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Portage and Autism Ranking: Insufficient/Mixed evidence

Father and childPortage is an early childhood intervention service that aims to support families who have young children with additional needs in their own homes.

The children are taught new skills through the use of questions and tasks, prompts, and rewards. Parents and carers are shown how to apply this system by a weekly or fortnightly visit from a Portage home visitor.

The training sessions are brief, usually about 15 – 20 minutes per day, and are scheduled when the parent believes the child will be at their most receptive. Typically, the parent will teach the child in a 1:1 situation, and will target one or two skills a week for teaching.

Monitoring and evaluation of progress occurs at the supervisors visits.

Typically, the parent will teach the child in a 1:1 situation, and will target one or two skills a week for teaching.

Monitoring and evaluation of progress occurs at the supervisors visits.

Our Opinion

There is currently very little research evidence on the use of portage for families with pre-school autistic children . There are more studies that provide some feedback on outcomes for pre-school children with a range of special educational needs.

The research evidence that does exist suggests that portage may provide some limited benefits to those families, especially when it is adapted for use with autistic children.

However the research evidence also suggests that portage may not provide as many benefits to families with autistic children as other early interventions.

Because portage is commonly used as an early intervention tool to support families with pre-school children with a range of disabilities we recommend that further, more rigorous studies are carried out into its use.

Disclaimer

Please read our Disclaimer on Autism Interventions


Aims and Claims

Aims

The aim of portage is to help pre-school children with special education needs to develop in five key developmental areas. Those areas are self-help skills, motor skills, cognition, social emotional skills, and communication.

According to Barakat, R., Drylie, L. and Nash, J. (2004)

"While there are not specific concepts and skills to be learned, the program tends to focus on behaviors identified for each individual child, based on their disability, and target skills identified from the initial assessment.  The individually developed goals that identify a child’s target skills and behaviors are consistently evaluated and adjusted accordingly as the child demonstrates the desired outcomes."

Claims

Various people have made claims for portage when used with children with a range of special needs. For example, according to Her Majesty’s Inspectorate at the Department of Education which conducted a survey of 13 portage services in 1998.

"The findings of the survey were generally encouraging; most of the work seen indicated that systematic and effective teaching and learning were taking place. The results compiled and opinions expressed by parents, home teachers and the various professionals involved in the project, indicated that the majority of the children had made accelerated progress."

There are much more limited claims for the use of portage and families with an autistic child. For example Reed, Osbourne and Corness (2005) found that portage provided a significant level of support for families who had young autistic children.

Audience

Portage is designed to help families with preschool children with special educational needs. This includes children who have profound and multiple learning difficulties, children with complex social communication difficulties /autism, and children with challenging behaviour.

Portage is designed to support families from the time that they notice their child has additional needs. This can be soon after birth or at any time in the pre-school period.

Key Features

Portage (also known as Portage Model or the Portage Home Teaching Program)  is a home-based teaching programme for preschool children with special educational needs. The children are taught new skills through the use of questions and tasks, prompts, and rewards. Parents and carers are shown how to apply this system by a weekly or fortnightly visit from a Portage home visitor.

The Portage home visitor

According to National Carers Service website, accessed July 2013, the portage home visitor

  • observes the child and talks to the parents to identify the skills the child already has
  • decides with the parents which skills are most important for the child's future learning
  • suggests a programme of activities for the parents and child to practise together
  • breaks down tasks that are difficult or take a long time into small steps
  • provides an activity chart or notebook for parents to record their child's progress
  • visits each week to check on progress and agree on new goals
  • writes progress reports and works with the parents to develop long-term goals

Portage Materials

According to Cameron 1997, the portage worker shows the parents how to use a variety of portage materials. Those materials include the portage checklist, the portage teaching cards and the portage activity chart.

The Portage checklist

"This developmental checklist is used to identify the child’s existing repertoire of skills in the follows areas: self help: motor, language, social, and cognitive development. In addition, there is a section of ‘infant stimulation’ activities which could be used either with very young children, or with older children who had acquired very few skills. The checklist can be used both for an initial assessment and to provide the information necessary to select appropriate future teaching objectives for the child."

