Parent Handbook

“A smile on a child’s face means there’s a connection that wasn’t there before.” –Mike Miller, CEO

5 Our Values

22 Your Clinical Team

6 Where Do We Go from Here?

24 Family Support

8 Treatment

26 Policy Highlights

14 Scheduling and Expectations

28 Share Your Caravel Experience with Us

16 Client Portal 2

Treatment We change 18 lives

Environments

30 Key Contacts

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“When our minds and lives were still spinning, you reached out and slowed the ride down a bit. Thank you for that. Thank you for always listening and making us feel like we mattered…that our child mattered. Thank you for listening to and answering my questions, even those that don’t really have an answer. You gave me hope and reassurance. Thank you. Know that you had an impact. You had a part in his success. His ability to take on the world is greater because of you.”

–Parent of a former Caravel client

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Caravel was founded to create better outcomes. Every day. For everyone touched by autism. Our Values: Principles that guide us Rigor

Unity

We put in the work because we care about the work. Every detail matters in delivering effective autism treatment. We must set and beat the bar–again and again.

As colleagues, we share in every success and struggle. Nothing is accomplished alone.

Innovation

Compassion

Constant improvement in our methodologies and technology is at the center of what we do.

The children and families we serve are everything to us. We do what we do for them.

Growth

Advocacy We work tirelessly to ensure access to the highest-quality treatment and connection to resources across the autism care community.

To be the best, we need to be staffed by the best. So we provide personal and professional growth for every team member in order to unlock their greatness.

Hope Optimism drives us in this necessary work. Progress motivates us. We seek better outcomes every day.

Better outcomes. Happier lives.

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“Where Do We Go from Here?”

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This question is often top of mind for the parents of children on the autism spectrum. Whether your child is newly diagnosed or you are looking for new treatment options, we are here to help you make the best decisions for your child and family. At Caravel Autism Health, we strive for better outcomes and happier lives for every child and family. Our team of dedicated professionals works to develop skills, create connections, and instill confidence. In this handbook, we will describe the features and benefits of our treatment program, what families can expect from us, and what we expect from families in order to achieve the best outcomes. We want you to be confident that you have made the right decision for your child and family by partnering with Caravel.

Better outcomes. Happier lives.

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Treatment

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What is Applied Behavior Analysis (ABA) Therapy? Applied Behavior Analysis (ABA) is a therapy based on the science of learning and behavior. ABA therapy programs can help: • Increase language and communication skills • Improve attention, focus, social skills, memory, and academics • Decrease problem behaviors ABA is considered an evidence-based bestpractice treatment by the US Surgeon General and the American Psychological Association. “Evidence-based” means that ABA has passed scientific tests of its usefulness, quality, and effectiveness.1 ABA therapy includes many different techniques. All of these techniques focus on antecedents (what happens before a behavior occurs) and on consequences (what happens after the behavior).

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More than 20 studies have established that intensive and long-term therapy (25–40 hours a week for 1–3 years) using ABA principles improves outcomes for many children with autism. These studies show gains in intellectual functioning, language development, daily living skills, and social functioning. The goal of any ABA program is to help each person work on skills that will help them become more independent and successful both in the short and long term.

Source: Autism Speaks

Better outcomes. Happier lives.

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ABA Therapy and Children

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ABA Therapy and Children Generally speaking, children with autism often need help with oral and verbal skills, gross and fine motor skills, and sensory processing. ABA uses techniques and principles to bring about meaningful and positive changes in behavior.

of sources including the American Academy of Pediatrics and the National Institute of

These principles help us to understand how behavior works, how the environment affects behavior, and how learning occurs.

Mental Health.2

In young children with autism, the goal of intensive, comprehensive intervention is to improve cognitive, language, social, and self-help skills. Decades of research have shown that intensive ABA treatment is the most successful approach for children with autism, and it is widely recognized by a number

During ABA therapy, baselines are established to set goals, which are then broken down into small steps. The steps are organized into a logical order and taught one at a time.

