Early Intervention

for Children with

Autism Spectrum
Disorders:
Guidelines for
Best Practice

Margot Prior
and
Jacqueline Roberts
2006

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 A
utism is a severe neurodevelopmental
disorder beginning at birth or shortly
after. The characteristic symptoms have
been described as a triad of impairments
involving delay and deviance in social and
communication development, along with restricted
interests and repetitive behaviours. The term Autism
Spectrum Disorders (ASD) covers diagnostic labels
which include Autistic Disorder, High Functioning
Autism, Asperger Syndrome, and Pervasive
Developmental Disorder – Not Otherwise Specified
(PDD-NOS). Children with these labels all share the
social and communicative symptoms which are the
core of autism, but they vary in severity of symptoms
and in level of functioning. No specific cause has yet
been identified although there is evidence that autism
may be inherited to a degree in some cases. To help
children with autism it is essential to focus on the
earliest years of development, since this is a critically
important time for early learning which powerfully
affects the child’s future life course.

A review of early intervention (EI) services for children

with autism was undertaken by the authors during
2006 for the Commonwealth Department of Health
and Aging, to evaluate the evidence of the value of the
available intervention programs. The review can be
found on the DoHA website.

Roberts, J. M. A., & Prior, M. (2006).

A review of the research to identify the most effective
models of practice in early intervention of children with
autism spectrum disorders. Australian Government
Department of Health and Ageing, Australia.

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 This booklet provides: a summary Educational Interventions (see full table in
comment on research findings relating to the review document)
early intervention for autism; an outline
of the kinds of programs available in Type of program
Australia; research and evidence based
guidelines for best practice in early Behavioural Interventions
intervention; and a list of contacts for Focus on application of learning theory
programs across Australia. and skill development. Use Applied
behaviour Analysis (ABA)
Evidence based treatment guidelines
are particularly important in the field of Developmental Interventions
autism where there has been so much Focus on building relationships and
debate, and where there are many heavily development of social emotional
promoted approaches for which there is no capacities. Example; Relationship
scientific evidence, and which can even be Development Intervention (RDI)
harmful.
Intensive educational and behavioural Therapy based Interventions
interventions have produced positive Focus on communication and social
outcomes for children with autism. There development or sensory motor
is little supporting evidence for other development. Usually designed for use
kinds of programs, or for medical or with other interventions. Example;
drug treatment. Some drugs may help Picture Exchange Communication
in treating particular symptoms such as System (PECS), Auditory Integration
agitation and aggression in some children, Training (AIT).
but none can ‘cure’ autism. Many families
are choosing to try a variety of alternative Combined Interventions
therapies, but there is no scientific Incorporate behavioural and
evidence that any of these can make a developmental strategies. Often include
significant difference. Information about sensory issues. Focus on working with
biologically based interventions can be and managing the characteristics of
found in the review (Roberts and Prior, autism. Example; TEACCH (Treatment
2006). A summary of various kinds of and Education of Autistic and related
educational and behavioural interventions Communication handicapped CHildren)
is provided in the adjacent table.
Other Interventions
Example; Music Intervention Therapy

Family Based Interventions

Focus on working with families to
develop skills in working with their
children. Example; The Hanen Program

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 The most systematic evidence available • Support for children in their transition
has come from evaluations of intensive from the preschool classroom.
behaviour intervention programs, such as • Support for family members including
The Lovaas program which uses Applied partnership with professionals involved
Behaviour Analysis (ABA) including Discrete in treatments.
Trial Training (DTT). These evaluations
have shown improved learning and Number of hours of treatment per week
behavioural development in a significant To be successful EI needs to be extensive
proportion of children. However these and intensive. A minimum of 20 hours a
methods do not suit all children and week over two or more years is essential
families, and strict conditions of timing, for young children to make major gains.
intensity, and quality of therapist training
influence the success of these methods. Individual Variation
Other programs have so far not provided
It is important to account for the whole
sufficient evidence of short or long term
spectrum of autism disorders and to
improvement to qualify for unreserved
recognise that no one child with autism
support.
will have the same pattern of strengths
Reviews of programs available and needs as another. In addition, families
internationally for children with autism differ in their goals, strengths, and needs.
are cautious in their conclusions about
Hence, no one program will suit all
longer term outcomes for the children,
children with autism and their families.
in social, adaptive or vocational areas, or
There are benefits from early, intensive,
greater independence in adulthood. There
family-based treatment programs, so long
are too few well controlled studies to allow
as these are adapted to the child’s pattern
for confident claims about what types of
of strengths and weaknesses and take
intervention are best for improving long
account of family circumstances
term learning and adaptive functioning
into adulthood.
We can define the key common elements
which are necessary for effective
intervention. Effective intervention
provides:
• An autism specific curriculum content
focusing on attention, compliance,
imitation, language, and social skills.
• Highly supportive teaching environments
which deal with the need for
predictability and routine, and with
challenging behaviour, obsessions, and
ritual behaviours.

