1 of 25

SERVICES AND SUPPORTS NLHS

Susanne O’Neill & Ashley Butt

Sept 27, 2025

Autism Conference

2 of 25

AGENDA

Intake Process

Services and supports

Questions

2

3 of 25

Direct Home Services Program and Autism Services

https://cwhp.easternhealth.ca/children-and-youth/child-development/direct-home-services-program/

The Direct Home Services Program (DHSP) is a family-centred, home-based early intervention program for children who are at risk of having, or who have, a developmental delay, available at any point between birth and the beginning of school.

3

Autism Services is part of DHSP. Children diagnosed with autism spectrum disorder (ASD) may be eligible for intervention up to the beginning of grade four (4)

4 of 25

    • Diagnosed privately or within NLHS
    • Referral sent to us
    • Accept referrals from familiy for re-referral or out of province
    • Referrals received are assigned to social worker or clinical lead

INTAKE PROCESS

4

Autism Services Referrals

5 of 25

Intake process

5

    • Review of diagnostic report & medical records
    • Consult with current service providers
    • Complete a home visit to obtain more information used to determine best next steps
    • Consult with a local intake team to ensure referral dates/make a referral if needed
    • Write Summary report with recommendations based on parental priorities and program suggestions

6 of 25

    • Recommendations are individualized
    • Based on availability - in current state
    • Current process and pathways may vary from zone to zone

IMPORTANT CONSIDERATIONS

6

7 of 25

Services from Autism Services are based on the science of Applied Behaviour Anaysis and utilize Evidence Based Practices (EBP)

OUR PROGRAM

7

8 of 25

WHAT IS ABA?

Applied Behaviour Analysis (ABA) is the science of behaviour and learning that seeks to understand why people do what they do. It looks at how learning and behavior are influenced by what’s happening around us and uses this knowledge to teach helpful skills and reduce challenging behaviors in a positive, supportive way. 

8

9 of 25

9

WHAT ARE EVIDENCE-BASED PRACTICES?

Many interventions exist for autism. Yet, scientific research has found only some of these interventions to be effective. The interventions that researchers have shown to be effective are called evidence-based practices (EBPs). One reason for using EBPs is because, by law, teaching practices must be based on evidence of effectiveness.

10 of 25

Services fall under three models:

      • Parent Implemented ABA
      • ABA Home Therapy
      • JASPER

AVAILABLE SERVICES

10

All services are VOLUNTARY!

11 of 25

WHAT IS PARENT IMPLEMENTED INTERVENTION (PI)?

It is a parent coaching model that utilizes strategies based on ABA to teach parents to help their children learn new skills, reduce unhelpful behaviors, and improve quality of life.

11

12 of 25

... but it can be expected that every intervention will involve caregiver coaching from the CMS to support the family in working towards identified goals

CMS will work with caregiver to choose and complete assessments

Goals are identified with the caregiver based on assessments, caregiver input, and team consultations

CMS will regularly meet with the family, coaching the caregiver to implement ABA strategies to target goals

Can be completed in-person or virtually

WHAT DOES PI INVOLVE?

12

Individualized....

13 of 25

PI HAS MULTIPLE OPTIONS

Can be completely designed by working with the parent

or

have some manualized/packaged options

13

14 of 25

RUBI PARENT TRAINING

Core Sessions

Understanding behaviour

Prevention strategies

Daily schedules

Reinforcement

Mindful attending

Effective instructions

Functional communication

Building new skills

Generalization and Maintenance

Supplemental Sessions

Token economy

Imitation skills

Time out

Sleep

Feeding

Toilet training

Crisis management

15 of 25

WHAT DOES RUBI PARENT TRAINING INVOLVE?

