Learn about the Levels of the Intervention Ziggurat
Sensory and Biological
The base of the Ziggurat represents what is, in one sense, the basis of all behavior – biology. This is especially important in the case of autism – a disorder that has strong genetic and neurological underpinnings. Multiple interacting genes are involved in the development of ASD. In fact, studies on twins indicate that across the spectrum, the heritability rate exceeds 90%. This is higher than any other heritable disorder, including schizophrenia and bipolar disorder (Nicolson & Szatmari, 2003; Rutter, 2000; Santangelo & Tsatsanis, 2005). Significant differences in the structure and development of the brain (size, volume, and mass) have been identified (Nicolson & Szatmari). These differences result in sensory and biological needs that often differ from those of neurotypical individuals. Unmet sensory and biological needs result in changes in behavior. For this reason, the development of effective behavior intervention programs requires consideration of biological factors and inclusion of interventions to address needs at this level. With individuals on the autism spectrum, this consideration must be informed by an understanding of biological and sensory differences fundamental to the disorder itself.
All intervention plans ultimately target the development or increase of a behavior or skill. This goal can only be accomplished by incorporating reinforcement into the comprehensive plan. Without reinforcement, there is no intervention. Because of its fundamental nature, reinforcement is included as the second level of the Intervention Ziggurat.
It may be necessary to think creatively about reinforcement for students with ASD. While social opportunities are often reinforcing for typically developing students, these may be some of the most challenging situations the same is usually not the case for students with ASD for whom social competence presents challenges. In seeking to identify effective reinforcers, it is often helpful to consider the student’s preoccupations (Sakai, 2005). Indeed, research has found that activities or objects related to obsessions are often more effective reinforcers than food (cf., Charlop-Christy, Kurtz, & Casey, 1990) for individuals on the autism spectrum.
Structure and Visual/Tactile Supports
The third level of the Ziggurat, Structure and Visual/Tactile Supports, is based on core characteristics of ASD including deficits in verbal communication and a need for routine and order. Visual reminders or lessons, called visual supports, are often provided to address these concerns. Tactile supports are an additional alternative to verbal communication and should be considered, especially for students with a vision impairment. The areas of structure and Visual/Tactile Supports often overlap. Visual supports such as pictures, written schedules, and task strips may be used as tools to clarify the structure of an activity. Visual schedules have been shown to be effective for improving the speed of transitions (cf., Dettmer, Simpson, Myles, & Ganz, 2000); decreasing behavior problems during transition (cf., Dooley, Wilczenski, & Torem, Vis2001); increasing on task behavior (cf., Bryan & Gast, 2000); and enhancing independence (cf., Pierce & Schreibman, 1994). There is substantial research support for other visual strategies, such as Social StoriesTM (cf., Sansosti, Powell-Smith, & Kincaid, 2004) and video modeling (cf., Nikopoulos & Keenan, 2004). The predictability and information that structure and visual/tactile supports make available to those on the spectrum are critical aspects of any comprehensive behavior intervention plan.
The Task Demands level of the Intervention Ziggurat provides another avenue for behavior intervention. Any aspect of a task that must be met is a task demand (e.g., social, communication, sensory, emotional, academic, etc.). Behavior problems such as meltdowns, social isolation, “shutting down,” and tantrums are often caused by demands exceeding an individual’s ability. Simply put, if a task is too demanding, the individual will fail. Interventions on the Task Demand level involve adjusting the demands and/or increasing supports in order to balance the individual’s ability with the task presented.
Skills to Teach
The first four levels of the Ziggurat set the stage for what the authors consider to be the ultimate goal of all behavior interventions—skill acquisition. Skills to Teach is the final level of the Intervention Ziggurat. It is possible to resolve some behavioral concerns by using interventions from other levels without ever teaching skills. Teaching skills increases the ability to function independently and decreases the need for support. Only by including interventions at this level does true growth occur.