**2. Autism and social behavior**

Difficulties in social relationships and interactions have been the defining features of autism. Hence, the need to understand the nature of these difficulties and to find effective treat‐ ments for them has been central to autism research and educational practices [5]. Unlike neuro-typical children who learn how to be social and interactive by watching how others talk, play and relate to each other, enjoy the give-and-take of social engagement and initiate, maintain and respond to interactions with others, children with autism often do not show the expected development of early social interaction skills. They are often socially avoidant, socially indifferent and awkward. Autistic children avoid social contact by having a tantrum or running away from people who attempt to interact with them. They seek social contact with people only when they want something. Factors that may affect development of social behavior are described below.

**•** Theory of Mind: Many children with autism also show profound empathy deficits. They develop a limited appreciation or no appreciation at all, of other people's feelings and ideas. They don't recognize and respond to faces as do normal children, and they thus do not learn that each face belongs to an individual separate person. To the severely autistic child, his/her own feelings and ideas are the only feelings and ideas that appear to exist. Autistic children may have no reaction to another person's crying, for example. They may have no idea that their words and actions affect other people. Many autistic children are completely unaware of their surroundings and other people in their surroundings. It is impossible for some autistic children to take another person's perspective without delib‐ erate training. For individuals with autism, it does not come naturally to consider other people's perspective. This makes it difficult for them to understand how others think and feel [6]. Clinicians and researchers call this inability to consider other's perspective as def‐ icit in *theory of mind.* Theory of mind, the ability to attribute mental states to self and oth‐ ers in order to understand and predict behavior, is an area of weakness among individuals in the autism spectrum. The development of theory of mind begins in infancy, as does the shift from the typical course that is seen in children with autism spectrum dis‐ orders. While the peak in theory of mind development occurs in typical children from the age of 3 to 4, mental state understanding in individuals within the autism spectrum often continues to be conspicuously absent throughout the lifespan and leads to significant so‐ cial and communicative challenges.

Research reports a significant difference between age-matched infants with autism and typically developing infants with respect to visual attention to social stimuli, smile fre‐ quency, vocalization, object exploration engagement, facial expression, use of convention‐

Identifying autism in toddlers is a recent practice. A large number of children have been di‐ agnosed reliably at 2 years. Professionals can now predict autism from the behaviors ob‐ served in a child younger than 2 years. Providing therapeutic intervention at this age would improve developmental and adaptive outcomes. The global trend in early intervention of autism is to provide training to parents so they can help the children develop in key areas of social responsiveness, attention skills, early communication skills, and interactive behavior.

Difficulties in social relationships and interactions have been the defining features of autism. Hence, the need to understand the nature of these difficulties and to find effective treat‐ ments for them has been central to autism research and educational practices [5]. Unlike neuro-typical children who learn how to be social and interactive by watching how others talk, play and relate to each other, enjoy the give-and-take of social engagement and initiate, maintain and respond to interactions with others, children with autism often do not show the expected development of early social interaction skills. They are often socially avoidant, socially indifferent and awkward. Autistic children avoid social contact by having a tantrum or running away from people who attempt to interact with them. They seek social contact with people only when they want something. Factors that may affect development of social

**•** Theory of Mind: Many children with autism also show profound empathy deficits. They develop a limited appreciation or no appreciation at all, of other people's feelings and ideas. They don't recognize and respond to faces as do normal children, and they thus do not learn that each face belongs to an individual separate person. To the severely autistic child, his/her own feelings and ideas are the only feelings and ideas that appear to exist. Autistic children may have no reaction to another person's crying, for example. They may have no idea that their words and actions affect other people. Many autistic children are completely unaware of their surroundings and other people in their surroundings. It is impossible for some autistic children to take another person's perspective without delib‐ erate training. For individuals with autism, it does not come naturally to consider other people's perspective. This makes it difficult for them to understand how others think and feel [6]. Clinicians and researchers call this inability to consider other's perspective as def‐ icit in *theory of mind.* Theory of mind, the ability to attribute mental states to self and oth‐ ers in order to understand and predict behavior, is an area of weakness among individuals in the autism spectrum. The development of theory of mind begins in infancy, as does the shift from the typical course that is seen in children with autism spectrum dis‐ orders. While the peak in theory of mind development occurs in typical children from the

al gesture, and pointing to indicate interest [4].

