by Dr. Moses L. James III, LPC, NCC, ACS, DCC
When it comes to counseling, James Consulting Services, LLC asserts the effective implementation of
evidenced-based strategies. In fact, we follow the established interventions described by
the National Autism Center and May’s Institute Center
Based on the National Autism Center’s National Standards Report (2015) the following components meet the criteria of research-based, effective interventions for children with autism:
Counseling using Cognitive Behavioral
- An educational component describing feelings/emotions,
physical responses to emotions, and prevalence of individuals with similar
- A cognitive restructuring component in which the therapist
assists the individual to modify cognitive distortions such as “all-or-nothing”
thinking or “catastrophizing.”
- Development of scale to identify anxiety or distress.
- Homework assignments. Individuals are expected to work on
skills in the home, school, and community setting. Typically, there is a
specific assignment that requires some type of recording of behavior or
- Parent sessions.
Counseling using Modeling
There are two types of modeling — live and video modeling.
Live modeling occurs when a person demonstrates the target
behavior in the presence of the child with autism spectrum disorder (ASD). When
providing live modeling:
- Clearly outline, in writing, the target behavior to model.
- Ensure all individuals modeling the target behavior are
doing so in a consistent manner. It may be helpful for
parents/caregivers/therapists to practice together to make certain each person
provides the same model.
- Obtain the child’s attention prior to modeling the target
- Develop a plan to fade or stop the use of modeling to
encourage the child to independently display the target behavior.
Video modeling occurs when you pre-record a person
demonstrating the target behavior. Video modeling can be a great option for
children/adolescents with an affinity for television shows, movies, or interest
in seeing themselves on a monitor (i.e., television screen, computer monitor,
video recorder monitor). Some children/adolescents may enjoy assisting in the
production of the video.
- Anyone who can correctly and independently perform the
task can serve as a model — this includes the person with ASD.
- Make sure your child is paying attention to and is
interested in the video.
- Point out the important steps/features to your child
during the video. Be sure to make the best quality video possible. Remember,
after the initial time invested in making the video, it is an easy-to-use
teaching tool, and is cost- and time-effective (e.g., the same video clip can
be used by multiple individuals any time).
Counseling using Naturalistic Teaching
Observe your child to find out what motivates him or her,
and then structure teaching interactions around those interests.
- Use materials your child is likely to encounter on a daily
basis. For example, if you want to teach her to identify items that fall into
the category “things you play with,” you might use dolls, blocks, and cars that
are available at home and at school.
- Teach skills in a variety of situations and settings (such
as the home and community) while using a variety of materials (e.g., teach
numbers by using different items such as pieces of candy or silverware).
- Provide consequences that are naturally found in the
environment and have a direct relationship to the activity you are completing.
For example, food might be a natural and direct reinforcer at lunch and toys
might be a natural and direct reinforcer during “playtime.”
- Provide loosely structured teaching sessions that vary
based on the child’s interests for that day. For example, if you are teaching
your child to request objects of different sizes, you may need to use dolls
rather than teddy bears if she shows a greater interest in dolls that day.
Counseling to Teach Parent Skills
Examples of skills parents learned to use include:
- Strategies to develop imitation skills
- Commenting on the child
- Expectant waiting to elicit communication
- Appropriate sleeping routines
- Joint attention
- Development of play date activities
Counseling Using Schedules
- Can be used once per day, multiple times per day, or once
- Are often used to help teach “first, then” concepts — such
as, first complete your chores, then you can watch television.
- Should be followed by access to preferred activities. You
can gradually increase the number of activities required before giving your
child access to preferred activities.
- Can be presented in multiple formats. You can use pictures
(real photos for example), written or typed schedules, 3-D objects, or
personal digital assistance programs.
The use of schedules may be as simple as:
- Placing the pictures/texts on the board at the time of the
- Pointing to the activity immediately prior to beginning
each step or activity
- Taking the picture off the board when the step or activity
- Placing the picture in a “done” container such as a bin,
box, or pile
Counseling Using Scripting
Scripting consists of providing the child/adolescent with
language to successfully complete an activity or interaction.
- Ensure prerequisite skills are mastered. For example, the
child should have necessary reading skills or be able to imitate a verbal
- Scripting is typically used in conjunction with behavioral
interventions such as reinforcement, modeling, and prompting.
- Scripts can be useful in a variety of social situations in
the school, home, and community setting.
- Scripts should be faded as soon as possible to increase
independence and spontaneity.
Counseling Using Story-Based
In particular, when using a story-based
intervention, use written descriptions for:
- The target behavior
- The situations in which the behavior should occur
- The likely outcome of performing the behavior. This often
includes a description of another person’s perspective.
information included in the story will vary based on your child’s cognitive and
developmental level, some typical features include:
- Information about the “who/what/when/where/why” of the
- Being written from an “I” or “some people” perspective
with the goal of increasing perspective-taking skills
- Discussion or comprehension questions to make certain the
child understands the main points
- Pictures to enhance comprehension of the skills
Story-based interventions are often used with individuals
who have acquired reading and comprehension skills, but may also be used with
individuals with strong listening comprehension skills.
Counseling is only one concern discussed by parents with regard to home based psychotherapy. Click here to learn other concerns and suggestions to address them.