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Programs and Services for Children

Children with special needs often have extraordinary problems that challenge community systems designed for typically developing youngsters. Having professional help from someone who is experienced in negotiating the network of services, and who is professionally trained in the medical, educational, psychological and social aspects of developmental disabilities can make all the difference for the family and the child. Help may be needed at only one, or perhaps at many, points.

• When developmental issues are first identified, as early as infancy
• When behavioral responses are excessive and threaten to disrupt health and home
• When entry to public education is the next challenge on the child’s agenda
• When, having successfully navigated through school, the young adult is ready to transition to the world of work and living in the community 
• The Institute is ready to provide services or support directly to a child and family, or to consult in helping to plan for and build a network that sustains them over the course of many years.

Parent-2-Child
Autism Training Program

A new support The Institute has developed is the Parent-2-Child Program. The program was launched in September of 2008 in collaboration with Gateways Community Services in Nashua. It addresses the critical shortage of trained personnel and funding encountered by parents seeking services for their very young children with autism.

Parent-2-Child helps children up to 3 years old who have an Autism Spectrum Disorder (ASD). The program coaches parents and other caregivers to support their children effectively and to provide therapeutic intervention during the many hours they already spend with their children. Parents learn a wide variety of techniques to develop their children’s learning, communication, and social skills. Parents are also shown how to avoid and solve common behavior problems for children with ASD. The techniques are designed to be used in everyday activities and reflect evidence-based practices and the principles of Applied Behavior Analysis.The program runs throughout the year, with families enrolling as soon as an ASD diagnosis is suspected.

The training program has five major components:   

• Ten hours of hands-on classroom instruction each week for the adult, together with the child
• Weekly home visits by an experienced therapist to assist parents in applying techniques at home
• Weekly lectures by a behavior analyst to introduce topic areas and to provide in-depth discussion
• Easy to understand support materials for parents including a "how to" play book and video modeling
• Regular data collection that tracks behavior problems and skill development with ongoing assessment of progress

For more information about the Parent-2-Child program, please contact:
Le’Ann Milinder, Ph.D., Director of Clinical Services at (603) 224-8085

School-Based Services

An Overview   The Institute provides a statewide Clinical Outreach Department whose clinicians go on-site to help students aged 3-21 experiencing behavioral challenges. Our Clinical Outreach department also offers comprehensive programs that remediate the fundamental problems of autism. Services include periodic or intensive and acute follow-through assistance as students graduate through their school systems. Services are flexible, and can help with:

• Academic planning and monitoring
• After-school activity
• Extended school year programs

A Sensible Process   For students with behavioral challenges, our clinicians:

• Meet with the student, school staff and parents to understand the student’s challenges and strengths
• Conduct a functional behavioral assessment
• Develop a behavior program that can be taught to classroom staff and parents, and then support its implementation
• Monitor progress
• Follow through to make any necessary modifications to the plan

In some situations, The Institute hires, trains and supervises classroom aides to carry out the behavioral support plan, with an additional goal of integrating the student into the academic and social aspects of the classroom.

During team meetings with school staff and parents, IPP staff serve as behavioral experts. They also facilitate communication between parents, who may be feeling the stress of their child’s difficulties, and school staff, whose resources may be stretched in trying to serve the child.

A Reliable Method   Each plan The Institute helps create is based upon the behavior of that particular child and is tailored to be successful. IPP clinicians are highly trained in Applied Behavior Analysis (ABA), a proven, research-based method of helping individuals acquire new skills and change their behavior. This involves detailed observation of the student to gather data about behavior and determine how to alter both the environment and people’s interactions with the child to achieve positive, long-lasting change. Once an ABA plan is crafted, it can be taught to those who spend time with the child, including teachers, classroom aides, parents and family members, and others.

Facilitation of the Parent-School Relationship   Parents and teachers make great progress when they are “on the same page” in implementing a behavior plan for the child. Schools often request – and parents appreciate – that The Institute’s clinicians can make home visits to help the parents carry out the behavior plan at home. This consistency between home and school is comforting to the child as well, and a key to the child’s achievements.

