Angela Persicke

Home-Based Services

Home-based services for individuals with developmental disabilities have been implemented successfully for several decades and have been the subject of a large amount of research demonstrating their effectiveness. This chapter reviews research on several varieties of home-based service delivery. In particular, home-based early intensive behavioral intervention (EIBI) for young children with autism is discussed, including research on EIBI implemented by university clinics, community-based agencies, and treatment directed by parents. The effects of age at intake and treatment intensity on EIBI outcomes are also reviewed. Research on other home-based services is also reviewed, including procedures for parent training and the reduction of challenging behavior. The latter section of the chapter discusses the relative strengths and limitations of home-based service delivery, as well as the importance of the quality of treatment. The chapter concludes with a discussion of variables to consider when selecting the most appropriate treatment setting for any given individual.

Economics of Autism Spectrum Disorders: An Overview of Treatment and Research Funding

Without question, autism research and treatment are big business. Autism impacts multiple aspects of the lives of individuals with autism spectrum disorder (ASD), their families, and the communities in which they live, attend school, and engage socially and vocationally. With no easy cure or preventative measures on the horizon, the field of autism treatment has attracted a plethora of questionable industries, promoting everything from dolphin therapy to fad diets. While researchers around the globe endeavor to determine the etiology of ASD, the reality is that intervention based on the principles of applied behavior analysis (ABA) remains the only evidenced-based treatment for children with ASD. While fidelity and reliability are critical to its effectiveness, bad purveyors of ABA are ubiquitous, triggering government task forces and certificate programs as local, state, and federal governments struggle to regulate a growing multibillion-dollar business.

Recovery and Prevention

Recovery and prevention are among the two most sought after achievements in the treatment of any disorder. Recovery from autism continues to be a controversial topic, receiving everything from total acceptance in some circles to complete denial in others. Recovery is talked about widely in the community of families affected by autism spectrum disorders (ASD), as well as amongst practitioners of complementary and alternative medical treatments (CAMs), but little has been written on the topic in peer-reviewed scientific publications. The unfortunate result is that families of individuals with ASD are left primarily with unsubstantiated claims that are propagated on the World Wide Web. In the first half of this chapter, we will review definitions of recovery from autism, elaborate our working definition, review existing scientific evidence on the topic, and discuss directions for future research on recovery.

Chapter 12 – Play

This chapter describes the Center for Autism and Related Disorders (CARD) approach to teaching play skills to children with autism spectrum disorder. Practical recommendations are given for teaching a variety of play skills, ranging from basic exploratory play to advanced sociodramatic play and games with rules.

Chapter 17 – Cognition

This chapter describes the Center for Autism and Related Disorders (CARD) approach to teaching learners with autism spectrum disorder (ASD) to identify and respond appropriately to their own and others’ private events, that is, perspective-taking skills. The traditional cognitive terms that encompass these behaviors include metacognition (knowledge about one’s own mental states) and social cognition (knowledge about others’ mental states). Using the Theory of Mind (ToM) framework of basic types of “mental states,” or what behavior analysts refer to as “private events,” combined with the principles and procedures of applied behavior analysis (ABA), this chapter describes strategies for teaching perspective-taking skills across 11 major areas: 1) desires, 2) preferences, 3) emotions, 4) physical states, 5) sensory perspective taking, 6) knowledge, 7) beliefs, 8) deception, 9) thoughts, 10) sarcasm, and 11) intentions.

Chapter 18 – Executive Functions

This chapter describes the Center for Autism and Related Disorders (CARD) approach to teaching learners with autism spectrum disorder (ASD) skills that involve intentional manipulation of their own environments in order to help them function more independently. The traditional cognitive terms that encompass these behaviors include inhibition, memory, attention, flexibility, planning, problem solving, and self-management. Using the principles and procedures of ABA, this chapter provides strategies for teaching these skills.

Chapter 13 – Adaptive

This chapter describes the Center for Autism and Related Disorders (CARD) approach to teaching daily living skills, including personal, domestic, safety, and community skills. Practical guidance is given on teaching a variety of daily living skills, and sample task analyses are provided.