Behavioural Therapist Perspective on Autism

Understanding Autism Through Behavioural Therapy Lens

Core Characteristics of Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects how a child communicates, learns, and interacts. Core characteristics include:

• Social communication differences – limited eye contact, delayed speech, or difficulty sharing interests
• Repetitive behaviours – hand-flapping, lining up toys, strict routines
• Sensory sensitivities – hyper- or hypo-reactivity to sounds, textures, or lights A behavioural therapist perspective on autism does not label these traits as “bad”; instead, we analyse why they happen and teach functional alternatives that improve quality of life.

How Behavioural Therapists Assess ASD

Assessment is the first step. At Cadabam's CDC we use:

1. Standardised tools – ADOS-2, CARS-2, and Vineland-3
2. Direct observation – play-based sessions recorded for detailed review
3. Caregiver interviews – structured questionnaires and open-ended discussions Data from all three sources is combined to build an accurate, strengths-based profile of your child.

The Role of Functional Behaviour Analysis

Functional Behaviour Analysis (FBA) answers the question, “What purpose does this behaviour serve?” Therapists look at antecedents (triggers), the behaviour itself, and consequences (what happens after). Common functions include:

• Escape – avoiding a difficult task
• Attention – seeking interaction from adults or peers
• Sensory – meeting an internal sensory need
• Tangible – gaining access to an item or activity Once the function is identified, we design interventions that teach a replacement behaviour serving the same function but in a safer, more socially appropriate way.

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Evidence-Based Behavioural Interventions for Autism

Applied Behaviour Analysis (ABA) – The Gold Standard

ABA is the most researched autism intervention worldwide. Key features:

• Individualised goals – tailored to each child’s age, skills, and family priorities
• Data-driven decisions – every session is measured and graphed
• Skill generalisation – teaching across people, places, and materials At Cadabam's CDC, ABA programmes range from 20 to 40 hours per week, depending on your child’s needs and family schedule.

Pivotal Response Treatment (PRT) for Natural Learning

PRT targets “pivotal” areas such as motivation and response to multiple cues. Instead of drills, learning occurs during play or daily routines. For example:

• Child chooses the toy – increases intrinsic motivation
• Natural reinforcement – if the child says “car,” he immediately gets the car, not a separate reward Studies show PRT boosts language and social initiations within weeks.

Early Start Denver Model (ESDM) for Young Children

ESDM blends ABA with developmental psychology for infants and toddlers (12–48 months). Sessions look like play but every activity is engineered to teach communication, joint attention, and motor imitation. Parent coaching is built-in, ensuring skills transfer to home and community settings.

Discrete Trial Training vs Natural Environment Teaching

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Behavioural Therapy Process at Cadabam's CDC

Initial Assessment & Diagnosis

Your first visit includes:

1. Parent interview (45 minutes)
2. Child observation in playroom (30 minutes)
3. Immediate feedback + written report within 48 hours If autism is suspected, we guide you to a developmental paediatrician for formal diagnosis, ensuring insurance coverage and school services.

Individualized Treatment Planning

Using assessment data, our BCBA drafts goals in four domains:

• Communication – requesting, commenting, conversational turn-taking
• Social – joint attention, peer play, perspective-taking
• Cognitive – pre-academic skills, problem-solving
• Adaptive – toilet training, dressing, feeding Parents review and approve every goal before therapy begins.

Family Involvement Strategies

Therapy works best when families practise at home. Strategies include:

• Weekly parent-training sessions – role-play, video feedback, troubleshooting
• Home visit kits – laminated visuals, data sheets, reinforcer menus
• 24/7 WhatsApp support – quick questions answered within 2 hours

Progress Monitoring & Adjustments

Every two weeks the team reviews:

• Graph trends – is the skill accelerating, decelerating, or flat?
• Barriers – motivation, prompt dependency, medical issues
• Next targets – always one step ahead of current mastery Parents receive a concise progress note and can schedule an in-depth review meeting any time.

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Comparing Behavioural Therapy Approaches

Effectiveness Metrics for Each Method

Age-Specific Recommendations

• Under 4: Start with ESDM, transition to ABA at school age
• 4–8: PRT for play skills, ABA for academics
• 8+: ABA with peer-mediated interventions and self-management training

Intensity Levels: 20 vs 40 Hours Weekly

• 20 hours – ideal for children already in mainstream school with moderate support needs
• 40 hours – recommended for early learners, severe language delays, or high-intensity behaviours Cost-effectiveness research shows 40-hour programmes produce 2–3× faster skill gains, reducing total therapy duration and long-term costs.

Cost-Effectiveness Analysis

Cadabam's CDC offers tiered pricing:

• Centre-based: ₹1,200/hr (includes BCBA supervision)
• Home-based: ₹1,400/hr (includes travel)
• Hybrid: Centre + home, discounted package rates Insurance empanelment with major providers (ICICI Lombard, HDFC Ergo) covers up to 80% of costs.

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Real Outcomes: Behavioural Changes in Autism

Communication Skill Improvements

• First words – average 8 weeks when started before age 3
• Sentence length – increases from 2 to 5 words within 6 months
• Spontaneous speech – 70% of sessions include unprompted comments after 1 year Case example: 4-year-old Arjun began with 10 words; within 9 months he requested toys, greeted peers, and answered “wh” questions.

Social Interaction Progress

• Eye contact – up from 2 seconds to 5–7 seconds on average
• Peer play – parallel play evolves to turn-taking games like hide-and-seek
• Emotion recognition – identifies happy, sad, angry faces in 80% of trials

Reduction in Challenging Behaviours

Using Functional Communication Training (FCT), tantrums linked to escape reduced from 20 to 2 per day in 6 weeks for 5-year-old Kiara. Parents reported calmer evenings and improved sibling relationships.

Academic & Daily Living Skills

• Reading readiness – phonics programmes increase letter-sound correspondence by 85% in 4 months
• Toileting – average 4 weeks to full independence
• Feeding – expands food repertoire from 3 to 15 items with systematic desensitisation

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Getting Started with Behavioural Therapy

What to Expect in First Session

1. Warm-up play – child explores toys while therapist observes
2. Skill probes – quick assessments of language, imitation, and self-help
3. Parent discussion – set mutual goals and schedule
4. Home plan – 2–3 simple strategies to try before next visit

Preparing Your Child & Family

• Visual schedule – show pictures of the centre, therapist, and activities
• Comfort item – favourite toy or snack during first few visits
• Sibling orientation – 15-minute session to explain what therapy looks like

Questions to Ask Your Therapist

1. What specific data will you collect?
2. How often will goals be updated?
3. How is generalisation to home and school ensured?
4. What is your crisis management protocol?
5. How do you measure parent satisfaction?

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