Registered Behavior Technician FAQs

MetroEHS behavioral technician doing a Q&A interview

Q: What is the RBT certification?

A: RBT certification is a paraprofessional certificate that is in the behavioral analyst field, and you work under the BCBA or BCABA treating and providing services to our kids.

Q: What are the requirements?

A: What it takes to become an RBT here at MetroEHS is you must be 18 years old, a high school diploma, you need the 40 hours of training, and then take a competency test with the supervisor, and then you apply at the BACB website, and take a test, and become an RBT.

Q: What does the training consist of?

A: The RBT training consists of like an interactive and comprehensive 40-hour training that you work in a small group or one on one with other technicians or your BCBA. You’re out in the clinic, hanging out with the kids, learning and watching how they run programs. That could be at the table time or out in natural environment and once you understand the new words in the ABA field, you take your competency test and take the test at the website.

Q: What is the competency test?

A: The competency test is when the supervisor comes out the clinic with you and they watch how you run programs, they interview you, ask questions about the terminology and it’s pretty much just one on one time or you and the supervisor and your client to make sure you understand the terminology and what you’re actually doing and it’s highly encouraged to actually take your RBT test within 90 days of your 40 hour training. It is free of charge. You take the test at the BACB website.

Apply now!

Q: How do I maintain my credentials?

A: To maintain my credentials as an RBT here at MetroEHS, I track all my supervision hours, and I retake my competency test at the year mark or year anniversary of my RBT testing date.

Q: What are the benefits if earning an RBT certification?

A: MetroEHS offers two benefits for becoming an RBT. One is a raise and two, once you become an RBT, you have more opportunities to move up the ladder and become admin or fun stuff.

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March 11, 2021

Opening up New Opportunities with Pediatric Therapy in Spanish!

Brittany: Hello! My name is Brittany, I am the bilingual Speech Pathologist at Metro EHS in Sterling Heights and Detroit.

Mallory: Hi! My name is Mallory, and I work in the Human Resources Department at the administrative office in Plymouth.

B: And we are so excited to announce that MetroEHS now offers speech therapy in Spanish and English!

M: That’s great! We can service Metro Detroit kids in their native language! But Brittany, can you tell me how to know if my child needs speech therapy?

B: Sure! If you have concerns about the language or articulation development of your child, it is possible that he/she might benefit from speech therapy. For example, if your child cannot pronounce certain sounds, does not say a lot of words or combine words to form sentences, or if you cannot understand him/her, we can do an evaluation to see if he/she qualifies for speech therapy.

M: That sounds great! What happens next?

B: After the evaluation, if therapy is necessary, we are able to initiate therapy in English, Spanish, or both languages to help your child communicate with family, friends and all of the people in the child’s life using their preferred language.

M: So cool! Are any other therapies offered?

B: Of course! We also offer therapy for feeding difficulties, stuttering, problems with social language secondary to autism, and the use of augmentative and alternative communication for children who are not able to talk using verbalizations. Here at MetroEHS we also offer occupational and behavior therapy at all of our centers. We have a phenomenal team of therapists that provide individualized services for your child. And Mallory, you can assist Spanish-speaking families get started, right?

M: Of course! We accept most insurances. I would be happy to answer any questions that families might have. Call our office to see if your child might benefit from speech therapy or other therapies in Spanish, English, or both languages. Our telephone number is 313-278-4601. We would love to talk to you!

Brittany: Hola! Me llamo Brittany y soy la terapeuta bilingue de habla en MetroEHS en Sterling Heights y Detroit.

Mallory: Hola! Me llamo Mallory y trabajo en el departamentro de recursos humanos en la oficina administrativa en Plymouth.

Brittany: Estamos emocionados de anunciar que MetroEHS ofrece la terapia de habla en ingles y espanol.

Mallory: Que excelente! Podemos proporcionar la terapia de habla a ninos en MetroDetroit en su idioma nativo. Brittany, me puedes explicar como saber si mi hijo necesita la terapia de habla.

Brittany: Por supuesto! Si tiene preocupaciones del desarrollo del lenguaje o de la articulacion de su hijo es posible que se beneficie de la terapia de habla. Por ejemplo,  si su hijo no puede pronunciar ciertos sonidos, no dice muchas palabras ni combina palabras para hacer oraciones, o si no le puede entender a su hijo, podemos hacer una evaluacion para ver si califica para la terapia de habla.

Mallory: Suena muy bien! Que pasara despues?

Brittany: Despues de la evaluacion, si las terapias son necesarias, podemos iniciar las terapias en ingles, espanol o ambos idimos para ayudar a hijo a comunicarse con la familia, los amigos y todas las personas en su vida usando su idioma preferido.

