Direct Treatment by Protocol (CPT 97153)
Client 1
Status at start
Client greeted the technician at the door and transitioned to the work area within 15 s with one gestural prompt.
Targets and techniques
Discrete-trial manding was run across three sets of ten trials using picture cards; the client emitted independent 2-word mands on 24 of 30 trials (80%), with echoic prompts on the remaining 6. Natural-environment teaching continued during play with contrived opportunities for requests. Techniques used: differential reinforcement of alternative behavior for mands; least-to-most prompting; visual transition schedule; planned ignoring of minor vocal protest; token economy with a five-token exchange for preferred play.
Behaviors
- Elopement: 2 instances, both during transitions from a preferred to a non-preferred activity. The technician blocked and redirected to the visual schedule; the client returned within 25 s and 40 s respectively.
- Aggression: 0 instances.
Client response and progress
Client responded to the visual schedule during transitions and emitted independent 2-word mands on 80% of trials.
Caregiver involvement
Mother was present for the final 20 minutes. The technician modeled the 2-word prompt; she practiced three opportunities with feedback.
Barriers
Flagged: no barriers were entered. Add any, or mark none.
Items for the BCBA
Independent 2-word mands reached 80% this session; the technician asks whether to begin fading the echoic prompt. Elopement continues during transitions from preferred activities.
The client's name, date of service, start and end times and your signature are added in your EHR.