Overview of the importance of early intervention for children with autism. Discusses some common signs of autism and research based treatment options such as applied behavior analysis (ABA)

1. +
The Importance of Early
Intervention
Courtney Bierman, MA, BCBA
Bierman ABA Autism Center

2. +
What is Autism?
 Autism Spectrum Disorder (ASD) is a neurological disorder
which effects an individual’s ability to communicate
effectively and interact with others.
 Effects 1 in every 50 children
 1 in 31 boys
 A “spectrum disorder” which effects everyone differently
 Diagnosis such as Asperger’s, PDD-NOS, Rett Syndrome, and
Child Disintegrative Disorder all fall under ASD umbrella
 Some children with autism appear normal before age 1 or 2
and then suddenly “regress” and lose language or social
skills they had previously gained.
Copyright Bierman ABA Autism Center www.biermanaba.com

3. + Signs and symptoms of social
difficulties in autism
 Basic social interaction can be difficult for children with autism
spectrum disorders. Many kids on the autism spectrum seem to
prefer to live in their own world, aloof and detached from others.
 Appears disinterested or unaware of other people or what’s
going on around them.
 Doesn’t know how to connect with others, play, or make friends.
 Prefers not to be touched, held, or cuddled.
 Doesn’t play "pretend" games, engage in group games, imitate
others, or use toys in creative ways.
 Has trouble understanding or talking about feelings.
 Doesn’t seem to hear when others talk to him or her.
 Doesn't share interests or achievements with others (drawings,
toys).
Copyright Bierman ABA Autism Center www.biermanaba.com

4. +
Signs and symptoms of speech and
language difficulties in autism
 Speaks in an abnormal tone of voice, or with an odd rhythm or
pitch (e.g. ends every sentence as if asking a question).
 Repeats the same words or phrases over and over.
 Responds to a question by repeating it, rather than answering it.
 Refers to themselves in the third person.
 Uses language incorrectly (grammatical errors, wrong words).
 Has difficulty communicating needs or desires.
 Doesn’t understand simple directions, statements, or questions.
 Takes what is said too literally (misses undertones of humor,
irony, and sarcasm).
Copyright Bierman ABA Autism Center www.biermanaba.com

5. + Signs and symptoms of nonverbal
communication difficulties in autism
 Children with autism spectrum disorders have trouble picking
up on subtle nonverbal cues and using body language. This
makes the "give-and-take" of social interaction very difficult.
 Avoids eye contact.
 Uses facial expressions that don't match what he or she is saying.
 Doesn’t pick up on other people’s facial expressions, tone of
voice, and gestures.
 Makes very few gestures (such as pointing). May come across as
cold or “robot-like.”
 Reacts unusually to sights, smells, textures, and sounds. May be
especially sensitive to loud noises.
 Abnormal posture, clumsiness, or eccentric ways of moving (e.g.
walking exclusively on tiptoe).
Copyright Bierman ABA Autism Center www.biermanaba.com

6. + Signs and symptoms of inflexibility in
autism
 Follows a rigid routine (e.g. insists on taking a specific route to school)
 Has difficulty adapting to any changes in schedule or environment (e.g.
throws a tantrum if the furniture is if a daily activity schedule changes.
 Unusual attachments to toys or strange objects such as keys, light
switches, or rubber bands.
 Obsessively lines things up or arranges them in a certain order.
 Preoccupation with a narrow topic of interest, often involving numbers
or symbols (e.g. memorizing and reciting facts about maps, train
schedules, or sports statistics).
 Spends long periods of time arranging toys in specific ways, watching
moving objects such as a ceiling fan, or focusing on one specific part of
an object such as the wheels of a toy car.
 Repeats the same actions or movements over and over again, such as
flapping hands, rocking, or twirling (known as self-stimulatory behavior,
or “stimming”). Some researchers and clinicians believe that these
behaviors may soothe children with autism more than stimulate them.
Copyright Bierman ABA Autism Center www.biermanaba.com

