Autism News Network


Packet of Information for Parents New to Autism,

 (on-line version)

Autism Spectrum Disorders

Common Intervention Techniques

(the following verbatim from ASA except where I added a * to indicate that more info/local sources may be found elsewhere in this packet.)

Parents of children who fall on the Autism Spectrum Disorder are frequently  overwhelmed when confronted with the many the many treatment/educational approaches suggested for working with their children.  The following is an  explanation of some of the most widely used techniques.  This list is not  exhaustive.  Some of these techniques are comprehensive programs, while  others are designed to target a specific area of difficulty.

There is little or no evidence to show that children with autism learn in  group situations.  Research findings indicate that children with autism learn only in one-on-one situations for approximately the first six months of  treatment.

Discrete Trial Training (ABA)*

Discrete trial training is based on applied behavior analysis principles.   This method involves breaking down tasks into simple elements and teaching  the child through repetition.  An individualized program is designed for each  child to that the child's specific strengths and weaknesses can be addressed.  The goal of the program is to teach the child everything that is required of  a normally developing child of the same age, so that the gap between the  child's chronological and mental age can be narrowed or eliminated.  The  content of instruction includes speech and language skills, gross and fine  motor skills, academic skills, self-care and social skills.

This program involves from 10 to 40 hours per week of one-to-one discrete  trials.  Play breaks of 20 to 30 minutes are included between each hour of  work.  Proponents of this treatment recommend that it start early in life and  continue for a long period of time.  The individual instruction is usually  performed in the home, with trained psychologists assisting parents and  "therapists" (trained professionals or paraprofessionals) in administering  this program.  The program emphasizes the importance of parents in following  through with the treatment.

Floor Time*

This therapeutic approach seeks to improve developmental skills through  analysis and intervention in six areas of functioning.  The first area has to  do with a child's ability to regulate his or her attention and behavior,  while being presented with a full range of sensations.  The second area has  to do with the child's ability to maintain quality and stability of  engagement in relationships.  The third area has to do with a child's ability  to enter into two-way, purposeful communication.  At its most basic level,  this program involves helping the child open and close circles of  communication.  A circle of communication is opened and closed when a child  evidences some interest or behavior and the parent responds to that interest  in a way that is acknowledge by the child.

The fourth level involves stringing together many circles of communication  into larger patterns.  This level is very important because many children who  have command of a number of words are still unable to maintain a flow of  two-way communication, which is necessary for negotiating many of the most  important emotional needs of life.  The fifth level has to do with the  child's ability to create mental representations or emotional symbols through  the ability to engage in pretend play or use words, phrases or sentences to  convey some emotional intention ("want that," "me mad" etc.).  The last level  has to do with the ability to build bridges or make connections between different internal representations or emotional ideas (e. g., "I am mad  because you are mean.")  This capacity is a foundation of higher level  thinking, problem solving and such abilities as separating reality from  fantasy, modulating impulses and mood, and learning how to concentrate and  plan.

The ideal treatment program for a child with emotional and developmental  challenges according to proponents of this approach, would include speech  therapy, sensory integration based occupational therapy, and an educational  placement which includes typically developing peers.  The focus of the  educational program should be on improving and increasing interaction  patterns.  However the cornerstone of this program is home-based, where it is  recommended that parents and care givers do "Floor Time" with the child in 20  to 30 minute intervals six times per day. Floor time involves building and  increasing interactions, and opening and closing circles of communication all  the time through following and building on the child's lead in play  activities.  This is an intervention based upon engagement at an emotional  level, so that the child seeks interaction and is satisfied by engagement  with the caregiver.

Picture Exchange Communication System (PECS)

The Picture Exchange Communication System (PECS) is a communication training  system developed within the Delaware Autistic Program.  PECS is used at the  Delaware Autistic Program with students from the ages 2 through 21 years.   Prior to using a picture exchange system, intensive verbal imitation  training, sign language training and picture pointing programs were used with  non-vocal students with limited success.  According to proponents of this  program possible reasons for the limited success of these previously used  training programs include: the use of arbitrary reinforcers, transient or  temporally bound stimuli, oral-motor difficulties, speaker/listener role  confusion, etc.

Students using PECS are required to give a picture of a preferred item to a  communicative partner in exchange for the item.  The initial communicative  behavior targeted is requesting.  In the request, preferred items are  presented as reinforcement of the response.  Further, request training takes  place in a social context.  Teaching students to request is a useful skill,  and may facilitate the teaching of other communicative intents.  The only  prerequisite to beginning request training is the identification of those  items or activities that are preferred by the student.  Two therapists are  initially required so that one sits behind the child and physically prompts  him/her to give a picture in exchange for the reinforcer.  Physical prompts  are quickly faded in order to ensure independent communication.  Once the  requesting with pictures is firmly established the child is then encouraged  to verbalize the request.

