The CSH RUCARES Severe Behavior Program provides specialized services to children and adolescents with autism and other developmental disabilities who display dangerous behavior such as self-injury, aggression, property destruction, and pica.

Children displaying severe behavior problems may:

• Pose significant health risks to self and others;
• Interrupt their own learning and development;
• Cause immeasurable stress and hardship for families;
• And, be at risk for long-term institutionalization.

The CSH RUCARES Severe Behavior Program works to improve the quality of life for children with severe behavior disorders and their families by:

• Providing the most advanced and comprehensive treatment services;
• Continuing to develop and refine effective treatments through clinical research;
• And, promoting effective treatment technologies through training and consultation.

Clinical Services
The program provides service to school-aged children (ages 3-21) who display severe destructive behavior, such as self-injurious behavior, aggression, or property destruction that poses a significant risk to self, others, or the environment and who cannot be safely managed or effectively treated in a less-intensive program. Each child moves through the program based on his or her individual needs. During therapy sessions, techniques are used to identify environmental variables that may be contributing to the behavior problem. A specialized therapeutic environment is used to allow the safe evaluation of dangerous behaviors.

• Initial Evaluation: The family and child are seen by a team of specialists with training and expertise in the assessment of severe destructive behavior. Some children require only an evaluation and written recommendations, while in some situations, outpatient, half-day, or full-day treatment will be required. Intake paperwork will need to be completed by the family prior to the initial evaluation.
• Half-Day Treatment: Children with moderately severe behavior problems will be seen daily for two to three hours.
• Full-Day Treatment: Children with the most severe behavior problems will be seen for up to six hours per day, five days per week.
• Parent Training: Caregivers attend weekly trainings to learn critical skills (e.g., how to respond to problem behavior safely and effectively, and how to improve compliance). Once an effective treatment is developed, parents and other care providers are trained on how to use it. The long-term success of the treatment depends on how accurately the program is carried out by parents, in-home aides, and other care providers. To facilitate accurate use of the treatment, training for parents and caregivers involves written and spoken instructions, modeling, role play, and feedback.

Therapists record occurrences of specific child and parent or caregiver behaviors. Session-by-session data are then graphed, reviewed, and analyzed multiple times each day by therapists and supervising behavior analysts or psychologists. Data are used to guide the assessment and development of treatment, and treatment is refined until goals are achieved.

A board-certified behavior analyst at the doctoral level (BCBA-D) or a psychologist with specialty training in applied behavior analysis oversees all therapy sessions. Assessments and treatments for each patient receive daily peer review by multiple senior behavior analysts and staff.

Age Groups	Children Adolescents
Health Services	Behavioral / Mental Health Behavioral Conduct Disorder Oppositional Defiant Disorder (ODD) Self-Injury Intellectual and Developmental Needs Autism Spectrum Disorders (ASD) Intellectual and Developmental Disabilities (I/DD) Special Needs
Treatment Services	In-Community Services Applied Behavior Analysis (ABA) Behavioral Assistance Outpatient Services Assessment / Evaluation Intensive Outpatient (IOP) Treatment Settings Hospital / Clinic Outpatient, Hospital / Inpatient
Payment Types	Managed Care Medicaid Private / Commercial Insurance Self Pay System of Care (CSOCI Medicaid / FlexFunds)
Areas Served	State-Wide

Last Updated: 09/08/24