Treatment Methods Flashcards
What are the 10 treatment methods we went over?
- AAC
- PECS (Picture exchange communication)
- DIR (Developmental, Individual-Difference Relationship-based)
- Discrete Trial Instruction
- Functional Communication Training
- Joint Attention Intervention
- Peer Mediation
- PRT (Pivotal Response)
- Social Stories
- Video Modeling
Of these 10, which are established?
- DIR
- FCT
- Joint Attention
- Peer Mediation
- PRT
- Social Stories
- Video Modeling
Which are emerging?
- AAC
- PECS
- Discrete Trial Instruction
AAC - what system and age range?
Pragmatics
Toddler-adult
AAC method
- system and target vocab
- responsive partners
- natural environment
AAC targets
- enhancement of existing skills
- expanding language
- structure to support language development
AAC Strengths
- socializing with diff. partners
- support for diff. characteristics
- multiple modalities – find best fit
AAC Weaknesses
- time and labor intense
- can be expensive
- lots of support needed
- vocab plan needs to be selected ahead of time
AAC Components
- Select system
- select vocab and plan for expansion
- Identify strategies
- train partners
- continuous monitoring and adapting
PECS system and age range
Behavioral
3-17
PECS method
- visual
- direct, natural reinforcement
- shaping and modeling
PECS targets
- spontaneous initiation of requests
* rejection of undesired and affirming for desired
PECS Strengths
- decrease in problem behaviors (yelling, tantrums) • teaches initiation
- easy to implement in a variety of settings
- can be used by a wide range of developmental and language levels
PECS Weaknesses
- No focus on pragmatics, only expressive language ???
- time consuming
- can be complex
PECS components
- communication partner
- helper/assistant
- High interest or motivating item/activity
- 6 phases
DIR system and age range
Development
18m - 9y
DIR method
- family based
- child directed
- interpersonal relationships
DIR targets
- shared attention and regulation
- two-way intentional communication
- complex problem solving
- emotional thinking
DIR Strengths
- nonverbal language improvements in gaze, turn taking, joint attention
- individualized approach
- emphasizes foundations of relating, communicating and thinking
- addresses behaviors, self-stimulation, self-absorption
DIR Weaknesses
- time consuming
- child directed (child has to engage in behaviors)
- considerable effort and skill by teacher or therapist
DIR Components
- keep child in same general area
- let child take initiative
- connect with joint attention
- talk during entire activity
Discrete Trial system and ages
Behavioral
3-21 years
DT method
- adult directed
- individualized one on one instruction
- predetermined correct responses
- operant conditioning
- contingent or differential reinforcement
DT Targets
- communication, social, and adaptive skills
* use of verbal operants (mands, tacts, echoics, intraverbals)
DT Strengths
- teaches specific behaviors
- can be applied to different backgrounds
- short trials keep child focused
- immediate reinforcement helps motivation
- starts at child’s skill level
DT Weaknesses
- difficult to generalize/transfer
- lack of peer interactions
- isolated skills with one on one prompt dependency
DT Components
- identify appropriate treatment goals
- 4 essential components (discriminative stimulus, response, consequence, intertrial interval)
- decisions about learning strategies (errorless or trial and error), how to present materials and trials
- plan for generalization
Functional Communication system and ages
Behavioral
3-21 years
FC methods
- functional behavior assessment
- selection of an alternative behavior
- fading prompts
- clinician directed
FC targets
Replacement of aggression, self-injury, and inappropriate sexual behavior with functional communication
FC Strengths
- designed for a variety of clients
- can also be effective for people who don’t have ASD
- extensive research
- easily taught
FC Weaknesses
- substituted behavior must be easy enough to be reinforced every time
- substituted behaviors must be culturally appropriate and acceptable
FC Components
assess function of behavior → select communication modality → create teaching situations → prompt communication → fade prompts → teach new communicative responses → modify environment
Joint Attention system and ages
Behavioral and Developmental
3-5 years
JA methods
- directed instruction
- individualized
- intensive
- social teaching
- parent and clinician implemented
JA Targets
Response to and spontaneous initiation of joint attention
JA Strengths
- joint attn. more natural with client directed
- functional for daily living skills
- facilitated through play
- increases social skills
JA Weaknesses
- child needs to be engaged
* child could become fixated and may not transition
JA Components
- developmentally appropriate toys
- follow child’s lead
- visual and verbal prompt
Peer Mediation system and age
Behavioral
3-14 years
PM methods
- peer interaction training
- opportunities to interact within and outside of instructional settings
- adult coaching and support
- instructional arrangements (cooperative groups, peer support)
PM targets
- initiating and maintaining conversations
- exchanging compliments
- turn taking
- collaboration
- conversation
PM Strengths
- generalization
- sense of belonging
- good for both children (teamwork and self-competence)
- academic engagement
- fosters awareness of disabilities
PM Weaknesses
- not proven effective for middle school to adulthood
- unclear if language is targeted
- lengthy process of peer selection and implementation
- confusion regarding peer relationships
PM components
- selecting peers
- Training and supporting peer
- Peer & focal child interaction in structured setting
- Implementing in class/clinic setting
- Extend initiations throughout the day
Pivotal Response Treatment system and ages
Behavior and Development
3-9 years
PRT methods
- play, family, and routine based
- child choice
- taking turns
- shared control of teaching opportunities
- direct and natural reinforcement
PRT targets
- first words
- basic social skills
- sophisticated language
- pivotal behaviors (motivation, responsivity to cues, self-management)
PRT Strengths
- shared control b/t client and clinician increases motivation
- flexible
- natural environment
- any moment is teachable
- natural reinforcement – easier generalization
PRT Weaknesses
- no standardized test available
- assessments can take a lot of time (not cost effective)
- hard to gather data
- needs more research
PRT Components
- clear, concise instructions
- establishing shared control
- maintenance tasks
- addressing responsivity
- immediate reinforcement
Social Stories system and age
Social-pragmatic
6-14 years
SS methods
- visually based
- situation specific
- individualized strategies (determine topic, gather info, develop story, generalization, maintenance)
SS targets
- reduction of disruptive behaviors
- establish routines
- understanding of new events
- social skills
- communication
SS Strengths
- individualized
- uses TOM
- flexible and cost efficient
SS Weaknesses
- time and research
* weak central coherence limits individuals access to social knowledge
SS Components
- determine topic
- Gather individualized information
- Develop the social story
- Consider additional supports
- Review and share the story
- Introduce the story
- Provide comprehension checks and revision
- Generalization training
Video Modeling system and age
Behavior and Development
3-18 years
VM methods
- visually based
- viewing positive models
- adult and peer modeling
- self modeling
VM Targets
- teach new skills or improve existing skills (self-help, dressing)
- cognitive, social, and language skills (play, prosody, turn taking, question asking and answering)
VM Strengths
- once video is made, its there to use
- many children attend more readily to video
- Models: animation - popular format for kids; pov - real-life depictions; adult/peer - easily staged; self - can boost confidence
VM Weaknesses
- can be time consuming initially
- child must attend to video
- Models: animation - can lack relevance; pov – limited range of behaviors; adult/peer – may not hold interest of child; self – difficult to stage
VM Components
- Model
- address wide variety of skills (development, cognitive, social, language, behavioral)
- equipment (camera, computer, video editing, hard drive storage)
- therapy props, learning cards, co-models, daily usage items (beds, toothbrush, pots and pans)
