Imagine the frustration of not being able to talk or understand the meaning or context of words. The world would be a lonely place, thoughts trapped inside, with no way to express them. Good communication is the back and forth between understanding and being able to express those thoughts. Communication is important because everyone longs to be heard, and everyone needs to be heard. If a child is suspected of having an autism spectrum disorder, early intervention is crucial. Children who have ASD (autism spectrum disorders) benefit greatly from early intervention, showing better brain function as well as advances in their abilities to communicate and behave like other children, according to a new study conducted by Yale School of Medicine Researchers and published in the Journal of Autism and Developmental Disorders. (Kearney, C. 2012) These first years of therapy can make a lifetime of difference.
There are many interventions that increase communication skills and promote independence in children on the autism spectrum. Brooke Ingersoll (2010) compares and contrast models…some of these models use an applied behavior analysis (ABA) approach, which incorporates explicit prompting strategies according to the child’s initiation and the developmental approach that does not use these strategies, instead choosing to focus on facilitative strategies such as adult responsiveness. (Hall, L.J. 2013) Each of these intervention strategies have seen success with the children that have used them. It truly is a matter of what the needs of the child are, as to which program might work best for him/her. The following list contains brief summaries of each intervention and how they work.
- The DIR/Floortime Model- This floortime philosophy, developed by Stanley Greenspan, M.D, is an approach for parents and educators that fosters the development of the whole child by engaging and creating partnerships. (Hanna & Wilford, 1990) (Hall, L.J., 2013) The PLAY project is based on this intervention.
- Responsive Teaching- This approach was developed by doctors, Gerald Mahoney, a clinical psychologist, and James McDonald, CCC-SLP. The responsive teaching method was developed to assist caregivers in maximizing the potential of each of the routine interactions with children (Mahoney & McDonald, 2007) (Hall, L.J, 2013) Joint activities between parent and child are used in this intervention.
- The Hanen Program- This program was developedd in 1975 by Ayala Hanen Manolson, a Canadian speech and language pathologist. Her focus was on helping parents communicate with their severely language delayed children. More Than Words is based on the Hanen Program.
- Relationship Development Intervention (RDI)- This intervention is a trademark of Gutstein, Sheely, and associates. (Gutstein & Sheely, 2004) Steven Gutstein (2009) describes RDI as an approach that uses methods that are continually evolving to address the information processing disability of individuals with autism spectrum disorders, by carefully building dynamic intelligence. (Hall, L.J, 2013) Spotlighting and framing are two strategies based on RDI concepts.
- Enhanced Milieu Teaching- The Milieu Teaching focuses on increasing the number of opportunities for teaching new skills by “eliciting communication through environmental arrangement, the mand model, and time delay procedures” (Yoder and Warren, 1993 p.46) (Hall, L.J, 2013) Strategies based on this intervention are the mand model (verbal communication that functions as a request), and time delay.
- The Denver Model/Early Start Denver Model- This model is multidisciplinary. It is used with young children that have autism. It started as a federally funded program in 1981. Almost all the therapies based on this intervention used play. Play is one of the most powerful cognitive and social learning tools (Rogers et al., 2001; Rogers & Lewis, 1989) (Hall, L.J, 2013)
- Pivotal Response Treatment (PRT)- This treatment uses both applied behavior analysis and a developmental approach. Five pivotal areas are covered, motivation, responsivity to multiple cues, self-management, self-initiations, and empathy. (Koegel, Openden, et al., 2006) (Hall, L.J, 2013)
- The SCERTS Model- This model is fairly new, and takes a multidisciplinary approach. This model covers three main areas. Social communication, emotional regulation, and transactional supports. (Prizant et al., 2006b) (Hall, L.J, 2013) This model takes into account the interaction styles and needs of the child, the family and professional team.
When working with these interventions, pull out (one on one/small group) language and speech sessions are helpful because of the focus on that individual child. Yet, pull out sessions should not be the only time these interventions are used. Pull out sessions are not enough. Children with autism spectrum disorders need to spend time with their peer group. Peer interaction would be considered an important component of social-emotional development. (Hall, L.J, 2013) Classmates are models for both communication and social interactions, which the child with ASD needs. It is appropriate and necessary that the speech and language pathologist work with the child in that child’s classroom among their peers.
Not being able to communicate would be frustrating and debilitating for both the individual with Autism Spectrum Disorder and his/her caregivers. The intervention therapies that have been mentioned in this post, can make a huge difference in the lives of children on the autism spectrum and their families. When intervention is successful, a whole new world is opened up for them and the future looks brighter.
Greenspan, S.I., & Wieder, S. (2006). Engaging autism: Using the floortime approach to help children relate, communicate, and think. Cambridge, MA: De Capo Lifelong Books.
This book explains the floortime philosophy, and how this helps foster development of the child.
Gutstein, S.E., & Sheely, R.K. (2002a). Relationship development intervention with young children: Social and emotional development activities for Asperger syndrome, autuism, PDD,and NLD. New York: Jessica Kingsley.
This book explains the RDI philosophy, and assists parents in developing a relationship with their child with ASD.
Hall, L.J. (2013). Autism Spectrum Disorder: From Theory to Practice, Second ed. Pearson.
A book that covers all the different aspects of Autism Spectrum Disorders.
The Interdisciplinary Council on Developmental and Learning Disorders with DIR®Floortime TM information
Ingersoll, B., & Dvortcsak, A. (2010b). Teaching social communication to children with autism: A practitioner’s guide to parent training. New York. Guilford.
This book discusses techniques that parents can use to help their child communicate. There are direct techniques such as prompting and reinforcing that are taught.
Kearney, C. (2012, November 7). Early Intervention for Autism Shows Major Brain Changes. website:http://www.medicalnewstoday.com/articles/252463.php
Children with ASD benefit greatly from early intervention. This article discusses Pivotal Response Treatment in children between the ages of two to five years old. Magnetic resonance imaging was taken of the children’s brains that were using this intervention therapy.
Koegel, R.L., & Koegal L.K. (2006). Pivotal response treatments for autism: Communication, social, and academic development. Baltimore. Brookes.
This book discusses Pivotal Response Treatment. This particular model uses both applied behavior analysis and the developmental approach.
Mahoney, G., & MacDonald, J. (2007). Autism and developmental delays in young children: The responsive teaching curriculum for parents and professionals. Austin, TX: Pro-ed.
Prizant, B.M., Wetherby, A.M., Rubin, E., Laurent, A. C., & Rydell, P.J. (2006b). The SCERTS model: A comprehensive educational approach for children with autism spectrum disorders: Volume II, Program planning and intervention. Baltimore, MD: Brookes.
This book explains the SCERTS model. The three main areas that this model covers are social-communication, emotional regulation, and transactional supports.
Rogers, S.J., & Dawson, G. (2010). Early Start Denver Model for young children with autism: Promoting language, learning and engagement. New York: Guilford.
This book explains the Early Start Denver Model. This intervention presents activities through play, and social games.