Intervention
Tools used and tailored to each student
Visual Immersion system
The Visual Immersion System (VIS) is a visually based approach to communication intervention. Within this approach, visual supports (e.g., photographs, pictures, text) are used in an intense and immersive manner to complement spoken language in order to improve comprehension, support expressive language, and provide organization and task expectations to facilitate learning within a learner’s zone of proximal development.
It is a framework and instructional philosophy for supporting communication and teaching language skills to individuals with ASD and other developmental disabilities. This system was developed within the Autism Language Program (ALP) at Boston Children’s Hospital (BCH) and is described in full in the books Enhancing Communication for Individuals with Autism: A Guide to the Visual Immersion System (Shane et al., 2014) (which will subsequently be referred to as “the VIS text”) and Visual Language in Autism (Shane & Weiss-Kapp, 2007).
JASPER
JASPER (Joint Attention, Symbolic Play, Engagement, and Regulation) is a treatment approach based on a combination of developmental and behavioral principles developed by Dr. Connie Kasari at UCLA. It targets the foundations of social communication (joint attention, imitation, play) and uses naturalistic strategies to increase the rate and complexity of social communication.
Over the past 15 years, JASPER has been tested in randomized controlled trials (RCTs) involving nearly 500 children with ASD with studies conducted both within the Kasari Lab and by independent researchers. Across many independent trials evaluating JASPER’s efficacy, it found improvements in joint engagement, social communication, and emotion regulation with decreasing negativity over time, as well as increasing parental co-regulation strategies.
JA
Joint Attention
Joint attention (JA) is the coordination of attention between objects and people for the purpose of sharing. Our studies show that children with ASD use more JA when these skills are modeled and taught directly.
SP
Symbolic Play
I model appropriate play, facilitate joint attention within play routines, and encourage greater diversity in types of play with the goal of helping children increase their diversity, flexibility, and level of play.
E
Engagement
Increases in engagement are critical because they lead to more opportunities for social communication and learning. For this reason, I aim to help children with ASD reach higher states of joint engagement with others.
R
Regulation
Our approach stresses the importance of emotion and behavior regulation. We offer a number of strategies to address lack of engagement, self-stimulatory behaviors, and regulation challenges in children with ASD.
SCERTS
SCERTS® is an innovative educational model for working with children with autism spectrum disorder (ASD) and their families. It provides specific guidelines for helping a child become a competent and confident social communicator, while preventing problem behaviors that interfere with learning and the development of relationships. It also is designed to help families, educators and therapists work cooperatively as a team, in a carefully coordinated manner, to maximize progress in supporting a child.
The acronym “SCERTS” refers to the focus on:
“SC” – Social Communication – the development of spontaneous, functional communication, emotional expression, and secure and trusting relationships with children and adults;
“ER” – Emotional Regulation – the development of the ability to maintain a well-regulated emotional state to cope with everyday stress, and to be most available for learning and interacting;
“TS” – Transactional Support – the development and implementation of supports to help partners respond to the child’s needs and interests, modify and adapt the environment, and provide tools to enhance learning (e.g., picture communication, written schedules, and sensory supports). Specific plans are also developed to provide educational and emotional support to families, and to foster teamwork among professionals.
Enhanced Milieu Teaching (EMT)
EMT is an evidence-based intervention with 20 years of research.
EMT is a naturalistic, conversation-based intervention that uses child interests and initiations as opportunities to model and prompt language in everyday contexts.
EMT can be used throughout the day as part of your everyday life.
EMT is a set of language tools to help you facilitate your child’s communication growth.
Setting up an Interactive Context enhancing opportunities for communication.
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Connecting with your child during play
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Managing challenging behavior
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Responsive Interaction: Responding to your child’s communication.
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Noticing and responding to child communication
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Taking and balancing verbal turns with your child
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Mirroring your child’s actions and mapping language onto these actions
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Modeling and Expanding Play: modeling and expanding play.
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Modeling new play actions
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Using new play objects
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Modeling Communication Targets: modeling child communication targets.
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Using language that teaches (target talk)
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Expanding your child’s utterances (expansions)
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Time Delay Strategies: using non‐verbal tasks to elicit communication.
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Milieu Teaching Procedures: prompting your child’s communication targets and providing functional reinforcement.
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Recognizing when your child’s requesting
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Following a prompting procedure at your child’s target communication level
The Greenspan Floortime Approach
The Greenspan Floortime Approach is a system developed by the late Dr. Stanley Greenspan. Floortime meets children where they are and builds upon their strengths and abilities through creating a warm relationship and interacting. It challenges them to go further and to develop who they are rather than what their diagnosis says.
In Floortime, I use this time with your child to excite his/her interests, draw him/her to connect to you, and challenge him/her to be creative, curious, and spontaneous—all of which move him/her forward intellectually and emotionally. (As children get older, Floortime essentially morphs into an exciting, back-and-forth time of exploring the child’s ideas.)
For any age child, we do three things:
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Follow your child’s lead, i.e. enter the child’s world and join in their emotional flow;
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Challenge him/her to be creative and spontaneous; and
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Expand the action and interaction to include all or most of his/her senses and motor skills as well as different emotions.
Social Thinking:
Social Thinking Methodology developed by Michelle Garcia Winner, uses evidence-based strategies to help people age 4 through adult improve their social competencies, including:
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Self-regulation
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Social-emotional learning
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Executive functioning
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Perspective taking
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Social problem solving
Social Behavior Mapping:
Social Behavior Mapping, a core treatment framework within the Social Thinking Methodology, and is a visual template that helps users figure out the hidden social rules of a given situation based on what is happening and the people present.
It helps students unpack that what’s happening around us influences our thoughts and feelings, reactions and responses. It also outlines a fundamental social concept we call the Social-Emotional Chain Reaction: how we act in a specific situation affects how others feel, how we make others feel affects how they treat us, and how we are treated affects how we feel about others and, ultimately, about ourselves.
Zones of Regulation:
The Zones is a systematic, cognitive behavioral approach used to teach self-regulation by categorizing all the different ways we feel and states of alertness we experience into four concrete colored zones. The Zones framework was developed by Leah Kuypers and provides strategies to teach students to become more aware of and independent in controlling their emotions and impulses, manage their sensory needs, and improve their ability to problem solve conflicts.
By addressing underlying deficits in emotional and sensory regulation, executive functioning, and social cognition, the framework is designed to help move students toward independent regulation.
Incredible 5 point scale:
Incredible 5-Point Scale, a behavior support created by Kari Dunn Buron and Mitzi Curtis (2003). This simple scale can be used to teach social understanding, and provides a visual representation of social behaviors, emotions, and abstract ideas. The Incredible 5-Point Scale allows abstract concepts and feelings to be made visual, concrete, static, and personal. Once a behavior is identified, it is task analyzed or broken into concrete parts. Each part is assigned a number and/or color. Then, in collaboration with the individual with ASD, these parts are assigned a label. The Incredible 5-Point Scale promotes self-management of behavior and emotional regulation.
Story Grammar Marker:
“Story Grammar” is the technical term for the parts of a story (narrative). Schools in many countries, including the United States, use the “goal-directed” style of a narrative. Story Grammar Marker® is a manipulative tool for narrative development that has several complementary resources supporting this methodology that help students in grades two through six develop reading, writing and speaking skills vital for academic and social success.The Story Grammar Marker® is a hands-on, kinesthetic tool designed with patented icons that represent the parts of a story. Children (and adults) can use the icons to “mark”—and keep track of—the situation unfolding in a story in an organized way for themselves, and for others to understand.