Treatment of Autism Spectrum Disorder Evidence-Based Intervention Strategies for Communication & Social Interactions SECOND EDITION Patricia A. Prelock Rebecca J. McCauley Foreword by Tony Charman --- Treatment of Autism Spectrum Disorder Evidence-Based Intervention Strategies for Communication & Social Interactions Second Edition edited by edited by Patricia A. Prelock, Ph.D. Provost and Senior Vice President Department of Communication Sciences and Disorders University of Vermont Burlington and Rebecca J. McCauley, Ph.D. Professor Department of Speech and Hearing Science The Ohio State University Baltimore·London·Sydney Excerpted from Treatment of Autism Evidence-Based Intervention --- PAUL H BROOKES PUBLISHING C. Paul H. Brookes Publishing Co. Post Office Box 10624 Baltimore, Maryland 21285-0624 Baltimore, Maryland 21285-0624 USA www.brookespublishing.com Copyright © 2021 by Paul H. Brookes Publishing Co., Inc. All rights reserved. Previous edition copyright © 2012 “Paul H. Brookes Publishing Co.” is a registered trademark of Paul H. Brookes Publishing Co., Inc. Typeset by Progressive Publishing Service, York, Pennsylvania. changed to protect confidentiality. Purchasers of Treatment of Autism Spectrum Disorder: Evidence-Based Intervention Strategies for Communication & Social Interactions, Second Edition are granted permission to access and stream the videos that accompany the text for education purposes. Purchasers are also granted permission to access and download select tables from the text for educational purposes. Purchasers can access the videos and downloads by visiting the Brookes Publishing Download Hub at http:// downloads.brookespublishing.com. Unauthorized use beyond this privilege may be prosecutable under federal law. The accompanying video clips that illustrate the interventions discussed in Treatment of Autism Spectrum Disorder: Evidence-Based Intervention Strategies for Communication & Social Interactions, Second Edition, were supplied by the chapter authors. Permission was obtained for all individuals shown in the footage. Library of Congress Cataloging-in-Publication Data Names: Prelock, Patricia A., editor. | McCauley, Rebecca Joan, 1952– editor. Title: Treatment of autism spectrum disorder : evidence-based intervention strategies for communication & social interactions / edited by Patricia A. Prelock, Provost and Senior Vice President, University of Vermont, Department of Communication Sciences and Disorders, Burlington and Rebecca J. McCauley, Ph.D., Professor, Department of Speech and Hearing Science, The Ohio State University, Columbus. Other titles: Treatment of autism spectrum disorders Description: Second edition. | Baltimore, MD : Paul H. Brookes Publishing Co., [2021] | Series: Communication and language intervention series | Includes bibliographical references and index. Identifiers: LCCN 2020056439 (print) | LCCN 2020056440 (ebook) | ISBN 9781681253985 (paperback) | ISBN 9781681254852 (epub) | ISBN 9781681254869 (pdf) Subjects: LCSH: Autism spectrum disorders—Treatment. | Autism spectrum disorders in children—Treatment. Classification: LCC RC553.A88 T735 2021 (print) | LCC RC553.A88 (ebook) | DDC 616.85/88200835—dc23 LC ebook record available at https://lccn.loc.gov/2020056440 British Library Cataloguing in Publication data are available from the British Library. 10 9 8 7 6 5 4 3 2 1 Excerpted from Treatment of Autism Evidence-Based Intervention 2025 2024 2023 2022 2021 --- Contents About the Videos and Downloads viii Series Preface Editorial Advisory Board About the Editors xii About the Contributors xiv Foreword Tony Charman xxiii Acknowledgments xxxi Chapter 1 Introduction to Treatment of Autism Spectrum Disorder (ASD) Patricia A. Prelock and Rebecca J. McCauley Chapter 2 Assessment for Treatment Planning and Progress Monitoring 19 Rebecca J. McCauley, Allison Bean, and Patricia A. Prelock Chapter 3 Language and Communication in ASD: Implications for Intervention 51 Ashley R. Brien and Patricia A. Prelock Chapter 4 Augmentative and Alternative Communication Strategies: Manual Signs, Picture Communication, and Speech-Generating Devices 81 Jane R. Wegner Chapter 5 The Early Start Denver Model (ESDM): Promoting Social Communication in Young Children With ASD 109 Jill Howard and Geraldine Dawson --- FOR MORE go to; https://bpub.fyi/ASDBundle vi Contents Chapter 6 Discrete Trial Instruction 133 Amanda Kazee, Susan M. Wilczynski, Maria Martino, Shawnna Sundberg, Molly Quinn, and Nicholas L. Mundell Chapter 7 The Developmental, Individual-Difference, Relationship-Based (DIR) Model and Its Application to Children With ASD 163 Sima Gerber Chapter 8 Functional Communication Training: Treating Challenging Behavior 193 V. Mark Durand and Lauren J. Moskowitz Chapter 9 The JASPER Model for Children With Autism: Improving Play, Social Communication, and Engagement 229 Connie Kasari and Kyle Sterrett Chapter 10 Enhanced Milieu Teaching 255 Ann P. Kaiser, Elizabeth A. Fuller, and Jodi K. Heidlage Chapter 11 Early Social Interaction 287 Juliann J. Woods, Amy Wetherby, Abigail Delehanty, Shubha Kashinath, and Renee Daly Holland Chapter 12 Peer-Mediated Support Interventions for Students With ASD 315 Erik W. Carter Chapter 13 Pivotal Response Treatment 353 Lynn Kern Koegel, Kristen Strong, and Elizabeth Ponder ® Chapter 14 The SCERTS Model: Social Communication, Emotional Regulation, and Transactional Supports 381 Amy C. Laurent, Emily Rubin, and Barry M. Prizant Chapter 15 Social Skills Interventions 413 Patricia A. Prelock and Ashley Brien TM Chapter 16 Social Stories 459 Tiffany L. Hutchins --- FOR MORE go to; https://bpub.fyi/ASDBundle Contents Chapter 17 Video Modeling for Persons With ASD . . . . . . . . . . . . . . . . 491 Tom Buggey Chapter 18 Future Directions 523 Rebecca J. McCauley and Patricia A. Prelock Glossary . . . . . 569 Excerpted from Treatment of Autism Evidence-Based Intervention --- About the Editors Patricia A. Prelock, Ph.D., Provost and Senior Vice-President, University of Vermont, Burlington Dr. Prelock is Provost and Senior Vice-President, University of Vermont. Formerly, she was the dean of the College of Nursing and Health Sciences at the University of Vermont for 10 years. She is also a professor of communication sciences and disorders and professor of pediatrics in the College of Medicine at the University of Vermont. Dr. Prelock has been awarded more than $11.9 million in university, state, and federal funding as a principal investigator (PI) or co-PI to develop innovations in interdisciplinary training supporting children and youth with neurodevelopmental disabilities and their families, to facilitate training in speech-language pathology, and to support her intervention work in ASD. She has more than 195 publications and 566 peer-reviewed and invited presentations/keynotes in the areas of autism and other neurodevelopmental disabilities, collaboration, interprofessional education, xii 566 peer-reviewed and invited presentations/keynotes in the areas of autism and other neurodevelopmental disabilities, collaboration, interprofessional education, leadership, and language learning disabilities. In 2019, she was named associate editor for the Journal of Autism and Developmental Disorders. Dr. Prelock received the University of Vermont’s Kroepsch- Maurice Excellence in Teaching Award in 2000 and was named an ASHA Fellow in 2000 and a University of Vermont Scholar in 2003. In 2011, she was named the Cecil & Ida Green Honors Professor Visiting Scholar at Texas Christian University, and in 2015 Dr. Prelock was named a Distinguished Alumna of the University of Pittsburgh. In 2016, she received the ASHA Honors of the association, and in 2017, she was named a Distinguished Alumna of Cardinal Mooney High School. Dr. Prelock also received the 2018 Jackie M. Gribbons Leadership Award from Vermont Women in Higher Education. Dr. Prelock is a board-certified specialist in child language and was named a fellow in the National Academies of Practice (NAP) in speech-language pathology in 2018. She was the 2013 president for the American --- FOR MORE go to; https://bpub.fyi/ASDBundle MORE go https://bpub.fyi/ASDBundle About the Editors Rebecca J. McCauley, Ph.D., Professor, The Ohio State University, Columbus Dr. McCauley is Professor in the Department of Speech and Hearing Sciences at the Ohio State University. Her research and writing have focused on assessment and treatment of pediatric communication disorders, with a special focus on speech sound disorders, including childhood apraxia of speech. She has authored or edited seven books on these topics and coauthored a test designed to aid in the differential diagnosis of childhood apraxia of speech. Dr. McCauley is a Fellow of the American Speech-Language-Hearing Association, has received honors of that association, and has served two terms as an associate editor of the American Journal of Speech- Excerpted from