1
Q
- Authors: Stanley Greenspan and Serena Wieder
- Comprehensive treatment
- multidisciplinary evaluation
- biomedical evaluations
- administrator: clinical team including clinicians and parent
- environment: clinic/school/home
- materials: those needed to reach the goals
- frequency: 6-8 20 minute sessions a day
- session aim: improvement of FEDLs
- procedures:
- floortime
- goals addressing each FEDL
- opening and closing circles of comunication
- semi-structured problem-solving
- sensory motor activities
- parent coaching
A
Developmental, Individual-Difference, Relationship-Based Model (DIR model)
1
Q
Is Hanen more developmental or behavioral?
A
developmental
1
Q
What approach involves key vocabulary such as language stage, SCERTS, natural environments, and family guided routines?
A
Early Social Interaction Project (ESI)
2
Q
- Therapy technique that focuses on social interaction
- 10 minute interaction between adult and child
- based on a turn-taking sequence
- one game is played repetitively for 10 minutes
- It is a mini conversation made up of verbal and/or nonverbal turns
- the adult looks for pragmatic behavior from the child and assigns communicative intent to it by responding with his turn
A
Giggle time
2
Q
naming, labeling, commenting
A
tacting
2
Q
Is ESI more developmental or behavioral?
A
developmental
2
Q
- Author: Ann Kaiser & Terry Hancock
- Skill specific intervention
- target client: children with ASD who are minimaly verbal (but not nonverbal)
- Administrator: clinician or parent
- environment: clinic/school/home
- materials: toys and materials for play
- frequency: 24 sessions (15-20 min clinician implemented; 45 min parent implemented)
- session aim: increase language complexity
- procedures:
- environmental arrangement
- responsevie interaction
- language modeling
- milieu teaching prompts
A
Enhanced Milieu Teaching (EMT)
2
Q
What is the frequency of ESI?
A
daily, goal of 25 hours/week
3
Q
Evidence Serotonin
A
1 RCT, insufficient evidence
3
Q
What is the session aim for behavioral intervention?
A
improve specified goals for the session
4
Q
interventions that involve request, reinforcement
you have to plan generalization
A
behavioral interventions
5
Q
- Five components of the program
- baseline level of performance
- direction for intervention
- system for tracking skill acquisition
- tool for outcome measures
- framework for curriculum planning
- Common verbal operants
- manding-requesting
- tacting- naming, labeling, counting
- listener- attends, follows directions
- echoic- imitation
- intraverbal- answering questions
- a verbal behavior- language that occurs in a behavioral context focusing on antecedents, behaviors and consequences
- Used for low functioning ASD
- Is a combined assessment/intervention
A
VB-MAPP
Verbal behavior milestones assessment and palcement program
6
Q
types of mind-body interventions (4)
A
- prayer/shaman
- biofeedback
- meditation/relaxation
- guided imagery
6
Q
Is Behavioral intervention more behavioral or developmental?
A
behavioral
8
Q
True or False
Children with ASD spend significantly less time in coordinated joint engagement
A
true
9
Q
interventions that look at normal developmental progression and treat weaknesses through typical developmental processes
A
developmental
9
Q
What is the frequency of JASPER?
A
- 30 minutes a day
- 3-5 days a week
- as few as 24 sessions total
10
Q
- authors: Robert Koegel and Lynn Koegel
- Comprehensive intervention
- administrator: clinician or parent- official training available
- environment: clinic/school/home
- materials: toys with multiple parts
- frequency: all waking moments are teaching moments
- session aim: language; play; social interaction; self-help; academic
- Procedure:
- presentation of an opportunity to respond
- reinforcement given following a response
*
A
Pivotal Response Treatment (PRT)
10
Q
Who is the administrator of EMT?
A
clinician or parent
11
Q
Types of complementary/alternative medicine (5)
A
- biologically based therapies
- mind-body interventions
- manipulation/body-based methods
- energy therapies
- alternative medical systems
13
Q
methylphenidate (ritalin)
A
stimulant
14
Q
requesting
A
manding
15
Q
types of alternative medical systems (2)
A
- acupuncture/acupressure
- anthroposophic medicine
15
Q
milieu teaching prompts (6)
A
- most-to-least support
- imitation to initiation
- providing verbal choices
- opportunities to answer questions
- time delay
- modeling expanded language
15
Who are the administrator of ESI?
