(Supplementary to Chapter 1, Terms of Engagement, in Autism Spectrum Disorder in the Inclusive Classroom, 2nd Edition: How to Reach and Teach Students With ASDs.)
Home- and School-Based Alternative Interventions
Many alternative treatment programs are available to help jumpstart the social, emotional, and cognitive development of young children who are believed to be on the autism spectrum. While most of the following modalities are conducted in the home setting, it may be useful for classroom teachers to be aware of the kinds of programming and reinforcements their students have been exposed to outside of your classroom.
All of these programs are based on the premise that when intensive interventions are implemented as early as possible in a child’s development, the child’s capacity for growth and development is maximized. Families may choose these programs in an effort to close significant gaps in the areas of relatedness, cognition, language development, daily living skills, attention, task completion, regulation, communication, and more.
Providers of such programs must be specifically trained and certified to practice their methodology.
ABA (Applied Behavior Analysis) is a form of operant conditioning, based on the works of B.F. Skinner in the 1930’s and Dr. O. Ivar Lovaas in the 1950s and ’60s. ABA uses a system of positive reinforcement to strengthen a behavior in a highly structured way using discrete trial teaching as part of the broader approach. Discrete Trial Teaching (DTT) incorporates prompts and immediate reinforcements to establish a connection between the desired behavior and the reinforcement. Each skill set is broken down, practiced, and reinforced for successful efforts. Most ABA programs rely on clear prompts and immediate reinforcements to ensure “errorless learning,” so that the child meets with success at every effort.
For example, three-year-old Tariq is not using words to answer questions. To facilitate verbal interaction, a trained therapist might lead him through an exercise like this:
Therapist: Tariq, what is this? (showing Tariq a book)
Tariq: (no response)
Therapist: Tariq, what is this? Say: “This is a….”
Tariq: This is a….
Therapist: Okay. (gives Tariq a raisin.) Now say, “This is a book.”
Tariq: This is a book.
Therapist: Very good! (gives Tariq another raisin.) So, what is this?
Tariq: This is a book.
Therapist: Great job! (gives Tariq another raisin.)
ABA builds from there to support generalization of learning. ABA can include chaining discrete skills together to facilitate sequential thinking and multi-step responses, and allows for some spontaneous task initiation. While critics complain that ABA is drill-oriented, asocial, and narrow in scope, proponents have shown that ABA can lead to improved communication across environments.
ABA is best started before age four, though older children have been seen to benefit from it as well. Effectiveness may demand up to forty hours per week of 1:1 therapy.
PRT (Pivotal Response Treatment) builds on the techniques used in ABA but avoids drill-like interactions. Rather than focus on individual skills, PRT works to enhance development in broad behavioral areas, such as communication, regulation, and socialization. Natural rather than rote reinforcers are used to help students make connections between desired behaviors and desirable outcomes. So instead of reinforcing a child’s efforts with a raisin if a child verbalizes the word “book,” his effort might be reinforced by granting him reading time.
DIR®/Floortime™ (Developmental, Individual-Difference, Relationship-Based / Floortime) model and technique was created by Stanley Greenspan, Ph.D. DIR/Floortime is based on the idea that students grow best when we meet them at their developmental level and build on their interests and emotions rather than focus on isolated skills and behaviors. Using these ideas, specially trained professionals and parents or caregivers work to enter the child’s world and follow her lead, while guiding her through the development of social, emotional, and intellectual skills, such as taking turns, flexibility, and sequential thinking. So if a child persists in rolling a toy car repetitively back and forth, the therapist might join her in rolling the car back and forth and then slowly introduce expanding ideas such as Where might the car might be going? or Uh-oh, the car bumped into a wall. What will happen next?
RDI (Relationship Development Intervention) is a family-based treatment that seeks to address missed components of emotional development among children on the spectrum. Steven Gutstein, who developed RDI, believes that students on the autism spectrum possess a form of “static intelligence,” which is the ability to know or learn facts and rote information. RDI harnesses the fluid nature of play, in the context of relationships and interactions, to transform static intelligence into a “dynamic intelligence.” The goal of RDI is to improve children’s ability to respond flexibly and creatively across different situations.
TEACCH (Treatment and Education of Autistic and Related Communication-Handicapped Children) is a school-based program built on the belief that students on the spectrum have the capacity to function independently in a highly structured environment.
TEACCH is significantly different from the programs listed above because it focuses on altering the environment to meet students’ needs as a way of allowing them to function productively and independently.
Though the TEACCH program can only be implemented by trained TEACCH instructors, many of the structured teaching elements of TEACCH can be implemented simply in any kind of classroom.
Some of the basic principles of structured teaching address:
- individualizing instruction and intervention
- organizing the physical classroom space in order to minimize distractions, maximize organization, and facilitate independence
- adhering to visually presented schedules and routines to reduce anxiety, facilitate independence, and help students understand what is expected of them
- using systematic prompts and reinforcers to support academic success
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