Autism Early Intervention - What Does it Look Like?

Discussion in 'Just Diagnosed' started by aspiemum, Nov 17, 2015.

  1. aspiemum

    aspiemum New Member

    Hi,

    My son, Charlie, has just been diagnosed with Autism. He is 3 years old and the child psychology pediatrician has referred him to an Early Intervention therapist. I have no history of Autism in my family and neither do I know anyone who has gone through this process for their child.

    I just wanted to know what an autism early intervention looks like?
     
    Last edited by a moderator: Nov 17, 2015
  2. theCounsellor

    theCounsellor Developmental Therapist

    Hi @aspiemum,

    You have asked a pretty open ended question, but I will give you a very detailed answer. I will give you 3 guarantees just to set expectations:
    1. This will be a long post
    2. If you have little or no exposure/experience with Early Intervention (EI), this post will provide you all the information that you need to look for the right EI provider with confidence. And
    In this thread, I won't talk about the basic stuffs like What is Early Intervention, etc. I am sure, if you dig the internet, you will find plenty of material around that. I will give you the inside story, what do Early Intervention therapists (like myself) know and practice!

    ... And I won't charge a dime for it ;). My only requests would be that if you find this information useful, please share it online, so that hundreds of other families might benefit from this information about Early Intervention.

    Today, I will cover the following topics:
    • Where we are today in terms of Early Intervention for Autism. What do the researchers say and under what circumstances, EI is likely to succeed (this post).
    • Incorporating Early Intervention practices in regular education (thread #3 on this post)
    • The 7 key principles of Early Intervention (thread #4 on this post)
    • 12 Things to consider before hiring an EI therapist for your child (another post)
    NOTE: These topics, and all the other related to Autism Early Intervention has been neatly bundled under one resource on this website. All the post could be accessible from this Early Intervention for Autism Resource. So make sure you bookmark it.

    Now before we start, lets watch this video on how parents react to EI:



    There are two very important points that I want to state upfront before I dive into the details:
    • We have very few studies looking at intervention for our very youngest children with Autism - by very young, I mean those who are younger than 3
    • The models that have been studied so far with older children may not fit how infants and toddlers learn.
    So researchers have tried took a closer look at what we know about effective autism early intervention in general in order to shed some light on early intervention for children with ASD. Specifically, they looked at well-designed intervention studies for three groups of infants and toddlers:
    • Children who were born prematurely
    • Children with developmental delays like Down syndrome, and
    • Children at risk for intellectual disabilities due to factors such as parental poverty and intellectual disability.

    They found the following four common characteristics across all the studies where intervention was effective:
    1. Parents were involved in the intervention. Professionals "coached" parents to be responsive and sensitive to their child's cues and to use intervention strategies that were developmentally based.
    2. Professionals used a curriculum (i.e., a planned, systematic and consistent approach based on empowering families with specific knowledge and skill-sets), but customized the curriculum for each child.
    3. Intervention focused not just on discrete skills but on a broad range of learning targets.
    4. When intervention started early, it lasted longer.
    The researchers also noted that the "effect size" (i.e., not only is the effect statistically significant, but it is also meaningful? Does it really matter?) of these intervention studies was similar to that of studies using intensive applied behavior analysis with older children with autism.

    [​IMG]

    The take-away message from is investigation is that those therapists who offer theoretically sound and evidence-based early intervention are likely to be more effective with children diagnosed with autism!

    Here's what the research group concluded:

    "The infant autism early intervention research suggests that:
    • The appropriate starting place is at home, with families,
    • It should be focused on the child's developmental needs,
    • It should be based on sensitive and responsive parent-child interaction styles, and
    • Family support would be the key success criteria.
    For families who can afford center-driven daycare, studies from other infants suggest that high-quality daycare can support development as well.

    Please check out the next 3 posts below for continuation.
    << Back to Early Intervention Resource
     
    Last edited by a moderator: Jan 20, 2016
  3. theCounsellor

    theCounsellor Developmental Therapist

    Autism Early Intervention Through Educational Practices

    To start with, you may want to check out our resource on Educating Children with Autism ©National Academy of Science.

    The recommendations in this book has be implemented for early childhood educational policy and decision-making at state and local levels. However, these recommendations were primarily based on evidence from effective and comprehensive preschool programs for children with Autism, not early intervention. Still, much of the content of this book has been adopted, for years, by therapists as an effective autism early intervention education tool.

    For many, going through this 325 page book might be quite a daunting exercise, so let me jot out some of the key callouts :
    • Intervention should begin as soon as an Autism is suspected.
    • Intervention should be intense; five days a week, 25 hours per week, all year round. However, the authors did not identify a specific model of intervention but instead defined intervention as systematically planned and developmentally appropriate.
    • Each child must receive a sufficient amount of individual, adult attention so that the child is engaged and can benefit from the planned intervention.
    • Intervention priorities should include the child's use of spontaneous communication, social interaction skills, cognitive development, play skills, and proactive approaches to behavior problems.
    • To the extent possible, intervention should occur in settings where typically developing children are present; and
    • Support and information should be provided to help parents address the challenges they face in meeting the needs of their children.
    In a later chapter of the book, the committee identified additional characteristics that cut across what they considered to be model early childhood programs. The programs varied along a continuum - from a developmental orientation at one end to a behavioral orientation at the other.