Treatment of Autism Evidence-Based Intervention --- About the Contributors Allison Bean, Ph.D., Associate Professor, The Ohio State University, Columbus Allison Bean, Ph.D., Associate Professor, The Ohio State University, Columbus Allison Bean is an associate professor at The Ohio State University. Dr. Bean’s research focuses on investigating the mechanisms underlying language development in minimally verbal children with autism. The ultimate goal for this work is to Ashley R. Brien, CCC-SLP, Speech-Language Pathologist and Doctoral Candi- date, University of Vermont, Burlington Ashley R. Brien is a speech-language pathologist in Vermont. She is pursuing her doctorate in interprofessional health sciences at the University of Vermont under the mentorship of Dr. Tiffany Hutchins and Dr. Patricia Prelock. Her research focuses on episodic memory and its relationship to theory of mind. She is currently designing interventions and treatment materials to support episodic memory and social Education, University of Tennessee at Chattanooga Tom Buggey began research on self-modeling at Penn State in 1992, working with preschoolers with language delays. Following the urgings of two gifted graduate assistants, together they conducted their first research with children on the autism spectrum in 1995 with very positive results. Thereafter, children with autism became the focus of his research. Dr. Buggey was recruited to serve as the Siskin Chair of Excellence in the Special Education Department at UTC in 2007. The next 7 years were devoted to research on developing language and social skills with preschool-age children with autism. In his career as a researcher, he has conducted more than a dozen studies on the use of self-modeling, all which have appeared in major journals; published several book chapters of self-modeling and other aspects Tom Buggey, Ph.D., Retired, Siskin Chair of Excellence in Early Childhood Special xiv Excerpted from Treatment of Autism Evidence-Based Intervention --- FOR MORE go to; https://bpub.fyi/ASDBundle XV About the Contributors Believing (Woodbine House, 2007), which is currently being translated and pub- Vanderbilt University, Nashville, Tennessee Erik W. Carter is Cornelius Vanderbilt Professor of Special Education at Vanderbilt University. Dr. Carter’s research and writing focus on promoting inclusion and valued roles in school, work, community, and congregational settings for children and Geraldine Dawson, Ph.D., Professor of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina Geraldine Dawson is the William Cleland Professor of Psychiatry and Behavioral Sciences at Duke University, director of the Duke Institute for Brain Sciences, and director of the Duke Center for Autism and Brain Development. Dawson is a licensed, practicing clinical psychologist and internationally renowned scientist whose work Abigail Delehanty, Ph.D., CCC-SLP, Assistant Professor, Duquesne University, Pittsburgh, Pennsylvania Abigail (Abby) Delehanty is an assistant professor and program director for the Language Disorders and Autism Clinic in the Department of Speech-Language Pathology at Duquesne University. Dr. Delehanty has extensive clinical experience serving preschoolers, school-age children, and adolescents with communication disorders in a public-school setting. For the last 5 years of her career in the schools, she served as a speech-language pathologist on a multidisciplinary autism evaluation team, conducting weekly developmental screenings in the community and connecting more than 100 children with school-based services each year. Dr. Delehanty’s research interests include studying and promoting social communication development in children with communication delays and autism and reducing the age of identification of communication delays and autism in young children from diverse V. Mark Durand, Ph.D., Professor of Psychology, University of South Florida --- FOR MORE go to; https://bpub.fyi/ASDBundle xvi FOR MORE go xvi About the Contributors Elizabeth A. Fuller, Ph.D., Vanderbilt University, Nashville, Tennessee Dr. Fuller specializes in early intervention and behavioral therapy for children with autism and developmental disabilities. She received her doctorate from Vanderbilt University in early childhood special education and is a board-certified behavior analyst (BCBA). She has over ten years of experience in play and behavior therapies and in coaching parents to implement effective strategies with their Sima Gerber, Ph.D., CCC-SLP, Professor, Queens College, City University of New York Sima Gerber is a professor of speech-language pathology in the Department of Linguistics and Communication Disorders of Queens College, City University of New York. She has been a speech-language pathologist for more than 40 years, specializing in the treatment of children with ASD and other developmental challenges. Dr. Gerber has presented nationally and abroad (China, Italy, The Netherlands, South Africa, Israel, Georgia) on language acquisition and developmental approaches to assessment and intervention for children with language and communication disorders. Dr. Gerber is a Jodi K. Heidlage, Ph.D., BCBA, Project Director, Vanderbilt University, Nashville, Tennessee Jodi K. Heidlage is a special educator with expertise in behavioral and naturalistic interventions for children with autism and significant learning challenges. She has more than 10 years of experience providing direct services for young children with ASD and has served as a therapist and parent interventionist on several clinical trials. She currently is the project director for an early reading intervention for children with intellectual and developmental disabilities at Vanderbilt Services Research, Florida State University, Tallahassee Renee Daly Holland is the assistant director of Early Intervention Services Research for the Autism Institute in the College of Medicine at Florida State University. Mrs. Holland’s clinical experience over the past 27 years has focused on home- and community-based early intervention for children with autism spectrum and speech and language disorders. As the lead interventionist for the Early Social Interaction Project (ESI), she currently oversees the fidelity implementation and supervision of the ESI model used in randomized controlled trials across multiple sites. An author of the Autism Navigator collection of Web-based courses and tools, Mrs. Holland also serves as an Autism Navigator Global Trainer and supports professionals within early intervention systems to deliver effective, evidence-based intervention in Renee Daly Holland, M.S., CCC-SLP, Assistant Director of Early Intervention Excerpted from Treatment of Autism Evidence-Based Intervention --- FOR MORE go to; https://bpub.fyi/ASDBundle https://bpub.fyi/ASDBundle About the Contributors Jill Howard, Ph.D., Assistant Professor, Licensed Psychologist, Duke University School of Medicine, Durham, North Carolina Jill Howard is a licensed psychologist and assistant professor at the Duke Center for Autism and Brain Development in the Department of Psychiatry and Behavioral Sciences. She specializes in conducting comprehensive diagnostic assessments and delivering intervention services to individuals and families affected by ASD. Dr. Howard’s primary research interests involve the early identification of and evidence-based treatments for ASD, as well as the development of social attention and Tiffany L. Hutchins, Ph.D., Associate Professor, University of Vermont, Burlington Tiffany L. Hutchins, Ph.D., Associate Professor, University of Vermont, Burlington Dr. Hutchins conducts research in social cognition and language development in autism, attention-deficit/hyperactivity disorder, hearing loss, and childhood trauma. She also teaches courses in measurement, language disorders, and psycholinguistics. Dr. Hutchins is primary author of the Theory of Mind Inventory and the Theory Ann P. Kaiser, Ph.D., Susan W. Gray Professor of Education and Human Develop ment, Department of Special Education, Peabody College, Vanderbilt University, Nashville, Tennessee Ann P. Kaiser is the Susan W. Gray Professor of Education and Human Development at Vanderbilt University. She is the author of more than 175 articles on early intervention for children with autism and other development communication disabilities. Her Connie Kasari, Ph.D., Professor of Human Development and Psychiatry, University of California Los Angeles Dr. Kasari received her doctorate from the University of North Carolina at Chapel Hill and was a National Institute of Mental Health postdoctoral fellow at the Neuropsychiatric Institute at UCLA. Since 1990, she has been on the faculty at UCLA, where she teaches both graduate and undergraduate courses and has been the primary advisor to more than 60 doctoral students. She is a founding member of the Center for Autism Research and Treatment at UCLA. Her