Sharon A. Reeve, PhD, BCBA Caldwell College ED 571 070 School & Home Based Programs for Children with Autism.

Sharon A. Reeve, PhD, BCBACaldwell College

ED 571 070 School & Home Based Programs for

Children with Autism

Scientifically Validated Treatment: Scientifically Validated Treatment: Applied Behavior Analysis (ABA)Applied Behavior Analysis (ABA)

(a/k/a Behavior Management; (a/k/a Behavior Management; Intensive Behavioral Intervention [IBI])Intensive Behavioral Intervention [IBI])

“The use of non-validated treatment approaches for children with autism may be ineffective and possibly harmful to your child and may take time away from treatments that have shown to be effective.” (Green, 1996; New York State Department of Health, 1999)

“Intensive, behavioral intervention early in life can increase the ability of the child with autism to acquire language and ability to learn.”

“Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior.”

U.S. Surgeon General, David Satcher, M.D., Ph.D.

Whether Home or School Whether Home or School Based Program, All Need:Based Program, All Need:

Assessment of current skillsIndividualized Goals and ObjectivesIndividualized Curriculum Assessment of on-going skillsIndividualized Teaching ProceduresMotivational Systems

Skill AssessmentSkill Assessment

Most of what we do is child-specific. There is no one correct sequence or number of

steps or number of pre-requisite skills. The is no “one size fits all”. One of the hallmarks of applied behavior analysis

is its focus on the identification of goals and the development of educational interventions specifically tailored for individual learners.

Assessment ToolsAssessment Tools

Standardized Tests– E.g., Brigance, WISC, WAIS-R

Assessment Forms that Relate to Specific Curriculum– E.g., Carolina Curriculum, IGS Curriculum, ABLLS

Informal Assessment Forms the Relate to Curriculum Guides or Educational Assessment– Organizationally developed forms & checklists

On-Going Data-Based Assessment

Which One?Which One?

All of them can be helpful

We will focus on informal assessment forms the relate to curriculum guides or educational assessments

Why? Enables us to develop a comprehensive and

individualized educational program for a child with autism

Sequencing of Events in Developing an Sequencing of Events in Developing an Educational Program for one LearnerEducational Program for one Learner

Assessment of the learner when they enter your program

Development of appropriate goals and objectives based on that assessment

Development of skill acquisition programs based on those goals and objectives.

Implementation of skill acquisition programs Conducting of ongoing assessments to ensure

program effectiveness

Effective Because?Effective Because?

Comprehensive– All skill domains are addressed

Integrated– the same tools are used for each and every component, from initial

assessment to program development Continuum of services

--------------------------------- General Specific

Individualized – Ongoing development of educational program for a particular

consumer– One size does not fit all

Integrated CurriculumIntegrated Curriculum

Not simply a reference or a rigid linear sequence, It is a curriculum that is fully integrated into

– The assessment, – Selection of goals and objectives, – Development of program – Implementation of the program– Ongoing evaluation of educational program

It is a work in progress because you are always developing additional individualized programs specific to a particular learner.


A curriculum is a framework based on the general education curriculum to determine appropriate sequencing for each child.

There is no instructional sequence that is appropriate for each child. – Often children with autism have splinter skills – May not learn in a developmental sequence


One must always choose goals in a context and take into consideration:– Age appropriateness – Level of skill in each skill domain– Criterion level of each skill .

Skill DomainsSkill DomainsExpressive LanguageReceptive Language Social and Peer Interaction Skills Gross Motor SkillsFine Motor Skills AcademicsMathReading

Skill DomainsSkill DomainsLeisureIndependenceSelf-Care and Home-Living SkillsCommunity Living Vocational SkillsTransitionMotivational systemNon-productive Behavior

Developing Individualized Developing Individualized Teaching ProgramsTeaching Programs

Operational definition of target skill– conditions under which behavior will

be displayed– criteria for acceptable performance

Teaching procedure Generalization Maintenance Inter-observer agreement (IOA)

Number of agreements

Number of disagreements + agreements X 100

Example of an Individualized Example of an Individualized Teaching ProgramTeaching Program

Skill: Color to Color Matching Operational Definition: Christopher places a colored object or a colored- picture card with its corresponding

match within 3 seconds of the verbal discriminative stimulus (SD). Data are collected weekly and are summarized as percentage of opportunities in which Christopher correctly matches the objects/pictures. During data collection, no prompts are used and the discriminative stimuli are presented in random order.

