1. TREATMENT FOR AUTISM SPECTRUM DISORDERS

2. Floor Time
This approach is based on the Developmental Individual Difference Model from Dr. Stanley Greenspan.
Floor Time is simply the idea that a child’s communication skills can be improved by building on his/her strengths while playing together on the floor.

3. Floor Time: Six developmental milestones include:
Self regulation and interest in the world
Intimacy or a special love for others
Two way communication
Complex communication
Emotional ideas
Emotional thinking

4. Implementation
The therapist enters the child’s activities and follows the child’s leads in play and guides the child in expanding his/her interactions.
Parents are instructed on how to move the child to more complicated interactions which are referred to as “Opening and Closing Communication Circles.
Speech, motor, and cognitive skills are addressed “Through a synthesized emphasis on emotional development.

5. Floor Time is sometimes used in conjuction with ABA.
Intervention is delivered in a low stimulus environment from 2-5 hours per day with the child’s family using the principles in daily life.
Interdisciplinary Council on Developmental Learning Disorders
Greespan, S., & Weider, S. (1998). “The Child with Special Needs”. Reading, MA: Addison-Wesley.

6. Floortime: Playtime for the Clinician
The principles of Floortime can easily be included in the therapy techniques of Speech, OT and PT.
Floortime allows for a fun, naturally reinforcing therapy environment.
SLP’s, OT’s, and PT’s already employ a variety of play therapy techniques in their interventions.

7. FLOOR TIME VIDEO

8. II. TEACCH
Training and Education of Autistic and Related CommuniCation for Handicapped Children (TEACCH)
Developed by Eric Schopler, PhD of the University of North Carolina
This is a highly structured program based on the “Culture of Autism”.

9. Culture of Autism
This term refers to the “relative strengths and difficulties shared by people with autism and that are relevant to how they learn”.

10. Intervention
In this approach, children are evaluated to determine emergent skills and intervention is designed to build on these skills.
The intervention plan is developed for each individual child to help plan activities and experiences.
The child refers to visual supports such as picture schedules to help them predict and cope with daily activities.

11. www.teacch.com The TEACCH program is for home or school interventions.
Training is available through TEACCH Centers in North Carolina and by TEACCH trained pshychologists, SPED Teachers and SLPS

12. This program focuses on cultivation of the child’s strengths and interests rather than focusing on his/her deficits alone.
The strengths of those with autism (visual skills, recognizing details, and memory can become the basis of successful adult functioning (Ohio’s Parent Guide to Autism Spectrum Disorders – Mesibov and Shea, 2006).

13. TEACCH and the Therapist
SLPs, OTs, and PT’s can easily include TEACCH procedures in their therapy sessions.
Therapists can incorporate the use of schedules, social stories and other techniques in their therapy plans, encouraging skill generalization.

14. TEACCH VIDEO

15. PECS VIDEO

16. SCERTS
Social Communication, Emotional Regulation, and Transactional Support
Developed by Barry Prizant, PhD., Amy Wetherby, PhD, Emily Rubin and Amy Laurent
SCERTS draws from other programs such as ABA, Pivotal Response Treatment, TEACCH, Floor Time and RDI.

17. SCERTS SCERTS encourages child initiated communication in daily life.
SCERTS aim is to help the child achieve “Authentic Progress”, which is defined as the ability to learn and spontaneously carry over functional skills into various settings and with many communication partners.

18. The Focal Aspects of SCERTS
Social Communication: spontaneous functional communication, emotional expression and secure and trusting relationships with others
Emotional Regulation: the ability to maintain a well-regulated emotional state and the ability to cope with daily stresses.

19. Transactional Support: development and implementation of supports to assist communication partners to adapt the environment and provide the tools to enhance learning(picture communication, written schedules, sensory supports).
Specific plans are developed to provide education and emotional support for families and to encourage teamwork among the intervention team.

20. Intervention
This program provides for children with Autism to learn with and from other children who are good social and language models
Transitional supports (environmental accommodations) and learning supports (picture schedules or visual organizers)

21. www.scerts.com www.barryprizant.com
This program is usually provided in the school settings by SCERTS trained professionals

22. Pros and Cons
Unlike ABA, this program focuses on group intervention rather than one on one treatment.
Uses a multidisiciplinary team approach
SCERTS is not an exclusive program and accepts other educational models that the team deems appropriate.

23. Therapist’s Perspective
The SCERTS model is an interdisciplinary approach. The model uses the knowledge base and experience of general and special educators, SLPs, OTs, PTs, and other professionals.
Therapists should be familiar with SCERTS principles and techniques and communication with the SCERTS provider, parents other members of the intervention team is critical to the success of the program.

