Reducing Negative Behaviours in Daily Routines for Young Children with Autism

The primary intervention drew on sensory integration theory (Bundy, Lane, & Murray, 2002). Five components built on an approach adapted from Anzalone and Williamson (2000) were considered as follows with a hypothetical example : 1) Observing and reframing sensory processing challenges in context (e.g., the child has an extreme reaction to the vacuum cleaner due to auditory over-responsiveness). The mother and the therapist, together, observed and discussed the behavior and developed management strategies. 2) Modifying the environment to reduce contributing sensory input (e.g., close doors to place a barrier between the child and the vacuum cleaner). 3) Modifying the activity to minimize unpleasant sensations (e.g., vacuum when the child is not home). 4) Managing the activity (e.g., use visuals to prepare for vacuuming; use calming sensory activities). 5) Promoting agency in the child in response to sensory challenges (e.g., teach the child to turn on a favorite TV show during vacuuming)..Four sessions occurred in the home for an hour once a week at a convenient time nominated by the family. The mother was the focus of the intervention, discussing intervention strategies and how they could be applied in the context of family routines. Sessions occurred over a four week period, however final scheduling was responsive to family needs. A second intervention was provided to all participants based on the “Being Responsive” (Braithwaite, Keen, & Rodger, 2004) program. The program outlines four roles and six strategies to promote responsiveness and encourage interaction that are common in autism early intervention programmes (Roberts and Prior, 2006) . In this study, the program was modified, identifying and applying specific roles and strategies to manage the target behaviour of concern. The four intervention sessions occurred in the home, with the mother the focus of intervention in coaching/consultation model. The focus of the sessions were to identify how to apply strategies to increase responsiveness in the context of family routines. The mother applied the strategies identified with the child in the main, with some modelling or demonstration by the therapist as needed. A fidelity checklist was completed by an independent rater, unfamiliar with the study. The rater completed the checklist after listening to a randomly selected audio recording of one session for each participant. Two weeks break occurred between the two interventions which were randomly allocated to order of intervention for each participant.