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Treating Our Toddlers
Wraparound Services for the Very Young

By Rebecca Klaw, MS, MEd
(Article originally published in the ABOARD newsletter in October/November, 2004)

Many providers of Wraparound are receiving requests to serve children between the ages of 1 and 2 who have been diagnosed with Autism Spectrum Disorders. In most cases the prescribing professional has advised parents that early intervention is crucial to optimum outcomes. Parents want more hours of intervention than the Birth to Three system can provide - they want intensive remediation for their toddlers with a hope that this service will ultimately push their child's growth and development in the right direction.

What does Wraparound look like for the very young child? Do you sit at a table? Does the parent leave? Are there drills and trials? How long can you work? All these questions and more should be considered by each and every Wraparound provider who takes on a very young client.

But before you answer the nitty-gritty questions such as those above, it is essential to have a developmental perspective. Providers must understand normal infant and toddler development before embarking on intensive remediation. During these very early months and years in a child's life, foundation skills are being developed. You must carefully build the skills that serve as the platform for all later learning.

What are these so-called foundation skills? The developmental literature would suggest that first, and foremost, the child needs to become socially attentive and engaged. Not just intermittently. Not just a moment of connection here and another moment there. The child must develop the skills for long, sustained, mutually rewarding interaction. The child needs to learn that being socially connected to others is a wonderful, exciting, memorable thing. The ability to relate to others, to sustain that relatedness and to seek a state of connectedness is the foundation of all other learning. That is what we need to teach our toddlers.

It is not easy. It takes time and skill and creativity and careful partnership with the parents. It takes flexibility of thinking, targeting and writing goals that are developmentally appropriate, and data collection that might not be based on percentages. And mostly, it takes a conviction that helping this toddler develop people skills is the stepping-stone to social, emotional and cognitive growth.

There are some simple guidelines that should be considered when you or your agency is planning intervention for your toddler:

  • Home-based intervention should occur in no more than 2-hour shifts with as many breaks as needed. The shifts may lengthen and the breaks may decrease as the child matures;
  • There needs to be access to parents for "refueling" as often as needed;
  • Play is the vehicle for remediation with gradual experiences at the table if the team decides that this will be an appropriate way for the child to learn as he or she becomes older;
  • All goals target social relatedness, social communication and expanding the child's experiences;
  • The Wraparound team must work closely with the Birth to Three professionals. These folks are experts in babies - their guidance and collaboration is often invaluable;
  • And finally, the focus of the intervention should be developing relationships as the foundation of the learning process.

As professionals diagnose children with autism spectrum disorders at younger and younger ages, and recommend that parents seek help in the form of Wraparound services, it is important for all Wraparound providers to be prepared to serve very young children if they intend to accept such clients. Providers and parents need to understand typical infant and toddler development. They both need to make intelligent and developmentally sound decisions about how to best bolster growth in the very young child.

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©2006, Rebecca Klaw. All Rights Reserved.