Autism Spectrum Disorder (ASD): Behavioral Training and Management

Overview

There are many different programs that can help a child who has ASD.

Some programs start early in your child's development to help with symptoms. These help your child focus on improving the ability to communicate, learn, be social, and adapt to new situations. Children usually work one-on-one with a trained therapist for 30 to 40 hours a week.

Another program that may be used is structured teaching. This involves organizing a child's day and school setting to help a child learn new skills.

Certain methods, like modeling behavior or modifying a child's environment, may be used. With modeling, a child with ASD learns a skill or desired behavior by watching you, a therapist, or another child.

A benefit of these programs is that they teach you how to work with your child at home and help your child practice new skills.

You and your care team can decide which program might be best for your child. By sharing what you know about your child and combining it with your doctor's advice, you can help your child get the help they need.

No matter what program you choose, all of the child's family members, teachers, and caregivers need to be trained in the techniques of the program you choose. Consistent use of the techniques gives the best results.

Behavioral programs and structured teaching

Applied behavior analysis (ABA) is a common technique used. This method rewards wanted behavior. It focuses on giving the child short, simple tasks. The child is rewarded when the task is completed. Some people think ABA therapy for autism tries too hard to change behaviors to fit typical standards, which might ignore the unique needs of someone with ASD.

Many programs are based on ABA. Some examples include:

Early intensive behavioral intervention (EIBI). EIBI is an approach that can help children:

Tasks like putting on pajamas are taught one step at a time. The therapist shows your child the drawer the pajamas are in. After many repetitions, the therapist asks your child which drawer the pajamas are in. The behavior is rewarded with a treat or praise like "good job." When the task is complete, the therapist will introduce new tasks, like picking out or putting on pajamas. These steps are repeated and rewarded until your child learns all the steps and can do it by themself.

Pivotal response training (PRT). PRT is a teaching style that can help your child gain language and social skills. It focuses on "pivotal" areas of your child's development, such as:

To boost your child's motivation to learn new skills, a therapist can use things your child is interested in, like a favorite toy. The therapist can also help your child read and respond to cues such as colors or letters, gradually becoming more complex. Your child will be taught how to manage tasks, seek help, and ask questions. The therapist may also help your child start a conversation, often with a peer who does not have ASD, to improve verbal and social skills.

Early Start Denver Model (ESDM). ESDM can help children as young as 12 months of age and up to 4 years of age develop and maintain communication and social skills.

A key part of this program is helping children connect with others. Children with ASD often prefer to play alone and don't make eye contact with others.

Through interaction and play, your child learns how to interact with others. For example, your child may learn how to pick up on and respond to social and emotional cues. These include gestures or pointing, smiling, laughing, or crying. Children with ASD may have a hard time understanding these cues. This can affect how well they relate to others. This interaction builds a shared interest in activities with others, such as playing a board game or with a toy.

Learning Experiences—An Alternative Program for Preschoolers and Parents (LEAP). LEAP is for preschool children ages 3 to 5 years old.

You and your therapist will set goals for your child based on your child's strengths and weaknesses. These may be individual skills your child needs to learn or practice. In addition to working on their goals, your child will follow the standard preschool curriculum. This will help your child learn skills that will prepare them to be successful in a regular classroom later.

A program that uses structured teaching includes:

Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH). TEACCH is based on the idea that the environment should be adapted to the child, not the child to the environment. Teaching strategies are designed to improve communication, social, and coping skills.

For example, children who have ASD may be too stimulated in a regular classroom. They may do best in a smaller group with a highly structured environment. TEACCH helps children understand their environment by having clearly defined areas for activities like playing or eating. It also helps children organize their day and schoolwork using schedules, calendars, written instructions, checklists, and notes.