Intervensi adalah bentuk hambatan yang mungkin dialami peserta didik dalam proses pembelajaran. Hal ini sangat berdampak dalam proses pendidikan, karena bisa menghambat perkembangan serta proses belajar. Intervensi dilakukan setelah asesmen dilakukan.

1. A N I S Y A H D E WI S Y A H F I T R I . , M . P D
INTERVENSI BAHASA
PADA ASD

2. BAHASA RESEPTIF
1. Pengertian Bahasa Reseptif
• Bahasa (language) adalah suatu bentuk
komunikasi baik secara lisan, tertulis maupun tanda
yang didasarkan pada sebuah sistem simbol-
simbol.
• Bahasa terdiri dari kata-kata yang digunakan oleh
suatu komunitas dan aturan untuk memvariasikan
dan menggabungkannya.
• Bahasa diperlukan untuk berbicara dengan orang
lain, mendengarkan orang lain, membaca dan
menulis (Santrock, 2011).

3. • Bahasa reseptif mendasari segala penggunaan
fungsi komunikasi (meminta benda, meminta
seseorang melakukan tindakan, menanyakan
informasi, memberi pernyataan, merespon
pertanyaan ya dan tidak (Paul & Cohen 2015).
• Bahasa reseptif yang berkembang normal dapat
dilihat dari ketepatan perilaku atau respon verbal
terhadap pesan yang disampaikan (Napitupulu,
2019).

4. • ASD yang menunjukkan kesulitan dalam bahasa
reseptif sangat mungkin mengalami kesalahan dalam
menginterpretasikan komunikasi, tidak mampu
bertanya untuk mengklarifikasi, menjadi frustasi dan
bingung, merusak barang, berperilaku agresif, menarik
diri atau melukai diri sendiri (Charles, Camerata &
Stephen 2012;

5. • Hernawati (2019), Anak yang mengalami
gangguan bahasa secara reseptif memiliki kesulitan
memahami bicara atau apa yang dikatakan orang
lain kepadanya. Meskipun pendengaran mereka
normal namun anak yang memiliki gangguan ini
tidak dapat memahami suara-suara, kata-kata
atau pernyataan-pernyataan. Dalam beberapa
kasus yang berat, anak tidak mampu memahami
kosa kata dasar atau kalimat sederhana, dan
kemungkinan besar mereka juga mengalami
ketidakmampuan mengolah suara, dan kesulitan
memehami simbol-simbol.

6. • Penyempitan pada area broca menyebabkan
kesulitan bicara, gangguan perencanaan dan
pengungkapan ujuran (kalimat yang diproduksi
terpatah-patah, ucapan tidak jelas).
• Perluasan area werniks berhubungan dengan
kesulitan memahami pesan dari penyampai pesan
(Napitupulu, 2019).
• Gangguan pada wilayah perifer atau tepi
disebabkan karena tidak berkembangnya paru-
paru, adanya gangguan pada fungsi oramotor
(lidah, pipi, dan rahang) dan gangguan pada alat
sensor (Danuatmaja

7. • Hambatan bahasa reseptif dan ekspresif pada anak
autisme disebabkan karena adanya gangguan
pada pusat bahasa diotak dan gangguan diwilayah
perifer atau tepi.
• Gangguan pada pusat otak terjadi pada werniks
dan broca’sarea.
• Gangguan dapat berupa penyempitan (aktivasi)
area broca dan perluasan (aktivasi) area wernicke
dari ukuran normal.
• , 2019)

8. 2. Aspek-aspek Bahasa Reseptif
• Aspek memahami
Secara operasional mamahami dapat diartikan dalam
konsep untuk membedakan, mengubah,
mempersiapkan, menyajikan, mengatur,
menginterpretasikan, menjelaskan,
mendemonstrasikan, memberi contoh, memperkirakan,
menentukan dan mengambil keputusan.
• Aspek merespon
Respon adalah setiap tingkah laku pada hakekatnya
merupakan tanggapan atau balasan (respon)
terhadap ransangan atau stimulus. maksudnya adalah
suatu reaksi atau atau jawaban yang bergantung dari
stimulus yang telah diterima

9. 3. Faktor-faktor yang Mempengaruhi Bahasa Reseptif
Penyebab gangguan bahasa reseptif seringkali tidak
diketahui, tetapi diduga terdiri dari sejumlah faktor yang
bekerja dalam kombinasi, seperti:
• kerentanan genetik , eksposur untuk bahasa,
dan pemikiran mereka perkembangan umum
• kognitif (dan pemahaman) kemampuan.
gangguan bahasa reseptif yang sering dikaitkan
dengan gangguan perkembangan seperti
autisme.
Dalam kasus lain, gangguan bahasa reseptif
disebabkan oleh cedera otak seperti trauma, tumor
atau penyakit

