- Posted by Nan Huai, Ph.D, Licensed Psychologist, BCBA-D
- On October 9, 2017
- 3 Comments
People are often surprised when they hear that autism treatment can start as early as 18 months. In addition, research on early Applied Behavior Analysis (ABA)-based treatment shows an average of 30-40 hours per week is best.
We often hear questions, such as “Why so early?” “Shouldn’t kids be playing and learning through play at that early age?” “Can children handle early intervention therapy?” “What do you do in therapy anyway?”
The answers to these questions help both parents and professionals understand why early intervention is important for a child.
Wondering if your child could be on the autism spectrum? Use our simple screening tool to find out.
“Why so early?”
Autism can be detected in a child as early as 18 months. An accurate diagnosis of autism spectrum disorders can be reliably made as early as 18 months as well. From the perspective of neuroscience, there have been ample evidence on neuroplasticity—if we intervene early, we have a better chance of changing the developing brain.
Behaviorally, early intervention stops problematic behavior from becoming a habit as age increases. Timing-wise, it is ideal for children to receive early individualized therapy to remediate any delays. This prepares a child to enter group learning when they reach school age.
“Shouldn’t kids be playing and learning through play at that early age?”
Play is an important developmental task for children. It is a kids’ “job” to play! However, a core symptom of autism spectrum disorder (ASD) is the lack of appropriate play skills, often accompanied by a pattern of repetitive activities and rigidity.
Typically-developing children often “pick up” a variety of skills as they observe and imitate others. They are naturally reinforced by imitating and engaging with others. Children with autism, however, tend to be engrossed in objects and activities that interest them. They are less likely to spontaneously imitate and interact with others in a wide range of activities. This is not to say that children with autism cannot learn to develop appropriate play.
If you were to place a child with autism in a group of children to play it would not automatically help this child build skills. For children with autism, play and social skills must be broken down, deliberately taught, practiced, and generalized. This teaching method will allow a child with autism to take part in play and peer group activities.
“Can children handle early intervention therapy?”
The recommendation for high intensity treatment, especially at the beginning stage of ABA treatment, is based on research findings that have stood the trials of many peer review processes.
Research on the efficacy of ABA based early intensive autism treatment began 3 decades ago with Dr. Ivar Lovaas. Original research showed that approximately 50% of the children who received intensive ABA-based treatment could “catch up” to average range in their intellectual and educational functioning. In the original research, the children received an average of 40 hours of therapy in the first 2 years, with somewhat reduced hours in the next 2 years of treatment. Additional studies have replicated Lovaas’ findings in the US, UK, Norway, and Australia. The consensus is that larger gains in cognitive functioning is associated with higher intensity treatment (up to 40 hours/ week).
Children with autism learn best through small steps and with repeated, consistent practice. For example, in ABA treatment, putting on pants is often taught with 4 or more steps, each step practiced sufficiently. More complex skills, such as having a back-and-forth conversation, requires even more “building blocks” and learning. With such nuanced skill break-down, the child needs time to practice the steps and generalize them to form a coherent skill set.
Even though ABA therapy is intense, it is also fun and the learning is meaningful! Play is important, and much of our therapy targets play and social interaction.
“What do you do in therapy anyway?”
At Caravel, we strive to teach the important developmental and social skills in an interesting and engaging manner. We aim to make therapy fun, meaningful, and useful. Parents’ input is essential in designing our treatment programs. What we do in therapy is connected with everyday activities for the child.
When a child starts therapy, our priority is to associate the therapist and therapy with a positive experience for the child. This is the foundation for continued learning. In therapy, learning targets are always tailored to the child’s level. Learning is presented with appropriate support so that the child is successful.
Learning times are structured in short segments (they can be as short as a few seconds for young children). Learning time and play time alternate to maintain interest and attention. The child’s interest is always considered when designing learning and play time. Whenever possible, skills acquired during structured learning are incorporated into naturally occurring activities. As children with autism continue to develop skills, their learning time begins to “look” and “feel” like that of their peers’. This helps prepare them for school entry.
When dealing with behavioral challenges, ABA-based treatment looks at the relationship between factors in your environment and behaviors. During treatment, we uncover the reasons behind problem behavior and what the child is getting out of this behavior. With the reason for problem behavior identified, we can develop and put in place a consistent behavior plan. This plan will help the child increase appropriate behavior and reduce inappropriate behaviors.
ABA-based intensive autism treatment is a comprehensive intervention package. For young children, ABA treatment is especially important. This treatment addresses a range of difficulties associated with autism spectrum disorder including, communication skills, imitation skills, cognitive skills, daily living skills, play and social skills, gross and fine motor skills, behavioral regulation, and safety skills. Treatment for young children, based on the best practices and research, helps children gain important skills that will allow them to participate in home, school, and community activities meaningfully.
Interested in learning more about what happens in early intervention? Check out Dr. Lund’s post on the keys to a quality early intervention.
If you would like to learn more about early intervention treatment, or would like to have your child evaluated for autism spectrum disorder, please call us at 844-583-5437, or Contact Us.