Our Overall Goal Our goal is to help your child improve their social, communication, daily living, and other learning skills through positive reinforcement. At Caravel Autism Health, we apply ABA with positive reinforcement as one of the primary interventions and methods to increase a specific behavior. When a behavior is followed by something that is valued, a child is more likely to continue that behavior.

Over time, this approach fosters desired change. By celebrating strengths and encouraging independence in developmental areas, we help your child achieve their full potential.

Source: Behavior Analyst Certification Board, Inc.®

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Better outcomes. Happier lives.

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“The work is challenging, and we are right there in the weeds through some tough times with the families. But seeing the small gains lead to larger gains–a child making a new friend at the playground or saying ‘I love you’ to their parent for the first time–is so rewarding and makes the investment worthwhile.

What Does Treatment Entail? Getting Started: Baseline Assessment

Going Deep: Comprehensive Treatment

If your child is diagnosed with Autism Spectrum Disorder and you decide to proceed with therapy, your child will need an additional assessment of their current skills in order to develop the treatment plan.

Research indicates that early intervention for children with developmental challenges results in the best outcomes for growth and development. We provide comprehensive, evidence-based early intervention services for children as young as 18 months old until they enter full-time school. Comprehensive treatment typically involves delivery of 30–40 hours per week. These programs reflect the needs of the client, targeted goals to address those needs, and measured responses to treatment.

We help you schedule the appointment, which you and your child attend. This appointment is called the “baseline assessment,” and it is conducted by a Board Certified Behavior Analyst (BCBA) who specializes in crafting an individualized treatment plan to meet your child’s needs. The appointment lasts about two hours and gives us a starting point to measure your child’s progress. A second baseline assessment appointment may be needed in order to gather enough information to build out a comprehensive treatment plan.

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Continuing the Effort: Focused Treatment While many children in our programs enter full-day school by age six, they may still need continuing support. As your child progresses through various stages of development, our clinicians adjust the individualized treatment program through an evidence-based approach. With scope narrowing and as other goals are completed, prescribed therapy may shift to 15–20 hours per week.

The most bittersweet moments come in the form of a child graduation from our services. We are sad to see them go but so incredibly proud of all they have achieved!” –Cierra Smith, Clinic Director

Step by Step: Individualized Treatment Plan At Caravel Autism Health, we partner with you to develop an individualized treatment plan. Each treatment plan is personalized to your child and family. Caravel’s treatment plans are designed to help children in many ways. We teach children with autism an array of skills which may include: • Skills for verbal and social interactions

• Becoming ready for school-based learning

• Receptive and expressive language skills

• Community skills

• Daily living skills such as dressing, using

the bathroom, and household tasks

Treatment includes one-on-one therapy, family guidance meetings, supervision, and parent and family training. BCBAs will continually monitor progress and update your child’s treatment plan as needed. ABA is data-driven, so your clinical team will consistently record data and write session notes during each therapy session, documenting your child’s responses using our proprietary computerized data system. Treatment plans must be submitted to funding sources on an ongoing basis for

authorization renewal. This is typically on a sixmonth recurrence but may vary based on your specific funding source. You and your child’s team can see how your child is progressing by logging onto our Client Portal at any time. We use this information to guide our clinical decisions and determine whether adjustments need to be made to the treatment plan. You will learn more about the Client Portal and how to get connected to your child’s therapy schedule and programs on page 17.

Better outcomes. Happier lives.

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Scheduling and Expectations

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Attendance and Parent Participation Agreement: A Shared Responsibility Your child’s treatment schedule is a long-term commitment between you and your clinical team. Depending on your child’s treatment plan, we may serve your child and your family up to 40 hours a week for anywhere from one to three years. In other words, we’re in it together. Maintaining your child’s weekly prescribed treatment is important: research shows that consistent treatment hours result in optimal gains for children and their families. We have a commitment to you to deliver outcomes and progress for your child and to fulfill the treatment schedule.