10. 4. Ciri-Ciri Menderita Gangguan Bahasa Reseptif
Hidayat (2017) Anak-anak dengan gangguan bahasa
reseptif, memiliki ciri-ciri sebagai berikut:
• Tidak mampu memulai suatu percakapan dengan
orang lain.
• Menggunakan kata-kata yang kurang tepat di
setiap percakapan.
• Tidak sanggup mengungkapkan kembali informasi
yang telah diterima kepada orang lain.
• Bergantung dan hanya terfokus kepada frase dan
kalimat-kalimat yang sederhana.
• Kesalahan dalam penulisan dan gramatikal suatu
kalimat atau percakapan.
• Kesulitan menggunakan bahasa lisan.
• Menggunakan kata kata yang salah dalam tugas
tugas sekolah

11. 5. Hambatan Bahasa Reseptif
Hernawati (2019) gejala hambatan bahasa
reseptif berbeda, tetapi pada umumnya adalah:
• Tidak mampu mendengarkan ketika ditegur
• Ketidakmampuan memehami kalimat
secara utuh
• Ketidakmampuan untuk mengikuti perintah
secara verbal
• Parroting kata atau ucapan (echolalia)
• Keterampilan berbahasanya rendah
dibawah usianya

12. PENGKAJIAN TINDAKAN TERAPI WICARA
• Wawancara
- Checklis
- Format
tanya
jawab
- Format
daftar
pertanyaan
• Pengamatan
• Tes
• Studi
dokumentasi
PEROLEHAN DATA PENGOLAHAN
DATA
• Validasi data
• Pengelompokkan
• Analisa data
• Perumusan/
Penentuan
diagnosis
• Prognosis
PERENCANAAN INTERVENSI EVALUASI
• Tujuan
program
- Panjang
- Pendek
- Harian
• Materi terapi
• Metode terapi
- Nama
- Langkah-
langkah
• Alat terapi
• Rencana terapi
- Durasi
- Frekuensi
• Rencana
evaluasi
• Tujuan –
program
• Metode terapi
• Alat terapi
• Langkah
terapi
• Evaluasi
• Advis
Berhubungan
dengan
• Perolehan
data
• Pengolahan
data
• Perencanaan
• Tindakan
• Ringkasan
akhir
REKOMENDASI
&
TINDAK LANJUT
• Terapi Selesai
• Terapi Dirujuk
• Terapi
Dihentikan
EDUKASI
DIKEMBALIKAN
TIDAK ADA
GANGGUAN
MANDIRI
RUJUKAN
SKRINING
ADA GANGGUAN
TATALAKSANA PELAYANAN
TERAPI WICARA
Permenkes RI Nomor 81 Tahun Tentang Standar Pelayanan Terapi Wicara,
C. Alur Pelayanan Terapi Wicara

13. ALUR PELAYANAN TERAPI WICARA
PENGKAJIAN
TINDAKAN
TERAPI
EVALUASI
 PEMEROLEHAN
DATA
 ANALISA DATA
 PERENCANAAN
TERAPI
 INTERVENSI
 EVALUASI UNTUK
TINDAKAN LEBIH
LANJUT
 EVALUASI SETIAP
KEGIATAN

14. ENSORY
YSTEM
S

15. SENSORY INTEGRATION
“The neurological process that organizes
sensation from one’s own body and from
the environment and makes it possible
to use the body effectively within the
environment.”

16. SENSORY INTEGRATION
 Designed to build up filtering
 Desensitization is to balance excitation
and inhibition
 Myelin – insulation on axon so stimulus
propelled more efficiently and
accurately
 Pruning process defective (over and
under) – leads to brain that has trouble
adapting to world

17.  Understand how neurological systems reacts and
interprets stimuli
 Individual Differences (Greenspan & Wieder (1998)
 sensory modulation (hyper / hypo responsiveness)
 processing
 motor planning & sequencing
 Nature vs. Nurture Dance
 Brain partially wired at birth; Rest occurs after birth;
genes & environment interact together
 Plasticity through puberty
 Support biology to overcome /compensate for deficits
 Brain creates itself through experiences; every
experience helps create connections

18. ABERRANT SENSORY
SYSTEM RESPONSES
Muscles
&
Joints
V
estibular
Organ
Light Touch
Temperature
Deep Touch
or Pressure
HYPER-RESPONSIVE
Taste
Smell
Movement
HYPO-RESPONSIVE
Sight
Hearing
Touch

20.  Inner ear; responds to gravity, weight
changes, position in three planes
 Stimulate by moving head; don’t have
to move whole body
 90% of cells in visual cortex also
respond to vestibular system
 85% of material presented for learning
is visual in the early years

21.  Peripheral Vision versus Focal Vision
 Peripheral = primitive, early vision; fight or
flight
 Focal / Central = higher level visual
development
 Developmental
 Watching marble in a maze helps develop focal
vision
 Watch to see if child using eyes together or
alternately - need both eyes for depth perception

