Where David Started
David and his family started their journey with Cornerstone in February of 2012. David, who was four years old at the time, began services with only 13 out of the potential 170 milestone points on the VB-MAPP, with substantial deficits across level one of the assessment, which correlates to the developmental age of a child from 0-18 months. When David first began 1:1 therapy at Cornerstone, communication was a significant challenge for him as he presented with limited functional communication skills. At that time, David communicated primarily through pulling people to what he wanted or would simply do things for himself; when unable to successfully communicate, he would engage in problem behavior such as physical aggression, tantrum, elopement, and moving his face inches from faces of others with vocal protest while upset.
Within the developmental operant of tacting, David was unable to label any items upon request. David also demonstrated significant challenges in the area of listener responding where he struggled to follow one-step instructions and respond to his name when called.
David’s Improvement In-Center
During his time in-center, David made substantial gains across parts of level two and three of the VB-MAPP assessment and had begun to excel in using American Sign Language to communicate across the verbal operants. David had also worked diligently on AFLS goals to increase his autonomy and achieved mastering daily living skills such as wearing gloves, toileting, brushing his teeth, and showering.
Telehealth and ABA Therapy
When the COVID-19 pandemic hit, Cornerstone quickly had to formulate a plan to help support clients, such as David, in getting continued access to ABA-based therapy. Through the implementation of telehealth therapy, David was able to continue to access direct therapy sessions with his BCBA, Stephanie Dille-Huggins. Although existing medical concerns kept David from transitioning back to therapy in-center, he continued to grow and blossom during his telehealth sessions that he attended three days per week via zoom, over the last one and one-half years.
How Cornerstone Adapted for Clients
“We had to quickly get creative in figuring out the best way for David to continue to learn while ABA-based therapy was being implemented through zoom. Through a support system of BCBAs at the center, we were able to support each other in figuring out the best way to implement therapy when separated from our clients with only a camera between us. I customized complete PowerPoint presentations prior to each therapy session that targeted the implementation of David’s programs from both the VB-MAPP and AFLS assessments so he could continue to work on the skills that were being addressed during therapy in-center, as well as new skills that needed to be addressed within the home setting. Having David’s mother as a key support during this time to help guide her son’s treatment was also critical in ensuring David’s success as we navigated through this new territory,” said Dille-Huggins.
Augmentative and Alternative Communication
David continued to consistently evolve with each telehealth session, demonstrating to his BCBA and mother that he was able to type out specific words on the screen to communicate through the verbal operants. What started as one-word typed responses, quickly evolved into David typing out complete sentences. With the support of his mother, David transitioned to using an AAC device, which allowed his BCBA to further push him through conquering programming goals across the AFLS areas of common knowledge, basic communication, community skills, and health, safety, and first aid.
David has achieved the ability to successfully share dangerous situations that can occur across various environments, identify the differences between a friend/stranger/acquaintance, identify all components of a calendar and specific information from the respective month, and answer more than 50 questions regarding his home, school, and community. In addition, David completed mastering over 2,500 targets across the VB-MAPP and AFLS.
Through the implementation of his AAC device and his reinforcement contingency contract, David learned to express his emotions and combat his previous engagement in maladaptive behavior. David formally graduated from Cornerstone on December 20th, 2021 and had achieved a total of 146.5 milestone points.
In a recent telehealth session, David shared with his BCBA and mother that he hopes one day to become a teacher. David touched many lives during his time at Cornerstone and was truly a joy to be around. His sweet and humorous personality will certainly be missed. It was an honor and privilege to serve him and his amazing family. We wish David the best of luck as he rocks 7th grade and works towards his goal of becoming a teacher!