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 BEST PRACTICE GUIDELINES Direct observation of the child is important
in the assessment of cognitive, social,
Reference to the guidelines presented here communicative (verbal & nonverbal), fine
will help parents, carers and professionals and gross motor, and adaptive functioning
to judge the value of programs for children with standardised tests and informal
with autism. procedures. The assessment should detail
It is not our role to recommend any the child and family strengths and areas
specific program. We provide a set of of need, to guide the development of
guidelines to interventions of value, which intervention and management plans. With
can help in decision making about the very young children, re-assessment and
suitability of any program on offer for review within a year is desirable, since
children with autism. behaviour may change and the effects of
intervention need to be monitored.
Recommendations for best practice in Recommendations from the assessment,
Early Intervention and implications for intervention support
should be combined in a comprehensive
i) Preparation written report presented to the family.
All children on entering intervention Contact and consultation with potential
programs should have had a intervention program providers needs
comprehensive, multidisciplinary to be part of this process. Entry to an
diagnostic assessment from an intervention program should follow as
interdisciplinary team of experienced soon as possible following the assessment
clinicians based on national and and diagnostic evaluation.
internationally agreed criteria. Diagnostic
ii) Timing
evaluations should include;
Intervention should begin as early as
• interviews with parents/care givers to possible in the child’s life, (optimally
review the child’s developmental history, between 2 and 4 years).
family history, previous assessments and
interventions; iii) Process
• collection of information from all All children should have an Individual Plan
professionals involved in the care of the (IP), for their education, designed to best
child; fit their needs and strengths, developed in
consultation with parents, and reviewed
• paediatric, psychological, and speech and revised regularly in light of the child’s
pathology examinations to assess progress and ongoing needs
communication, relevant health
conditions including motor skills, iv) Intensity
vision, and hearing, and any associated A program needs to be of at least 20 hours
problems such as intellectual disability per week over an extended period of at
and anxiety. least two years, with continuing support
into, and through the school age years.

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 v) Content and focus viii) Problem behaviours
Autism specific content including: A functional approach to problem
behaviours including positive behaviour
Teaching joint attention skills, play, and
support (PBS) which includes teaching
imitation skills.
alternative appropriate skills and
Building functional communication skills communication skills to replace the
through language and Alternative and problem behaviours.
Augmentative Communication (AAC) such
as picture systems, gestures and signs. ix) Staffing
Teaching social interaction skills in a Teachers, therapists, and child-care
supported environment. personnel should be specifically trained
in working with children with autism and
Daily Living skills, e.g. toileting, washing have knowledge and skills required for
hands, eating. their special needs.
Management of sensory issues.
x) Family collaboration
Generalization of learning strategies to
new situations and with new people Parents need information about autism
and services, especially at key times like
Management of undesirable or challenging first diagnosis and school entry. Programs
behaviours. should include parent involvement, such
vi) Settings as provision of support, counselling, and
parent education to help the child with
Programs can be delivered in various play, social, and communication skills
settings, individually, and with peers. Both development, and with management of
centre-based and individual/home-based challenging and repetitive behaviours.
interventions are valuable. Including
typically developing peers for at least a Families are often in need of respite care,
part of the program is highly desirable but hence reliable provision for this service is
peer interaction needs to be supported. essential to decrease family burden and
stress.
vii) Program design and methods
xi) Associated therapies
A high degree of structure in the program
is essential, i.e. well organized, regular and Multidisciplinary collaborative teams
predictable, focused on specific objectives, including specialist support such as
and consistently managed. speech therapy, occupational therapy and
counselling should be available as needed.
A supportive teaching environment with
modelling, prompting, praise, shaping, xii) Research and evaluation of program
and generalization strategies will maximise Evaluation of treatment outcomes should
learning. be built into EI programs using systematic
Centre based programs require a low child/ assessment of the child’s social, cognitive,
staff ratio with a maximum of 2-4 children and adaptive functioning before, during,
per adult. and at the end of the program.

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 xiii) Transition most children in the toddler age period
There should be systematic connection and (18 - 30 months). Very early therapeutic
integration between the early intervention intervention is likely to improve
program and the next stage for the child, developmental and adaptive outcomes so
whether it is transition to school or to it will be necessary to develop, implement
another therapeutic or special educational and evaluate interventions for this age
setting. Parents, teachers and therapists group in Australia. Trials of interventions
need to collaborate in preparing the child in the USA and UK are focusing on
for transition. training parents to work with their very
young children in the key areas of social
Interventions for Infants responsiveness, attention skills, early
communication skills, and interactive play.
Recognising and diagnosing autism before
pre-school age has been uncommon Information families need. Families
until the last few years. But increasingly should ask for more than personal stories
autism is being identified very early in of treatment success when deciding
development. It has been shown that which intervention programs would be
diagnosis can be valid and reliable at 2 safe and beneficial for their child. When
years of age, and signs can be recognisable considering a program for your child use
and predictive of autism even from early the information provided in this booklet
in the second year of life. In future it is to determine the extent to which the
likely that autism will be diagnosed for program meets recommended guidelines.

