Infant Toddler Development Training
Module 6, Lesson 5
Specific Intervention Strategies for Autism
There is no single "best treatment" for every child with autism. One point, on which most professionals agree, is the importance of early intervention. Another is that most individuals with autism respond well to highly structured, specialized programs.
The following are examples of a few intervention strategies proven to be effective for children with autism.
Positive Behavior Support
Positive Behavior Support (PBS) is a process for understanding and resolving the problem behavior of children that is based on values and empirical research. It offers an approach for developing an understanding of why the child engages in problem behavior and strategies for preventing the occurrence of problem behavior while teaching the child new skills. Positive behavior support offers a holistic approach that considers all factors that impact on a child and the child's behavior. It can be used to address problem behaviors that range from aggression, tantrums, and property destruction to social withdrawal. PBS contains the following components:
- Behavior Hypothesis Statements - Statements that include a description of the behavior; triggers or antecedents for the behavior, maintaining consequences, and purpose of the problem behavior.
- Prevention Strategies - Strategies that may be used to reduce the likelihood the child will have problem behavior. These may include environmental arrangements, personal support, and changes in activity; new ways to prompt a child, changes in expectations, etc
- Replacement Skills - Skills that will replace the problem behavior.
- Consequence Strategies - Guidelines for how adults will respond to problem behaviors in ways that will not maintain the behavior. In addition, this part of the plan may include positive reinforcement strategies for promoting the child's use of new skills or appropriate behavior
- Long Term Strategies - Includes strategies that will assist the child and family in meeting their long-term goals.
Applied Behavior Analysis
Applied behavior analysis (ABA) has become widely accepted as an effective treatment strategy for children with autism. Many years of research demonstrate the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior. The goal of behavioral management is to reinforce desirable behaviors and reduce undesirable ones. An effective treatment program will build on the child's strengths and interests. It will offer a predictable schedule, teach tasks as a series of simple steps, actively engage the child's attention in highly structured activities, and provide regular reinforcement of behavior.
Parental involvement has emerged as a major factor in treatment success. Parents work with teachers and therapists to identify the behaviors to be changed and the skills to be taught. Recognizing that parents are the child's earliest teachers, more programs are beginning to offer training to parents so they may continue the therapy at home.
Effective programs will teach early communication and social interaction skills. In children younger than 3 years, appropriate interventions usually take place in the home or a child care center. These interventions target specific deficits in learning, language, imitation, attention, motivation, compliance, and initiative of interaction.
Visual Supports and Environmental Strategies
Visual tools and supports help create an environment that is predictable and understandable to the child with autism. This will make communication, social, and behavioral difficulties less likely to occur. The purpose of using these aids is to enhance the child's understanding of what is happening and what is expected. Although the primary purpose of these tools is to support communication, they are also used to give information, provide structure, etc.
Children with autism tend to be visual learners living in a very auditory world. Visual supports focus on the strength of the child. Thus children with autism often learn more if the ITDS and caregivers use visual rather than auditory teaching strategies. These techniques work for verbal, as well as non-verbal, children. Implementing a system of visual tools and supports significantly reduces various behavior problems and increases effective communication and interactions. Some examples of visual supports and environmental strategies include daily activity schedules, task analysis visual aids, checklists, mini-schedules, choice boards, and 'First-Then' choice boards.
Integrated Play Groups
Integrated play groups, first developed by Pamela Wolfberg (1987, 2004), are an effective means for teaching appropriate social interactions and play skills with peers. During the process of functional play groups, the adult mirrors the child's play and directly teaches play imitations with the toys. The situations are highly structured to assure attending and practice, using carefully planned themes and materials. Other strategies within the realm of functional play might include Pivotal Response Training (PRT) and Incidental Teaching.
Social Skill Strategies
Strategies for teaching and enhancing social skills have been found to be effective for some children. One of the best strategies to teach social skills is through the use of Social Stories, which were developed by Carol Gray (1996, 2004). These scenarios describe social situations along with their relevant social cues. Social Stories provide information on what is occurring and why. They explain the perspective and experiences or behavior of others. Power Cards, developed by Elisa Gagnon (2001), are another social skill strategy. These consist of small, visual aids that use the child's special or unique interest to motivate and teach appropriate social interactions. A final strategy is the use of visual scripts. These clarify choices in social situations, provide an actual 'script' of upcoming events or conversations and reduce the child's anxiety by assisting with conversation starters.
Autism can be complex, severe and frightening. But, it is not hopeless. With the help of good intervention and services, many individuals with autism can make excellent progress and achieve integration within their community.
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