What are some teaching, caregiving, and playing evidence-based practices for autistic children?

Recent research by the Frank Porter Graham Child Development Institute in conjunction with the The National Professional Development Center on ASD identified 27 evidence-based practices. Based on Unitopia’s volunteerism  experience, the most relevant EBPs that support acceptance and inclusion are provided in a holistic, concise manner. EBPs are important to improve outcomes for  autistic individuals, while also providing the best available evidence based on research papers, clinical trials, and other scientific literature. While many interventions and treatments focus on curing autism, this set of strategies improves comfortability and inclusion for individuals on the autism spectrum.

When unspecified, definitions of each intervention come from the National Professional Development Center on Autism Spectrum Condition.

The following sections have been separated into three sections: general strategies, teaching practices, and play practices. An explanation for each section is provided as well.

 

What are some general strategies and evidence-based practices for children with autism?

The evidence-based practices below are general strategies, applicable to any activity or environmental setting.

Cognitive Behavioral Intervention

​The evidence-based practices below are general strategies, applicable to any activity or environmental setting.Cognitive behavioral therapy is an important intervention for supporting autistic adolescents and children, especially with its role that can reduce disruptive behavior and comorbid neuropsychiatric conditions like anxiety. CBT focuses on adaptive responses that allow for the specialization based on specific environments, improving memory that can be utilized in real-world situations. CBT has led to significant clinical results for many other adolescent conditions, and students with autism have also seen stronger educational performances and information processing as a result of behavioral therapy.


Some CBT-related practices include the utilization of SMART goals, which develop specific, measurable, achievable, relevant, and time-bound goals that have empirically supported stronger self-control and social interaction with autistic children. With more and more cases of anxiety and mental health conditions growing in association with autism, CBT offers a range of services that can offer inclusion specialists, personalized interaction, and skill development, improving cognitive perception and functioning.

Antecedent-Based Intervention

Antecedent-based intervention (ABI) includes environmental modifications to shape student behavior.  Factors affecting behavior are identified through behavioral assessments, and the interventions are focused on different factors:

1. Modifying educational activities, materials, or schedule. Taylor et al. examined that modifications to routines improved peer interaction and conversation initiation.

2. Incorporating student choice in educational activities/materials. Carter finds that disruptive behaviors were reduced and social interaction improved in both home and classroom settings when considering students in language skills.

3. Preparing students for upcoming activities. Priming strategies for younger children in autism were displayed by Schreibman et al., producing discussion regarding videographic priming while reducing disruptive behavior and providing methods to facilitate positive behavior strategies.

4. Modifying the environment to improve stimuli. Ladd et al. provided evidence that created preventative measures for self-injurious acts by producing environmental modifications to compete with the urge of skin-picking, eliminating the injurious decisions.   Caregivers should also display “role-model”-like interests, engaging and interacting in a respectful manner.

Task Analysis

This practice is used to simplify tasks for a child through breaking down activities and allowing for the performance of individual steps, and eventually building combinations for larger skills. Parker and Kamps write that task analysis with self-management provided stronger results for task completion in an independent manner, verbal and social interaction, and the engagement in the relevant activities conducted in the study such as cooking or appropriate games.

Examples of task analysis that Unitopia volunteers have conducted are through our arts and crafts sessions that deconstruct complicated steps for students with ASC and other conditions. For example, during our first session for creating clay roses, there was a 20-time step in which petals were created; breaking these steps down based on the individual’s needs was especially key in the success and creation of the final product.


 

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Positive Reinforcement

While reinforcement strategies can be positive or negative, the focus on positive psychology and reinforcement is especially key, as it encourages the positive practices rather than discouraging the individual with ASC. Reinforcement is utilized in collaboration with many other practices, especially with peer-mediated instruction.

Cicero and Pfadt find that combinations of interventions including positive reinforcement and prompting rapidly produced positive effects for toilet training and other mundane activities that can be generalized and substantiated to a larger social setting, such as a school or park.

Positive reinforcement can also be a simple rhetorical focus, shifting from “Don’t do _____” to “You should try this method instead of _______”. For example, if a child would prefer to play alone, positive reinforcement such as “I like the way you are so focused while you are playing video games!” or using positive instructions (preventing the use of words such as “stop” or “can’t”) is especially key. This simple shift builds gradual positive reinforcement that can build specific outcomes.

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Activity Schedules

Activity schedules are a strong method within classroom and household settings and instructions that enable routines. Activity schedules provide predictability throughout the student’s day and allow a student to anticipate changes in the daily routine.   This provides strengthened solutions to refusing transitions from one activity to the next; those solutions can support academic progress and build self-dependence and agency.

Such schedules can be extremely cross-applicable, across different mediums of learning, with different students, and can encourage independence. In fact, schedules can also be incorporated into home and household environments to improve the routine building and independence for children with autism according to MacDuff and Krantz in 1993.

Examples of activity schedules include in-classroom whiteboard setups, flashcards, picture communication symbols as proposed by Dettmer and Simpson in 2000.

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