Autism Interventions

There is a range of interventions available for autism today. Many of them have been effective for all children with autism while some have insufficient empirical evidence about their long term benefits. Such interventions have shown good results in a few children but lack research based support as effective intervention for majority of children with autism. The intervention approaches and methods described here have been found suitable for autism by a large number of researchers and practitioners globally.

Developmental

Here the development of a child with autism is compared with the developmental norms of non-disabled children. Early childhood assessment tools are used to determine the patterns of typical development. The skills that the child demonstrates are indicative of his or her developmental level.

The intervention goals are set for the skills the child failed or partially accomplished during assessment. A developmental approach to intervention is also referred to as child centered approach in which the adult follows the child’s lead. SOPAN professionals use Floor time, an intervention model based on the developmental approach

Floor time: Floor time is a model of early intervention (EI). It enables professionals and parents to assess and implement intervention programs that address the unique developmental needs of children with autism. The major element of this intervention entails that (a) professionals do floor time with the child (b) parents observe floor time being done with their child, and (c) parents change their style of relating to the child with regard to a given milestone. Floor time a child-centered method of EI. SOPAN teachers use floor time as a systematic way to help a child climb up the developmental ladder. Floor time is provided in one to one sessions to children in the EI group. Based on the Developmental, Individual, Relationship-based (DIR) Modelgiven by Greenspan in 1989. Floor time can be used in conjunction with other behavioral therapies.

Behavioural

Behavioral approach is based on the principles of applied behavior analysis (ABA).The effectiveness of ABA as an intervention method for autism has been documented globally. Use of ABA involves systematic observation of a child’s behavior patterns so that desired behaviors can be rewarded and undesirable behaviors can be discouraged. ABA is also used to teach new skills in the social, motor, and language domains. As a child learns each skill step by step, he/she is rewarded. 

Training and Education of Autistic and Related Communication Handicapped Children (TEACH). Premised on behavioral approach TEACHis an unique program that respects the “culture of autism”. Structured teaching is the salient feature of TEACH. The program entails providing structured and predictable learning environment. TEACH is used across the levels of students at SOPAN. Use of demarcated work areas, work systems, visual schedules and visual structures help students understand what is expected of them and how to complete a given task.

Discrete Trial Training (DTT) DTT is a one-to-one instructional method based on the ABA approach. It promotes the development of social and play skills, language and communication, adaptive behavior, cognitive and academic skills. At SOPAN it is typically used with younger children i.e. those in the EI group and below 10 years of age. Individual skills are broken down into small discrete tasks and students learning is guided through prompting and reinforcement.

 Analysis of Verbal Behaviour (AVB) It is an effective method to address the language deficits in children on the autism spectrum. It comprises of teaching verbal behaviors such as “mand’, “tact” and ‘intraverbal”. AtSOPAN,the teachers and the Speech and Language Pathologist use AVB for development of language and communication skills. AVB can be used in conjunction with AAC systems..

Cognitive

Development of cognitive skills enhances the ability to comprehend social situations. Children with autism have deficits in social relationships and social communication. Whereas ABA techniques are useful for teaching language, concepts, functional self care, and acceptable behaviors, cognitive strategies are important for developing reciprocal behaviors, and the ability to respond to others in age-appropriate manner. Cognitive approach enables children with autism to develop skills for self regulation, self management and self determination which are critical in adulthood.

Social Stories: The objective of a Social Story is to teach socially acceptable behavioral options in a reassuring manner that is easily understood by a child with autism. A social story is an individualized short story that describes social relevant cues in any given situation. It breaks down a challenging social situation into understandable steps by omitting irrelevant information and by being highly descriptive to help an individual withASD understand the entirety of a situation. It includes answers to questions such as who,what, when, where, and why in social situations through the use of visuals and written textAt SOPAN, social stories are frequently used as a learning aid to describe a problem situation, skill, or concept in terms of relevant social cues, perspectives, and common responses in a specifically defined style and format.

Mind Reading: Theory of mind is the ability to guess what a person is thinking or feeling through his/her facial expression and body language. Thisability is impaired in a person with autism. At SOPAN, students are taught to understand emotions through the technique of mind reading. Various emotions are taught to the student by presenting pictures of situations which arouse different emotions in a person. Emotions are presented through schematic drawings. The student learns to identify the correct emotion with the situation presented to him. For e.g. a picture of a birthday party would evoke a feeling of happiness in a student, so the student picks up the schematic drawing of ‘happy’.

Visual

Visual Approaches include the use of body movements, environmental cues, pictures, objects and written language etc. to enhance language comprehension and expression. Children with autism perform better when content and instructions are presented in visual forms.

 Visual Activity Schedule: A Visual Activity Schedule(VAS) is a set of pictures that communicates a series of activities or the steps of a specific activity. Children with autism are visual learners. They tend to forget a sequence in an activity so a VAS has pictures set up in the sequence the activity is supposed to take place. VAS is widely used at SOPAN to develop independence in any activity. VAS also has several levels. If a student has developed the ability to perform several activities independently, he/she is then trained on a VAS which will help them do a series of activities in a sequence.

Visual Schedule: Visual schedule systems are used to provide children consistent visual cues about their daily activities. Children with autism require this structure so they are able to anticipate the next activity. This reduces anxiety and helps the student accept transitions easily. It also motivates the student to get through a difficult activity if it is known to them through a visual schedulethat a preferred activity follows. This can prove a good strategy in maintaining appropriate classroom behavior as the student is able to make transitions with the visual supports. At a later stage, students can also be trained to prepare their own schedule by choosing activities which they like.

Alternative & Augmentative Communication (AAC)

Alternative & Augmentative Communication (AAC) includes all forms of communication (in addition to speech) that are used to express thoughts, needs, wants and ideas. Facial expressions, gestures, symbol, pictures or written matter come under the broad umbrella of AAC. Makaton and PECS are widely used as AAC systems at SOPAN

Makaton- Originally a British multi-modal system of AAC Makaton has been adapted for use in India. Makaton uses hand signs, symbols and speech to encourage language development in children and adults with communication difficulties At SOPAN, Makaton signs and symbols are used to train students at varying stages of language development.

PECS- Picture Exchange Communication System (PECS) is designed to teach functional communication with an initial focus on spontaneity. It has been and continues to be implemented in a variety of settings (home, school, community) so users have the skills to communicate their wants and needs. PECS does not require complex or expensive materials since it uses picture symbols as the modality. PECS is a method to teach young children a way of communicating within a social context. Research has shown that many preschoolers using PECS also begin developing speech. PECS is used with young children to promote and facilitate speech at SOPAN