Autism Spectrum Disorder

Methodology

 

The ASD classroom stresses a positive and systematic approach to developing the skills and functional behaviors necessary for effective communication and the ability to learn. Students will be engrained in leading therapeutic models based on their individual needs, including TEACHH, DTT, verbal behavior, incidental learning, sensory integration training, social skills training, and other effective interventions. These components include a high level of structure, a behavioral orientation, active parental involvement, intensity of intervention with objectives clearly stated, and focus upon generalizing newly learned skills.


The program will take advantage of various psychoeducational stations, which will be used as the core components for each student’s psychoeducational plan. In this respect, each client will have a specific regimen of interventions that will be scheduled on a daily and weekly basis, with most major empirically-supported interventions available in the center for unique opportunities for clients to benefit from the combination of treatments optimal for development on an individual basis. Therapeutic Stations (listed in order from the most concrete to the most abstract interventions):
 

  • Discrete Trial Training – Based on the influential work of Ivar Lovaas, DTT will be used with many of the clients in the program, at least initially, to foster compliance with directions and treatment protocol, as well as to augment the development specific adaptive behaviors and academic skills. The basic protocol of our proposed DTT program follows:

 

    • Client will be placed in a chair where s/he will remain seated and focused on the program.

    • The evaluator will present a stimulus to elicit a response.

    • If client provides the correct response, s/he will receive a predetermined reward, and the evaluator will repeat the trial until 10 trials are complete.

    • If client does not provide the correct response, the evaluator will count to 5, and say “no”, and repeat the stimulus.

    • If client still does not respond correctly, he will be given an additional cue, and then rewarded for an assisted response. The trials will be continued until 10 are completed

    • The evaluator will carefully chart the child’s success/failure rates.

    • The process will be repeated up to 3 times per day for each program prescribed.

 

Additional programs will be added to the protocol as s/he masters each program, beginning with repetitive compliance tasks, graduating to discrimination tasks, communication tasks, and then to social skill and adaptive behavioral tasks.

 

 

  • Verbal Behavior – As an adaptation of ABA principles also used with DTT, verbal behavior protocols will be developed as necessary for certain children. Mand training will be taught extensively with lower functioning students predominantly, as manding many items for which motivation has been captured, has proven to lead to improvements in vocalizations. Motivative operations will be stressed as conditions in the learning environment that transform various activities, food items, and preferred objects into reinforcers for the learner. Then, these reinforcers are used to teach the learner to mand, or request, them.

 

  • TEACHH – One of the most powerful components of the TEACHH model, described here as small group learning, can be modified ideally to create a generalization opportunity for a variety of skills developed initially through more concrete interventions, and also for instruction in novel skills. Small group learning involves having a teacher located in the center of a semi-circular table, with 3-4 children around the table being assisted from behind by assistants. In this process, each child’s skill can be generalized to the small group setting, while social expectations of the model are simultaneously stressed. The teacher’s job is strictly to teach, the students’ jobs are to attend and respond appropriately, and the assistants’ jobs are to support accurate responses of the children, even with hand-over-hand assistance as necessary.

 

  • Sensory Integration – Several mini-stations will be available for guided therapeutic play, designed to increase sensory integration through tactile stimulation. Some stations will include: sand tray; dry rice/beans bin; water container; fabric table with different types of cloth; brushing mini-station with surgical brushes and other soft objects; ball/block bin with various shapes and textures or balls and blocks; joint manipulation chair.

 

  • Metronome/Music Training – Studies have shown that by developing the ability to stay on beat, PDD clients are actually able to increase their personal control and organizational skills. Computer software from Interactive Metronome will be used to promote and track the progress of the children through specifically designed programs. According to the authors of Interactive Metronome, “(special education students) who were IM trained, were compared with a control group receiving no intervention, and a second control group receiving a placebo computer based intervention. The IM group showed statistically significant improvements in 12 areas of attention, motor control, language processing, and reading, and in their ability to regulate aggression over both control groups. This peer-reviewed research appears in the March/April 2001 issue of the American Journal of Occupational Therapy.”

 

  • Miller Apparatus – Based on the work of Arnold Miller, a miniature obstacle-course type of guided-play apparatus promote the development of problem solving skills, as well as gross and fine motor control among clients. Language development will also be promoted using this intervention method.

 

  • Social Stories – Based on the work of Carol Grey, the social stories method can be seen as an ideally designed, interactive, and creative process of breaking down social skills through a carefully disguised task analysis. Once this has been accomplished, each portion of the task can be conceptualized and trained with the student in a way that is engaging and enjoyable. The process of setting this task analysis to assisted, personal story writing fosters a myriad of interactions between and among the students and teacher.
     

  • Floor-Time Area – Based on the work of Stanley Greenspan, social skills, fine motor, and problem solving skills will be developed through semi-structured activities on the floor with other children. A wide variety of toys and games will be available according to the abilities of each particular child.

    While there is some variation in the way that each child will be approached, combining various methods to provide optimal results, the general trend is for children at lower developmental levels to be involved in more concrete interventions. As progress is made, the skills these children develop will be generalized through the various interventions over time, graduating from the more concrete to the more abstract methods. However, some involvement in all of the interventions to some extent may prove to be beneficial for many of the children. The psychoeducational programming provided for the students will begin with their functional level, transposed onto a continuum of eclectic interventions from the most concrete to the most abstract intervention, according to Mitchell’s Eclectic Model of Autistic Intervention.

 

Contact Dr. Eric Mitchell

215-843-4528