Parent with clinician support; clinician must be trained in SCERTs
16
Do you need to be certified to do ESI?
Yes, in SCERTS
16
Who is the administrator of DIR?
Clinical team: including clinician(s) & parent- those certified in DIR
17
What is the environment of behavioral intervention?
* home/school/clinic
* often a dedicated space where teaching occurs "table time"
18
What is the environment for EMT?
clinic/school/home
19
language that occurs in a behavioral context focusing on antecedents behaviors and consequences
Verbal behavior
20
Do you need to be certified to use JASPER?
no
22
What is the gold standard for credible evidence?
systematic meta-analysis of more than one randomized control trial
23
imitation
echoic
24
haloperidol (haldol)
antipsychotic
26
What is the environment for ESI?
home
27
types of energy therapies (1)
healer/healing touch
29
Is EMT more behavioral or developmental?
behavioral
30
* not necessarily ABA
* evaluate preparedness to learn
* administrator: supervising clinician (BCBA), direct care clinician, parents
* environment: home/school/clinic; often a dedicated space where teaching occurs "table time"
* materials: data collection tools, reinforcers, teaching materials
* frequency: 40 hours a week
* session aim: improve specified goals for the session
* procedure:
* discrete trial instruction
* verbal behavior
* prompts
* teaching variants
* shaping
* differential reinforcement
behavioral intervention
32
Who is the administrator of JASPER?
clinician
33
What approach involves key vocabulary such as Joint Action Routines, Joint attention, Joint engagement
JASPER
35
What approach involves key vocabulary such as child profile and functional emotional developmental levels (FEDLs)?
Developmental, Individual-Difference, Relationship-Based Model (DIR)
36
What is the environment for JASPER?
Clinc/school/home
36
What treatment approach involves the following key vocabulary: discrete trial training, differential reinforcement, shaping?
Behavioral Intervention Strategies
37
attends, follows directions
listener
38
What is the environment for PRT?
clinic/school/home- individual's typical environment
38
amphetamine
stimulant
39
What does SCERTS stand for?
Social Communication Emotional Regulation Transactional Supports
40
Child Proflie
D
I
R
* D- Functional emotional developmental levels (FEDLs)
* I- Individual processing profile- individual differences in sensory, motor, and language abilities
* R- Caregiver- child relationship
42
What is the frequency of DIR?
6-8 20 minute sessions a day
43
DIR FEDLs (6)
* Shared attention and regulation
* engagement and relating
* two-way intentional communication
* complex problem solving
* creative representations and elaboration
* representational differentiation and emotional thinking
45
* authors: Amy Wetherby & Juliann Woods
* comprehensive treatment
* administrator: parent with clinician support; clinician must be trained in SCERTS
* environment: home
* materials: those available in the family's home
* frequency: daily- goal 25 hrs./wk
* Session aim: improvement of SC and ER goals
* procedures:
* family guided routines
* parent-implemented embedded intervention
* collaborative consultation
* positive behavior supports
*
Early Social Interaction Project
46
Who is the administrator of PRT?
clinician or parent
47
What is the session aim of DIR?
improvement of FEDLs
48
risperidone (risperdal)
anti-psychotic
49
answering questions
intraverbal
49
ESI language stages (4)
* preverbal
* early one-word
* late one-word
* multi-word
50
Who is the administrator of Behavioral Intervention?
supervising clinician (BCBA), direct care clinician, parents
51
Evidence stimulants (3)
* 1 RCT
* insufficient evidence
* increased challenging behaviors and loss of appetite
52
What can be used to evaluate level of joint attention (4)
* M-CHAT 2
* Early Social Communication Scale (ESCS)
* Parent-Child interaction
* Non-structured play observation with adult
53
What is the environment for DIR?
