Early Education for Autistic Children


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Can autistic children become indistinguishable from so-called 'normal' children? I have seen it happen sufficiently often to believe; though, in every case, the parents invested significant time and money to their child's treatment,
Lewis Mehl-Madrona
Ultimately relationships based on trust, honesty, openness and the sharing of up-to-date information will serve both our families and ourselves best. We need to be mature in our responses to the challenges to our knowledge and capabilities�
Peter Rosenbaum
The role of the professionals is to help the parents to identify potential problems and support them in responding firmly and consistently thus to minimise the impact of the problems as the child grows up.
Mike Connor
Provides background information and an impetus for creating publicly funded intensive early intervention programs (i.e., prior to school entry) for children diagnosed with a PDD. Highlights the need for intensive services.
Tracie Lindblad
Discusses behavioral, medical, nontraditional and therapeutic interventions.
Autism researchers have identified a set of common effective practice elements for early intervention (EI) (e.g., intensive programming). The current study examined the reported use of common elements of effective interventions in community EI settings. Eighty EI providers reported about their programs. The majority of participants reported using common effective elements, however, the depth and quality of the use of these elements was highly variable. Taking community program structure into account in future research will facilitate the development of methodologies, which immediately fit into the context of community programming rather than requiring program adaptation for use in the real world. Recommendations for using current community program structure to improve use of evidence-based practices are discussed.
AC Stahmer
An overview of treatment approaches include Applied Behavioral Analysis (ABA); Discrete Trial Training (discrete trials); TEACCH; PECS; Floor Time; and Social Stories, and sensory integration.
A sampler of quotes and critiques
Autism National Committee
Is autism/PDD a thing a person has? Can you cure it by training a child to act normal? Should early intervention focus on teaching compliance, or is there a more crucial and appropriate goal to aim for?
Provide information to professionals and the public about a range of practical applications of behavioral technology.
A blog posting about Soma Mukhopadhyay, featuring replies for Mukhopadhyay and a number of autistic persons.
moggy et al
Using a more cognitive approach sounds easier than it is in practice. The key is in the techniques that the therapist uses to help the child explore strategies, make decisions, apply and evaluate.
Cheryl Missiuna, Theresa Malloy-Miller, Angela Mandich
We compared the effects of 3 treatment approaches on preschool-age children with autism spectrum disorders. Twenty-nine children received intensive behavior analytic intervention. A comparison group received intensive eclectic intervention in public special education classrooms (AP). A second comparison group comprised 16 children in nonintensive public early intervention programs (GP). Independent examiners administered standardized tests of cognitive, language, and adaptive skills to children in all 3 groups at intake and about 14 months after treatment began, The groups were similar on key variables at intake. At followup, the IBT group had higher mean standard scores in all skill domains than the AP and GP groups.
Jane S. Howard, Coleen R. Sparkman, Howard G. Cohen, Gina Green, Howard Stanislaw
Home of the Relationship Development Intervention (RDI) Program, a parent-based clinical treatment for individuals with autism spectrum and other relationship-based disorders.
Steven Gutstein
Autcom's Red Flags And Rules of Thumb for Evaluating Treatments
Review of Lovaas, TEACCH, PECS, Greenspan, Inclusion, Social Stories; Background, Goals, Implementation, Outcomes, Advantages, Concerns, Errors to Avoid
Polly Yarnall
The aim of the research was to develop and evaluate a model of good practice which would make an explicit link between diagnosis and intervention, and so give parents a very clear rationale for the autism-specific yet individualized programme that they were carrying out. It employed an action research design, which essentially is responsive to participants, thus developing a user-friendly model of service. The programme was based on the developmental perspective that the pragmatics of language are the precursors of speech itself and enable both communication and relationship between child and parents. Since these are impaired in autism they should therefore be prioritized in early intervention. Ten children aged 1:10 to 2:9 at assessment, and with a diagnosis of autism, underwent an intervention based on home visits, modelling, workshops and written information, with parents as 'therapists' in naturally occurring situations. Within 18 months all children made substantial progress in social interaction and expressive communication, including gestural and verbal communication.
Susie Chandler et al
It is possible to remediate the pragmatics of children with autism at a relatively early age. These children are receptive to intervention techniques which have previously been used with older children within a school setting.
Susie Chandler, Phil Christie
Each child has a unique personal load limit, as does a bridge. When that limit is exceeded, a very complex constellation of problems results.
Patricia Lemer
Advances in early identification and intervention services for children with autism have significantly contributed to better long-term outcomes for this population. However, the fact remains that response to even the most effective treatment is characterized by a great variability. Thus, while some children may improve substantially, even achieving normal or near normal functioning, the majority improve to a lesser degree or not at all. This variability in treatment outcome suggests that there are variables affecting outcome that have not yet been identified. Given the heterogeneity in the autism population in terms of symptom presentation, it is likely that important child variables are operating.