Discriminative Stimulus: Saying “Match” with typical inflection and conversational volume.while handing Christopher an object/picture . Criterion for Advancement: Matching at least 90% of the colored objects/pictures for two consecutive sessions. Procedure for Teaching: The instructor sits across from Christopher who is sitting at a table or on the floor. The

instructor puts 5 or more colored objects/pictures on the table, on the floor or velcroed on a board on the wall in varying positions. Contingent on Christopher making eye contact, the instructor presents the SD. If Christopher correctly matches, the instructor rewards with a conditioned reinforcer via his individualized motivational system and/or behavior-specific praise using the object/picture color label (e.g., “Yeah, you matched red”). If Christopher incorrectly matches, the instructor will use a visual prompt to indicate the correct match. Christopher will be required to then make the correct match. If necessary manual prompts will be paired with the visual prompts. All prompts will be systematically faded contingent on correct responses. All objects/pictures are frequently re-positioned and distracter objects/pictures are changed. Differential reinforcement is also used during this teaching procedure. Sets of target object/pictures are simultaneously taught and interspersed with mastered matching responses to maximize attending.

CONTINUES ON NEXT SLIDE…

Example of an Individualized Example of an Individualized Teaching ProgramTeaching Program

Color to Color Matching (CONTINUED)

Generalization: Generalization of matching items across stimuli is programmed by using multiple stimuli. Generalization across stimuli is assessed by probing Christopher’s matching skills with colored objects/pictures not previously associated with teaching. Generalization across people and settings is programmed by conducting teaching across multiple instructors and settings, respectively. Generalization across settings and people will be individually assessed by probing with items in a setting not previously associated with teaching and with a person not previously associated with teaching.

Maintenance: Christopher’s matching skills will be maintained during his use of various skills such as picture-object correspondence and following an activity schedule.

Inter-Observer Agreement: Inter-observer agreement data are collected monthly and calculated by using the formula:

Number of Agreements X 100 Number of Agreements + Disagreements

What are “Data”?What are “Data”?

“Data are the quantitative results of deliberate, planned, and usually controlled observation.”

(Johnston & Pennypacker, 1980)

(Translation: These are the values of what we’ve measured!)

What are Data? (cont’d)What are Data? (cont’d)Quantitative

– behavioral observations are translated into numbers

Deliberate– data and IOA are collected carefully

Planned– decisions to collect data are made

before the observation sessionControlled

– data are collected under same conditions each time

Why Collect Data?Why Collect Data?

Monitor child’s progress within programs

Monitor child’s progress across programs

Required by funding agency Empirical evidence to demonstrate

progress to funding agencies Used to make curriculum decisions Used to verify effectiveness of specific

teaching procedures for a specific child

Data: Types to CollectData: Types to Collect

Acquisition dataFluency dataGeneralization dataMaintenance dataInter-observer Agreement (IOA)

data

Data Collection: Data Collection: FrequencyFrequency

“Testing” and “teaching” are different procedures

Collect data at an interval that matches acquisition speed

Data Collection: Data Collection: ProceduresProcedures

Data should reflect conditions under which you want the terminal performance

Select a measurement procedure that is appropriate for your response definition

Only collect the amount of data that you will graph and use

Incidental Teaching

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TeachingPretest

Why TeachWhy TeachMotivational Systems?Motivational Systems?

Contingency managementManagement of stereotypyIncreasing skill acquisition leads to

intrinsic motivationCommunication

Types of Motivational Types of Motivational SystemsSystems

Direct snacks and preferred activities Token economies

– choice– behavioral chains

Edibles in a cup Behavioral contract DRO (Differential Reinforcement of

“Other” behavior)

Components of Components of Comprehensive School-Comprehensive School-

Based ABA ProgramBased ABA Program Individualized Skill Assessment and Goal Selection Individualized Teaching Programs Individualized Curriculum Individualized Data Collection Assessing Progress Of

Each Skill On-going Hands-on Staff Training Workshop Training School Visits Home Visits Related Services Evaluation of Program Effectiveness

