A range of behavioral and educational interventions is available for treatment of children with autism spectrum disorder. Most of the interventions are based on Applied Behavior Analysis which has been proven effective through various studies. The common denominator of Autism interventions is to assess the current level of functioning in all major areas (sensory, motor, cognitive, ADLs, academic etc.) and teach the age appropriate skills using the principles of ABA. Various Psychological interventions include Modified Applied Behaviour Analysis (ABA) (Develop core skills, Reinforcement/operant conditioning principles, ABA kit), Sensory Integration (SI) ( SI strategies and SI kit, Enhanced sensory inputs(tactile,auditory,vestibular and proprioceptive) in meaningful activities, Structured Teaching (Explicit information for tasks and routines, Home environment)
Principles of Autism Interventions
- Individualized- The intervention is adjusted according to the various child related factors (age, IQ, level of function, problem behavior etc.)
- Comprehensive- It should cover all the areas of development (motor, adaptive, language, cognitive) and take care of multiple contexts (home, school, community).
- Development- The skills should be taught according to the developmental level of the child and simple tasks should be taught before more complex tasks.
- Early and intensive- Intervention should start as early as possible (before 4 years). The time devoted should be at least 25 hours per week to make it intensive (continuously for 3years).
- Evidence based- intervention should be based on proven techniques based on applied behavior analysis.
Done by ABC charts, direct observation and questionnaires. The various ABA intervention techniques include:
- Discrete trial training (DTT) It is a form of ABA therapy which works on the principle of reinforcement (when a behavior is rewarded, it is likely to be repeated).
- Pivotal response training (PRT): Few areas are identified as Pivotal areas (e.g. motivation, ability to respond to multiple cues) which are focused during the sessions.
- Relative improvements are expected in other developmental areas.
TEACCH (Treatment and education of autistic and related communication handicapped children)
It is a special education program used in schools and has been adapted for home based teaching. The principles and concepts are:
- Respect the culture of autism
- Focus on structured teaching and visual learning
- Improved adaptation: through the two strategies of improving skills by means of education and of modifying the environment to accommodate deficits.
- Parent collaboration: parents work with professionals as co-therapists for their children so that techniques can be continued at home.
- Assessment for individualized treatment: unique educational program is designed for all individuals on the basis of regular assessments of abilities.
- Skill enhancement: assessment identifies emerging skills and work, then focuses upon these. (This approach is also applied to staff and parent training.)
- Cognitive and behavior therapy: educational procedures are guided by theories of cognition and behavior suggesting that difficult behavior may result from underlying problems in perception and understanding.
- Generalist training: professionals in the TEACCH system are trained as generalists who understand the whole child, and do not specialize as psychologists, speech therapists etc
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