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Three B-E-D Intervention Models & Differing Autism Community Philosophies: Developmental Model
DEVELOPMENTAL models seek to design programs that meet and match with the needs, innate learning stylesm and unique intrinsic motivations of individuals with and without Autism. This is way of being together is "doable" through the use of mutually adaptive environmental, communication, and social strategies that use affordable and available family and community resources. Early and ongoing work/job and play/recreation skills teaching is 1:1, in a daily rhythm that matches with home and school/employment activities and with the specific goal to immediately generalize skills to appropriate independent and interactive forms of functional work or play using adaptive visual and physical prosthetic communication systems. To be able to work and play independently and with satisfaction of reaching our own full potentials is the core value of a functional developmental approach. The only risk-of-harm in this method is what may be the typical community resistance to systematically adapting environments and materials. To overcome ourselves as obstacles we must just always say "yes" to peoples' needs, then clarify our mutual expectations of how we may or may not be ready, able, or willing to meet them, and then wait negotiate our personal wants last. This supports to the universal Autism community need for able advocacy work in relation to each of the Behavioral, Eclectic and Developmental models discussed here in our web page.
You can see how the Developmental model compares to Behavioral and Eclectic models in our:
B-E-D CHART
The most well-established and successfully replicated approach to developmental Autism research and intervention approaches is The University of North Carolina/Medical School, Department of Psychiatry Division TEACCH model. The purported benefit of their comprehensive person-focused, family-centered and community based Developmental models is 90%+ family satisfaction with 90%+ adult independent of services achieved by a large statewide population over several decades. Other developmental education approaches that complement the TEACCH "Structured Teaching" approach are: Dr. Stanley Greenspan's Floor Time™ therapy, Dr. Carol Grey's Social Stories™, Dr. Barry Prizant’s SCRET™ communications skills training, Arnold Miller & Eileen Eller-Miller's Cognitive Developmental Approach, and various Sensory Integration therapies. There may also be other developmental model centers near you, However this is the set of developmental providership models we are currently using in our ADAPT model. Since 1991, Threshold has sought to integrate these complementary model approaches. We are a developmental model provider and have provided more introductory information on the sources of developmental interventions below. Contacts for the same sources we have accessed for our training are listed in the Community links. If you choose this model, but not to choose to work with Threshold, we encourage you to get connected to those sources and providers to support you.
A DEVELOPMENTAL SYSTEMS APPROACH TO BEST PRACTICE AUTISM INTERVENTION MODELS
Developmental models are based on cognitive theory and are supported by experimental research on the cognitive processes and development of typical groups and longitudinal observational studies of large Autism populations in community settings. Proponents of Developmental Autism Interventions support individualized adaptive strategies to facilitate positive growth and independent functioning, which can be applied across the full life-spans and entire spectrum of people with Autism. Structured Teaching was developed through a long-term federally-funded research project in how to: 1) create a statewide model for the screening, diagnosis and educational intervention of Autism, and; 2) implement effective behavioral strategies without any aversive elements, across the full life span and spectrum of people with Autism, across home, school and community using available public service and family resources. The state of North Carolina and its integrated university system represented an ideal research setting and community to pursue these goals. The project began in the 1970-80’s, just as our nation approached full educational inclusion and as the field of psychology launched into a cognitive revolution. The components of the comprehensive intervention model that resulted were many, and the design of an affordable and integrated statewide public service system was elegant. (Several states development of Regional Autism Programs are more or less modeled on the North Carolina model of service, however, most public provider communities pursue more Eclectic approaches across all their services.)
Over the first decade, of their last three decades of statewide providership, U.N.C.'s/Division TEACCH (Treatment & Education of Autistic & Communication Handicapped Children) gradually moved away from behavioral models and the pursuit of solely normative outcomes. It moved towards the use of prosthetic visual communication systems and the identification of the need for adaptation of typical social environments, in order to be more inclusive of people with atypical cognitive development and to pursue optimum developmental outcomes for the full spectrum of people with Autism. These adaptations were seen as positive and proactive ways of facilitating functional engagement within the Autism community. They productively integrated effective individualized life-span planning into a process of cultural change towards fuller able-diversity inclusion at large. This departure from behavioral philosophy/practice then created an alternative approach for family and service providers, by utilizing more contemporary knowledge of human cognition.