INTERVENTION SERVICES FOR CHILDREN WITH AUTISM AND

THEIR FAMILIES IN AUSTRALIA
Please note that while every effort was made to ensure this information is as accurate, up
to date and comprehensive as possible, there may be services which are not included. See
review for information about program costs, type, waiting times, staff training and more.
State Lead Agency Program Contact
Autism Intervention Units
ACT Department of Education Communication & Social
(02) 6205 9198
and Training Awareness Playgroups
Learning Support Units (Autism)
ASD consultancy and
ASD Consultancy and Support Service
ACT (02) 6291 0425
Support Service The Social and
Friendship Skills Program
Gay Von Ess, Autism Consultant
Consultancy services 0413 776 922
& Special Educator
Autism Assessment
Therapy ACT (02) 6205 1274
and Family Support Team
Continued on page 7

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 State Lead Agency Program Contact
ASPECT Schools for Children
with Autism
Building Blocks Early
Intervention Services
Behaviour Intervention Service
Autism Spectrum Australia
Central Coast School Early (02) 8977 8300
(ASPECT)
Intervention Service
Jigsaw Program
“Recipe for Success”
Parent/Carer Training Program
School Outreach Service (SOS)
Autism Behavioural
Behaviour Support Program 0438 074 604
Intervention NSW
NSW Connect Therapy Connect Therapy 0402 119 319
Centre for Autism and Related Centre for Autism and Related
(02) 9763 5466
Disorders (CARD) Disorders (CARD)
First Chance:
Early Childhood Intervention (02) 4921 5000
The University of Newcastle
Early Learning
Giant Steps (02) 9879 4971
Play Steps
Hunter Prelude Early
Hunter Prelude (02) 4937 4549
Intervention
Supported Playgroups
Koorana Child and Home Based Early Intervention (02) 9750 4100
Family Centre Inclusion Support Program
Preschool Preparation Group

Continued on page 8

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 State Lead Agency Program Contact
Let’s Play (02) 9534 1710
Early Starter’s Program
Learning Links Preschool
Linking with Pre-School
Learning Links Program
(02) 9534 1710
Parents experiencing children
with autism
The Hanen Program:
More Than Words
Various Programs throughout
Lifestart Cooperative Ltd (02) 9807 9700
Sydney
NSW
Lizard Children’s Centre Lizard Children’s Centre (02) 9428 2467
Macarthur Early Childhoold
Mission Australia (02) 9641 5000
Intervention Service
Pathway Early Childhood Pathway Early Childhood
(02) 9572 8840
Intervention Service Intervention Services
Relationship Development Relationship Development
(02) 9405 5833
Intervention (RDI) Intervention (RDI) Program
Sound Therapy International Sound Therapy for Children 1300 55 77 96
Together Hand in Hand Together Hand in Hand
Wisconsin Early Autism Project Early Autism Project Pty Ltd (02) 9310 7322
Woodbury School Woodbury School (02) 9639 6152
Autism Behavioural Autism Behavioural
(07) 3264 2582
Intervention Queensland Intervention Queensland
Autism Early Intervention Autism Early Intervention
QLD (07) 3849 6099
Outcomes Unit (AEIOU) Outcomes Unit (AEIOU)
Autism Intervention and
Applied Behavioural Analysis 0402 854 390
Management Strategies

Continued on page 9

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 State Lead Agency Program Contact
ProAQtive Early Intervention
Group Placement
Autism Queensland (07) 3273 0000
Early AQtion Programs +
Advisory Visits
QLD Little Souls Taking Big Steps Little Souls taking Big Steps (07) 55 631 490
Minds and Hearts Clinic Minds and Hearts Clinic (07) 3844 9466
Intensive Hone-Based Applied
symetry.psych
Symmetry Psychological Services Behaviour and Verbal Behaviour
@bigpond.com
Intervention Program
Diagnostic Services
Autism SA The Early Development Program (08) 8379 6976
Family Support Program
Department of Education The Briars Special Early
(08) 8365 9808
and Children’s Services Learning Centre
SA
Pyramid Educational Pyramid Educational
(08) 8240 3811
Consultants of Australia P/L Consultants of Australia P/L
Aquatic Therapy for Children
SASRAPID Inc (08) 8410 6999
with Autism
School of Psychology, Early Intervention
(08) 8201 5104
Flinders University EI Reserach Program
Autism Behavioural Autism Behavioural
(03) 6223 2317
Intervention Tasmania Intervention Tasmania
TAS Behavioural Intervention Behavioural Intervention
0409 557 958
Services Services
Giant Steps Giant Steps (03) 6362 2522
Autism Behavioural Autism Behavioural
(03) 9830 0677
Intervention Association (ABIA) Intervention Association (ABIA)
Integrated Education Integrated Education
VIC (03) 9893 5547
and Communication and Communication
Irabina Childhood Irabina Childhood
(03) 9720 1118
Autism Services Autism Services

