JCPSLP Vol 16 no 3 2014_FINAL_WEB

Research

Top ten resources in an intensive, group-based intervention setting for young children with autism spectrum disorder Katherine Pye

T he Victorian Autism Specific Early Learning and Care Centre (Vic ASELCC) is a federally funded service that is governed by La Trobe University. he service is part of the Community Children’s Centre and has a research partnership with the Olga Tennison Autism Research Centre (OTARC). We provide intensive intervention for young children with autism spectrum disorder (ASD) in a naturalistic (childcare) setting, using the transdisciplinary Early Start Denver Model (ESDM). Currently our children are aged 2–6 years and on average they attend for four days each week. Most intervention happens in the playrooms during 1:1 interactions, facilitated play with peers and small/large group activities. Children needing additional input (e.g., to target motor speech [Rogers et al., 2006]) are withdrawn for individual therapy sessions. 1 ESDM resources for young children with autism The Vic ASELCC is a transdisciplinary setting where teaching staff and allied health (speech pathologists, occupational therapists and psychologists) are all ESDM trained. Reaching “fidelity” as an ESDM therapist involves formal training and submission of videos that demonstrate effective use of the technique in 1:1 interactions. The ESDM manual (Rogers & Dawson, 2010a) is vital during this process, particularly for the “Teaching fidelity rating system”, which is used by trainers to assess prospective ESDM therapists. Children are assessed on arrival and every three months using the ESDM curriculum checklist (Rogers & Dawson, 2010b). This in turn guides goal writing to target the nine developmental areas supported by the ESDM. 2 Data collection system Once a child’s sixteen (or more) SMART goals are written and broken down into 5–6 steps, their data sheets are kept in the playroom so the team can target goals and record data throughout the day. The data is reviewed weekly and children are moved up their steps toward achieving their goals. We are in the process of moving from paper data sheets to a more efficient electronic (tablet-based) system of data collection and analysis. The ESDM is focused on teaching children with ASD to learn in their natural environments and it is not assumed that all children need the same type or level of support. When children do not progress as expected, a decision tree is used to plan an alternative teaching structure, reinforcement and supports to help the child achieve their goals. For example, if a child does not respond and learn from clear verbal, gestural, object and tactile prompts, aided language displays (ALDs) may be used to support their communication. Other

alternative visual supports include high- and low-tech communication devices and visual timetables. 3 Research We are very lucky to have a full-time researcher, Dr Giacomo Vivanti, working in the centre, and he often alerts us to new findings and articles that are relevant to our practice. Members of our team also attend local and international conferences, use the university library and benefit from regular updates from Informa Healthcare (http://informahealthcare.com) – it’s a great time-saver to receive articles relevant to your needs, straight to your inbox! The centre was established following international findings that early, intensive, behavioural intervention is the most effective (Granpeesheh, Dixon, Tarbox, Kaplan, & Wilke, 2009; Odom, Boyd, Hall, & Hume, 2014; Peters- Scheffer, Didden, Korzilius, & Matson, 2012; Rogers, 2013), and more recent research has supported the efficacy and long-term cost-benefits of approaches including the ESDM. We continue to be guided by current research. 4 The transdisciplinary team The transdisciplinary team is based on shared skills, open communication and thorough organisation. We meet twice weekly and use email, cheat sheets, joint working and frequent face-to-face updates to keep each other up to speed with children’s needs and our own workloads. In a busy group setting, timetabling is crucial: groups, transitions, inclusion visits, therapy space, staffing, meals and the children’s toileting are all tightly scheduled to keep things running as smoothly as possible, providing children with learning and care throughout the day. The therapists in the room have clear roles and expectations at all times. Families are central to the team around each child. As we are a childcare setting, parents are not present in the therapy provided on a daily basis, but regular meetings ensure their concerns are addressed and consistency between home and the centre is increased. Parents are offered training in ESDM techniques and they take part in goal-setting with their child’s key workers. Seeing parents every morning and afternoon helps us to build a strong relationship through regular communication – we learn a lot from each other. 5 Standardised tests Standardised tests are used to track children’s progress through the program, enabling comparison with alternative intervention models, such as Applied Behaviour Analysis (ABA). Our research psychologist carries out this work, which evaluates the effectiveness of the ESDM in a group

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JCPSLP Volume 16, Number 3 2014

www.speechpathologyaustralia.org.au