Monarch Center for Autism

Monarch Center for Autism at Bellefaire JCB provides a comprehensive living and learning environment for children and adolescents with Autism Spectrum Disorder (ASD) and other co-occurring diagnoses. Located on a beautiful 32-acre campus, Monarch offers residential treatment programs, a residential education school, and a day school, grounded in our visual language immersion treatment model, and supported by a highly credentialed interdisciplinary team of professionals. We empower individuals by employing personalized and consistent visual and regulation supports, technology, and elements of Applied Behavior Analysis (ABA). These help to develop communication, alleviate frustration, reduce maladaptive behaviors, build confidence, increase independence, and enrich quality of life.

The leadership team at Monarch is driven by a shared commitment to helping individuals with autism reach their fullest potential. With expertise spanning education, clinical services, and program innovation, our leaders work collaboratively to provide exceptional, evidence-based support that meets the unique needs of each individual and family.

Monarch Center for Autism Leadership Team
  • Medical Director: Emily Cao, MD
  • Director of Residential Autism Services: Eric Feitl, MA, BCBA, COBA
  • Monarch School Director: Jennifer O’Keefe, LPCC-S
  • Monarch School Assistant Director: Monica Fisher, M.Ed., BCBA, COBA
Monarch Residential Autism Services
Monarch Day School

The Monarch Model

Guided by decades of evidence-based research and a commitment to addressing the complex needs of individuals with autism, Bellefaire JCB partnered with Harvard Medical School and Boston Children’s Hospital to develop an innovative model of care unlike any other in the region. The result was the creation of the Monarch Model and the opening of Monarch Day School in 2000. Building on its success, Bellefaire JCB expanded the continuum of care with Monarch Boarding Academy (QRTP) in 2004, Monarch Residential Education School in 2023, and the Monarch Psychiatric Residential Treatment Facility (PRTF) in 2024. Today, Monarch’s comprehensive approach, grounded in individualized programming, structured and supportive environments, interdisciplinary collaboration, and active family engagement, sets it apart as a leader in autism services across the lifespan, improving the quality of life for individuals with autism and their families for decades.

Monarch’s visual language immersion treatment Model combines concept-driven language instruction, visual and regulation supports, technology, and Applied Behavior Analysis (ABA). Developed through an ongoing partnership with Dr. Howard Shane at Boston Children’s Hospital and Harvard Medical School, it leverages the strong visual processing abilities of individuals with autism, and supports communication, comprehension, language development, social skills, behavior and sensory intervention, and academic achievement. The Model is concept-driven to ensure learning is generalized to multiple contexts including school, home and the community. It is predicated on the systematic and individualized introduction of language concepts accompanied by visual supports, to help individuals with autism develop modes of communication. These modes – spoken, visual and/or written – assist in alleviating frustration, reducing maladaptive behavior, building confidence, and enriching the individual’s quality of life.

The Monarch Model has eight critical elements that are incorporated into daily life at Monarch Center for Autism. Applied Behavior Analysis (ABA) principles and strategies are embedded in each of the elements, thereby maximizing their effectiveness:

The Monarch Model emphasizes the use of assessments to guide instruction. Each student’s visual language, communication, academic, sensory, behavior, and other developmental domains are assessed by a team of Monarch professionals including Speech-Language Pathologists, Occupational Therapists, Intervention Specialists, Board-Certified Behavior Analysts (BCBA), and Psychiatrists. To ensure IEP and SP goals and objectives are appropriate and socially significant, it is critical to assess a student’s current level of functioning in all areas.

The Monarch Model maximizes the learning opportunity that visuals can provide by applying visual supports within a structured language system rather than using them as isolated icons. Each individual’s level of visual representation is assessed, so customized visual supports (e.g., photographs, line drawings, clipart, written words) can be created that are meaningful and effective, around three primary constructs:

  • Visual Instruction (adapting instruction so it is presented visually)
  • Visual Expression (using visuals to facilitate expressive communication)
  • Visual Organization (using visuals to organize activities and daily schedules)

Educational software, video modeling, mobile devices, and web-based tools, including VizZle™, are used liberally to support each student's Individualized Education Program (IEP)/Service Plan (SP). In addition, many individuals at Monarch use Speech Generating Devices, as well as Apple iPads, computers and SmartBoards, which facilitate interactive instruction and expressive and receptive communication. Technology is an integral and essential way to reinforce concepts by taking advantage of the attraction it holds for individuals on the autism spectrum. Technology-based instruction has been proven to promote motivation, attention, reinforcement, instruction, expression, and organization among individuals with autism.

