Evidence-Based Practice
The Cooperative Research Centre for Living with Autism (Autism CRC) has recently published its Early Intervention Report highlighting best practices for Early Intervention. DIR Floortime™ gets a mention in this report, which is a start, but unfortunately not all DIR Floortime™ studies have been incorporated. Therefore, the findings still do not fully show how this approach supports the child’s social, cognitive and social emotional development as well as building confidence in families to understand their child, support their development and advocate for them.
You can read the full report here: Developmental Interventions
Mixed Reaction
Although these types of reports are a start to helping families understand the different types of interventions for Autism, unfortunately they often do not show the whole picture. Sometimes they may be biased to one or another intervention based on how much research is being done in that area and what contact the researchers may have with other researchers.
For example, we sent this report to the DIR Floortime™ practitioners and researchers in the USA and they were surprised by these findings. In the USA, Medicaid Insurance is reviewing its insurance cover for behavioural interventions because of reports by adults with Autism about the harmfulness of such methods. A great website and position paper about behavioural interventions by adults with Autism can be found here: Reframing Autism – Position Statement on Therapies and Interventions.
Referral Bias
It is unfortunate that many families are steered towards behavioural interventions from the day their child has an autism diagnosis, and are being told that this intervention is ‘evidence based’. We are hoping that more families who experience other types of interventions, such as developmental approaches (such as DIR Floortime™, naturalistic teaching strategies), sensory based interventions (this includes Music Therapy, sensory diet, environmental enrichment/adaptation), and even animal-assisted therapies, start to speak up about what has helped their child and family and specifically how it has helped. These benefits may include:
- strengthening the parent-child relationship;
- helping the child to develop their communication skills;
- helping the child to stay calm and alert;
- teaching the parent about the child’s individual profile and their own individual profile and where there may be a match or mismatch.
Developmentally Appropriate
In our work we use a combination of practices which includes environmental adaptation, developmental therapies and sensory based interventions. We even use behaviour modification strategies where we see it is useful for the child to learn a new skill – however the child needs to be at the right developmental level for this.
If, developmentally, a child is just understanding their own body and who they are, they may not be ready to learn to share with others. The child’s actual age may be 6, 7 or 8 years of age but developmentally they may be functioning at an 18 month or 2 year level. Our aim is to find the best way to help the children and families who come to us for strategies around helping the child’s development, and starting where the individual child (and family) is at.
Just the Beginning
It’s great that this report has been released, however we all need to read it with caution and think about what approaches work for our children and families and then relay the benefits of these approaches to our communities. It shows that more unbiased research across a much larger sample population is needed in the area of Early Intervention Practices.