Establishing Interactions currently services the greater St. Louis Metropolitan area.

Clinical Visit/Client Observation

A client observation can be carried out at the child's home, school, or both, depending upon parent concerns and priorities. Each visit runs approximately 55 minutes. Some of the skills that can be observed during an appointment are: Self-regulation skills, focus and attention in small or large group environments, language skills, social skills, affect/emotional regulation, and classroom participation. Please note that as a specialty private practice, I do not accept insurance or have the capability to bill insurance for clients, although clients can pursue their own reimbursement and many clients choose to do so. I also conduct all visits and training personally, and never send out trainees or junior-level staff, such as behavior technicians or BCaBAs (board certified assistant behavior analyst) in my place.

Educational Consultation and IEP Preparation and Attendance

Dr. Abernathy has experience observing clients at many schools, both public and private, in the St. Louis area. School observations can help pinpoint the differences between environments that may be the cause of behavioral or learning differences between environments (i.e., behavioral difficulties at school but not at home or vice versa). In addition, school observations can be helpful when assessing social skills, level of classroom participation, and attending or focus difficulties. Assisting parents in the writing and development of IEPs as well as attending IEPs is another area of service.

Functional Behavior Assessment (FBA) and Behavior/Social-Emotional Support Plan

A functional behavior assessment (FBA) is an assessment that allows for the determination of the function or functions of challenging behaviors. This assessment is used to discover the functions that are maintaining the behavior and for the development of a behavior support plan that will treat the behaviors according to their function. Treating a behavior by its function is a much more precise and effective form of behavior management than applying general behavior management techniques to behaviors.

An FBA is conducted because behaviors often appear different (behavior topography) than their primary maintaining factor (behavior function). An FBA can generally be conducted within 1-3 visits of 1 to 1.5 hours in length and the length of the FBA is shorter if one function is found and longer if two or more functions are discovered (multiple functions). This distinction is generally apparent by the second visit. After the function(s) of the behavior are determined, a set of individualized recommendations is developed and parents and/or therapists and/or teachers are taught to implement a behavior support plan. Simple acting-out behaviors can typically begin to be treated within 1-2 visits, moderate behaviors 2-3 visits, and more challenging behaviors within 4-5 visits. The behavior support plan will be focused on how to redirect the behavior successfully, to develop a set of functional appropriate alternatives, and to incorporate reinforcement for the selected alternatives. Dr. Abernathy will also conduct a language sample during the FBA, to rule out that a comprehension difficulty or use of language concepts is not part of the child's presenting issue, as this is quite common.

Social Skills Groups

There are currently six social skills groups running for the 2018 semester. There are a minimum of 5 students and a maximum of 9 students for each group; attendance fluctuates every 5-week period but is typically within these boundaries. Parent conferences are held 3 times per year during the group to work on child goals, parent carry-over, and address parent priorities for their child. All clients in all groups are at the conversational verbal level; each child is able to ask questions, answer questions, make comments, offer suggestions, and has the self-regulation abilities to demonstrate calm behavior and self-regulation throughout the entire group. Each child varies slightly in their verbal abilities, personal challenges, and their abilities to attend to and execute multi-step small and large group instruction.

School Support and Educational Assistants

School support consists of training and supervising an educational assistant (also known as a therapist assistant, ABA therapist or implementer, or classroom para or aide) for a child's private school to assist the child when needed during the school day and to fade back when the child is successful. The education assistant appears more like a teacher's assistant when observed, so it is not obvious to other adults or children that they are there for a particular student. Most children receiving support have a personalized behavior/social-emotional support plan in place, and the shadow is trained to implement this plan, which often focuses on bringing the child into contact with reinforcement for gradually increasing social-emotional/learning/self-regulation requirements. The therapist works within the unique culture and requirements of the school and classroom, providing support to the child and the classroom teacher in the service of the child. Each shadow is supervised by Dr. Abernathy personally once every 2-4 weeks.

Applied Verbal Behavior Intensive Program

Applied Verbal Behavior is Dr. Abernathy's specialty in practice, which in is itself a subspecialty in Applied Behavior Analysis, that focuses on the integration of language skills as an integral part of every learning objective in each child's program. Dr. Abernathy specializes in teaching initial language skills to children who are nonverbal or minimally verbal as well as furthering initial language progress when a child seems stuck or at a plateau. She has extensive experience in designing verbal behavior programs for children with developmental delays, social skills challenges, Fragile X, ADHD, Apraxia and other language or communication difficulties, Social (Pragmatic) Communication Disorder, and ASD/Asperger's. Advanced language and social skills work are another of Dr. Abernathy's research and practice interests. Children in the intensive program receive 4-25 hours per week of therapy. Dr. Abernathy develops the initial program, trains a therapist assistant(s) to implement it, and personally supervises the program monthly.