Hi All,
sharing details of another session, this was organized by APASLAP WB series committee. The details of the session are:
Topic – ABA vs ST vs OT vs BM in ASD
Speaker – Mrs.Sowmya MASLP
Date – 20th Sep 2020
Time – 6 pm to 7 pm IST
Mrs.Sowmya is a qualified Speech Language Pathologist, done her certification on sensory integration and special educator for children with learning disabilities. She is a co-founder of a center in Chennai, its called “Five Pediatric Therapy Services”, it also has a branch in Bangalore.
The points shared in the session are given below:
1) DSM 5 Criteria definition are given below:
Criteria A
Persistent deficits in social communication and social interactions across multiple contexts. (Must meet all 3 criteria):
a) Deficits in Social – emotional reciprocity
b) Deficits in nonverbal communicative behaviors used for social interaction
c) Deficits in developing, maintaining and understanding relationships
Criteria B
Restricted, repetitive patterns of behavior, interests or activities. (Must meet atleast two of the following):
a) Stereotyped of repetitive movements, use of objects or speech
b) Insistence on sameness, inflexible adherence to routines or ritualized patterns of behavior
c) Highly restricted, fixated interests that are abnormal in intensity
d) Hyper of Hypo reactivity to sensory input or unusual sensory interest
Criteria C
Symptoms were present in early developmental period
Criteria D
Symptoms cause clinically significant impairments in social functioning
Criteria E
Disturbances are not better explained by intellectual disability or global developmental delay
2) Most commonly known intervention methods are:
- Speech – Language Therapy
- Behavior Therapy
- Occupational Therapy
- ABA
3) OCCUPATIONAL THERAPY – It is the most fun and important intervention that should be done right from the very beginning. SLPs who work on Oral Motor skills, need to look at oral motor functions as well, for that they need to work with Occupational therapist as well. It covers:
- Physical Development
- Neuro-motor
- Sensory Motor
- Sensory Processing
- Cognition
- Social-Emotional
- Self Regulation
4) SENSORY INTEGRATION THERAPY : The vestibular system plays a big role in hyperactivity, also from neurological perspective vestibular system and auditory system are located close to each other, when the vestibular system is disturbed its unlikely to have a well regulated auditory system. Apart from that it works in integrating all the below senses:
- Auditory
- Visual
- Tactile
- Vestibular
- Proprioception
- Olfactory
- Gustatory
5) BEHAVIOR THERAPY : Below are the well known approaches that are available:
- Applied Behavior Analysis (ABA)
- Verbal Behavior Therapy (VBT)
- Treatment and Education of Autistic and Related communication Handicapped Children (TEACCH)
- Relationship Development Intervention (RDI)
- Developmental and Individual Differences Relationship (DIR) Therapy – Floor time
- Cognitive-behavior Therapy (CBT)
Behavior is defined as:
a) The way in which one acts or conducts one self, especially towards others
b) The way in which an animal or person behaves in response to a particular situation of stimulus
Behavior can be INNATE or LEARNT.
VERBAL BEHAVIOR THERAPY: They look at Four “Operants”:
a) Mand – A request such as saying “water” to ask for water
b) Tact – A Comment used to share an experience or draw attention such as water to point out a bottle of water.
c) Intraverbal – A word used to respond or answer a question, such as “Where do you live in Chennai? “Annanagar”
d) Echoic – A repeated of echoed, word such as “Water?” “Water !”. This is important as imitating will help the student learn.
TEACCH – Treatment and Education of Autistic and Related communication Handicapped Children
- Structured Teaching
- Structured Environment
- Visual Modality (Schedules, etc..)
RELATIONSHIP DEVELOPMENT INTERVENTION
Dynamic Intelligence:
a) Teaches individuals with ASD the value of interpersonal relatioships
b) Focus on “Shared experiences”
c) Parent-directed, not a direct intervention for children
THE DEVELOPMENTAL INDIVIDUAL DIFFERENCES AND RELATIONSHIP BASED MODEL (DIR) – Floor Time:
a) D – describes development from the perspective of the individual, where they are and where they are headed.
b) I – describes the unique ways each person takes in. regulates, responds to, and comprehends the world around them.
c) R – describes how relationships fuel our development. Humans are social beings and relatioships are a key to our human development.