Brooke Ingersoll, Laura Schreibman, Aubyn Stahmer
A classroom-based program for young children 3-5 years of age exhibiting problems with social-communication and social relationships. Our Classroom uses developmentally appropriate intervention and follows the SCERTS Model
Pamela Rosenthal Rollins, University of Texas at Dallas
The first purpose of this article is to review the social communication characteristics of very young children with ASD, which have important implications for early identification. The second purpose is to review evidence-based intervention practices for children with ASD and to develop a set of guiding principles for providing intervention for infants and toddlers who are at risk for ASD.
Juliann J. Woods, Amy Wetherby
We consider literature reviews, program descriptions, and empirical studies in two broad areas of early intervention: for children with developmental disabilities, and for children considered at-risk for developmental problems.
Bruce L Baker, Kristin Abbott Feinfield
Across the country, states are reporting increases in the number of children with autism enrolled in the education system. Although a few specific treatment methods have been established as efficacious for some children with autism in controlled settings, research examining the translation of these treatments into early intervention programs has been minimal. The current study examined provider self-reports of the use of interventions in community settings through focus groups. Providers report the use of both evidence-based and non-evidence-based techniques and indicate that they often combine and modify these techniques based on child, personal, and external factors. Few providers had a clear understanding of evidence-based practice, and all providers reported concerns about adequate training. Implications for early intervention research are discussed.
Aubyn Stahmer
Primary Care Providers must enhance their knowledge about child development and acquaint themselves with services available to all children who may benefit from specialized interventions.
Mary Belkin
Early Intervention program service offerings vary widely. They should, however, be determined by the child's needs, not just what happens to be available or customary in your area.
Mitzi Waltz
Communication disorders in infants and toddlers appear to be increasing in prevalence. There are tools available to the PCP, which can be used in the office setting to enhance the precision of screening or initial assessment of these young children.
Sheila Daly Russo, David Bailey
Early intervention can ameliorate, and in some cases, prevent developmental problems; result in fewer children being retained in later grades; reduce educational costs to school programs; improve the quality of parent, child, and family relationships.
Christine L. Salisbury, Barbara J. Smith
This article describes the development of the Parents Plus Early Years Programme (PPEY): a video-based early intervention for parents of pre-school children with behavioural and developmental difficulties. PPEY combines individual parent-child sessions using video feedback with parenting group sessions using video-based teaching over a 12-week period. As well as detailing the research basis, theory and practice of the PPEY, the article describes the results of an initial study of 30 children, with a range of conduct, attention and developmental problems whose parents completed the programme. Results showed a significant drop in conduct problems and hyperactivity as measured by the Strengths and Difficulties Questionnaire, decreased parental stress as measured by Parent Stress Scale, and significant gains towards parent-defined goals. In addition, before and after video observation of parent-child interaction showed an increase in positive parent-child attention and a decrease in parent-child instructions, as measured by independent observers. Gains were maintained at 5-month follow-up. The article also includes some initial results of a follow-up qualitative evaluation of parents' experience after attending the programme.
John Sharry et al
Feelings don't matter, only doing matters. Do exactly as you are told and you get a cookie. Being autistic is a bad thing. Don't stare out the window in rapt amazement at the fluttering of leaves on a tree or at the formation of a cloud. It's not allowed.
Camille
My autism-related experiences have primarily resulted in written products in four primary areas: (a) effective classroom practices, (b) personnel preparation, (c) parent/family support, and (d) distinguishing traits and unique features of individuals with ASD.
Richard L. Simpson
To help parents in the early stage of the journey that they begin upon learning that there is a problem with their young child's development. Therapeutic Approaches; Biomedical Interventions; Sensory Processing; Education Interventions; Law and Advocacy.
Many families and autism professionals have written asking about Tito, his mother Soma, our son Dov, and the new teaching method Soma has pioneered. This method is called the Rapid Prompting Method (RPM).
Portia Iversen, Terry Sejnowski, Eric Courchesne
On early, abnormal developmental processes, development of motor skills and language in children with severe disabilities, development of social relationships in people with disabilities, and treatment efficacy in autism.at the UC Davis MIND Institute.
Rogers, Mastergeorge
On early, abnormal developmental processes, development of motor skills and language in children with severe disabilities, development of social relationships in people with disabilities, and treatment efficacy in autism.at the UC Davis MIND Institute.