22. CORTEX
PROCESSING
RETICULAR FORMATION
SCREENER AROUSAL
VESTIBULAR SYSTEM
NEUROLOGICAL CONNECTION

23. BIOCHEMICAL TEETER-
TOTTER
Endorphins
Anxiety
Anxiety
Endorphins

24. PENDULUM OF
EMOTIONS
Low
Energy
Quiet
Alertness
Optimal Level
High
Energy

25.  Individuality of Sensory Triggers
 Personal Preferences
 Calm Flooding vs. Vigorous
Exercise
 Time Element
 Maintain Biochemical Balance

26. INTERNAL VS. EXTERNAL
“The perceptual problems of deafness, muteness, and
blindness are experienced as very real. They are, nevertheless,
caused by extreme stress, brought on by an inability to cope
with emotion. Perhaps this very real perception and the
behavior it leads to are caused by oversensitivity triggering
protective chemicals or hormonal responses in the brain.
Perhaps in something of a vicious circle, this emotional
hypersensitivity in turn leads to developmental problems…which
leaves such children functioning on a far more sensory time and
space.”

27. SELF-STIMULATORY
BEHAVIORS
 Rocking, hand-shaking, flicking objects
“Provide security and release, and thereby
decrease built-up inner anxiety and tension,
thereby decreasing fear. The more extreme the
movement, the greater the feeling I was trying to
combat.”
 Laughing
“Often a release of fear, tension, and anxiety

28. MODIFICATION
“…under overload conditions any of
several meaning systems can shut down
partially or completely, in combination
or isolation. Sensorially, this can mean
that any one or any combination of the
senses can become extremely acute.”

29. Sensory Kit
ALTERNATIVES T O PROVIDE SENSORY I N P U T WITHOUT B E I N G
DISRUPTIVE / I N A P P R O P R I A T E

30. BRAINSTORMING
SESSION
 Proprioceptive /Vestibular
 Visual
 Auditory
 Tactile
 Olfactory / Gustatory

31. Contractions of muscles and joints to
mediate appropriate body movements
 Improve body awareness in space
 Therapy in front of mirror – provides
visual
 Pair speech production with motor
movements
 Jump on mini-tramp, say sound/words
 Clap out spelling words
 Climb stairs reciting alphabet
 T-stool, therapy ball, stand at desk

32. Information about body in space; mediated
primarily in balance centers of inner ear
 Modify/shape self-stimulatory behaviors
 Engage in bilateral and cross lateral
games and activities
 Movement exercises and activities
 Isometric and aerobic exercise breaks
 Walking, running, treadmill, stationary bike
 Sit and spin
 Rocking chair, scooter board
 Swinging

33. Stimuli received in the retina; relatively
concrete for interpretation
 Develop central focal vision
 Use slant board to present material
 Monitor and modify aversive stimuli
 Poor visual perception leads to
distortion
 Handwriting - poor letter formation and
orientation on page
 Reading and interpretation of diagrams

34. acoustic stimuli defined by decibels
(volume) and frequency (pitch)
 Music
 Desensitization to environments
 Barrier noise to control aversive
stimuli
 Teach alternative behaviors to
outbursts
 Use positive to avoid negative

35. STRATEGIES FOR TACTILE:
density and type of receptors in the skin
 Use deep pressure for calming
 Cape, hat, weighted vest, mat
 Bean bag, “pizza pocket”
 Water play, water table, ball pit
 Wrap up in blanket
 Identify problematic touches
 Desensitize

36. Smell based in chemical receptors in nasal passages;
taste based in chemical receptors of tongue
 Identify pleasant / like vs. unpleasant
/ don’t like
 Desensitize in gradual steps
 Use likes to approach dislikes
 Teach alternatives to inappropriate
outbursts

37.  Internal vs External Trigger
 Play Detective; Don’t Treat Symptom
 Analyze Behavior (e.g., confusion, control)
 Behavior = Nonverbal Communication
 Legitimate problems
 Be cautious re: quick fix
 Modify / Shape /Sensory ‘Toys’
 Sensory Breaks

38. DEAL WITH PRODUCTIVELY
 CLEAR EXPECTATIONS; RULES
 CONSISTENCY
 LOGICAL CONSEQUENCES
 STAY CALM
 REMAIN OBJECTIVE
 SENSE OF SECURITY
 COMFORT ZONE
 ENDORPHIN ACTIVITY

39.  Sensory Defensiveness (mild, moderate,
severe)
 Logic Behind Behavioral Disruptions
 Use Sensory System as Facilitator
 Respect Sensory Sensitivity
 Down-Time vs. Time-Out
 Prepare; Pre-warn
 Provide Structure

