Nesrhten……….

Children with autism spectrum disorders are in need of effective and research-based intervention. Providing good information on different interventions and the research base for them should be a priority for all professionals providing autism intervention. This information should be based on factual information on the intervention and the research that it builds on. Unfortunately this is not always the case. Today I found via @autismoaba a commercial on YouTube doing the opposite. Providing not supported statements, not only on the intervention promoted but also providing not factual information to discredit another intervention. This is surely not what children with autism and their families need. Let´s provide factual and scientific evidence for autism interventions. Watch the video;

In many countries and regions the use of paraprofessionals in autism interventions is extensive. Using paraprofessionals require effective and qualitative good training in order to ensure treatment fidelity and effective interventions for persons with ASD. Rispoli, Neely, Lang and Ganz have published a systematic review of the literature on training paraprofessionals to implement interventions for people with autism spectrum disorders in Developmental Neurorehabilitation.

Their review identified a variety of training procedures, such as explanations, modeling, video, role play and feedback. And that paraprofessionals had successfully implemented a variety of intervention including Picture Exchange Communication System (PECS), Discrete Trial Training (DTT), Pivotal Response Training (PRT), and more. These results are promising, but the research is limited and more research involving more subjects and more randomized design should be conducted to ensure the effect of using paraprofessionals.

Imitation is an early skill that most likely is important for social development and skills. As mentioned earlier Reciprocal Imitation Training (RIT) is an effective intervention for teaching the social function of imitation to children with autism. Ingersoll have now studied the effect of a focused RIT intervention for 3 hours per week for 10 weeks, compared with treatment as usual. Results from this study indicates that children receiving RIT made significantly gains in joint attention initiations both at post-treatment measurement and follow-up. Results also indicates that social-emotional functioning at follow-up was better for the intervention group, measured by the Social-Emotional Scale of the Bayley Scales of Infant Development.

This study indicates that RIT may contribute to promote social development for children with autism, and be an effective intervention for increase the frequency of joint attention initiations.

Reference.
Ingersoll, B. (2011). Brief report: Effect of a focused imitation intervention on social functioning in children with autism. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-011-1423-6

National Institute of Mental Health have published a guide for parents of children with ASD. This guide includes information on ASD, including diagnostic information and information on effective interventions. Read more…

Discrete Trial Teaching (DTT) is an effective teaching procedure and an important part of most Early Intensive Behavioral Intervention (EIBI) program. And effective error-correction strategies is important for effective and high fidelity implementation of DTT. Based on two studies published by Turan, Moroz and Paquet Croteau the evidence may indicate that the most effective error-correction procedure are individual between children – but consistent over operants.

Stereotypic behaviors are one of the diagnostic features of autism spectrum disorders (ASD). Stereotypic behaviors are typically interfering considerably with learning and may lead to exclusion from social settings. Many children with ASD display vocal stereotypy that creates great challenges in intervention and programs.

Lanovaz and Sladeczek has conducted a review of the behavioral interventions targeting vocal stereotypy. Based on their review the authors recommend that first step in intervention, as other behavioral interventions, should be a functional assessment or analysis. Then the use of response interruption and redirection (RIRD) is found to have the most empirical support. When RIRD is not applicable the clinicians may consider non contingent access to matched stimuli.

Even if there is numerous studies documenting effect of behavioral interventions on vocal stereotypy, more replications and further research is recommended.

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.