    [​IMG]

    Regardless of where the programs fell on the continuum, they shared certain key characteristics that contributed to their effectiveness:

    Since the time the book was published, our understanding of early autism red flags has increased, and, as we talked about in a previous section, it is possible to diagnose an ASD before the age of 3. And that means that those children and their families will have an advantage coming in for Autism early intervention supports and services.

    << Back to Early Intervention Resource
     
    Last edited by a moderator: Nov 17, 2015
  4. theCounsellor

    theCounsellor Developmental Therapist

    7 Key Principles of Autism Early Interventions

    Okay, so lets take a step back. What is the mission of early intervention for Autism? What is our "overarching reason" for an early intervention system of services and supports?

    In this post, I will refer to another document in DW Autism resource, the 7 Keys Principles of Autism Intervention.

    So what are the seven key principles of early intervention services? What are the foundational key concepts that support so much of a therapist's work with infants and toddlers with delays/disabilities and their families?

    Below are excerpts from "Seven Key Principles: Looks Like/Doesn't Look Like."

    1. Infants and toddlers learn best from day to day experiences and interactions with familiar people in familiar circumstances.

    • Learning activities and opportunities must be functional, based on child and family interest and enjoyment
    • Learning is relationship-based
    • Learning should provide opportunities to practice and build upon previously mastered skills
    • Learning occurs through participation in a variety of enjoyable activities

    2. All families, with the necessary resources and supports systems, can enhance their children's development and learning.

    • All means ALL (income levels, racial and cultural backgrounds, educational levels, skill levels, living with varied levels of stress and resources)
    • The consistent adults in a child's life have the greatest influence on learning and development - not EI [early intervention] providers
    • All families have strengths and capabilities that can be used to help their child
    • All families are resourceful, but all families do not have equal access to resources
    • Supports (informal and formal) need to build on strengths and reduce stressors so families are able to engage with their children in mutually enjoyable interactions and activities

    3. The key role of a service provider is to support and work with family members and caregivers in the children's lives.
    • Autism Early Intervention providers engage with the adults to enhance confidence and competence in their inherent role as the people who teach and foster the child's development
    • Families are equal partners in the relationship with service providers
    • Mutual trust, respect, honesty and open communication characterize the family-provider relationship

    4. The early intervention process, from initial contacts through transition, must be dynamic and tailored to reflect the child's and family members' specific preferences, cultural beliefs and learning styles.
    • Families are active participants in all aspects of services
    • Families are the ultimate decision makers in the amount, type of assistance and the support they receive
    • Child and family needs, interests, and skills change; the IFSP must be fluid, and revised accordingly
    • The adults in a child's life each have their own preferred learning styles; interactions must be sensitive and responsive to individuals
    • Each family's culture, spiritual beliefs and activities, values and traditions will be different from the service provider's (even if from a seemingly similar culture); service providers should seek to understand, not judge
    • Family "ways" are more important than provider comfort and beliefs (short of abuse/neglect)

    5. IFSP outcomes must be functional and based on children's and families' needs and their priorities.
    • Functional outcomes improve participation in meaningful activities
    • Functional outcomes build on natural motivations to learn and do; fit what's important to families; strengthen naturally occurring routines; enhance natural learning opportunities
    • The family understand that strategies are worth working on because they lead to practical improvements in child and family life
    • Functional outcomes keep the team focused on what's meaningful to the family in their day to day activities

    6. The family's priorities, interests and needs are best addressed by a primary provider who represents and receives support from team and community.
    • The team can include friends, relatives, and community support people, as well as specialized service providers
    • Good teaming practices are used
    • One consistent person needs to understand and keep abreast of the changing circumstances, needs, interests, strengths, and demands in a family's life
    • The primary provider brings in other services and supports as needed, assuring outcomes, activities and advice are compatible with family life and won't overwhelm or confuse family members
    7. Interventions with young children and family members must be based on explicit principles, best available research, validated practices, and relevant laws and regulations.
    • Practices must be based on and consistent with explicit principles
    • Providers should be able to provide a rationale for practice decisions
    • Research is on-going and informs evolving practices
    • Practice decisions must be data-based and ongoing evaluation is essential
    • Practices must fit with relevant laws and regulations
    • As research and practice evolve, laws and regulations must be amended accordingly
    So this is the framework that should be used as early interventionists designing intervention in response to the needs of children with Autism and their families.

    << Back to Early Intervention Resource
     
    Last edited: Nov 17, 2015
  5. theCounsellor

    theCounsellor Developmental Therapist

    Last edited: Nov 17, 2015
  6. Rebeccagee0

    Rebeccagee0 New Member

    is there any parents support section here?
     

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