Early Intervention for the Treatment of Autism Spectrum Disorder
27 February 2018
Natalia Iwan
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Autism Spectrum Disorder (ASD) is a neurological disorder, also referred to as a developmental disorder, affecting millions of individuals in the United States and worldwide.


Over the past 20 years the incidence and diagnosis of ASD has been growing exponentially.  Though the growth might be in part to a true increase in the absolute number of cases, it is also due to better awareness and diagnostic procedures, a widened definition of the disorder, as well as a decrease in stigmatization that previously led to some families to choose to remain without a diagnosis.  Individuals with ASD often have delays in several developmental areas, such as communication, academics, social skills, self-care, and behavior.  These deficits may lead to difficulties with schoolwork, making and sustaining friendships, an inability to complete basic routines of self-care, and/or difficulty with emotion-regulation which can lead to anxiety, tantrums, and aggression.  ASD is known as a spectrum disorder because individuals diagnosed with ASD may display a wide range of skills and deficits. On one end of the spectrum, individuals may have significant deficits in all areas and may not speak any functional language.  On the other end of the spectrum, individuals may be able to live and work independently but have some minor social skills and language deficits.

 

The cause of Autism is not yet known, but researchers believe that autism is due in part to genetic factors.  Younger siblings of a child diagnosed with Autism have a significantly higher rate of diagnoses than the general population.  Researchers also believe that autism is caused in part to environmental factors, such as viruses.  It is worth noting that the research study linking Autism to vaccinations was proven to be falsified, and no further studies found any link between Autism and vaccines.  Currently there is no known cure for Autism, however, Early Intervention (EI) for the treatment of children diagnosed with ASD can lead to significant gains in targeted skill areas.  Research shows Early Intensive Behavioral Intervention (EIBI) using ABA often leads to the best outcomes for students with autism.  It is recommended that these services begin as soon as symptoms are seen or a diagnosis is made.  Generally, these therapies will begin between the ages of one to three years.  The earlier the services begin, the better the chance of catching up with same age peers and decreasing the amount of services required later in life.  It is recommended that services be provided 5 days per week and that opportunities to practice skills be repeated consistently and daily.

 

Early Intervention services for children with ASD are undeniably beneficial for the children and their families.  It is important when planning to start an EI program for your child to choose a service that incorporates practices that have been researched and shown to be effective for individuals with Autism.  The learning environment can be at the child’s home, a school, a therapy center, or a combination.  Services can be one-on-one learning, or in a small group with a very low ratio of students to teachers.  The environment should be structured, with limited distractions that can over-stimulate very young students.  Consistent and predictable routines should be built into the learning time, to teach common routines and daily activities.

 

Early Intervention services for young children with Autism should include family and caregivers.  Family members should be actively participating in some of the therapy time to learn how to practice skills when the service providers are not there.  There should be open communication about priorities for the family, as well as goals and progress for therapy time.  Service providers need to use feedback from the family to help create appropriate goals that address the needs of the child as well as the needs of the family.   The program should be highly individualized for each child and their family.  All goals should be written specifically for that child and based on their assessment results.  Tactics and teaching strategies should be evidence-based and appropriate for the age and developmental level of the learner.  

 

Applied Behavior Analysis (ABA) is currently the only evidence-based methodology proven to be effective for children with Autism.  ABA is a scientific approach to understanding behavior and how the environment affects it is affected by the environment.  ABA looks at the functions of behavior to determine the most appropriate and effective methods to change or shape behavior.  Goals are broken into objective and measurable parts and taught systematically.  ABA is data-driven so that progress can be easily seen and lack of progress can be addressed immediately.  Essential components of ABA therapy include building routines and consistency into daily life, using assistive communication methods and visual supports, consistent consequential strategies and reinforcement, and modifying the environment for the benefit of the individual with autism.  Pairing is an essential process for beginning a new program, especially for the young learners in EI programs.  This process helps the child understand that the provider and learning environment are comfortable, fun, and engaging.  This process can lead to good rapport between the student and therapist, as well as build compliance for learning opportunities.  Pairing is a necessary step in beginning a program and the time it takes to build a rapport will lead to better responding and greater learning as the program progresses.

Quality EI services should be designed and implemented by qualified and credentialed service providers.  Every country and state may have their own group of licensed professionals.  Common national credentials include Board Certified Behavior Analysists (BCBAs) and Registered Behavior Technicians (RBTs) who are licensed by the Behavior Analytic Certification Board (BACB).  Many individual states in the United States also offer Licensed Behavior Analyst (LBA) certifications.  Other licensed professionals who can provide beneficial services for children with autism include Speech and Language Pathologists (SLPs), Occupational Therapists (OTs), and Physical Therapists (PTs).

 

 

Tamar Varnai, MA, BCBA, is a Board Certified Behavior Analyst originally from New York. She received her Master’s degree in Applied Behavior Analysis from Columbia University, Teacher’s College in New York and has been working with students with special needs for over 20 years.  She specializes in working with children on the Autism Spectrum, as well as shaping behavior and teaching language and social skills to students of all ages.  Tamar has worked in special education and inclusion classrooms and supervised home-based ABA programs.  She has extensive experience working with children and teenagers, ages 1 year through 16 and has worked in several countries outside of the United States and throughout Europe.

 

Tamar provides direct teaching services individually or in group settings, educational and behavioral assessments, program development and supervision, language and social skills instruction, as well as training for parents and teachers.

 

Resources:

https://www.bacb.com/about/

Cohen, Howard, Amerine-Dickens, Mila, Smith, Tristram. (2006). Early Intensive Behavioral Treatment: Replication of the UCLA Model in a Community Setting. Journal of Developmental & Behavioral Pediatrics, 27 (2), 145-155.

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis (2nd Ed). Upper Saddle River, NJ: Merrill/Prentice Hall.

Jacobson, John W., Mulick, James A, Green, Gina, et al. (1998). Cost Benefit Estimates for Early Intensive Behavioral Intervention for Young Children with Autism:  General Model and Single State Case. Behavioral Interventions, 13, 201-226.

National Research Council. (2001). Educating Children with Autism. Committee on Educational Interventions for Children with Autism. Cathernie Lord and James P. McGee, eds. Division of Behavioral and Social Sciences and Education. Washington DC: National Academy Press.

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