Pivotal Response Training (PRT):
Pivotal response training is a set of techniques used in various forms of therapy such as ABA. PRT aims to motivate the child through giving choices, varying tasks and promoting success through the use of reinforcement of attempts and pairing previously learned activities with new activities. The child is encouraged to be independent via self-monitoring and taking responsibility as well as initiating learning opportunities through enquiry. Generalisation of taught skills is a further priority in PRT.
Behaviour Intervention Programs/Positive Behaviour Support (PBS):
Behaviour intervention programs are put into place in an attempt to reduce undesired behaviours and to replace them with more appropriate alternatives. Often children with developmental delay engage in undesired or inappropriate behaviours as they are unable to communicate their needs. It is important that (following the ruling out of any medical reasons for the behaviour) the function or the reason that the child is engaging in the behaviour is identified and appropriate alternative is taught as a part of the intervention process.
An individual and comprehensive intervention plan is developed consisting of a functional analysis of the behaviour including observations and interviews, removal of antecedents for the behaviour (where appropriate) and replacing the behaviour with an appropriate alternative.
Parents/carers and educational staff take on the responsibility of continuing with the intervention plan outside of the clinical setting.
Play therapy is a type of counselling that allows children to transcend traditional language barriers to be able to communicate through toys and actions. It is most effective with children aged 2-10 years old. Play is the natural language of children and toys can be their words. Through the toys, art materials and other objects in the playroom, children can express their thoughts and feelings, explore relationships and share about their experiences. The play therapist may join in play direction or request of the child or direct play to address specific issues.
Cognitive Behaviour Therapy (CBT)
CBT is one of the most established and researched psychological therapies for emotional, psychological and psychiatric dysfunction. The application of CBT varies according to the focus of the therapy, but is essentially a collaborative and individualized program that helps individuals to identify unhelpful thoughts and behaviours and learn or relearn healthier skills and habits. A strength of CBT is that it helps people overcome current symptoms while teaching new skills and strategies that can be applied to future problems.
Psycho-educational therapy aims to empower the client and family through educating them on their condition. It is an important component of all psychotherapy which provides information and support in the initial stages of therapy as well as throughout the treatment. It aims to reduce the stress of the client and family by helping them understand the symptoms of the condition and what to possibly expect in the future.
These assessments are standardized Psychological tests that are used to provide estimates of the child’s intellectual functioning. Often referred to as IQ tests they are used to provide a cognitive profile of the child’s intellectual strengths and weaknesses. Cognitive assessments are also used to provide a comparison of cognitive functioning between the child and peers of the same age. Cognitive assessments are used for a number of reasons including eligibility for applications with various government agencies such as the department of health and aging as well as assistance with decision making regarding appropriate school placement and levels of support.
The Wechsler Intelligence Scale for Children®- Fifth Edition Australian Standardised Edition (WISC-IV) provides essential information and critical clinical insights into a child’s cognitive functioning.
Using updated norms to match the current Australian census data it is designed to provide a profile of intellectual functioning of children aged 6.0-16.11 years.
The WISC-V provides scores that represent intellectual functioning in five specified domains, Verbal Comprehension IQ, Visual Spatial IQ, Fluid Reasoning IQ, Processing Speed IQ and Working Memory IQ.
The WISC-V also provides a full scale IQ score measuring general intellectual ability
WIAT-III : Wechsler Individual Achievement Test (Aus & NZ)
The WIAT-III A&NZ is a measure of academic achievement.
Using a total of 16 sub-tests it provides information to identify the academic strengths and weaknesses of a student, assist with making informed decisions regarding eligibility for educational services, educational placement, or diagnosis of a specific learning disability.
The WIAT-III is further designed to assist with instructional objectives and plan interventions that will assist with intervention and skill development.
ABAS-3 : Adaptive Functioning Assessment
The Adaptive Behvaiour Assessment system (ABAS-3) is a comprehensive, norm-referenced assessment of adaptive skills needed to effectively and independently care for ones-self, respond to others, and meet environmental demands at home, school, work and in the community.