Mallory: Guau(wow)! Ofrecen otras terapias?

Brittany: Tambien ofrecemos terapias para dificultades con la alimentacion, el tartamudeo, problemas con el lenguje social secundario al autismo, y el uso de comunicacion aumentativa y alternativa para ninos que no puede hablar con verbalizaciones. En MetroEHS, ofrecemos la terapia ocupacional y la terapia de comportamiento (ABA). Tenemos un equipo fenomenal de terapeutas que proporcionan servicios individualizados para su hijo. Mallory, tu puedes ayudar a las familiar que hablar espanol en la oficina, verdad?

Mallory: Por supuesto! Aceptamos muchos seguros medicos. Yo estaria encantada de responder a cualquier pregunta que tenga. Llame nuesta oficina para ver si su hijo se podria beneficiar de la terapia de habla en espanol, ingles, o ambos idiomas. El numero de telefono de la oficina es 313-278-4601. Nos encantaria hablar con usted.

April 14, 2026

When Should Physicians Refer a Child for Integrated Pediatric Therapy?

Why Integrated Therapy Models Can Improve Functional Outcomes in Pediatric Patients

Pediatric patients with developmental, neurological, behavioral, and sensory conditions rarely present with isolated deficits. In clinical practice, delays in motor function, communication, regulation, feeding, and adaptive behavior frequently overlap, influencing one another in ways that can complicate both diagnosis and treatment planning. Yet despite this reality, many children still enter care through fragmented referral pathways, receiving services across separate disciplines without a unified plan of care.

For physicians, this can create a familiar challenge: a child may be referred for speech concerns, but underlying sensory processing difficulties, motor impairments, or behavioral barriers may be limiting progress. Another patient may be receiving occupational therapy while untreated communication deficits continue to interfere with participation, safety, and family routines. When care is siloed, treatment goals may be addressed in isolation rather than in the context of the child’s overall functional development.

An integrated therapy model offers a more clinically aligned approach. By coordinating services such as Applied Behavior Analysis (ABA), Occupational Therapy (OT), Speech-Language Pathology (SLP), and Physical Therapy (PT) under one interdisciplinary framework, integrated care supports shared functional outcomes rather than disconnected discipline-specific objectives.

The Clinical Problem With Fragmented Pediatric Therapy

Children with autism spectrum disorder, global developmental delays, neurological diagnoses, genetic syndromes, feeding disorders, and sensory-behavioral challenges often require support in multiple developmental domains at the same time. Traditional referral patterns, however, can delay this process. Families may be referred sequentially, moving from one specialty to another over the course of weeks or months. In the meantime, opportunities for early, coordinated intervention may be missed.

This fragmented model can contribute to delayed progress, duplication of effort, inconsistent treatment strategies, and increased caregiver burden. Parents may be left trying to reconcile different home programs, communication methods, and therapeutic priorities across providers. Physicians, in turn, may receive updates from multiple sources without a single cohesive picture of the child’s functional status or trajectory.

What Is an Integrated Therapy Model?

An integrated therapy model brings multiple pediatric disciplines together within a coordinated plan of care. Rather than treating communication, mobility, sensory regulation, and behavior as separate issues to be addressed in parallel but independent tracks, the interdisciplinary team collaborates around shared goals tied to everyday function.

These goals may include functional communication, feeding independence, improved transitions, school readiness, social participation, gross motor mobility, or greater independence with activities of daily living. The emphasis is not simply on increasing therapy volume, but on aligning interventions so that each discipline reinforces the others.

For the referring physician, this model can improve both clinical clarity and continuity of care. Instead of scattered recommendations, the result is a more streamlined treatment course centered on measurable, meaningful progress.

Why Integrated Care Can Produce Faster Functional Gains

One of the primary advantages of integrated pediatric therapy is simultaneous skill development. A child is not required to “complete” one form of therapy before another begins. Instead, deficits across domains can be addressed concurrently, which is often more reflective of how development actually occurs.

For example, a child working on expressive language in speech therapy may also need occupational therapy support for sensory modulation and motor planning, while ABA helps reinforce communication attempts across routines and environments. In a coordinated model, those interventions are not separate—they are mutually reinforcing. This kind of overlap can accelerate the acquisition and generalization of functional skills.

Integrated care also improves goal setting. When therapists across disciplines are aligned around outcomes such as feeding, social participation, transitions, mobility, or independence, treatment tends to be more efficient. This reduces contradictory strategies, minimizes duplication, and makes progress easier for both families and physicians to follow.