Rogers, Mastergeorge
Brooke Ingersoll, A. Dvortcsak
With the passage of IDEA '91, intervention for young children with autistic spectrum disorders (ASD) is now provided for children under three. While research suggests that children with autism benefit from inclusive programming, inclusive early intervention programs are rare. The current study used a quasi-experimental design to analyze the outcomes of 20 young children with ASD in an inclusive program for children under three. Both outcomes on standardized assessments such as the Bayley Scales of Infant Development, 2nd Ed. and the Vineland Adaptive Behavior Scales, as well as functional outcomes were compared at entry into and exit from the program. Significant increases were found in standard scores on the standardized assessments from intake to exit, with 37% of the children functioning in the typical range on the Bayley at program exit compared to 11% at program entry. Significant improvements were also seen in performance on functional measures. At intake, 50% of the subjects had no functional communication skills. At exit (approximately nine months later), 90% of the children utilized a functional communication system. In addition, social and play behaviors increased substantially. These data suggest that inclusive programming for children under three is a successful method for increasing children's developmental level, communication, play, and social skills. Use of augmentative communication systems and a combination of research-based programming is discussed.
Brooke Ingersoll, Laura Schreibman
Miller Method®: A Cognitive-Developmental Systems Approach for Children with Body Organization, Social, and Communication Issues
Arnold Miller, Eileen Eller-Miller
Children who are between four and seven years at intake may benefit greatly from intensive, school-based behavioural intervention.
Svein Eikeseth
ACN is dedicated to exploring advanced and complementary treatments for neurological conditions: autism, Tourette syndrome, attention deficit disorder/hyperactivity, learning disabilities, and exploding child.
True inclusion into a society starts from recognising and valuing uniqueness, not denying and suppressing it.
Rita Jordan
We must clarify the goals of these practices (medical, educational, or support, by questioning the circumstances under which each has been deemed appropriate, and by assuring that our criteria for judging validity and success are valid themselves.
Autism National Committee
It is commonly suggested that autistic children will remain autistic throughout their lives and that methods currently available to treat autism can produce only modest decreases in autistic behaviors.
Michelle MacAlpine
Cognitive-Developmental Systems Approach for Children on the Autism Spectrum
Movement in autism has been studied, at best, sporadically and, for the most part, impressionistically. Relationship-building should constitute the core element in all programs and all approaches to people with autism.
Autism National Committee
The EarlyBird team encourages an informal, friendly atmosphere which is aimed at breaking down potential barriers between professionals and parents.
Jane Shields
Early intervention bridges the gap between early diagnosis and appropriate educational placement. The National Autistic Society has developed an autism-specific three-month parent package, the NAS EarlyBird Programme, that emphasizes partnership with parents. Six families participate in each three-month programme, which combines weekly group training sessions for parents with individualized home visits. During the programme parents learn to understand autism, to build social communication, and to analyse and use structure, so as to prevent inappropriate behaviours. The use of video and the group dynamic amongst families are important components of the programme. An efficacy study evaluated the pilot programme and further monitoring is in progress. Training courses in the licensed use of the NAS EarlyBird Programme are now available for teams of professionals with prior experience of autism. Strengths and weaknesses of the programme are discussed. This short-term, affordable package, with supporting evidence of efficacy, offers a model of early intervention that is very popular with parents.
Jane Shields
International organization of parents and professionals dedicated to helping children and adults reach their full potential.
Discussions of Allergy treatments; Eye therapies; Bodywork; Multifaceted approaches; Evaluating alternative interventions
Mitzi Waltz
Mukhopadhyay said the key to her technique is the self-stimulating behavior, such as hand flapping, that is common in autistic children. She matches the pace of her questions to the speed of their repetitive behavior or 'stim.'
Stacey Burling, Philadelphia Inquirer
Most proposed therapies, other than some nutritional and pharmacologic therapies, are not potentially harmful, but they could cause psychological and/or financial grief.
TEACCH
I wonder if people with autism are closer to Nirvana than mere mortals like us. They have the quality of detachment, contentment and pristine purity. Are these to be considered as gifts or a disability?
Mythily Chari
In this issue we include some more activities and suggestions on how to introduce our children to the wonderful world of 'Pretend Play'.
Indu Chaswal
To promote playfulness among family members, I am including some kid-tested popular games. Give them a try, allow different family members to choose a game, or better yet, make up a game unique to your family!
Derenda Timmons Schubert
This paper examines methods of social skills training and cooperative learning from here and abroad, which informed the writer's practice when planning cooperative play experiences.
Celeste Littek
The principal aim of this study is to establish whether change in communication behaviours of children with PLI can be detected in an intervention study. Thus it is a signal-generation study and not an efficacy or effectiveness study.
