Effective Intervention Program features
Interventions Supported by Research
Examples of Therapeutic Intervention Programs
Other Models of Intervention
Goals for Educational Services
Key Points and Next Steps

Goals for Educational Services

At the root of questions about the most appropriate educational interventions for autistic spectrum disorders are differences in assumptions about what is possible and what is important to give children with autism through education.

The appropriate goals for educational services for children with autistic spectrum disorders are the same as those for other children: personal independence and social responsibility. These goals imply progress in social and cognitive abilities, verbal and nonverbal communication skills, and adaptive skills; reduction of behavioral difficulties; and generalization of abilities across multiple environments.

A large body of research has demonstrated substantial progress in response to specific intervention techniques in relatively short periods of time (e.g., several months) in many specific areas, including social skills, language acquisition, nonverbal communication, and reductions in challenging behaviors. Longitudinal studies over longer periods of time have documented changes in IQ scores and in core deficits (e.g., joint attention), in some cases related to treatment, that are predictive of longer term outcomes.

Children's outcomes are variable, with some children making substantial progress and others showing very slow gains. Although there is evidence that interventions lead to improvements, there does not appear to be a clear, direct relationship between any particular intervention and children's progress. Thus, while substantial evidence exists that treatments can reach short-term goals in many areas, gaps remain in addressing larger questions of the relationships between particular techniques and specific changes.

It is strongly recommended that ongoing measurement of treatment objectives and progress be documented frequently across a range of skill areas in order to determine whether a child is benefiting from a particular intervention and that the intervention be adjusted accordingly.

Appropriate objectives should be observable, measurable behaviors and skills. These objectives should be able to be accomplished within a year and be anticipated to affect your child's participation in education, the community, and family life.

The Individualized Education Plan (IEP) and Individual Family Service Plan (IFSP) should be the vehicles for planning and implementing educational objectives.

Appropriate educational objectives for children with autistic spectrum disorders should be observable, measurable behaviors and skills. These objectives should be able to be accomplished within 1 year and expected to affect a child's participation in education, the community, and family life.

They should include the development of:

• Social skills to enhance participation in family, school, and community activities (e.g., imitation, social initiations and response to adults and peers, parallel and interactive play with peers and siblings).
• Expressive verbal language, receptive language, and nonverbal communication skills. Teaching a method of sign language can facilitate acquisition of speech or, in more severe cases, may substitute for speech.
• A functional symbolic communication system such as the Picture Exchange Communication System (PECS).
• Increased engagement and flexibility in developmentally appropriate tasks and play, including the ability to attend to the environment and respond to an appropriate motivational system.
• Fine and gross motor skills used for age appropriate functional activities, as needed.
• Cognitive skills, including symbolic play and basic concepts, as well as academic skills.
• Replacement of problem behaviors with more conventional and appropriate behaviors.
• Independent organizational skills and other behaviors that underlie success in regular education classrooms (e.g., completing a task independently, following instructions in a group, asking for help

Ongoing measurement of educational objectives must be documented in order to determine whether a child is benefiting from a particular intervention. Every child's response to the educational program should be assessed after a short period of time. Progress should be monitored frequently and objectives adjusted accordingly.

Key Points and Next Steps

In summary, from the literature reviewed in this report there are a few key points to walk away with in relation to your child, based on the range of scores outlined in the earlier section of this document:

• A complete assessment is required by a team of professionals that includes a cognitive assessment (where and when possible); a verbal and nonverbal communication evaluation; a fine and gross motor evaluation; an oral motor evaluation (where speech delays are present); a thorough social cognition and social behavior evaluation to include direct observations during peer play sequences; autism-specific diagnostic assessments (i.e., ADI-R, ADOS, GARS, etc.); and, a test for lead and Fragile X by the child's pediatrician. Children of school age should also have their executive functioning assessed.
• Following assessment, early intervention is absolutely necessary in order for the child to develop all the skills necessary to learn and function independently in the world. There is a narrow "window of opportunity" for developing these skills that exists approximately from 2 through 7 years of age. An early intervention program runs for a minimum of 25 hours per week, 12 months per year.
• When selecting an existing program or designing a home-based intervention program, consideration of programs validated by the research literature should be given priority. There are many programs that have appeared over the internet in the past few years that make exceptional and unsupported claims as to their efficacy and ability to work wonders. You must ask yourself this question before considering purchasing any of them: "Can I afford to gamble with my child's future by risking very precious time during their "window of opportunity" by using an intervention that has not been scientifically and therefore rigorously validated by the scientific community?" It is a very difficult choice indeed.
• When considering an intervention program, research demonstrates that the likelihood of positive outcomes for a child is strongly enhanced when parents become educated and involved with their child's program. Approximately 15 hours per week is recommended.
• Of more importance than which program you chose, is the adult-child teaching ratio. It should be one adult to 2-3 children.
• Services should continue year around due to frequently occurring high rates of regression and loss of skills over even a 2-week period.
• Consideration should be given to programs that use incidental teaching techniques that occur naturally and spontaneously during the child's day in order to increase the likelihood that newly learned skills will generalize to new situations.
• Finally, as parents and as advocates for your child, you can never give up or lose faith in your child's ability to persevere and overcome their challenges. Parents are the single greatest resource that a child with autism will ever have.

Citations:

Information in this section is based on source material drawn from:

National Research Council (2001) Educating Children with Autism. Committee on Educational Interventions for Children with Autism. Catherine Lord and James P.McGee, eds. Division of Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.

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