40. SENSORY PROCESSING
DISORDER
• Immature or delayed myelination in
neurological development will result in
sensory system differences
• Sensory deficits can occur independent of
autism spectrum disorder
• Often accompany medical syndromes (i.e.,
Down Syndrome, Fragile X, Rett
Syndrome) and cognitive/intellectual
impairments

41. SENSORY PROCESSINGABNORMALITIES
• Cross-sectional study examined auditory, visual, oral,
and touch sensory processing as measured by
Sensory profile
• 104 subjects with diagnosis of ASD
• 3-56 years of age
• Gender and age matched to community controls
• ASD had abnormal auditory, visual, touch, and oral
sensory processing significantly different than
controls
• Lower levels of abnormal sensory processing in later
ages
• Conclusion: Global sensory abnormalities in ASD
involving several modalities; potential to improve
with age

42. ASD- PROLONGATION IN
‘TEMPORALBINDING WINDOW’
• Brain has trouble associating visual and auditory
events
• Weakness in binding or pairing audio and visual
stimulation
• Hypothesize have difficulty dealing with more
than one sense and a time
• Results in a confusion between the senses

43. ISSUES TO CONSIDER
Don’t judge success/failure too quickly
Do careful observation of sensory
system
Justify sensory “toys”
Balance movement and quiet time
Routines and structure
AND …..

44. STRATEGIES FOR
STIMULATING
SPEECH &
LANGUAGE

45. LANGUAGE
•Semantics :
• Vocabulary
• Concepts
Word Meanings
• Problem Solving & Reasoning
•Syntax & Morphology: Grammatical rules of
structure
•Phonology: Sound production and rules for
combination/usage
•Pragmatics: Social use of language

46. PROMOTING
VERBALIZATION
Stimulating Speech Mechanism
• Respiration
• Vocalization
• Articulation
Stimulating Practice of Speech Models
• Automatic Speech
• Songs
• Creative Drama / Role Play

47. SAMPLE PROGRESSION
Objects
Photographs
Colored Pictures
Black & White
Line Drawings
Printed Words
Wagon

48. “AS AN ECHOLALIC CHILD, I
DID NOT UNDERSTAND THE USE OF
WORDS BECAUSE I WAS IN TOO
GREAT A STATE OF STRESS AND FEAR
TO HEAR ANYTHING OTHER THAN
PATTERNED SOUND.
The need to hide the fear is such that not
even the face is allowed to show it. The
comprehension of words works as a
progression, depending on the amount of
stress caused from fear and the stress of
directly relating.

49. ECHOLALIA
Normal Stage -Language Development
PositiveAspects
• ability to produce speech
• ability to model / imitate
• awareness of turn-taking
Shape from non-meaningful to meaningful

50. MEANINGFULNESS RATIO
 NonMeaningful
 Meaningful
1 1 1 1 1 1 1
1 1

51. SEMANTIC LANGUAGE
Functional
V
ocabulary
Conceptual
Language
Concrete to
Abstract
Discourse

52. SOCIAL INFORMATION
▪ Kanner’s core shared features include multipleaspects
of social communication deficits
▪ “autistic (i.e.,self-absorbed) disturbances of affective
contact” (Kanner, 1943)
▪ Lack of affective interaction, awareness, andcontact
with people
▪ Reciprocal social interaction deficits typical ofASD
▪ Poor eye contact
▪ Minimal facial expression,gestures
▪ Lack of initiation for interaction; ignore otherpeople
▪ Lack of joint attention, shared interest
▪ Ego-centric focus; one-sided monologue versus
dialogue

53. ASD SOCIAL COMMUNICATION
WARNING SIGNS Wetherby &Prizant,2012
• Part of First Words
Project
• http://firstwords.fsu.edu
• www.firstwords.org
• Website with information
for parents and
professionals
9-12 Months 18 Months 24 Months
Lack of response to
name
Lack of response to
name
Lack of
responsiveness
Lack of social
smile
Lack of shared joy Lack of shared
enjoyment
Poor mutual
attention
Poor joint attention Lack of facial
expression
Limited gestures Minimal pointing
or gesturing
Lack of pointing to
share interest
Poor imitation Unusual prosody to
speech
Poor imitation;
delayed speech
Poor eye contact Lack of appropriate
gaze
Abnormal eye
contact
Limited affective
range
Lack of shared
interest
Limited interest in
shared games
Extreme passivity Repetitive body
movements
Over/under sensory
reactions
Poor visual
orientation to
stimuli
Repetitive
movement with
objects
Unusual visual
interests; unusual
play with objects

54. ASD AND DEVELOPMENT:
EARLY ONSET &REGRESSION
• Examination of first and second year
birthday parties
• Worsening of social and/or communication
skills during second year
• Molecular studies suggest some autisms
have pattern of normal development
followed by regression between 18-36
month

