By Joanne Gerenser, PhD, CCC-SLP
used with permission from Different Roads to Learning www.difflearn.com
With the rising incidence of autism spectrum disorders comes the challenge of providing adequate and appropriate services. It has been widely established that Early Intensive Behavior Intervention (EIBI) offers children on the spectrum the greatest hope for positive outcomes. In fact, a percentage of children with ASD who receive effective EIBI eventually lose the diagnosis and move fully into general education. What happens, however, to the children who do NOT achieve this outcome? That is, what does the research tell us is the most effective model of intervention for teens and young adults with ASD who continue to need significant supports?
Interestingly, there is not a great deal published to guide educators as to best practice for children with ASD as they get older. We do not have clear outcome data available to benchmark our efforts. Having given this a great deal of thought in the past few years, I have decided that there are a few outcome measures that should be considered. The first, and most important, is level of independence. It is not good enough to simply teach a teen with autism to make a meal or do the laundry. The real goal is that the teen can make the meal or do his laundry in the absence of adult prompting. Data should be collected on how long a child with ASD can remain on task across preferred and non- preferred activities in the absence of adult supports. A second measure should be level of maladaptive behavior. Our goal for our teens and young adults should be to work, live, and play in the community to the greatest extent possible. These activities become significantly more restricted with the presence of very difficult behaviors. The real goal for students should be to develop self-management skills to assist in the move from high staffing patterns in schools to low staffing patterns in the adult services world.
A third measure should be effective communication skills. Each individual with ASD should have some formal way to make his or her wants and needs known to others. There are many options available to us today to provide communication systems to individuals with ASD who are not verbal. The goal, however, needs to be spontaneous and independent use of whatever system chosen. There are a number of different evaluations and program guides available today to assist those who work with teens and young adults with ASD. For example, the Assessment of Functional Living Skills (AFLS) by Partington and Mueller offers a comprehensive guide with task analyses and teaching recommendations for practical every day functional skills. Don’t forget, though, that teaching the skills alone is simply not going to be sufficient. Remember, even if the child can perform ALL of the skills in the AFLS but engages in high rates of aggression or will only complete the tasks when prompted by an adult or in adult presence, it’s like he or she does NOT have the skills at all.
There are so many children with ASD who will be aging out of the education system in the coming years. Staffing patterns in adult services programs are at best half of what they are in schools and in most cases, even worse than that. It is essential that we begin to create common outcome measures for teens and young adults. It is through these common outcome measures that we can begin to establish best practices for education programs for this population that result in independent, successful adults with autism. A good quality of life becomes the goal, and independence is the route to achieving this.
About the Author
Dr. Joanne Gerenser is the Executive Director of the Eden II Programs. She is a member of the Scientific Advisory Council for the Organization for Autism Research and a founding member of the Council on Autism Services. Joanne’s primary interests are in promoting collaboration across disciplines, particularly SLPs and Behavior Analysts as well as developing effective services for teens and adults on the autism spectrum.