Therapies for Challenging Behaviors
What are therapies for challenging behaviors?
To help children with autism spectrum disorder change problem behaviors, we use evidence-based therapy called applied behavior analysis (ABA). We work with parents and other caregivers to assess how your child acts and the purpose of their behavior. For example, the behavior might get your child something they want, like attention. Or it might help your child avoid something they do not want, like a noisy classroom.
Then we make a treatment plan and teach skills to help reduce your child’s problem behavior. Appointments are at Seattle Children’s Autism Center.
RUBI Parent Training Program
Our current program, RUBI, is a training program for parents and other caregivers of children ages 3 to 10 with autism and mild-to-moderate behavior problems. We work 1-on-1 to teach you ways to reduce your child’s problem behaviors and improve daily living skills, such as self-care and helping around the house. Experts in the RUBI Autism Network have created and tested this step-by-step training. RUBI stands for Research Units in Behavioral Intervention.
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Who can RUBI training help?
This program is for parents and other caregivers who have a child:
- Between 3 and 10 years old
- Diagnosed with autism or related developmental disabilities
- Who has problem behaviors that get in the way of daily life
- Who can follow simple, 1-step instructions
We help with behaviors like:
- Hitting, kicking and biting
- Tantrums and meltdowns
- Screaming
- Not doing what you ask (noncompliance)
This program is NOT a good fit for children who:
- Mainly need to address self-harming, severe aggression, eating nonfood items (pica) or running or wandering off (elopement)
- Only need to increase language skills, play skills or social skills
- Only have problem behaviors at school
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What can I expect at RUBI training?
RUBI is an outpatient service. You and a therapist will work 1-on-1 in weekly 1-hour sessions for up to 13 weeks. Your child only attends the first visit. It is best if the same adults attend each week. The program has the best results when caregivers make the time and effort to learn the skills and practice them at home.
We explain why kids behave the way they do. Sessions also cover how to:
- Prevent problem behaviors from happening
- Promote positive behaviors in your child
- Respond to problem behaviors more effectively
- Teach your child new skills that can replace a problem behavior
- Make positive behavior changes last over time and work across situations
We will work with you to schedule a regular day and time for your visits. One month after you finish the program, you will have a follow-up visit.
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Who is on the RUBI team?
The RUBI program at Seattle Children’s is run by Erin Olson, PhD, a leading expert in treating challenging behaviors in children with autism. She supervises a team of therapists who work with families.
Biobehavioral Outpatient Program
The Biobehavioral Outpatient Program provides short-term applied behavior analysis (ABA) therapy to children with intellectual and developmental disabilities who have complex behavioral needs that may cause them to harm themselves, others or the environment, like aggression, self-injury, pica (eating things that aren’t food) or other disruptive behaviors.
Read more about the Biobehavioral Outpatient Service’s Family Behavioral Consultation. (PDF) (Simplified Chinese) (Somali) (Spanish) (Vietnamese) (COMING SOON)
Read more about the Biobehavioral Outpatient Service’s Intensive Services (PDF) (Simplified Chinese) (Somali) (Spanish) (Vietnamese) (COMING SOON)
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Who should attend?
Children ages 3 through 17 who have all of the following:
- An intellectual or developmental disability diagnosis
- Significant intellectual or communication impairment (i.e., non-speaking, communicating by single words or gestures)
- Unsafe or other disruptive behaviors that may impact the child’s safety or the ability to do daily tasks (i.e., self-injury, aggression, pica)
Most visits will involve you and your child. During some visits, we may work with you or your child individually. A care team member will discuss what your appointments will look like with you.
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What is covered?
We will:
- Work with you and your child to figure out when disruptive behaviors are more likely to happen.
- Teach your child new skills, like communication, to help prevent disruptive behaviors.
- Help your child develop skills to remain safe during a difficult or frustrating situation.
- Help you learn strategies to reduce your child’s disruptive behaviors and practice their new skills at home and in the community.
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How long is the program?
Our program offers short-term ABA therapy that focuses on disruptive behavior concerns. We will work with you and your child during 1 or more visits per week depending on your child's needs. Visits can last for 1 hour up to 2 and a half hours. A care team member will meet with you and your child to determine what services you need and how often we will see you.
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How can I prepare for my first visit?
Please bring a copy of your child’s most recent individualized education program (IEP) and school evaluation report. You can request a copy from your child’s school. If your child has an autism diagnosis, please provide us with the diagnostic evaluation report.
Scheduling an Appointment
- If your child is already being seen at Seattle Children’s Autism Center, ask your child’s therapist to refer you.
- If your child is not a current patient at Seattle Children’s, ask your child’s primary care provider or mental health provider to place a referral to either the RUBI Parent Training Program or Biobehavioral Outpatient Program.
- When we get the referral, we will place you on our waiting list. When a space opens, we will contact you to set up your first visit.
Contact Us
Learn more about how to get services at the Autism Center.
Providers, see how to refer a patient.
Paying for Care
- It’s always best to call your insurance plan to check your benefits. Find out if they cover the cost of the program and how much you need to pay if the full cost is not covered.
- We bill you or your insurance company for each session.
- RUBI Training Program: The procedure code billed for RUBI Parent Training Program sessions is 90846. This is “family therapy without patient.”
- Biobehavioral Outpatient Program: We bill applied behavior analysis procedure codes for the Biobehavioral Outpatient Program sessions.
- Read about insurance and mental health coverage at Seattle Children’s.
- Learn more about paying for care at Seattle Children’s, including billing and financial assistance.
