The child undergoes an extensive evaluation which involves psychoeducational assessments, speech-language testing, a neuropsychological test battery, occupational therapy evaluation, medical history, and neurological examination, as well as an interview with the parents and child which focuses on psychosocial issues.
Many children referred to us have already undergone recent extensive evaluations. We do not repeat this testing but may need to assess specific areas that were not addressed in any previous test batteries. For more detailed information on the evaluation, please click here.
The intensive program is a ten-week, 5 hours a day, 5 days a week program that is delivered on a one-to-one basis and is carefully monitored. Each treatment session lasts for 45 minutes and is followed by a 15-minute break for recreational activities. Each day the therapists meet and evaluate the individual’s progress and response to treatment. Behavioral issues are closely monitored. The next day’s therapy plan is then developed for that individual.
Intensive Cognitive Rehabilitation
The staff develops a program that is tailored to the individual’s needs after reviewing the findings from the evaluation. Typically, the program consists of ten weeks of treatment and learning customized to the needs of the individual child. While some similarities do exist with other students, we focus on providing the best combination of treatments to promote progress and long-lasting results. See below for details on this portion of the treatment.
Reporting and Tracking Progress
Parents and guardians are provided a weekly report that tracks the student’s progress, academic skill improvements, and highlighted treatments. The reports are customized for each student and provide an overview of the week as well as, expectations for homework and study subjects at home.
Transition Back to School
After the intensive ten-week program is completed, each student’s academic skills are re-evaluated to measure therapeutic gains. The WINSi staff meet with parents to share results and recommendations, and a meeting with WINSi, parents and the child’s teachers is scheduled during which this information is shared. WINSi and the school work collaboratively to determine any helpful modifications in the classroom.
Extended Intensive Program
On some occasions, ten weeks is not sufficient for a student to achieve the desired level of progress before returning to school. Children with severe reading, language, or behavior problems may need to remain at WINSi for continued intensive therapy. The length of extended intensive therapy is determined on an individual basis.
The Post-Intensive Follow Through Program
As soon as the student returns to school, follow-through therapy begins. The student comes to WINSi after school 1 to 5 hours a week to work on classroom assignments in one-on-one sessions conducted by the same therapists the students have seen in the intensive program. Each student’s progress is carefully monitored in a collaborative manner involving school teachers, parents, and WINSi therapists. Follow-through therapy continues with decreased frequency until the student has reached a level of independence and successful academic functioning. This may take 1 to 3 years.
Follow-through therapy is a crucial part of the program and ensures that the student is applying his newly acquired skills in all schoolwork. Behavioral issues continue to be addressed as needed. Without continued monitoring of academics and behavior, there is a serious risk that the student could lapse back into the maladaptive strategies used habitually prior to coming to WINSi. Another critical aspect of the Follow-Through Program is the daily practice of reading aloud to a parent at home. Research has demonstrated that daily practice is essential if the child is to maintain and further improve reading ability. This requires parental monitoring, encouragement, and sometimes positive incentives. The psychotherapeutic interventions continue as needed.
After the student has completed the intensive program, he or she returns to WINSi for continued therapy after-school and throughout the summer. Depending on the student’s needs, this can range from 1 to 5 hours a week. The duration of the follow-through phase varies and depends upon how rapidly the child becomes independent and successful with academic skills. Typically, the follow-through phase may last anywhere from 1 to 3 years.
The initial phase of speech/language therapy involves comprehensive training in phonological awareness. Individuals will progress through this phase at different rates. Once phonological awareness is solidly achieved, the student practices decoding and encoding strategies at increasingly complex levels. After reading accuracy is established, the student begins training to increase reading fluency (speed and phrasing). Depending upon the student’s needs, the program may be expanded to include reading comprehension, vocabulary knowledge, morphology, and word relationships as well as syntax or sentence structure.
Older students often need assistance with the organization and integration of larger volumes of written information. Writing skills are taught hand in hand with comprehension at the sentence, paragraph, and essay level. Pragmatics, the use of language in a social context, is addressed as needed in both therapy sessions and in interactions with staff and peers.
The Occupational Therapy (OT) components play a crucial role with all the children at WINSi. The treatment targets oral awareness, fine motor coordination, handwriting, learning to touch type, learning to regulate arousal levels, and sensitivity to sensory stimuli.
For younger children, pre-school/early elementary, the OTs typically focus heavily on sensorimotor activities. Children in this age group will spend some time working with slime, playing in the sand tray, or doing other similar activities. This helps young children integrate and improve motor behaviors and visual-spatial, proprioceptive, and sensory inputs, and engages eye-hand coordination. We will also coach parents and guardians on how to use these activities at home to help further development.
For older students, in addition to focusing on learning skills, we teach systematic procedures for routine daily tasks. This can range from tooth brushing to cleaning out the dishwasher. Other activities– learning to write efficiently and to touch type — are very helpful to kids with ADHD, because with repetitive training they acquire the ability to perform routine tasks efficiently. We also help them learn many different activities of daily living, including training in life skills, such as organizational strategies and use of a planner, keeping track of appointments, and in some cases even money management.
Individualized Math Instruction
Children with language and/or reading disorders often struggle with math. Instruction is tailored to begin at the level at which each student is successful with the goal of meeting math curriculum criteria in the standard developmental sequence. The Math Program focuses on the development of both conceptual as well as procedural knowledge.
Treatment of Behavioral and Social-Emotional Problems
If a child presents with social-emotional difficulties or behavioral problems, these are addressed in various combinations of individual or group therapy. Parents and other family members are integrated into these interventions as needed.
Children in our Intensive Program work hard and it is important for them to have breaks during the day in which they can go outside or participate in other recreational activities. Recreational Therapy is also a time for children to acquire or practice social skills and work on improving self-esteem. Social skills consist of everyday behaviors that allow us to effectively communicate with other people. For some children, these daily interactions are difficult and frustrating experiences, and improved social skills may be part of an individual treatment plan.
If medical management of ADHD or other behavioral problems is required, this is provided and the response to treatment is closely monitored so that rapid and effective adjustment of medication is possible.