692 Recent Advances in Autism Spectrum Disorders - Volume I

**2. Autism and social behavior**

behavior are described below.


stressed, they may not be able to let others know how they are feeling and may react vio‐ lently or aggressively. Additionally, appropriate social interaction in autism is hampered by a tendency to become fascinated by special interest that dominates the child's time and conversation, and the imposition of routines that must be completed. The interest is a soli‐ tary pursuit and not that evinced by age peers. A lack of completion of the activity in a routine can lead to distress and anxiety. Researches indicate that insistence on completing an activity in a particular way may be the child's attempt to find patterns and look for rules and organization within environment [8]. Once a pattern has emerged it must be maintained. Thus, establishment of a routine ensures that there is no opportunity for change. As social situations are inherently dynamic, this adherence to routine and limited interest deeply impacts the child's ability to be socially active in appropriate manner.

ingly autism is being identified very early in development. It has been shown that diagnosis can be valid and reliable at 2 years of age, and signs can be recognizable and predictive of autism even from early in the second year of life. In future it is likely that autism will be diagnosed for most children in the toddler age period [18 - 30 months). Very early therapeu‐ tic intervention is likely to improve developmental and adaptive outcomes. Trials of early intervention need to focus on training parents to work with their very young children in the key areas of social responsiveness, attention skills, early communication skills, and interac‐ tive play. The findings of a study by Ivar Lovaas [10] on early behavioral intervention of children with autism in 1987 showed a significant gain in IQ and that 49% of children who

Early Intervention of Autism: A Case for Floor Time Approach

http://dx.doi.org/10.5772/54378

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The guidelines for best practice in early intervention for children with autism [11] recom‐

**•** Preparation: All children on entering intervention programs should have had a compre‐ hensive, multidisciplinary diagnostic assessment from an interdisciplinary team of experi‐ enced clinicians and based on national and internationally agreed criteria. Diagnostic evaluations should include interviews with parents/care givers to review the child's de‐ velopmental history, family history, previous assessments and interventions; collection of information from all professionals involved in the care of the child; paediatric, psycholog‐ ical, and speech pathology examinations to assess communication, relevant health condi‐ tions including motor skills, vision, and hearing, and any associated problems such as intellectual disability and anxiety. Additionally, direct observation of the child is impor‐ tant in the assessment of cognitive, social, and communicative (verbal & nonverbal) do‐ mains, fine and gross motor, and adaptive functioning using both standardised tests and

**•** Timing: Intervention should begin as early as possible in the child's life. Since a child at risk of autism can be screened by 16 months the intervention may start immediately.

**•** Process: All children should have an Individual Family Service Plan (IFSP), for their edu‐ cation, designed to best fit their and their family's needs and strengths, developed in con‐ sultation with parents, and reviewed and revised regularly in light of the child's progress

**•** Intensity: Ideally the intervention should be provided for 20 hours a week for two years,

**•** Content and Focus: The content should be autism specific and include teaching joint at‐ tention skills, play, and imitation skills; building communication through Alternative and Augmentative Communication (AAC) techniques such as pictures, symbols and signs; developing social interaction and daily living skills; and management of sensory issues

**•** Settings: The intervention should be delivered in various settings, individually and with peers. Implementation should happen both at the centre and at home. Including age peers

with continuing support into, and through the school age years.

received EI were mainstreamed in regular classrooms.

mend the following:

informal procedures.

and ongoing needs.

and challenging behaviors.
