Common Preschool Interventions for Autism

The most studied intervention for Autism is Discrete Trial Training (DTT). It starts with an analysis of the child's behavior and motivation. DTT focuses on the child's knowledge but is directed by the teacher. Early on, it teaches children to do things like sitting in a chair. The child will be asked to sit, if he does not sit the teacher will physically help him to sit, and then he will be reinforced. Next, requiring the child to imitate nonverbal movements is used to get the child to watch you. The instructor tries to get the child to comply with early nonverbal behaviors so that later they can get them to do this with language. Reinforcement is huge here. The child is asked to do something and when the child does it they are reinforced for the behavior. The teacher must use something that they have found to be reinforcing to the child such as hugs or stickers. There are usually 10 different things that the child has to do in each trial, such as point to the correct object in 10 pictures. After they get through this, they are given a reinforcement period where they are allowed to play or do something they enjoy.

This intervention works in that the children improve their language skills and have a higher IQ afterward. The criticism for this type of intervention is that the kids can do what they are asked when in the classroom but they do not always generalize what they have learned to the outside world. The child will be able to say school bus when they see a picture of a school bus in the classroom but will not say it when they are outside and see a real bus. Another problem is that the children often wait for a certain cue such as "what's this?" before they will use the words that they know. Most kids who get this type of intervention receive 10-40 hours a week. It usually starts in a one to one setting with the child and the trainer in the home and then progresses to spending some time in a classroom with less one on one time.

Naturalistic Behavior Interventions

Naturalistic Behavior Interventions (NBI) are a type of intervention that is a little less structured than DTT but still uses behavioral techniques. In Pivotal Response Training, children are taught skills that can affect language. This often starts will trying to get the child to do something like requesting since it is a pivotal skill. It is pivotal because it is a functional skill that can be used in many different situations. It allows generalization to naturally happen because there are more cues. For example, getting the child to say "more" can be done in many different situations. In this case, the child imitates the interaction. The reinforcement is more internally related because the child gets more of whatever he asks "more" for. The criticism here is that some children do not have the motivation to sustain interaction with other people and do not have many things that they like to do. This intervention does not work well if there isn't much that the child is motivated to do because they just do not have the desire to interact.

Developmental Pragmatic Interventions

Developmental Pragmatic Intervention (DPI) is the least structured of these three interventions. The emphasis here is on play and relationship building. The reinforcement here comes from the attention you give the child and joint eye gaze. You also need a child that is interested in interacting with you. The trainer follows the child's lead and does what they are want to do. It works to build relationships between the child and parents and siblings. This type of intervention has been around for awhile but there have not been many studies done and there isn't much evidence to show that it works. Even though this type of intervention is harder to study since it is less structured, that does not mean it does not work.

None of these interventions can be called the best. Depending on the child, different types of interventions work better than others. Researchers are trying to figure out characteristics of the children that will distinguish them into categories that put the child in the type of intervention that is best for them.