The National Academy of Sciences (NAS), in its report “Educating Children with Autism” (National Academy of Sciences, Committee on Educational Interventions for Children with Autism, NRC, 2001), states that there is research support for a number of approaches, including DIR/Floortime and behavioralinterventions, but that there are no proven “relationships between any particular intervention and children’s progress” (page 5) and “no adequate comparisons of different comprehensive treatments” (page 8). The report concludes that effectiveinterventions vary depending on an individual child’s and family’s needs.
The NAS analysis further indicates that behavioral interventions are moving toward naturalistic, spontaneous types of learning situations that follow the child’s interests, and note that “studies have reported that naturalistic approaches are more effective than traditional discrete trial at leading to generalization of language gains to natural contexts” (Koegel, Camarata, Valdez-Menchaca, and Koegel, 1998; McGee, Krantz, and McClannahan, 1985).
The NAS points out that these contemporary behavioral approaches are becoming increasingly similar to developmental, relationship-based approaches that focus on working with children’s and families’ individual patterns with thegoal of creaying learning relationships that build the foundations (which have often been missing or dysfunctional) for relating, communicating, and thinking.
The academy cites ten comprehensive programs with some evidence of being effective. Three are based on developmental, relationships, and family support two are highly structured behavioral programs; and four involve combined elements including a movement toward more naturalistic teaching methods.
As indicated earlier, one of the programs has its own unique educational framework. One of the models cited by the analysis as illustrative of developmental, relationship-based models is the Developmental, Individual Difference, Relationship-Based (DIR/Floortime) approach that we describe in this book. In analyzing the research on the different models cited by the NAS, it’s useful to look at the types of gains observed and reported for the different models.
For example, behavioral approaches have tended to focus on educational outcomes as measured by structured performance-based tests and change in surface symptoms (such as perseveration and self-stimulation). Relationshipbased, developmental approaches have tended to focus more on relationships, social skills, and meaningful, spontaneous use of language and communication.The DIR/Floortime approach is unique in showing gains not only in the basic social and emotional functioning of relating, interacting, and communicating meaningfully but also, for a subgroup of children, in the attainment of capacities often thought to be beyond the reach of children with autistic spectrum disorders.
These include the capacities for making inferences, engaging in high levels of empathy, and enjoying age-expected peer relationships.
To read the complete report please click here.