Autism Interventions and Visual Supports
There are a variety of autism interventions that have benefitted children with autism by supporting their understanding and communication. Autism interventions, particularly visual supports that are used in the home, school, work and community settings have resulted in improved social engagement, independence and learning.
In response to increasing awareness of the rise in cases of autism globally, multiple autism intervention are being researched and studied to assess the value they have on the specific impairments of autism disorder. There are a variety of autism interventions that have been shown to positively impact children with autism. The use of visual supports to enhance understanding and facilitation of communication has continually been proven to be critical in many settings.
Visual supports used in settings such as home, school, work, and community assist children with autism by providing them with the tools to process the whole message. Visual supports are essential because they are part of everyone’s communication system, attract and hold children’s attention, enable individuals to focus on the message and reducing anxiety, transform abstract concepts into concrete information, and help children openly express thoughts and emotions (Rao & Gagie, 2006). A common program, which focuses on implementing visual supports to provide structure and supports, is the Picture Exchange Communication System (PECS). PECS helps individuals attain a means of communication. It is especially beneficial to individuals who have minimal verbal communication skills, difficulty with motor planning, and limited communicative partners (Rao & Gagie, 2006).
In addition to PECS, Photovoice as one of a variety of autism interventions has shown promising results in facilitating improved social engagement and learning. Photovoice begins with participants photographing personal objects and activities that are specific to a certain topic. After the pictures are taken, the participant chooses which photographs he or she will share with the group. Meetings are held where participants are expected to engage in dialogue focused around the photographs and the importance they represent. Photovoice allows for teachers to implement structure into the classroom, which is essential when teaching children with autism (Carnahan, 2006).
Photovoice depends on three main structural components; visual schedules, physical structure, and visually structured learning materials (Carnahan, 2006). Visual schedules serves the function as a “to-do” list for children with autism, however, visual representations of the tasks help them process the whole activity. Having physical structure in classrooms allows the children to understand what activities takes place in each area of the classroom, which helps with transitioning from one activity to the next. Lastly, visual structure clearly indicates the work being assigned along with the sequence of how the task should be done. By establishing a classroom that maintains structure in all areas, children with autism have a greater chance of improving many skills that are beneficial to their everyday life.
In addition to the autism interventions of developing a structured environments and learning materials, developing independent skills are a priority for all children in the classroom setting. However, children with autism have a greater difficulty attending to common lengthy verbal lectures, which decreases their active engagement in the task. Children with autism often demonstrate stimulus over selectivity, which means attention is focused on specific parts of a situation with little regard for the context within which the situation is occurring (Happe & Frith, 2006). Also, the lack of dual focus skills makes sequencing and organization difficult for children with autism. Not understanding what has to be completed first or next, while simultaneously comprehending the relationship between each step and what the end result should look like creates additional problems and obstacles in the classroom. Lastly, children with autism have difficulty generalizing information from one environment to another. For example, skills learned in a classroom are oftentimes beneficial in other environments as well. However, children with autism have difficulty seeing how skills can be broadened to many different situations.
Therefore, all of these specific attention and processing impairments make working and living independently very challenging for individuals with autism. In order to assist in teaching independent skills, autism interventions including visual supports like work systems help to organize the environment for children with autism so they can understand what is being presented. The goal of a work system is to organize tasks in ways that are logical to students with autism. In order to implement a work system, the teacher must clearly tell the student was to do first, next, and last, but all work systems are catered to the specific needs of each child. For example, a work system will differ if a child is able to read and write versus a child who cannot. Therefore, careful thought must be put into each work system being designed for specific children’s interests and needs.
The first step in implementing a work system is to determine which activities and routines of the child’s life require independence. They can range from academic tasks to getting through the lunch line. Next, the type of work system needs to be decided. An example of this would be for a concrete learner, a left to right work system would prove to be most beneficial. This system will teach the child to move items from left to right after they have been completed. After the work system is designed, it must be taught to the student with minimal prompting, so that adult supervision and help does not become part of the work routine. Visual supports have been shown to be effective autism interventions for students on the autism spectrum and are consistent with research guidelines for autism best practices in education.
Autism Behavior Intervention
Difficult behaviors associated with autism require a well planned Autism behavior intervention to address the function or reason the behavior is occurring. This begins with a thorough understanding of the cycle of behavior, deficits of autism that may contribute to the behavior and strategies to support the development of more appropriate positive behavior.