The Portage teaching cards

"A card file provides specific teaching instructions for each of the 600 or so items in the Portage checklist.  These cards have two main functions – providing useful teaching hints, particularly for new or inexperienced home teachers and providing suggestions on different ways of teaching the same skills, thus enabling the child to generalize and adapt the skills taught."

The Portage activity chart

"This is a carefully designed procedure which allows parents to teach their child and also record the results of their teaching effort.  Each activity chart it written to a carefully worked out formula which not only specifies the activity to be taught but also how it is to be taught and at what level of success."

Cost and Time

Cost

Portage is usually provided free of charge to parents within the UK, the USA and some other countries.

Time

The training sessions are brief, usually about 15 – 20 minutes per day, and are scheduled when the parent believes the child will be at their most receptive.

Typically, the parent will teach the child in a 1:1 situation, and will target one or two skills a week for teaching. Monitoring and evaluation of progress occurs at the supervisors visits.

According to Barakat, R., Drylie, L. and Nash, J. (2004)

"The Portage Project and its materials/components are based on a strong belief that parents play the most important role in the development and teaching of their preschool child and on the value of a clearly defined method of presenting the curriculum in small, achievable steps.  Parents are educated on how to teach their children, what behaviors to reinforce and also how to record data on targeted behaviors.  Of anyone, parents spend the most amount of time with their children so it is important that they interact in a way that is beneficial to their child.  The Portage Project involves the parents in every aspect of education such as assessments and curriculum planning.  The child’s current skills are built upon slowly as to achieve long-term goals."

Risks and Safety

Hazards

There are no known hazards from undertaking portage.

Contraindications

There are no known contraindications (something which makes a particular treatment or procedure potentially inadvisable) for portage.

Suppliers and Availability

Suppliers

In the UK, a core training programme is run by the National Portage Association. The National Portage association provides details of where these services can be found.  

Credentials

The National Portage Association (NPA) has developed a core curriculum for the Portage Basic Workshop to ensure the national consistency and credibility of its training. Each Portage Basic Workshop lasts for the equivalent of 3 full days, often delivered over 4 days. Portage Basic workshops are organised by Accredited NPA Trainers. Portage Basic Workshops are normally delivered at regional or local level. After this initial training, continuing support and development is available to Portage Home Visitors through the regular (weekly or fortnightly) supervisory meetings.

The National Portage Association has published Core Competencies for Portage Home Visitors. Registered services are advised to use this document to support all newly trained home visitors. There is no set amount of time suggested for its completion. Much will depend on previous experience and the current caseload.

The workshop focusing on children with complex social communication difficulties and autism is highlighted to enable participants to:

  • examine the Portage model and how it supports meeting the needs of children with social communication difficulties: autism
  • consider the relationship between the Portage model and recent developments in early interventions for children with social communication difficulties
  • understand the needs and individual differences of children with social communication difficulties
  • plan home visits reflecting recent knowledge in ASD and develop appropriate methods of recording
  • develop strategies for enhancing the communication, play, learning and behaviour of children with social communication difficulties

Related Suppliers and Availability


History

The Portage Project began as a project funded by the U.S. Department of Education in 1969. It was named after the town of Portage in Wisconsin where the project started.

The Portage Project was developed as a way of supporting parents to help their children in their own homes. This idea was tried in Portage because parents in this rural area found it difficult to get to centre-based services.

Since then Portage has been adopted in many different countries and is sometimes included within other programmes. For example, according to Barakat, R., Drylie, L. and Nash, J. (2004)

The Portage Project has been incorporated into many other programmes in the USA such as Head Start, Early Head Start Child Care, 4 year old Kindergarten, Early Childhood Special Education, Preschool Programs, Inclusion Programs and Home Visitation Programs. 

Current Research

We have identified four scientific studies of portage used as an intervention for autistic children published in peer-reviewed journals.

These trials included more than 150 children with autism and/or speech and language difficulties aged from 2 to 4 years old. 

In the study by Reed et al (2007) 16 autistic children who received portage made less progress than the children receiving other early interventions – such as special nursery provision, or behavioural programmes based on the principles of applied behaviour analysis.

