When your pre-school child has been diagnosed with autism or Asperger syndrome, you may experience mixed feelings of grief and frustration. But by reading up-to-date information on autism, and making use of the sources of practical help available to you, you will find that there is much you can do at this stage to maximise your child's development. This guide points you towards some useful programmes and strategies.

Early intervention is known to help children with a range of developmental disorders, including ASD, and the involvement of parents is essential.

Some interventions work with and through parents to help their child, eg the NAS EarlyBird programme). Others involve the child in home-based intensive programmes, eg Lovaas or ABA (Applied Behavioural Analysis) and the Options Son-Rise programme.

There are other ways in which parents may choose to help their pre-school child, such as:

  • using picture symbols to develop communication
  • trying a gluten- and/or casein-free diet
  • using educational software on a home computer.


All of these options are explored in more detail on the following pages.

The EarlyBird programme

EarlyBird is a three-month parent programme. It combines group training sessions for parents with individual home visits, when video feedback is used to help parents apply what they learn when they are working with their child.

A research study, carried out after we set up the EarlyBird programme, confirmed parents' feelings of being helped by participating in it.

Parents have a weekly commitment to a three-hour training session or a home visit, and to ongoing work with their child at home during the three-month long programme. This short-term, focused model of early intervention supports parents in the period between diagnosis and their child starting school.

EarlyBird aims to help parents understand why the development and behaviour of their pre-school child with autism may be different, so that parents can go on working out how best to help their child. EarlyBird is offered by licensed teams across the UK.

Read more about our EarlyBird programme at www.autism.org.uk/earlybird or contact the EarlyBird centre:

NAS EarlyBird Centre
Barnsley Road
Dodworth
Barnsley
South Yorkshire S75 3JT
Tel: 01226 779 218
Email: earlybird@nas.org.uk

Lovaas/ABA

The Lovaas method is an early intensive behaviour therapy approach for children with autism and other related disorders. It is also known as the UCLA (University of California Los Angeles) Model of Applied Behavioural Analysis (ABA). It is based on extensive American clinical experience and research carried out over more than 30 years by Ivar Lovaas.

Lovaas and his colleagues recommend that treatment should begin as early as possible, preferably before the child is five years old and, ideally, before the child reaches three and a half years. This is necessary in order to teach basic social, educational and daily life skills. It can also reduce stereotypical and disruptive behaviours before they are established. The home-based programme consists of 40 hours per week of intensive therapy. Results of Lovaas' studies show the importance of maintaining these hours in order to maximise the benefits to the child.

The therapy is on a one-to-one basis for six-eight hours a day, five-seven days a week for two years or more. Teaching sessions usually last two-three hours without a break. The intensity of the therapy means that there is usually a need to establish a programme team which normally consists of at least three persons. These people have all undergone a full training programme. All skills are broken down into small tasks, which are achievable and taught in a very structured manner, accompanied by lots of praise and reinforcement. Examples of reinforcers are small bites of food, play with a favourite toy and social rewards such as verbal praise, hugs and tickles.

The intervention programme progresses very gradually from teaching basic self-help and language skills, to teaching non-verbal and verbal imitation skills, and establishing the beginnings of toy play. Once the child has mastered basic tasks the second stage teaches expressive and early abstract language and interactive play with peers. In more advanced stages of intervention the child can be taught at home and school.

Lovaas and his colleagues believe that with early intervention a sizeable minority of children (just under 50%) with autism and related disorders are able to achieve normal educational and intellectual functioning by the age of seven. For those children who do not achieve normal functioning it is claimed there are usually substantial decreases in inappropriate behaviours and acquisition of basic language is achieved. There is continuing discussion as to the validity of Lovaas' findings. The treatment is extremely long and intensive and can therefore prove to be very expensive. However, a growing number of parents have used this method and have been pleased with the results.

More information about the Lovaas/ABA method of early intervention is available from our Lovaas information sheet, or from:

Peach (Parents for the Early Intervention of Autism in Children)
The Brackens
London Road
Ascot
Berkshire SL5 8BE
Telephone. 01344 882248
Facsimile. 01344 882391
Email: info@peach.org.uk
Website: www.peach.org.uk

The Son-Rise Program

This program uses an interactive approach to early intervention emphasising the importance of developing a relationship and communication between the child and its parents. The programme is child-centred: the child is not judged and their behaviours are not seen as good or bad; rather the child is seen to be doing the best they can.

The Option method developed from the efforts of Barry and Samahria Kaufman to help their autistic son, Raun. The Kaufmans designed and implemented a home-based programme for Raun, and later published their experiences, which were also made into a film, 'Son-Rise, A Miracle of Love'. As interest grew, in 1983 they established the Option Institute and Fellowship in the United States. The Option Institute offers training programmes for families with special children, using the methods originated by the Kaufmans and taught under their supervision.

The Son-Rise philosophy encourages the parent (or instructor, therapist or facilitator) to become the student of the child's world, observing, learning, assisting and supporting the child's development in a loving and non-judgmental environment. The child becomes the teacher, guiding the process, discovering and exploring self and the world. This approach of going with the child, rather than against, helps the child to become more motivated to explore and develop. Many of the ideas used in this approach can be seen in parallel principles which underlie the procedures of behavioural intervention, especially those used in gentle teaching.

Parents are trained, and then set up and manage the programme at home. The use of a therapy room, designed to offer as little distraction as possible, is recommended. The therapy room should have diffusers on the windows, a diffused artificial light source and only one adult working with the child at any one time. These measures are designed to filter out distractions and help the child to concentrate. Materials are placed out of reach of the child and can only be obtained by the child through communication with the adult. The Option approach emphasises imitation, based on research showing that an adult imitating the actions of a child increases the eye contact between the two and develops the use of creative play.

