Nurture and Nature’s programs are based on Applied Behavior Analysis and other evidence-based practices. 

Specializing in Discrete Trial Training, Language Acquisition, Pivotal Response Treatment, Functional Communication Training, Verbal Behavior, Behavior Modification, Play Skills, Social Skills, Adaptive Skills Training and Parent Education, Nurture & Nature’s clinical programs are tailor built to serve the diverse needs of our clients.

We utilize daily family and community activities to provide individualized teaching and instruction. This may include modeling, role-playing, shaping, chaining, and errorless learning to insure that consumers and their families are receiving the most valuable instructional opportunities possible.

ABA basic principles

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Reinforcement

Extinction

Stimulus Control: Discrimination and Generalization

Respondent Conditioning

Task Analysis

 

ABA procedures to establish new behavior

Shaping

Video Modeling

Pivotal Response Training

Prompt hierarchy and transfer of stimulus control

Chaining

Behavior skills training

 

ABA procedures to increase desirable behavior and decrease undesirable behavior

Pivotal Response Training

Prompt hierarchy and transfer of stimulus control

Chaining

Behavior skills training

 

ABA procedures to increase desirable behavior and decrease undesirable behavior

Ecological manipulations

Antecedent control procedures

Promoting generalization

Self-management


Additional ABA behavior change procedures

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Habit reversal

Token Economy

Behavioral Contracts

Fear and Anxiety reduction procedures

Cognitive Behavior Modification

Self Generated Mediators


Parent Training Groups–16 hours

Nurture & Nature will collaborate our work with Regional Centers to provide parent-training groups for families while increasing skills with Applied Behavior Analysis to create the necessary knowledge foundation for a more effective assessment and successful ABA program.  We work to connect families with community resources that will serve their interests and expand access to resources.

 

Intensive Behavior Intervention Services

Nurture & Nature will provide one-to-one instruction delivered in a shared, structured format with opportunities for family members to apply their emerging and developing skills.  These services will emphasize teaching and learning about behavioral reduction and skill acquisition for the client and his or her family.  Also, the intervention services will engage parents, guardians, grandparents, and/or siblings to assist in the application of instruction and emphasize training families to acquire skills when managing interfering behaviors and teaching new, functionally equivalent replacement behaviors.

 

Discrete Trial Training / Pivotal Response Treatment

We recognize the need to provide Discrete Trial Training and Pivotal Response Treatment for early intervention as an effective empirically validated teaching strategy for our clients. Services will target consumer’s skill deficits in the areas of eye contact, play skills, receptive language, expressive language, pre-academics, social skills, cognitive sequencing, attention span, fine and gross motors skills, expansion of food repertoire, creating flexibility, independent living skills, as well as decreasing inappropriate behaviors and increasing replacement behaviors through skill acquisition.

Adaptive Skills Program Goals 

It is the goal of Nurture and Nature to provide Adaptive Skills Services to our clients and their families by accessing the needs in the skill domain areas of Socialization, Communication, Personal Hygiene, Self Help, and Community Integration, Community Based Instruction and Participation. 

Goals will be met by utilizing the principles of reinforcement, errorless learning and shaping.  Interventions will occur in the most natural environment for the client.

Programs will be created for the individual encompassing cultural beliefs, safety plans, realistic expectations, empirical strategies and parent education.

Photo by Les Johnstone/iStock / Getty Images

Nurture and Nature recognizes the need for Adaptive Skills and looks to apply the best practice standards for client skill acquisition.

Parent participation is a requirement that will support teaching strategies and aid in faster skill acquisition and provide for lasting effectiveness and positive long-term outcomes.

Anticipated Consumer Outcomes

Nurture and Nature is committed to family education that will teach parents, guardians, grandparents, and/or siblings living at the same domicile to access behavioral support so they can be trained to increase their child’s skill acquisition with ABA services.