To achieve their more inclusive vision, Division TEACCH offers a “Structured Teaching” approach based on Cognitive Learning Theory: the structure and function of people’s brains determine our optimum systems for learning, working and playing; individual intrinsic motivators can be tapped to immediately promote optimum functioning; we can support more spontaneous independent communications and actions, rather than risking gains in only prompted or shaped speech and actions. So structure offers adaptive communication and inclusive social environmental strategies as mutual support-vs-demand systems for people with and without Autism. Receptive Structured Systems offer:
1) Work Routines to systematize clear, consistent and concrete indicators of both “start” to “finish” sequences and predictable rhythms of “first work then play/relief” that are the central functional communication and intrinsic motivation structure of the whole system;
2) Physical Structure to organize the environment with very clear and very substantial separations of work -vs- recreation spaces that make mutual social expectations objectively and explicitly clear;
3) Transition Schedules to use individualized passing level visual cue systems (object/pictures/print word) to show where to go and when to be there;
4) Work Systems to organize what to do/series of tasks and choice options in structured recreational activities, and;
5) Visual Instructions to clearly structure, organize and instruct using how-to-do-work task directions during 1:1 teaching sessions and to then allow immediate generalization to independent work areas across home, school and community.
Finally, spontaneous expressive systems are individually assessed and structured within these receptive systems or as independent portable systems according to needs and passing functional skill levels, to meaningfully relate and to foster appropriate self-management. Together these systems bring us both into mutual communication and positive relation in ways we all need to survive, feel secure, function competently and socially belong. People with Autism do not have special needs, they share in our needs for these same things. They only need that we provide for these same needs in ways that make sense and bring the same comfort that typical communication and functional systems do.
Systems are not faded with time or greater skill achievement, but rather they are advanced according to those skills and then expanded across setting and adapted to levels of adult independent functioning demands and if possible, condensed to become more portable and discrete. But higher levels of systems in not the goal of any structured system, it is greater functional independence regardless of the form of the schedule. That is the long term focus.
TEACCH also developed a companion method for ongoing informal assessment to individualize Structured Teaching. Its P.E.F. scale uses: Passing skills to design all communication systems for immediate independent functioning; higher Emerging skills to target readily attainable goals, and: mid-Emergent skills to monitor for new emerging potentials. Lower Emergent skills are prosthetically supported and we avoid placing demands on Failing skills. (Threshold has adapted this to be an "O-P-E-N" Observe>Passing>Emergent>Non-Emergent tool that is more able-friendly and easy-to-remember). This assessment system addresses the lack of usefulness that plagues typical standardized evaluations in relation to the atypical nature inherent to the spectrum of Autism, making the system very effective. This system can be univerally used as a mutual developmental asssement tool between people with and without Autism.
Together, these and other structured teaching model elements, support the reliability of the model and ensure the success of people who must live, work and cope with Autism and have shown to work well in combination with other compatible developmental approaches. Developing such systems, through individualized plans that systematically structure systems of clearly understandable high supports with high demands, relative to a persons developmental levels, allows that both the characteristic strengths and weaknesses of people with Autism may be used to their and own mutual advantage. Providers who are centered on more typical or harsh forms of behavioral methods may need begin to negotiate our resistance to using these adaptive systems, and seek a more proactive engagement in mutually positive relations.
Understanding Autism Webbook. Copyright © 2000-03 by Sharone Lee. ALL RIGHTS RESERVED. All names, concepts, methods, materials, products and publications are protected by trademark and copyright, and no part of this text or this web page may be reproduced or distributed in any manner, for any purpose, including educational purposes, without express written consent from: THRESHOLD • SALEM, OREGON • 503-375-9462 • sharone@understandingautism.org. Portions of "The Path Out of the Woods" were published in The Net Journal of the Autism Society of Oregon, with the Author's permission in Autism 2001 and Complimentarly Issue 2002. |
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