From ABA to PBS, methods for working with autistic children can be a confusing soup of acronyms. It's common for schools to cherry pick from each of these strategies and use a little of each. Others however will follow one specific model, such as ABA, so if you are considering these schools, it's important to be sure that this approach is right for your child and his or her developmental stage. Some commonly used approaches are:
ABA (applied behaviour analysis)
What is it? ABA looks at the causes and the consequences of behaviour. It then makes changes to what happens before the behaviour occurs (the antecedent) and what happens after the behaviour occurs (the consequence). An antecedent may be a change to the environment, or it could involve a demonstration, for example how to interact with other children. Prompts (visual or verbal or both) may be used to indicate what should happen next. Any task, even things like ‘brush your teeth’ will be broken down into lots of smaller manageable steps. Over time the prompts and small steps will gradually disappear. The consequence is then a reward or positive reinforcement that helps the child to think, ‘When I do this, that enjoyable thing happens, so I’ll keep doing it.’
How can it help? ABA aims to develop and increase the good behaviours, and to minimise the behaviours that interfere with learning or relationships, or those that could be harmful. It can also help to teach basic skills.
Who can it help? ABA is designed to work with all age groups. But it is controversial – while some parents are firm fans, others in the autism community are critical.
PBS (positive behaviour support)
What is it? PBS seeks to understand the reason for challenging behaviour. By assessing a person’s life history, physical health and emotional needs, it looks to minimise the triggers for this by making changes to the environment or to routines. So proactive strategies might be dimming the lights, tying hair back to stop it being pulled, giving rewards, or using a sign to confirm a task is finished. Reactive strategies include not responding to behaviour, distracting the child, giving reminders, or leaving the room. A good PBS plan has more proactive than reactive strategies.
How can it help? PBS aims to reduce anxiety or confusion that can lead to challenging behaviour. Additionally, PBS teaches a child more appropriate ways of communicating and getting what they want - using words or signs for example.
Who can it help? Anyone with behavioural difficulties, including children with ASD. PBS can also be used with people with learning, developmental and social difficulties.
PECS (Picture Exchange Communication System)
What is it? PECS is a systematic way to teach a child to communicate using pictures. It provides an alternative means of communication allowing children who cannot talk or write to share their thoughts and opinions. For example, in simple terms, if a child wants a drink, he will give a picture of 'drink' to the adult who will then give him a drink.
How can it help? Originally, some believed PECS could hinder any progress with speech development. However, in practice even those previously uninterested become more open to trying other forms of communication, like speech. It also helps to alleviate frustration, minimising tantrums and challenging behaviour. It can be especially helpful to encourage children to interact and socialise.
Who can it help? PECS was originally designed for children with autism spectrum disorder and related developmental disabilities, but can be used for other non-verbal children as well as adolescents who have a wide range of communicative, cognitive and physical difficulties.
SCERTS (Social-Communication, Emotional Regulation and Transactional Support)
What is it? SCERTS is an educational model which aims to teach children with autism the core skills that are needed in order to have the best outcomes in later life, and to be able to apply functional skills in different settings. It focuses on social communication (functional communication and emotional expression) and emotional regulation (coping with everyday stress). It may involve modifying the environment or providing learning tools like picture communications, written schedules, or sensory supports.
How can it help? SCERTS provides a framework so that families, teachers, and therapists can all work on a child’s individual plan, which will cover goals and objectives for learning both at home and at school. So for example they may work in tandem on getting a child to communicate food choices at mealtime through pictures, words or gestures; or to respond in the same way when a child shows sign of emotional overload, whether that might be through offering deep pressure, or clarifying tasks with visual prompts.
Who can it help? Mainly children with ASD and their families, but the SCERTS model can also be used across a range of developmental abilities.
SPELL (Structure, Positive approaches and expectations, Empathy, Low arousal, Links)
What is it? A framework for understanding and responding to the needs of children and adults on the autism spectrum. The aim is to provide a basis for communication, and reduce the disabling effects of autism. Developed by the National Autistic Society.
