Saturday, December 24, 2011

Interventions Targeting Attention in Young Children With Autism

Patten, E. & Watson, L. R. (2011). Interventions targeting attention in young children with autism. American Journal of Speech-Language Pathology, 20, 60-69.

The importance of attention in one’s ability to learn cannot be understated. While research on autism is quite prevalent, autism studies that focus on attention are rare. Patten and Watson (2011) provide a guide for clinicians which showcases autistic children’s attention characteristics as well as interventions which successfully improve attention.

Patten and Watson (2011) identify three main categories of attention commonly affected in children with autism: orienting, sustaining, and shifting. Orienting describes the physical adjustment to a stimulus (i.e., a head turn or eye shift), sustaining refers to the maintenance of attention to a stimulus, and shifting is the act of both disengaging from one stimulus and then shifting and reorienting to a new one. These three factors all influence social interaction through joint attention, which refers to the shared attention between two individuals and an object or stimulus. Children with autism have trouble orienting to stimuli, and sometimes overfixate on them when they do.

The authors review intervention methods which either “habilitate or improve attention skills in the long term” (therapeutic interventions) or “focus on compensatory strategies or accommodations that effectively improve attention relatively quickly and contingently” (accommodations). The therapeutic interventions presented are based on 12 studies, and can be generally categorized into four methods: Child-directed play, in which the child chooses an activity and adult intervention is implemented within that context; reinforcement, in which children get a reward for performance; imitation, in which adults imitate children with the hopes that eventually the roles will reverse and children will imitate the adults’ behaviour; and prompting, in which physical prompts begin in an over exaggerated manner, and the exaggeration is gradually reduced until the children display the correct behaviour by themselves. The accommodations which the authors suggest are strategies such as referring to objects of attention by specific labels or offering rewards for good behaviour, which seem to be effective in the short term, but offer no long term advances.

The authors conclude that research results largely indicate that attention interventions benefit children with autism. This conclusion is based on findings of a systematic review in the National Standards Project (NSP) report (National Autism Center, 2009). Furthermore, the authors suggest that interventions are beneficial regardless of who administers the intervention (they suggest it can be a therapist, parent, or peer).

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