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Minnesota Department of Human Services Early Intensive Development and Behavioral Intervention Manual
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Treatment modalities

Page posted: 2/17/17

Page reviewed: 7/31/18

Page updated: 8/23/18

Legal authority

CMS-approved state plan amendment (PDF), Minn. Stat. §256B.0949

Overview

A person may receive treatment intervention according to one of the DHS-recognized treatment modalities.

This page explains the treatment modalities and the process for revising them. For more information about intervention as a covered service, see EIDBI – Intervention.

DHS recognizes the following treatment modalities:

Applied Behavior Analysis (ABA)

Applied Behavior Analysis (ABA) is a set of data-driven practices grounded in behavioral science. This approach can be applied to people of all ages.

ABA focuses on increasing positive and appropriate behaviors through reinforcement while decreasing interfering/unwanted behaviors or behaviors that interfere with learning.

Under ABA, the provider systematically analyzes factors in the person’s environment that interfere with his or her success and teaches new and more appropriate ways of responding.

ABA uses a combination of treatment strategies, including:

• Discrete trial training (DTT): Breaks down a desired behavior or response into individual steps and teaches each of those steps as a series of trials

• Pivotal response training (PRT): Targets teaching behaviors that make the largest impact on the person’s overall development (e.g., increasing motivation, self-monitoring and functional communication skills)

• Verbal behavior intervention (VBI): Focuses on teaching verbal communication skills with the principles of ABA.

Certified providers

For information about provider qualifications, training and locating a provider, see the ABA section of EIDBI – Treatment modalities – Certified providers.

Resources

For more information, see:

DIR/Floortime Model

The Developmental, Individual Difference, Relationship-Based (DIR)/Floortime Model provides a framework for a provider to conduct a comprehensive assessment of the person and develop a program tailored to his or her unique needs and strengths. This approach can be applied to people of all ages.

DIR/Floortime creates opportunities for learning through spontaneous exchanges. These exchanges help the person build critical developmental abilities, including the ability to:

  • • Attend to environments and people in the environments
  • • Engage and relate to others
  • • Initiate and respond to communication
  • • Participate in shared, social problem-solving
  • • Think and play creatively and flexibly.
  • DIR/Floortime focuses on:

  • • The person’s natural interests and emotions, which have shown to be essential in building on his or her social, emotional and intellectual skills
  • • The role of the parent and other primary relationships in the person’s life.
  • Certified providers

    For information about provider qualifications, training and locating a provider, see the DIR/Floortime section of EIDBI – Treatment modalities – Certified providers.

    Resources

    For more information, see:

    Early Start Denver Model (ESDM)

    The Early Start Denver Model (ESDM) integrates a relationship-focused, developmental model with Applied Behavior Analysis (ABA) teaching practices. The program typically serves children ages 12 to 48 months.

    The program:

  • • Focuses on the powerful pairing of interpersonal exchange and positive affect to promote shared engagement and teach social language and communication skills, play skills, cognitive and motor skills and personal independence
  • • Supports parents’ involvement
  • • Is designed to be implemented in natural settings
  • • Utilizes behavioral and developmental strategies and increases opportunities to promote typical development.
  • Certified providers

    For information about provider qualifications, training and locating a provider, see the ESDM section of EIDBI – Treatment modalities – Certified providers.

    Resources

    For more information, see Early Start Denver Model.

    PLAY Project

    The PLAY Project is an evidence-based, parent-implemented, early intervention program.

    Under the PLAY Project, trained PLAY consultants coach parents in the natural environment and provide feedback about how to support their child’s language, social interaction and overall development. The parent is taught to be the primary provider of the intervention.

    The PLAY Project methods and techniques:

  • • Focus on children from 18 months to 6 years of age
  • • Build on the child’s current levels of development
  • • Individualize treatment to each child’s unique developmental and sensory-motor status
  • • Show parents how to support and expand on their abilities to improve their child’s social interaction, communication and regulatory skills.
  • Certified providers

    For information about provider qualifications, training and locating a provider, see the PLAY Project section of EIDBI – Treatment modalities – Certified providers.

    Resources

    For more information, see The PLAY Project.

    Relationship Development Intervention (RDI)

    Relationship Development Intervention (RDI) is a family-based, behavioral treatment that builds on the theory that “dynamic intelligence” is key to improving quality of life for people with ASD and related conditions. This approach can be applied to people of all ages.

    Dynamic intelligence is the ability to think flexibly and includes:

  • • Appreciating different perspectives
  • • Coping with change
  • • Integrating information from multiple sources (e.g. sights and sounds).
  • RDI aims to help people with ASD and related conditions form personal relationships by gradually strengthening their ability to build social connections.

    Certified providers

    For information about provider qualifications, training and locating a provider, see the RDI section of EIDBI – Treatment modalities – Certified providers.

    Resources

    For more information, see RDIconnect®.

    Revising treatment modalities

    DHS may revise covered treatment modality options (i.e., add or take away options) as needed based on outcome data and other evidence. Anyone can initiate a revision (e.g., stakeholders, providers, advocates, parents, etc.).

    EIDBI treatment modalities approved by DHS must:

    • Cause no harm to the person or the person's family

    • Be individualized and person-centered

    • Be developmentally appropriate and highly structured, with well-defined goals and objectives that provide a clear direction for treatment

    • Be based in recognized principles of developmental and/or behavioral science

    • Use sound practices that are replicable across providers and maintain the fidelity of the specific modality

    • Demonstrate the modality is evidence-based

    • Have goals and objectives that are measurable, achievable and regularly evaluated and adjusted to ensure the person is making adequate progress

    • Be provided intensively with a high staff-to-person ratio

    • Include participation by the person and the person's legal representative in decision-making, knowledge and capacity building and developing and implementing the person's individual treatment plan (ITP).

    Before revisions in DHS-recognized treatment modalities become effective, DHS must provide public notice of the changes, the reasons for the change and a 30-day public comment period to those who subscribe to the electronic mailing list (i.e., eList). To sign up for the EIDBI eList, see the “more information” tab on DHS – EIDBI benefit.

    Proposing new treatment modalities

    If you have an additional treatment modality you would like to recommend, write a proposal that includes evidence to support the modality’s effectiveness with people with ASD or related conditions. Send the proposal to ASD.DHS@state.mn.us.

    Proposing revisions

    If you have proposed revisions to the current list of treatment modalities, send your suggested revision and reason for the proposed change to ASD.DHS@state.mn.us.

    Additional resources

    CBSM – Person-centered practices
    EIDBI – EIDBI services

    EIDBI – Intervention

    EIDBI – Treatment modalities – Certified providers

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