Quality assurance will be provided by using observable and measurable goals, all programs will be overseen by a qualified supervisor and a Board Certified Behavior Analyst.  Clinical meetings will occur quarterly to include parent participation and a review of progress. Services will utilize individualized teaching strategies to promote generalization to ensure long-term outcomes with care and compassion.

Nurture & Nature will work collaboratively, to teach consumers and families accessing social skills training and community inclusion with committed professionalism, expertise and ethics.  We serve consumers with developmental disabilities and their families. e provide effective treatment to meet measurable and meaningful goals through several social skill training programs:


PEERS

Parent-Assisted Social Skills Training to Improve Friendships
 in Teens with Autism Spectrum Disorders

Ages 12-19

We provide effective social skills training through the empirical PEERS model (Laugeson, Frankel, Mogil & Dillion 2009) of social skills training to teach functional social skills within a twelve month 16 week time period using utilizing a direct model of two 2(2- hour sessions per week with peers and a peer coach (caregiver or parent)) in a group setting. per week and three hours of direct supervision a per month.

Our program begins with an evaluation and an assessment or re-assessment to determine the individual consumer’s and family’s needs. Our individualized program goals are based on utilizing integrating consumers with peers in the community and in aacross naturalistic natural settings to address social skills deficits through role-plays, perspective taking, and practice. The goal of Peers is to create lasting friendships..  Parents and caregivers will learn how to find sources of friends for the consumer and how to coach social skills through weekly homework assignments.

Domains and Programming Skill Acquisition Targets

Communication and Respondent Listener Skills

•    Initiating and offering appropriate greetings
•    Increasing eye contact with others when speaking
•    Increasing eye contact when others are talking
•    Perspective taking
•    Responding to on-topic conversational exchanges chosen by others
•    Creating a conversational segue (e.g. smoothly transitioning to different topics of conversation)
•    Initiating conversations and entering into a conversation
•    Maintaining conversations for increasing periods of time
•    Maintaining conversations with the opposite sex
•    Terminating conversations with friends
•    Empirical and powerful strategies for addressing bullying/rumors 
•    Discriminating between comical vs. serious language
•    Discriminating between formal vs. informal language
•    Discriminating between figurative vs. literal language
•    Sharing jokes and the role of humor across daily activities
•    Interpreting the body language of others (e.g. open body language and social cues expressing interest vs. closed body language (e.g. crossed arms and/or crossed legs) and social cues expressing disinterest
•    Initiating and offering socially appropriate goodbyes

Socialization While Creating and Maintaining Friendships

•    Friendship is a choice, and how to choose friends
•    How not to be a conversation hog
•    What to do during a get together
•    How not to police the conversation
•    Discriminating and applying serious vs. comical language and situations in context
•    Discriminating and identifying emotions of others
•    Responding to the emotions of others 
•    Dispute resolution and how to deal with hurt feelings
•    Accepting the perspectives of others 
•    Sharing feelings and expressing empathy 
•    Identifying social cues during ongoing conversations across contextually relevant situations
•    Responding to social cues during ongoing conversations across contextually relevant situations
•    Initiating individual social cues to others during ongoing conversations across contextually relevant situations
•    Permitting others to speak in the absence of interrupting while presenting active listening skills
•    Tolerating the opinions of friends and agreeing to disagree with the opinions of friends
•    Sharing an opinion across contextually relevant situations
•    Initiating social questions with friends and peers
•    Discriminating people we know (e.g. friends) from people acquaintances from people we do not know (e.g. strangers) in context  
•    Discriminating and responding to appropriate and/or inappropriate behaviors of strangers, acquaintances, peers, friends and family
•    Maintaining a social calendar, and how to initiate a get together
•    Extending and responding to social invitations
•    Calling friends, peers, elders and family by name
•    Initiating and responding to phone calls in contextually relevant situations across friends, peers, parents and other persons of authority
•    Initiating and responding to text messages in contextually relevant situations across friends, peers, parents and other persons of authority

Parent Participation and Social Coaching

•    Providing social opportunities in the home and community ( a requirement when entering the program)
•    Learning ABA methodology and principles of reinforcement
•    Participating in role plays as a priming technique, and side coaching during homework activities
•    Fostering social inclusion and lasting healthy friendships
•    Finding appropriate sources of friends and facilitating get togethers.


