Approach Key	Features	Comments
Clinician-directed *Clinician	specifies treatment type, goals, and reinforcement	*Less naturalistic *Maximize practice of specific targets
Child-directed *Clinician	provides naturalistic opportunities for a child response *Clinician follows the child’s lead	*Useful when poor compliance with clinician-directed approaches *Useful for “unassertive communicators”
Parent-mediated	*Parents use direct, individualized intervention practices with their child *Increased opportunity for language input	*Cost effective *Growing evidence for early intervention
Treatment Type	Key Features	Comments
Behavioral Therapies	*Use behavioral learning principles *Increase desired behaviors *Decrease inappropriate behaviors	*Instructional: Discrete Trial Training *Play-based: Pivotal Response Training *Frequently used ASD and DD
Milieu Therapy	*Therapist elicits and reinforces targeted responses *Naturalistic settings *Child may select topic to initiate interaction	*Evidence in several groups: late-talkers, ASD, ID, children from high-risk and low income families
Relationship Based Approaches	*Promotes parent-child interactions *Common in early intervention programs	*Greenspan/DIR/Floortime encourages interaction through play *Used in ASD
Modalities Key	Features	Comments
Augmentative Alternative Communication	*Supplemental methods to replace speech *Can address impaired production or comprehension	*Aided symbols: Picture Exchange Communication System (PECS) and speech generating devices *Unaided symbols: manual signs *Strong evidence in ASD & ID
Computer Based Instruction	*Computer programs teach language skills	*Advantage of higher number of trials than with therapist *Example: FastForWord
Video Modeling	*Videos show desired behaviors *Learners are video-taped *Practice videos are reviewed	*Parent-mediated example: Hanen Program