research aims to development novel, evidence-tested interventions implemented in community settings. Recent projects include targeted treatments for early social-communication development in at-risk infants, toddlers, and preschoolers with autism and peer relationships for school-age children with autism. She leads several large multisite studies, including a network on interventions for minimally verbal school-age children with ASD, and a network that aims to decrease disparities in interventions for children with ASD who are underrepresented in research trials. She is on the science advisory board of the Autism Speaks Foundation and regularly presents to both academic and practitioner --- FOR MORE go to; https://bpub.fyi/ASDBundle xviii xviii About the Contributors Shubha Kashinath, Ph.D., CCC-SLP, Associate Professor, California State University, East Bay, Hayward Shubha Kashinath is currently chair of the Department of Speech Language and Hearing Sciences at Cal State East Bay. Her academic and professional interests focus on autism across the life span, treatment efficacy, caregiver-focused interventions, and personnel preparation. She has more than 20 years of experience as a Amanda Kazee, M.A., School Psychology Extern, Registered Behavior Technician, Ball State University, Muncie, Indiana Amanda Kazee is a doctoral candidate in the School Psychology program with a specialization in applied behavior analysis at Ball State University. Amanda has presented and published scholarly work alongside Dr. Susan Wilczynski on evidencebased practice. She currently serves as a registered behavior technician and school Lynn Kern Koegel, Ph.D., CCC-SLP, Clinical Professor, Stanford University Rhode Island Amy Laurent specializes in the education of autistic children. Her work involves creating learning environments designed to facilitate children’s active engagement at home, in schools, and throughout their communities. She is a coauthor of The SCERTS Model and frequently lectures around the globe. She is passionate about neurodiversity and helping others to honor and understand the implications of --- FOR MORE go to; https://bpub.fyi/ASDBundle https://bpub.fyi/ASDBundle About the Contributors Maria Martino, M.A., Clinical Project Coordinator, University of Alabama, Tuscaloosa Maria Martino received her master’s in clinical psychology from Ball State University. Maria has focused on evidence-based practice and identifying abuse for populations with ASD under the supervision of Dr. Susan Wilczynski. Maria is currently coordinating an NIH-funded study examining reading comprehension and neural connectivity in children with ASD under Dr. Rajesh Kana at the University of Lauren J. Moskowitz, Ph.D., Assistant Professor, St. John’s University, Queens, New York Lauren Moskowitz is an associate professor in the Department of Psychology at St. John’s University. She earned her bachelor of science degree from Cornell University, her master’s and doctorate in clinical psychology from Stony Brook University, and completed her clinical internship and postdoctoral fellowship at NYU Child Study Center. Her research focuses on behavioral assessment and intervention for problem behavior and anxiety in children with ASD and developmental disabilities. Dr. Moskowitz has coauthored several papers and book chapters; has presented at numerous international, national, and regional conferences; has taught several undergraduate and graduate courses covering ASD and developmental disabilities, applied behavior analysis, and positive behavior support, and has been on Nicholas L. Mundell, B.S., Graduate Research Assistant, Ball State University, Muncie, Indiana Nicholas (Nick) Mundell is a dual-degree master’s student in the Clinical and Quantitative Psychology programs at Ball State University. Nick serves as a graduate research assistant in the Department of Special Education. In his spare time, Nick Autism Center, California Elizabeth began her training in Pivotal Response Treatment (PRT) as a research assistant at the Koegel Autism Center while completing her bachelor of arts in psychology at the University of California, Santa Barbara. After graduating, Elizabeth expanded her knowledge and skills pertaining to ASD and PRT by working as an interventionist. In 2009, she entered the Special Education, Disabilities and Developmental Risk Studies (SPEDDR) graduate program at the University of California, Santa Barbara, with Dr. Robert Koegel as her advisor. After receiving her master’s degree in 2011, she went on to become a BCBA and has continued her work with individuals on the spectrum, with a focus on parent and professional education Elizabeth Ponder, M.A., BCBA, Clinical Supervisor, PRT Trainer, Stanford --- FOR MORE go to; https://bpub.fyi/ASDBundle XX xx About the Contributors Barry M. Prizant, Ph.D., CCC-SLP, Adjunct Professor, Brown University, Director, Childhood Communication Services, Providence, Rhode Island Dr. Barry Prizant has 45 years’ experience as a speech-language pathologist, author, researcher, and international consultant. He is an adjunct professor at Brown University and director at Childhood Communication Services, a private practice. Barry is a codeveloper of The SCERTS Model, an educational framework now being implemented in more than a dozen countries. His recent book is Uniquely Human: A Different Way of Seeing Autism (Simon & Schuster, 2015), which has received the Autism Society of America’s Dr. Temple Grandin Award for the Outstanding Molly Quinn, M.A., Behavior Analyst, Ball State, University, Muncie, Indiana Molly Quinn, M.A., Behavior Analyst, Ball State, University, Muncie, Indiana As a professional, Molly Quinn has been defined as a teacher, a behavior analyst, a parent-training consultant, and a researcher. She has worked with people between the ages of 2 years and 30 years who were diagnosed with a developmental disability, within their homes, schools, and communities, for the last 15 years. In her personal life, Molly is a mother of three and a foster mom to two children, living in Plainfield, Indiana. If given the opportunity for leisure, Molly enjoys reading and is passionate Emily Rubin, M.S., CCC-SLP, Director, Educational Outreach Program, Marcus Autism Center, Atlanta, Georgia Emily Rubin is the director of the Educational Outreach Program at the Marcus Autism Center in Atlanta, Georgia. She is a speech-language pathologist specializing in autism, Asperger syndrome, and social-emotional learning. She is a coauthor of The SCERTS Model, a criterion-referenced assessment tool and educational framework for social communication and emotional regulation. Her current work is focused on building the capacity of public-school systems to embed interpersonal and learning supports that benefit all students and young Kyle Sterrett, M.A., Doctoral Candidate, University of California Los Angeles Kyle Sterrett’s research interest lies in the optimization of evidence-based interventions through the understanding of their active ingredients using quantitative methods—for example, understanding of the role of speech-generating devices within efficacious interventions for language learners with autism. He has been involved as a clinician in a number of recent intervention trials, implementing interventions for children with autism and developmental delays within schools and in home settings through parent training in the JASPER Kyle Sterrett, M.A., Doctoral Candidate, University of California Los Angeles --- FOR MORE go to; https://bpub.fyi/ASDBundle https://bpub.fyi/ASDBundle About the Contributors Kristen Strong, Ph.D., Psychologist, Acacia Counseling and Wellness, Isla Vista, California Dr. Strong is a clinical psychologist and received her doctoral degree from the University of California at Santa Barbara. She worked with Drs. Robert and Lynn Koegel and has significant experience working with individuals with ASD across the life Shawnna Sundberg, M.A., Ball State University, Muncie, Indiana Shawnna Sundberg, M.A., Ball State University, Muncie, Indiana Shawnna received a bachelor of arts degree in psychology from Purdue University in 2008, and a master’s degree in special education with certifications in applied behavior analysis (ABA) and autism from Ball State University in 2015. Shawnna is a board-certified behavior analyst with more than 10 years of experience working in the mental health and ABA/verbal behavior (VB) field. Shawnna has worked as a child and adolescent home-based case manager, ABA/VB therapist, training spe- Jane R. Wegner, Ph.D., Clinical Professor, Clinic Director, Schiefelbusch Speech- Language-Hearing Clinic, University of Kansas, Lawrence Dr. Wegner is a clinical professor and director of the Schiefelbusch Speech-Language-Hearing Clinic at the University of Kansas (KU). She directs the Pardee Augmentative and Alternative Communication Resource and Research Laboratory on