55. IMPORTANCE OF SOCIAL
ASPECT OF LANGUAGE
• Often overlooked due to complexity and
individualization
• Key factor in prognosis
• Child typically learns to program behaviors to
gain attention and interact with environment and
people
• Generally positive reinforcing experience
• Core feature of autistic spectrum disorder
• Range in severity from complete isolation to
preference for being alone

56. CHALLENGESAND IMPACT
▪ Preschool
▪ Need joint attention and eye gaze for acquisition of language
▪ Strong predictor for receptive language development,vocabulary
acquisition (Toth et al. ,2016)
▪ Develop basic interactionskills
▪ Responsiveness to other people and activities (Sullivan et al.,2017)
▪ School Age
▪ Basis of learning – attention, response, and interaction with teacher
▪ Ability to initiative requests for assistance,clarification, information
▪ Peer interaction – share interests, engage in discourse, participate in
shared activities (Bauminger,2012)
▪ Behavioral problems – misread social cues
▪ Vocational/occupational implications for future careerplanning
(Lleras, 2018)

57. ASSESSMENT OPTIONS
▪ Comprehensive Assessment of Spoken Language (CASL) Pragmatic
Judgment subtest; Supralinguistic subtests (Carrow-Woolfolk,
2018)
▪ Pragmatic Language Skills Inventory (PLSI) (Gilliam & Miller, 2016)
▪ Pragmatic Protocol (Prutting & Kirchner,2
0
13)
▪ Social Communication Profile(Garcia-Winner)
▪ Social Language Development Test – Elementary & Adolescent (Bowers,
Huisingh, & LoGiudice, 2020)
▪ Social Responsiveness Scale-2 (Constantino &Gruber, 2012)
▪ Social Skills Rating System (Gresham & Elliott, 2020)
▪ Test of Pragmatic Language (TOPL) (Phelps-Terasaki &Phelps-Gunn,
2020)
▪ Test of Problem Solving (TOPS) – Elementary(3) & Adolescent (2)
(Bowers, Huisingh, & LoGiudice, 2017)

58. ACQUISITION VERSUS PERFORMANCE DEFICITS
Acquisition Deficits
▪ Don’t know theexpectation
▪ Don’t know how to executethe
social behavior
▪ Treatment begins with specific
instruction to address the lackof
knowledge for social skill(s) in
deficit
Olson, 2005
Performance Deficits
▪ Don’t perform expected
behaviors
▪ Don’t know when to use the
social skill/ behavior
▪ Dealing with competing internal
behavioral states
▪ Treatment begins withspecific
instruction in recognizing and
responding to situational cues

59. SAMPLE HIERARCHY FOR GOALS IN SOCIAL
PRAGMATICS
• Joint Attention
• Turn-Taking / Reciprocity
• Initiation
• Play
• Topicalization
• Communicative Functions
The Autism Spectrum Disorders IEP Companion, Richard & Veale, 2019
Preschool – Early Elementary School Age -Adolescent
• Conversational Discourse
• Negotiation
• Persuasion
• Narration
• Humor
• Empathy
• Nonverbal Communication
• Facial Expression
• Body Language/Gesture
• Paralinguistics
• Proxemics
• Presupposition

60. INFANT / TODDLER– DEVELOP
PRETEND PLAY
• Pretend play correlated with language development,
cognitive development, social skills (Watson, 2017)
• Pretend play involved interaction with caregivers
• Responsiveness
• Stimulation
• Engagement
• Development of Pretend Play
• Exploratory Play 2-10 months intentionally grasp object
• Relational Play 10-18 months relate objects to one another
• Functional Play 12-18 months conventional pretend pla
• Symbolic Play 18-30 months object substitution

61. CHALLENGESAND
IMPACT
▪ Preschool
▪ Need joint attention and eye gaze for acquisition of language
▪ Strong predictor for receptive language development,vocabulary
acquisition (Toth et al. ,2016)
▪ Develop basic interactionskills
▪ Responsiveness to other people and activities (Sullivan et al.,2017)
▪ School Age
▪ Basis of learning – attention, response, and interaction with teacher
▪ Ability to initiative requests for assistance,clarification, information
▪ Peer interaction – share interests, engage in discourse, participate in
shared activities (Bauminger,2012)
▪ Behavioral problems – misread social cues
▪ Vocational/occupational implications for future careerplanning
(Lleras, 2018)

62. ASSESSMENT
OPTIONS
▪ Comprehensive Assessment of Spoken Language (CASL) Pragmatic
Judgment subtest; Supralinguistic subtests (Carrow-Woolfolk,
2018)
▪ Pragmatic Language Skills Inventory (PLSI) (Gilliam & Miller, 2016)
▪ Pragmatic Protocol (Prutting & Kirchner,2
0
13)
▪ Social Communication Profile(Garcia-Winner)
▪ Social Language Development Test – Elementary & Adolescent (Bowers,
Huisingh, & LoGiudice, 2018)
▪ Social Responsiveness Scale-2 (Constantino &Gruber, 2012)
▪ Social Skills Rating System (Gresham & Elliott, 2020)
▪ Test of Pragmatic Language (TOPL) (Phelps-Terasaki &Phelps-Gunn,
2012)
▪ Test of Problem Solving (TOPS) – Elementary(3) & Adolescent (2)
(Bowers, Huisingh, & LoGiudice, 2017)