The Option Institute offers a one-week programme which it says "provides a customised/individualised training, which enables families to return home and direct a successful Son-Rise Program". Additional advanced training and return weeks is available. The Institute recommends that both parents of the child attend the course or if this is not possible a close relative, friend or other support person.

More information about the Option Institute's Son-Rise Program is available from:

Autism Treatment Center of America
THE SON-RISE PROGRAM
The Option Institute
2080 S Undermountain Road
Sheffield, MA
USA 01257
Tel: 00 1 413 229 3202 
Email: sonrise@option.org 
Website: www.option.org

Using picture symbols

Children with an ASD have difficulties with social communication and many are slow to develop an understanding and use of spoken language.

Since people with autism are often visual learners, visual communication methods, such as the use of picture symbols, can really help.

The Picture Exchange Communication System (PECS) was developed in the USA in 1987 to help young children with an ASD learn to make requests and communicate their needs.

PECS teaches children to exchange a picture card for something they like and want. Objects, pictures or symbols may be used, according to the child's developmental level, but many young children with autism find the less detailed line drawing of a symbol easier to understand, especially if this is accompanied by written words.

PECS first assesses the child's preferences for a small number of food items and some toys. The child is then taught, in a series of small steps, to exchange a symbol representing one of these food items for the item itself.

At first two adults are needed so that the child can be physically, but not verbally, prompted to exchange the symbol, rather than grab the item they want. There are six phases of PECS in all. The child should gradually become independent of adult prompting and learn that communication is a two-way process which can achieve desired needs.

PECS is easy to use and does not involve expensive equipment, testing or training, although training courses for professionals are available.

More information about PECS is available in Picture symbols for professionals and students, Picture symbols (including PECS) - a parent's view and from Pyramid Educational Consultants:

Pyramid Educational Consultants UK Ltd
Pavilion House
6 Old Steine
Brighton
BN1 1EJ
Tel: 01273 609 555
Email: pyramid@pecs.org.uk
Website: www.pecs.org.uk

PECS helps pre-verbal children with autism learn how to express their needs. Children who can already speak may also benefit from the use of picture symbols to help them understand the sequence of daily routines. Using pictures in this way can prevent tantrums and help children learn skills that involve sequencing, such as getting dressed.

Symbols can also be used to help the child understand choices, or to reinforce the concept that something is finished and show the child what will happen next.

More information on using picture symbols as part of visual structure can be found in:

L. Hodgdon (1995) Visual strategies for improving communication. Quirk Roberts Publishing
Available from Winslow Press, Tel: 0845 230 2777  Website: www.winslow-cat.com

Diet modifications

Some parents use gluten- and/or casein-free diets for their children with an ASD.

Gluten and casein are found in many processed foods, as well as in food such as bread, biscuits and cakes (gluten), and dairy products (casein). Meat, vegetables and fruit will not contain gluten or casein.

It seems that the children most likely to benefit are those who have bowel problems such as constipation, diarrhoea or abnormal stools. Research into the effects of exclusion diets, and into the related area of using secretin, is still ongoing.

Parents can get help in planning a gluten- and/or casein-free diet from their GP, who may refer them to a dietician.

Lots of supermarkets offer products which are gluten-free. Some products are available on prescription from pharmacies; others are sold by health stores.

A list of gluten-free products is available from:

The Coeliac Society
PO Box 220
High Wycombe
Bucks
HP11 2HY
Tel: 01494 437 278 (9.30am - 2.30pm)

You can also get information from:

The Autism Research Unit
School of Health Sciences
University of Sunderland
Sunderland
SE2 7EE
Email: aru@sunderland.ac.uk

More information can be found in Diet modifications - a parent's view, and details of gluten and casein-free diets can also be found at www.GFCFDiet.com 

Home computer software

Children with an ASD are often quick to understand computers and enjoy their visual and logical nature - so computers can be good learning tools. Be aware that computers may become an obsession for some children with an ASD, and you might wish to moderate their use.

As yet, autism-specific software is in short supply but readers of our members' magazine, Communication, shared suggestions of software which their child had found attractive.

The Jump Ahead Series, published by Cendant software, seems very popular and has parent support material to guide use at home. The Jump Ahead Series is recommended as starting off in a user-friendly way and working on skills such as visual memory.

Reader Rabbits Toddler, from Learning Company, is also aimed at pre-school children and is recommended as easy to use, with no need to click the mouse, but introducing counting, colours, shapes and the alphabet.

Stockists of special needs software include:

  • REM (Rickett Educational Media)
    Great Weston House, Langport, Somerset TA10 9YU. Tel: 01458 253636
  • Semerc
    1 Broadbent Road, Watersheddings, Oldham OL1 4LB. Tel: 0161 627 4469
  • Widgit Software
    26 Queen Street, Cubbington, Leamington Spa, Warwickshire CV32 7NA.
    Tel: 01926 333680 Fax: 01936 885293 Email sales@widgit.com or support@widgit.com
  • Sherston
    Angel House, Sherston, Malmesbury, Wiltshire SN16 0LH. Tel: 01666 840433.


You can find more information in Computers: applications for people with autism

Conclusion

There are various options available for pre-school intervention. The choice of which one is best will probably vary according to personal prefences, finances and time available. There is evidence that these can assist a young child in adapting to his or her surroundings and, while not providing any form of cure, can help improve their quality of life.


Quick link to this page: www.autism.org.uk/19493