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Examples of behavioral and developmental approaches for children with autism spectrum disorder

Examples of behavioral and developmental approaches for children with autism spectrum disorder
Model Description
Naturalistic developmental behavioral models
Early Start Denver Model (ESDM) Integrative program that uses a combination of developmental science and applied behavior analysis (ABA); can include parents/caregivers as therapists.
Milieu therapy Focuses on teaching children new communication skills and behaviors in their natural environments.
Pivotal Response Training (PRT) Uses play and ABA principles to focus on "pivotal" areas of development (eg, motivation, response to cues, self-regulation, initiation of social interactions) instead of one specific behavior to improve socialization, communication, and overall behavior.
Natural Environmental Training (NET) Uses play and ABA principles to teach skills by incorporating teaching into the child's natural environment to reinforce language and social skills.
JASPER Uses behavioral principles embedded into play routines to build joint engagement and regulation skills while improving social communication, language, play, and social skills.
Project ImPACT (Improving Parents as Communication Teachers) Manualized, 24-session curriculum to teach parents/caregivers how to embed routines and strategies that promote social communication, social responsiveness, imitation, play, and behavioral regulation skills into day-to-day routines.
Behavioral models
Discrete Trial Training (DTT) Structured approach that uses intensive ABA-based programming to establish learning readiness and to teach foundational skills such as attention, compliance, imitation, and discrimination learning.
Verbal Behavior Approach Focuses on teaching language and communication skills by applying principles of ABA to teach how words can be used to communicate ideas and to make requests.
Relational models
Developmental Individual Difference Relationship-based (DIR), also called Floortime Focuses on "floor time" play sessions and other strategies to enhance relationships and social interactions to facilitate emotional and cognitive development; seeks to address deficits in auditory processing, language, motor planning and sequencing, sensory modulation, and visual-spatial processing.
Relationship-Development Intervention (RDI) Focuses on activities that elicit interactive behaviors to engage the child in a social relationship; utilizes play-based scenarios that draw out social behaviors and secondarily motivate the child to be more social.
Responsive Teaching (RT) Developmental curriculum implemented by parents/caregivers during routine interactions in the child's natural environment to address cognitive, communication, and social needs.
This table includes some examples of behavioral and developmental approaches for children with autism spectrum disorder categorized by type of model. Geographic availability and medical insurance coverage of these interventions often vary. Refer to related UpToDate content on behavioral and educational interventions for children and adolescents with autism spectrum disorder for additional details.
References:
  1. Hyman SL, Levy SE, Myers SM, COUNCIL ON CHILDREN WITH DISABILITIES, SECTION ON DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics. 2020;145(1) Epub 2019 Dec 16.
  2. Waligórska A, Kucharczyk S, Waligórski M, Kuncewicz-Sosnowska K, Kalisz K, Odom SL. National Professional Development Center on Autism Spectrum Disorders (NPDC) model – an integrated model of evidence-based practices for autism spectrum disorder. Psychiatr Pol. 2019;53(4):753. Epub 2019 Aug 31.
  3. Centers for Disease Control and Prevention. Autism spectrum disorder (ASD). Treatment and Intervention for Autism Spectrum Disorder. Available at: www.cdc.gov/autism/treatment (Accessed on December 6, 2024).
  4. Paskov K, Kent J, McNealis M, et al. Racial and Ethnic Disparities in Geographic Access to Autism Resources Across the US. JAMA Netw Open. 2023 Jan 3;6(1):e2251182.
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