ASPERGER SYNDROME AND MILD AUTISM: RESOURCES FOR ABA TREATMENT OF YOUNG CHILDREN

(The following is an excerpt from the article Recovery From Asperger Syndrome and Other Forms of Mild Autism:  A Parent’s Perspective.)

There are a few books I considered essential reading at the time my own children were in treatment.  And there are new books and videos available now that I’m sure I would have found helpful.  But what matters most is not so much which books you use but how and what you teach.  

Teaching strategies need to be intensive and based on behavior analytic theory.  What you teach must be very individualized and based on a careful inventory of your child’s specific deficits.  Try to find a knowledgeable ABA professional with experience in the more advanced levels of autism treatment.  They will know the sequence in which skills should be taught for optimal progress.

I would caution you that not all ABA professionals are autism specialists.  And not all autism specialists are able to treat all kids on the autism spectrum effectively.  For example, many who are skilled at providing Early and Intensive Behavioral Intervention (EIBI) to three-year-olds with autistic disorder lack the appropriate experience to make treatment recommendations for older AS kids.  

This is also true for therapists.  The same person, who excels at teaching a nonverbal three-year-old  how to sit in a chair or pay attention, may be clueless when it comes to teaching an AS child how to make appropriate comments in a social conversation or refrain from self-stimulatory behaviors.

If you don’t have access to an experienced consultant, there’s still a great deal you can accomplish on your own, using ABA techniques (taught through books, videos, conferences, workshops, etc.) and drawing upon the various curricular materials that are available for purchase. 

My own guiding mantra was to observe normally developing children closely at every opportunity – however painful that sometimes was.  These observations - of infants in the supermarket, toddlers on the playground, and preschoolers at recess - helped me better understand the depth of my own children’s deficits and the enormous amount of “catching-up” that they would need to do.  

Time and again, I was struck by the extent to which even the youngest of these normal children would spontaneously study my face and body language or seek to engage me by exchanging smiles.  What an extraordinary amount of social learning was going on!  It was stressful to realize how much my own children had missed, beginning as early as their infancy.  But it did motivate me to press hard to catch up with that always moving target of “normal development.”

Books for Teaching

My own personal favorite is Teaching Individuals With Developmental Delays: Basic Intervention Techniques (Ivar Lovaas, Pro-Ed, 2003).  Its curriculum addresses only the earliest stages of treatment, so it wasn’t particularly useful for my children. But I found the book invaluable for its insights into the various behavior problems associated with autism spectrum disorders.

Lovaas doesn’t concern himself with the various DSM-IV diagnostic classifications (e.g. autistic disorder vs. Asperger disorder).  Instead, he views all the autism spectrum disorders as involving “developmental delays,” the number and severity of which vary across the spectrum.  He describes how behavioral excesses (e.g. self-stimulation, repetitiveness) and deficits (e.g. poor imitation, motivation, attention) interfere with the development of normal social and learning behaviors.  I found this a very useful way to look at my children’s developmental problems.

Also essential for me were A Work in Progress (Leaf and McEachin, 1999) and Teach Me Language (Freeman and Drake, 1997).  The former contains a curriculum, together with guidance on how to implement it using behavioral techniques.  The latter’s most valuable feature, for us, were the instructional materials (e.g. exercises and games) for building social language skills.  I’ve never found anything comparable.  You’ll find all three of these books, as well as other worthwhile resources, extensively reviewed in the “Recommended Reading and Videos” section of this web site.

After you establish a behavioral foundation, there are tons of other helpful books to draw upon, both in and out of the ABA world.   Many excellent resources have been developed by special education teachers, speech and language pathologists (SLPs), and psychologists. 

Some examples of these are:  1) the “Skill Streaming” series, especially Skill Streaming in Early Childhood: New Strategies and Perspectives for Teaching Prosocial Skills (McGinnis, and Goldstein, revised edition 2003); 2) Teaching Your Child the Language of Social Success (Duke, Martin, and Nowicki, 1996); and 3) various of the ready-to-use language and special education books marketed by the LinguiSystems company (www.linguisystems.com). 

Though they didn’t exist at the time my children were in treatment, some of the materials developed by Steven Gutstein for his trademarked “Relationship Development Intervention” (RDI) program probably would be useful, especially some of the social skill exercises outlined in his book Relationship Development Intervention With Young Children (Gutstein and Sheely, 2002).  You don’t need to buy into Gutstein’s theories about autism, or claims for the comprehensiveness or effectiveness of his treatment model (both of which I find utterly unconvincing), in order to make use of his materials. 

All of the resources  I’ve mentioned can be adapted for use within a behavior analytic approach – e.g. involving task analysis, systematic teaching,  prompting and generalization techniques, fluency training, and data-based decision making regarding how and what to teach.

General books on Asperger Syndrome

Most books for parents on the general topic of Asperger Syndrome tend to be very disappointing when it comes to providing treatment advice for young children.  They may exhaustively detail what your child needs to learn (e.g. “language,” or “social,” or “attending,” or “organizational” skills).  But they don’t explain how to do it.

If they refer to ABA treatment at all, it’s only in connection with reducing “problem behaviors” like tantrumming.  They fail to recognize that ABA is as powerful a tool for increasing positive behaviors as it is for decreasing negative ones.  They underestimate, or misunderstand, the way ABA techniques can be used to teach most everything.

 

An exception to this is the wonderful OASIS Guide to Asperger Syndrome: Advice, Support, Insight and Inspiration (Bashe and Kirby, 2^nd edition, 2005). The book draws its title from the popular web site:  Online Asperger Syndrome Information and Support (OASIS) www.aspergersyndrome.org.  The site, maintained by the parent authors who wrote the guide, should be the first port of call for any parent of a newly diagnosed child. 

The OASIS Guide provides a general but comprehensive overview of diagnostic and treatment issues.  There is also an insightful section on  “The Whole Child,” with chapters on “Your Child’s Emotional Life,” “Your Child in the Social Realm,”  “Your Child in School,” and “Growing Up.”  In my view, it is the single most helpful introduction into the fascinating and challenging world of Asperger Syndrome.

Another excellent overview book, written by a team of prominent psychologists, is A Parent’s Guide to Asperger Syndrome and High Functioning Autism: How to Meet the Challenges and Help Your Child Thrive (Ozonoff, Dawson, McPartland 2002). The first section focuses on understanding AS and high functioning autism (e.g. diagnosis and treatment issues), while the second section provides ideas for living with AS at home, in school, and through the lifespan.

Though it doesn’t deal with Asperger Syndrome specifically, Overcoming Autism: Finding the Answers, Strategies and Hope That Can Transform a Child’s Life (Koegel and LaZebnik, 2004) describes how to use behavioral techniques to improve the symptoms of autism at home and in the community.  Even if you aren’t interested in pursuing an intensive intervention program, you’ll probably find some helpful ideas that will enhance your child’s quality of life.  

Though it doesn’t contain any treatment information that I consider particularly useful,  psychologist Tony Atwood’s touching Asperger’s Syndrome: A Guide for Parents and Professionals (1998)  is well worth reading for its uplifting tone and insights into what it feels like to be a person with AS.

Once you have your treatment program in gear, and have the time or inclination to learn more about the neurological underpinnings of Asperger Syndrome, a good choice would be the collection of scholarly articles found in Asperger Syndrome (Klin, Volkmar, Sparrow, Editors, 2000).  The editors are internationally renowned researchers at the Yale Child Study Center.