Pivotal Response Training (PRT)

This intervention technique is based on the principles of applied behavior  analysis.  The intervention identifies certain behaviors for treatment that  will produce simultaneous changes in many other behaviors  "Pivotal  behaviors" are thought to be central to wide areas of functioning and  positive changes in pivotal behaviors should be widespread effects on many  other behaviors.  Two important pivotal behaviors addressed using this  technique are motivation and responsivity to multiple cues.  The program  works to increase motivation while increasing important skills, typically  language acquisition, social interaction, and play skills, in hard to teach  children with autistic spectrum disorders.  The training uses the following  components:
The question/instruction/opportunity to respond should:
* Be clear, uninterrupted and appropriate to the task
* Be interspersed with maintenance tasks
* Be chosen by the child
* Include multiple components when appropriate

Reinforcers should be:

* Contingent upon behavior
* Administered following any reasonable attempts to respond
* Related to the desired behavior in a direct way

Pivotal Response Training provides parents, teachers and caregivers with a  method of responding to their child with autism/PDD, which provides teaching  opportunities throughout the day.  It can be used in structured one-on-one  teaching or in the "natural setting."  Important aspects of training include  turn taking, reinforcing attempts at correct responding, frequent task  variation, allowing the child a choice of activities, interspersing  maintenance tasks, and using natural consequences.  This type of training is  flexible and allows the teacher, parent or other caregiver to require more  difficult responses as the child progresses.  It was specifically designed for use by parents and can easily be integrated into everyday life in order  to facilitate generalization and maintenance of behavior change.


Social Stories*

Many persons with autism have deficits in social cognition, the ability to  think in ways necessary for appropriate social interaction.  This deficit can  be addressed by a technique, which is used to help individuals with autism  "read" and understand social situations.  This technique, called "Social  Stories," presents appropriate social behaviors in the form of a story.   There are a number of ways a social story can be implemented.  For a person  who can read, the author introduces the story by reading it twice with the  person.  The person then reads it once a day independently.  For a person who  cannot read, the author reads the story on an audiotape with cues for the  person to turn the page as he/she 'reads' along.  These cues could be a bell  or verbal statement when it is time to turn the page.  Once the autistic  individual successfully enacts the skills or appropriately responds in the  social situation depicted, use of the story can be faded.  This can be done  by reducing the number of times the story is read each week and only  reviewing the story once a month or as necessary.  Fading can also be  accomplished by rewriting the story or gradually removing directive sentences  from the story.

Social stories are useful for helping individuals with autism learn  appropriate ways to interact in social situations.  They can be  individualized to incorporate the specific needs of the person for whom the  story is written.  Activities are taught using flexible directive statements  such as "I will try to stay in my bed until morning," to encourage the  individual to try to reach the final goal.  They can teach routines, how to  do an activity, how to ask for help and how to respond appropriately to  feelings like anger and frustration.

TEACCH: Treatment and Education of Autistic and Communication Handicapped Children*

TEACCH is a state funded public health program available in North Carolina,  which provides services from the level of diagnosis and early counseling for  parents and professionals to adult community based centers.  Educational  strategies are established individually on the basis of a detailed assessment  of the person with autism's learning abilities, trying to identify potential  for acquisitions rather than focusing on deficits.  Educational programs are  revised frequently, according to the child's maturation and progress.
A hallmark of the TEACCH program is to provide 'structured teaching.'  This  technique is based upon the observation that children with autism learn and  integrate information differently than other children.  Many noncompliant  behaviors of children with autism are a result of their difficulty  understanding what is expected of them.  Structured teaching places heavy  reliance upon teaching through visual modes due to difficulties that most  children with autism have with processing verbal information.  Visual  structure is provided at many levels, such as organizing areas of the  classroom, providing a daily schedule using pictures or written words, visual  instructions and visual organization signaling the beginning and end of  tasks.  Successful education of the child with autism demands a continuum of  services.  A continuum of services can best be conceived by covering a wide  range of different approaches and different sites for children within the  same age group.

Such a structured teaching system helps the child with autism


Being able to predict or anticipate the activities of the day gives the child  a sense of control, security and independence.  Schedules can be used in the  home or classroom.  They help to clarify communication between parent/child  and teacher/student.

Presenting information in a visual form:

Schedules are very helpful to children with autism who also have problems  processing verbal commands.  Children with autism as a whole are visual  learners, so schedules are a natural and easy way to learn and understand.   Schedules are made up of cards with pictures of activities or items with the  name of the activity or item on it.

The schedule gives the child information such as:

* What is happening today (regular activities)
* What is happening today (something new, different, unusual)
* What is not happening today
* What is the sequence of events
* What is changing that I normally expect
* When it is time to stop one activity and move on to another one

The Autism Society of America does not endorse individuals or programs.
References regarding programs, resources, treatment, etc. should not be  interpreted as an indication of endorsement by The Autism Society of America.  They are provided for information only.


Packet Contents

Support Groups Illinois Family Assistance Program Books Articles
Newsletters Therapies/Treatments Private Schools Dietary Treatments
"Twelve Commandments" Research More Resources ABA
Educational Materials Autism Society therapy summary Extra Stuff tax deductions updated link!