Specialized Focus Areas
Introduction

Beaverbrook STEP is well known for its excellent clinical and behavior management services designed for adults dually diagnosed with intellectual and developmental disabilities and mental health and/or behavioral disorders, as well as, adults with Autism Spectrum Disorders (ASD), neurological disorders, traumatic and/or acquired brain injury, and/or chronic medical conditions.  Our clinical team works with individuals and families to develop comprehensive residential, day and community services using person centered planning designed to meet each individual’s unique needs. Our services include:

•  Therapeutic services:  occupational, physical, sensory, behavior management and speech/ language.
•  Nursing (RN), health care management and in-home health care services.
•  Medication evaluations and management by STEP’s psychiatrist.
•  Applied Behavioral Analysis (ABA) services developed by STEP’s Master’s level, board certified ABA professionals.
•  Psychological and counseling services provided by licensed social workers (MSW, LICSW and LCSW) and mental
    health counselors (LMHC).
•  Durable medical equipment, assistive and adaptive devices and electronic communication systems.
•  Transportation to medical appointments.

Beaverbrook STEP’s programs are organized into 4 major categories:  Residential, Day Services, Family Support Resources and Community & Recreation.  All of these services are designed to maximize each person’s learning, independence, community inclusion and overall quality of life.
•  Behavior Management
Population Served

Nearly 1 out of every 150 children born in the United States today will be affected by Autism Spectrum Disorder (ASD).  Moreover, individuals with intellectual and developmental disabilities are at increased risk of developing co-occurring behavioral and psychiatric disorders.  Beaverbrook STEP is a leader in the development of person-centered, behavioral approaches to meet these growing needs.

Characteristics of ASD include impairment in social interactions, difficulty learning language and communication skills, repetitive and/or restrictive actions and behaviors and intense focus on special interests.  Many behaviors such as head banging, hand flapping and repetitive actions make social interactions very difficult.  People with ASD often have lifelong difficulty with unique stressors, including environmental stressors and changes in routine.  Without appropriate and individualized educational and behavioral interventions, adults with ASD can develop aggressive behaviors and have difficulty learning to communicate and socialize.

Additionally, medical advances and technology have resulted in a growing population of individuals with disabilities related to neurological disorders, brain injury, physical disabilities and medical  conditions that may be characterized by behavioral outbursts, aggressive and assaultive behaviors, self injurious actions and other negative behaviors.  These individuals also have a high incidence of speech and language disorders that negatively affect the development of communication, social and independent living skills.
Clinical, Behavioral & Medical Services

Beaverbrook STEP is a leader and expert in the provision of intensive clinical, behavioral and medical services for adults with behavioral needs within our quality, community-based residential, alternative day, and employment training programs.  Our person-centered services are based upon proven strategies, techniques and interventions that focus on positive reinforcement as the foundation for all learning—social, academic, communication, sensory and independent living.  As individuals served learn how to attend to daily living tasks, communicate effectively, interact with peers, form meaningful relationships, develop personal care skills, and explore new interests, their frustrations, impulsiveness and negative behaviors are mitigated, resolved and/or replaced with appropriate interactions that are consistently reinforced.

STEP’s clinical team includes health care professionals, social workers, mental health counselors, and behaviorists (ABA certified) who work together to provide appropriate, structured living and learning environments, designed to maximize the acquisition of new skills and foster positive, socially acceptable behaviors.  Using a behavioral approach to services, the clinical team develops personally-designed behavioral strategies and interventions for each person.  These plans are executed using intensive staff supports, role modeling and positive reinforcement that insure successful and lasting outcomes.