the Lawrence campus of KU. Dr. Wegner directed numerous personnel preparation projects funded by the U.S. Department of Education, Office of Special Education Programs, including the Communication, Autism, and Technology Project and the Augmentative Communication in the Schools Project. She has authored numerous articles and book chapters on Augmentative and Alternative Communication. Dr. Wegner is a Fellow of the American Speech-Language-Hearing Association and served on the ASHA Ad Hoc Committee on Autism Spectrum Disorders Amy Wetherby, Ph.D., CCC-SLP, Distinguished Research Professor, Department --- FOR MORE go to; https://bpub.fyi/ASDBundle xxii FOR MORE go xxii About the Contributors project director of a doctoral leadership training grant specializing in autism and funded by the U.S. Department of Education. She served on the National Academy of Sciences Committee for Educational Interventions for Children with Autism and is executive director of the Florida State University Center for Autism and Related Disabilities. Dr. Wetherby is project director of the FIRST WORDS Project, a longitudinal research investigation on early detection of ASD and other communication disorders, funded by the U.S. Department of Education, National Institutes of Health, and Centers for Disease Control and Prevention. She is also the principal investigator of an early treatment study, funded by Autism Speaks and the National Institutes of Health, teaching parents of toddlers with ASD how to support Susan M. Wilczynski, Ph.D., BCBA-D, Professor, Ball State University, Muncie, Indiana Dr. Wilczynski is the Plassman Family Distinguished Professor of Special Education and Applied Behavior Analysis and the former executive director of the National Autism Center. Dr. Wilczynski has edited or written multiple books and published scholarly works in Behavior Analysis in Practice, Journal of Applied Behavior Analysis, Behavior Modification, Focus on Autism and Other Developmental Disabilities, and Psychology in the Schools. Dr. Wilczynski is a licensed Juliann J. Woods, Ph.D., CCC-SLP, Professor Emeritus, Florida State University, Tallahassee Juliann J. Woods is professor emeritus and consultant, Communication and Early Childhood Research and Practice Center in the School of Communication Science and Disorders, and associate director of research to practice in the Autism Institute at Florida State University. Throughout her career, she has emphasized the translation of research to practice, has published extensively, and presents regularly at national conferences on early communication and intervention for young children and their families, early identification and intervention in autism, coaching and --- Introduction to Treatment of Autism Spectrum Disorder (ASD) of Autism Spectrum Disorder (ASD) INTRODUCTION INTRODUCTION This book is intended to introduce readers who have some familiarity with autism spectrum disorder (ASD) and its core impairments to a group of interventions focused on social communication and social interaction. Because the diagnostic category for autism has undergone modification since the first edition of this text, this chapter describes these changes and briefly highlights some implications for these changes. The chapter then provides updates on national reviews of interventions considered to be established in support of the social communication and social interaction of children with ASD. CHANGES TO THE DSM-5 When the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision (DSM-IV-TR; American Psychiatric Association [APA], 2000) was updated to DSM-5 (APA, 2013), pervasive developmental disorder/autism, with its subthreshold diagnoses, changed to autism spectrum disorder. The diagnostic criteria also moved from three primary diagnostic categories to two: 1) social communication and social interaction and 2) restricted, repetitive, and stereotyped patterns of behavior. Expansion within each category also occurred. Table 1.1a summarizes differences between the earlier (DSM-IV-TR, APA, 2000) and the current characterization of ASD (DSM-5; APA, 2013). A particularly significant change is that language and cognition are now considered to be potential comorbid conditions and require a separate assessment to ensure deficits in these areas cannot be better explained by an intellectual disability (ID) or a global developmental delay. --- FOR MORE go 2 Prelock and McCauley Table 1.1a. A summary of changes associated with autism spectrum disorder (ASD) diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision | | DSM-IV-TR | | DSM-5 | | --- | --- | --- | --- | | Possible diagnoses | Autism spectrum disorders with pervasive developmental disorder-not otherwise specified(PDD-NOS),autistic disorder,Asperger disorder,childhood disintegrative disorder | Autism spectrum disorder is the sole diagnosis and should be used for individuals with well-established diagnoses of autistic disorder,Asperger disorder,或PDD-NOSby using the DSM-IV-TR criteria. | | | Diagnostic criteria for ASD | Clinically significant,persistent deficits in social communication and interactions(must meet two of the social and one of the communication criteria)Restricted repetitive patterns of behavior,interests,and activities(must meet one of the behavior criteria)Symptoms must be present in early childhood(but may not become fully manifest until social demands exceed limited capacities). | Deficits in social communication/ interaction(must meet all three of the social criteria)Restricted and repetitive interests(must meet two of the four behavior criteria) | | | Onset | Must have been seen before age8 | Symptoms must have been present since early development,even if only recognized later. | | | Possible co-occurring diagnoses | - | Attention-deficit/hyperactivity disorder;speech sound disorder,language disorder,childhood-onset fluency disorder;NOT social(pragmatic)communication disorder | | | Possible specifications | - | With or without accompanying intellectual impairmentWith or without accompanying language impairmentAssociated with a known medical or genetic condition or environmental factor | | | Severity level description | Severity level description was not specified. | Severity level described in three levels.See Table 1.1b for a description of each level. | | Table 1.1b describes the severity levels now associated with each of the two primary Table 1.1b describes the severity levels now associated with each of the two primary diagnostic categories (DSM-5; APA, 2013). Several implications are discussed in the literature regarding the application of the new DSM-5 criteria. For example, Young and Rodi (2014) found only 57.1% of those with pervasive developmental disorders (PDDs) on the DSM-IV met the criteria for DSM-5, whereas 50%–75% maintained diagnoses in a review completed by Smith and colleagues (2015). In both studies, children with a diagnosis of PDD-not otherwise specified (PDD-NOS) and Asperger’s disorder were less likely to meet the DSM-5 criteria, specifically all three social communication and social interaction description specified. Excerpted from Treatment of Autism Evidence-Based Intervention --- FOR MORE go to; https://bpub.fyi/ASDBundle MORE Introduction Table 1.1b. Severity levels associated with the two diagnostic criteria for autism spectrum | Severity level | Social communication | Restricted, repetitive behaviors | | --- | --- | --- | | Level 3: Requiring very substantial support | Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning,very limited initiation of social interactions,and minimal response to social overtures from others(e.g.,a person with few words of intelligible speech who rarely initiates interactionand,when he or she does,makes unusual approaches to meet needs only and responds to only very direct social approaches) | Inflexibility of behavior,extreme difficulty coping with change,or other restricted/repetitive behaviors markedly interferewith functioning in all spheresGreat distress/difficulty changing focus or action | | Level 2: Requiring substantial support | Marked deficits in verbal and nonverbal social communication skillsSocial impairments apparent even with supports in placeLimited initiation of social interactions;and reduced or abnormal responsesto social overtures from others(e.g.,a person who speaks simple sentences,whose interaction is limited to narrow special interests,and has markedly odd nonverbal communication | Inflexibility of behavior,difficulty coping with change,or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interferewith functioning in a variety of contextsDistress and/or difficulty changing focus or action | | Level 1: Requiring support | Without supports in place,deficits in social communication cause noticeable impairmentsDifficulty initiating social interactions,and clear examples of atypical or unsuccessful response to social overtures of othersMay