“By utilizing a variety of behavioral techniques our IPP clinician has helped Chloe with eating and sleeping issues, reduce maladaptive and self-injurious behaviors. Chloe has gained some independence with activities of daily living (dressing, bathing, tooth brushing, hair brushing, household chores, etc.). The clinician also assisted in training school aides and support providers so they could carry out her behavior programs accurately. The behavior plans were based on Chloe’s particular needs, never “cookie cutter.” Now she interacts more positively with her siblings, family and friends. As a result the quality of our lives has improved and Chloe has gained many skills." 
                                                                       -Jennifer & Shawn Bertrand, Chloe’s parents

 “She (IPP clinician) is a valuable member of the large team of parents, therapists, teachers and principal – we work as a strong team. She has always been easy to work with and has a lot of ideas for solutions. She helps with the program in the home. If something we try does not work, she’ll come up with something else to try. It’s amazing."
                                                                      -Danielle Costa, M.Ed., Special Education Case Manager, K-3, Mont Vernon Village School

"This is one of the best behavior plans I've ever seen and IPP has been very responsible with the school district's money."   
                                                                       -Renea Sparks, (former) Assistant Director of Special Services, SAU 39                     

For more information about School-Based Services please contact:
Le’Ann Milinder, Ph.D., Director of Clinical Services (603) 224-8085

Outreach Assistance to Children and their Families

The Institute’s clinicians who provide outreach services to children and their families bring two essential ingredients to this partnership:

• A high level of skill in Applied Behavioral Analysis (ABA)
• A set of values that respects, empowers, and acknowledges the strengths, abilities and preferences of each child and each family we serve.

We offer two services that are helpful to children and their families. Often, but not always, these take place in the home setting.

Early Intensive Behavioral Intervention (EIBI) services are designed for very young children, birth through 3, newly diagnosed with autism. This highly structured clinical program is aimed at remediating the fundamental problems of autism. Our well-trained clinicians and therapists provide evidence-based ABA services in close collaboration with the family. The strategies  used to help children acquire skills such as paying attention, communicating, establishing eye contact and listening result from university-based research studies and are proven to be effective in helping children learn. IPP clinicians help parents acquire teaching and child-management skills that enable them to be more effective at the difficult job of parenting. The Institute is also available to help create the smoothest transition possible into the world of school when the child turns three.

In-Home Supports help children ages 3-21 living at home who are struggling with various kinds of medical and developmental challenges. The Institute's staff assist these young people and their parents find solutions that reduce stress and make home life go more smoothly.When invited to do so, an Institute clinician enters the family home and studies the child’s behavior, helping to assess the activities, interactions, needs and interests of the child. This in-home observation is sufficiently in-depth to create a behavior plan likely to hit the mark in helping the child learn more adaptive methods of getting his or her needs met. The behavior plan devised by the clinician includes quite specific instructions for parents to follow on a daily basis, a helpful map of “how to’s” for encouraging positive behavior and opening up learning options that are satisfying to the child. Parents learn from the direct modeling that the clinician provides during instructional settings with the child. Home visits are flexibly scheduled to meet the family’s needs, and the plan is adapted based on what is and what is not working.  Progress is measured carefully so growth can be applauded and “tweaks” in teaching methods can be made.

“Sarah was diagnosed with autism at 14 months. That was so overwhelming.  Our IPP clinician started helping us at 17 months and stayed with us until Sarah was 3 years old. She brought ABA to us, and definitely helped me learn the ins and outs of autism. She helped me communicate with my own child! ABA came through for us. It helped us expand Sarah’s language, and play with visual scripts to help show her play sequence. The clinician never talked over my head. She always broke things down and made me feel comfortable asking questions, even though she has a Ph.D. She’s family-oriented. She understands. Then she helped with our transition into public school when Sarah turned 3. She shared with me what to look for in the classroom environment and teaching approach, then helped me with questions regarding the school IEP. She made me feel good about the school district I was working with. When your child enters public school, it’s frightening. She helped me feel like I was not alone. Sarah’s doing well now, though her health challenges still get in the way. But I couldn’t imagine where she’d be if we hadn’t had this incredible help early on."
                                                                  -Michelle Abbott, Sarah’s mother and guardian

                              

              Sarah...the swimmer, the ballerina, the sweet, curious and incredibly determined sister and daughter.

