AMS-MOH Clinical Practice Guidelines

AMS-MOH Clinical Practice Guidelines is the first national guideline that incorporates the best available evidence from the scientific literature to assist all children with ASD and the healthcare professionals who work with them. Below is the extract of the Management:Intervention section with AutismSTEP adheres and strongly believes in.

Management: Intervention

• Every pre-school child diagnosed with ASD should have an individualised intervention plan that sets out the goals, type(s), frequency and intensity of intervention, in order to address particular developmental and educational needs.

• An individualised intervention plan should consist of a variety of quality programmes and activities. This includes attendance in comprehensive early intervention programmes, programmes targeting specific needs and also positive engagement with parents and/or caregivers.

• All pre-school children with ASD should undergo early intervention as soon as significant developmental need is recognized by a trained professional because outcomes improve with early intervention.

• The intensity of intervention should be continually monitored and varied according to the child’s changing need.

• Interventions for impaired communication should address the development of pivotal skills such as spontaneity, initiation, motivation and self-regulation.

• Interventions for impaired communication should aim to increase joint attention and symbolic play in order to improve expressive language development.

• There is no single language or communication intervention method that is appropriate for all children with ASD. The optimal communication intervention for an individual child with ASD depends on the needs of that particular child.

• Alternative-augmentative communication systems may be recommended for pre-school children with ASD because they expand (spoken or written) communication, may stimulate speech acquisition in non-verbal children and enhance expression in verbal children.

• Visual strategies are useful interventions for children with ASD because they offer visual support to communication, increase spontaneous imitation and socially communicative behaviour.

• Parent/caregivers should be educated that the use of alternative- augmentative communication systems or visual strategies neither inhibits speech nor replaces the development of expressive spoken language skills.

• Social skills are best taught explicitly through modeling and feedback.

• Social skills programmes depend on the functioning level of the preschool child with ASD and may include

–  Assessment and teaching of social skills interaction in natural settings

–  Provision of structure, visual cues and predictability

–  Making abstract concepts more “concrete”.

–  Activities that enable purposeful and appropriate interaction with 
typically developing peers.

–  Goals focusing on fostering self-appreciation and self esteem. 
B Interventions for children with ASD with challenging behaviours based 
on functional behavioural assessment are recommended

• Children with ASD who present with perceptual distortions, fine and gross motor co-ordination difficulties, impaired play skills and impaired self-care and adaptability may benefit from consultation with appropriate specialists such as occupational therapists and/or physiotherapists.

• In the assessment and management of feeding difficulties in children with ASD, the healthcare professional needs to consider challenges in executive functioning, fears, sensory processing, social and language skills.

• Management of gastro-intestinal disorders and feeding difficulties in children with ASD may require collaboration between healthcare professionals such as primary care doctors, paediatricians, gastro- enterologists, dietitians and therapists.

• Environment, tasks and timing of activities of children with ASD should be adapted to minimize negative sensory reactions and meet their sensory needs.

• “Sensory integration” intervention is not recommended as standard therapy in management of children with ASD but may be considered where the child has sensory difficulties that affect daily functioning.

• Early Intensive Behavior Intervention (EIBI) can be recommended as an intervention option for children with ASD.

• Structured Teaching can be recommended as an intervention option for children with ASD.

• The Hanen “More Than Words®” programme may be considered as an intervention option for children with ASD.

• Developmental models such as Developmental, Individual-difference, Relationship-based (DIR)/Floortime and Relationship Development Intervention (RDI) models may be considered as intervention options for children with ASD.