Components of Components of Comprehensive School-Comprehensive School-

Based ABA ProgramBased ABA Program INDIVIDUALIZED SKILL ASSESSMENT AND

GOAL SELECTION (Bondy, 1996; Jacobson, 2001)– First several weeks after child enters program – Skills assessed in all domains: gross- and fine-

motor skills, academics, pre-requisite learning skills, self-help, independence, receptive and expressive language, non-productive behavior that interferes with learning, and leisure skills

– Updated on a continual basis– Goals selected by parents, teacher, speech

therapist, occupational therapist, and school psychologist

More Components of Comprehensive More Components of Comprehensive School-Based ABA ProgramSchool-Based ABA Program

INDIVIDUALIZED TEACHING PROGRAMS (McClannahan & Krantz, 2001; Smith, Donahoe & Davis, 2001)

– Operational definition, Measurement procedure, Discriminative Stimuli, Teaching Procedures (e.g., activity schedules, video modeling, peer tutoring, audio modeling, small group instruction, discrete trial instruction, incidental teaching) Generalization, Maintenance, IOA, specific teaching sets

– 30-40 individualized teaching programs will be written based on the above criteria for all skill domains for each child.

– Approximately 90% of each child’s individualized programs are language-based programs.

– Programs that are child initiated, that promote generalization across multiple staff, or that need rapid skill acquisition are taught by all instructors

– Programs that have complex fading procedures, involve initial acquisition of discrimination or involve shaping procedures are initially taught by one instructor and then generalized to all instructors.

INDIVIDUALIZED CURRICULUM (Bondy, 1996; Taylor & McDonough, 1996; McClannahan & Krantz, 2001; Smith, Donahoe, & Davis, 2001)– Curriculum is based on general preschool

curriculum broken down into multiple steps– All curriculum written by the teachers and the

consultant – Skills are taught in a systematic fashion

(mastering pre-requisite skills before being introduced to more complex skills)

– Examples of general packaged curriculum that can be used and possibly modified are Edmark Reading, Distar Language, MacMillan Math, Sensible Pencil, Learn to Cut

– Almost all curriculum materials are specifically made for a particular child


INDIVIDUALIZED DATA COLLECTION ASSESSING PROGRESS OF EACH SKILL (McClannahan & Krantz, 2001; Jacobson, 2001)

– Ongoing monitoring of skill acquisition– Data are collected on every program

approximately once a week (some programs more frequently, some programs less frequently depending on a child’s skill acquisition)

– Accountability!


ON-GOING HANDS-ON STAFF TRAINING (Bondy, 1996; Jacobson, 2001; Smith, Donahoe & Davis, 2001; McClannahan & Krantz, 2001)– No one is ever fully trained in ABA,

training will be ongoing and provided by a classroom teacher and/or consultant

WORKSHOP TRAINING (Jacobson, 2001, Bondy, 1996; Smith, Donahoe & Davis, 2001; McClannahan & Krantz, 2001)– Twice a month all staff members

participate in workshop trainings in the principles of ABA and other relevant topics related to teaching children with autism


SCHOOL VISITS (McClannahan & Krantz, 2001; Jacobson, 2001; Bondy, 1996)

– Weekly school visits in which parents will receive training in teaching their child various skills

– During school visits parents access to child’s data notebook and can monitor progress

– Workshop training several times per year


HOME VISITS (McClannahan & Krantz, 2001; Smith, Donahoe & Davis, 2001; Bondy, 1996)– Home visits provided at least monthly by classroom

teacher, instructional aide, and/or consultant– Child’s progress will be reviewed – Training provided in areas specific to home (e.g.,

going to dentist, doctor, mall, grocery store; eating; sleeping; leisure skills; language skills)

– Any instructional staff hired by the parents at home has the opportunity to receive training several times per week by the school program. Recommend that approximately 20 hours of training with child at school before home staff teaches the child at home.


RELATED SERVICES: – Many ABA techniques shown to be effective for

increasing and improving language and communication in children with autism (e.g., activity schedules, audio modeling, video modeling, PECS) (Skinner, 1957; Lovaas, 1977, 1987; McGee, Krantz, & McClannahan, 1985; Sundberg & Partington, 1998; McClannahan & Krantz, 1999; New York State Department of Health, 1999; Bondy & Frost, 1994; Fenske, Krantz, & McClannahan, 2001; Rappaport, 2001; Reeve, Reeve, Poulson, & Buffington-Townsend, manuscript in preparation).