Pictured: Sarah Abbott 

“The IPP clinicians are always a crucial part of a team to help children with complex needs. That team will include parents and other professionals. One of IPP’s strengths is working in homes, helping with bedtime routines and other situations that are particularly stressful for the family.”
                                                                       -Nancy Dowey, Program Manager for Early Supports and Services, Gateways Community Services 

“At this point she (clinician) comes to our house once a month and helps us update our goals for my son, Max. When I am struggling with a particular issue with Max, she asks a lot of questions, then taps out a plan on her laptop that she can leave with me. Sometimes she gets on the floor with him to try out some things directly with him, but her goal is always to leave me with the tools I need. At 7 years, he wasn’t toilet trained. She typed out a plan and it looked so simple that I said, “No way, that won’t work.” Two weeks later, he was trained during the day and in another month he was the using the toilet around the clock, even washing his hands. It was amazing. It boggled my mind that it worked. Max has made progress in communication, safety awareness, talking to people in the community. He has made so much improvement in the last 3 years."
                                                                      -Melissa Casparro, Max’s mother and guardian

                    

Mom, Melissa and sister, Ali, find Max's increasing confidence and hapiness contagious.

Pictured: Max Casparro

“Our 9-year-old Teddy is severely autistic and has lots of special needs. IPP staff provide an after school program for him 2 hours each afternoon, Monday through Friday. This is great because at home he gets bored and is always tugging at my wife. Teddy gets some structured time doing things he likes in the community –things he can’t do in school or here at home – and we get to spend time with our other two kids, helping with homework and just spending time devoted to them. IPP even gives Teddy some extra academics. This really helps our family.”
                                                                       -Brad Canfield, Teddy’s father and guardian

                           

   

No couch potato, Teddy enjoys invigorating swims 5 days a week, accompanied by his good friend and IPPI instructor Chuck.

Pictured: Teddy Canfield

To learn more about Child and Family Outreach Services, which may be funded privately, through private insurance, the local developmental disabilities area agency, the local school system, or cost-sharing arrangements, please contact: Le’Ann Milinder, Ph.D., Director of Clinical Services (603) 224-8085

Enhanced Family Care

When a child with disabilities needs a comfortable home she or he can share with a caring and competent individual, couple or family, The Institute can make that happen. Using a model often referred to as “foster care,” we carefully match children, based on needs, interests, preferences and goals, with Enhanced Family Care Providers who wish to share their homes with individuals needing special kinds of support so they can live in the community. It takes great care and thoughtfulness to create a match between children with complicated medical and behavioral issues and the right home care providers able to meet those needs. Providers must have either the existing skills and values to support individuals with extraordinary challenges, or the potential, with training, to develop these skills.

Creating a successful match requires that The Institute:

• Develop a comprehensive understanding of the child -- history, critical day-to-day needs and routine, likes and dislikes, and preferences for a living situation
• Identify the skills and training a provider must have in order to be successful in supporting the child
• Use our network of professional colleagues and creative recruitment strategies to find a group of potential top-notch home providers
• Choose a provider from this group who has the skills, or can be trained, to provide essential supports
• Help with introductions and the critical early transitional stages of building a trusting and comfortable relationship that will last

Sustaining that successful match involves:

• Planning – to articulate clear goals and outline the steps to achieve those goals, including personal care, health maintenance, daily routines, enriching weekend and vacation activities, and strategies to handle a crisis
• Monitoring progress – to help the child, home provider, and support team track progress toward the goals, and make course corrections as needed
• Providing flexible, 24/7 staff response – to solve problems, no matter what they involve, or when and where they occur
  

 

“The IPP coordinator was one of the best coordinators I’ve ever worked with because she was so involved in what this young woman and her home care provider needed. The IPP nurse was also very involved, and the two of them worked really well together as a team to support this woman and her provider whenever assistance was needed --- way over and beyond 9 to 5.”
                                                     -Megan Holmes, Case Manager, Moore Center Services, Inc.

