Types of Autism Behavior Interventions: It involves taking actions, sometimes with the help of others, to improve specific conditions or behaviours. The child, the parent, and the therapist must all work together to make an intervention successful. Interventions can be successful with teamwork and consistent practice.

Many interventions are available to help parents deal with the challenges they face when raising a child who has autism. Some interventions can be done once, but others need to be repeated over some time.

When should autism intervention strategies be used?

Autism affects children differently. The parents, family, and caregivers can determine whether a child has autism and needs treatment to correct harmful or unacceptable behaviour. A variety of challenging behaviours can characterize autism.

• Inappropriate behaviour in a social setting (e.g., hitting people with utensils, causing them to hurt themselves, etc.).
• Aggressiveness
• Tantrums
• Repetitive behaviour ( stimming).
• Hurting yourself or others
• Demand Avoidance

Children with autism can act out in unexpected or surprising ways for a variety of reasons. These include:

• A difficulty in understanding non-verbal or verbal language including gestures, tone and context meanings
• Communication difficulties (some children with Autism are non-verbal). This can lead to frustration
• Sensitivity of the senses to sounds, sights and smells
• Aggressive behaviour
• Anxiety
• A dislike for a change in routine

Parents and primary caregivers for children with autism must understand what triggers challenging autism behaviors, and then respond accordingly. Time-outs and other punishments such as time-outs may not be enough to stop unwanted behaviours.

Plan to implement and start an intervention

Decide on the best method for an intervention. To learn more about different types of interventions, consult your child’s physician. Your child’s doctor will be able to assess the needs of your child and recommend a treatment plan.

There are several treatments and techniques available today for autism-related behaviour problems.

ABA therapy has been proven to be effective in treating children with autism.

Treatments and strategies for tantrums may be either focused or comprehensive. Focused interventions use a single strategy, either alone or with other strategies to improve a particular behavior or skill. Comprehensive interventions are multi-strategy approaches that aim to change a wide range of behaviours.

Applied Behavior Analysis

ABA aims at a positive behaviour change based on the premise that people will improve their behaviour if they are given positive rewards or consequences. It’s a collection of techniques that are used to teach autistic people a new skill or reduce undesirable behaviour.

Dr. Ole Lovaas is a clinical psychologist at the University of California and a professor. He was the pioneer of ABA, and the first person to demonstrate that it can be used effectively in modifying the behavior of children with autism.

In his research “Behavioral Treatment and Normal Intellectual and Educational Functioning in Young Autistic Children”, 19 children with autism were given 40 hours per week of ABA for two years. Nine of the 19 children who were in the ABA program at the end of the two years had achieved cognitive function and could perform in school without any help.

ABA Therapy focuses on rewarding good behaviour. Children with autism are more likely than not to repeat a behaviour if they receive a reward for it.

The ABCs is a tool that ABA uses to observe.

A : Antecedents: events, actions or circumstances that occur before a behaviour.

B : Behavior: The behaviour that is the result of the antecedent

C : Consequences: The action or reaction that follows a behaviour

A good example in everyday life is:

A: A parent tells the child that he must stop playing to eat his dinner

B: The child is refusing and throwing a fit after being asked repeatedly.

C: The child is left alone by the parent and goes back to playing.

In an ABA environment, therapists change antecedents to achieve the desired behaviour (positive).

Early intensive behavioural interventions

Early Intensive Behavioral Intervention, or EIBI, is a part of ABA. This method is only for children under five years old with autism. For a child to receive a successful EIBI, they must attend 20-40 hours per week.

EIBI, like ABA, uses positive reinforcement to achieve targeted autism behaviour. It can also be used to curb harmful and destructive behaviors such as self-harm Hurting others, aggressive behaviour, and irrational temper tantrums.

In 2014, a research study concluded that EIBI is effective in improving the behaviour of children. This was especially true for those who began treatment before age two.

The study also suggests that EIBI may be one of the most evidence-based behavioural treatments for repetitive behaviours associated with autism. The study concluded that “Increases in direct measures of JA (joint-attention), play, imitation, language, and stereotypy were observed regardless of the level of performance when entering EIBI.”

Distinct Trial Training

Discrete Trial Training (DTT) is a teaching technique that can be used with other intervention techniques. DTT is commonly used in ABA sessions. This is best for children with autism ages 2-6.

DTT simplifies learning for children with autism by breaking down tasks into their most basic components. It’s easier to follow a task such as tooth brushing if it is broken down into simple steps. The majority of DTT methods are based on repetition to ensure that the child masters the skill.

The child is rewarded or motivated for completing each step of the task. For example, they may be told “Great Job!” or receive a star stamp on the backside of their hand.

The five steps to DTT are as follows:

1. The therapist will usually give instructions or requests as an antecedent.

2. Prompt: (Any gesture that guides the child towards what he/she should do)

3. Response (the targeted behaviour)

4. Consequence for correct response (reinforcement/praise)

5. Consequences of incorrect responses (correction).

6. Inter-trial (a break between tasks or points of learning)

DTT benefits children with Autism because they can learn more easily with this technique. Each activity in DTT is kept brief to ensure maximum concentration. This approach also works well when it is delivered in a 1-on-1 session. Tasks are then tailored to meet the child’s specific needs.

Milieu Teaching

Milieu teaching, a behavioural intervention in the natural environment, is used to improve the language skills of children with autism.

