Nesrhten……….

Effective social skills interventions is an essential part of autism services, and even if there are several studies demonstrating effective interventions more knowledge is welcome. Kasari, Rotheram-Fuller, Locke and Gulsrud has conducted a randomized trial comparing a child-assisted approach (CHILD) and a peer-mediated approach (PEER). In this study that found significant improvements were found in social network alliance, number of friendship nominations, teacher report of social skills in the classroom, and decreased isolation on the playground for children who received PEER interventions. This result was obtained after a brief intervention and persisted to the 3-month follow-up.

Pivotal Response Training (PRT) is an evidence-based intervention for children with autism focusing on changing pivotal responses and behaviors that may have widespread effects on communication and social interaction. One central part of PRT is involvement of parents or caregivers, and the implementation of PRT throughout all interacting with children. There has been published several studies showing training parents an others to implement PRT, in various ways. However there are several factors that may influence the effectiveness of PRT, and now Randolph, Stichter, Schmidt and O´Connor has investigated the influence of educational level of caregivers on fidelity and effectiveness of parent implemented PRT.

in their study they included three caregivers without a college degree. The provided 10 training sessions to the caregivers in how to implement PRT. Based on this research there are found that caregivers without a college degree may effectively and with high fidelity. As this study only includes participants without a college degree, it do not compare any differences to caregivers at other educational levels, thereby limiting the generality of the results. There are also several other factors that may affect the results, many of them mentioned in this article, that should be investigated to better understand how to effectively implement PRT.

The need for knowledge on autism and evidence-based interventions is large and growing, at the same time the number of skilled professionals is limited in several areas. Based on this Kobak and colleagues has conducted a pilot study on implementing a web-based tutorial for parents with autism spectrum disorders. Based on their study the parents scored significantly better on a knowledge test on intervention after fulfilling the tutorial, and rated is in the excellent area on measurement of usability.

The use of web-based tutorials and resources is an important area that may be used within all effective interventions, and this study supports the use of web-based tutorials for increasing the knowledge of central aspects of an intervention.

Research indicated that children and adults with autism spectrums disorders (ASD) are more likely to suffer from other psychiatric conditions that others. One of the conditions the children and adolescents with ASD key suffer from is anxiety. A common and effective treatment for others with anxiety is cognitive-behavioral therapy (CBT), and it seems that this treatment also may be effective for children with ASD as well. Now Sung and colleagues from Singapore has conducted a randomized trial with 70 children with ASD and anxiety, comparing CBT and a social recreational (SR) program. As earlier studies often have studied CVT against a waiting-list control.

in their study they found that both the CBT and the SR group showed significant reduction in anxiety symptoms after 6 months. According to the authors this may indicate that factors such as regular structured sessions, consistent therapists, social exposure and the use of strategies founded of understanding of autism challenges are important components in management of anxiety.

The number of treatment and educational approaches for autism spectrum disorders (ASD) is large, and still raising. Many of the treatments offered has minimal research support, and may be regarded as fad-treatments. Others, as applied behavior analysis, has better research support in the improvement for children with ASD What factors that influence the choice of treatment parents do for their children with ASD needs to be understood in promoting the best treatment available for each children.

Miller, Schreck, Mulick and Butter has investigated the choice of 400 parents of children with ASD. The results from this study indicates that parents choose treatments in all levels of research support, and that slightly less than half of the parents choose a research supported treatment. In this study the authors did not find that the choices significantly correlated with demographic variables. The parents seems to be more influence by anecdotal resorts and “work of mouth” referrals than from scientific sources of research support.

But professionals´ referrals was on form of powerful influence. This emphasizes the important responsibility professionals providing autism services have in providing science-based and objective information to parents, free of personal opinions and preferences. Professionals should also seek to provide factual information adapted for parents and their situations after receiving an ASD diagnosis for their child, in order to assist in providing the best available intervention for children with autism.

Deficits or challenges with adaptive skills, such as self-help, leisure, hygiene etc is common for people with autism spectrum disorders (ASD). There has been developed several effective behavior analytic interventions to help persons with ASD improving their adaptive skills, including as mentioned earlier high-functioning persons with autism.

Now Matson, Hattier, and Belva has published a review on behavioral interventions for treating adaptive living skills for persons with autism. In this review published in Research in Autism Spectrum Disorders they show that applied behavior analysis methods have proven to be highly effective in teaching adaptive skills in a variety of persons with autism, but compared to other challenging areas for persons with autism adaptive skills is understudied.

Based on clinical experience this is somewhat strange. Especially in services for adults with autism spectrum disorders the use of behavioral interventions to extensive. And the clinical experience supports the notion of the review that these interventions is highly effective. Even so more research should be conducted in order to support the extensive use of these interventions.

Teaching and training behavior therapists in different procedures and aspects of Early Intensive Behavioral Intervention (EIBI) is an important part of supervisors tasks, and may increase the quality of intervention to the most effective level. How to train and teach the therapists responsible for day-to-day treatment may be conducted in different manners. One of the most used form is presentation of relevant theory and skills, and in-vivo feedback. And learning skills trough rehearsal and feedback is well documented.

Bishop and Kenzer has studied group classroom instruction and the need for in-vivo feedback when teaching behavior therapists to conduct brief paired-stimulus preference assessment, published in Research in Autism Spectrum Disorders. The data from this study indicates that classroom instruction is usually sufficient to teach EIBI therapists to perform the desired assessment. And in the cases where classroom instruction was insufficient – in-vivo feedback resulted in proficient performance.

Sometimes one may hear statements like “he is to high functioning for ABA intervention”. For all involved in behavior analysis this statement don´t make sense, but for a lot of others it seems to do. Therefor it is need for many studies and demonstrations shown how behavior interventions are effective in teaching for all children and maybe specially for persons wit high-functioning autism.

Palmen, Didden and Lang have now published a review of behavioral intervention studies aimed at improving adaptive skills in high-functioning young adults (above 16) with autism spectrum disorders. Their review indicates that there are some evidence that behavioral interventions may improve adaptive skills for young adults with high-functioning ASD. But there is still need for more research, especially involving true experimental designs.