Michael J. Morrier

An Incidental Teaching Approach to Early Intervention for Toddlers with Autism

In an effort to move incidental teaching research to practical applications for toddlers with autism, a comprehensive early intervention model was developed for use in the natural environments of a childcare center and childrens homes. Based on the premise that social readiness will best be achieved by providing early social learning opportunities, the center based component of the model targets the developmental needs of an inclusive group of children with and without autism. The home based component involves parents of children with autism as key participants in their childrens learning and prepares them to be effective advocates in their childrens futures. The curriculum addresses what it is that toddlers need to learn, what environmental arrangements provide the most powerful teaching opportunities, and how teachers and parents can most effectively teach children to progress at their optimum pace. Outcome data are presented that documents an impact on the language and social behavior of participating toddlers with autism. Two of the more controversial Walden curriculum components are discussed. Current impediments to system change are considered in the hope that appropriate and effective early intervention may become available to all children with autism.

Benchmarks of Social Treatment for Children with Autism.

Data on the social behavior of typical children may inform practitioners and researchers regarding the appropriate goals of intervention for children with autism. This study assessed the ongoing levels of naturally occurring social behavior in 64 preschool-aged children. A 2 × 2 factorial design was used to analyze population (children with autism and typical children) and age (3 years 3 months vs. 4 years 4 months) differences at the time of preschool entry. Predictable population differences were found for key social behaviors of proximity to children, social bids from children, and focus of engagement on children, as well as for behavioral context variables of verbalizations, adult focus, and atypical behaviors. No differences were found in the amount of time spent focused on toys or objects. There were also no differences in the presenting behaviors of younger and older children with autism. Results are discussed in terms of implications for establishing early social intervention goals.

Examining the Overlap between Autism Spectrum Disorder and 22q11.2 Deletion Syndrome.

22q11.2 deletion syndrome (22q11.2DS) is a genomic disorder reported to associate with autism spectrum disorders (ASDs) in 15–50% of cases; however, others suggest that individuals with 22q11.2DS present psychiatric or behavioral features associated with ASDs, but do not meet full criteria for ASD diagnoses. Such wide variability in findings may arise in part due to methodological differences across studies. Our study sought to determine whether individuals with 22q11.2DS meet strict ASD diagnostic criteria using research-based guidelines from the Collaborative Programs of Excellence in Autism (CPEA), which required a gathering of information from three sources: the Autism Diagnostic Interview-Revised (ADI-R), the Autism Diagnostic Observational Schedule (ADOS), and a clinician’s best-estimate diagnosis. Our study examined a cohort of children, adolescents, and young adults (n = 56) with 22q11.2DS, who were ascertained irrespective of parents’ behavioral or developmental concerns, and found that 17.9% (n = 10) of the participants met CPEA criteria for an ASD diagnosis, and that a majority showed some level of social-communication impairment or the presence of repetitive behaviors. We conclude that strictly defined ASDs occur in a substantial proportion of individuals with 22q11.2DS, and recommend that all individuals with 22q11.2DS be screened for ASDs during early childhood.

I Wanna Play Too: Factors Related to Changes in Social Behavior for Children With and Without Autism Spectrum Disorder After Implementation of a Structured Outdoor Play Curriculum

Children with autism spectrum disorder (ASD) have difficulties interacting with same-aged peers during unstructured play (e.g., on the playground). Thirty-five toddler and preschool children with and without ASD participated in a structured 15-min outdoor play curriculum. The intervention, the Buddy Game, used familiar songs, movement, and games to promote peer social interaction. A 2 × 3 ANOVA assessed changes in overall targeted social behaviors during baseline, the Buddy Game, and generalization to free-pay. Multiple regression analyses examined factors related to increases in social interactions. Predictors were ASD status of child and age of child. Results indicated the Buddy Game increased overall social interactions and that social interactions were influenced more by ASD status than age. Implications for practitioners are highlighted.

Brief Report: Relationship Between ADOS-2, Module 4 Calibrated Severity Scores (CSS) and Social and Non-Social Standardized Assessment Measures in Adult Males with Autism Spectrum Disorder (ASD)

The ADOS-2 Modules 1–3 now include a standardized calibrated severity score (CSS) from 1 to 10 based on the overall total raw score. Subsequent research published CSS for Module 4 (Hus, Lord, Journal of Autism and Developmental Disorders 44(8):1996–2012, 2014); however more research is needed to examine the psychometric properties of this CSS. Forty males with ASD completed an assessment battery consisting of ADOS-2 Module 4 and other clinical measures assessing core ASD symptomology and comorbidity. Pearson correlation analyses found that CSS did not correlate with measures that assessed core social deficits of ASD or general psychiatric co-morbidity, but CSS did correlate negatively with intellectual quotient. These findings provide information on the limitations and relevance of CSS to be taken into account in future clinical evaluations of ASD.