Pervasive commitment to service makes unique campus clinic work
Helps children with severely aberrant behavior
Story By Peter Tormey
Special education Professor Mark Derby swears he will never leave Gonzaga, not after the way the University rallied to support the program he started to help children with severe behavioral challenges.
The 1997 reauthorization of the federal Individuals with Disabilities Act mandated that functional behavioral analysis assessments and treatment methods be conducted in schools. This created a shortage of professionals trained to conduct the procedures, so Derby and Special Education Program colleagues created two interdependent programs to meet the demand and to determine if such a clinical setting could work at GU.
In 1999, Derby and colleagues established a behavioral clinic at the Rosauer Center for the School of Education to provide services to children with severely aberrant behavior. The clinic also provides invaluable experience for students in the special education master's program.
The Gonzaga Center for Applied Behavior Analysis, co-directed by Derby, Assistant Professor Anjali Barretto and Associate Professor Kim Weber, is the only program of its kind nationally, operating without a hospital or a large research university, that provides this level of training for students. The center also offers a previously unavailable service to area residents.
Derby and his former GU special education colleague Stephanie Peck had developed a functional analysis track within the master's program that required four classes, all of which have a clinical component.
"So, the Gonzaga students had to see kids in a clinical setting but there was no clinic in Spokane or anywhere in the Pacific Northwest that offered those services," Derby said. "So, what Stephanie and I did was see kids here and there, but with the development of that track we had to develop this clinic."
Soon after the clinic was developed, however, Peck left GU so Derby and colleagues continued to run the clinic independently until it became obvious that they needed Gonzaga's support and protection to continue.
Derby feared Gonzaga might shut down the clinic because of the liability it posed. He certainly did not expect the reaction he received.
"Gonzaga said, 'What can we do to make this better and safer because we support what you are doing?' " Derby recalls. "They said, 'Wow, we're doing that? That's really great for kids; how do we make it better?' They proved their mission of service beyond a shadow of a doubt with this population." In addition, the University supported the hiring of Barretto, which has enabled the clinic to expand services.
GU marketing Assistant Professor Scott Bozman and Corporation Counsel Mike Casey helped Derby and colleagues develop a plan for the clinic and a legal structure to protect it and Gonzaga so the clinic could continue providing services to residents and custom education to students.
"What we did, with the guidance of a third-year GU School of Law student, was draw up our articles of incorporation and became a nonprofit organization. We did that three years ago," said Derby, adding that other universities have tried to replicate their success.
The nonprofit status of the clinic allowed it to get its own malpractice insurance and got the University off the hook for any potential liability arising from its unique work.
"After all, Gonzaga is not in the medical business but this is an important community service and an important part of the special education curriculum," Derby said.
For many of the children with severely aberrant behavior, the clinic is a last resort after schools and other entities have exhausted all resources to help them. The challenges the children face who see Derby and his colleagues and students include both excessive behavior, such as obsessive-compulsive disorder, and lack of behavior, such as failure to use language or speech. Other difficulties facing the children include failure to thrive, developmental syndromes such as autism and down syndrome, slapping, punching and biting, and normally intelligent children with habit disorders, such as an obsessive hair-pulling disorder called trichotillomania.
All of the children the clinic sees are under age 10; small enough to ensure the safety of the therapists and the children. The child's parent or adult guardian is present in each clinical session and is the ultimate authority in every step of the treatment.
The clinic now evaluates approximately 15 children each year and therapists are willing to follow up if necessary.
"We try to bring their behavior down to a certain level, and we do parent training. After that, it has to be on an as-they-call basis," Derby said, estimating that the clinic has a success rate of approximately 50 percent.
Because of Gonzaga's support, therapists can provide a service unavailable anywhere else in the Northwest for only $35 per visit.
"The people of the Inland Northwest are so lucky to have this clinic," Derby said, "and we are able to provide a service to the community that they would not otherwise be able to get while providing outstanding training for our students as well."
The students have demonstrated the academic benefit of working in the clinic; 43 have delivered national presentations since 1999 and many have published their work in peer-reviewed academic journals. Also, students leave GU qualified to take a national exam to become Board Certified Behavior Analysts, a new national designation.
"It is most gratifying helping the children, but it is even more gratifying to watch our students get the opportunity for this kind of clinical experience for special education with a clinical bent," said Derby, who came to GU in 1996.
Even with the full support of the University administration, the program could not have worked here except for the pervasive, campus-wide commitment to service, Derby said.
"I can't think of one time that I have not had a student step forward and say, 'I am willing to put in the extra effort,' " Derby said. "What propels this clinic is the fact that we have an incredibly strong commitment to service from our students and our administration."