appear to have decreased interestin social interactions(e.g.,a personwho is able to speak in full sentencesand engages in communication butwhose to-and-fro conversation withothers fails and whose attempts tomake friends are odd and typically unsuccessful) | Inflexibility of behaviorcauses significant interferencewith functioning in one or more contextsDifficulty switchingbetween activitiesProblems of organizationand planning hamper independence | make friends are odd and typically unsuccessful) the new criteria continue to receive the intervention services they require (Smith et al., 2015; Young & Rodi, 2014). A study with 185 children under 5 years old indicated that children with autism on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR; APA, 2000) were also diagnosed with ASD on the DSM-5, but children with previous PDD-NOS diagnoses had fewer comorbid and emotional behaviors and insufficient symptoms in the restricted repetitive patterns of behavior category to qualify for an ASD diagnosis (Christiansz et al., 2016). Another study (Zander & Bolte, 2015) of younger children between 20 and 47 months found that 12%–67% of the children who met the DSM-IV-TR criteria did not meet the the new criteria continue to receive the intervention services they require (Smith --- FOR MORE go 4 Prelock and McCauley consistent diagnosis. Reports by the Centers for Disease Control and Prevention (Baio et al., 2018), however, indicate the number of children meeting the DSM-5 criteria for ASD as compared to the DSM-IV-TR criteria are fairly similar, with DSM-IV- TR cases exceeding DSM-5 cases by less than 5% and with an 86% overlap between the two definitions. It remains unclear what the impact has been or will be to the prevalence of ASD diagnoses with the addition of social communication disorder (APA, 2013). Although this disorder is characterized by challenges in the social use of both verbal and nonverbal communication similar to ASD, there is no evidence of restricted and repetitive patterns of behaviors, interests, or activities. Whatever the ultimate impact is of the application of the DSM-5 on the diagnosis of ASD, children still require evidence-based interventions that address their social communication and social interaction impairments, as prevalence numbers continue to rise with 1 in 59 children receiving a diagnosis (Baio et al., 2018). BACKGROUND ON INTERVENTION STRATEGIES FOR COMMUNICATION AND SOCIAL INTERACTION Since 2000, thinking has evolved about which intervention approaches are most appropriate for supporting the social interaction and communication needs of children with ASD as well as children with social pragmatic disorders who may not meet the ASD diagnosis. Although traditional behavioral interventions are plentiful in the literature (e.g., Cooper et al., 2007) and tremendously influential in a variety of settings (Downs et al., 2007; Lafasakis & Sturmey, 2007; Taubman et al., 2001), social-pragmatic developmental interventions continue to gain traction, including those that involve parent training, in part because they emphasize opportunities for people with ASD to establish positive social connections and generalize their skills in the natural environment. Interest in these approaches has also arisen in response to limitations identified in traditional behavioral approaches to ASD in terms of generalization of targeted behaviors, particularly those related to the social use of communication and language (Wetherby & Woods, 2006, 2008). This book focuses primarily on such approaches because of their special promise in addressing the social communication and social interaction challenges at the core of ASD and have more recently been elaborated upon and modified to address the special challenges presented by ASD. Several of the interventions described in this text capitalize on the value of integrating the best of behavioral and developmental approaches to achieve functional and relevant social and communicative outcomes for children, adolescents, and adults with ASD. For example, Prizant and Wetherby (1998), recognizing the --- MORE Introduction to intervention, proposed contemporary behavioral interventions (i.e., middle ground interventions) to support the communication and social interaction needs of children with ASD. In particular, they described the value of giving children choices, sharing communication opportunities between the interventionist and the child, and using preferred activities and materials—strategies that characterize pivotal response training (Koegel, Koegel, Harrower, & Carter, 1999; Koegel, Koegel, otal response training (Koegel, Koegel, Harrower, & Carter, 1999; Koegel, Koegel, Shoshan, & McNerney, 1999). As intervention approaches have evolved, so too have comprehensive guidelines for best practices. In 2001, the National Research Council (NRC) offered a description of best practices for children with ASD through the early childhood years. A number of intervention guidelines emerged from a comprehensive review of the literature, including initiating treatment as soon as possible; ensuring active engagement during intensive instruction; using developmentally appropriate, goal-based, and systematically planned activities; implementing planned teaching opportunities throughout the day; and involving families and peers in the intervention to facilitate generalized skill learning. Many early intervention programs have used these best practices to design comprehensive educational programs for young used these best practices to design comprehensive educational programs for young children with ASD. As a follow-up to the NRC (2001) description, Iovannone and colleagues (2003) proposed six educational practices as appropriate and effective for school-age children with ASD: 1) providing individualized supports and services that matched a student’s profile as defined through the individualized education program (IEP) process; 2) offering systematic, carefully planned, and defined instructional procedures to achieve valid goals with a process for measuring outcomes; 3) creating a structured learning environment; 4) adding specialized curriculum content in the area of social engagement and recreation and leisure skills; 5) defining a functional approach to problem behaviors; and 6) engaging families in their student’s educational success. Challenges remained, however, in determining the most effective instructional procedures for children of varying ages, language abilities, and cognitive levels with diagnoses of autism and subthreshold diagnoses, such as Asperger approaches were identified as making a significant contribution but requiring more research (NAC, 2009). In 2015, the NAC published a second report, examining research from 2007 to 2012, including any intervention research for those with ASD over 22 years of age (from 1987 to 2012), collapsing a couple of the behavioral packages under behavioral interventions and adding a couple of intervention categories. Their findings continued to support behaviorally based interventions, although limited research was found for adults over 22, with only 28 studies meeting the inclusion criteria, find- --- FOR MORE go 6 Prelock and McCauley with ASD. Notably, however, the 2015 NAC report added three interventions to the established category for individuals from birth to age 21: 1) language training (specifically language production using behavioral principles); 2) parent training; and 3) a social skills package. The report’s chapter on behavioral interventions speaks to some of the more recent work in language production training. This second edition of Treatment of Autism Spectrum Disorder includes two new chapters that involve parent training, which adds to the three chapters from the first edition that already focus on the value of parent training, and this edition also features a new already focus on the value of parent training, and this edition also features a new chapter on social skills training. Table 1.2 lists the 14 interventions included in this book according to their level of evidence at the time of the most recent publication of the National Standards Project (NAC, 2015). Established treatments are those identified with sufficient evidence leading to positive outcomes. Emerging treatments are those with one or more studies yielding positive outcomes but requiring additional high-quality studies to show consistent results. Unestablished treatments are those with little evidence and that consequently require additional research. No treatments are those judged to be ineffective or harmful. Interventions described in this book fall primarily within the top two categories of evidence—established and emerging; only one intervention Table 1.2. Levels of evidence for interventions included in this book based on the National Stan- | Level of evidence | Level description | Chapter | Intervention | | --- | --- | --- | --- | | Established(14 interventions identified) | Sufficient evidence that the intervention leads to positive outcomes | 6 | Behavioral intervention strategies | | 9 | Joint attention intervention | | | | 10 | Enhanced Milieu Teaching (EMT) | | | | 12 | Peer-mediated support strategies | | | | 13 | Pivotal Response Treatment (PRT) | | | | 15 | Social skills training | | | | 16 | Social Stories | | | | 17 | Video modeling | | | | Emerging(18 interventions identified) | One or more studies yielding positive outcomes, but study quality and results are inconsistent | 4 | Augmentative and alternative communication(AAC), includingPicture Exchange Communication System(PECS) | | 8 | Functional communication training | | | | 7 | Floortime and the Developmental, Individual-difference, Relationship-based(DIR) model | | | | Unestablished(13 interventions identified) | Little evidence and requiring additional research | 7 | Floortime and the Developmental, Individual-difference, Relationship-based(DIR) model | | Not specifically named in theNAC reportbut all involve parent training,which is an established intervention | — | 5 | Early Start Denver Model | | 11 | Early Social Interaction Project | | | | 14 | The SCERTS®Model | | | established intervention From National Autism Center (2009). National Standards Project—findings and conclusions: Addressing the needs for evidence-based practice guidelines for autism spectrum disorders. Randolph, MA: Author; adapted Excerpted from Treatment of Autism Spectrum Disorder: --- MORE Introduction training, which is an established intervention. Also, three interventions are included that relate specifically to parent training (i.e., Early Denver Start Model [Chapter 5], ® Early Social Interaction Project [Chapter 11], and The SCERTS Model [Chapter 14]) that were not specifically named in the 2015 NAC National Standards Project report. With the National Standards Project as a guide for evidence-based practice with children and youth affected by ASD, this text is timely because it emphasizes key established and emerging interventions used to facilitate the communication and social interaction of individuals with ASD and highlights those interventions with parents playing a key role. PURPOSE OF THE BOOK This book describes and critically analyzes specific treatment approaches used to address the communication and social interaction challenges of children, adolescents, and adults with ASD. Although these challenges are of specific interest to speech-language pathologists, providers across disciplines have a stake in using evidence-based intervention to respond to these core areas of impairment for individuals with ASD. Approaches selected for inclusion have empirical evidence of efficacy or effectiveness established through systematic reviews or at least two peer-reviewed articles that indicate the approaches are well-established, probably efficacious or promising emerging interventions (e.g., Chambless et al., 1998; Chor- the About the Videos and Downloads page in the front matter for guidance on how to access the video clips). Readers will learn that the interventions emphasize somewhat different prin- instances of randomized control trials do exist (e.g., joint attention training using the JASPER model). Table 1.3 provides a summary to facilitate the reader’s understanding of the similarities and differences among the interventions in terms of basic principles, techniques, teaching methods, treatment targets, and ages for which evidence has been established. This table also identifies the evidence rating provided by the National Autism Center (2015). In addition, to make the treatments accessible to the reader and to facilitate their comparison, the table’s descriptions were standardized using a template adapted from that used in McCauley and Fey (2006) in which critical features of each treatment are highlighted. Treatments are also illustrated by a short video example, which can be accessed on the Brookes Download Hub (see the About the Videos and Downloads page in the front matter for guidance on how Excerpted from Treatment of Autism Spectrum Disorder: --- Table 1.3. National Autism Center (2015) categorization of featured interventions Targets National Autism Center (2015) categorization of featured interventions | Interventions | ratinga | Basic principles | Methods | Targets | Ages | | --- | --- | --- | --- | --- | --- | | AAC including PECS (Chapter 4) | Emerging | Social-pragmatic and behavioral | Assessment of partner and environmental influenceAAC system and target vocabulary selectionMeaningful contextsResponsive partnersNatural environmentFamily and person centeredSystematic teachingTime delayDirect, natural reinforcementShapingModelingPromptingVisually based | Enhance existing communication skillsExpand languageReplace speechProvide structure to support language developmentInitiate requests spontaneouslyRequest reinforcing items or activities, help, or a breakReject offers for undesired items or activitiesAffirm offers for desired items or activitiesFollow a direction to waitRespond to directionsFollow transitional cues and visual schedules | Toddler through adult | | Early Start Denver Model (Chapter 5) | Not specifically reported but is parent training focused, which is established | Developmental and behavioral | PlayRelationship buildingApplied behavior analysis techniquesNaturalistic developmental behavioral techniques including natural interactions, shared control, natural contingencies | Receptive and expressive languageSocial skills with adults and peersJoint attentionImitationPlay | 1-5 years | $$ \mathrm {N a t u r a l e n v i o r m e n t} $$ $$ P l a y $$ --- | Behavioral intervention strategies: discrete trial learning, differential reinforcement, and shaping (Chapter 6) | Established | Behavioral | Adult-directed, individualized one-to-one instructionPredetermined correct responsesContingent or differential reinforcementShaping behaviorsOperant conditioningMassed trialsMaintenance trialsMand-modeling | Communication, social, and adaptive skillsUse of verbal operants(e.g., mands,tacts, echoics,intraverbals) | 3-21 years | | --- | --- | --- | --- | --- | --- | | DIR Floortime(Chapter7) | Unestablished | Developmental | Family basedChild directedInterpersonal developmentIndividual differencesCaregiver-child relationshipsParent and clinician implemented | Shared attention and regulationEngagement and relatingTwo-way intentional communicationComplex problem solvingCreative representations and elaborationRepresentational and emotional thinking | 18 months-9 years | | Functional communication training(Chapter8) | Emerging | Behavioral | Functional behavior assessmentSelection of an alternative behaviorFading promptsResponse match,success,efficacyacceptability,recognizability,and milieuNatural communities of reinforcement | Replacement of aggression,self-injury,elopement,and inappropriate sexual behaviorwith functional communication forms | 3-21 years | | Joint attention:JASPER Model(Chapter9) | Established | Behavioral and developmental | Directed instructionIndividualizedIntensiveMilieu teachingParent and clinician implemented | Response to and spontaneousinitiation of joint attention | 3-5 years | | Enhanced Milieu Teaching(Chapter10) | Established | Behavioral and developmental | Environmental arrangementResponsive interactionLanguage modelingMilieu teachingParent and clinician implemented | Productive,spontaneous,andmeaningful use of new languageformsInitiations and responses | 3-9 years | (continued) --- Methods | Interventions | NSP rating* | Basic principles | Methods | Targets | Ages | | --- | --- | --- | --- | --- | --- | | Early Social Interaction (Chapter 11) | Not specifically reported but is parent training focused which is established | Developmental | Family basedChild directedEnvironmental arrangementResponsive interactionsPreferred activities and materialsRoutine basedNatural environment | Social communication from preverbal to multiword stageGesture useInitiation of and response to joint attentionWord knowledgeReciprocity | 18 months-3 years | | Peer mediation (Chapter 12) | Established | Behavioral | Peer interaction trainingPeer network strategiesRegular opportunities to interact within and outside instructional settingsAdult coaching, guidance, and supportInclusive environmentCommunities of reinforcementInstructional arrangements(e.g., cooperative groups), peer support arrangements) | Initiating and maintaining conversationExchanging complimentsTurn-takingHelping behaviorsSharing materialsCollaborating on assignmentsMaking introductionsConversing about shared interests | 3-14 years | | Pivotal Response Treatment (Chapter 13) | Established | Behavioral and developmental | Play basedFamily basedNatural environmentRoutine basedChild choiceTurn takingShared control of teaching opportunitiesDirect and natural reinforcementReinforcing