Educational Intervention Approaches
Instructional Methods
Schools today face the challenge of providing appropriate services to a diverse and increasingly numerous student population diagnosed with ASD. In order to achieve this goal, evidence-based practice is essential in the schools. Students with autism should be provided with research-based, best practice approaches, based on assessment results and IEP team decisions. Some of the most commonly used “established” and “emerging” autism interventions include:
Antecedent Interventions: These interventions involve making changes to situational events that typically occur before problem behavior happens. These alterations are made to increase the likelihood of success or reduce the likelihood of problems occurring. Examples include: behavioral momentum; choice; contriving motivational operations; cueing and prompting/prompt fading procedures; modification of task demands; incorporating special interests or thematic activities into tasks; priming; and the use of time delay.
Behavioral Interventions: These interventions are designed to reduce problem behavior and teach functional alternative behaviors or skills through the application of basic principles of behavior change. Examples include: shaping; chaining; task analysis; contingency contracting; differential reinforcement strategies; discrete trial teaching; functional communication training; generalization training; relaxation training; and the use of token economies.
Joint Attention Interventions: These interventions involve building foundational skills involved in interacting with others. Joint attention often involves teaching a child to respond to the nonverbal social bids of others or to initiate joint attention interactions. Examples include: pointing to objects; showing items/activities to another person; and following eye gaze.
Modeling
These interventions rely on an adult or peer providing a demonstration of the behavior that should result in an imitation by the individual with ASD. Modeling can include simple and complex behaviors. This intervention is often combined with other strategies such as prompting and reinforcement. Examples include both live modeling and video modeling.
Naturalistic Teaching
These interventions involve using primarily child-directed interactions to teach functional skills in the natural environment. These interventions often involve providing a stimulating environment, modeling how to play, encouraging conversation, providing choices and direct/natural reinforcers, and rewarding reasonable attempts. Examples of this type of approach include incidental teaching, embedded teaching, and natural environment training.
Peer Training Package
These interventions involve teaching children without disabilities strategies for facilitating play and social interactions with children on the autism spectrum. Peers may often include classmates or siblings. These interventions may include components of other treatment packages (e.g., self-management for peers, prompting, reinforcement, etc.). Common names for intervention strategies include peer networks, circle of friends, buddy skills package, Integrated Play Groups™, peer initiation training, and peer-mediated social interactions.
Picture Exchange Communication System (PECS)
PECS involves using behavioral principles to teach functional communication skills to children with limited verbal and/or communication skills. PECS is considered a specific form of augmentative or alternative communication.
Pivotal Response Teaching
This treatment, also referred to as PRT, focuses on targeting “pivotal” behavioral areas (e.g., motivation to engage in social communication, self-initiation, self-management), with the development of these areas resulting in more widespread collateral improvements in other areas. Key aspects of PRT intervention delivery also focus on parent involvement in the intervention delivery, and on intervention in the natural environment such as homes and schools with the goal of producing naturalized behavioral improvements.
Use of Schedules
These interventions involve the presentation of a task list that communicates a series of activities or steps required to complete a specific activity. Schedules are often supplemented by other interventions such as reinforcement. Schedules can take several forms including written words, pictures, or photographs.
Self-management
These interventions involve promoting independence by teaching individuals with ASD to manage their behavior by recording the occurrence/non-occurrence of desired or undesired behaviors, and being reinforced for doing so. Initial skill development may involve other strategies and may include the task of setting one’s own goals. Examples include the use of checklists (using checks, smiley vs. frowning faces), wrist counters, visual prompts, or tokens.
Story-based Interventions
Treatments that involve a written description of the situations under which specific behaviors are expected to occur. Stories may be supplemented with additional components (e.g., prompting, reinforcement, discussion, etc.). Social Stories™ are the best known story-based interventions and they seek to answer the “who,” “what,” “when,” “where,” and “why” in order to improve a child’s ability to react to situations in a socially appropriate manner.
Structured Teaching
Based on neuropsychological characteristics of individuals with autism, this intervention involves a combination of procedures that rely heavily on the physical organization of a setting, predictable schedules, and individualized use of teaching methods. These procedures assume that modifications in the environment, materials, and presentation of information can make thinking, learning, and understanding easier for people with ASD if they are adapted to individual learning styles of autism and individual learning characteristics. These treatment programs may also be referred to as TEACCH (Treatment and Education of Autistic and related Communication-handicapped CHildren).