From a mile to a smile
Intervention For Autism
Intensive Behavioural Intervention
Early Intensive Behavioural Intervention helps Autism
Scientists using the Early Start Denver Model (ESDM), a behavioral intervention, previously showed that this treatment had significantly improved IQ and language abilities in toddlers with ASD. Researchers also investigated whether the intervention had changed brain functioning. Children who completed the ESDM intervention had faster neural responses and higher cortical activation when looking at faces compared to objects. Those received treatment as usual (a common community intervention) showed the opposite pattern. Additionally, higher cortical activation during face-viewing was associated with better social behavior. This suggests that the ESDM intervention may cultivate the brain that results in higher IQ, language abilities and social behaviors.
Could "the new drug" make a difference for kids with autism?
Fifteen-year-old Marshall Scarpulla is one of three children in his family with autism. His mother, Alissa Scarpulla, said she noticed some of the signs when he was 3 years old.
“He was having a speech delay and the school brought it to my attention, too,” she told CBS News.
There is no cure for autism, but researchers at Montefiore Medical Center in the Bronx are studying whether a first-of-its-kind drug called balovaptan, could make a difference for kids like Marshall.
“There are not any approved treatments for what we think of as the core symptoms of autism… all of the social difficulties, repetitive behaviors and the ability to function in everyday life,” said Dr. Eric Hollander, director of the Autism and Obsessive-Compulsive Spectrum Program at Montefiore. Marshall is part of the nationwide clinical trial, which includes 300 children and teens with high functioning autism.
Researchers are testing whether the drug, balovaptan, can help with autism symptoms by affecting neuro-system to influence social behavior. Hollander says the drug could be one piece of the puzzle.
“There would still be need for speech therapy, occupational therapy, educational interventions and applied behavioral interventions,” he explained.
Developing a bond with a child
The role of the key person
It is a statutory requirement of the ESDM that all children should have a key person. A key person is someone who can develop a strong relationship with an individual child and their family. This supports the child’s emotional well-being and so allows them to settle and learn. The role is particularly important in relation to children who have SEN and disabilities and as such is recognized in the Code of Practice.
Developing a bond with a child.
The basis of a strong key person relationship is that a child develops a bond with a practitioner. This does take time, especially if a child has never been separated from their parents before or has had an ‘unsuccessful’ separation which has left the child unsettled. It is worth getting as much as information of a child from a parent before the first meeting, including one’s temperament, interest and previous experiences. This way you can gain insight into what is the best way to respond to the child and how you might build the child’s trust. Unless there are exceptional circumstances, you should ensure that you have made a bond with a child before any separation takes place and the parents leaving. This is because young children can quickly show separation anxiety and their distress can prevent them from being able to form a relationship.
Valuing and empowering children
The starting point for working effectively with any children is to respect and value them for being themselves. A common criticism of practitioners is the tendency to focus so much on the area of developmental impairment or condition, and the child becomes a problem that has to be solved. This can lead to low self-esteem and underachievement, which is one of the reasons why the Code of Practice stresses the importance of children having an active voice and involvement in their care and education. Thus the Code of Practice looks at the importance of building strong relationships with children and finding ways to empower children.
The Code of Practice
A good starting point is to look at the Code of Practice and its requirements in relation to involving children. One of the principles of the code states that local authorities must have regard to ‘the views, wishes and feelings of the child or young person, and the child’s parents’.
In addition, the Code states that this principle is designed to support ‘the participation of children, their parents and young children in decision-making.’
As well as the Code of Practice, there is also other legislation in place. It is notably related to the United Nations Convention of the Rights of the Child (UNCRC), which gives children a right to have their views considered when decisions that will impact them are being made.
‘Children have a right to receive and impart information, to express an opinion and to have that opinion taken into account in any matters affecting them from the early years. Their views should be given due weight according to their age, maturity and capability.’
Problems faced by Autism At different stages
In general, we will distinguish four stages of grown for children with autism: preschool, primary school, adolescents and adults. At different stages, not only the individuals with autism but also their families are facing different problems.
Problem in the preschool period
Preschool refers to the learning phase before the age of six. Children with autism are often reluctant to get in touch with the outside world, they may be obsessed with playing cars, sensory toys etc. In fact, children at about 2 years old can go through clinical assessment for autism. Children with autism may have problems on behaviors, communication and social issues. As a result, preschool children need the social, communication, and mitigation behavioral training the most. During this golden training phase, they should seek appropriate treatment as early as possible in order to overcome the barriers and reduce some derivative problems.
Problems at primary school
Children with autism will either attend special schools or mainstream primary schools based on their cognitive and adaptive skills. If your children are enrolled in a special school, there will be more services and backup support, including behavioral therapy, speech therapy and emotional regulation training, thus enjoying more intensive care. Some children with autism are enrolled in mainstream schools. However, some may not be fully ready for school and may still immerse in their own world. They play and work alone without any social interactions with others. In addition, children with autism may usually have higher difficulties in having self-control and social interaction, their behaviors may lead to teachers and classmates’ complains. For example, they may not be able to sit in class, follow the rules of the classroom, follow teachers’ instructions, or appropriately express their needs.
At this stage, children with autism who are enrolled in mainstream schools may need shadow teachers to help them with their social life and train their learning to learn behaviors, such as sitting and listening to enhance their learning. There are also children with autism who will take a one-on-one behavioral therapy after class to enhance their learning, social skills, and reviewing school-based or problem-solving skills such as answering questions, sharing toys, etc.
Problems at adolescence
Adolescence is an important period for making friends. Students with autism over the age of 12 begin to enter adolescence. Learning how to deal with friends and heterosexual may often cause problems for teachers and parents.
Middle school students may need to acquire appropriate social behaviors and know how to express and control themselves especially how to get along with the opposite sex. Children with autism with low functioning may have more difficulties in emerging and being accepted by their peers. They may have weaker self-esteem and social interpersonal awareness. Behavioral therapists may use interactive teaching to demonstrate and rationalize them about appropriate social behaviors. It is important to teach teenagers with autism about what they should do, but interactive teaching is more important to bring out the rationale on the appropriate behaviors. If teenagers with autism cannot relate and understand why they can’t do certain kinds of behaviors – e.g. touching others’ body parts at random, they will not have the motivation to control their behaviors. In this case, teenagers with autism may only control their behaviors when the parents or therapists are present. In the absence of surveillance, they will act as usual with inappropriate behaviors. Therefore, it is important to let teenagers with autism understand why they can or cannot do certain kinds of behaviors, thereby enhancing their motivation to control their behaviors.
The difficulties faced by people with autism and their families at different stages are different. Undoubtedly, the guidance and help from professionals are especially important! Parents can seek professional help; such as behavioral therapy, to help individuals with autism to better and sooner emerge to society.
Scientists have been trying hard to look for the cause of ASD but they have only find correlations, in other words, risk factors. Although there is no cure for ASD, but research has shown that applied behavior analysis (ABA) can effectively increase social, language, and life skills. And the golden period for treatment is between 2 to 6 years old.
The queue for assessment from governmental services is 1 to 2 years with longer waiting time for younger children. It is highly possible that a child may miss the golden period for treatment by the time he/she gets the assessment result. Even if your child does not have the assessment result yet, you should start intervention to deal with his or her behavioral problems and avoid any delay in treatment.