Saturday, November 15, 2008

The Early Start Denver Model

My ongoing investigation of various autism approaches brought me to look recently at the Early Start Denver Model. This is a developmental approach which has integrated some aspects of traditional behavioral intervention--including the intensity and the data keeping. Dr. Sally Rogers, who is the founder of this approach described autism as a "disruption of social communicative development" (which) "creates a secondary set of processes, like the exaggerated interest in objects and repetitive patterns" She goes on to say that "if we begin very early to focus on the social communicative processes, we can prevent some of the cascading effects of autism." (see the link to her name above for the full interview with Dr. Rogers) As I was reading about the Denver Model on a Mind Institute Website (click on quote below for full article), there was one sentence in particular that set me to thinking. It was a sentence that describes one of the three main goals of this intervention approach:

Consider this. Most preschool and even elementary children are interacting socially almost every waking moment. All children need to interact socially many, many hours and every day in order to learn and grow in a healthy way. Having autism does not constitute an exception to this need for learning that takes place in a social context. In fact, the social isolation experienced by children with autism, in the view of many researchers and not just Dr. Rogers, causes many of the more troubling characteristics that we associate with autism.

But, it may take a lot more effort to make sure that a child with autism has many, many hours of social interaction in a day. I often walk into a classroom, a daycare setting, or a home and see a child with ASD who is essentially alone--even though there are children and adults close by. I see children in settings where the child has almost no social interaction beyond being herded here or there and shushed. Other children on the spectrum have hours of social interaction but it is of such an odd nature (including many of our therapies) that the child cannot possibly be expected to learn to engage in the ordinary back and forth of communication by doing these things. For example, matching tasks seem to make up an inordinate amount of some children's school curriculum and the social conversation around matching things over and over is not very interesting after a while. The adults don't want this to be the case but they find it very difficult to solve the problem of social isolation and may give up trying when instead, they need to find new strategies. If you look over your child's day and week and realize that he or she is socially isolated for many more hours than typical children are, and rarely interacts with anyone about anything he or she cares about, you may want to look over every section of every day and find ways to promote meaningful social interaction in each setting, with each social partner, with new social partners, and with you.

I promote simplified social play activities on Autism Games Website for children with autism because you, as a parent or teacher or caregiver may not know enough ways to socially engage the child in your care. Play is typical social interaction for children and even though these games are simplified they are intended to be playful and fun rather than drills. They are intended to be like the play that any other child engages in spontaneously only at a level that your child can understand. These games, if you find some that work, will help you get started with one important kind of social interaction and what you learn in the laboratory of varied kinds of play will help you engage your child in other social activities as well.
In the game clip on this page, what would otherwise be a repeated sequence of solitary play (running across the floor with a truck which this little guy likes to do often) becomes social play with no more than the addition of an interesting curvy roadway (Goodwill table place mats which now have a higher purpose than uglifying someones house). Even though I was holding a camera, I could narrate the play and engage this very new verbal communicator into a little conversation. Either I or this little guy's dad would make changes to the shape of the roadway (when he was not looking) and this way have something new to talk about every time the roadway changed. Dad was excited to see that his son was trying to stay on the roadway, as prior to this game, he ran the truck back and forth in a straight line across the floor. Blue painter's masking tape would also have created an interesting roadway on the floor and the roadway could go over, under and around things that can all be changed and discussed. Truck crashing is always fun as well.

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