Social Play / Social Skills Training

Ages 5-12

We provide effective social skills training through community inclusion, play facilitation, pivotal response treatment and applied behavior analysis. Based on shaping and practice, role-plays, facilitated play dates, behavior rehearsal, peer modeling and reinforcement, Nurture & Nature’s programs are custom built to address the individual needs of our clients. per week and three hours of direct supervision a per month.

Our program begins with an evaluation and an assessment or re-assessment to determine the individual consumer’s and family’s needs.

Skill Acquisition Targets

Communication and Respondent Listener Skills

•    Initiating and offering appropriate greetings
•    Increasing eye contact with others when speaking
•    Increasing eye contact when others are talking
•    Increase eye contact when responding to directives
•    Responding to on topic conversational exchanges chosen by others
•    Creating a conversational segue (e.g. smoothly transitioning to different topics of conversation)
•    Initiating conversations 
•    Maintaining conversations for increasing periods of time
•    Terminating conversations with friends
•    Addressing bullying and Functional Communication Training
•    Discriminating between comical vs. serious language
•    Discriminating between formal vs. informal language
•    Discriminating between figurative vs. literal language
•    Sharing jokes and the role of humor across daily activities
•    Sharing opinions with Functional Communication Training:: “I like/I don’t like because/ when/since…”
•    Interpreting the body language of others (e.g. open body language and social cues expressing interest vs. closed body language (e.g. crossed arms and/or crossed legs) and social cues expressing disinterest
•    Initiating and offering socially appropriate goodbyes

Socialization While Creating and Maintaining Friendships

•    Discriminating and applying serious vs. comical language and situations in context
•    Discriminating and identifying emotions of others
•    Responding to the emotions of others 
•    Dispute resolution
•    Accepting the perspectives of others 
•    Sharing feelings and expressing empathy 
•    Identifying social cues during ongoing conversations across contextually relevant situations
•    Responding to social cues during ongoing conversations across contextually relevant situations
•    Initiating individual social cues to others during ongoing conversations across contextually relevant situations
•    Permitting others to speak in the absence of interrupting while presenting active listening skills
•    Tolerating the opinions of friends and agreeing to disagree with the opinions of friends
•    Sharing an opinion across contextually relevant situations
•    Presenting enthusiasm when agreeing or disagreeing with the opinion of a friend
•    Terminating conversations and walking away from friends across contextually relevant situations
•    Initiating social questions with friends and others
•    Discriminating people we know (e.g. friends) from people acquaintances from people we do not know (e.g. strangers) in context  
•    Discriminating and responding to appropriate and/or inappropriate behaviors of strangers, acquaintances, peers, friends and family
•    Maintaining a social calendar
•    Extending and responding to social invitations
•    Calling friends, peers, elders and family by name
•    Initiating and responding to phone calls in contextually relevant situations across friends, peers, parents and other persons of authority
•    Initiating and responding to text messages in contextually relevant situations across friends, peers, parents and other persons of authority

Play Skills

•    Asking others to play and/or join an activity
•    Permitting others go first
•    Taking turns
•    Engaging in functional play sequences with others
•    Engaging in imaginary or symbolic pretend play sequences with others
•    Entering into pretend play
•    Maintaining reciprocal play for up to 20 minutes
•    Following the rules of a game
•    Playing a game someone else has chosen
•    Joining play in progress
•    Introducing oneself to peers
•    Try a novel game or activity
•    Tolerating losing a game
•    Developing peer relationships
•    Sustaining peer relationships
•    Joining and sustaining group activities
•    Learning unspoken, contextually relevant social rules by environment(s) and social situation(s)
•    Contributing and helping others while increasing community involvement
•    Addressing a social audience and maintaining affect to match the age, status and culturally relevant situations for the audience members
•    Addressing individualized social fears
•    Presenting appropriate behavior after accessing special events training (e.g. birthdays, groups, clubs, celebrations)
•    Presenting following skills with friends and leading skills with friends