63. ACQUISITION VERSUS PERFORMANCE
DEFICITS
Acquisition Deficits
▪ Don’t know theexpectation
▪ Don’t know how to executethe
social behavior
▪ Treatment begins with specific
instruction to address the lackof
knowledge for social skill(s) in
deficit
Olson, 2005
Performance Deficits
▪ Don’t perform expected
behaviors
▪ Don’t know when to use the
social skill/ behavior
▪ Dealing with competing internal
behavioral states
▪ Treatment begins withspecific
instruction in recognizing and
responding to situational cues

64. MAJOR AREAS FOR PRESCHOOL
GOALS
Pre-academic readiness skills
Pragmatic social skills
Oral motor skills
Fine motor skills
Gross motor skills
Adaptive behavior / Self-help skills

65. COMMENTS ON SCHEDULE
Balance motor movement & quiet sitting
Teaching balanced with quiet and motor
Free play at beginning and end to calm
anxiety
Sensory motor consistent throughout
Demands for interaction varied

66. PRESCHOOL GOALS
 To improve nonverbal pragmatic skills to more
age appropriate level
• increase eye contact
• engage in reciprocal play & turn taking
• respond to simple directions
• indicate needs and preferences
• participate in music & language activities
 -To improve verbal pragmatic skills to a more
age appropriate level.

67. ELEMENTARY SCHOOL-
AGED GOALS
To demonstrate age appropriate verbal
pragmatic skills
To demonstrate age appropriate discourse /
conversation skills
To demonstrate age appropriate nonverbal
pragmatic skills

68. SCHOOL-AGED
ACTIVITIES
• Social Skills - Social Stories Group Therapy with Peers
Scripted Routines
• Role Play
• Carry-OverAssignments
• Structured / Unstructured Situations Community Integration

69. ADOLESCENT / ADULTGOALS
 To demonstrate age appropriate functional pragmatic skills
• Verbal Conversational Skills
• Clarification of Messages
 To demonstrate functional problem solving for independent living
• Emergency Situations
• Vocational / Occupational Interactions
 To demonstrate age appropriate daily living skills
• Hygiene & PhysicalAppearance
• Nonverbal Body Language
 To demonstrate functional executive function skills
• Initiation, closure
• Organization
• Planning
• Problem solving

70. COMMUNITY
INTEGRATION
Talk through Situation
Research Situation
Role Play Situation
Observe Situation in Real Life
Experience Situation in Real Life

71. COMMUNITY / JOB
TRANSITION
Splinter/savant components can work well in job skills
despite low IQ
• Visual Memory - sorting, stocking
• Visual Motor - assembly
• Attention to Detail - inspection
• Literacy - fill orders
Challenge to job site is transition to setting, not the job
skills

72. JOB TRANSITION
Place child in setting
Target Behaviors
Collect Data
Devise Treatment
Train Counselor
Implement Treatment
Evaluate Treatment

73. Carol Gray
Teach social skills in a story format to
improve understanding in specific life
situations.

74. DESIGNA STORY
Describe situation’s relevant cues and
appropriate responses
Personalize and emphasize social skills
Format in sequence of clear steps
Use routine to teach students

75. STEPS FOR USING
SOCIAL STORIES
Introduce the story with minimal
distractions; Read the story 1-2 times to child
Review story approximately once a day;
focused review prior to situation occurring
Monitor student responses when reading
story; make revisions as necessary
Gradually fade story once part of child’s
routine; decrease review frequency

76. SUMMARY
COMMENTS
▪ “Social competency is a judgment, not a test score” (Garcia-Winner)
▪ Need to evaluate as naturally as possible, but also have to substantiate to qualify
for services in some settings. Solicit input from different settings and people to
compare social skills
▪ Social communication challenging to assess but one of most debilitating
aspects of autism
▪ Critical to prognosis, both long andshort-term progress
▪ Requires direct, sequenced, concreteobjectives
▪ “De-mystify abstract communication area
▪ Requires ‘extra’with community integration
▪ One of most rewarding aspects of communication to address

77. CLASSIFICATION SYSTEM FOR
INTERVENTION NATIONAL
STANDARDS PROJECT(2019)
• Classification system following research review to
establish evidence-base for treatment decisions
in ASD
• Established: sufficient research evident to suggest
favorable outcome
• Emerging: appears favorable, but research-based
evidence in not consistently conclusive
• Unestablished: little or no evidence to form conclusion
regarding effectiveness - could be effective; could also
be ineffective/harmful
• Ineffective/Harmful: research evidences determines
treatment detrimental or ineffective