Clinic/school/home
54
What are the most common types of complementary/alternative medicine
* modified diet
* vitamins/minerals
* food supplements
55
ariproprazole (abilify)
anti-psychotic
56
* comprehensive model
* blended model- combining applied behavior analysis and developmental practices
* delivered in the homes-relationship focused
* Clinicians must be certified
* manualized
* strong evidence
Early Start Denver Model
58
interventions that address all areas
comprehensive
60
DIR language levels (6)
* self-regulation & interest in the world (birth-3m)
* forming relationship & affective vocal synchrony (2-7m)
* intentional two-way communication (8-12m)
* first words: sharing meaning in gestures and words (12-18 m)
* word combinations: sharing experiences symbolically (18-24m)
* early discourse: reciprocal symbolic interactions with others (24-36m)
61
Interventions that only look at language, only look at repetitive behaviors, only look at adaptive behaviors etc.
skill specific
62
Is DIR more developmental or behavioral?
developmental
63
* author: Connie Kasari
* skill specific intervention
* administrator: clinician
* environment: clinic/school/home
* materials: toys and materials for play
* frequency: 30 minutes a day; 3-5 days a week for as few as 24 sessions total
* session aim: spontaneous display of target skill
* procedures:
* play- selected by following the lead and interests, developmentally appropriate level
* setting up the environment
* following the lead
* scaffolding
* expanding
* imitating
* prompting
* person-engaged play
Joint Attention Symbolic Play Engagement Regulation (JASPER)
64
True or False
Higher levels of coordinated joint engagement predict higher language levels
true
65
What are the 3 levels of engagement?
* supported joint
* coordinated joint
* symbol infused joint
67
Do you need to be certified to use DIR?
yes
68
Is JASPER more developmental or behavioral?
developmental
70
What is the purpose of persons with ASD taking seratonin re-uptake inhibitors?
decreasing repetitive and problem behaviors
71
What is the frequency of EMT?
* 24 sessions
* 15-20 min clinician implemented
* 45 min parent implemented
73
What is the session aim of EMT?
increase language complexity
74
* Discrete Trial Training
* learning trials using atecedent- response- consequence- time
* used for teaching attending, receptive language, and imitation tasks
* Pivotal Response training
* interactions contextually developed settings. Used for expressive language, play, and social interaction skills
* Incidental teaching in functional activities
* follow the child's lead and use functional routines. Used for daily routines and self-care skills for generalization to appropriate contexts without direct cues
STAR program
75
fluoxetine (prozac)
serotonin re-uptake inhibitors
76
What is the session aim of ESI?
improvement on SC and ER goals
78
Types of biologicaly based therapies (3)
* modified diet
* vitamins and minerals
* food supplements
79
types of manipuation/body-based methods (5)
* massage/bodywork
* craniosacral therapy
* special exercises
* auditory integration
* vagus nerve stimulation
80
What is the session aim for JASPER?
spontaneous display of target skill
81
Purpose of anti-psychotic medications in children with ASD
decrease challenging behaviors:
* irritability
* aggression
* self injury
82
* treatment and education of autistic children communication handicaps
* five targeted areas
* communication functions
* communication contexts
* semantic categories
* unit of communication (e.g. words, signed symbols, or gestures)
* communicative modalities (e.g. sings, print symbols, speech)
* 3 basic premises
* Physical structure
* time, space, material
* Scheduling
* how the time will be used
* highly structured program
* work system
TEACCH Program
83
3 types of medical intervention
* Anti-psychotic medication
* Serotonin- reuptake inhibitors
* Stimulants
84
What does JASPER stand for?
Joint Attention Symbolic Play Engagement Regulation
85
dextroamphetamine
stimulant
86
What is the frequency for PRT?
all waking moments are teaching moments
87
What treatment approach involves key vocabulary such as pivotal behaviors, motivation, responsivity to multiple cues, self-initiations, and self-management?
Pivotal Response Treatment
88
Is PRT more developmental or behavioral?
behavioral
89
Adaptive behaviors=
Activities of Daily Living (ADLs)
90
Evidence
Anti-psychotic medication (2)
* Risperidone - 2 strong RCTs support use, but side-effect was sleepiness
* Aripiprazole- 2 RCTs support use, sponsored by makers of drug, most common side-effect was sleepiness
91
* 8 parent group meetings
* 3 individual visits
* Clinicians must be certified
* Manualized and well marketed
* carcy acronyms
Hanen
92
citalopram (celexia)
serotonin re-uptake inhibitor