Parent Training

•    Providing social opportunities in the home and community ( a requirement when entering the program)
•    Learning ABA methodology and principles of reinforcement
•    Participating in role plays as a priming technique
•    Fostering social inclusion 
•    Facilitating play 
•    Fulfilling data collection requirements 


Anticipated Consumer Outcomes

Nurture & Nature is committed to family education that will teach parent(s), guardian(s), and/or sibling(s) living at the same domicile to access skill acquisition supports so consumers can achieve greater levels of independence. Working side by side with parents, families and consumers will be trained to increase the child’s social skills with the empirically validated principles of Applied Behavior Analysis, Pivotal Response Treatment and PEERS.  

We target teaching behaviors through skill acquisition programming, task analysis, chaining, role-play, behavioral rehearsal, modeling and feedback.  

Our programs create meaningful and measurable social skills goals with the aim to have a lasting impact on the lives of the clients and families we serve.

Why and How?

Measuring behavior allows the Nurture & Nature team and parents, information regarding the degree of performance discrepancy as compared to typically developing peers.  This information is provided prior to intervention to determine baseline measures from which to generate goals. Measurement within the intervention period serves as an objective basis by which to assess progress, teaching procedures and program modifications, as necessary. A trained observer records the target behavior in a specific period of time (e.g. observation period) in either natural settings or contrived settings to inform programming and progress.

What type of data will be collected?

 

In addition to client history and files from the referring source, data collection will be consistent with the relevant dimension of the targeted skill.  Data will measure the     duration, intensity and frequency of the behavior.  Commonly, Nurture & Nature will use frequency/rate and percentage of opportunity data.

 

Recording methods

 

There are a variety of recording methods that may be used to best capture the behavior of concern and/or the skill replacement behavior that is targeted for acquisition. At Nurture and Nature, we select the measurement method(s) that will be the most informative.  A common practice is the use of frequency or event recording data informs the data collector on the number of times a behavior occurred during a specific period of time.

 

How often is data collected and summarized?

 

Baseline data will be collected during the assessment and throughout the intervention. Parent data collection methods as suggested by the program supervisor, the baseline data will be established to determine the present level of performance and the current level of skill deficit, as necessary.


During intervention, data will be collected daily on skill acquisition and parent education goals. 

 

Validating the Data

 

Nurture & Nature validates their data using a method where the entire clinical team and family takes data and then compares for accuracy of behavior reporting. Fidelity and implementation checks will be taken monthly during supervision visits by the program supervisor. 

 

Privacy & Record Keeping

 

Guided by the ethical code of the BACB and HIPAA, Nurture & Nature will code all data and keep all files locked in secured cabinets. All data that is collected, is coded to protect the client’s confidentiality, all data will be collected and records maintained for a period of seven years, as in compliance with state laws.  

 

Client Records

 

All client files are kept confidential, in accordance with the HIPAA regarding client’s right to privacy, and kept under lock and key in a locked office.  Access to each client’s file will be limited to the Nurture & Nature team, funding sources and parents.  All hard copies of data will be filed and kept on site for a period of 7 years.  

 

Nurture & Nature’s offices are open 8:30am to 5:00pm Monday through Friday.  Also, Nurture & Nature’s executive staff is on call to respond to scheduling issues.  Emergency contact information, including that of the Clinical Directors, will be provided in the Client Service Agreement.

 

Holiday Closures:

Services will not be provided on the following holidays that include: New Year’s Day, Martin Luther King Day, Presidents day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day and Christmas Eve., Christmas Day, and New Year’s Eve.  

Nurture and Nature, Inc., will make every reasonable effort to accommodate clients for cancellations due to other holidays that are not aligned to those closures described above. 

Grievance Procedures 

Nurture & Nature encourages open and honest communication between all parties involved.  If client or family has a grievance, they will be heard and we will make every reasonable effort to accommodate necessary changes.  

