In
recent times, there has been a notable increase in statistics of children with
autism. The United States Center for Disease Control (CDC) states that cases of
children with autism has increased from 1 in 88 to 1 in 68 children. With the
rise in the cases of autism, more and more families are faced with the
challenge of accessing intervention programs for their children with autism.
When
you hear “early intervention,” some questions come to mind. I would attempt to
answer some of them.
Q. How early should I start intervention?
To put
it simply, intervention should start as early as possible. When parents begin
to notice that their child is not developing as expected and they voice these
concerns, a common response is, “They’ll grow out of it, just wait.”
Unfortunately, the longer you wait the more difficulty you and your child may
have eventually. If you are concerned about your child’s development, whether
it’s their communication, social skills or behaviours, then you should begin
seeking information and assistance as soon as you can.
The
earlier a problem is identified, the earlier intervention can begin, and the
more likely your child is to learn the skills they need to communicate engage
in social interactions and manage their behaviour. If you’re still waiting for
an official diagnosis, you shouldn't be waiting to start intervention. If you
think there is something that needs to be addressed, get the information,
services and training you need to address it.
Q. Why
start intervention so early?
Research
shows that children who receive intensive early intervention services are more
likely to have improved long-term outcomes. These services can maximize their
learning potential by addressing communication, play, problem behaviours and
overall skill development from a very early age. We know, through extensive research
on the human brain, that neural plasticity (the brain's ability to learn new
skills) decreases with age. When children are very young their neural
plasticity is high, but as they get older it decreases. When this plasticity
decreases, it becomes more difficult to learn new skills.
This
is not to say that individuals with autism are not able to learn skills if
intervention is not started by a certain age. Their brains, just like everyone
else’s, are capable of learning and using new skills and information at any
time. Behaviourally speaking, however, as we all age and grow the skills we
have learned which are effective and efficient will be more difficult to change
due to a longer history of reinforcement. So the earlier we intervene to
address an individual’s difficulties with communication, social interactions
and problem behaviours the more likely we are to elicit quick and positive
change.
Q. How
much intervention should my child receive?
Research
suggests that children should receive 25-40 hours of intensive early
intervention per week. While this may seem like an extraordinary amount of time
for a child, this intensity of intervention has been shown to be the most
effective in addressing the needs of children. Intervention hours may be
provided by ABA therapists, speech therapists, occupational therapists, parents
or other family members (after receiving training on intervention
implementation) or other service providers. In an ideal situation, intervention
procedures should be implemented throughout the day, across settings and across
people with whom the child interacts. This intensity and consistency of
intervention can help catapult a child to success.
Q.
What are the goals of early intervention?
The
basic goals that should be addressed with early intervention are child
engagement, independence, functional spontaneous communication, cognitive skill
development, social competence, play skill development, generalization of
skills, and proactive approaches to problem behaviour. The specific goals for
intervention will be based on the child’s chronological age, developmental
level, specific strengths and weaknesses, and the needs or priorities of their
family.
Q.
What interventions are available and most effective?
There
is no single treatment protocol for all children with autism, but most
individuals respond best to highly structured behavioural programs. The
National Institute of Child Health and Human Development lists Applied
Behaviour Analysis among the recommended treatment methods for autism spectrum
disorders. Some of the most common interventions are Applied Behaviour Analysis
(ABA), Speech and Language Therapy, Occupational Therapy, PECS, AAC, Sensory
Integration Therapy and the school-based TEAACH method.
Q. How
do I know if an intervention is effective?
The
only way to know for certain an intervention is effective is to see the data.
These data should be collected and reported to you as a parent on a frequent
basis. If there is no data to support the efficacy of the intervention, then
you are right to question whether or not the intervention should continue. Data
provide us the capability to make timely decisions about interventions. For
instance, if the data show the child is not making significant improvements in
the expected time frame, we might consider changing something about the
intervention. If, on the other hand, the data show the child is making the
expected gains we know we’re on the right track. If interventionists are not
collecting data, there is no way to quantify change and there is no way to make
informed decisions about the efficacy of the interventions being used.
Q. How
involved should I be in my child’s intervention?
Your
participation as a parent is vital to your child’s success. This may seem like
a bold statement, but the truth is that if you are not involved in your child’s
therapy programs the likelihood of success is much lower. This is because when
you are involved in the development and implementation of interventions the
intervention procedures are more likely to be used across contexts and people
and your child is likely to learn and use skills more quickly. If on the other
hand, teachers and therapists develop and implement interventions but these
interventions are not supported or implemented at home the skills are likely to
be learned slower and the likelihood of them having long term benefit is going
to be small.
As
parents, you are the people who spend the most amount of time with your child.
You should be integrally involved in the development of interventions, and you
should receive extensive training from the professionals who work with your
child so you also know how to implement the interventions well. Don’t settle
for a simplified explanation of the intervention plan with no hands-on
training. The professionals working with your child should be showing you and
teaching you how to work with your child. This doesn't happen as much as it
should and this can be detrimental to the progress of your child. It is
important that you really know how to implement the intervention so you can
support what the therapist(s) working with your child are doing and help your
child generalize the skills they are learning.
If you wish to learn more about Early Intervention services and the benefits to a child with Autism Spectrum Disorders, you may begin by attending the C.A.D.E.T. Academy FREE autism seminar, tomorrow, Saturday 12 April 2014. The venue is: SRC Meeting Room, 10b Owena Close, off Yedseram Street, Maitama, Abuja. The seminar starts at 11am and would last for 2hours.