DIR harnesses the key effective (Emotional) aspect of these relationships to promote development.
FEUERSTEIN’s INSTRUMENTAL ENRICHMENT
Structural Cognitive Modifiability Mediated Learning Experience, which works on the principle that the brain is always open to change:
- Insight into deficient cognitive functions
- Foster reflective reasoning
- Move from passive recipients of information into active learners.
We work based on our impulses, for example, if you are with your child playing with Puzzles, you would ask him collect puzzles pieces, turn it this way, look at it that way, etc… we would be consistently providing directions to the child. In Mediated learning experiences, it involves more observation to see how the child approaches on a task in front of him, how he sees it, how he understands about that, how he uses that …etc.. based on that information intervention would be decided.
APPLIED BEHAVIOR ANALYSIS: It is a science of learning and behavior, based on skinners conditioning method. It looks in to:
a) An Antecedent: This is what occurs right before the target behavior. An antecedent may come from the environment, from another person, or be internal (such as a thought or feeling)
b) A resulting Behavior: this is the person’s response or lack of response to the antecedent. It can be an action, a verbal response or something else.
c) A Consequence: This is what comes directly after the behavior. It can include positive reinforcement of the desired behavior or no reaction for incorrect/inappropriate responses.
Discrete Trial Teaching (DTT)
DTT teaches skills in a controlled, step-by-step way. It breaks desired behaviors into the simplest steps. The therapist/teacher uses positive feedback to encourage the child to use new skills.
Early Intensive Behavioral Intervention (EIBI)
EIBI provides individualized, behavioral instruction to very young children (less than 5 years) with ASD, It requires a large time commitment and provides one-to-one or small group instruction.
Pivotal Response Training (PRT)
PRT takes place in the child’s everyday environment and is more play based. The goal is to improve a few “pivotal” skills such as motivation, self management, initiative to communicate. These skills then help the child to learn many other skills and deal with many situations.
Positive Behavioral and Support (PBS)
PBS aims to figure out why a child presents a particular problem behavior. It works to change the environment, teach skills and make other changes that make a correct behavior more positive for the child. This encourages the child to behave correctly.
6) SPEECH-LANGUAGE THERAPY: The three aspects are:
a) Speech (Motor) – Fluency, Articulation, Voice, ability to speak etc.
b) Language (Cognitive) – Comprehension etc..
c) Communication (Social)
7) WAY FORWARD: There is no single intervention that can be used all he time, it is purely dependent on the child’s current needs the respective intervention method is suggested. Therapist needs to profile the child first and decide the best-suited intervention method.
- Multidisciplinary vs Interdisciplinary – When therapists of different platform does not speak among each other, it does not really makes sense. Therapists keeps to put all their differences in opinion/philosophies down and keep the child as the goal, to get better outcomes.
- Collaboration NOT Competition
- Training beyond SLP Degree
- Evidence based Practice
- Documentation and Research
- Constantly updating knowledge and skills
We worry about what a child will become tomorrow, yet we forget that he is someone today – Stacia Touscher
In times of change, the learners will inherit the earth, while the knowers remain well prepared for a world that no longer exists – Eric Hoffer.
My Personal Feedback,
“Mediated Learning Experience” was the only new thing for me, rest of the content seemed to be very basic in nature and really short, not something i would have expected from MASLP, given the time constraint, she wanted to touch all the aspects but would be beneficial for parents who are not familiar with the other interventional approaches out there. Session title was misleading, this could have been avoided, it this was done with an intention to attract more participants.
Regards,
Saranya and Karthik
karthiksaranyaparents@gmail.com
Autism Spectrum Disorder - Personal Experiences (Chennai Family) 