Client Rights as per Lanterman Act

If you have a developmental disability, you have the right to:

•    Treatment, and services and supports to help you live the most independent, productive, and “normal” life possible.
•    Services that protect your freedom in the least restrictive way.
•    Dignity, privacy, and humane care.
•    Treatment, services and supports in natural, community settings, as much as possible.
•    Participate in an appropriate public education program, regardless of your disability.
•    Prompt medical care and treatment.
•    Freedom of religion, conscience, and freedom to practice your religion.
•    Participate in community activities, and interact with peers.
•    Physical exercise and recreation.
•    Be free from harm, including unnecessary physical restraints, isolation, excessive medication, abuse or neglect.
•    Say “no” to unsafe procedures.
•    Make choices in your own life. This includes where you want to live, who you want to live with, your relationships, how you spend your free time, your education, and work, your personal goals, and making a plan that fits your needs, and wants.

Choices and Decision-making

You have the right to:

•    Have DDS, regional centers, service providers, and others give you information you can understand to help you make choices.
    The Law Gives You Rights    Supplement B
•    Have DDS, regional centers, service providers, and others give you the chance to make decisions.
•    Have DDS, regional centers, service providers, and others respect your choices. 

 

Open Positions


Clinical Supervisor

This position requires specific education and work experience requirements.  The Clinical Supervisor will have education and work experience that meets or exceeds Board Certification with BCBA status and a certifying number conferred by the BACB. While remaining in good standing with the BACB and continuing to meet continuing education requirements in the field of applied behavior analysis, a Clinical Supervisor will maintain a valid driver’s license with evidence of auto insurance. The Clinical Supervisor will have the primary responsibilities of:

o   Coordinating with the Director of Operations to acquire Regional Center contracts

o   Working with a myriad of funding sources since ABA Services may be funded through additional Regional Centers

o   Coordinating in tandem with the Director of Operations with the sourcing, screening and hiring of behavioral staff.

o   Collaborating with the leadership team to evaluate and employee performance and quality assurance.

o   Pairing behavioral staff with clients to best suit the program supervision needs for service delivery.

o   Providing in-field staff training and education

o   Attending weekly meetings with clients and reviewing cases to advance their progress.

o   Completing progress reports for their assigned caseload and submitting the same in a timely manner

o   Attending annual ABA-related conferences in order to remain current with research and issues related to the field.

o   Reporting case information to the Clinical Director

o   Supervising the Behavioral Therapists

o   Serving clients and their families during the days and hours of Monday through Sunday with service hours ranging from 8:00 am to 8:00 pm 


Behavioral Therapist

This position requires specific, minimum education such as a Bachelor’s degree in Psychology, Education, Social Work or related human services field.  The Behavioral Therapists will have at least two years of fieldwork experience.  The Behavioral Therapist is responsible for:

o   Implementing the individualized, direct intervention for clients

o   Following the procedures that are in accordance with the policies of Nurture & Nature

o   Implementing behavior management procedures

o   Teaching new behaviors while modeling the same for families

o   Collecting data to inform the programming and client progress

o   Entering data into our system

o   Completing session notes

o   Reviewing cases with his or her direct supervisor

o   Attending clinical meetings with his or her assigned Clinical Supervisors

o   Obtaining up-to-date client contact information

o   Completing Parental Verification Forms for services provided


Adaptive Skills Supervisor

The Adaptive Skills Supervisor shall possess the following minimum requirements of: Master's Degree in one of the following: education, psychology, counseling, nursing, social work, applied behavior analysis, behavioral medicine, speech and language, or rehabilitation; and at least one year of experience in the design and implementation of adaptive skills training plans. Supervisors must possess three years of experience working with children; Persons with less than three years of experience will be considered on a case-by-case basis depending on education, references, and experience.  The supervisor shall have primary responsibility for the following functions:

o   Reviewing assigned cases and performing all of the program development

o   Providing direct supervision and implementation for adaptive skills programs.

o   Car rides or car sharing are not permitted by supervisors due to safety and insurance issues unless mutually agreed upon in advance and determined as necessary programming with written approval by funding source. 

o   Following procedures that are in accordance with the program and company policy.

o   Obtaining up-to-date contact information from clients.

o   Completing graphing of data and data analysis.

o   Writing semi-annual reports in a prompt manner and submitting the same for review by the clinical directors.

o   Attending clinical meetings.

o   Attending weekly team meetings.

o   Attending trainings.


