Treatment of Core Symptoms of Autism Spectrum Disorder

Treatment of Core Symptoms of Autism Spectrum Disorder ASD is comprised of core deficits in social and communication skills and high levels of engagement in restrictive, repetitive behaviors and interests. To date, treatments based on the science of behavior analysis have been shown to be the most effective treatment of core symptoms of ASD. Further, the earlier these behavioral interventions are initiated, the better the treatment outcomes. This topic provides an overview of treatment options for social skills, communication skills, and restrictive, repetitive behaviors and interests.

• Social Skills • Deficits in social interaction and social communication are a core deficit of ASD (American Psychiatric Association, 2013). To meet the DSM-V diagnostic criteria for ASD, an individual must present with or have a history of deficits in (a) social-emotional reciprocity, (b) deficits in nonverbal communicative behaviors used for social interaction, and (c) deficits in developing, maintaining, and understanding relationships (American Psychiatric Association, 2013). This section surveys representative treatment options for a range of social interaction skills, starting from basic (i. e. , eye contact and joint attention), intermediate (i. e. , play skills), and advanced (i. e. , perspective taking and lying). The following section details strategies for teaching communicative social skills in additional detail.

• • • Basic Social Skills One of the core deficits – that is identified as an early indicator – for individuals with ASD is lack of eye contact. Many individuals with ASD do not develop eye contact without specific training. Thus, eye contact is one of the first skills taught to learners in an early intensive behavior intervention (EIBI) program. Eye contact with both an instructor and instructional materials is a pivotal behavior in order to learn new skills and interact socially. Several techniques have been developed to teach eye contact. Early behavior analysts used a verbal cue (e. g. , “Look at me”) and a differential reinforcement and prompting procedures to bring eye contact under instructional control of the verbal cue. Although eye contact can be successfully taught through this procedure, it is rather contrived and may not come under control of the appropriate antecedents and consequences, thus having little generality outside of the instructional activity. More recently, behavior analysts have shifted to teaching eye contact under natural contexts, such as embedded within discrete trial instruction (e. g. , imitation, matching, etc. ), mand training, and play.

● ● Mand training, which takes advantage of a learner’s motivation, is one contextually appropriate context that can be used to increase eye contact and social initiations. Charlop-Christy, Carpenter, Le. Blanc, and Kellet (2002) taught three children with ASD to mand using the Picture Exchange Communication System and evaluated potential collateral effects related to social behaviors, such as eye contact and joint attention (JA). Following mand training, an increase in eye contact and JA, from 25% in baseline to 54% in intervention, was observed across all three participants. However, eye contact was not required during the mand to receive access to the requested item. More recently, O’Handley, Radley, and Whipple (2015) compared the effects of an intervention package, which consisted of social stories and video modeling, on the eye contact of six adolescents with ASD. Findings of this study indicated that using only social stories led to moderated improvements, but after video modeling was combined to social stories, participants demonstrated further improvements. Applying video modeling in isolation showed strong intervention effects, and combining social stories to video modeling contributed to minimal additional improvements. The acquisition of eye contact may also be a prerequisite skill for teaching more advanced social skills such as joint attention. Joint attention refers to a set of behaviors that involve the shared attention between a social partner and a stimulus, and attention could be shared by using various topographies. Some of the topographies may include shift in eye gaze, gestures, vocal or verbal communication using one or more words, or any combination of those. Joint attention skills are considered a pivotal skill in a child’s social and communication development. Thus, joint attention should be one of the earliest social skills taught in a child’s EIBI curriculum. . ﺭﺍﺟﻊ ﺻﻔﺤﺔ ﺍﻟﻔﻴﺲ ﺣﻴﺚ ﺍﻟﺘﻮﺿﻴﺢ ﺑﻤﺮﻓﻘﺎﺕ ﻓﻴﺪﻳﻮ ﻭﺃﻤﺜﻠﺔ ﺣﺎﻻﺕ ﻭﻧﻤﺎﺫﺝ ﻭﻣﺮﺍﺟﻊ ﺗﻢ ﺭﻓﻌﻬﺎ ﺑﺎﻟﻔﻌﻞ ﻣﻦ ﺍﻟﻤﺤﺎﺿﺮﺓ ﺍﻟﺴﺎﺑﻘﺔ