Although, reviews and outcome research supports empirical evidence for Early Intensive Behavior Intervention in pre-scholars, intensive behavioral service provision for school-aged children with autism spectrum disorders (ASD) are less subject to research studies. In order to provide effective behavioral interventions for school-aged children it was first necessary to comprehend key variables that are common to empirically validated programs and to tailor the to the needs of older children and their families in community settings. The proposed Comprehensive Behavioral Model “Una Breccia nel Muro” (UBM) includes individualized assessment and skill building, treatment provision in inclusive setting and cross-service collaboration, parent inclusion and support, and intensive training for parents, staff as well as school teachers.
Autism is a neuro-developmental disability that is the core disorder of the pervasive developmental disorders (PDDs; APA, 2000). Autism, however, is a dimension (autism spectrum disorders, ASD) rather than a distinct category, characterized by varying degrees of pervasive deficits in social communicative behaviors, including pragmatic language usage, impairments in social reciprocity, and the tendency toward behavioral rigidity. Children with ASD lack understanding of how to initiate and respond to joint attention with other persons, have difficulties in social timing of communication, and may not understand other people's intentions expressed by language and gestures, demonstrating difficulty with organizing appropriate responses, and with inhibition of repetitive behaviors and interests. Children with core autism have more profound difficulties, and are more likely to have associated speech and mental retardation, than those with other diagnoses within the PDDs (Volkmar, Lord, Bailey, Schultz, & Klin, 2004).
There is a growing body of empirical evidence of treatment for both the deficit features of autism (e.g., cognitive, language and social) and the expressed behavioral features of deficit areas of the autism continuum (e.g., repetitive behaviors, problem behaviors) (Lord et al., 2005, Makrygianni and Reed, 2010, Matson and Smith, 2008, Rogers and Vismara, 2008, Spreckley and Boyd, 2009 and Zachor et al., 2007). Key features of an empirical approach to behavioral interventions have been defined as: (1) operational definition of observable target behaviors, (2) definition of behavioral antecedents and consequents that make explicit the functional relationship between the treatment environment and the target behavior, (3) a task analysis that explicitly defines the treatment procedures, and (4) a measurement system for quantifying the acquisition, maintenance and generalization of the target behavior (Rogers, 2000). Several models and treatment principles of behavioral treatment for autism have been established such as Applied Behavior Analysis (ABA), Treatment and Education of Autistic and related Communication-handicapped Children (TEAACH), Pivotal Response Training (PRT), and Incidental Teaching (IT).
School-aged children with autism have greatly benefited from Intensive Behavioral Intervention programs and techniques. The purpose of the present paper is to provide a Comprehensive Behavior Model (UBM) that allows one to tailor effective program components to be tailored to a to individual family and child needs, in order to take account of children who respond less favorably and parents who demonstrate difficulties in adjusting to child deficits in daily life situations and are less capable of confronting intensive demands towards treatment implementation.
