Supportive Environment for Young Children

¶ … Supportive Environment

for Young Children with Autism

Creating a Supportive Environment for Young Children with Autism

"Children with an autism spectrum disorder need to know what is going to happen next"

Marci Wheeler (2003).

For Young Children with Autism

For young children with autism, according to Marci Wheeler (2003), with the Indiana Resource Center for Autism at Indiana University, routines prove to be vital. "Even in a temporary new environment, routines may help" (Wheeler, p. 2). In the article, "Good night, sleep tight, and don't let the bed bugs bite: Establishing positive sleep patterns for young children with autism spectrum disorders," Wheeler explains that at night the bedtime routine for young children with autism needs to be set for a regular time in a predictable and comforting environment. This paper, which examines considerations regarding creating a supportive environment for young children with autism, particularly relates to children from their birth through five years of age.

In the article, "Autism, treatment approaches and young children -- what do we need to know?," Martie Kendrick, M.Ed. And Bonnie Blagojevic, M.Ed. (2005) note that although a number of theories allude to possible causes of autism, researchers basically remain "in the dark" as to its cause, as no concrete criteria has yet been confirmed. Potential causes thought to attribute to this disorder include dietary reasons, genetic issues, neurological factors, metabolic components, and vaccines. The article, "Learning with autism; Inclusive education can help," (2009) relates the story of a toddler, Ben Adams, currently five-years old, would hide from his family. Ben refused to be touched by anyone, even by his mother. When he was 18 months old, Ben still had not yet spoken his first word. Prior to Ben's second birthday, doctors diagnosed him with autism, (Learning with autism…, 2009, ¶ 1).

In the past, as physicians did not regularly encounter autism, they considered this malady to be a rare disorder. The limited amount of focus researchers invested in examining autism adversely affected the quality and quantity of the research conducted (Kendrick & Blagojevic, 2005). Kendrick and Blagojevic explain that symptoms of autism, a complex disorder, affect a range of physiological functions.

What is known about autism is that it constitutes one of a collection of disorders identified as autism spectrum disorders (ASDs). "ASDs are developmental disabilities that cause substantial impairments in social interaction and communication and the presence of unusual behaviors and interests" (Autism Spectrum Disorders Overview, 2007, What is autism? section). Development disabilities may begin at any point of the child's development, up to 22 years of age. A child with development disabilities experiences problems with primary life activities, which include the following:

1. Language,

2. mobility,

3. learning,

4. self-help, and

5. Independent living. (Autism Spectrum Disorders Overview, 2007, Developmental

Disabilities section)

Figure 1 portrays the changes over time for the criteria for diagnosing autism.

Figure 1: Changes in Autism Diagnostic Criteria (Autism Spectrum..., 2007, Changes in… Section).

Creating a Supportive Environment

Melinda Smith, M.A. And Jeanne Segal, Ph.D. (2007) assert in the Web article, "Helping an autistic child," that parents can do a number of things to help autistic children cope with and overcome their challenges to have a productive life. First, parents need to learn all they can about autism. According to Smith and Segal, along with understanding as much as possible about autism, the parent of a child with autism needs to involve the child in treatment. These two efforts, along with the following guidelines may help the parent create supportive, positive, peaceful environment for the child.

Be consistent. Autistic children have a hard time adapting what they've learned in one setting (such as the therapist's office or school) to others, including the home.

Stick to a schedule. Autistic kids tend to do best when they have a highly-structured schedule or routine. Again, this goes back to the consistency they both need and crave. Set up a schedule for your child, with regular times for meals, therapy, school, and bedtime. Try to keep disruptions to this routine to a minimum. If there is an unavoidable schedule change, prepare your child for it in advance.

Reward good behavior. Positive reinforcement can go a long way with autistic children, so make an effort to "catch them doing something good." Praise them when they act appropriately or learn a new skill, being very specific about what behavior they're being praised for. Also look for other ways to reward them for good behavior, such as giving them a sticker or letting them play with a favorite toy.

Create a home safety zone. Carve out a private space in your home where your child can relax, feel secure, and be safe. This will involve organizing and setting boundaries in ways your child can understand. Visual cues can be helpful (colored tape marking areas that are off limits, labeling items in the house with pictures).

Make time for fun. A child coping with autism is still a kid. For both autistic children and their parents, there needs to be more to life than therapy. Find ways to play and have fun together. Don't obsess over whether or not these activities are therapeutic or educational. The important thing is to enjoy your child's company! (Smith & Segal, 2007, p. 2).

According to Ling-Ling Tsao, University of Wisconsin-Oshkosh, and Samuel L. Odom (2006), Indiana University, in the study, "Sibling-mediated social interaction intervention for young children with autism," during 2005, the prevalence of autism was determined to be 2 to 6 individuals per 1,000 persons. That number, however, is reportedly increasing. As children with autism, spend most of their time in the home and community environments, Tsao and Odom "investigated the effectiveness of a sibling-mediated intervention for promoting the social competence of children with autism" (¶ 1), with four sibling dyads (i.e., four children with autism and four typically developing siblings) between 3 years and 6 years of age, participated in their study.