We understand that other appointments for your child, such as doctor, dentist, OT, and PT, will come up. To minimize disruptions to your child’s therapy schedule, we do ask that they be scheduled outside of treatment hours. In the event that appointments conflict with the treatment schedule, we will work with you to create a proactive plan to make up the missed time with your child’s clinical team.

A Schedule That Works for Family and Staff

Family Vacations and Time Away

We recognize that time is precious. Caravel Autism Health schedules your child’s therapy within morning, afternoon, and late afternoon scheduling blocks, depending on availability. Maintaining availability for scheduled therapy within 3–4 hour time blocks increases the potential to fulfill your child’s needs and deliver desired outcomes. The consistency of block schedules and standard windows of client availability allows for increased retention of staff and the ability to match clinical talent with families.

Parent and Family Training You are an important part of your child’s treatment. So participation in parent and family training is required and part of the prescription. Depending on your child’s treatment plan, your team will schedule training on a regularly recurring basis, typically weekly. Some of these training sessions may be delivered via telehealth, as appropriate.

We understand and appreciate that family time and vacations together are important. Extended time away from therapy may impact your child’s progress. We ask that family vacations be limited to 1–2 weeks per year and that vacation plans be submitted at least six weeks in advance. Families are expected to make up sessions that are missed, and your team will ask to reschedule upon notice of cancellation. As part of the intake process, the BCBA responsible for your child’s treatment plan will meet with you to review the therapy schedule and sign the Parent/Guardian Participation Agreement. You will have many opportunities at that meeting to ask questions about the therapy schedule, our commitment to you and your child, and your obligations as a family.

Better outcomes. Happier lives.

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Client Portal

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Caravel’s Client Portal is the most convenient way to access everything you need for initiating, tracking, and engaging in your child’s treatment.* Using your computer, tablet, or smartphone, you can access your child’s profile on the portal and review their therapy appointments, parent training appointments, diagnostic evaluation reports, and medical records forms. When your child starts therapy, you will be able to review the therapy session notes and the clinical data collected by your child’s treatment team. Your child’s data is uploaded daily so you will have immediate access to your child’s progress in therapy. *Information in the Client Portal is secure and complies with healthcare privacy law.

Logging into Client Portal If it is your first time logging in or you cannot remember your password: • • •

Go to members.centralreach.com/#login. Click “Forgot Password/First Time User” Enter the email address you provided at intake and click Reset.

You will receive a Central Reach password reset email, which you can use to set a new password and log in.

Better outcomes. Happier lives.

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Treatment Environments Caravel offers ABA treatment in both clinic-based and home-based environments, depending on the clinical needs of your child.

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Clinic-Based Therapy Our treatment areas are optimized for a variety of therapeutic activities based on your child’s individualized treatment plan. Our clinics offer one-to-one therapy and peer interaction in a welcoming, child-friendly environment designed especially for children on the autism spectrum. We have ample space for children to engage in activities that promote exercise as well as opportunities to improve communication and social skills. You will be offered a virtual or in-person tour of the clinic. We provide you with the list of items your child will need to bring, including personal care items, snacks, or lunch. We will review your child’s individualized therapy schedule, including drop-off and pick-up times at the clinic. We prefer to deliver as much of most children’s treatment as possible in the more controlled setting of a clinic-based environment. That said, home-based therapy is more effective in certain situations.

Better outcomes. Happier lives.

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Home-Based Therapy We recommend that some children receive their therapy in a home-based setting. A member of the clinical team will visit your home and create a plan with you about when and where therapy will take place. Initially, your child’s best opportunity for progress is a location that is free of distraction, such as a den, basement, or bedroom. We recognize that you are opening your home to us for therapy and will act with the utmost respect for your personal space. In return, we ask that the entrance to the home, including walkway and steps, as well as the therapy area be clean and free of obstacles or safety hazards. Smoking or vaping while the therapist is in the home is not permitted. Pets must be under control, and proof of animal vaccination may be required.

Telehealth Caravel is equipped to deliver certain elements of our treatment, like parent training, counseling, or supervision, via telehealth.

