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Educating Children with Autism (2001) / Chapter Skim
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Pages 140-174

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From page 140...
... This chapter begins with a description of the process by which the ten models were selected for review and a brief description of each program. The theoretical backgrounds of the various approaches are then considered, followed by an examination of points of convergence and divergence across the program models and consideration of the empirical underpinnings of each approach.
From page 141...
... Department of Education were also included. Model programs that provided invited representation in the Autistic Spectrum Disorders Forum Workgroup of the National Early Childhood Technical Assistance Systems were also included.
From page 142...
... Developmental Intervention Model at The George Washington University School of Medicine As in the Denver Model, this relationship-based approach is derived from a developmental orientation. There is a home component of intensive interactive floor-time work, in which an adult follows a child's lead in play and interaction, and children concurrently participate in individual therapies and early education programs.
From page 143...
... Individualized Support Program at the University of South Florida at Tampa A parent-training program developed in West Virginia served as the predecessor of this model, which started in its current form in 1987. The Individualized Support Program is implemented in children's homes and community settings during a relatively short period of intensive assistance and ongoing follow-up.
From page 144...
... Using a parent education approach, the ultimate goal of the Pivotal Response Model is to provide individuals with autism with the social and educational proficiency to participate in inclusive settings. In early stages, this model used a discrete-trial applied behavior analysis approach, but there has been a shift toward use of more naturalistic behavioral interventions.
From page 145...
... . The Individualized Support Program is sponsored by a Department of Child and Family Studies, and LEAP is currently in a Department of Special Education.
From page 146...
... Three programs operate out of university-based clinics, although a significant portion of the interventions take place in homes and community settings (i.e., Developmental Intervention Model, Pivotal Response Training, and the Young Autism Project)
From page 147...
... Thus, the Denver Model and the Developmental Intervention Model were conceptualized from a deductive framework, in which developmental theory was used to organize hypotheses regarding the fundamental nature of autistic spectrum disorders. Group design research has been aimed at seeking confirmatory evidence regarding deviations from normal development that need to be addressed in intervention.
From page 148...
... Relationships and affective interactions may go awry secondarily, and intervention is aimed at helping a child try to work around the processing difficulties to reestablish affective contact. Behavioral Approaches By far, the bulk of autistic spectrum disorders intervention research has been conducted from the perspective of applied behavior analysis.
From page 149...
... Developmental researchers may criticize behavioral approaches for failure to target the specific deficits associated with autistic spectrum disorders (Rogers et al., 1986) , and it has been argued that this failure to select target skills within a meaningful developmental framework results in isolated skills that are difficult to transfer to other situations and skills (Rogers and Lewis, 1988~.
From page 150...
... , clinic Structured (24 and up) teaching UCLA Young Autism Project (30 to 46)
From page 151...
... . Although several programs (e.g., Developmental Intervention Model, Young Autism Project)
From page 152...
... . Families Are Actively Involved in Their Children's Intervention All ten models explicitly acknowledge the importance of having parents play a central role in their children's intervention, although how
From page 153...
... In others (Individualized Support Program, Pivotal Response Training, Walden) , parental instruction is blended into normal daily home and community activities.
From page 154...
... In addition, the trend towards broadened parent supports reflects an appreciation of the challenges faced by these families. Staff Are Highly Trained and Specialized in Autism All ten programs are directed by at least one doctoral-level professional with a long-standing reputation in the treatment of autistic spectrum disorders.
From page 155...
... A number of the programs were developed as model demonstration programs (Denver, Individualized Support Program, LEAP, and Walden) with support from the U.S.
From page 156...
... Ongoing Objective Assessment of a Child's Progress Although the assessment measures varied, all ten programs reviewed have a mechanism for tracking the progress of individual children, and the systems for ongoing assessment permit timely adjustments in the child's intervention plan. As would be predicted by both the goals and associated methodological trends, the programs with a developmental orientation tend to rely on standardized assessment instruments, while the applied behavior analysis programs include a component for direct observation and measurement of specific target behaviors.
From page 157...
... The Individualized Support Program obtains systematic videotaped
From page 158...
... Virtually all of the model programs assess cognitive functioning, while relatively few directly assess the effects of intervention on a child's everyday social functioning. Curricula Provide Systematic, Planful Teaching Each of the program models has a custom-designed curriculum, a term used broadly here to refer to the environment, staffing, materials, and teaching interactions.
From page 159...