Continued on page 10

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 State Lead Agency Program Contact
Barwon ECIS flexible packages
program
Gateways Support Services (03) 5221 2984
Gateways early childhood
Intervention program
Illoura Early Childhood
Knox City Council (03) 9758 7991
Intervention Services
Mansfield Autistic Centre & Mansfield Autistic Centre &
(03) 5775 2876
Travelling Teacher Service Travelling Teacher Service
Noah’s Ark West
Noah’s Ark West (03) 9304 7402
Autism Program
Pam Langford ABA or Intensive Behavioural
(03) 9553 8808
VIC Psychological Services Intervention Programs
Kalparrin ECI Program/Specialist Northern Autism
(03) 9435 8311
Children’s Services Outreach Service
Southern Autistic School Southern Autistic School (03) 9563 8139
The Learning For The Learning For Life
(03) 9836 0422
Life Autism Centre Inc. Autism Centre Inc.
Victorian ABA Providers Pty Ltd Victorian ABA Providers Pty Ltd (03) 5485 2036
WestArc – Autism Program WestArc – Autism Program (03) 9284 7267
Western Autistic School Western Autistic School (03) 9337 9175
Yooralla Society of Victoria + Early Childhood Autism Services
(03) 9359 9366
Broad Insight Group – Northern
Autism Association
Early Intervention Program (08) 9489 8900
of Western Australia
David J Leach The Whole Behaviour Program (08) 9456 2423
Department of Education
Autism Units (08) 9264 4111
and Training
WA
Disability Services Commission Mildred Creek Autism Team (08) 9472 1608
Individual and Family Support,
Disability Services Commission (08) 9426 9200
Home Based Autism Service
DSC funded program
ISADD (08) 9397 5970
Private funded program
Continued on page 11

10

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 State Lead Agency Program Contact
Kim Beazley School
Kim Beazley School (08) 9335 7933
ABA Program
WA Leaps and Bounds Inc Leaps and Bounds Inc (08) 9401 8119
Therapy Focus in
Therapy Focus (08) 9478 9500
Early Intervention

CONTACT INFORMATION FOR AUTISM ASSOCIATIONS IN AUSTRALIA

Autism Council of Australia

Head: Mr Mick Clark (President)
Phone: (02) 8977 8300 (Secretary)
Web: http://www.aspect.org.au/aca/
Autism Victoria
Head: Mrs Amanda Golding (CEO)
Phone: (03) 9885 0533
Email: [email protected]
Web: http://www.autismvictoria.org.au
Autism Association of Western Australia
Head: Jon Martin (Executive Director)
Phone: (08) 8379 6976
Email: [email protected]
Web: http://www.autismsa.org.au/html/contact.html
Autism Spectrum Australia (ASPECT)
Head: Adrian Ford (CEO)
Phone: (02) 8977 8300
Email: [email protected]
Web: http://www.aspect.org.au/contact/centraloffice.asp
Autism Association of Western Australia
Head: Mrs Joan McKenna Kerr (Executive Director)
Phone: (08) 9489 8900
Email: [email protected]
Web: http://www.autism.org.au/

11

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 Autism Tasmania
CEO: Mrs Rose Clark (President)
Phone: (03) 6423 2288
Email: [email protected]
Web: http://www.autismtas.org.au/oldsite/index.htm
Autism Northern Territory
Head: Alison Bird (Director)
Phone: (08) 8948 4424 (9-1pm)
Email: [email protected]
Autism Queensland
Head: Mrs Penny Beetson (CEO)
Phone: (07) 3273 0000
Email: [email protected]
Web: http://www.autismqld.asn.au/
Autism ACT
Head: Mrs Gaye Von Ess (President)
Phone: (02) 6290 1984
Email: [email protected]
Web: http://autism.anu.edu.au/

The full text of

A review of the research to identify the most effective models of practice in
early intervention of children with autism spectrum disorders
by Jacqueline Roberts and Margot Prior
available on the website of
the Australian Government Department of Health and Ageing
www.health.gov.au
(review includes this booklet both in abreviated and
more comprehensive versions)

12

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 Early Intervention
for Children with
Autism Spectrum
Disorders:
Guidelines for
Best Practice

Margot Prior
and
Jacqueline Roberts
2006

3501 Autism Book Covers 02 1-2 8/1/07, 1:50 PM