The Monarch Model embraces a natural language curriculum that serves as an extension and elaboration of state curricular standards. We recognize that the individual’s available language system, including vocabulary and concepts, can dictate the extent to which they can successfully participate in learning. By maximizing access to language and providing continuous "teachable moments" in a natural environment, the potential for richer and more meaningful expression and understanding is made possible. Students are taught seven communicative functions, which include:

  1. Protesting and Refusal
  2. Organization and Transitions
  3. Requests
  4. Directives
  5. Comments
  6. Questions
  7. Social Pragmatics
  • Applied Behavior Analysis (ABA) principles and strategies are embedded throughout Monarch’s Visual Language Immersion Treatment Model, thereby maximizing its effectiveness.
  • School-wide Positive Behavioral Interventions and Supports (PBIS) is a prevention model. It is based on the premise that all students can benefit from well implemented, evidence-based practices for improving student behavior. School-wide PBIS provides informed decision making based upon an analysis of data that guides the process of assessing students’ needs and providing additional levels of behavioral support to those who benefit from it. In accordance with the Ohio Department of Education’s Policy on Positive Behavioral Intervention and Support, PBIS utilized at Monarch School encompasses a wide range of positive strategies to reinforce desired behaviors, decrease the recurrence of challenging behaviors, and teach appropriate alternative behaviors to students.
  • The goal of PBIS is to provide support at different levels of intensity based on what the student needs at the school wide (Tier 1), targeted (Tier 2), and individual (Tier 3) level of support. The PBIS prevention-oriented framework applies to all students, all staff, and all settings. School staff complete annual training to identify conditions such as where, under what conditions, with whom, and why specific inappropriate behavior may occur. School staff also complete annual training on the supports that correspond with each tier of the PBIS model. 

Monarch School recognizes that to ensure students are ready to learn, we must provide them with appropriate, personalized, and proactive supports to promote a state of regulation (e.g., an individual’s ability to manage his or her internal emotional and physical state to stay calm and engaged). All components work together to facilitate student engagement and participation in their daily routines, including academic, self-help, social, and vocational expectations.

  • Sensory input is a foundational component of how we interact with the world and our bodies; students may demonstrate unique patterns in which they require more or less of different types of sensory input to understand, process, and respond, as well as promote a state of regulation. All sensory systems (i.e., auditory/sound, tactile/touch, visual/sight, olfactory/smell, gustatory/taste, proprioceptive/body awareness, vestibular/balance & coordination, and interoceptive/internal sensations) are considered and addressed proactively on an individualized basis.
  • Co-Regulation is a key aspect of regulation (including future self-regulation) that dictates how adults model and provide support to students during both times of calm and times of distress. Specifically, it is the attuned and responsive interactions between a child and adult that allows them to reach a state of regulation together. This requires building meaningful, trusting relationships with students that positively influence the growth, development, and integration of their brains.
  • Teaching and modeling effective and individualized coping strategies during times of calm are integral to supporting a student’s ability to access and engage in co-/self-regulation when needed. This includes targeted instruction in mindfulness and “noticing in” to further develop students' awareness of their body signals and what those signals mean to promote independence with knowing when/what coping strategy is needed for a given situation.
  • The final key component to promoting regulation is the use of a Strengths-Based practice approach, which encompasses integrating student interests into lessons, fostering their sense of self-worth and successes by providing the “just-right” challenge, facilitating autonomy, competence, and relatedness in student/adult interactions, and ensuring foundational needs are met (e.g., physiological - food/water/warmth/rest; safety - security/safety) prior to placing external demands. This concept asks adults to strike a balance between expecting students to learn new skills (to regulate) and asking the change to come from elsewhere (e.g., adult, environment, routine, etc.).

As individuals on the autism spectrum become more competent in their understanding and use of language, they are better able to manage the demands of a comprehensive educational curriculum. To support this, the Monarch Model selected key language concepts in the content area curriculum and made them a critical, foundational component of instruction. As a result, math, social studies, science, language arts, and reading instruction are more comprehensible and manageable, which enables students to more effectively meet their learning potential.

Individual and program progress are continually assessed and reported with a unique data collection system. The data is analyzed and used to adapt teaching strategies, individualized treatment plans, and crisis management plans, and to generate narrative reports and statistics that reflect the individual’s progress on IEP and SP goals and objectives. This progress is shared with families through case management updates, quarterly progress reports, and annual IEP meetings.