbal stim or screaming so you can see if your BMP is working if there is a decrease in this behaviour. These should be detailed plans.
Estimation or Hard Data can and should be taken on any of the following programs or goals: communication temptations/mands/requests, academic programs, self help skills, the child’s behaviours, i.e. self injurious or stims.
These are to be displayed in a
graph form.
Behaviours that are disruptive to learning and family life should be tackled immediately.
The ABLLS may also be used to track the progress of the child.
Below is an image example of the ABLLS grid used to track the developmental progress of the child.
The ABLLS is an assessment tool, curriculum guide and skills tracking system.
Family Goals are very important to the family and success of the child and should be implemented by the program staff. i.e. toilet training, screaming, uncontrolled hand flapping or other inappropriate or disruptive behaviours. A written clinical reason should be given if the C-I-C doesn’t agree with the implementation of family goals.
All of the documentation mentioned above should be kept in a binder along with team meeting notes and the daily anecdotal notes taken by staff.
There should be one team meeting every month.
A team meeting is like a brain storming session. One team meeting a month with all your team is mandatory and this meeting should include all the IBI therapists working with your child, your ST, your CIC (if possible), yourself or the family, and other staff that should be allowed to attend include EA’s, PT OT SLP RT etc. This is where the team and family can make tremendous progress by ensuring consistency It also helps to provide a quicker assessment of the motivation of some of the behaviours you may be seeing in the child when all present can comment on their own experiences with the child.
In addition to the monthly team meeting, there should be a clinic or meeting held with the CIC (the BCBA or Psychologist) once per month (or more if the ST or BCBA needs this extra support). This is especially true in the north where again, an experienced ST or IT is more rare then in the southern urban areas.
According to the MCYS, the proposed Benchmarks have not been approved by the ministry and the Regional Providers should not be using the Benchmarks to discharge kids from IBI.
Instead, the IBI CONTINUATION CRITERIA is supposed to be referred to when discharging children from the IBI program.
If your regional provider is using the Benchmarks now then please notify the ministry and ombudsman immediately.
WHY is this so IMPORTANT? (BESIDES BEING STANDARD AS DICTATED BY THE MINISTRY WHO FUNDS THE DFO and SO IBI PROGRAM)
From what I have observed, fulfilling these standard requirements and providing adequate supervision is important because:
1) Adequate supervision greatly enhances the IT’s skills- in turn this greatly enhances the quality of therapy the student receives. This is especially important in the regional program in the north where enough of the therapists are unfamiliar with autism and/or IBI before being hired and only receive a two week training course where they jam in years of instruction and teaching into this minute time frame. The ratio of CIC to therapist should be greater with a non experienced therapist than a more well seasoned IB Interventionist.
2) Frequent supervision provides the senior therapist or C-I-C with more insight into how staff manage behaviours and whether the intervention plan is effective. They are able to get a much better picture seeing the child on a regular ongoing basis then if they only drop in for an a hour or two every few weeks or months. Therefore clinical advice is based on the general behaviours of the child and not anomalies.
3) Ensures consistency in the way that each team member carries out programs and manages behaviours etc.
4) Allows senior therapist an opportunity to review staff notes and data collection before a team meeting - since team meetings occur only once per month, we only have a short time to discuss issues, make program changes and update the binder etc. Time can be managed better if there is frequent supervision where the senior can answer staff questions and clarify goals on an ongoing basis before entering the meeting.
5) Provides opportunity for the senior therapist to conduct curriculum assessments and probe new skills to be developed into programs. It is very important that the ST be able to write the programs based on the individual child’s need and not just cookie cutter programming.
6) With out adequate supervision, a program is more glorified baby-sitting than IBI.
7) Inadequate supervision not only affects the quality of programming but it affects staff morale causing poor job satisfaction and more staff turnover which again makes the program redundant and the child regress (as the program switches focus to transition and new people and gaining instructional control).
8) Video tapes of sessions can be used for the purpose of supervision as long as the ST and C-I-C are present on site (i.e.in person) more often then video tapes being used for observation and supervision.
9) Please download the MCYS guidelines for education requirements for ST’s, etc. or visit the Senior Therapist page for more information on this position and all it requires.