communication attemptsPreferred activities and materialsInterspersing maintenance tasks within teaching sessions | First wordsBasic social skillsSophisticated language and social skillsPivotal behaviors(e.g., motivation, responsivity to multiple cues, self-management, self-initiations) | 3-9 years | $$ \mathrm {R e c i p r o c i t y} $$ $$ M a k i n g i n t r o u c t i o n s $$ $$ \mathrm {B a s i c s o l i c s k i l l s} $$ --- | Social Stories(Chapter 16) | Established | Social-pragmatic | Visually basedSituation specificIndividualized instructional strategy(determine topic, gather information,develop the story, consider additionalsupports, critical review, introducestory, generalization training,maintenance and fading) | Reduction of disruptive behaviors(e.g., tantrums, aggression, self-injurious acts)Establish routinesIntroduce changes in routinesUnderstanding of a new or unfamiliar eventSocial skills (e.g., getting a peer'sattention, making choices, playingindependently, peer engagementand participation)Communication (e.g., reduction of echolalia, interrupting,and loud talking) | 6-14 years | | --- | --- | --- | --- | --- | --- | | Video modeling(Chapter 17) | Established | Behavioral anddevelopmental | Visually basedViewing positive video modelsAdult and peer modelingPoint-of-view modelingSelf-modeling including feed forwardand positive self-review | Teach new skills or improve existingskills across developmental domains(e.g., self-help skills-dressing,feeding, washing; cognitive skills-play, perspective taking, attention,social skills-conversation, prosody,turn-taking; language skills-question asking and answering,greeting, comprehending stories) | 3-18 years | | The SCERTS®Model(Chapter 14) | Not specificallyreportedbut is parenttrainingfocusedwhichisestablished | Developmental | CollaborationCurriculum-based assessmentNatural routines | Social communicationEmotion regulationTransactional supports | Preschoolthroughschool age | | Social skillsinterventions(Chapter 15) | Established | Social-pragmaticand behavioral | | | | | *Source: National Autism Center. (2015).Key: AAC, augmentative and alternative communication; ESDM, Early Start Denver Model; JASPER, Joint Attention, Symbolic Play, Engagement, and Regulation; PECS, Picture ExchangeCommunication System; SCERTS, Social Communication, Emotional Regulation, and Transactional Supports. | | | | | | --- FOR MORE go 12 Prelock and McCauley development in children, adolescents, and adults with ASD; therefore, there is not one best approach for all individuals. Instead, there are profiles of individuals affected by ASD who are likely to benefit most from each intervention guided by the evidence. Early, intensive, and structured intervention as well as a collaborative approach to working in home, educational, and community settings appear to be critical features of effective intervention. Further, this book emphasizes the impor- tance of addressing the core deficits of social interaction and social communication. HOW TREATMENTS ARE DESCRIBED HOW TREATMENTS ARE DESCRIBED Authors prepared their intervention chapters, Chapters 4–17, using a template, with sections indicated by the headings provided in Table 1.4. Each chapter begins with a brief introduction summarizing the treatment approach and defining the subgroups of individuals with ASD for whom the treatment is designed. The chapter also includes the age, developmental level, language level, and service delivery model the treatment entails, including its basic focus and methods. In the description of the subgroups for whom the intervention is appropriate, the authors consider not only subgroups for whom the intervention is appropriate, the authors consider not only the specific diagnoses (e.g., autism spectrum disorder, social communication dis the specific diagnoses (e.g., autism spectrum disorder, social communication dis order) but also the individual’s level of verbal skills and cognitive abilities. order) but also the individual’s level of verbal skills and cognitive abilities. The next section in each chapter includes the theoretical basis for the treatment approach. Here the authors discuss four main components. The first component is a theoretical explanation or rationale for the treatment. The second component includes underlying assumptions regarding the nature of the communication and social interaction impairment being addressed by the treatment. The third compo- social interaction impairment being addressed by the treatment. The third component describes the functional outcomes or desired consequences (e.g., increase joint addressed. The final component highlights the treatment target (e.g., language or social functioning). The theoretical basis is followed by a summary of research providing an empirical basis for the treatment. In this section, the authors summarize and interpret studies providing evidence that supports the use of the treatment. Authors have prepared a level of evidence table in which they present the major research designs used to examine the intervention and the outcomes reported for both group and single-subject research. Where possible, effect sizes are reported as originally pub- discussion of time demands, training, or expertise required by clinicians wishing to use the intervention and any materials or equipment needed for treatment implementation. Practical requirements are followed by a description of the key components of the intervention approach. The goal for this section is to ensure the reader has a strong, preliminary understanding of the procedures. Authors provide information about the nature of the goals addressed by the intervention, how multiple goals are addressed over time (e.g., sequentially, simultaneously, cyclically), a procedural or operational description of activities within which the goals are addressed, and the nature of involvement of participants beyond the clinician and child (e.g., peers, sib- single-subject research. Where possible, effect sizes are reported as originally published or computed for the chapter when means and standard deviations were given. To support practitioners’ use of the described interventions in their specific settings, in the next section of each chapter, authors outline some practical requirements for implementing the treatment. This section of each chapter includes a discussion of time demands, training, or expertise required by clinicians wishing to use the intervention and any materials or equipment needed for treatment --- FOR MORE go to; https://bpub.fyi/ASDBundle MORE Introduction | Section | Content | | --- | --- | | Introduction | Overview of the intervention is provided, including the specific individuals for whom it is designed and their age (i.e., infants/toddlers, children, adolescents, adults), developmental level, and language level. The service delivery model involved, the intervention's basic focus, and its primary methods are highlighted. | | Target populations | Description of those subgroups on the autism spectrum (i.e., autistic disorder, Asperger disorder, pervasive developmental disorder-not otherwise specified, Rett disorder, and childhood disintegrative disorder) for whom the intervention is primarily designed and for whom there is empirical support for its use. Level of verbal skills and cognitive abilities are also discussed. Assessment methods used to establish the appropriateness of the treatment for an individual child, adolescent, or adult with autism spectrum disorder (ASD) are presented. | | Theoretical basis | Description of the dominant theoretical explanation or rationale for the treatment approach, underlying assumptions regarding the nature of communication and social interaction impairment being addressed by the treatment, the functional outcomes being addressed, and the area of treatment being targeted. | | Empirical basis | Comprehensive summary and interpretation of studies providing evidence that supports the use of the intervention, including descriptions of the experimental design and treatment effects for both group and single-subject research, the nature of outcome data reported (e.g., standardized testing vs. naturalistic probes), intervention fidelity, maintenance and generalization of treatment effects, and social validity | | Practical requirements | Description of the time and personnel demands for the primary clinician and related other participants, whether or not a team approach is used, required training of personnel involved, or materials required | | Key components | Description of the goals addressed by the intervention, how multiple goals are addressed over time (e.g., sequentially, simultaneously, cyclically), activities within which the goals are addressed, and involvement of participants beyond the clinician and child (e.g., peers, siblings, teachers, primary caregivers) | | Assessment for treatment planning and progress monitoring | Description of the major assessments and assessment points used to reach decisions about 1) the appropriateness of the intervention; 2) initial and subsequent treatment targets, etc.; 3) advancement through treatment; and 3) treatment termination | | Considerations for children from culturally and linguistically diverse backgrounds | Discussion of the applicability of the intervention to children from linguistically and culturally diverse backgrounds and ways in which the intervention might be modified to be most appropriate | | Application to a child | Description of a real or hypothetical case of a child illustrating the implementation and effectiveness of the treatment approach | | Application to an adolescent or adult | Description of a real or hypothetical case of an adolescent or an adult, illustrating the implementation and effectiveness of the treatment approach | | Future directions | Discussion of additional research needed to advance the refinement or ongoing validation of the intervention across populations of individuals with ASD and related neurodevelopmental disabilities | | Suggested readings | Summary of a few readings of greatest use to readers who might want to know more about the specific intervention | | Learning activities | Topics for further discussion, ideas for projects, questions to test integration of the reading material, and possible writing assignments to facilitate the readers' learning | --- 14 Prelock and McCauley manuals, which can support a more thorough understanding of the procedures manuals, which can support a more thorough understanding of the procedures involved in the intervention they describe.) Assessment methods used to establish the appropriateness of the treatment plan and progress monitoring for an individual child, adolescent, or adult with ASD are presented in the next section. Recognizing the critical role of data to guide practice, this section of each chapter also describes data collection methods to support decision making. The authors provide descriptions of how data are collected, ways to evaluate progress, strategies for determining when and how adjustments should be made, and when the intervention approach should be terminated. They explain how data collection is used to guide ongoing treatment decision making and to how data collection is used to guide ongoing treatment decision making and to assess immediate and long-term outcomes. This section is followed by implications for inclusive practice, offering examples where the intervention can be applied in the home, school, work, and/or community where the intervention can be applied in the home, school, work, and/or community setting. Considerations for implementing the intervention for children from culturally and linguistically diverse backgrounds are described in the final section before ally and linguistically diverse backgrounds are described in the final section before specific applications are made to children, adolescents, or adults. The authors offer guidance in planning modifications related to the particular cultural and personal factors affecting an individual child, adolescent, or adult while ensuring consistency factors affecting an individual child, adolescent, or adult while ensuring consistency in the treatment approach. In the next two sections, the authors provide a description of potential applications of the intervention to a child and to an adolescent or adult. They offer two brief case studies: one of a younger individual with ASD for whom the treatment is considered appropriate and effective and one of an adolescent or adult for whom the treatment is considered appropriate and effective if, in fact, the intervention is NEW COMPONENTS This book includes two new chapters beyond the intervention chapters to facilitate the reader’s use of the book. Chapter 2 highlights the importance of assessment to treatment planning and progress monitoring. The context for assessment is discussed recognizing the importance of a family-centered, culturally informed approach that is both interdisciplinary and comprehensive. The role of screening and diagnostic testing to identify the presence of ASD and comorbid conditions is also described, but more briefly. This chapter includes approaches to identifying severity and creating profiles of social communication and social interaction challenges. Most vention is provided. --- MORE Introduction Chapter 3 highlights the language and communication strengths and challenges most often seen in children with ASD, as these have implications for intervention. Early communication challenges are discussed, including intentional communication, gesture use, word learning, and the use of unconventional verbal behavior. The chapter emphasizes those challenges that specifically impact language development, social communication, and social interaction, such as impairments in joint attention, play, and theory of mind. This chapter is designed to help the reader understand what researchers know about the syntactic, semantic, phonological, and pragmatic interaction challenges as well as the possible strategies that can help address them. what researchers know about the syntactic, semantic, phonological, and pragmatic development of children with ASD and what the implications are for intervention. In addition to these changes in the content included in this second edition, a companion resource, Case Studies for the Treatment of Autism Spectrum Disorder (Prelock & McCauley, 2021), is offered as an optional supplementary resource. Through 14 individual cases, readers are introduced to hypothetical but instructive scenarios posing the kinds of clinical problems that face clinicians who wish to devise comprehensive services for clients with ASD. 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(2014). Redefining ASD using DSM-5: The implications of the proposed DSM-5 criteria for ASD. Journal of Autism and Developmental Disorders, 44, 758–765. Zander, E., & Bolte, S. (2015). The new DSM-5 impairment criterion: A challenge to early autism spectrum disorder diagnosis. Journal of Autism and Developmental Disorders, Excerpted from Treatment of Autism Evidence-Based Intervention --- "Would make an excellent text for a course in treatment of ASD, as well as a great resource for practitioners searching to find the most appropriate treatments for a wide range of individuals with ASD." —Rhea Paul, Ph.D., CCC-SLP, HASHA, Professor and Chair Department of Communication Disorders, Sacred Heart University "No single book can possibly capture all one needs to know for supporting learners with autism, but this volume is an excellent foundation for the journey." Mareile Koenig, Ph.D., CCC-SLP, BCBA, Professor and SLP Graduate Program Coordinator, Communication Sciences and Disorders, West Chester University To work effectively with individuals who have autism spectrum disorder (ASD), SLPs and other practitioners need in-depth knowledge on choosing and implementing interventions for communication and social challenges. This bestselling textbook gives professionals the foundation they need to evaluate and compare today's widely used interventions—and determine which ones will promote the best outcomes for the people they serve. Readers will get a thorough introduction to 14 evidence-based interventions, complete with key details on each intervention's theoretical and empirical basis, components, practical requirements, applications for both children and adults, and considerations for children from diverse cultural and linguistic backgrounds. Twelve video clips (available for streaming) illustrate the interventions in action, and in-text learning activities prepare SLPs and other practitioners to make sound decisions in scenarios they're likely to encounter in the field. - New chapter on language and communication strengths and challenges often seen in children with ASD - New chapter on assessment for treatment planning and progress monitoring WHAT'S NEW: - Videos to demonstrate the newly added interventions - New in-depth profiles of the Early Start Denver Model, The SCERTS $ ^{\circledR} $ Model,and Social Skills Interventions - Updates to reflect the DSM-5 - More information on inclusive practices - More on working with children from culturally and linguistically diverse backgrounds COMPANION CASEBOOK AVAILABLE: Available on its own or as a bundle with the textbook, Case Studies for the Treatment of Autism Spectrum Disorder walks readers through 14 realistic cases and helps them hone their decision-making skills. - A sample syllabus that demonstrates how faculty can integrate this book into a course ABOUT THE EDITORS: Patricia A. Prelock, Ph.D., is Provost and Senior Vice President at University of Vermont. Rebecca J. McCauley, Ph.D., is Professor in the Department of Speech and Hearing Sciences at the Ohio State University. ISBN-13: 978-1-68125-398-5 ISBN-10: 1-68125-398-4