Written by Laurie Stephens, PhD – Senior Director of Autism Programs and Dr. Megan Beardmore, PhD, NCSP
Why Does Early Intervention Matter?
Neuroplasticity is a concept that refers to our brains’ ability to grow and evolve by developing new connections between regions, as well as rewiring and reinforcing existing connections. For example, when you learn a new skill such as riding a bike, new neural pathways are established. Each time you practice riding your bike, those pathways are strengthened. That’s why learning new skills can be so good for our minds!
Although the brain retains this remarkable ability throughout the lifespan, it is most malleable during the first five years of life. The minds of young of children are open to learning much more compared to the brains of adults – in fact, toddlers have twice as many neurons compared to adults. Because of this, it’s incredibly important that we capitalize on this developmental period – not only to teach children new skills but to help them unlearn any unhelpful or harmful ways of thinking and reacting. For autistic children, we want to equip them with strategies to overcome social-communication challenges. One study that examined the effectiveness of behavioral interventions in youth with autism found that younger children gained more skills compared to older children. Thus, the goal should be to provide effective interventions early in life so the children won’t need as much support in the future.
It’s also important to acknowledge that we don’t know much about the effects of COVID-19 on the developing minds of young autistic children. It is reasonable to hypothesize that social isolation negatively impacted social skills development. One recent study found that stress increased in autistic individuals during the pandemic. However, another study reported that social distancing actually had a positive effect on the well-being of children with autism due to diminished social demands. Additionally, because wearing masks prevents us from seeing the whole face, it is plausible that emotional expression less noticeable and we may miss important facial cues. It will be interesting to learn more about this as new research is published.
What Types of Interventions Work Best?
Decades of research have shown that behavior modification principles, such as those found in Applied Behavior Analysis, Discrete Trial Training, and the TEACCH Method are very effective in teaching new skills (e.g., language, socialization, life skills) and overcoming challenging behaviors (e.g., aggression, self-injurious behavior). This can be accomplished in a variety of ways and involves providing feedback on target behaviors and skill development– this feedback is used to either increase or decrease the likelihood of a behavior reoccurring. We all use feedback to help us navigate safely and effectively in the world. For example, we stop at a red light, even if we are in a hurry or don’t want to stop at the light, because the consequences of not stopping (getting a ticket/fine, getting in an accident, injuring ourselves or others) are motivating us to follow the expectation/rule.
We want to acknowledge that many autistic adults did not always find ABA helpful and in fact, for some, they felt it harmful. As such, it is just as important to incorporate naturalistic principles in early intervention. Although still grounded in behavior principles, naturalistic modalities emphasize the “here and now,” which lends itself into taking a more holistic, play-based interaction that considers and values the unique individual. For instance, in teaching word recognition, rather than using a typical preschool list, words should be of high interest to the child. For example, instead of learning “goat” and “boat,” if the child has an interest in shapes, the target words should be “circle,” “square,” and/or “triangle.” For very young children, it is incredibly important to nourish intrinsic motivation, and that we follow up with a high level of praise/reinforcement for effort and accuracy. In this type of intervention, the child is observed completing their day-to-day routines and activities to determine what skills the child would benefit from. Perhaps the child struggles with brushing their teeth. After we’ve investigated possible sensory sensitivities and worked through those barriers, we can then focus on performing the steps independently. Because the intervention should take place “in the moment,” when the natural opportunity presents, that’s when assistance/teaching should be provided. In combination with a holistic, strengths-based approach, the child’s passions can be incorporated in this activity. If this child enjoys music or singing, you might find a song that includes the steps to tooth brushing.
When looking for an early intervention program for a child with autism, make sure that the curriculum is comprehensive – not one that takes simply a behavioral, relational, or academic approach. The program should target skills such as communication, independence/life skills, and emotion regulation. For example, our after school social skills group for 4 to 6 year-olds incorporates team work, problem solving, exploring, and ample social opportunities. Additionally, play is essential to a child’s brain development. Some autistic children have difficulty with functional/pretend play. It’s important to recognize that a behavioral approach goes against the nature of play, which is intrinsically motivating to the child. Therefore, we must join in what the child naturally engages in and transform that into a play activity is the best way to encourage growth in this area. For example, if our child enjoys spinning objects, that can easily be turned into a game that incorporates taking turns and shared enjoyment with other children. Lastly, the goal of an early intervention program should not be to make the child “less autistic” or pretend to be normal. The idea is to target the malleability of mind so the child experiences less anxiety, less sensory overwhelm, and feels more confident navigating the world.
Learn More
Interested in learning more about The Help Group’s social skills group for 4- to 6-year-olds? Contact Laurie Stephens to learn more.
Also, please check out our previous webcast, where our expert panelists will cover understanding the ASD diagnosis, early intervention for children with ASD, and issues related to social skills development during the COVID-19 pandemic.
References
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