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A responsible adult aged 18 or older, who can safely supervise your child, must be present in the home while therapy is happening. You or the designated adult may not be required to participate in daily therapy. However, you or the designated adult need to be available to respond to environmental situations such as cleaning your child’s bodily fluids, including the result of toileting accidents or diaper changes, administering medications, or applying skin care products. You will receive additional information about how to prepare for therapy and your responsibilities as a parent when a member of your clinical team visits your home to get started.

“This is hard work. Feeling like you make a difference is what gets you up in the morning, day after day.” –Alia McCann, Clinic Director

Better outcomes. Happier lives.

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Your Clinical Team Your clinical team is led by an experienced BCBA and is built and trained to meet the needs of your child. Following a baseline assessment, your clinic director assembles a team to design and deliver an individualized treatment plan for you and your child.

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Every member of your clinical team has been trained and prepared to deliver ABA treatment. Our clinical teams have extensive training and supervision support. Their specific roles are highlighted below. Clinic Director

Senior Therapist (Midwest)

The Clinic Director is the leader of the location

The Senior Therapist coordinates your child’s therapy

where your child is assigned for therapy, whether that

in your home or at the clinic. Senior Therapists are

treatment takes place in a clinic or at home. The Clinic

responsible for supervising the Behavior Technicians

Director approves client schedules, supervises the staff,

providing frontline therapy, assessing your child’s

and coordinates the clinic and/or in-home operations to

progress in therapy, updating treatment programs,

ensure children get the best therapy.

and providing hands-on training and supervision for the Behavior Technicians working with your child. Senior Therapists have a bachelor’s degree and at

Board Certified Behavior Analyst Our Board Certified Behavior Analysts (BCBAs) are master’s degree–level clinicians who have completed a rigorous certification program administered by the Behavior Analyst Certification Board, an international not-for-profit association dedicated to ensuring highquality and ethical behavior analysis treatment. The BCBA oversees the treatment team to navigate

least 2,000 hours of supervised experience in the use of ABA for autism. All Senior Therapists complete rigorous training prior to working independently and receive continuous ongoing training throughout their employment. The Senior Therapist may lead or participate in parent meetings, family guidance, parent training, and staff supervision. Senior Therapists work under the supervision of a BCBA.

your child through the individualized treatment plan. The BCBA will lead or participate in parent meetings, training, and staff supervision.

Behavior Technicians and Registered Behavior Technicians Behavior Technicians provide the frontline therapy

Board Certified Assistant Behavior Analyst A Board Certified Assistant Behavior Analyst (BCaBA) has, at minimum, a bachelor’s level degree and is certified to provide behavior analytic services under the direction of a BCBA. A BCaBA also supervises Registered Behavior Technicians (RBTs).

experience to your child by engaging them in the therapy programs of the individualized treatment plan. Behavior Technicians enjoy interacting with children and helping them learn. They are typically college students or recent graduates trained through a combination of online curriculum and ongoing supervised experience. Training involves learning the basics of Applied Behavior Analysis, collection of data, ethics, professionalism, avoiding dual relationships, and confidentiality. Training with experienced staff ensures consistency across team members and gives the newly assigned Behavior Technician time to build a positive rapport with your child.

Better outcomes. Happier lives.

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Family Support

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Through its team of licensed clinical psychologists, psychometrists, and outpatient therapists, Caravel Counseling & Diagnostics (CCD) partners with our ABA teams to provide diagnostic evaluations, regular clinical updates and assessments, and family counseling services for our clients and their families. The clinical staff at CCD have been expertly trained in the evaluation and diagnosis of Autism Spectrum Disorder (ASD). During the course of ABA treatment, the CCD staff will obtain updated behavioral data (through parent questionnaires and progression reports). This information will be compared to initial diagnostic data to highlight behavioral and adaptive gains as well as provide therapy teams with possible direction related to treatment planning.