Teaching opportunities can be found in the everyday activities of the child, such as getting up for school, eating breakfast, or playing at the playground. The teacher (usually a parent or primary caretaker) waits until the child shows interest in something, such as sliding or eating a snack. The child will then be encouraged to use their communication skills to ask for something, give more information or answer questions.

Three teaching methods are used in Milieu:

1. Model: The teacher models the target language for the child to imitate.

2. Mand: A teacher will ask the child to tell them what they want.

3. Time delay: The instructor waits for the child to respond and then prompts them with non-verbal signals, such as raising their eyebrows.

EMT – Enhanced Milieu Teaching

Milieu Teaching is a version of Enhanced Milieu Teaching. EMT is typically done by parents trained in the method.

EMT aims not only to improve communication but also to manage challenging behaviour. Among the strategies to prevent unwanted behaviour, there are:

• Use a timer to smooth transitions. (The child should stop whatever he/she is doing when the timer ends)
• Use a visual calendar (pictures of the child’s daily activities)
• Giving choices to the child (gives them a sense of control)

A 1994 study found that parents who practised EMT at home with their children saw positive results. The treatment helped children improve their communication and relationship with their parents.

Indirect Teaching

It is a naturalistic method of teaching that is part of ABA. It’s used to improve communication skills in children with autism. It is recommended that children between the ages of 2-9 receive incidental teaching, but it can be used at any age.

This is the process of incidental teaching:

1. Prepare a room for your child that will make him/her feel welcome. For example, set up a playroom with all of his/her favourite games and toys.

2. Limit the access of a child to an object or toy that they want by placing it somewhere visible but out of reach.

3. When the child asks for or points to the toy, wait for it to be requested.

4. What toy animal would you like?

5. You can wait for a child to answer, such as “Horse.”

6. As a reward, give the toy equine.

In contrast to a structured environment such as a school, incidental learning is carried out in an informal setting where the child is the leader. According to research, this type of teaching can help children apply their knowledge and skills in a variety of situations.

Positive Behavior Support

Positive Behaviour Support is an intervention that aims to reduce or eliminate triggers of unwanted behaviour and teach a child a new, acceptable behaviour to replace the difficult or undesirable behaviour.

PBS is based upon the Human Rights Act, which states that all children have a right to dignity and the opportunity to receive a good education.

PBS’s treatment strategy focuses on teaching the child how to communicate effectively to achieve what they want, and not to have to behave inappropriately. When a child exhibits challenging behaviour, the teacher or the therapist will try to replace it with more appropriate behaviour.

PBS also uses:

• Change the routine or environment
• The tactic of ignoring the behaviour
• Diversion
• Rewarding good behaviour
• Children’s expectations and their adjustment
• Desensitization is one of the methods used to modify a system.
• Teach others how to react when they are around a child
• Time out
• Medication

PBS will not punish or correct a child who behaves unexpectedly. In this situation, it is best to calmly offer the child options.

You don’t simply tell a child to stop being loud. Instead, you give them a choice: “You can either play quietly, or you can leave the room.”

The philosophy behind this is that children should be treated with respect at all times and that coercion or punishment are violations of their rights.

Pivotal Response Treatment

Pivotal response treatment (PRT), is a naturalistic form similar to EIBI or Incidental teaching. PRT is a naturalistic form of ABA that uses play to help children with autism improve their social, communication and play skills. PRT lessons include socialization, imitation, joint attention, and taking turns.

According to PRT, there are four “pivotal areas” of child development that will influence later development.

• Motivation: the desire of a child to learn new things and experiment with them
• Self-initiation: answering questions from the child when he/she is interested in a topic
• Self-management: Helping a child to be independent and learn independently
• Response to multiple cues: Teach children to respond to prompts with different meanings (Comb your Hair, “Fix Your Hair,” “Please Use the Comb for Your Hair”).

Typically, a PRT session involves:

• Choose a goal that the child can achieve, like saying “please” and “thank you.”
• Use an item that the child enjoys as an interesting point and a way to achieve the goal.
• When the child attempts to achieve the goal, praise and/or reward him/her.

The child doesn’t have to score a goal in PRT before they are rewarded. A reward is given for just attempting.

Verbal Behavior Approach

The Verbal Behavior Approach (also known as Verbal Behavior Therapy) is based on theories of ABA. This approach helps children with autism connect what they say to their desired actions. This method teaches children with autism that speaking or using words will help them achieve what they want.

This technique uses four different “operants” or languages:

1. Mand is a request, such as “Water” to ask for more water.

2. Tact – A comment made to express an experience or attract attention. As an example, you could point to the sink while saying “sink.”

3. Intraverbal: Using words or phrases to answer a query

4. The word echoic is used to describe words that are repeated.

The Verbal Behavior Approach is based on errorless learning. It uses prompts to encourage children to respond. The process is repeated repeatedly until the child does not need prompts anymore to complete a task.

UCLA Young Autism Project

The University of California at Los Angeles Young Autism Project, also known as the Lovaas program, is a comprehensive and structured intervention designed to help young children who have autism.

The method is designed to help children learn self-help skills, communication, thinking and social abilities. Children are rewarded as they learn. However, challenging behaviour is ignored.

UCLA YAP uses a variety of methods including Discrete Training, Discrimination Training and Incidental Learning. This intensive training requires parents to spend 40 hours a week with the assistance of a specialist.

Conclusion

It is not an easy decision to choose the best behaviour intervention for your child. You can develop a treatment plan with the help of a doctor or behaviour analyst for your child and you will be well on your way to improving your child’s behaviour.