 Adaptive  Skills Tutor/  Supervisor

The Adaptive Skills Tutor shall possess the following minimum requirements of: Master's Degree in one of the following: education, psychology, counseling, nursing, social work, applied behavior analysis, behavioral medicine, speech and language, or rehabilitation; and have at least one year of experience in the design and implementation of adaptive skills training plans. The tutor should possess two years of experience working with children. Persons with less than two years of experience will be considered on a case-by-case basis depending on education, references and experience.  Tutors shall have primary responsibility for the following functions:

o   Reviewing assigned cases and performing all program development with the supervisor or self-supervision while consulting with the Director of Adaptive Skills. 

o   Providing direct intervention to clients as per individual programs.

o   Ensuring that car rides by supervisors for tutors are not permitted by tutors due to safety and insurance issues. 

o   Following procedures which are in accordance with the program and company policy.

o   Obtaining up-to-date contact information from clients.

o   Entering data and writing monthly summaries.

o   Attending clinical meetings.

o   Attending trainings.


Social Skills Supervisor

The Social skills Supervisor shall possess the following minimum requirements of: Possess a Master's Degree in in one of the following: education, psychology, counseling, nursing, social work, applied behavior analysis, behavioral medicine, speech and language, or rehabilitation; and at least one year of experience in the design and implementation of social skills training plans. Also, Supervisors supervisors must possess three years of experience working with children.  ; Persons with less than three years of experience will be considered on a case-by-case basis depending on education, references, and experience.  The supervisor Supervisor shall have primary responsibility for the following functions:

o   Reviewing assigned cases and performing all of the program development for these casesPEERS.

o   Implementing and Providing providing direct supervision and implementation for social skills programs.

o   Car rides or car sharing are not permitted by supervisors due to safety and insurance issues. unless mutually agreed upon in advance by all of the parties and determined as necessary programming with written approval by NLACRC. 

o   Following procedures that are in accordance with the each client’s program and company policy.

o   Obtaining up-to-date contact information from clients.

o   Completing graphing of data and data analysis.

o   Writing semi-annual reports in a prompt manner and submitting the same for review by the clinical Clinical directorsDirectors.

o   Attending clinical meetings.

o   Attending weekly team meetings.

o   Attending training sessions.


Social Skills Facilitator

The Social Skills Facilitator shall possess the following minimum requirements of: Possess a Bachelor's Degree in one of the following: education, psychology, counseling, nursing, social work, applied behavior analysis, behavioral medicine, theatre, speech and language communication, or rehabilitation. The facilitator should possess two years of experience working with children. Persons with less than two years of experience will be considered on a case-by-case basis depending on education, references and experience.  Facilitators shall have primary responsibility for the following functions:

o   Reviewing assigned cases and performing all program development with the supervisor or self-supervision while consulting with the Director of Social Skills.

o   Providing direct intervention to clients as per individual programs.

o   Ensuring that car rides by supervisors for facilitators are not permitted by facilitators due to safety and insurance issues. 

o   Following procedures which are in accordance with the client’s program and company policy.

o   Obtaining up-to-date contact information from clients.

o   Entering data and writing monthly summaries.

o   Attending clinical meetings.

o   Attending training sessions.

 


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Self Evaluations

 

Nurture & Nature will adhere to all HIPAA, BACB and funding source guidelines for responsible conduct.  As part of Nurture & Nature’s mission to provide quality assurance, program supervisors will do random and scheduled field visits. Each employee will undergo performance evaluations regularly. This information will assist in assuring quality services on behalf of Nurture & Nature.