CCD staff offer psychotherapy and family support services in addition to diagnostics. Generally, as a way of introducing families into ABA treatment, family support is recommended after the initial diagnosis. Individual psychotherapy and family support might also be beneficial for a child who is waiting to start intensive ABA therapy. One-on-one psychotherapy also provides a valuable transitional resource for children and families graduating out of intensive services.

Better outcomes. Happier lives.

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Policy Highlights

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HIPAA and Confidentiality

Information about the children and families within our program is highly confidential. We adhere to all Health Insurance Portability and Accountability Act (HIPAA) laws. We do not discuss the child, diagnosis, behaviors, programs, or progress with anyone outside of the child’s care team, or with anyone within the organization who does not have a need to know for billing, treatment, or administration of our programs. We do not discuss one child with the family members of another child. Therapy staff is trained to never mention children’s last names, addresses, school placements, case histories, or any other identifying information. If you have a question or concern, please discuss with the BCBA on your child’s treatment team.

Protecting the Therapeutic Relationship

Staff are required to maintain professional conduct at all times. Caravel Autism Health’s expectations of professionalism include, but are not limited to, areas of personal appearance and appropriate attire, therapeutic practices, written and oral communication, conflict resolution, and personal presentation. In order to maintain professional working boundaries, staff are not permitted to engage in social media with any member of a client’s family, accept gifts, or socialize outside of treatment hours with families. These boundaries align with the Behavior Analyst Certification Board’s (BACB’s) code of ethics and professional conduct.

A Word about Social Media and Electronic Devices

In online social networks, the lines between private and public, personal and professional are blurred. Just by identifying yourself as a client of Caravel, you are creating perceptions about our company, its leaders, and employees. To maintain a professional relationship, Caravel prohibits our staff from “friending” or “following” our families on any social networking site.

To protect staff and client privacy, we prohibit the use of electronic devices for recording therapy without Caravel’s expressed written consent. In order to be actively engaged in your child’s treatment, family members are welcomed into the same space where therapy occurs when in your home at any time. For times when parents are not in the same space that therapy is occurring, monitors can be utilized in order to continue to observe the therapy process.

Mandated Reporting Policy

Caravel’s employees serve a vulnerable population and are legally required to ensure that a report to local Child Protective Services is made when abuse is observed or suspected. All employees are trained Mandated Reporters. Employees who have information regarding an incident are required to immediately report the incident to their immediate supervisor or Clinic Director.

Equal Employment Opportunity and Treatment Team Assignment

Caravel is an Equal Employment Opportunity employer. Federal law prohibits discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment on the basis of race, color, religion, gender (including pregnancy), age, disability, or national origin. Caravel does not condone or tolerate an atmosphere of intimidation or harassment based on race, color, religion, national origin, gender, sexual orientation, age, or disability. Caravel reserves the right to discontinue treatment to a child if anyone in the household objects to the assignment of a treatment team member based on any of these mandated protections.

Better outcomes. Happier lives.

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Share Your Caravel Experience with Us

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From your first interaction with Caravel’s intake team to the day your child graduates from our ABA program, we are committed to providing an experience that is professional, informative, compassionate, and prioritizes the clinical needs of your child. Annual Survey

We will periodically–once a year or so–seek your feedback in an anonymous survey. During regularly scheduled family meetings, our BCBAs will also solicit your input. Family Inputs

In the event you have feedback you’d like to share or concerns not addressed by your clinical team, you can contact your Clinic Director, or email us at: [email protected]

We respond to all concerns within one business day.

Better outcomes. Happier lives.

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Key Contacts Your Local Team

caravelautism.com/locations • Clinic Director: • Office Coordinator Phone:

Billing & Medical Records (Midwest) Phone: 920.857.9041

Billing & Medical Records (Pacific Northwest) Phone: 509.203.4665 (via Keystone)

Caravel Communications You will, from time to time, receive direct email communications from Caravel regarding changes in policy or company-wide updates in our protocols and services (e.g., COVID safety announcements).

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Notes:

Better outcomes. Happier lives.

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caravelautism.com xxx.xxx.xxxx 32