Another important factor is treatment intensity without fragmentation. Children with complex needs often benefit from more frequent intervention, but high therapy intensity can become burdensome when services are spread across unrelated systems, schedules, and locations. Integrated models can increase intensity while preserving continuity, making it easier for children to receive comprehensive care without overwhelming families.

Reinforcement Across Disciplines Improves Generalization

Generalization remains one of the most important markers of meaningful pediatric progress. A skill demonstrated in a single therapy session has limited value if it does not transfer into the home, school, or community environment. Integrated care helps close this gap.

When one provider introduces a communication strategy, self-regulation support, mobility goal, or feeding intervention, the rest of the team can reinforce that same skill during their own sessions. A child who practices requesting in speech therapy may use the same communication system during ABA and OT. A sensory regulation strategy introduced in occupational therapy may support participation during speech sessions or improve tolerance for physical therapy tasks.

This consistency can speed carryover and reduce the risk that gains remain context-dependent. For physicians monitoring developmental progress, that translates into more functional outcomes rather than isolated clinical wins.

The Importance of Early Multidisciplinary Access

Early intervention is well established as a major factor in pediatric outcomes, but access delays across disciplines remain common. A child may begin one service while waiting for another referral, evaluation, or authorization, even when needs in multiple domains are already evident.

Integrated models reduce that lag by allowing children to access multiple specialists earlier in the care process. This is especially important for patients whose communication, sensory, behavioral, and motor needs are intertwined. Earlier multidisciplinary involvement can support developmental momentum, reduce avoidable decline in function, and improve long-term participation outcomes.

For physicians, this means that an integrated referral may be appropriate not only when a child is already receiving multiple therapies, but also when the clinical presentation strongly suggests interconnected needs from the outset.

Which Patients May Benefit Most From an Integrated Referral?

Integrated therapy is particularly valuable for pediatric patients whose presentation crosses traditional discipline boundaries. This often includes children with autism spectrum disorder, global developmental delay, speech and language delays with behavioral or sensory components, neurological conditions, genetic disorders, feeding difficulties, and motor impairments that affect participation in daily routines.

It may also be the right model for children whose progress has plateaued in a single-discipline setting, especially when underlying barriers appear to involve multiple systems. In these cases, coordinated treatment can help identify whether communication, regulation, sensory processing, strength, endurance, or adaptive functioning is limiting advancement.

What Referring Physicians Can Expect

From the physician’s perspective, integrated care can simplify the referral and follow-up process. Instead of navigating feedback from multiple unconnected providers, physicians can expect more coordinated communication, a unified plan of care, and reporting that reflects cross-disciplinary collaboration.

Families also benefit from reduced navigation burden. When care is organized around the child rather than around separate service lines, it becomes easier for caregivers to understand treatment priorities and implement strategies consistently. This can improve adherence, engagement, and follow-through outside the clinic.

Most importantly, integrated care better reflects how children function in the real world. Development does not occur in isolated domains, and pediatric therapy is often most effective when treatment recognizes that reality.

A More Functional Model for Pediatric Referral

For pediatric patients with complex developmental, behavioral, sensory, and physical needs, integrated therapy models offer a more coordinated and clinically meaningful path forward. By aligning ABA, OT, SLP, and PT around shared functional outcomes, interdisciplinary care can reduce fragmentation, support faster skill acquisition, and improve generalization into daily life.

When multiple developmental domains are affected, a multidisciplinary referral is not simply convenient—it may be the most appropriate model of care.

To refer a patient, visit https://www.metroehs.com/referrals

October 12, 2021

Post Frenectomy Care

What is a Frenectomy?

A frenectomy is a minor surgical procedure involving the removal or modification of a frenulum, a small fold of tissue that prevents an organ in the body from moving too far.

Frenectomy Care

Follow Post-Op Instructions:

  • Adhere strictly to the post-operative care instructions provided by your healthcare provider.

Pain Management:

  • Use recommended pain relief medications as directed.
  • Apply cold compresses to reduce swelling and discomfort.

Oral Hygiene:

  • Keep the area clean to avoid infections. Gently rinse the mouth with a saline solution as advised.
  • Avoid using mouthwash with alcohol as it can irritate the surgery site.

Dietary Adjustments:

  • Stick to soft foods and avoid hot, spicy, or acidic foods that may cause irritation.
  • Ensure adequate fluid intake to stay hydrated.

Stretching Exercises:

  • Perform any stretching exercises as recommended by the surgeon to ensure proper healing and flexibility.

Monitor Healing:

  • Keep an eye on the surgical site for signs of infection such as increased redness, swelling, or discharge.
  • Contact your healthcare provider if you notice any unusual symptoms.

Follow-Up Appointments:

  • Attend all scheduled follow-up appointments to monitor the healing process and address any concerns.