Intervention, Education & Treatment
There is a huge array of intervention methods being used for people with autism and Asperger syndrome. In order to make informed decisions about which intervention is appropriate for a child on the autism spectrum, parents and other professionals need to read unbiased information about the various interventions and evaluate the evidence for/against each one. To read more, click here.
Read more about education of people with autism and Asperger syndrome below.
Evidence Based Practice – Education Children with Autism Spectrum Disorders
Autism spectrum disorders (ASD) are present from very early on and affect essential skills or behaviors such as social interaction, communication, play skills, the ability to develop relationships, cognitive skills, and daily living skills. Individuals with ASD generally have lifelong deficits in social communication and language development, have significant delays in independent daily life skills, and often lack skills in self management and executive function. Even though there are similar characteristics across individuals with ASD, there is no single behavior that is always typical of ASD.
There are obviously so many questions when a family first begins the journey in educating their child with ASD. What is possible? And… What is important? The National Research Council (NRC) pinpoints specific goals for educational services for children with ASD. Mainly, the answer to those very broad questions are simple, the appropriate goals for educational services for child with ASD are the same as those for other children: personal independence and social responsibility. These long term objectives imply careful progress in smaller learning domains or subject areas such as, social and cognitive abilities, verbal and nonverbal communication, adaptive skills, play skills, leisure skills, generalization of skills making learning meaningful and reducing challenging and socially inappropriate behaviors. The NRC points out that ongoing measurement of treatment objectives and progress needs to be documented frequently and across a range of skill areas in order to determine whether a student is benefiting from a particular intervention or treatment approach. The objectives need to be observable, measureable, and obtainable, meaningful progress should be documented within a year’s time. Intervention should be adjusted accordingly to progress or lack of progress, intervention approaches for individual students can and should change over time.
The NRC recommends early, intensive intervention for children with autism consisting of 25 hours of structured learning for each child. The difficulty for parents and professionals is choosing how to fill these hours of intervention for their child. Today, many efforts are taking place to help educate and evaluate treatment programs, but these efforts still lack the funding and the awareness to make them accessible to families and schools. There is certainly no shortage of interventions for ASD. However, not all treatment options have evidence to support them, and it is important for parents and professionals to look at the research behind various treatment options before choosing a program for their child.
The most important thing to keep in mind when choosing an appropriate intervention strategy for a child is to understand that each child with autism is an individual and has unique needs. This means, that regardless of what anyone may have told you in the past, one size does not fit all, and that there is no one treatment approach that works for every single child with autism. Many practitioners and clinicians will pull from several treatment approaches to create an individualized intervention program that fits the child’s skills, unique needs, and families’ priorities. These treatment objectives should fit nicely into the lifestyle of the families and should also be collaborative in nature and be a part of home, school, and community settings. Studies comparing different treatment approaches are rare and so there is little evidence to suggest that one approach is better than any other. The best advice for parents is to choose based on careful research of the different options out there and then carefully monitor the child’s progress. Also, continue to educate yourself about different interventions so that you will feel that you always have choices when your program is no longer working for your child.
Below we have included some brief descriptions of behavioral and developmental approaches that may be appropriate for families and their students. Please note that although ASW is offering this information, it does not mean that these approaches are better than any other approaches. What is listed below includes approaches that have been well documented over the years in peer reviewed journals. Please continue to investigate these approaches and learn more before making decisions for your student.
This approach focuses on increasing and decreasing skills using the science of Applied Behavior Analysis (ABA). There are MANY treatment approaches under the ABA umbrella, and the interventions tend to be very research based and data driven. Some of these approaches are not strictly behavioral and incorporate aspects of other philosophical approaches (e.g. TeachTown, PECS, TEACCH).
1) Discrete Trial Training (DTT): In this approach, children are taught skills using a stimulus-response-consequence pattern in a massed trial format. This is one of the more structured teaching approaches and is often helpful for introducing new skills or working on skills which require memorization or rote learning.
2) Verbal Behavior: This approach, first introduced by B.F. Skinner, uses operant conditioning to teach language. This approach requires understanding the vocabulary used such as mands, tacts, intraverbals, etc. These operants are all taught systematically in a discrete trial type of teaching. This is also a fairly structured approach to teaching.
3) Fluency/Precision Teaching: This approach focuses on increasing the frequency of behaviors and the rate at which they occur. This approach requires a good deal of training to be able to implement the program and use the charting that is required.
4) Pivotal Response Training: This ABA approach is a less structured, naturalistic approach to teaching. It focuses on pivotal behaviors such as motivation and multiple cues to teach a variety of skills.
5) Incidental Teaching: This is a very natural teaching paradigm where the teacher sets up the environment in a manner that increases learning opportunities in a natural way. Graduated prompting procedures are used to increase and improve responses and initiations.
6) Picture Exchange Communication System (PECS): This is an augmentative communication training approach which teaches the child to exchange pictures to communicate with others. This approach requires a fair amount of training and requires 2 adults per child at least in the initial stages of training.
7) TEACCH: This approach focuses on working with the child’s strengths to introduce new skills. The main goal is to increase the child’s independence and visual supports are often used to accomplish this. This approach is popular in schools and is often also used in home settings to increase independence with leisure skills, chores, and homework.
8) TeachTown: Basics: This child-centered program pulls from years of research in ABA, developmental psychology, special education, and speech pathology. It includes hands on learning lessons offered via a Computer Based Instruction curriculum that incorporates the basic principles of ABA. Automatically linked to each CBI lesson are Natural Environment Teaching activities utilizing the critical elements of PRT and incidental teaching to enhance generalization of learned skills in CBI as well as provide more instruction in the natural environment focusing on expressive language, play, and social communication. For more information, click here
1) Milieu Teaching: This approach is based on over 10 years of research and is cited as an intervention approach in many scientific publications. This technique also works on relationship building by teaching overall communication (e.g. joint attention, gestures, facial expressions, body language) rather than just language. The approach uses child motivation and focuses on the child’s interest (similar to PRT) but the focus is more on increasing the child’s social motivation.
2) Social Communication Emotion Regulation Transactional Support (SCERTS): This is a multi-disciplinary model of intervention that is grounded in the science of child development and learning. There are systematic tracking and progress reports recommended in this approach to capture the important program evaluation. The SCERTS model provides a comprehensive curriculum that focuses on social communication, emotional regulation, and transactional supports (i.e. adults maximizing learning environments and providing positive support for the child)(e.g. providing visual supports to ease anxiety and increase learning). For more on SCERTS and their training programs, check out their site.
It is well known that in recent years there has been a dramatic increase in the diagnosis of Autism Spectrum Disorders. With that increase in diagnosis, has come an increase in unproven treatment options for families who have children diagnosed with ASD. This increase both in the diagnosis of ASD and in the treatment options for children with ASD, has created a pressing need for researched and proven treatment approaches. Although ASW does not promote any one of these treatment options above more than another, these are at least some options that have published bodies of research supporting their effectiveness. Remember to educate yourself, research your options, document progress of the interventions you choose, and continue to educate yourself as your student grows and changes. As your student grows and changes, so should his/her educational planning and intervention model.