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Many children with autism display reactions to auditory stimuli that seem as if the stimuli were painful or otherwise extremely aversive. This article describes, within the contexts of three experimental designs, how procedures of systematic desensitization can be used to treat hypersensitivity to auditory stimuli in three young children with autism. Stimuli included the sounds from a vacuum cleaner, blender, hand-mixer, toilet flushing, and specific animal sounds from musical toys. A changing criterion design was used and data were collected on (a) the number of hierarchical steps completed as comfortable with the stimulus per week and (b) the mean level of anxiety per probe. A clinical replication was implemented using a replication of the desensitization procedures for three children. In addition, a systematic replication across three different stimuli is presented for one child in a multiple baseline. The data show that the children's responses could be modified to the point where they were comfortable with these noises. Furthermore, this level of comfort was maintained at follow-up. The discussion suggests that the extreme reactions to auditory stimuli many children with autism exhibit may be decreased with procedures that have been shown to be effective with reducing phobias, and the possibility that the reactions may be symptomatic of a phobia rather than actual pain.

Children with autism often lack appropriate means to communicate and may rely on aggression and other disruptive behaviors to express their needs. This may be a particularly serious problem when aggression occurs toward an infant or toddler, who could be severely injured by an older sibling. This study examined the use of functional assessment and individualized parent-implemented intervention plans in the home setting, including functional communication training with relevant ecological manipulations. Data were collected in the context of a multiple baseline design across three families. The results showed that after the intervention there were: (1) large reductions in the children's aggression toward their infant or toddler sibling, (2) increases in parent and child happiness level, and (3) increases in strangers' level of comfort with respect to interacting with the family. The results are discussed in terms of improving the overall quality of life for families of children with autism.

This study investigates the toilet training of four severely handicapped autistic children who regularly participated in a number of diverse community settings. In the context of a multiple baseline design, the children were first provided a systematic toilet training program in only some of the environments. In a subsequent "continuity" condition, the same toilet training program was systematically and simultaneously implemented within all of the children's environments. Results showed no consistent trends towards acquisition when training was provided in only some of the settings, even when the program was in progress for over two years. However, the continuity approach which coordinated all of the children's daily activities produced immediate and steady gains in successful toileting. This success was evident with children who had long histories of unsuccessful training attempts as well as with a child who had no previous exposure to toilet-training programs of any kind, These data are discussed in terms of the need for and benefits of continuity of treatment across settings for severely handicapped individuals.

This study systematically asked whether individual topics or themes on which children with autism perseverated across a variety of settings (often called obsessions) could be used to create the theme for a socially appropriate game. Data collected within the context of a multiple baseline design revealed very low levels of social interaction during play periods in the baseline condition. In contrast, when the children with autism were taught a socially appropriate game (e.g., one child who perseverated on maps was taught a tag game played on a giant outline of a US map), the percent of social interactions increased dramatically and continued to be high during follow-up measures. Generalization measures indicated that following intervention, the children also demonstrated increases in social interaction during other play activities. The results are discussed in terms of incorporating obsession themes into common games to create intrinsically reinforcing appropriate activities for increasing social interactions, and in relation to developing activities that capitalize on the child with autism's interests, so that the child is a valued member of the peer group.

Difficulties with social interaction are characteristic of autism. This study presents data illustrating the use of motivational strategies in play dates to improve the quality of social interactions between children with autism and their typically developing peers. Specifically, a multiple baseline design across participants shows how a contextual support package implemented during play dates can promote reciprocal interactions and improve affect. These results support the use of intervention strategies that target the pivotal area of motivation and provide evidence for using play dates as a context for intervention. The findings are discussed in terms of promoting quality interactions and encouraging friendship development.

Despite improvements in interventions for children with autism, assessments tend to focus on their social, cognitive, and behavioral deficits, without similar systematic examination of their strengths. Strength-based assessment (SBA), which has been used in work with children with milder behavioral disorders, may also have value for individuals who have autism. Although not supplanting usual assessment procedures, SBA provides a method for identifying personal, familial, and broader contextual strengths. Research outside the area of autism has found that SBA can be a useful addition to assessment protocols because it provides specific information on assets that can be incorporated into interventions. Further, SBA has the potential to affect the attitudes and beliefs of parents and educators involved in the assessment, creating greater hope about the ability of the child to function well and contributing to a stronger bond between the assessor, the child, and their family. This article describes ways in which SBA can be added to typical assessment protocols for children with autism. Examples are provided on how to identify and utilize strengths that can be used for planning interventions and for building more effective working relationships between clinicians and children with autism and their families. Areas for future research are also discussed.

The literature and our observations suggest that self-initiations may be an especially important part of intervention for children with autism. Therefore, the purpose of this study was to conduct preliminary assessments as to whether self-initiations might be associated with highly favorable postintervention outcomes. In the first phase of this study, archival data were analyzed for 6 children. At intake, according to traditional variables, they appeared to have especially good prognoses for reducing symptoms of autism, but had extremely different outcomes (either exceptionally good or exceptionally poor) after years of intensive intervention. Results of Phase 1 indicated that the children who had highly favorable outcomes exhibited more spontaneous self-initiations at preintervention. Given these results, Phase 2 of the study assessed whether a series of self-initiations could be taught to children with autism who demonstrated few or no spontaneous self-initiations at preintervention, and whether this intervention would result in highly favorable postintervention outcomes. Results indicated that these children learned a variety of self-initiations and had extremely favorable outcomes. The results of this exploratory study are encouraging in terms of assessment of key pivotal target behaviors that may be identified as prognostic indicators, and that may be important during intervention for children with autism.