Consent to Participate in Remote Social Skills Group

What to expect: 

● Social Skills Groups will meet for 8 weeks 

● Group meets once per week for 60 minutes 

● Groups will consist of structured lesson plans including homework assignments, interactive discussions, role-play, and games 

● ABA staff may be available to facilitate participation in the group. Parents or caregivers may also facilitate participation 

● Students in group are assigned a cohort based upon current strengths and weaknesses in different social skills domains 

● Groups will be led by Michelle Berlinski, M.Ed., BCBA, LBA and MaKenzie Johns, M.Ed., BCBA, LBA What not to expect: 

● For most students, it is not expected that successful participation will be achieved without adult supports during some parts of group times 

● Discussion of individual student needs, or discussion of individual student’s ABA programs will not be permitted during group meetings. 

Confidentiality

Throughout the course of participation in these remote social skills groups, steps will be taken to limit exposure of your child’s personally identifiable and medical information to other members of the group. It is expected that some personally identifiable information will be made available to the group throughout the course of social skills treatment. This may include but is not limited to, your child’s name, their age, and the inside of their home. Exposure of personally identifiable information will be limited to information that is necessary to facilitate socialization and successful social skill acquisition. EAS staff are required to maintain the confidentiality of all members of the group. It is expected that what is discussed in the group, will remain in the group. Each child’s ABA team may discuss the progress of their student with other members of the student’s ABA treatment team. Caregivers may discuss their overall experience with participation in the group, so long as personal information regarding any other student participant is not discussed. 

Remote social skills groups will be conducted over Zoom. In accordance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), any of your child’s personally identifiable and medical information is deemed Protected Health Information (PHI) and subject to HIPAA Privacy Standards. Any video that is transmitted is encrypted to ensure compliance with these standards. Any video that takes place is streamed live for treatment purposes and not recorded and any electronic transmission of information is sent through secure platforms. PHI will not be disclosed unless permitted by law and any breaches will be disclosed to you immediately. 

Parents or caregivers that have specific questions or are seeking explanations about program or material information (i.e. individual progress, behavioral plans, visual supports, etc.), should schedule an outside follow-up conference, team meeting, phone call or email with their supervising BCBA. This is to avoid disruption to the learning environment and ensures the confidentiality of all clients. 

Observers cannot disclose any client identifying information that was witnessed during a group session to others. This includes but is not limited to, disclosing names, physical descriptions, their medical or therapeutic needs, etc. through oral statements or in writing. 

Student Attendance

Attendance during social skill group meetings is very important. Consistent attendance is required from all students in order to facilitate a successful group dynamic. Absenteeism, from any student, will negatively impact the dynamic of the group, and produce less successful outcomes from all students in the group. Groups will be scheduled weekly, at the same time and day each week. In the event that your student should not be available to attend a group session, or in the event that a student should choose to leave the group, caregivers are expected to notify the ABA team and Michelle Berlinski 24-hours prior to the next scheduled group session. Cancellations with less than 24-hours notice will result in a charge of $30 for the missed time.

Acknowledgment of Consent:

I understand the clinical scope of remote social skills groups, including what to expect, and what not to expect with group participation. I understand the requirements of attendance and consequences of lack of consistent attendance. I understand I may see, hear, or be exposed to confidential information about other clients. I acknowledge that is my responsibility to respect the privacy and confidentiality of this information. I will not access, use, or disclose any confidential information outside of observations. I understand that Early Autism Services reserves the right to rescind my participation in therapy observations if any of the following guidelines are found in violation of this Agreement and/or I may be subjected to civil or criminal liability. If I have any questions concerning this Agreement, I shall direct them to the Clinical Director.