– When teaching children with autism, related services have been shown to be maximally effective when delivered using the principles of ABA (Jacobson, 2000; Smith, 1993; New York State Department of Health, 1999; Bondy, 1996; Romanczyk, Lockshin,& Matey, 2001; Meyer, Taylor, Levin, & Fisher, 2001).


Evaluation of Program Effectiveness (McClannahan & Krantz, 2004)

– Engagement with Activities with Other Persons

– Opportunities to Respond– Behavior-Descriptive Praise– Relationship Building– Children’s Hygiene and Personal

Appearance– Social Competence – Inappropriate Behavior– Family Participation in Intervention


Direct Care Team Direct Care Team MembershipMembership

Consultant/Director – Provides consultation for 1.5 - 2 hours per week, per

child– Provides supervision for teacher– Helps teacher develop goals and objectives for each

child– Helps teacher develop data management system to

evaluate effectiveness of each child’s program– Provides direction for the development of curriculum– Trains teacher in effective individualized teaching

procedures – Provides frequent hands-on training to all instructional

staff– Provides workshop training for all team members– Periodically accompanies teacher and/or instructional

aide on home visits– Consults with and brings in other doctoral level

professionals in the field when necessary


Teacher/Trainers– Enrollment in BCBA-approved program and certified in

special ed– Develops individualized programs for each child– Manages all data collection systems to ensure

program effectiveness for each child– Creates individualized curriculum to accompany each

program for each child– Provides hands-on training to instructional aides and

the implementation of individualized programs for each child

– Provides hands-on training to parents and any person that frequently interacts with the child

– Teaches each child


Instructional Aides– Training in applied behavior analysis (ABA) and

autism– Continually receives hands-on training – Teaches all children in the classroom rotating

approximately every half hour– Serve as data analyst for one child– Prepares individualized curriculum for one

specific child– May be selected by consultant and teacher to

provide home visits and training on home staff


Parents– Active participation in at least annual home and

school selection of goals and objectives for their child

– Receives hands-on training in how to effectively keep their child engaged in productive activity at home and in the community, increase child’s direction following skills, and maximize their child’s use of language at home and/or whatever other area parent requests training in

– Receives workshop training in specific areas of applied behavior analysis

Home-Based Program: Home-Based Program: Similarities and DifferencesSimilarities and Differences

Similarities:– Assessment of Skills– Individualized Curriculum– Individualized Teaching Procedures– Ongoing Assessments– Motivational Systems

Differences– “Set up”– Program Allocation – Parent training/Staff training– Related Service providers– Evaluation of Program Effectiveness– Direct Care Team Membership

Types of Home-Based Types of Home-Based ProgramProgram

Full Home Program (@40 hrs/wk)

Home-based After school Program (@15 hrs/wk)

Setting Up a School at Home:Setting Up a School at Home:Programming for GeneralizationProgramming for Generalization

Home room – location of curriculum materials

Remainder of home– Rewarding toys

Backyard– language

Community/Grandparents house/Restaurants– on-task behavior

Maximizing Maximizing Teaching OpportunitiesTeaching Opportunities

Every opportunity for teaching should be used!

Increase social opportunities and language opportunities during rewards and preferred activities

Skills should be taught in sets

Maximizing Maximizing Instructional EfficiencyInstructional Efficiency

Some programs should only be taught by the same instructor– those involving initial acquisition of

discrimination (sets) Receptive language,

– shaping E.g., articulation programs, self-help skills

– complex prompt fading procedures E.g., fine motor program

MaximizingMaximizingInstructional EfficiencyInstructional Efficiency

Other programs should be taught by all instructors– those in which you are programming

for generalization with multiple staff Gestures

– child initiated programs Spontaneous language, spontaneous

requesting, schedule following

Selecting a ConsultantSelecting a Consultant

Board Certified Behavior Analyst (BCBA) or eligible– Master’s degree– course work in behavior analysis– supervised experience in behavior

analysis

Supervised training by a doctoral level professional specifically in teaching children with autism

How Do I Find Certified How Do I Find Certified Behavior Analysts?Behavior Analysts?

