Features of Early and Intensive Behavioral Intervention

An intervention program meeting the high quality standards set by clinicians and pioneers in this field will include several features.

Early
Researchers have documented dramatic improvements in functioning among children with autism when behavioral intervention programs are initiated in the third year of life (Lovaas, 1987). We recommend that parents start a behavioral intervention program when their child is between 2 and 3 years of age, yet parents of older children (5 years and up) will not be turned away. Older children can benefit from behavioral intervention and programs can be designed to meet their individual needs.

Intensive
Researchers also document the advantages of intensive (i.e., 35-40 hours per week) behavioral

intervention. Consistent with this research, we typically recommend that a program consist of 35-40 hours per week of one-to-one instruction during its initial phases (for children 3 years of age and older). For children under age 2, we typically recommend a gradual increase to 35-40 hours per week by their third birthday. After a child learns those skills that will increase his or her likelihood of success in and out of the classroom, hours of home-based instruction are gradually reduced and replaced with group instruction (e.g., preschool, Pre-K or Kindergarten). Some amount of one-to-one instruction is continued for those children requiring additional support and is gradually faded for those children no longer needing it.

Behavioral
Applied Behavior Analysis (ABA) is the application of the science of behaviorism (the examination of behavior using the principles of science) to accomplish a desired goal: to increase or decrease a particular behavior, to improve the quality of a behavior, to stop a maladaptive behavior, or to teach a new and desired behavior. Applied Verbal Behavior, the Discrete Trial Teaching method, and Natural Environment Training (NET) are key components of our intensive behavioral intervention services. The following is a brief description of how skills are taught using a behavioral approach.

A target behavior (e.g., requesting popcorn by stating "popcorn" while pointing to the food) is broken down into simpler, more manageable steps (e.g., pointing to the popcorn when asked "What do you want?", saying "pop" when asked "What do you want?", saying "popcorn" when asked "What do you want?"). The target skill is systematically reached through prompting, chaining, and reinforcement of these simpler steps.

One-to-one instructors or tutors (a.k.a. therapists) provide assistance or prompting to a child to help him or her complete a target behavior. This help is gradually and systematically faded to facilitate the child’s independent responding.

Reinforcement is presented following a desired behavior in order to increase the likelihood of the reoccurrence of that behavior. What is considered reinforcement is individual to every child but general examples include highly preferred toys or activities, hugs, tickling, and small pieces of food or candy. If used, food and similarly artificial reinforcers are gradually replaced as effective social reinforcers (e.g., privileges, high 5’s, etc.) are discovered and developed.

Should aggression or self-stimulatory behavior (e.g., hand flapping) interfere with learning and/or transfer of skills to new contexts, these behaviors are replaced by teaching alternate, more appropriate behaviors while ignoring the problem behavior. We do not recommend the use of physical punishment to reduce these or any behaviors.

Generalization and Integration with Typical Peers
Once foundational skills are acquired through home-based intensive behavioral instruction, a child should be introduced into a group instruction setting. Parents should make the greatest effort to have their child participate in a regular education setting where a child’s peers will model appropriate social, language, and play skills. Tutors and parents should promote the generalization of skills learned at home to this and other settings. With time and hard
work, it is hoped that the child will learn new skills within this group setting and not require the same intensity and structure provided in a home-based program.
A home-based program requires the creation of a Behavioral Intervention Team, which will include regular Team Meetings. Depending on your area,
Full Staffing may be available.

Program Progression
Very briefly, early and intensive behavioral intervention programs begin with teaching foundational skills including visual-spatial tasks, receptive language,
non-verbal imitation, self-care, and simple toy play skills modeled after the early skills of typically developing children. With mastery at earlier levels, the program progresses into teaching verbal imitation skills, early expressive language skills, and more advanced play. With continued mastery, program goals become increasingly advanced and move into abstract and conversational language skills, interaction and socialization with peers, classroom-based generalization and learning, and academic tasks such as spelling, writing, reading, and mathematics.

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