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Elements of Effective Programs

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As part of a NECTAS sponsored Forum on Autism Spectrum Disorders (1997-2001), a group of 8 representatives from seven models or programs were invited to participate as a "ASD Forum Experts." Care was taken to assure that the final group represented the well-known models that families recognize and frequently request and that state and local service systems often engage for replication or training. This group also included parent representatives (N=4), the coordinator of the National Institutes of Health's network for research on neurobiology and genetics of autism (N=1), other clinicians or researchers with expertise with young children with ASD (N=2) and NECTAS staff with experience providing technical assistance to state-level early intervention and early childhood special education programs (N=7).

Identifying key elements

This group of experts engaged in a facilitated, consensus-building exercise where each model program representative was asked to identify the core elements of their program. Group participants discussed the identified elements, defined the meaning of the emerging constructs as a group, and clarified each with illustrative program practices. Then the participants grouped the elements or features of the programs into categories of the same or similar constructs until all participants were satisfied that key elements of effective programs had been articulated. This process yielded nine mutually exclusive elements or features of program practice, as well as definitions and descriptions of the elements that were clear and acceptable to the group.

Once these program elements were defined, the program representatives identified elements that were an important part of their program and those that were not. This process yielded six areas of agreement — elements of effective practice agreed upon by all participants. In addition, three program components were identified that were very important to some participating programs, but were not components of all the represented programs.

The nine elements of effective programs ("Areas of Agreement" and "Program Areas That Are Part Of Some, But Not All Programs") are described in detail in the following table.

Table: Elements of Effective Programs

Program Element	Brief Definition
Areas of Agreement
Earliest Possible Start to Intervention	Children receive services appropriate to their needs as soon as they are identified as having ASD
Individualization of Services for Children and Families	Adjustments in goals, intervention strategies, and evaluation criteria are made for each child and family receiving services, determined by the child's needs, strengths, and interests and the family's concerns, priorities, and resources; as well as the program's overall theoretical and conceptual framework
Systematic, Planful Teaching	Instruction or intervention that is carefully thought out, logical, and consistent with a conceptual or theoretical basis and involves planning, implementing, and assessing intervention steps; each step is intentional, coordinated with an overall approach, and builds toward meaningful goals.
Specialized Curriculum	A core curriculum to address specific needs of children with ASD, includes these key areas: attending to elements of the environment, imitating others, language comprehension, use of language, playing appropriately with toys and interacting socially with others
Intensity of Engagement	Engagement refers to the amount of time that a child is attending to and actively participating in the social and nonsocial environment. Intensity of engagement is sometimes expressed as the percent of enrolled time that is spent in teaching interactions, or in activities in which the child is actively learning. The time that a child is engaged in learning opportunities may occur during program time and in home or community settings.
Family Involvement	Includes family involvement in their own child's program; services provided to families primarily because their child has ASD; services provided to families that are not directly related to ASD but may impact on overall family functioning; family support and networking; and family involvement in the overall program.
Program Areas That Are Part Of Some, But Not All Programs
Structured Environment	Arranging the environment, instructional materials, and teaching interactions to elicit, facilitate, or support specific skill attainment or development, including the use of environmental arrangements or visual cues to organize or schedule activities, to facilitate choices, and to define work, play, or rest spaces
Developmentally-Appropriate Practices	Practices that have been designed for all young children; programs are guided by information about child development and learning, each individual child's strengths, needs, and preferences and knowledge of the social and cultural contexts in which children live.
Intervention in Settings with Typical Children or in Natural Environments	Some or all interventions occur in settings with typical children. This may include fully integrated toddler or preschool settings, community childcare, community recreation activities and other supports in home and community settings.

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