Behavior Analyst Certification Board Certificant Registry– Search for all BCBA in NJ– http://www.bacb.com/CertRegistry/certlist-nav.html

Association for Applied Behavior Analysis– Search for all members of ABA in NJ for contact

information– http://www.abainternational.org/sub/membersvcs/me

mbership/directory/abadb.asp?Lname=&Fname=&City=&State=NJ&Country=&match=AND

http://www.bacb.com/CertRegistry/certlist-nav.html

http://www.abainternational.org/sub/membersvcs/membership/directory/abadb.asp?Lname=&Fname=&City=&State=NJ&Country=&match=AND



What Else NeedsWhat Else NeedsTo Be Done?To Be Done?

Interview Individual Obtain Curriculum Vitae

– E.g., http://faculty.caldwell.edu/sreeve/Sharon's%20webpage%20VITA.htm

Obtain 3 references that can attest to their clinical and supervisory skills and contact them!– most of these individuals should have a

doctorate and be happy to discuss the candidate with you

Responsibilities of Responsibilities of ConsultantConsultant

Assessment of child Continual development of child’s

individualized program Continual teaching of child Continual training of all staff members Continual training of parents Continual supervision of curriculum

preparation

Responsibilities of Responsibilities of InstructorsInstructors

One-year commitment to familyConducts sessions with child

– If need to miss a session, will find a substitute

Implement training feedback provided by consultant

Graphs data of progress

Possible Responsibilities Possible Responsibilities of Parentsof Parents

In collaboration with consultant, decides rate of pay for instructors

Coordinates schedule of instructorsPrepares house to accommodate

instructional timePrepares curriculum materials for

child

Staff TrainingStaff Training

On-going hands on staff training provided by the consultant

Monthly workshops on topics in behavior analysis

Team meetings?

Parent TrainingParent Training

Consultant will provide training to parents on relevant skills, beginning with on-task behavior

Parents will continue to keep child engaged when not in session

Parent will be taught to maintain all learned skills

Related ServicesRelated Services

Preferably noneIf must have them, they need to be

supervised and trained to teach the child by consultant

Evaluation of Program Evaluation of Program EffectivenessEffectiveness

How can this be done?

Goal of Home ProgramGoal of Home Program

To get into a school!!!!

After-School Home-Based After-School Home-Based ProgramsPrograms

Goal Selection– Skills specific to home

Non-academic Self help

– Dressing, hand washing, toileting, nail cutting Leisure/social

– Model building, game playing Community based

– Dentist, doctor, Skills mastered in school program

– Language

ReferencesReferences Bondy, A. (1996). What parents can expect from a public school program.

In C. Maurice, G. Green, and S. Luce (Eds.), Behavioral intervention for young children with autism (pp. 323-330). Austin, TX: Pro-ed.

McClannahan, L. E. & Krantz, P. J. (2004). Some guidelines for selecting behavioral intervention programs for children with autism. In H. E. Brigs and T. L. Rzepnicki (Eds.), Using social work practice: Behavioral perspectives. Chicago, IL: Lyceum.

Fenske, E. C., Krantz, P. J., & McClannahan, L. E. (2001). Incidental teaching: a not-discrete-trial teaching procedure. In C. Maurice, G. Green, and R. Foxx (Eds.), Making a difference: Behavioral intervention for autism (pp. 75-82). Austin, TX: Pro-ed.

Fenske, E. C., Zalenski, S., Krantz, P. J., & McClannahan, L. E. (1985). Age of intervention and treatment outcome for autistic children in a comprehensive intervention program. Analysis and Intervention in Developmental Disabilities, 5, 49-58.

Green, G. (1996). Evaluating claims about treatment for autism. In C. Maurice, G. Green, and S. Luce (Eds.), Behavioral intervention for young children with autism (pp. 15-28). Austin, TX: Pro-ed.

More ReferencesMore References Green. (1996). Early behavioral intervention for autism: what does

research tell us? In C. Maurice, G. Green, and S. Luce (Eds.), Behavioral intervention for young children with autism (pp. 15-28). Austin, TX: Pro-ed.

Jacobson, J. W. (2001). Early intensive behavioral intervention: Emergence of a consumer-driven service model. The Behavior Analyst, 23(2), 149-171.

Harris, S. L., Handleman, J. S., Arnold, & M. S., Gordon. (2001). The Douglass Developmental Disabilities Center: two models of service delivery. In J. Handleman and S. Harris (Eds.), Preschool education programs for children with autism (pp 233-261). Austin, TX: Pro-ed.

