methods of modifying of autism

Question 1

who was PECS developed by? what Is it? improves what?

Answer 1

Brody and Frost in 1985. Its a from of communication to complement spoken language. It improves functional communication that usually develops in a child’s first year.

Question 2

what does PECS replace?
ASD fail to do what?

Answer 2

replaces spoken words with pictures. Recommends verbal speech but that’s secondary. It uses operant conditioning and modelling to improve communication and social behaviour.
fail to begin conversations. PECS helps them to spontaneously begin conversations.

Question 3

what is the first stage of pecs?

Answer 3

Pre programme preparation – find object interested in to reinforce communicative behaviour.

Question 4

whats the second stage of pecs ?

Answer 4

Physical exchange – teacher shows learner a motivating object, learner will reach and facilitator encourages leaner to pick up card for what they want. Physically helps hand over. Repeated many times using different objects and different locations.

Question 5

whats the third stage of pecs ?

Answer 5

Increasing independence - more effort from child, try and try again – not rewarded immediately. Picture cards also made into a book, moving the pictures around.

Question 6

whats the 4th stage of pecs?

Answer 6

Learning to discriminate – number of pictures increased, decide between similar pictures.

Question 7

whats the 5 stage of pecs ?

Answer 7

Sentence structure – build sentence stirps.

Question 8

what the 6th stage of PECS?

Answer 8

Answering direct questions – should be automatic – asked direct questions like what do you want?

Question 9

whats the 7th stage of pecs?

Answer 9

Commenting – asked wide range of questions like what do you have? Move beyond simply asking for objects to form more complex sentences.

Question 10

what supporting research is there for PECS?

Answer 10

Christy et al - 3 boys with ASD all had non existent spontaneous speech before PECS. Twice a week for 15 minutes. Once child improved 28%-100% and was still shown 12 months later. Eye contact and joint attention also improved. (small sample and androcentric)

Question 11

evidence of easy to use - pecs?

Answer 11

Christy et al – study showing it can be used easily and quickly – 170 minutes for all 6 stages. Easy to implement and use.

Question 12

PECS - wide applications?

Answer 12

Not require to possess sills like eye contact before – many can have access.
Flippin et al – meta analysis on 11 differnt studies, some cases speech development was negatively affected. Flawed methodology – rated quality of studies as ‘adequate’.

Question 13

PECS - Psychological harm?

Answer 13

child is likely to enjoy the process as they receive regular positive reinforcement by obtaining their desired object. Low risk of psychological harm.

Question 14

PECS - impact on the family?

Answer 14

family stress reduced as communication becomes easier and more effective.

Question 15

why is baron Cohen critical?

Answer 15

critical of any treatment that relies on external rewards. Desired item withheld until they give the card – short term psychological harm, distress. Also removes freedom from the child . Argues for internal rewards like pre existing interest the child has.

Question 16

Alternative treatments to pec?

Answer 16

Alternative treatments may also bring costs and could be more expensive and less effective. The effectiveness may be worth the costs. Cost could be minimised through homemade versions of the picture cards.

Question 17

economic benefits of PECS ?

Answer 17

greater independence and potentially more workers. Economic benefits as less money to spent on welfare and disability benefits.

Question 18

social implications - what is PECS?

Answer 18

trademarked and branded training program belonging to Pyramid educational Consultants. Purchase cards for a price. PECS practitioners are trained by them and these costs are usually met by public sector. May not be justified can claim has limited long term effectiveness and it may actually harm some people.

Question 19

What does RDI focus on trying to improve? how does it work? type of what?

Answer 19

trying to improve the cognitive and empathy deficits. RDI works by modifying the child’s perceptions of other peoples thoughts and feelings. Its a type of cognitive behavioural therapy.

Question 20

what do Gustein and Shelly address?
Based on what assumption?
who needs to be involved?

Answer 20

address emotional and communication deficits. RDI is based on the assumption that children with ASD have missed important developmental skills. Skills like beginning a conversation, sharing a joke and sharing feelings with others cannot be developed by parents alone – RDI consultant needs to be involved.

Question 21

what is RDI based on? whats the aim of RDI?

Answer 21

based on dynamic intelligence – the ability to think flexibly that includes appreciating different perspectives, coping with change and combining information from multiple sources at the same time.
RDI aims to help individuals with ASD form personal relationships by gradually strengthening the building blocks of social connections. RDI is thought to offer a second chance.

Question 22

whats the first objective of RDI?

Answer 22

Emotional referencing – improving ability to share emotional experiences through verbal and non verbal communications.

Question 23

whats the second objective of RDI?

Answer 23

Social coordination – observe and control behaviour to successfully participate in social relationships.

Question 24

whats the third objective of RDI?

Answer 24

Declarative language – language and non-verbal communications to express curiosity, invite interactions, share perceptions and feelings and work/play with others.

Question 25

what the fourth objective of RDI?

Answer 25

Flexible thinking – adopt and alter plans as circumstances change

Question 26

what the fifth objective of RDI?

Answer 26

Relational information processing – put things into context and solve problems that lack clear cut solutions.

Question 27

whats the sixth objective of RDI?

Answer 27

Foresight and hindsight – anticipate future possibilities based on past experiences.

Question 28

what does the RDI consultant do?

Answer 28

works closely with the family of the child with ASD meeting them once or twice a week. During each session the consultant sets aims, plans activities and evaluates the progress with the 6 objectives.

Question 29

what does the parent do for RDI?

Answer 29

Parents video interactions so the consultant can assess and make suggestions, attend workshops to develop communication skills and met other parents of children undertaking RDI.

Question 30

what does the child do for RDI?

Answer 30

will work with a partner who is local to enable to apply communication further. Monitored and reassessed every 6-12 months.

Question 31

what supporting research is there for RDI?

Answer 31

Gutstein = 16 children with ASD following RDI programmes. 15 were taught in special education, only 3 remained after. 14 children considered to be showing significant autistic behaviours, only 2 remained after. Suggest RDI is effective and helps improve communication of many children. However, could have researcher bias as he’s interested in showing RDI is effective.

Question 32

RDI - lacks high quality research?

Answer 32

peer review by gold standard. No gold standard research for RDI. Difficult to assess effectiveness as little research. Not following academic processes?

Question 33

RDI - time consuming?
cost issues?

Answer 33

usually a lengthy and fairly labour intensive intervention, 3 hours a week.

estimates $5000 (£4000) for the first year. Means not available for many limiting the effectiveness.

Question 34

RDI - difficult to identify ethical issues?

Answer 34

Many anecdotal reports from parents describe it as ‘life changing’. Key benefit may be tackling psychological harm which may occur otherwise without RDI.

Question 35

RDI - stress/anxiety?

Answer 35

subjectively helps to reduce stress and anxiety and to improve self esteem.

Question 36

RDI - false hope?
Financial burden?

Answer 36

false hope which is ethically unacceptable may lead to psychological harm.

financial burden on families = argue that RDIconnect are behaving unethically by marketing RDI before further research.

Question 37

RDI - financial costs?

Answer 37

high cost need to be met by public sector. Need to ensure value for money.
takes money away from budgets which could be spent on other therapies which are shown to be effective.

Question 38

RDI - fad therapies?

Answer 38

Tom Zane argues that with recent increase in children being diagnosed with ASD has also become a large rise in ‘fad therapies’. This could mean that truly beneficial treatments are not popular and are not given access to effective therapies.