Differs from PI as this is a manualized plan

15

    • 14-16 week specific training program
    • Individualized training for caregivers
    • Lessons and learnings are layered each week
    • Can be done on-on-one or as a group
    • Completed virtually or in-person

16 of 25

Practical Functional Analysis-Skills Based Treatment (PFA-SBT) “My way” program

Practical Functional Assessment (PFA) and Skill-Based Treatment (SBT) are powerful assessment and intervention strategies designed to support children, youth and adults who experience challenging behaviour in their daily lives. At the heart of SBT is a trauma-informed perspective, recognizing that past experiences may impact behavior.

This approach emphasizes the importance of treating clients with respect, ensuring their safety, and building strong, trusting relationships. Through SBT, children learn essential life skills, such as communication, tolerating disappointment, following directions, and adapting to unexpected challenges

17 of 25

Typically 2-3 sessions a week

Range from 3-12 months

    • Step 1: Caregiver Interview (Part I of the PFA)
    • Step 2: The IISCA Assessment (Part II of the PFA)
    • Step 3: Skill-Based Treatment (SBT)
    • Step 4: Extending SBT into Daily Life

WHAT DOES PFA-SBT INVOLVE?

17

18 of 25

18

WHAT IS HOME THERAPY (HT)?

ABA Home Therapy (ABA HT) in Newfoundland and Labrador is an intensive home-based early intervention program offered to young children (up to grade 4 entry) with a diagnosis of autism. In other regions it is often otherwise known as Early Intensive Behavioural Intervention (EIBI). ABA HT or EIBI is a therapy based on ABA, which focuses on understanding and improving behavior. ABA helps children learn new skills by breaking tasks into small, manageable steps and reinforcing progress. The goal is to teach positive behaviors while respecting each child’s unique needs and strengths. 

19 of 25

    • Recommendation made by CMS based on assessment and consultation with caregivers
    • Based on developmental and behavioral needs, family factors, and identified goals
    • Funding is provided by provincial government
    • Families hire a home therapist

19

What does ABA HT involve?

    • Up to 10 or 30 hours / week
    • Home-based intervention
    • Based on assessment and client and family need
    • HTs trained and guided by the CMS on weekly or bi-weekly basis
    • HT implement ABA strategies to target a variety of goals
    • Also trained in a variety of data collection methods

20 of 25

An intervention that targets the foundations of social communication (joint attention, engagement, and play) and uses naturalistic developmental and behavioral strategies to increase the rate and complexity of social communication. Interventionists assess the child to identify developmentally appropriate social communication and play level targets and then select motivating toys that match the child’s skill level. They then use play routines, or collections of play steps that the adult and child take turns going through together, to engage the child and work on these targets. In JASPER, the interventionist focuses on helping the child initiate new ideas to share with others.

20

Joint Attention Symbolic Play Engagement and Regulation

JASPER

21 of 25

WHAT DOES JASPER INVOLVE?

21

    • SPACE assessment
    • Commitment of twice a week
    • Sessions are 30-60 minutes long
    • Take place in homes, schools, and clinics
    • In-person clinician led from trained CMS
    • Child and adult play together with toys

    • Target skills are individualized and follow the order of development
    • Uses a natural learning context: play with objects
    • Works to support a joint engaged state: connecting with another person and objects

22 of 25

JASPER Caregiver Coaching

    • Once or two times a week for 12 weeks
    • Trained clinician coaches caregiver
    • Caregivers learn to deliver JASPER strategies one on one with the child
    • Can be done in home, clinic, schools
    • Can be done in-person or virtually
    • Ideally use toys in the home
    • Use toys based on the child’s developmental level and interests
    • Goal is for the caregivers to implement the strategies in the natural daily routine

23 of 25

Social Communication

Play

Engagement

Regulation

JASPER TARGETS

23

24 of 25

THANK YOU FOR LISTENING!

QUESTIONS?

24

25 of 25

25

Resources

https://www.kasarilab.org/intervention

https://afirm.fpg.unc.edu/afirm-modules/

https://www.rubinetwork.org/

https://practicalfunctionalassessment.com

https://afirm-modules.fpg.unc.edu/Selecting-EBP/content/#/lessons/TGdz2LmGUTG-Y86qzWR0lzDAMcXb6WZ_