7. +
Common self-stimulatory behaviors:
 Tapping ears
 Hand flapping
 Scratching
 Rocking back and forth  Lining up toys
 Spinning in a circle  Spinning objects
 Finger flicking  Wheel spinning
 Head banging  Watching moving objects or
watching objects fall
 Staring at lights
 Flicking light switches on
 Moving fingers in front of the eyes and off
 Snapping fingers  Repeating words or noises
Copyright Bierman ABA Autism Center www.biermanaba.com

8. +
Early signs of autism in babies and
toddlers
 Doesn’t make eye contact (e.g.  Doesn’t make noises to get your
look at you when being fed). attention.
 Doesn't smile when smiled at.  Doesn’t initiate or respond to
cuddling.
 Doesn't respond to his or her
name or to the sound of a  Doesn’t imitate your movements
familiar voice. and facial expressions.
 Doesn’t follow objects visually.  Doesn’t reach out to be picked
up.
 Doesn't point or wave goodbye
or use other gestures to  Doesn’t play with other people
communicate. or share interest and enjoyment.
 Doesn’t follow the gesture when  Doesn’t ask for help or make
you point things out. other basic requests.
Copyright Bierman ABA Autism Center www.biermanaba.com

9. + The following delays warrant an
immediate evaluation by your child’s
pediatrician.
 By 6 months: No big smiles or other warm, joyful expressions.
 By 9 months: No back-and-forth sharing of sounds, smiles, or
other facial expressions.
 By 12 months: Lack of response to name.
 By 12 months: No babbling or “baby talk.”
 By 12 months: No back-and-forth gestures, such as pointing,
showing, reaching, or waving.
 By 16 months: No spoken words.
 By 24 months: No meaningful two-word phrases that don’t
involve imitating or repeating.
Copyright Bierman ABA Autism Center www.biermanaba.com

10. +
Autism does not just “go away”
 but studies show that early diagnosis and intervention lead to
significantly improved outcomes.
 If autism is caught in infancy, treatment can take full
advantage of the young brain’s remarkable plasticity.
Although autism is hard to diagnose before 24 months,
symptoms often surface between 12 and 18 months. If signs
are detected by 18 months of age, intensive treatment may
help to rewire the brain and reverse the symptoms.
Copyright Bierman ABA Autism Center www.biermanaba.com

11. +
What is an early intervention
program?
 Designed for children from 0-3 years of age.
 30-40 hours per week
 Should be “individualized” to meet each child’s specific needs
 Uses research-based principles to improve desirable behaviors and
reduce undesirable behaviors (Applied Behavior Analysis)
 Highly trained therapists and/or teachers deliver the intervention
under the supervision of an experienced professional
 Play-based and uses reinforcement based strategies to improve
behavior.
 Involves data collection to track progress
 Designed to make learning fun
Copyright Bierman ABA Autism Center www.biermanaba.com

12. +
Why seek early intervention?
 Children’s brains are “sponges” due to increased neural plasticity
and this neural plasticity decreases with age.
 IQ gains up to 17 points higher compared to children who do not
receive early intervention
 Lovaas study- “50% children mainstreamed into typical classroom
after receiving intensive 40 hour per week ABA therapy over
several years.
 Increased chance of “catching up with peers” and being
successful at school vs. falling behind, displaying difficulty, and
only adequate supports provided by schools.
 Can decrease long term cost of care by over 2/3
Copyright Bierman ABA Autism Center www.biermanaba.com

13. + What to do if you suspect your child is not
meeting developmental milestones?
 Don’t wait and hope it goes away- can loose precious time.
 Schedule an appointment with your pediatrician right away
for an autism screening
 The American Academy of Pediatrics recommends all children
receive routine developmental screenings for autism at 9, 18, and
30 months of age.
 Your Dr. may refer you to a a developmental specialist for a
comprehensive diagnostic screening.
 Search for available and reputable services within your area using
research-based techniques provided by qualified professionals.
 ABA therapy is the most effective and research-based treatment
for autism (Center for Disease Control)
Copyright Bierman ABA Autism Center www.biermanaba.com

14. +
Questions ?
Copyright Bierman ABA Autism Center www.biermanaba.com