Individualizing Care And Intervention For Those Diagnosed With Autism
The bulk of modern research in the realm of autism spectrum disorders (ASD) has been directed towards the areas of potential causes and prevention, justifiably so. However, for individuals who are already diagnosed, or who are at risk of diagnosis, research into the cause isn't as pressing as delving into early intervention and treatment.
The most effective and evidence-based approaches for treating people with special needs are in the methodologies of applied behavior analysis (ABA), behavioral psychology and positive behavior support. Despite this, some still question the utility of such interventions, citing that behavioral approaches shape rote responding or stifle the unique attributes each person possesses, leading to the perception of rigid behaviorists who only care about gaining compliance and looking at data paths.
The most vital goals of the assessment and intervention process are to help provide the needed support for people with special needs and to collaborate with families and caregivers in order to foster independence, decrease dependence, improve quality of life for all involved and facilitate integration into society as a whole. What some service providers fall into the trap of, which may contribute to some of the misconceptions surrounding ABA, are "cookie-cutter" programs which apply the same intervention plan across numerous individuals, in the absence of any individualization catered to their specific needs.
While skills such as gross motor imitation, which is a prerequisite towards imitative play skills, or answering WH-questions, necessary to engage in reciprocal conversation, are essential skills, they are likely not the priority for a child who is more severely impacted by ASD or related developmental disorders. An intervention for a child with proficient verbal skills and limited challenging behaviors, such as aggression or self-injury, but who isolates themselves at recess, should have very different goals than an intervention for a child who is non-verbal and who engages in head-banging on a regular basis when transitioning to the dinner table or the bathroom. The objective for the first child may include facilitating positive social interactions with peers at recess through social skills training, while the objectives for the second child will likely be to teach some form of functional communication and build tolerance towards non-preferred tasks in order to reduce instances of self-injury.
Ethically, and by definition of "applied" in applied behavior analysis, service providers must always analyze what is most severely impacting their clients and their families, applying the most effective and relevant interventions, while incorporating that child's specific strengths and interests whenever possible. The assessment process entails a plethora of questions but often involves asking parents and caregivers, "What are the top challenges your child faces on a regular basis?" and "Where do you see your child in 6 months, 1 year or 5 years down the line?" Teachers, behavior analysts, behavior therapists and other service providers must also remember to ask themselves those same questions when it comes to their clients.
Article written by:
Pasha Bahsoun, M.A., BCBA, earned a Bachelor's of Science in Psychobiology from UCLA and a Master of Arts in Developmental Psychology from Teachers College, Columbia University, where he researched and implemented various approaches to educating children diagnosed with autism, including through social skills training and the use of educational media. Pasha’s thesis was titled, “The Use of Educational Media with Children Diagnosed with Autism,” in which he worked with the PBS television show “Super Why!” to develop games and programs catering to the developmentally disabled. Pasha currently serves as the Director of Social Skills, BCBA Supervisor at the Center for Applied Behavior Analysis.