For help in learning more about Enhanced Family Care Arrangements for children, which are typically funded by local school districts, local developmental disabilities agencies, private pay, or cost sharing, be in touch with:

Community-Based Transition Programs for Teens and Young Adults

When students with disabilities begin to “age out,” that is, when they have benefited as much as they can from what is contained within the curriculum and walls of the school, they still have much to learn in order to continue to grow. Poised to gain increased independence and autonomy, they need training in life skills to make a successful transition to adulthood.  To meet this need, IPP offers individualized programs for students aged 18 to 21. We engage the student, family and school district in creating a program that matches the student’s interests and skills levels and meets the school’s IEP objectives.

Our services are provided primarily through 1:1 support within the home, neighborhood and community, creating opportunities for academic and real world skill development in natural settings. Some examples of skill development areas include:

• Prevocational and vocational – occupational competence; interviewing; resume development; behavior on the job; job expectations; getting along with your boss and coworkers
• Household maintenance – planning the menu; shopping; cooking; household repairs and upkeep; laundry; lawn care; cleaning
• Financial responsibility – identifying bills and coins; budgeting; purchasing; banking
• Social activities – having a conversation; stranger/friend identification and safety; resolving conflicts; reducing challenging behavior
• Health – medical management; exercise; psychological well-being; dental care; good nutrition; good sleep habits
• Handling a crisis – keeping safe and in touch; responding to an emergency

“Betsy has Prader-Willi syndrome. At 20 years old, her school was not able to offer the in-school supports she really needed and offered us the opportunity to use an outside provider until she reached 21. Betsy required a one-to-one aide who could manager her stresses and occasional acting-out behaviors.  IPP was recommended to us as a top-flight provider who could hire a dedicated caregiver to carry out a community-based learning and skills building program, including academics and work and volunteering. The transition from school into the real world can be one of the most difficult times that special needs families face – finding a job and worthwhile things for the person to do.  The IPP team made that transition work for Betsy, although it wasn’t always easy.  One of IPP’s greatest strengths is their ability to provide “emergency services” to their clients if needed; so, for example, if Betsy had a stress ‘meltdown’ or any problem in the community they would respond immediately. Knowing that they were always there for our daughter allowed us to relax and ‘breathe’ during the day.”
                                                         -Tim McMahon, Betsy’s father and guardian 

                                                  

Betsy's close knit family supports her love of animals, community theatre and athletics. 

Pictured: Betsy McMahon

To learn more about the community-based teen and young adult transition programs, which are typically funded by local school districts or paid for privately, be in touch with:

        Behavioral Consultation and Training for Professionals and Parents

Professionals often seek further knowledge to increase their effectiveness in helping individuals they serve. Parents want to become more skilled at assisting their children in learning new skills and reducing challenging behavior. In response to these needs, The Institute’s Clinical Outreach Department shares its expertise with both of these audiences, in New Hampshire and throughout the country. We offer group trainings and workshops, as well as individualized consultations, that are targeted to suit trainees’ particular needs and interests.

Most consultations and training events focus on teaching Applied Behavioral Analysis (ABA) principles, and demonstrate the practical applications of these proven methods across a wide variety of everyday experiences. The combination of two elements – a strong value base of respect and caring, and scientific ABA methods – creates a powerful tool set that equips parents and professionals to have a positive impact on those for whom they care.  

Examples of training topics include:

• Functional behavioral assessments
• Supporting students with autism
• How to establish effective routines for children (getting to sleep, mealtimes, toilet training)      
• Creating individualized staffing designs that work
• How to develop enhanced family care arrangements

 

“Our organization provides services for individuals with traumatic brain injury and those with challenging medical needs. IPP consults with our staff, and together we develop behavioral support programs that enable these folks to have more control over their lives, expanding where they can go and what they can do. We don’t have this specialized expertise in-house, so we contract with IPP for it. Working with IPP has given our staff clarity on how to provide excellent behavioral supports.
                                                   -Joel Green, Director of Client Services,Community Services Council of New Hampshire

“His preparedness was phenomenal, beautiful handouts, PowerPoint, examples. The materials were fabulous and his impromptu responses to questions from the audience were great.”
                                                   -Workshop Participant

“This was the best workshop that I’ve attended as a parent. I’m taking home a framework of understanding and ideas about ways to help my daughter get to sleep. What a gift this will be!"