For individuals diagnosed with Autism Spectrum Disorder, physical and sensory disabilities and behavioral or psychiatric disorders, STEP’s nursing staff and health care clinicians (Occupational Therapist, Physical Therapist, Speech/Language Pathologist, Behaviorist, Social Workers, Mental Health Counselors and Sensory consultant) work with each person’s medical team and staff to develop and implement home based health, medication, clinical and medical services.  Homes are modified to meet each person’s accessibility needs and durable medical equipment and assistive/adaptive devices are incorporated into each home environment to maximize independence, self esteem and learning for each person.  All of these interventions prevent unnecessary hospitalizations, reduce the number of emergency room visits and prevent placement in nursing homes and long term rehabilitation facilities.
Applied Behavioral Analysis (ABA)

Using empirically proven educational and behavioral strategies, STEP’s Board Certified Applied Behavioral Analyst develops individualized programs and interventions for each person needing behavioral supports.  The ABA works collaboratively with other members of the Beaverbrook STEP clinical team, including licensed and certified social workers, mental health counselors and nursing staff.

The clinical team supports and trains our well qualified staff who implement the specialized, intensive, individualized supports within adapted living and working environments.  These highly successful programs are designed to maximize the mastering of daily living activities, social, communication and job readiness skills, as well as enhance positive behaviors for each person served to promote increased independence, self esteem, social interactions and quality of life.

There are various types of training and applications that are part of Applied Behavioral Analysis.  STEP uses many of these approaches including Discrete Trial Training (DTT), Pivotal Response Training (PRT) and Verbal Behavior Intervention (VBI). All of these methodologies focus on positive reinforcement, breaking tasks down into small, teachable components and building verbal and communication skills.  STEP also uses Functional Communication Training (FCT), a highly effective tool for identifying and eliminating Behaviors Of Concern (BOC) that have been identified through careful observations as strong reinforcers of severe behaviors for individuals.

All of these approaches are used in conjunction with other therapeutic services (occupational, physical, behavioral, speech & language pathology, sensory) as part of a comprehensive treatment plan.  Behavioral plans are also developed for individuals to help encourage learning new skills and social behaviors.  Emphasis is on positively reinforcing achievements and ignoring unacceptable behaviors until they are extinguished.
Communication & Social Skills Training

STEP places a great emphasis on teaching adults with behavioral issues how to communicate.   Our goal is to teach individuals verbal, sign or other alternative language and communication skills.  Once mastered, then they have a solid basis for learning social skills, developing meaningful relationships and participating in community life.  Individuals also work one to one and in small groups with staff developing appropriate social skills, forming personal relationships and building self-confidence.

STEP uses augmentative and alternative communication devices such as picture boards, communication books and electronic devices to teach language and communication skills and build independence, self esteem and personal control for individuals served.  Our staff are also trained to use the Picture Exchange Communication System (PECS) to promote conversations and practice communication skills. 

New devices, particularly the Apple iPad, have sophisticated applications (apps) that STEP uses to teach language, organization and time management skills, as well as social and academic curricula.  The iPad also has applications that can be programmed to serve as personal communication devices for individuals served.   In fact, the iPad itself holds enormous potential for the future of adults with disabilities.
Training & Resources

Beaverbrook STEP provides comprehensive training for staff and managers focused on meeting the areas of clinical, behavioral and medical needs of adults with behavior management needs. On- going training includes:

•  Theory, techniques and applications of Applied Behavioral Analysis
•  Diagnosis and characteristics of dual diagnoses, mental health & behavioral disorders, Autism Spectrum Disorders
    and other disabilities
•  Development and implementation of behavior plans; data collection & analysis
•  Person centered and future vision service planning
•  Exercise, nutrition and wellness
•  Seizures and other health care conditions
•  Home based medical services
•  Human Rights
•  Social skills development
•  Multi-modal communication techniques
•  Therapeutic and clinical services
•  Durable equipment, adaptive and assistive equipment and devices
•  Communicating with clinical and medical staff, ABA professionals, home health care providers, families and
    community members

In addition, Beaverbrook STEP provides educational workshops for family members and guardians around topics of interest including Recreation & Leisure Services, Nutrition and Wellness; Estate Planning and Guardianship; and Communicating with Care Providers.  For more information click here:  Family Support Services.
85 Main St., 2nd floor
Watertown, MA 02472
Tel: (617) 926-1113
Fax: (617) 926-1226
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