In the study by Reed et al (2012) 18 children with autism who received an adapted version of portage made similar progress to the children who received special nursery or local authority provision but less progress than the children who received behavioural programmes based on the principles of applied behaviour analysis.

In the study by Smith, Goddard and Fluck (2004), all of the children in the second experiment described received portage. 12 received normal portage and 10 received portage with the addition of a developmental intervention called the Scheme to Promote Early Interactive Conversations (SPEIC), which replaced the language element of portage. Both groups made progress but the group using SPEIC made greater progress in language development than the group using normal portage.

In the study by Reed P. et al. (2013), 16 children who received portage made less progress in a number of areas (such as adaptive behaviour and language) than 16 children who received the Barnet Early Autism Model (BEAM) for autistic children.  In the same study, levels of stress were seen to increase significantly in those parents who used portage whereas levels of stress in parents who received BEAM decreased significantly.

Status Research

Cameron 1997, states that ‘...research relating to positive outcomes of families receiving a Portage service has been consistently reported over the past two decades’

However two systematic reviews of the use of portage for a range of children with developmental disabilities are less positive. For example

Brue and Oakland (2001) stated that 'Empirical evidence was available from few studies. In addition, small sample sizes, brief duration of interventions, lack of control groups, restricted dependent measures and lack of follow-up studies precluded an appropriate evaluation of the Portage Guide's effects. Research that overcomes these and other methodological problems is needed. Lacking suitable evidence, professionals are encouraged to be conservative when discussing the Portage Guide's beneficial effects.'

Sturmey (1986) stated that 'A wider range of dependent variables is needed to assess more fully the impact of Portage on both the child and the family. As yet no data are available on long‐term effects of Portage. The case is made for viewing Portage as one amongst several service options available for developmentally delayed preschool children and their families. '

There are limitations to all of the individual research studies on this topic that we have identified to date.

For example, none of the studies used a blinded, randomised controlled format.  The study by Smith, Goddard and Fluck (2004) provided insufficient data about the characteristics of the participants, the intervention used, and the outcomes of the intervention. This was largely because the focus of the study was on a different intervention.

For a comprehensive list of potential flaws in research studies, please see ‘Why some autism research studies are flawed’.

Future Research

Summary of Existing Research

There is currently very little research evidence (four studies) on the use of portage for families with pre-school autistic children.

The research evidence that does exist suggests that portage may provide some limited benefits to those families, especially when it is adapted for use with autistic children.

However the research evidence also suggests that portage may not provide as many benefits to families with autistic children as other early interventions.

Recommendations for Future Research

Because portage is so widely used there is a need for more research into its use for families with autistic children. Future studies should investigate issues such as whether portage provides any kind of benefit to autistic children and/or their parents and carers 

Studies and Trials

This section provides details of scientific studies into the effectiveness of this intervention for autistic people which have been published in English-language, peer-reviewed journals.  

If you know of any other publications we should list on this page please email info@informationautism.org

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Related Studies and Trials


Other Reading

This section provides details of other publications on this topic.

You can find more publications on this topic in our publications database.

If you know of any other publications we should list on this page please email info@informationautism.org

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Related Other Reading


Personal Accounts

We have identified the following any personal accounts about the use of portage for autistic people.

From a parent of an autistic child using the Portage Service in Dorset

“I am writing to tell you about our experience with the Portage Service in Dorset since my younger daughter was diagnosed as autistic a year ago. After an initial assessment visit, we were assigned our Portage worker and Deb began her weekly visits. Deb quickly established a good rapport with my daughter. Goals were drawn up which reflected areas that my daughters speech therapist wanted us to work on, but also incorporated areas that we, as parents, were concerned about. My daughter has benefited from having home visits from someone she has come to know and to like. Her autism means that she likes stability and security and being able to work at home gives her the confidence to try new things. She has made great progress over the last year and the Portage Service has been a major factor in his progress. I cannot speak highly enough of the service and the benefits it has given to us as a family. I know we have all been very lucky to have met such an excellent Portage Worker and we will all be very sad to lose Deb when my daughter starts school. I would thoroughly recommend the service to any family with an autistic child as it seems to be ideally suited to her needs.”

Updated
17 Jun 2022
Last Review
01 Jan 2017
Next Review
01 May 2023