The ABAS-3 is a versatile instrument and allows for a variety of respondents including parents/carers in addition teachers and other professionals.
The ABAS-3 cab be used for individuals from birth to 89 years in many different settings.
The ABAS-3 reflects current standards of describing adaptive behaviour and diagnosing conditions in which it may be impaired.
The results of the ABAS-3 are also used assess and create interventions to support and promote daily living skills and an individual’s overall quality of life.
MASC2: Multidimensional Anxiety Scale for Children
The MASC2 is a comprehensive, multi-rater assessment of anxiety dimensions in children and adolescents aged 8 to 19 years. The MASC2 assists in rating the range and severity of anxiety related symptoms and I useful in the process of diagnosing anxiety disorders.
The MASC2 allows various raters to contribute information including parent rating forms and self-assessment forms. This allows feedback from both parents/carers from an observable standpoint as well as self-assessment to assist with identifying valuable information about the internal features of anxiety that are not easily observable by others.
The ABAS2 is also an effective tool for assisting with creating therapy goals for children experiencing anxiety and to measure pre and post treatment presentations.
CONNERS Comprehensive Behaviour Rating Scales
The CONNERS comprehensive behaviour rating scale (Conners CBRS) is a comprehensive assessment tool that assesses a wide range of behavioural, emotional, social and academic concerns and disorders in children and adolescents.
It is a multi-informant assessment that is applicable across multiple settings.
Parent and teacher ratings can be obtained for children and adolescents from 6 to 18 years old and self-report ratings can be completed by 8 to 18year olds.
The Conners CBRS has direct connections to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) used to apply formal diagnosis of all mental conditions.
Autism Spectrum Diagnosis
Autism Diagnostic Observation Schedule (ADOS)
The Autism Diagnostic Observation schedule is a semi-structured, standardized assessment of communication, social interaction, and play or imaginative use of materials in individuals aged 2years through to adulthood.
The ADOS consists of a variety of social and play based activities that allow the examiner to observe behaviours that have been identified as being important to the diagnosis of Autism spectrum disorders.
Consisting of four modules, the examiner contrives opportunities to observe various skills in language and communication, reciprocal social interaction, play and stereotyped behaviours and restricted interests. Observations are then coded and provide the basis for determining the current diagnosis.
Autism Spectrum Rating Scales (ASRS)
The Autism Spectrum Rating scales are specifically designed to measure behaviours that are associated with the Autism Spectrum Disorders.
The ASRS helps identify characteristics of the Autistic Spectrum Disorders in children aged 2 to 18 years. The various scales on the ASRS cover a wide range of ASD related behavioural deficits, such as difficulties with social and communication skills, engagement in unusual behaviours and struggles with self-regulation. The ASRS also includes a scale that is directly related to the symptomatic criteria from the Diagnostic and Statistical Manual (Sam Goldstein & Jack A. Naglieri 2010).
The ASRS is also used to evaluate intervention effectiveness over time based on the comparison of behaviours measured at two points of data collection e.g. at the beginning of an intervention and six months later.
The ASRS is used to gather information regarding the above areas from parents/carers and teachers to ensure a thorough examination across all relevant environments.
Autism Diagnostic Procedure:
Diagnosis of Autism Spectrum Disorders (ASD) is made through conducting comprehensive, evidence based assessment of children suspected of or who display ASD traits.
The assessment process includes the following:
– Screening assessment using the Autism Spectrum Rating Scales to determine the prevalence of various symptoms of Autism
– Informal interview with parents/caregivers to determine developmental history
– Formal observation using the Autism Diagnostic Schedule (ADOS)
– Observation (pre-school/school) where possible to gather information regarding socialisation and behaviour in the school setting
– Feedback session outlining assessment outcomes and an opportunity for questions
– Comprehensive written report within one month of the assessment date