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Tracking Rehabilitative Advancement through Accountable Care (TRAAC)

Our Mission 
Nicklaus Children's Hospital provides hope through advanced care for our children and families. We serve in order to achieve every child’s highest functional level and quality of life. Thank you for choosing Nicklaus Children's Hospital, formerly Miami Children's Hospital.

Your Guide to Rehabilitation Services

Most Nicklaus Children's locations offer a rehabilitation team that includes clinical specialists, such as Audiologists, Applied Behavior Analysts (ABA), Occupational Therapists (OT), Physical Therapists (PT), and Speech-Language Pathologists (SLP) who use Evidence-Based Practices in order to achieve every child’s therapy needs.

Scheduling Appointments

Each child is seen for an initial evaluation by one of our therapists. The therapist writes an evaluation report and a plan of care based on your child’s individual needs, diagnosis, and age. After all insurance authorizations are obtained, the Nicklaus Children's Hospital scheduling department will contact the parents to coordinate all the therapy appointments.

Duration, Type and Frequency of Treatment

Our therapists use a service delivery model known as TRAAC (Tracking Rehabilitative Advancement through Accountable Care), to create an individual plan of care that meets your child’s unique needs. At different times during the child’s treatment period, the TRAAC model may change. All members of the team (child’s parents, caregivers, teachers, and therapists) work together to identify the therapy goals, focus of treatment, and the best TRAAC for each child.

TRAAC 1: Intensive (3 or more weekly sessions)
For children who:
  • had surgery recently or have complex medical needs.
  • make fast progress towards short and long term functional goals.
  • may lose functional skills due to present medical condition.
  • need frequent changes to their plan of care.
  • need an intensive family education/training program.
  • with their parents’ help, follow the given home program.

TRAAC 2: Weekly (1 or 2 weekly sessions)

For children who:
  • were recently diagnosed with a condition or disorder.
  • are making steady progress towards short- and long-term functional goals.
  • need occasional changes to their plan of care.
  • need education/training and whose families follow the given home program.

TRAAC 3: Periodic (1 or 2 monthly sessions)

For children who:
  • are making slow or limited progress towards goals.
  • are achieving functional goals.
  • need education/training with frequent updates, and whose families follow the given home program.

TRAAC 4: Consultative

Frequency scheduled as needed (1 session every 2-6 months) with re-evaluations as recommended. For children who:
  • are slowly gaining functional skills.
  • require family education/training with infrequent updates, and family follows the given home program.
  • are receiving community services and require occasional consultation with a therapist to ensure continued progress in the therapy goals or to address concerns.
  • have specific new challenges identified by the child or family.
  • have a new need for or will require updating of specific adaptive equipment (e.g., wheelchairs, standers, gait trainers).

  • Completed every 6 months.
  • Information gathered during evaluation/re-evaluation is used to create a plan of care according to the TRAAC model, and to make treatment decisions, recommendations, and plans for discharge.

Skilled Therapy on Hold Criteria:

Treatment may be placed on hold due to:
  • medical reasons.
  • family choosing to stop receiving therapy due to inability to pay for services, after being offered available hospital financial assistance programs and after being referred to community resources.
  • after referral to another discipline, before starting or continuing skilled OT/PT/SLP/ABA.

Discharge Criteria:
Therapy services will end when:
  • the therapy needs and goals of the child have been met.
  • the condition, injury or disorder is resolved.
  • the child can use compensatory strategies by himself.
  • Evidence-Based Practices no longer result in measurable progress.
  • child’s functional skills are decreasing and cannot be improved by skilled therapy.
  • parents do not participate in therapy.
  • parents are unable to follow the Attendance Contract.
  • family chooses to stop therapy or moves away.
  • child is referred to another provider or community resource.
  • family chooses to stop therapy due to inability to pay for services.

Trial Therapy
Therapy may be given on a trial basis for a short period of time when:
  • a new program/treatment approach is started (e.g., Augmentative and Alternative Communication (AAC), Feeding and Swallowing Therapy).
  • child is not meeting measurable goals or improving test results in a period of 12 weeks.
  • child has a long history of therapy services as reported by parent or medical records.
  • prognosis or rehabilitation potential is fair or guarded.
  • child is preparing to transition to therapy services in academic or natural environment, and/or alternative therapies.
  • child is preparing to transition to community based or extracurricular activities.
  • a home program is being used to maintain general skills within natural environment.

To schedule a rehabilitation services appointment at a Nicklaus Children's Hospital, formerly Miami Children's Hospital, location near you, please call 305-663-8413 or toll-free 877-624-8413.

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