Early forms of play involving the exploration of objects is repetitive and limited in scope in children with autism, consistent with a weak drive towards central coherence. The importance is stressed of early manipulative and relational play for the development of meaningful perceptual representations and the subsequent development of functional and symbolic play. It is argued that intervention designed to promote these early forms of play is therefore of critical importance. A 'toy-play' intervention programme is described that was initially used in a research setting with 24 children with autism, using outcome measures and a 1 year follow-up assessment. The original intervention was successful. However, improvements in play were not maintained unless children continued to receive play support. A 'play stimulation' programme building on the toy-play programme is there- fore now carried out with children in small groups after completion of the one-to-one toy-play programme.
I. A. van Berckelaer-Onnes
Rita Jordan et al
The SCERTS model prioritizes Social Communication, Emotional Regulation, and Transactional Support as the primary developmental dimensions that must be addressed in programs designed to support development of young children with ASD and their families.
Barry Prizant
This article evaluates the effectiveness of a developmentally based early intervention programme. Two groups of children were compared, a treatment group and a no-treatment control group. Standardized assessments were administered before and after the intervention period by an independent clinician. Pre-treatment comparisons revealed that the control group had a significantly higher pre-treatment IQ; but the two groups were comparable for age, mental age, socioeconomic status and number of hours of non-experimental therapy. Results demonstrated that children in the treatment group improved significantly more than those in the control group on measures of joint attention, social interaction, imitation, daily living skills, motor skills and an adaptive behaviour composite. A measure of requesting behaviour fell short of statistical significance. The total stress index reduced for treatment group parents and increased for the control group parents (but not significantly). The results of the study are considered to support the efficacy of this treatment approach.
Jeff Salt et al
Basically kids get to stare at a series of flashing lights that re-wire the brain stem to combat sensory overload.
Millie Martinez
Snoezelen is a multi-sensory stimulating environment specifically designed for individuals with severe sensory impairment, autism, or multiple disabilities.
Teresa Nicodemus
Recent evidence has proven that there are a considerable number of patients with autism/Asperger syndrome within adult psychiatry and forensic psychiatry. Special educational programmes would also be beneficial within adult psychiatric settings.
Eve Mandre
From the moment parents absorb the shock that their child may be autistic, they enter a dizzying world of specialists, therapists and, alas, purveyors of snake oil. Getting the right help quickly is paramount, but it is hard to make good decisions when you are in a panic or fighting despair. While the majority of U.S. programs for autistic children are based on ABA techniques, DIR has made inroads, and many programs now mix elements of both. How do the techniques differ in practice? To find out, TIME visited two schools, each a model for one school of thought.
Claudia Wallis, TIME
We have compiled the best suggestions for teaching specific skills from parents, therapists and consultants from internet discussion lists, conferences and private discussions
These techniques should be used to assist the child with autism to develop their thinking skills and a more coherent understanding of their world.
The aim of this review is to outline the background to the EarlyBird programme and the current evidence for its effectiveness, and inform the development of a set of outcome criteria which could be used to evaluate the programme.
Christina Birkin, Angelika Anderson, Dennis Moore, Fred Seymour
Highlights the contribution that occupational therapy practitioners can give to the autistic child's global development.
Nathalie Buhagiar
Theraplay is a treatment for enhancing attachment and engagement, self esteem, and trust in others. It is based on the natural patterns of healthy interaction between parent and infant, and is personal, physical and fun.
Margery Reiff, Phyllis Booth
Short-term, therapist-directed play therapy for children and their parents.
With appropriate services, training and information, children with autism will grow and can learn, even if at a different developmental rate than others.
Brief description of treatments and approaches above will give you an idea of what is available. Before embarking on any therapy or treatment, consult your physician.
Reports of the Working Groups on Psychoeducational/Behavioral Interventions, Psychopharmacology, Biomedical and Clinical Neuroscience, and Integrative Issues.
NIMH
Verbal Behavior is a therapy system, that is founded on sound well established principles of Applied Behavior Analysis, and draws together relevant streams of current research, is gaining acceptance and popularity.
Ann Jose Varavukala
Early intervention is known to help children with a range of developmental disorders, including autism, and the involvement of parents is essential. A number of models are becoming available.
National Autistic Society
Can brain functioning be improved with flashing lights and pulsing tones? Many seem to think so... sound therapy utilizing strictly sound training, which de-sensitizes the person with sensory issues, has been helpful for many on the autism spectrum
There is a wide range of views on the best way to treat people with autism. Some approaches are based on very specific theories as to the possible causes of autistic spectrum disorders.
National Autistic Society
Unfortunately, a number of individuals and programs who claim to be able to provide intensive behavioral programming for young children with autism are not qualified to do so.
Gina Green
People with autism experience the world differently and should be approached with openness and respect.
Marjorie Olney

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