... Across the ten programs, the adult-child staffing ratios range from 1:1 to 1:8, depending on the program format, class size, and children's developmental and chronological age. The Developmental Intervention Model and the Young Autism Project remain nearly exclusively 1:1 throughout the intervention period, including the use of a one-on-one "shadow" if a child is eventually included in a regular early childhood center.
From page 160...
... The Developmental Intervention Model stands alone in focusing on nonverbal communication and interactions rather than teaching verbal language (Greenspan and Wieder,1997~. The Individualized Support Program (and most of the behavioral programs)
From page 161...
... , or a position that early social skills are most feasibly developed when children are included with typical children from the outset in intervention (Strain et al., 2001~. The Developmental Intervention Model and the Young Autism Project tend to include successful children with autism with typical peers near the end of their early intervention period (Greenspan and Wieder, 1997; Smith et al., 2000a)
From page 162...
... . Although the Individualized Support Program is philosophically committed to inclusive education, the reality of very limited inclusion options for children with autistic spectrum disorders leads to a pragmatic approach of providing intervention in the most natural settings available.
From page 163...
... , while Walden provides all instruction using an incidental teaching approach (McGee et al., 2000~. The other five behavioral programs use a mixture of discrete-trial and naturalistic teaching procedures, although the Individualized Support Program (Dunlap and Fox, 1999a)
From page 164...
... The technical foundation for the Denver Model and the Developmental Intervention Model differ significantly from the behavioral approaches, yet each involves teaching in natural contexts. Meaningful differences, however, tend to center on the role of reinforcement in the instructional process.
From page 165...
... For example, 35 percent of the first 20 children treated in the Denver Model went to nonspecialized schools or daycare centers with normally functioning peers (Rogers et al., 1986~; however, today, those numbers would be higher, because Colorado now has a statewide policy of including the vast majority of children with disabilities in regular settings. The Walden program was able to replicate placement outcomes achieved in Massachusetts, an area in which inclusion was well accepted and promoted, when the program relocated to Georgia, where inclusion of children with autistic spectrum disorders was rare.
From page 166...
... In some cases, the programs originated as applied laboratories in which to develop and test intervention procedures, so research about the effects of specific procedures was the natural output. As reviewed in other sections of this report, this cumulative body of procedural research serves as evidence that early educational interventions do enable young children with autistic spectrum disorders to acquire a variety of skills.
From page 167...
... , but these are beyond the scope of the model outcome data considered here. Denver Model There are at least four peer-reviewed outcome reports on the Denver Model, including the evaluation of a comprehensive training model described above (Rogers and DiLalla, 1991; Rogers et al., 1986; Rogers and Lewis, 1988; Rogers et al., 1987~.
From page 168...
... Somewhat inconsistent with the outcomes reported by others, expressive language scores were reported to be above those for receptive language, and self-care skills were lower than communication and socialization abilities. Individualized Support Program The Individualized Support Program model has reported single-subject data on the first six participating children (Dunlap and Fox, 1999a)
From page 169...
... As a group, the 10 children treated with Pivotal Response Training had very good outcomes, but the absence of experimental design leaves it unclear whether these improvements can be attributed directly to the program's intervention; this is a difficulty that holds true for almost all of the data reported for the ten model programs. TEACCH Program evaluation information on the TEACCH model has included consumer satisfaction data from parents, trainees, and replication sites (Mesibov, 1997)
From page 170...
... UCLA Young Autism Project Although the UCLA program has generated the most rigorously controlled early intervention research published to date, there has been considerable controversy due to various methodological and interpretational limitations (Gresham and MacMillan, 1997~. In the original report (Lovaas, 1987)
From page 171...
... In addition, by the time of program exit, 71 percent of the children showed increases in the amount of time that they spent in close proximity to other children, with only one child showing levels of peer proximity that were outside the ranges displayed by typical children. Summary of Intervention Studies As a group, these studies show that intensive early intervention for children with autistic spectrum disorders makes a clinically significant difference for many children.
From page 172...
... Although possible changes in diagnosis are implied, these have not been systematically documented or supported with independent observations or reports. Considered as a group, these peer-reviewed outcome studies suggested positive change in the language, social, or cognitive outcomes of children with autistic spectrum disorders who received intensive early intervention beginning at young ages.
From page 173...
... ill Policy, Legal, and Research Context
From page 174...
... Appropriate educational objectives for children with autistic spectrum disorders should be observable, measurable behaviors and skills. These objectives should be able to be accomplished within ~ year and expected to affect a child's participation in education, the community, and family life.


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