Autism Spectrum Disorder
knowledge of early intensive behavioral intervention research
A. ABA early intensive intervention helps all ages, but those who start before age 2 were most likely to make dramatic gains B. early intensive behavioral intervention or treatment (EIBI or EIBT) consists of 20-40 hours per week of individualized instruction for children with autism who begin treatment at the age of four years or younger and who usually continue for 2-3 years. The UCLA model is one EIBI model and emphasizes instruction at home with discrete trial training. other models provide instruction in classrooms; some emphasize teaching methods other than discrete trial training, such as incidental teaching. C. Dr. Ivar Lovas (UCLA) is well known for his research in early intervention his research showed that 40 hours per week of intervention had better results than 10 hours per week of intervention "intensive behavior intervention (IBI) is the only empirically validated treatment for ASD.
distinguished between evidence-based intervention vs. non-evidence-based interventions
A. evidence-based (EB) means treatment that has been proven effective through outcome evaluation (research) B. EB research outcomes have been replicated to show consistent results C. in implementing ABA services, we are using ONLY evidence-based practices/procedures
knowledge of levels of severity across social communication and restricted, repetitive behaviors
A. restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following: 1. stereotyped or repetitive motor movements, use of objects, or speech (ex. simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases) 2. insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal nonverbal behavior 3. highly restricted, fixated interests that are abnormal in intensity or focus 4. hyper- or hypoactivity to sensory input or unusual interests in sensory aspects of the environment B. severity is based on social communication impairments and restricted, repetitive patterns of behavior. level 3 - "requiring very substantial support" (few intelligible words, rarely initiates interaction, extreme difficulty coping with change) level 2 - "requiring substantial support" (simple sentences, interaction is limited to narrow special interests, odd nonverbal communication, inflexibility, difficulty coping with change) level 1 - "requiring support" (engage in full sentence communication but reciprocal conversations with others fail, attempts to make friends are odd and typically unsuccessful, inflexibility, problems with organization and planning)
knowledge of foundational autism research
A. there not one known cause of autism B. research suggests that autism often develops from a combination of genetic and non-genetic, or environmental, influences that increase the risk a child will develop autism C. however, increased risk is not the same as cause (ex. genetic markers associated with autism are also found in people who not have autism)
knowledge of research regarding treatment intensity
A. treatment dosage, which is often referenced in treatment literature as "intensity" will vary with each individual and should reflect the goals of treatment, specific patient needs, and response to treatment. treatment dosage should be considered in two distinct categories: intensity and duration. B. intensity: is typically measured in terms of number of hours per week of direct treatment. intensity often determines whether the treatment falls into the cateogory of either focused or comprehensive: i. focused ABA treatment generally ranges from 10-25 hours per week of direct treatment (plus direct and indirect supervision and caregiver training). however certain programs for severe destructive behavior may require more than 25 hours per week of direct therapy. ii. comprehensive ABA treatment often involves and intensity level of 30-40 hours of 1:1 direct treatment to the individual per week, not including caregiver training, supervision and other needed services. C. duration: treatment duration is effectively managed by evaluating the individuals' response to treatment: this evaluation can be conducted prior to the conclusion of an authorization period. some individuals will continue to demonstrate medical necessity and require continued treatment across multiple authorization periods.
knowledge of deficits in developing, maintaining, and understanding relationships
deficits in developing, maintaining, and understanding relationships, ranging examples: from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
knowledge of deficits in nonverbal communicative behaviors used for social interaction
deficits in nonverbal communicative behaviors used for social interaction, ranging for example, from poorly integrated verbal and nonverbal communication; ti abnormalities in eye contact and body language or deficits in understanding and use of gesture; to a lack of facial expressions and nonverbal communication. examples of nonverbal communication include: shrugging shoulders when you don't know, pointing at a picture in a book to show another person, frowning when someone tells you sad news.
knowledge of deficits in social-emotional reciprocity
deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions. example: the teacher tells students to find a partner to work with on a math activity. as students move around the classroom pairing up, Michelle, a student with autism, stands in the middle of the classroom looking at the other students. For this assignment, Michelle may be having difficulty with initiating social interactions.
knowledge of highly restricted, fixated interests that are abnormal in intensity or focus
highly restricted, fixated interests that are abnormal in intensity or focus example: strong attachment to or preoccupation with unusual objects, excessively circumscribed or preservative interests. examples of restricted, fixated interests: Elly is a student with autism who loves littlest pet shop figures. she carries one with her at all times and if given the opportunity, will talk non-stop about them. you find that she is motivated to complete schoolwork by earning littlest pet shop stickers.
knowledge of hyper or hypoactivity to sensory input or unusual interests in sensory aspects of environment
hyper- or hypoactivity to sensory input or unusual interest in sensory aspects of the environment example: apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling, or touching of objects, visual fascination with lights or movement examples of hypersensitivity to sensory input: whenever the maintenance crew uses lawn mowers and leaf blowers near the school grounds, Cole covers his ears, gets under his desk, and cries.
knowledge of insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior
insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior example: extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day
knowledge of stereotyped or repetitive motor movements, use of objects, or speech
stereotyped or repetitive motor movements, use of objects, or speech example: simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases
