Children diagnosed with autism are on the increase, so knowing how to teach these children and which strategies to use, is extremely important. Listed are some tried and true strategies that will ensure that every autistic child receives the best education possible.
These strategies can be implemented both in a classroom and at home.
These ten suggestions should help in educating the autistic child with less stress and in a more focused environment taking into account their limitations.
Autism Teaching Methods: Applied Behavior Analysis and Verbal Behavior
Applied Behavior Analysis, or ABA, is a method of teaching children with autism and Pervasive Developmental Disorders. It is based on the premise that appropriate behavior – including speech, academics and life skills – can be taught using scientific principles.
ABA assumes that children are more likely to repeat behaviors or responses that are rewarded (or "reinforced"), and they are less likely to continue behaviors that are not rewarded. Eventually, the reinforcement is reduced so that the child can learn without constant rewards.
Research shows that ABA works for kids with autism. "Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior," according to a U.S. Surgeon General's Report.
The most well-known form of ABA is discrete trial training (DTT). Skills are broken down into the smallest tasks and taught individually. Discrete, or separate, trials may be used to teach eye contact, imitation, fine motor skills, self-help, academics, language and conversation. Students start with learning small skills, and gradually learn more complicated skills as each smaller one is mastered.
If a therapist is trying to teach imitation skills, for example, she may give a command, such as "Do this," while tapping the table. The child is then expected to tap the table. If the child succeeds, he receives positive reinforcement, such as a raisin, a toy or praise. If the child fails, then the therapist may say, "No." The therapist then pauses before repeating the same command, ensuring that each trial is separate or discrete. The therapist also will use a prompt - such as physically helping the child tap the table - if the child responds incorrectly twice in a row. This "no-no-prompt" method is used in some traditional ABA programs.
However, many ABA programs now use prompts for every trial, so the child is always correct and always reinforced by praise or a toy. This technique is called "errorless learning." The child will not be told "no" for mistakes but rather will be guided to the correct response every time. The prompts will be gradually reduced (or "faded," in ABA language), so the child will learn the correct response on his own.
ABA may take place in the home or a school. A consultant or board certified behavior analyst -- usually someone with a master's or doctoral degree in psychology -- often supervises the therapy.
Some people incorrectly assume that ABA only describes the method developed by Dr. O. Ivar Lovaas, a pioneering researcher in the Psychology Department at UCLA. Lovaas developed one form of ABA. In 1987, he published a study showing that nine of the 19 preschoolers involved in intensive behavioral intervention -- 40 hours per week of one-on-one therapy -- achieved "normal functioning" by first grade. Note: Several decades ago, Lovaas described using mild physical punishment for severe behaviors during therapy sessions. He later rejected punishment, and modern behavior therapists do not use it. Dr. Lovaas, 83, died in 2010.
ABA programs usually draw upon Lovaas's decades of research, but they also may incorporate different methods and tools.
Applied Verbal Behavior or VB is the latest style of ABA. It uses B. F. Skinner’s 1957 analysis of Verbal Behavior to teach and reinforce speech, along with other skills. Skinner described categories of speech, or verbal behavior:
A VB program will focus on getting a child to realize that language will get him what he wants, when he wants it. Requesting is often one of the first verbal skills taught; children are taught to use language to communicate, rather than just to label items. Learning how to make requests also should improve behavior. Some parents say VB is a more natural form of ABA.
Like many Lovaas ABA programs, a VB program will use errorless teaching methods, prompts that are later reduced, and discrete trial training. Behavior analysts Dr. Vincent Carbone, Dr. Mark Sundberg and Dr. James Partington have helped popularize this approach.
One drawback to ABA/VB: some school districts and insurance companies do not pay for it, and it can be expensive for parents to fund. If you decide to pay for it yourself, carefully research the credentials of anyone claiming to be an ABA or VB consultant or experienced therapist. A consultant should have, at a minimum, a master's degree in psychology or ABA, or should be closely supervised by someone who does. When hiring therapists, some families find volunteers or students willing to work for lower pay in order to gain experience with autism.
Autism Teaching Methods: Relationship Development Intervention
Relationship Development Intervention (RDI®) is a parent-based clinical treatment that tries to fix the social problems at the heart of autism, such as friendship skills, empathy and the desire to share personal experiences with others. Psychologist Steven Gutstein developed RDI with his wife, Dr. Rachelle Sheely. Their approach takes into account the ways in which typically-developing children learn how to have emotional relationships beginning in infancy.
RDI tries to help children interact positively with other people, even without language. When children learn the value and joy of personal relationships, according to RDI, they will find it easier to learn language and social skills. RDI is based on the idea that children with autism missed some or many of the typical social development milestones as infants and toddlers. They can be given a "second chance" to learn these skills through play, "guided participation" and other activities, according to RDI.
Here's an example of RDI in action: "The adult holds a treat in one closed fist, displays both closed fists to the child, and then looks at the hand that holds the treat. The child is given repeated opportunities to 'find' the treat in the hand the adult looks at," according to the Handbook of Autism and Pervasive Developmental Disorders
Early research of RDI's effectiveness published in 2005 indicates that RDI may be more effective that some other treatments. When compared to a control group with autism, children whose families participated in RDI showed greater improvement on the Autism Diagnostic Observation Schedule and more independence at school. Dr. Gutstein acknowledges that more research needs to be done of his method, which is relatively new. It was first publicized in 2001.
Some families are using RDI in addition to ABA and other teaching methods. About 5,000 families were receiving RDI in 2009, according to RDI connect. A goal of the family-centered program is "normalization of family life for all members."
Considerations: RDI is more often used in homes than schools, though that is changing. RDI-certified consultants can be expensive. More research needs to be done on RDI.
Autism Teaching Methods: Sensory Integration Therapy
All children learn about the world through their senses. Children with autism spectrum disorders, however, often have unusual responses to the senses of hearing, sight, touch, smell and/or movement. These responses can interfere with learning and affect behavior.
Children with autism spectrum disorders may over-react or under-react to things they hear, see, taste and touch. "Thus, they may be suspected of being deaf or visually impaired. It is common for such young children to be referred for hearing and vision tests. Some children avoid gentle physical contact, yet react with pleasure to rough-and-tumble games. Some children carry food preferences to extremes, with favored foods eaten to excess. Some children limit their diet to a small selection," according to the National Information Center for Children and Youth with Disabilities.
Is your child extremely sensitive to certain noises, bright lights, food textures or crowds? Does he look out of the corners of his eyes? Is he afraid of swings or very clumsy? Does she spin for hours without feeling dizzy? Does he dislike being touched or hugged unless he initiates it? Is he unusually irritated by tags or seams on his clothes? Does he refuse to wear a coat and make a huge fuss over socks and shoes? Does he have an unusually high or low tolerance for pain?
These may be signs of Sensory Processing Disorder, also known as Sensory Integration Dysfunction. Sensory processing problems are common among children with autism, Pervasive Developmental Disorder and Asperger's Syndrome. However, sensory problems alone do not mean a child has an autism spectrum disorder. Some children have a sensory processing disorder only, but no other diagnosis.
The theory of sensory integration was developed by occupational therapist A. Jean Ayres Ph.D. In the 1970s. Sensory integration occurs when our brains organize the information from our senses for our use.
For some people, sensory integration does not develop properly. Sounds, sights and movement may seem more chaotic, more distracting and stronger than they do to others. Balance and coordination may also be a problem.
Because of these sensory problems, a child may avoid the playful, sensory-rich experiences that are natural building blocks to learning and developing relationships, according to occupational therapist Tara Delaney in 101 Games and Activities for Children With Autism, Asperger’s and Sensory Processing Disorders.
Occupational therapists (OTs) who are trained in sensory techniques will engage a child in playful activities designed to help him process the information he receives from his senses in a more typical manner.
The therapist may work with the child in a room with platform swings, large exercise balls and other equipment. "The goal of therapy is not to teach skills, but to follow the child's lead and artfully select and modify activities according to the child's responses," according to Marie DiMatties and Jennifer Sammons at The Council for Exceptional Children.
The therapist can develop a treatment plan for a child that a parent can also follow at home, often using common household items. The child may need to play with different textures (such as sand, play-dough or shaving cream), to swing, to chew on a special chewy tube, or to sit atop large sensory ball. The activities should be just challenging enough to help the child respond better to sensory information without feeling overwhelmed.
Activities to improve focus and to calm the child can be built into his day. "The How Does Your Engine Run? Program is a step-by-step method that teaches children simple changes to their daily routine, such as a brisk walk, jumping on a trampoline before doing their homework, and listening to calming music, that will help them self-regulate or keep their engine running 'just right.' Through the use of charts, worksheets, and activities, the child is guided in improving awareness and using self-regulation strategies," according to DiMatties and Sammons.
Children with autism, PDD and Asperger's Syndrome may receive free physical and occupational therapy at their public schools or through their state's early intervention program. Parents can ask their school system to evaluate their child to see if he qualifies for these services, including sensory integration activities.
At school, an occupational therapist also may work with the child to improve his fine motor skills (holding a pencil, using scissors, handwriting) and self-help skills (using buttons, zippers and silverware). A physical therapist may work on gross motor skills such as running, balance and climbing.
Sensory Integration Therapy is almost never offered as a sole treatment for autism spectrum disorder; instead, it may be a piece of a larger program.
Some studies show a benefit from Sensory Integration Therapy while other studies do not. A small study released in 2008 by Temple University researchers found that children with autism spectrum disorders who had sensory integration therapy had fewer "autistic mannerisms" than children who received fine motor therapy alone.
Sensory integration treatment can be expensive if not covered by medical insurance or provided by the school or early intervention office. Some insurance plans will not cover sensory integration therapy, but they may cover therapy that focuses on motor skills.
Remember, a child's "occupation" is play and learning about the world.
Autism Teaching Methods: TEACCH (Treatment and Education of Autistic and Related Communication-Handicapped CHildren)
TEACCH was developed by psychologist Eric Schopler at the University of North Carolina in the 1960s; it is used by many public school systems today. A TEACCH classroom is structured, with separate, defined areas for each task, such as individual work, group activities, and play. It relies heavily on visual learning, strength for many children with autism and PDD. The children use schedules made up of pictures and/or words to order their day and to help them move smoothly between activities. Children with autism may find it difficult to make transitions between activities and places without schedules.
Young children may sit at a work station and be required to complete certain activities, such as matching pictures or letters. The finished assignments are then placed in a container. Children may use picture communication symbols -- small laminated squares that contain a symbol and a word -- to answer questions and request items from their teacher. The symbols help relieve frustration for nonverbal children while helping those who are starting to speak to recall and say the words they want.
This method of "structured teaching" is often less intensive than Applied Behavior Analysis or Verbal Behavior programs in the preschool years.
According to information previously published on its web site, TEACCH respects "the culture of autism" and embraces a philosophy that people with autism have "characteristics that are different, but not necessarily inferior, to the rest of us." It says, "The person is the priority, rather than any philosophical notion like inclusion, discrete trial training, facilitated communication, etc."
Drawbacks to this method: Social interaction and verbal communication may not be as heavily stressed as other teaching methods; TEACCH is more focused on accommodating a child's autistic traits than in trying to overcome them. Also, more research is needed into the effectiveness of TEACCH, especially in comparison to Applied Behavior Analysis and other teaching methods.
In contrast to the outcome studies of ABA published by Dr. Ivar Lovaas, TEACCH has not published comprehensive, long-term studies of its effectiveness in treating and educating children. A short-term study in 1998 found that young children who received four months of a home-based TEACCH program improved more than children who received no treatment at all.
Parents who want their child completely included in all classes with nondisabled children may not be happy with a TEACCH program. Some schools primarily use TEACCH in self-contained "autism classrooms," but it can be used in other settings.
The TEACCH program developed in North Carolina includes an array of services such as evaluations, parent training and support groups, social and recreation groups, counseling, and supported employment. However, these services may be missing from public schools in other states that have adopted this method for their autism classroom. You may wish to learn more about the North Carolina model to see how your school's TEACCH program measures up.
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