Why do autistic behaviours improve with intervention?

[nikos]

Ds has a provisional dx of Aspergers and I've been doing a communication course for children with ASD's. I'm trying to take in a lot of info in a short space of time, but one of the things I find difficult to make sense of is the developmental nature of ASD's.
On the course they say that early intervention is hugely important but what actually does this do? Are we retraining the brain with these techniques, teaching it to fire in new ways? Or is an adult with autism inherently the same as the child but just with the techniques to make life work? Can we actually remodel the brain with the early intervention?
Hope this isn't too clumsy, does anyone know what I mean?

Nikos - I think ABA could help yes, but even if you don't do formal ABA, the behavioural techniques are very useful ( I even use them on my other child and on my DH!). The basic thing is that you ignore or "put on extinction" attention-seeking behaviour. We found this hard on head-banging, but it worked as he realised in time that this strategy DIDN'T get him attention, and it's now stopped. They also use aversive therapies for aggression (I used hairwash, but you can use naughty step or go to your room) and for avoidance behaviours they use redirect (eg clap hands, say this) and then go back to the thing they are avoiding. For an older kid, they might have to change these techniques and it might be tricky at pre-school, but I think perhaps if she gets a time-out and it's very boring for any aggression, she might learn not to do it??

Knat - your dd sounds exactly like our ds, although he's a year younger. Actually at home with his two siblings he is fine. And when he was in a small group at nursery he was fine. But increase the group size and he gets aggressive and anxious. We're hoping to get a one to one for him at preschool in September.
The other problem we've got is running away when we are out. He has no fear and although he won't run in the road, he will happily run off and not look back for me. Could ABA help with that?

Nikos - we had the same problem with DS re running away, and I believe some of the ABA programmes we've done have helped with this. One was called "seeing leads to knowing", and this helped Ds understand that people only know what they can see or have seen - he hadn't been able to grasp that concept before. I think it made him realise that if he wanders out of sight, I have no idea where he is and he is lost. We also did "cause and effect" and "safe/dangerous" programmes and they helped as well, he is now a lot less likely to run/wander off.
Oh and I'd also be interested in that article you mentioned, could you post the title of it please?

ancient - how does your DS copes with having his hear washed "normally" in the bath nowadays? (not criticising your method btw, I do agree it is important to get a handle on aggressive behaviours, just interested!)

Homsa what's the seeing leads to knowing programme. Sounds like it might be a bit advanced for ds1 but would be bloody useful if we could.

We had a respond to stop programme and a walk with me one. Which work quite well now. Especially in open spaces (less successful on the street with lots of distractors).

Homsa - If you google Eric Courchesne, it's the first thing that comes up and is an interview with him.
Re reading it I realise he said that of those diagnosed at 2-3, only 70% will retain the dx of autism at 6-7. Slightly different to what I first wrote.

No probs giving email Pipin. Could you try losing DVD or TV time if he screams or is that too intangible? When we first started ABA, they tried with my DS a bag of buttons, and when he did something naughty they would tip out all the buttons and he had to pick up every single one and put it back in the bag. It didn't work for my DS as he rather enjoyed this, it suited his sense of "completing" something, but it might work for your DS? Homsa, my DS still hates having his hairwash even when it's a normal hairwash time, but to me that's a small price to pay for the aggression going. Reckon he will one day grow out of his fear of hairwash, and haircut, and hairbrush, but for now it suits me fine if that doesn't sound too mean!

Thanks nikos, I've read that interview now, that is really quite surprising. It would be interesting to read those studies he mentions - but it does sound more like he thinks it's not due to intervention or maturation - "growing out of it" - but to autism being misdiagnosed at an early age?

The "seeing leads to knowing programme" I mentioned is from a book by Baron-Cohen called "Teaching children with autism to mind-read". You can get it from Amazon. There are two strands to it - one is teaching the child to recognise emotions (by reading facial expressions) and infer emotions based on a situation, a person's desires and a person's beliefs.
The second strand teaches the "five states of informational state understanding". I'll try to summarise:

1. simple visual perspective taking: for example, show child two cards with different images; put cards back-to-back, so that child can only see one image, tutor sees the other; ask child "what can you see?" / "what can I see?"
2. complex visual perspective-taking: teach child to understand that a "6" will appear as a "9" to a person sitting opposite him, etc.
3. seeing leads to knowing:

self judgement: show child two items, e.g. a red ball and a blue ball. Ask child to close his eyes. Put red ball into a box. Ask "do you know which ball is in the box?" (no) "why don't you know?" (because I didn't see which one you put in) other's judgement: play the same hiding game, but this time the child hides the ball and a third person (or a doll) closes their eyes. Ask "does x know which ball is in the box?" "why doesn't x know?"

1. predicting actions on the basis of a person's knowledge: you need two identical items, a play house and a play person. "show" the play person where one of the items is in the play house (location 1). Play person then "leaves". Put the other item into a different place in the play house (location 2). Play person comes back. Ask "where does the play person think the item is?" (location 1) "why does he think that?" (because he saw you put it there) "where will he go to get it?" (location 1) "why?" (he knows it's there)
2. understanding false beliefs:

unexpected transfer: this is identical to the Sally-Anne test unexpected contents: put a pen into a smarties tub, or similar. Ask child to look inside. Ask "what did you think was in there?" "what is really in there?" Do this with a 3rd person/doll as well.

We also did some teaching of gaze monitoring beforehand (first with a schematic drawing, then asking "what am I looking at?")

Argh that was a long post sorry. But you did ask!