Problem behaviors that are associated with stress and anxiety are common in children with autism. Stress and anxiety can be often triggered by environmental stressors, which include uncomfortable social situations, a sense of loss of control, trouble predicting outcomes of various situations, and rigidity in moral judgment (Myles & Hubbard, 2005). This stress and anxiety can often trigger aggressive or oppositional behavior that is labeled as tantrums, rage, and meltdowns, which can be disturbing to the entire classroom environment. Therefore, it is very important in any Autism behavior intervention to understand the triggers to these behaviors and the underlying causes of what stressor is igniting feelings of anxiety in the student with autism.
One of the most important aspects of Autism behavior intervention is the analysis of the tantrums that occur in individuals with autism. During the entire meltdown, it is very possible and often the case that the child does not realize that they are in a state of stress. They often do not perceive themselves as being upset or angry. Therefore, there is rarely ever a warning before the tantrums occurs, making it difficult for educators and adults to realize the state that the child is in before it is already too late. Typically, tantrums occur in three stages, the first being the rumbling stage. Here, children with autism usually show specific behavioral changes that are often minor and unrelated to the ensuing meltdown. For example, it can be as simple as clearing his or her throat. Adults who notice this sign should immediately intervene without becoming part of the struggle. One Autism behavior intervention that can be used such as antiseptic bouncing, which is requesting that the child do something outside of the immediate environment like going to retrieve an object from another room. This allows the child to gain a sense of calmness by engaging in a specific and concrete task.
The second stage of a meltdown is called the rage stage. This occurs when the behavior is not diffused during the previous stage. At this point, the child is uninhibited and acts impulsively, emotionally, and oftentimes explosively. The important aspect of this stage is to ensure everyone’s safety and create a space where the child can eventually regain control. Oftentimes, the rage stage has to run its course before the child can calm down. Finally, there is the stage of recovery. After a meltdown, children with autism often cannot remember what just happened and may deny any inappropriate behavior. It is important as part of the behavioral intervention, that during the recovery stage, teachers realize that the child is not ready to learn yet. Therefore, it is essential that teachers help the child become part of the routine again as quickly as possible by directing the child to a highly motivating task that has a high chance of being completed.
In addition to being highly sensitive to environmental stressors and anxiety, children with autism also have impairments that can result in higher levels of inappropriate behavior. They typically have poor modulation of arousal systems, which can be seen in their difficulty maintaining focus and falling asleep easily. Individuals with autism also have poor strategy formulation to complete complex tasks. This means that their planning strategies are deficient compared to their normal developing peers. They may demonstrate difficulty in their ability to break up tasks in chunks, sequencing of actions to meet the goal, and low flexibility when it comes to completing a task. All these impairments can result in high levels of frustration, which could lead to tantrums. Furthermore, children with autism tend to be hyperactive, which makes it hard for them to sit still in their seat, focus on one task without bouncing from one thing to the next. Also, children with autism often have the urge to engage in repetitive body movements that can be disturbing to other students in the classroom. Additionally, their resistance to change can frequently escalate into a meltdown due to low frustration tolerance and difficulty in delaying gratification. All of these impairments can be underlying factors that need to be understood and considered in any Autism behavior intervention to shape positive behavior and teach children with autism adaptive skills to the world around them.
By understanding the reasons behind maladaptive behavior, it is important that classrooms develop an Autism behavior intervention that includes teaching strategies for individuals with autism. Children with autism need a functional communication system appropriate for their developmental level. By providing an adequate means of communication, stress and anxiety can be reduced dramatically on a regular basis. Also, task pacing, time schedules, and structuring of interactions are helpful when trying to keep a child with autism focused on the task and to avoid attention distractions.
Furthermore, during task work it is important that the adult structure the environment to modulate sensory arousal systems and alter conditions to the specific needs of the child. Other considerations for Autism behavior intervention involve providing guidance when it comes to social situations. Therefore, it is important that an adult help the student understand the social world through techniques such as social story instruction and social script instruction. When situations become too stressful and overwhelming, the child should be offered a “time away” or access to a preferred activity throughout the day to avoid heightening levels of frustration.
Other autism behavioral intervention supports have proven to be beneficial for children with autism in a learning environment and include direct one-on-one instruction for a new skill, which is accompanied by very structured follow through activities that help the child generalize the skill to outside contexts. These tasks and rules should be learned through visual prompts (icons, words) that prove to be easier to process for children with autism as opposed to just verbal instruction. Behavior demonstrated by children with autism is sometimes learned from inappropriate models of behavior because they may mimic or copy others’ actions. Therefore, it is crucial that the child is surrounded by good models of behavior to decrease disruptive behavior.