How can it help? SPELL looks at ways in which we can change or structure the environment to make an individual feel safe and reduce their anxiety. It helps us to see the world through their eyes and understand which noises or smells or environments can be overwhelming.
Who can it help? Any child on the autism spectrum. It works well with other interventions, especially TEACCH.
TEACCH (Treatment and Education of Autistic and Communication-Handicapped Children)
What is it? In collaboration with parents, TEACCH looks to understand the whole child or adult, focusing on their skills, interests and needs. Individual plans are designed to make the most of their strengths within a structured environment. This is sometimes called ‘structured teaching’ and involves looking at the physical structure or the organisation of the room, visual schedules (where/when/what the activity will be), visual information (what can we do in this work or play area), and task information (visually clear information on what the task is about).
How can it help? The TEACCH programme helps to prepare people with autism to live or work more effectively at home, at school and in the community by focusing on communication and social skills, independence, coping skills and skills for daily life. It provides a wide range of services including educational services, supported employment programmes, parent training and counselling and individualised treatment programmes.
Who can it help? Any child or adult with autism. Some people may need some form of TEACCH in place throughout their whole life. TEACCH is a key element of the SPELL approach and the National Autistic Society’s Earlybird programme.
NAS Earlybird (National Autistic Society Earlybird)
What is it? A support programme aimed at families of preschool children. Parents sign up for group training sessions and home visits, which help them to understand autism, communicate with their child, and manage behaviour.
How can it help? It helps parents to understand their children and establish good practice at an early age by using techniques from TEACCH, PECS and SPELL.
Who can it help? It supports parents of children under 5 years old. The NAS EarlyBird Plus Programme is for families whose child is 4-8 years old.
What is it? Portage is a home-visiting educational service for pre-school children with special needs. It focuses on three main elements; child-led play, structured teaching and family focus. Portage teachers show parents how to take a ‘small steps’ approach to learning, breaking down long-term goals into achievable targets.
How can it help? Through playing and learning together at home, home life for the whole family can be improved. Plus, families can work together on the skills needed to interact and socialise outside of home.
Who can it help? Children with special needs and their families.
The Son-Rise programme
What is it? Sometimes also known as the Options Method, it's an alternative autism treatment where parents lead the teaching and therapy at home, where the child feels safest. Parents learn how to ‘join’ their child in their world so they can build a relationship before trying to teach any new skills. If the child starts flapping his hands or repeating an action, parents must copy. Parents learn to relate to the child in a way that the child can understand and a trust is built between them.
How can it help? By establishing trust, parents can then begin to teach through play, helping to develop communication and social skills.
Who can it help? Children on the autism spectrum as well as children with other disabilities.
Auditory Integration Training (AIT)
What is it? AIT is an educational music programme based on the idea that some people are hypersensitive (over-sensitive) or hyposensitive (under-sensitive) to certain frequencies of sound. This can cause issues with concentration, understanding or communication, and may lead to irritability, tantrums, slow responses and tiredness.
How can it help? AIT involves a person listening to a selection of music that has been electronically modified so the frequencies have been changed. The aim is to reduce ‘distorted’ hearing and hypersensitivity of specific frequencies by ‘re-educating’ the brain, so that all frequencies can be heard equally well.
Who can it help? People who have ADHD, ADD, dyslexia, hearing sensitivities, autism, developmental delays, poor concentration, speech and language problems as well as a variety of other special needs.
Sensory Integrative Therapy/ Sensory integration training
What is it? A therapy to help people cope with sensory difficulties by exposing them to sensory stimulation in a structured, repetitive way. Sensory difficulties could be noise or taste-related, or they could be tactile or visual.
Treatments could involve wearing a weighted vest, being brushed or rubbed with various instruments, riding a scooter board, or sitting on a bouncy ball.
How can it help? The idea is that through repetition, the brain will adapt and respond in a more ‘organised’ way to sensations and movement. Sensory difficulties can make everyday situations unbearable, but therapy can change the lives of whole families, enabling them to do everyday things like taking a trip to the supermarket together.
Who can it help? Any child or adolescent, particularly with ASD, who struggles to process sensory information such as textures, sounds, smells, tastes, brightness and movement.