Community Implementation of Early Behavioral Intervention: Higher Intensity Gives Better Outcome

A didactic perspective on negotiations and collaborations between different actors within the Swedish support system: children with autism spectrum disorders included in community-based preschool settings

“…The focus on the child cornerstone demonstrates that preschools, HCs, and parents agreed that the children had specific challenges included in the ASD diagnosis (e.g., American Psychiatric Association, 2013). Even though the present study cannot tell us about the effects, there was an agreement that children with these type of difficulties do not learn as much with the 'common' didactic practices in preschools as they do with IBI, thus supporting previous research (e.g., Eikeseth et al, 2012;Eldevik et al, 2019). As stated by Leaf et al (2016), Lovaas was quoted as saying, 'If a child cannot learn in the way we teach, then we must teach in the way the child can learn.'…”

“…As Nilholm and Göransson (2017, p. 239) put it 'The fact that children with disabilities attend ordinary classes is a necessary but insufficient condition for inclusion.' Given that IBI is effective for children with ASD to learn (e.g., Eikeseth et al, 2012;Eldevik et al, 2019;Matson & Konst, 2014), the children in the current case-study are included, in the sense of getting education that meets their individual needs. Yet, the participants in the current study described that many other Swedish preschools (that is, not applicable to the ones included in the case-study) do not meet the needs of children with ASD.…”

“…Since then, the practices have been developed and include a variety of teaching procedures (discrete trial, incidental, and natural environmental teaching). Research suggests that when skilled professionals use IBI, children with ASD can make significant gains (e.g., in adaptive behaviour, intellectual ability, and sociocommunicative skills); however, outcomes in 'real-life' community-based settings have been reported to be smaller than within controlled set-ups (e.g., Eikeseth, Klintwall, Jahr, & Karlsson, 2012;Eldevik, Berg Titlestad, Aarlie, & Tønnesen, 2019;Matson & Konst, 2014;Reichow, Barton, Boyd, & Hume, 2014).…”

“…Common elements in IBI interventions are that they are individualized, skills are built step-by-step, practices are based on the child's initiatives as well as adultdirected, positive reinforcement is used, generalization of skills is planned, interactions with typically developing peers are included (one-to-one practices are also used), and progress is measured in the natural environment (e.g., Eldevik et al, 2019;Leaf, Taubman, McEachin, Leaf, & Tsuji, 2011). When IBI is provided in Swedish preschools, pedagogues are expected to work with these elements.…”

“…When IBI is provided in Swedish preschools, pedagogues are expected to work with these elements. In addition, the children preferably start participating in IBI before the age of four, the children spend approximately 20-40 hours a week involved in structured activities, and the pedagogues need appropriate knowledge and are supervised (e.g., Eldevik et al, 2019;McGee, Morrier, & Ala'i-Rosales, 2019). Tailoring IBI to individual children requires understanding of ASD, applied behaviour analysis, child development, the individual child and the context (e.g., the preschool setting), and there is a need for adults to be structured, yet flexible (e.g., Leaf et al, 2016;McGee et al, 2019).…”