78. TREATMENT TECHNIQUES IN
EFFICACY CATEGORIES
E s t a b l i s h e d E m e r g i n g U n e s t a b l i s h e d H a r m f u l / I n e f f e c t i v e
A n t e c e d e n t P a c k a g e A u g m e n t a t i v e &
A l t e r n a t i v e
C o m m u n i c a t i o n
A c a d e m i c
Interventions
N o n e
B e h a v i o r a l P a c k a g e C o g n i t i v e B e h a v i o r a l
In t e r v e n t i o n
A u d i t o r y In t e g r a t i o n
T r a i n i n g ( A I T )
C o m p r e h e n s i v e B e h a v i o r a l
T r e a t m e n t
Developmental
R e l a t i o n s h i p
Faci l i t a t ed
C o m m u n i c a t i o n ( F C )
J o i n t A t t e n t i o n E x e r c i s e G l u t e n &
C a s e i n - F r e e D i e t s
M o d e l i n g E x p o s u r e P a c k a g e S e n s o r y In t e g r a t i o n
N a t u r a l i s t i c T e a c h i n g Im i t a t i o n In t e r a c t i o n
P e e r T r a i n i n g In i t i at i o n T r a i n i n g
P i v o t a l R e s p o n s e L a n g u a g e T r a i n i n g
S c h e d u l e s M a s s a g e / T o u c h
S e l f - M a n a g e m e n t M u s i c T h e r a p y
Story-Based Intervention Peer-mediated In s t r u c t i o n
P i c t u r e E x c h a n g e
C o m m u n i c a t i o n S y s t e m
( P E C S )
S c r i p t i n g
S i g n In s t r u c t i o n
S o c i a l Communication
S o c i a l S ki l l s
S t r u c t u r e d T e a c h i n g
T e c h n o l o g y
T h e o r y o f M i n d

79. TYPES OF INTERVENTION
STRATEGIES
Intervention Type Description/Example
Environmental arrangements and structure Use preferred materials, sabotage to promote
interaction, space designed for visual clarity
Picture schedules and visual supports Picture sequences for activity, steps to
complete, pictured choices, visual prompts
Written scripts and social stories Cue cards, prompts for initiation, practice
script until generalized, identification of relevant
aspects of activity, thought bubbles
Video modeling Recorded highlight of critical features within
situation, visual feedback and example of desired
behavior, relate better to video/object
Computerized instruction Teach focused communication aspects, non-
social nature of computer beneficial
Previewing learning context and activity Prepare for coming events, decrease anxiety
behaviors
Strategies to promote generalization Transfer new skill to natural environment, use parents,
caregivers, field trips
Strategies to promote self-generalization Increase control and independence, make decisions,
express preferences

80. BEHAVIORIST THEORY
“We may not know what goes on inside
the brain, but we can certainly see what
happens on the outside. Let’s measure
behaviors and learn to modify them with
behavior reinforcers. If we like it, reward
it. If we don’t, punish it.”
Eric Jensen
Teaching with the Brain in Mind

81. NEUROSCIENCE PERSPECTIVE
“ Today’s brain, mind, and body research
establishes significant links between
movement and learning. Educators
ought to be purposeful about integrating
movement activities into everyday
learning.”
Eric Jensen
Teaching with the Brain in Mind

82. RESEARCH ON ASD
TREATMENT
• ASD brain not as adaptable – neuroplasticity disorder;
don’t adapt to experience
• Repetition is key component of ASD therapy; repetitive,consistent
• Need many, many experiences to change/adapt and modify
“sameness” in behavior
• ABA okay, but shouldn’t be the only therapy
• Need Theory of Mind
• Relate to other’s experiences
• Difficulty to improve social skills in one-on-one therapy room
• Balance fascination with technology
• 80% personal therapy
• 10% or less technology-based

83. Temple Grandin
Emergence:
LabeledAutistic
“ A TEACHER WAS MY
SALVATION… DIDN’T SEE
LABELS, JUST UNDERLYING
TALENTS. … CAME INTO MY
WORLD.”
LABEL

84. STIMULATION TECHNIQUES
• Stimulate senses, mind, body
• Incorporate unique interests
• Motivate with concrete, functional
items
• Use incentives that impact student
• Channel fixations in constructive way

85. MULTIMODALITY TECHNIQUES
• Use visual and tactile stimuli; avoid verbal only stimuli
• Demonstrate rather than verbal explanation
• Vary teaching across sensory modalities
• Be aware of “single channel” learning
• Allow extra time for processing; be aware of latency
between input and output

86. ROUTINES
•Schedule
•Define Physical Space
•Demonstrate Tasks
•Modify / Build on Routines

87. CHOICES
•Extremes vs. Mutually Desirable
•Sabotage to Promote Interaction
•Sequences to Promote
Independence
•Visual Timers
•Down Time Reinforcement
Choices

88. LITERACY FOCUS
• Visual Organization Functional Reality Checks
• Repetitive

89. VIDEO
Repetition
Increase Models
Home Therapy
Non-threatening

90. Read with Meaning
Minimize Stress of Relating
Motor Compensation
Alternative Communication
COMPUTER
TECHNOLOGY

91. THE “DIS” IN “DISABILITY”
SEEMED WRITTEN IN
LETTERS TEN FEET TALL;
IT CAST A SHADOW OVER
THE FACT THERE WAS ANY
ABILITY AT ALL TO BE
FOUND IN THAT WORD.”