McClannahan, L. E., & Krantz, P. J. (2001). Behavior analysis and intervention for preschoolers at the Princeton Child Development Institute. In J. Handleman and S. Harris (Eds.), Preschool education programs for children with autism (pp 191-213). Austin, TX: Pro-ed.

McEachin, J. J, Smith, T., & Lovaas, O. I. (1993). Long term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation, 97(4), 359-372.

More ReferencesMore References Meyer, L. S., Taylor, B. A., Levin, L., & Fisher, J. R. (2001).

Alpine Learning Group. In J. Handleman and S. Harris (Eds.), Preschool education programs for children with autism (pp 135-156). Austin, TX: Pro-ed.

Rappaport, M. (1996). Strategies for promoting language acquisition for children with autism. In C. Maurice, G. Green, and S. Luce (Eds.), Behavioral intervention for young children with autism (pp. 307-319). Austin, TX: Pro-ed.

Romanczyk. R.G., Lockshin, S.B., & Matey, L. (2001). The Children’s Unit for Treatment and Evaluation. In J. Handleman and S. Harris (Eds.), Preschool education programs for children with autism (pp 249-94). Austin, TX: Pro-ed.

Smith, T. (1993). Autism. In T. Giles (Ed.), Handbook of effective psychotherapy (pp. 107-133). NY: Plenum Press.

More ReferencesMore References

Smith, T. (1996). Are other treatments effective? In C. Maurice, G. Green, and S. Luce (Eds.), Behavioral intervention for young children with autism (pp. 45-59). Austin, TX: Pro-ed.

Smith, T., Donahoe, P. A., & Davis, B. J. (2001). The UCLA young autism project. In J. Handleman and S. Harris (Eds.), Preschool education programs for children with autism (pp 29-48). Austin, TX: Pro-ed.

Taylor, B. A., & McDonough, K. A. (1996). Selecting teaching programs. In C. Maurice, G. Green, and S. Luce (Eds.), Behavioral intervention for young children with autism (pp. 63-177). Austin, TX: Pro-ed.

ABA ResourcesABA Resources

• Books– Handleman, J. S., & Harris, S. L. (2001).

Preschool education programs for children with autism. Austin, TX: Pro-Ed.

– Harris, S. L., & Weiss, M. J., (1998). Right from the start: Behavioral intervention for young children with autism. Bethesda, MD: Woodbine House.

– McClannahan, L. E., & Krantz, P. J. (1999). Activity schedules for children with autism: Teaching independent behavior. Bethesda, MD: Woodbine House.

ABA ResourcesABA Resources

• Books– Leaf, R., & McEachin, J. (Eds.). (1999). A work in

progress: Behavior management strategies and a curriculum for intensive behavioral treatment of autism. New York: DRL Books.

– Lovaas, O. I. (2002). Teaching individuals with developmental delays: Basic intervention techniques. Austin, TX: Pro-Ed.

– Maurice, C., Green, G., & Fox, R. M. (Eds.). (2001). Making a difference: Behavioral intervention for autism. Austin, TX: Pro-Ed.

– Maurice, C., Green, G., & Luce, S. C. (Eds.). (1996). Behavioral intervention for young children with autism. Austin, TX: Pro-Ed.

ABA ResourcesABA Resources• Websites

– NY State Dept. of Health Guidelines http://www.health.state.ny.us/nysdoh/eip/autism/autism.htm

- Behavior Analyst Certification Board (BACB) http://www.bacb.com

- General Information about Autism and ABA http://www.asatonline.org/autism_info.html http://www.behavior.org/autism/ http://www.njcosac.org/cosacindex

• Research Journals– Journal of Applied Behavior Analysis (JABA)– Journal of Autism and Developmental Disorders (JADD)– Behavioral Disorders– Education and Training in Mental Retardation and

Developmental Disabilities

http://www.health.state.ny.us/nysdoh/eip/autism/autism.htm

http://www.bacb.com/

http://www.asatonline.org/autism_info.html

http://www.behavior.org/autism/

http://www.njcosac.org/cosacindex

Sharon A. Reeve, PhD, BCBA Caldwell College ED 571 070 School & Home Based Programs for Children with Autism.

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