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For Autism Spectrum Disorders (ASD) children an early treatment is important for them as well as the early diagnosis. The behavioral approaches are used to treat children with ASD, the approaches include different programs such as the Developmental-Individual Difference-Relationship Based Model (DIR) and the Applied Behavior Analysis (ABA).
The DIR model is a treatment approach that concentrates on learning the communication skills which is necessary to the social interaction with other people. Also, is focused on the “Opening and closing circles” which the child use in his context to direct play. The collaboration between the family and the educational team is substantial to increase these circles. The development of suitable play and interaction are formed by the adults. The DIR model is useful to build shared interest that leads to engagement and to work out on communication and problem solving. A part of the DIR is the Floortime model which promote the ASD child to interact with parents and other through play activities on the floor in a natural sitting (home, play session, playground). It focuses on multi goals which are: following the child lead, challenging him to be more creative and spontaneous; and also involving his senses, motor skills, and emotions. Intensive DIR/Floortime programs up to be over 25 hours per week.
The ABA approach is used to help the child to construct a variety of skills (social skills, communication, self-monitoring and control) as well as assist him to popularize these skills into other situations. It concentrates on the theory of behavior which says that behaviors can be learned and educated through a system of rewards and consequences. Dissect the behavior using the ABC model (A is state for antecedent, B for Behavior; and C for consequence) is the first step in the ABA. Strategies of ABA help to reduce problematic repertoires and build socially useful ones. The strategies include task analysis, chaining, prompting, fading, shaping, differential reinforcement, generalization, video modeling, discrete trial training (DTT), and natural environment training (NET). ABA techniques can be used in both structured (classroom) and everyday (family dinnertime) settings and in one-on-one or group instruction. ABA techniques are used in intensive, early intervention (below the age of 4 years) programs. Intensive programs of ABA total from 25 to 40 hours per week for 1-3 years.
The DIR and ABA share three main similarities which are the involvement of parents, intensive planning, and progressive steps toward a goal.
First is the involvement of parents in therapy. In Floortime, parents are a large part of therapy. The parents work with the therapist to make goals and engage their child in both therapy sessions and in everyday environments. In ABA parents are involved in planning programs and the setting of goals, as well as regular meetings to see their child’s progress.
Second is the intensive planning. Both programs require dense amounts of time. Floortime includes willful time with the parent throughout the day plus sessions with a therapist, are up to be over 25 hours per week. ABA often has more than 25 hours per a week of therapy with the therapist straight.
Finally, the progressive steps toward a goal. Both the ABA and Floortime seek an improvement of levels in order to reach a goal. Floortime is collecting the child’s attention and focus so that child can be willing to learn, while the ABA teaches “how to learn” behaviors.
Also, DIR and ABA have multiple differences such as how the child’s mood affects his level of alertness and the role of relationships in therapy, how the child processes and imparts, how the child see the world and shares his thoughts, and how well emotion is organized throughout the programming.
First is how the child’s mood affects his level of attention and the role of relationships in therapy. Parents play a major role in Floortime. The relationship with the parent is supportive and loving, that gets emotions to the front of Floortime therapy, furthering communication, attention, and engagement. Every behavior is important and is construed to understand what the child with ASD is trying to communicate. Although in the ABA the parents are involved, parents do not needs play a role in implementing therapy, but rather reinforce the ABA mechanism across settings.
Second is how the child processes and learns. The DIR focuses on the unique “sensory motor profile” each child had, that explains the child’s behaviors and guides the future of treatments. However, the ABA considers these behaviors and individual differences to be antecedent or consequence of other behaviors.
Third is how the child views the world and shares his ideas. In Floortime, the child uses self-directed play to represent his internal impersonations of the world and his thoughts. However, the ABA educates the child with ASD how to play, that is supposed to let future development and growth in their processes and expressions of internal thoughts.
Finally, it’s how emotion is regulated. In Floortime, parents demonstrate emotions and provide them to their child, including support and love. When the child with ASD reacts with any type of emotion (anger, fear, joy, etc.), therapists and parents try to find what caused that response. However, with ABA, moods and emotions are considered behaviors that can be changed and measured through reinforcements. Wanted behaviors are rewarded with a positive reinforcement, but the origin of behaviors is not considered.
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