intervention and support

Question 1

William’s syndrome vs Autism

Answer 1

• William’s syndrome:
  –> known cause
  –> strong profile of associated strengths and weaknesses
• Autism:
  –> unknown cause
  –> varied profile of associated strengths and weaknesses

Question 2

William’s syndrome strengths

Answer 2

• strengths in William’s Syndrome tend to be classed as ‘relative’
  –> delayed compared to peers
  –> but a real strength in their OVERALL profile
• verbal language ability is a well documented strength

Question 3

relative strengths in William’s Syndrome

Answer 3

• speech production
• fluency
• syntax
• grammar

Question 4

difficulties in William’s Syndrome

Answer 4

• Difficulties with pragmatics
  –> understanding intended meaning of words
  –> e.g. ‘raining cats and dogs’, ‘what time do you call this?’

Question 5

weaknesses of William’s Syndrome:

Answer 5

• difficulties in executive functions:
  –> inhibitory control
  –> planning
  –> working memory
• visuospatial abilities
  –> e.g. as measured by the WISC (standardised IQ test)

Question 6

potential strengths in Autism

Answer 6

• excellent attention to detail and pattern recognition
  –> ‘strong systemising’ abilities = heightened attention to detail and advanced capabilities in pattern recognition (Baron-Cohen et al., 2009)
• superior visual search skills

Question 7

Shirama, akto & kashino (2017)

Answer 7

• used two visual search tasks and increased the level of difficulty of each task:
  1. conjunction search
  2. feature search
• regardless of the difficulty of the task autistic individuals outperformed neurotypical individuals on every task

Question 8

autistic vs control adults

Answer 8

in visual search tasks:
- both autistic & control adults were able to accurately identify when the target was present
- but autistic adults improved overtime in accurately rejecting bags where the target wasn’t present
- conclusions:
–> when tasks tap into particular strengths of autism, enhanced performance may be observed
–> further research should investigate whether autistic individuals are especially well suited to specific real-world visual search tasks

Question 9

potential weaknesses of autism

Answer 9

• executive functioning:
  –> inhibitory control
  –> cognitive flexibility
  –> working memory
• Theory of Mind
  –> difficulties in understanding the emotions, thoughts and intentions of others

Question 10

Theory of mind and Autism

Answer 10

• autistic children show failures in Theory of Mind tasks
• BUT research is equivocal (ambiguous, open to interpretation etc…)

Question 11

benefits of strengths and weakness profiles

Answer 11

allows clinicians, psychologists, parents & educators to identify the best and most appropriate support for that child

Question 12

briefly mention physical symptoms of William’s Syndrome

Answer 12

• poor muscle tone
• poor balance
• poor coordination difficulties

Question 13

4 types of therapies/interventions

Answer 13

1. physical
   –> physiotherapy
2. behavioural
   –> ABA
   –> Early Start Denver Model
3. psychological
   –> music therapy
   –> play therapy
4. language
   –> PECS

Question 14

what is PECS?

Answer 14

• both William’s Syndrome and Autism are associated with delays or difficulties in speech
• Picture Exchange Communication System (PECS) = a form of alternative communication

Question 15

what are the stages of PECS?

Answer 15

• picture exchange
  –> swap pic for item
• generalise to other locations and people
  –> realise they can use PECS outside of their home
• two picture exchange
  –> use two pics to ask for an item
• sentence construction
  –> add ‘i want’ before the pictue
• verbs, adjectives
  –> more complex aspects of speech
• answer a question
  –> use PECS to respond to others’ questions
• commenting
  –> more complex sentences
  –> e.g. starting with ‘i see’, ‘i hear’

Question 16

Play Therapy

Answer 16

• adult should join child in their world / at their level if they struggle to express themselves
• children learn to understand the world and their place in it through play
• free to act out their inner feelings and deepest emotions
• toys can act as symbols and take on greater meaning (if you know what to look for)

Question 17

specific facts about Play Therapy

Answer 17

• typically 30mins to 1 hour once a week
• therapy can take place individually or in groups
• techniques include:
  –> storytelling
  –> role-playing
  –> toy phones
  –> puppets
  –> dolls
  –> action figures
  –> arts and crafts
  –> blocks and construction toys
• demonstrated to reduce behaviours associated with ADHD & social anxiety
• increases social-emotional competency in autistic children

Question 18

directive vs non-directive Play Therapy

Answer 18

• Directive:
  –> therapist will take the lead by specifying the toys or games that’ll be used in the session
• Non-directive:
  –> less structured
  –> the child is able to choose toys and games and play in their own way
  –> the therapist will observe closely and participate as appropriate

Question 19

Music Therapy

Answer 19

• clinical, psychological intervention
• delivered by trained music therapists
• very similar to psychotherapy or CBT or talking therapies
• uses the same theory as the above therapies but uses music and sounds to communicate to clients, rather than using words
• do speak but use music primarily
• music is used as the communication tool
  –> no pressure to find right words

Question 20

potential benefits of Music Therapy

Answer 20

• help a child to listen
• encourage spontaneous play
• strengthen muscles & coordination
• improve concentration (both Autism and William’s Syndrome can be co-morbid with ADHD)
• aid self-expression
• stimulate language development through songs and turn taking

Question 21

can music be an educational tool in William’s Syndrome?

Answer 21

• can use music therapy to train / test verbal working memory
• ask kids questions like
  –> ‘what is this animal?’
• they are told the answer
  –> sung or spoken
• Two groups:
  1. those with music training
  2. those without
• better verbal recall when the information was sung for those without lessons (without training)
• those with training showed good recall for spoken information

Question 22

What is Applied behavioural Analysis (ABA)?

Answer 22

• type of therapy that can improve social, communication, and learning skills through positive reinforcement
• originally developed to focus on Autism
  –> now used across a range of disorders/conditions
• intensive therapy
  –> originally recommended for 40 hours per week 1 to 1
  –> although more recently this contact time has lowered

Question 23

how does ABA work?

Answer 23

• positive conditioning:
  –> kids rewarded for showing desired behaviour
• therapist observes the child
• consults with the parents
• makes a plan to address certain behaviours
  –> e.g. reducing tantrums or harmful behaviours
  –> e.g. increasing or improving communication
• plan will include specific strategies caregivers, teachers, and the therapist can use to achieve treatment goals
• ABA relies on parents and caregivers to help reinforce desired behaviours outside of therapy

Question 24

effectiveness of ABA (Peters-Scheffer, Didden, Korzilius & Sturmey, 2011)

Answer 24

• meta analysis on effectiveness of Early Intensive Behavioural Intervention (a type of ABA)
• 11 studies with 344 children
• groups who received early intensive behavioural intervention outperformed the control groups on:
  –> IQ
  –> non-verbal IQ
  –> expressive and receptive language
  –> adaptive behaviour

Question 25

summary

Answer 25

• important to gain a clear understanding of each individuals strengths and weaknesses
• there are a range of different therapies, including:
  –> Physical therapy
  –> Behavioural therapy
  –> Speech and Language therapy
  –> Psychological therapy
• whilst behavioural therapies are useful they are not without criticism