Intervention, Support and Context Flashcards
interventions
potential therapies (need to approach with caution and check for scientific evidence)
early educational programs
- communication support (Picture exchange communication system [PECS])
- behavioural interventions (Applied behavioural analysis [ABA])
- general development/educational strategies (elements from elsewhere)
Picture exchange communication system (PECS)
- a unique augmentative (large one of its kind) intervention for individuals with ASD and related developmental disorders
- moderate to severe learning difficulties
- children of school age struggling to develop spoken language
- pictures used to start communication with child
- also helps with challenging behaviour as the child can communicate and is less frustrated
- building up through 6 phases
PECS 6 phases
Phase 1 - how to communicate (exchange pictures for items)
Phase 2 - distance of persistence (using single pictures in different places
Phase 3 - picture discrimination (select 2 or more pictures of their favourite things from communication book)
Phase 4 - sentence structure (learn to construct simple sentences on detachable strip - expanding using adjectives)
Phase 5 - answering questions (‘what do you want?’)
Phase 6 - commenting (in response to questions, learning to make up new sentences)
applied behavioural analysis (ABA)
- Lovaas (1987)
- began around autism but can be applied to other disorders
- very rigid structure (intense)
- begin before 3 years
- 40h per week for 2 years
- one-to-one discrete trials (same thing every time)
- often applied in a less rigid way
e.g. Early Start Denver Model (ESDM)
Early Start Denver Model (ESDM)
- early as 12 months as not too far behind peers
- 20h per week (aiming to teach every 10s)
- uses eye contact, sound effects and vocal imitation
- ‘treatment appropriate’ - trying to ‘normalise’ child (training autism out of child)
\+ reduces challenging behaviour \+ can be positive for parents \+ can improve adaptive behaviour \+ can facilitate communication - false hope - financial -outcome may not be positive - training someone to be neurotypical
Makrygianni and Reed (2010)
- review of behavioural programs
- improve several developmental aspects
- predictors of improvement: program intensity, duration, prenatal training, age and adaptive behaviour at intake
Family support
- important to consider what family members are worried about and what they value or disvalue about their childs behaviour, language and education
- Cridland et al (2014) - family systems
- bi-directional influence on family (affects each other)
- affects daily routines, self care, mobility, communication and stress
- research could influence clinical support services
Guite et al (2004)
support different family members (multiple people within the family)
Cridland et al (2014)
- boundaries (border between family system and environment, external boundary between family and other systems)
- permeability - degree of difficulty or ease that information and system members have at crossing this boundary
- boundary ambiguity - confusion about roles and responsibilities experienced by family members resulting from poorly regulated boundaries
- resilience - ability to cope with challenging life circumstances (physical, psychological, emotional, social resilience)
- traumatic growth - extension of resilience (coping involves positive change as a result of changing life circumstances (e.g. increases life appreciation, family solidarity - positive change due to change in circumstance)
permeability
- open systems can be weak resulting in confusion about family roles, identities and goals
- closed systems can be rigid and restrict information flowing limiting physical, psychological and social growth
positive impact of autism on family
- improved communication skills
- higher level of empathy and patience
- increased compassion
- refocus of energy
- improved self-concept and self-confidence
context
- variability
- use of standardised measures
- sample size
no static end state of the developmental trajectory
variability
universality of deficit
- some individuals may not experience same difficulty
inter-individual variability
- one child could share features with another, but may be variation within that child thats unique
intra-individual variability
- going to have differences within an individual depending on sleep, mood, hormones, environment …
sample size
the larger the better (practical consideration, e.g. funding)
what effect size is expected
expected drop out rate
participant fatigue
whats the research question