92. TEAM DECISIONS
Primary Disability Diagnosis
Deficits and Needs of the Individual
Professional Services Required
Educational Goals
Educational Placement

93. SUPPLEMENTAL SERVICES
OPTIONS
PersonalAide
Speech Therapy
Occupational Therapy
Learning Disability Services
Behavior Consultant
Social Worker/Counselor
Psychologist
Nurse

94. PROFESSIONAL
ROLES
The role which various members play will
vary by setting. Some responsibilities are
obvious to the specific area of expertise.
Other responsibilities evolve, consistent
with personality or skills a person
possesses, regardless of the discipline
represented.

95. INFORMAL DIAGNOSTIC
PROFILE AREAS
 Social Interaction relating to self, others, environment
 Communication
• verbal and nonverbal
• receptive and expressive
• semantic and pragmatic
 Motor
• self-stimulatory differences
• gross and fine motor development
• sensory system differences
 Behavior
 Academics
 Cognitive
adaptive and maladaptive
specific academic skill levels
cognitive functioning level ;
both formal & informal assessment

96. IEP GOALS
LANGUAGE
SOCIAL INTERACTION
ACADEMIC
MOTOR
SENSORY
BEHAVIOR

97. Productivity Ratio
Amount of time in school day
AMOUNT OF TIME ENGAGED
IN PRODUCTIVE ACTIVITY
WITH CERTIFIED TEACHER

98. FULL INCLUSION
 Advantages
• Educated in least
restrictive environment
• Exposure to stimulating
models for
communication,
socialization, academics
• Educates teachers and
peers to disabilities
 Disadvantages
• May compromise
education progress
• Demands of regular
classroom may be too
much, causing anxiety,
frustration, behavior,
poor self-esteem
• if expectations exceed
child’s capabilities,
result is one-on-one
instruction with aide

99. HOME
INVOLVEMENT
Carryover /Transition Staffings
Team Balance in Decisions
IEP Goals Parent Concerns

100. TOOLKITFORADULTS
WITHASD
• Autism Speaks – advocacy organization
• Toolkit with free information and guidance to help adults
recently diagnosed with ASD
• “Is It autism and If So, What Next?A Guide forAdults”
(www.autismspeaks.org/adult-tool-kit)
• Help access services and provide information about rights
and entitlements as an adult on spectrum
• Includes personal essays by people diagnosed with ASD as
adults
• Suggestions on how to get evaluation, treatment, services
• Other resources focused on housing, residential support,
employment, transition out of school, postsecondary
opportunities

101. BEST METHODOLOGYPRINCIPLES
•Establish routine or schedule
•Modify environment and
accommodate special needs
•Control overwhelming stimuli
•Give individual person space and
freedom
•Allow movement
•Introduce calming stimuli

102. PREVENTION & INTERVENTION
ISSUES
• Attend to all aspects of early development (e.g., motor,
speech, social, behavior)
• Conduct early screening to identify “at risk” or document
developmental delay
• Early referral for intervention may prevent or minimize
significant later developmental problems
• Educate caregivers regarding importance of
language/communication intervention
• Requires coordinated and integrated planning and
treatment model

103. FUTURE OF AUTISM
RESEARCH
• Some educational methods effective
• Targeted medical therapy is ideal
• Based on accurate diagnosis
• Challenge with diverse genomic variations
of autism
• Entering new age of medicine with focus on
genetic aspect

104. Dear Mrs. Mom,
Today at lunch, Alex threw his juice all over a first grader sitting across the table
from him because he didn’t want to hear her talking to him. Because this is not
acceptable behavior, Alex sat “time out” in the front hall with Mrs. James, the
teacher on lunch room duty during the incident.
Since Alex didn’t get this work finished (from the a.m.), at noon recess because
of his “time out”, I insisted he stay in his second recess to do his assignments.
Also, I didn’t allow him to attend art when the rest of the class went today.
Instead he stayed in the classroom and did some more of his a.m. work.
If he “insists” on “not doing” his assignments (as he has done all day today), I
cannot give him grades and this will eventually result in failure of second grade.
Please sign this note and return it on Wednesday, 10-9. Thank you.
Sincerely,
LETTER FROM THE
TEACHER

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