The National Center for Evidence-Based Practice
in Communication Disorders
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Summary of Clinical Practice Guideline

National Research Council; National Academy of Sciences; U.S. Department of Education

Educating Children with Autism
Lord, C., & McGee, J. P., eds. (2001).
Washington (DC): National Academy Press, National Research Council: Division of Behavioral and Social Sciences, 323 pages.

AGREE Rating: Highly Recommended

Description:
This guideline provides recommendations for assessment and treatment of children with autism spectrum disorders (ASD). This report also addresses the needs of families of these children. The target audience of this guideline is professionals involved in the diagnosis and management of children with ASD, including speech-language pathologists. A detailed review precedes the recommendations, which describes the current evidence base for specific treatment approaches.

Recommendations:

Autism Spectrum Disorder
  • Assessment/Diagnosis/Screening

    • General Findings

      • Assessment for ASD should include a “formal evaluation of social behavior, language and nonverbal communication, adaptive behavior, motor skills, atypical behaviors, and cognitive status by an experienced multidisciplinary team. Additionally, observations and concerns of parents should be systematically gathered. Diagnosis should be made as early as possible and follow-up diagnostic and educational assessments should be performed within the next one to two years" (p. 214).

    • Assessment Areas

      • Cognition/Language

        • Assessment for ASD should include a “formal evaluation of social behavior, language and nonverbal communication, adaptive behavior, motor skills, atypical behaviors, and cognitive status by an experienced multidisciplinary team. Additionally, observations and concerns of parents should be systematically gathered. Diagnosis should be made as early as possible and follow-up diagnostic and educational assessments should be performed within the next one to two years" (p. 214). 

  • Treatment

    • Cognition/Language

      • General Findings

        • Educational objectives should be observable and measurable and should affect the child’s participation in everyday activities. Objectives should include development of social skills, expressive verbal language, symbolic communication, engagement and flexibility in play, fine and gross motor skills, cognitive skills, appropriate behaviors, and organizational skills (p. 218).

        • “Educational services should begin as soon as a child is suspected of having an autistic spectrum disorder” and should include “a minimum of 25 hours per week, 12 months a year” (p. 220). This treatment should include individualized attention and specialized instruction in  settings with typically developing children (pp. 220-221). Lack of progress over a 3-month period should result in increased intensity of service (pp. 220- 221).

        • A primary focus of early intervention should be functional, spontaneous communication. “For very young children, programming should be based on the assumption that most children can learn to speak” (p. 221).

        • Cognitive intervention should focus on skills that are expected to be used in the natural context and there should be an emphasis placed on generalization and maintenance (p. 221).

      • Pragmatic/Social Skills

        • General Findings - Social skills instruction should be integrated into daily activities and play instruction should involve the use of appropriate toys and play with peers (p. 221).

  • Service Delivery

    • Dosage and Format

      • "Educational services should begin as soon as a child is suspected of having an autistic spectrum disorder" and should include a minimum of 25 hours per week, 12 months a year" (p. 220). This treatment should include individualized attention and specialized instruction in settings with typically developing children (pp. 220-221). Lack of progress over a 3-month period should result in increased intensity of service (pp. 220-221).

 
Social Communication Disorders
  • Assessment/Diagnosis/Screening

    • Assessment Areas

      • Cognition/Language

        • Assessment for ASD should include a “formal evaluation of social behavior, language and nonverbal communication, adaptive behavior, motor skills, atypical behaviors, and cognitive status by an experienced multidisciplinary team. Additionally, observations and concerns of parents should be systematically gathered. Diagnosis should be made as early as possible and follow-up diagnostic and educational assessments should be performed within the next one to two years" (p. 214).

  • Treatment

    • Cognition/Language

      • General Findings 

        • Educational objectives should be observable and measurable and should affect the child’s participation in everyday activities. Objectives should include development of social skills, expressive verbal language, symbolic communication, engagement and flexibility in play, fine and gross motor skills, cognitive skills, appropriate behaviors, and organizational skills (p. 218).

      • Pragmatic/Social Skills Treatment

        • "Appropriate educational objectives for children with autistic spectrum disorders...should include the development of social skills to enhance the participation in family, school, and community activities" (p. 218).

        • "Social [skills] instruction should be delivered throughout the day in various settings, using specific activities and interventions planned to meet age-appropriate, individualized social goals" (p. 221).

  • Service Delivery

    • Dosage & Setting

      • "Social [skills] instruction should be delivered throughout the day in various settings, using specific activities and interventions planned to meet age-appropriate, individualized social goals" (p. 221).
Keywords:
Autism Spectrum Disorders

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