Lecture 5 Intervention, Support & Context Flashcards
What are some potential therapies of ND disorders?
Zinc, music therapy, diet, art therapy, homeopathy, holding therapy, sensory integration therapy
- Exert caution and check for scientific evidence around these therapies
What is the Picture Exchange Communication System (PECS)?
It is a communication programme which helps people with severe difficulties in developing their communication skills
Developed in 1985
Originally specifically designed for ASD children
What is involved in Phase 1 of PECS?
Phase 1: How to communicate
- Learn to exchange single pictures for items/activities they really want
What is involved in Phase 2 of PECS?
Phase 2: Distance & Persistence
- Learn to generalise new skill by using it in difference places, with different people, and across distances
- They are also taught to be more persistent communicators
What is involved in Phase 3 of PECS?
Phase 3: Picture discrimination
- Students learn to select from two or more pictures to ask for their favourite things
- These are placed in a communication book, a ring binder with velcro strips where pictures are stored and easily removed for communication
What is involved in Phase 4 of PECS?
Phase 4: Sentence structure
- Students learn to construct simple sentences on a detachable sentence strip using an “I want” picture followed by a picture of requested item
What is involved in Phase 5 of PECS?
Phase 5: Answering questions
- Learn to use PECS to answer the question “what do you want?”
What is involved in Phase 6 of PECS?
Phase 6: Commenting
- Taught to comment in response to Qs, such as “what do you see?”, “what do you hear?”, “what is it?”
What is Applied Behavioural Analysis?
First published in 1987 as part of the UCLA Young Autism Project. The program recommends:
- starting before age 3
- at least 40 hours per week
- therapy should last at least 2 years
- one to one discrete trials
A very strict and intense intervention
What is an important consideration for these kind of interventions?
Is it appropriate to train the autism out of people?
What is the Early Start Denver Model?
Developed by Sally Rogers, a development of the ABA
For children as young as 12 months
20 hours a week, teach exercises to parents that they can continue at home
Works on improving several skills at once e.g. communication, eye contact, vocal imitation
Aims to have a learning opportunity every 10 seconds
BUT what is the goal of the program and is it appropriate?
What are the key predictors of improvement?
In a review of 14 studies finding these programs to be effective, the key predictors of improvement were:
- Program intensity
- Program duration
- Parental training
- Age at intake
- Adaptive behaviour at intake
What are the pros of these interventions?
Parents an experience positive interactions
Challenging behaviour can reduce
Can improve adaptive behaviour
Can facilitate communication
What are the cons of these interventions?
Can be seen as training to be neurotypical when someone isn’t
Can give parents false hope
Financially
Outcomes may not necessarily be positive
What does “effective” mean?
- Less autistic behaviour?
- Higher IQ?
- More adaptive behaviour?
- Long term social outcomes?
What is the bi-directional influence on family?
- Daily routines
- May need support with self care, mobility, communication and cognitive or emotional tasks daily
- Increased experience of stress
Research on family could inform clinical support services, and facilitate coping and support mechanisms
What did Guite et al. (2004) find?
That we should consider different family members separately
Found that mothers report more sibling adjustment problems compared to sibling self-report
What is the positive impact of ASD on family?
- Improved communication skills
- Higher levels of empathy & patience
- Increased compassion
- Refocus of energy
- Improved self-concept and self-confidence
What is the family systems approach?
It is useful for understanding what the family system is and how they impact one another (Cridland et al., 2014)
Outline the boundaries aspect of the FSA
Boundaries are hypothetical borders between and within a family system and its environment
The external boundary defines the family in relation to other systems
Internal boundaries determine who is included and excluded in the sub systems
Outline the permeability aspect of the FSA
The degree of difficulty or ease that information and system members have in crossing the boundaries
Open systems can be weak as boundaries are loosely defined results in confusion about family roles, identities and goals
Closed systems can be rigid and restrict info permitted into the system, limiting physical, psychological and social growth
Outline the boundary ambiguity aspect of the FSA
Confusion about roles and responsibilities experienced by family members resulting from poorly regulated boundaries
Outline the resilience aspect of the FSA
Ability to cope with challenging life circumstances. Includes physical, psychological, emotional and social resilience
Outline the traumatic growth aspect of the FSA
An extension of resilience where coping involves positive changes as a result of challenging life circumstances such as increased appreciation of life, personal strength, family solidarity and quality of relationships
