Established practices
Established practices, also known as scientifically-based or evidence-based practices, are defined as methods that have significant and convincing empirical evidence supporting their effectiveness. Positive results can be expected when knowledgeable and skilled professionals, in collaboration with parents and families, use these methods when working with individuals with autism spectrum disorder (ASD). However, even among established treatments, improved outcomes may not occur for every person with ASD.
The treatments described in this section have been identified by the National Standards Project as falling into the established category. (Treatment descriptions are from the National Standards Report.)
Antecedent package
These interventions involve the modification of situational events that typically precede the occurrence of a target behavior. These alterations are made to increase the likelihood of success or reduce the likelihood of problems occurring. Treatments falling into this category reflect research representing the fields of applied behavior analysis, behavioral psychology and positive behavior supports.
Behavioral package
These interventions are designed to reduce problem behavior and teach functional alternative behaviors or skills through the application of basic principles of behavior change. Treatments falling into this category reflect research representing the fields of applied behavior analysis, behavioral psychology and positive behavior supports. Specific examples include discrete trial teaching, differential reinforcement strategies and functional communication training.
Comprehensive behavioral treatment for young children
This treatment reflects research from comprehensive treatment programs that involve a combination of applied behavior analytic procedures (e.g., discrete trial, incidental teaching, etc.) which are delivered to young children (generally under the age of 8). These treatments may be delivered in a variety of settings and involve a low student-to-teacher ratio (e.g., 1:1). These treatment programs may also be referred to as applied behavior analysis programs, behavioral inclusive programs or early intensive behavioral intervention.
Joint attention intervention
These interventions involve building the foundational skills involved in regulating the behaviors of others. Joint attention often involves teaching a child to respond to the nonverbal social bids of others or to initiate joint attention interactions. Examples include pointing to objects, showing items/activities to another person and following eye gaze.
Modeling
These interventions rely on an adult or peer demonstrating the target behavior that should result in an imitation of the target behavior by the individual with ASD. Modeling can include simple and complex behaviors. This intervention is often combined with other strategies, such as prompting and reinforcement. Examples include live modeling and video modeling.
Naturalistic teaching strategies
These interventions involve using primarily child-directed interactions to teach functional skills in the natural environment. They often involve providing a stimulating environment, modeling how to play, encouraging conversation, providing choices and direct/natural reinforcers, and rewarding reasonable attempts. Examples of this type of approach include focused stimulation, incidental teaching, milieu teaching, embedded teaching, and responsive education and prelinguistic milieu teaching.
Peer training package
These interventions involve teaching children without disabilities strategies for facilitating play and social interactions with children with ASD. Peers may include classmates or siblings. When both initiation training and peer training were components of treatment in a study, the study was coded as "peer training package." These interventions may include components of other treatment packages (e.g., self-management for peers, prompting, reinforcement, etc.). Common names for these intervention strategies include peer networks, circle of friends, buddy skills package, Integrated Play Groups™, peer initiation training and peer-mediated social interactions.
Pivotal response treatment
This treatment is also referred to as PRT, pivotal response teaching and pivotal response training. PRT focuses on targeting "pivotal" behavioral areas — such as motivation to engage in social communication, self-initiation, self-management and responsiveness to multiple cues — with the development of these areas having the goal of very widespread and fluently integrated collateral improvements. Key aspects of PRT intervention delivery focus on parental involvement in the intervention delivery and on intervention in the natural environment, such as homes and schools, with the goal of producing naturalized behavioral improvements. This treatment is an expansion of natural language paradigm, which is also included in this category.
Schedules
These interventions involve the presentation of a task list that communicates a series of activities or steps required to complete a specific activity. Schedules are often supplemented by other interventions, such as reinforcement. Schedules can take several forms including written words, pictures or photographs, or work stations.
Self-management
These interventions involve promoting independence by teaching individuals with ASD to regulate their behavior by recording the occurrence/nonoccurrence of the target behavior and securing reinforcement for doing so. Initial skills development may involve other strategies and may include the task of setting one's own goals. In addition, reinforcement is a component of this intervention with the individual with ASD independently seeking and/or delivering reinforcers. Examples include the use of checklists (using checks, smiling/frowning faces), wrist counters, visual prompts and tokens.
Story-based intervention package
These treatments involve a written description of the situations under which specific behaviors are expected to occur. Stories may be supplemented with additional components (e.g., prompting, reinforcement, discussion, etc.). Social Stories™, the most well-known story-based interventions, seek to answer the "who," "what," "when," "where," and "why" in order to improve perspective-taking.
Source: National Standards Report, National Standards Project, National Autism Center, 2009
Updated: February 11, 2013