Results have indicated that, compared with the traditional struc

Results have indicated that, compared with the traditional structured models, interventions that are less structured and more child-focused result not only

in faster learning by children with ASD,20,27 but also result in children displaying higher levels of affect21 and engaging in less avoidant and Fasudil molecular weight disruptive behavior.20,28 As our ability to accurately diagnose autism in the first few years of life has improved, there has been an increased Inhibitors,research,lifescience,medical demand for intervention approaches that integrate developmental and behavioral approaches to target social communication skills in toddlers and preschoolaged children with ASD. Kasari’s JASPER (joint attention, symbolic play, emotion regulation) program resulted in increased expressive language skills with continued gains 1 year post study completion.29 This combined developmental and naturalistic behavioral approach Inhibitors,research,lifescience,medical was more effective than a more traditional applied

behavioral intervention preschool program. Similarly, the Early Start Denver Model30 incorporates behavioral and developmental strategies and has been associated with increased cognitive development and adaptive behavior. While not Inhibitors,research,lifescience,medical directly targeting requesting behavior, the focus on facilitating early social communication skills is designed to increase spontaneous communication skills and decrease challenging behaviors. Most of these naturalistic interventions include a caregiver Inhibitors,research,lifescience,medical education/training component. The caregiver has an advantage as s/he can optimize learning moments throughout naturally occurring opportunities during Inhibitors,research,lifescience,medical daily activities within the home and community. This may be more successful than instruction occurring only during specified times, which may burden the family by requiring extra time and effort.31 Thus,

naturalistic approaches are Tryptophan synthase ideally suited for caregivers.7,32 Recently, a large community-based study found improvements for up to 1 year in children’s expressive and receptive communication and decreases in problem behavior with parents who learned how to implement pivotal response treatment.33 Similarly, Minjarez and colleagues32 found significant increases in children’s functional spontaneous speech for parents who participated in a communication intervention training where feedback was delivered based on the videotapes they brought in. However, more research is needed to determine whether caregiver-mediated interventions that combine developmental and behavioral approaches are effective at decreasing challenging behaviors.

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