24. SCERTS VIDEO https://www.youtube.com/watch?v=WKVttP3Rfag

25. The Hanen Approach
This approach is based on the belief that parents should be the child’s language teachers, because they have the strongest bond and have many opportunities to teach language in the natural contexts of daily living.
Parents are trained by Hanen certified SLPS.

26. The Hanen Approach
Trained parents can then adapt the approach to meet the individual and unique needs of their child.
Programs for Parents include:
“It Takes Two To Talk”-Hanen program for parents.
“More Than Words”- Hanen program for parents of children with Autism Spectrum Disorders
“Target Word” – Hanen program for parents of Late Talkers.

27. The Hanen Approach www.hanen.org
The Hanen Centre has also developed supports for teachers (Learning Language and Loving It – A Guide to Promoting Children’s Social, Language, and Literacy Development second edition – Weitzman and Greenber, 2002).

28. Pros and Cons Parents are to be the sole providers for this approach.
It is not intended to be a curriculum
It does not exclude other educational models.

29. HANEN VIDEO https://www.youtube.com/watch?v=W-6frim4Ojc

30. The Son-Rise Program
The Son-Rise Program was developed by Barry Neill Kaufman and his wife when their son Raun was diagnosed as severely and incurably autistic.
The program is a system of treatment and education focusing on joining children instead of working against them.

31. Principles of the Son-Rise Program
Joining in the child’s repetitive and ritualistic behaviors is considered the “key to unlocking the mystery of these behaviors”, facilitating eye-contact, social behaviors and the inclusion of others in play.
Utilizing a child’s own motivations advances learning and builds the foundation for education and skill acquisition.
Teaching through interactive play results in effective and meaningful socialization and communication.

32. Principles of the Son-Rise Program
The program encourages providers and parents to teach with enthusiasm and to employ a non-judgmental attitude.
This approach considers the parent to be the most important and best resource. It encourages the creation of a distraction free work and play environment to facilitate optimal learning.

33. Intervention
Intervention is provided through parent-training at one the Autism Treatment Centers of America.
Parents are the primary providers, however they can include family and friends in the intervention process.
The Son-Rise Program combines effectively with other complementary therapies (ie. Biomedical interventions, sensory integration, diet and Auditory Integration therapies).

35. Applied Behavioral Analysis
This treatment program (ABA) is based on the principles of positive reinforcement of B.F. Skinner.
Simply, it is the repetitive use of positive reinforcement to teach specific skills and decrease inappropriate behaviors.
What is occurring in the child’s environment to cause negative behaviors?

36. ABA Three Step Procedure
Antecedent: The verbal or physical stimulus such as a command or request.
Resulting Behavioral response to stimulus or a lack of response
Consequence: the positive reinforcement or no response for inappropriate behavior

37. ABA Intervention
ABA is not synonymous with Discrete Trial Training. DTT was developed by Dr. O. Ivar Lovass. DTT is a strategy used in ABA
In ABA, skills are broken down into small, discrete tasks which are taught using prompts, which are faded out gradually as a skill is mastered.
Students are positively reinforced with either verbal praise or something tangible that he/she finds rewarding.

38. ABA programs are carried out at school or in the home with a one on one aide
The goal is the carryover of the skills to other environments.
Facilitated play with peers is also part of this program.
The ABA provider is responsible for data collection and analysis.

39. Providers must be board certified behavior analysts
Providers must be board certified behavior analysts. The provider is responsible for writing and managing the program. Individual “Trainers”, who are not necessarily board certified provide the daily intervention.
Sessions last between 2-3 hours with minute breaks at the end of each hour for incidental teaching and play time.
Intervention requires hours per week with families encouraged to use these techniques daily.

40. 40 hours of intervention a week is often considered to be just too much for many families.
The cost is prohibitive. While some schools will provide ABA, few will pay the cost of 40 hours per week of one on one intervention for “just” one child.
Critics suggest that ABA can create an “emotionless, robotic” child who has difficulty carrying over skills to a natural environment.

41. The Therapist’s Role in ABA
ABA is usually paired with other therapies in early intervention. The therapists should team.
Speech Therapy, Occupational Therapy, and Physical Therapy are often areas where the child can generalize and practice skills with integrated goals.
Each discipline brings to the patients treatment plan differing goals and objectives in terms of communication modalities, positioning and sensory needs.

42. Verbal Behavior
This program uses Skinner’s analysis of language as a system to teach language and modify behaviors.
It encourages the student to learn language by developing a connection between a word and its meaning.
Verbal Behavior is based on the idea that the way we talk influences how sensitive or aware we are of changes to our environment.

43. The intervention first focuses on using language to request or “mands”.
Then the focus turns to naming or labeling referred to in the program as “Tact”
Finally the focus of treatment moves to “Intra-Verbal Communication” which includes understanding and use of wh-questions and conversation.

44. ABA VIDEO