Findings from the single-subject, multiple-baseline design across dyads, Tsao and Odom (2006) evaluated the effects of the sibling intervention. Findings from the three phases in this study included baseline, intervention, and maintenance. Findings also lend moderate support to the perception that a social intervention involving siblings as mediators of social interactions for children with autism proves to be effective. This study also found that when the siblings made social initiations, the children with autism responded to their siblings. Tsao and Odom conclude that their study contributes "to a growing body of evidence concerning the effectiveness of siblings in supporting the learning and development of young children with autism" (Conclusion section, ¶ 1). Unless the researcher designs systematic programming for generalization as part of the intervention, Tsao and Odom purport, the effects of social interventions for children with autism frequently often do not spontaneously generalize across settings. Siblings and Children with Autism

Ilene S. Schwartz, Susan R. Sandall, Bonnie J. McBride and Gusty-Lee Boulware (2004) recount that during the first years of the 1990s, autism changed from a seldom diagnosed disability with a reported prevalence of 3 to 5 individuals out of 10,000 to a prevalence of 1 in 166. During the study, "Project DATA (Developmentally Appropriate Treatment for Autism): An inclusive school-based approach to educating young children with autism," Schwartz, Sandall, McBride and Boulware stress that despite strides in diagnosis, assessment, and intervention for children with autism, numerous unanswered questions regarding this disability remain unanswered. Music Dr. Petra Kern, Frank Porter Graham, University of North Carolina, and David Aldridge, PhD, (2006), University of Witten-Herdecke, Germany, report that autism, typically linked with repetitive and restricted patterns of behavior, is usually apparent before age 3 in the child. In the study, "Using embedded music therapy interventions to support outdoor play of young children with autism in an inclusive community-based child care program," Kern, Graham and Aldridge, find that playgrounds prove to be appropriate settings to implement music therapy interventions "to facilitate learning and development for both children with and without special needs" (Discussion section, ¶ 6). Consequently, music therapy intervention appears to facilitate involvement with others by attracting the child to the music's sound, and providing the opportunity for the child with autism to use the instruments. In addition, interventions for children with autism using songs produced desirable interaction outcomes.

Joe Reichle, Patricia L. Dropik, Elizabeth Alden-Anderson, University of Minnesota, Minneapolis and Tom Haley (2008) Minnesota Autism Center, Minnetonka, stress in the study, "Teaching a young child with autism to request assistance conditionally: A preliminary study," that the need exists to evaluate the conditional use of newly taught communicative behavior. Reichle, Dropik, Alden-Anderson and Haley implemented a within-participant multiple-probe design across three functional tasks to evaluate the 5-year-old boy's acquisition and conditional utilization of requests for help during intervention with every task.

During the study by Reichle, Dropik, Alden-Anderson and Haley (2008), the boy with autistic disorder and severe language delay conditionally utilized requests for assistance. Results of this study indicated that an initial acquisition of requests for assistance proceeded a brief period of overgeneralization. "As independence in completing a task increased, requests for assistance correspondingly decreased. The participant's conditional use of requests for assistance and independent task completion were sustained across time" (Reichle, Dropik, Alden-Anderson & Haley, 2008, ¶ 1). A number of young children with autism experience considerable communicative delays.

Peter (a pseudonym), a 5-year-old boy, diagnosed with autism and global developmental delay, had been diagnosed with autism at 3 years, 8 months (Reichle, Dropik, Alden-Anderson & Haley, 2008, Participants section, ¶ 1). Sessions for the study by Reichle, Dropik, Alden-Anderson & Haley occurred in Peter's home. The following expands on what happened during this study.

Peter's mother, younger sibling, and one or two staff persons moved freely in and out of this area during intervention sessions. Teaching requests for assistance occurred across three different functional activities that included opening a jar (Activity 1), opening a wrapper (Activity 2), and unfastening his pants (Activity 3). Peter's parents and intervention team identified these as activities that he could not perform independently. Interventionists implemented baseline and intervention procedures for the first two activities at a child's table or on the family room floor. The third activity was baselined and subsequently taught during routine toileting activity (Reichle, Dropik, Alden-Anderson & Haley, 2008, Activities and setting section, ¶ 1).

For each of the noted three activities, intervention consisted of two phases:

1. Traching Peter to request assistance followed by

2. teaching him to complete the task independently. (Ibid.)

In addition, the interventionists used a most-to-least response prompt hierarchy during the two phases. Stimulus prompts, structured as modified task difficulty, also taught the participant to open a jar and open a wrapper. Reichle, Dropik, Alden-Anderson and Haley (2008) assert that a young child with autism may learn to utilize requests for assistance conditionally. Even though Peter's mother rated the basic intervention acceptability and effectiveness to be high, results indicate that an interventionist cannot assume the child's obligatory utilization of requesting assistance will produce correct conditional use. After Peter acquired some initial skill in completing the task he was learning, the conditional use of requests occur ed.

In the study, "The usage and perceived outcomes of early intervention and early childhood programs for young children with autism spectrum disorder," Koro Hume, Scott Bellini and Cathy Pratt (2005), Indiana University in Bloomington, stress the value of early intervention (EI) and early childhood education (ECE) for young children with autism spectrum disorder (ASD. Young children with autism may progress quicker than young children with other severe neurodevelopmental disorders, Hume, Bellini and Pratt assert. They purport that some early intervention strategies seem to reduce the debilitating impact of autism. They also note that when an intervention starts before the autistic child reaches 5, children with autism possess significantly better outcomes.