Autism Spectrum Disorder (ASD): A Brief Summary*
*From: Peralta Rivera, Sabino (2021). Teaching of vocal mands to children with ASD: a systematic review. [Unpublished Master Thesis]. Universidad Complutense de Madrid.
Autism Spectrum Disorder (ASD) is a developmental disorder that affects an individual’s ability to communicate, socialize, create, and imagine. The Handbook for the Diagnosis and Statistics of Mental Disorders, 5th edition (DSM-5) outlines five criteria that must be met to make a diagnosis of ASD. These criteria are, succinctly:
- Persistent difficulties in social communication and social interaction in different contexts.
- Repetitive and restricted patterns of behavior, activities, and interests.
- Symptoms should be present in early childhood.
- Limitation and impediment in daily functioning.
- The alterations described are not better explained by intellectual disability or overall developmental delay.
(American Psychiatric Association, 2014, pp. 28-33).
The World Health Organization (2013), estimates that the global prevalence of ASD is 1 per 160 children, accumulating about 7.6 million individuals with ASD worldwide. However, prevalence is unknown in many low- and middle-income countries. On the other hand, the U.S. Center for Disease Control (CDC) reported that, in the United States, approximately 1 in 54 children is diagnosed with ASD, 1 in 34 boys, and 1 in 144 girls (Autismspeak.org).
“Although the cause of ASD remains unknown, some specific prenatal, perinatal, and environmental risk factors, such as high maternal and paternal age and specific gene mutations, have been identified, it is unclear what role these risk factors may play in the reported increase in prevalence” (World Health Organization, 2013).
Communication in individuals with ASD
Signs of communication disorder are present in children with ASD from the earliest years of their lives, even before the time when the first monosyllables or words expect to be vocalized by typically developing children. These signals can be seen in the exchange of affective expressions and in the use of gestures (Landa, 2007). “It has been estimated that up to 50% of children with ASD do not develop functional, vocal and verbal behavior…, which severely limits social participation” (Ward & Shukla Mehta, 2019, p. 1). The non-acquisition of a form of early communication causes the person to acquire destructive, harmful and self-injury behaviors, as well as self-stimulation and social isolation. (Kooistra et al., 2012). Teaching children with ASD to improve their communication is essential so that they can actively integrate into a social environment and reach their maximum capacity. Training “should address both the child’s behavior and communication skills and offer regular reinforcement of positive actions” (U.S. Department of Health and Human Services, 2020).
Concept of verbal behavior
The individual’s communication or language skills are defined by Skinner (1957), as verbal behaviors. Verbal behavior is “that behavior that is reinforced by the mediation of other people” (Skinner, 1957. p. 24). Skinner’s (1957) analysis of verbal behavior focuses on its functional characteristics, “in particular, the motivational, discriminative, and reinforcing factors that influence the occurrence of verbal behavior” (Fryling, 2017, p. 32).
Skinner (1957), classifies verbal behavior into six verbal operators: touch (or label), command (or request), echoic (repeated words or phrases), intraverbal (conversation), textual and transcription. Each verbal operant is functionally independent, with unique antecedents and consequences. Since then, specialists and educators have recognized the paramount importance of verbal mand operant in early childhood development.
Expanding a little further on the concept of mands, these are defined by Skinner (1957), as “a verbal operant in which the response is reinforced by a characteristic consequence and, therefore, under the functional control of relevant conditions of deprivation or aversive stimulation” (p. 35). more clearly said, a command is the same as making a request, for example, asking for information, requesting objects or other stimuli, saying no at the request of another person, and so on; always in order to satisfy a need.
Although each operant is functionally independent, it has been shown that the mand accelerates the development of other verbal operants such as intraverbals. According to Ward et al. (2019), the controls or, rather, the absence of controls plays a critical role in the development of children with autism spectrum disorder (ASD).
Treatment of ASD
Today there is no cure for ASD, but there are certain psychological interventions that can help the person develop skills that allow them to have a higher quality of life (Cooper et al., 2014; Gulsrud & Renno, 2021; World Health Organization, 2021). Evidence shows that the most effective treatments are those derived from behavioral techniques, such as Applied Behavior Analysis (ABA) (e.g. Lovaas, 1987). Early intervention has also been shown to have a highly positive impact on people with ASD (Lovaas, 1987; World Health Organization, 2021).
Applied Behavior Analysis
Applied Behavior Analysis or ABA therapy is arguably the most popular treatment for treating ASD (Gulsrud & Renno, 2021). This therapeutic approach is based on the principles of operant conditioning and the research carried out by Skinner (1987).
Lovaas (1987), was the first to apply Skinner’s basic principles of learning (1987), and to develop the first intensive ABA therapy for children with ASD. The pioneer showed that when using the discrete trial training (DTT) approach, focused on teaching skills in an individual setting using discrete and repeated steps, for 40 hours a week for a period of at least 2 years, children who received the intervention obtained large gains that were associated with a higher IQ and the possibility of being educated in conventional environments; and not only was there an improvement, but the results were maintained over time. Results that were compatible with another experimental research.
Bibliography
American Psychiatric Association (Ed.). (2014). Reference guide to the diagnostic criteria of the DSM-5. American Psychiatric Publishing.
Cooper, J. O., Heron, T. E., & Heward, W. L. (1987). Applied behavior analysis. USA: Pearson, 2014.
Department of Health and Human Services. (2020, April). Autism Spectrum Disorder: Communication Problems in Children. National Institute of Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/autism-spectrum-disorder-communication-problems-children.
Fryling, M. J. (2017). The functional independence of skinner’s verbal operants: Conceptual and applied implications. Behavioral Interventions, 32(1), 70-78.
Gulsrud, A.C., & Renno, P. (2021). The autism spectrum: Intervention, treatment, and services. In APA handbook of intellectual and developmental disabilities: Clinical and educational implications: Prevention, intervention, and treatment., Vol. 2. (2020-80415-006; pp. 131-152). American Psychological Association. https://doi.org/10.1037/0000195-006
Kooistra, E. T., Buchmeier, A. L., & Klatt, K. P. (2012). The effect of motivating operations on the transfer from tacts to mands for children diagnosed with autism. Research in Autism Spectrum Disorders, 6(1), 109-114.
Landa, R. (2007), Early communication development and intervention for children with autism. Ment. Retard. Dev. Disabil. Beef. Rev., 13:16-25.
Skinner, B. F. (1957). Verbal Behavior. New York: Appleton-Century-Crofts.
World Health Organization (2013) Meeting report: autism spectrum disorders and other developmental disorders: from raising awareness to building capacity: World Health Organization. Geneva, Switzerland.
Ward, K. D., & Shukla Mehta, S. (2019). The Use of a Stimulus Control Transfer Procedure to Teach Motivation-Controlled Mands to Children With Autism [Article]. Focus on Autism and Other Developmental Disabilities, 34(4), 215-225.