A Review of the TEACCH Method for Autism Treatment Jennifer Cheselka and Svetlana Vigdorchik...

A Review of the TEACCH Method for Autism Treatment

Jennifer Cheselka

and

Svetlana Vigdorchik

Caldwell College

What is TEACCH?

Treatment and

Education of

Autistic and

Related

Communication-handicapped

CHildren

TEACCH Mission Statement

To enable individuals with autism to function as meaningfully and as independently as possible in the community;

To provide exemplary services throughout North Carolina to individuals with autism and their families and those who serve and support them;

As a member of the University community, to generate knowledge; to integrate clinical services with relevant theory and research; and to disseminate information about theory, practice, and research on autism through training and publications locally, nationally and internationally.

http://www.teacch.com

TEACCH Program

Dr. Eric Schopler (1927-2006)– Developed the “culture of autism”

Gary Mesibov– Current Director of TEACCH– Worked with Schopler for 32 years

Nine TEACCH centers across the state CLLC for adults Administrative and research section

Characteristics of the TEACCH Program

Statewide (based in North Carolina) Comprehensive Community based Emphasis on family involvement TEACCH philosophy Funding

The TEACCH Method

Provides a family-centered evidence based practice for autism that is person-centered and individualized

- Based on theoretical conceptualization of

autism

- Supported by empirical research and

clinical expertise

Services Provided by TEACCH

Diagnostic Evaluations Individualized Curriculum Social Skills Training Vocational Training Parent Counseling and Training

Diagnostic Evaluations

One hour interview or screening session with staff psychoeducational therapist

Staff referral meeting Full evaluation (unless family feels clear

about diagnosis and wants to begin clinic teaching sessions)

Standard Assessment Team Includes:

A clinical psychologist Three psychoeducational therapists A pediatrician

Formal Testing Included in the Assessment Process

Wechsler Preschool and Primary Psychoeducational Profile (PEP-R, Schopler) Autism Diagnostic Interview Vineland Childhood Autism Rating Scale

Individualized Curriculum Based on Structured Teaching Recognizes:

Each child with autism is unique Diverse family situations Differences in cognitive, social and language

levels of each child

Social Skills Training Utilizing Individualized and Group Instruction

Individual interests Highly structured groups Typically developing peers Conversational guidelines

Vocational Training

Farming Supported Employment

Parent Counseling and Training

Teaches parents to understand the nature of autism spectrum disorders

Provides approaches to skill development and behavior management

Identifies and facilitates individualized intervention

Introduces parent to a supportive, welcoming network

The TEACCH Program Describes Deficits of Autism as:

Receptive language Expressive language Sequential memory Organization Controlling Behavior

Social skills Hypersensitivity to

sensory input Distractibility

What is Structured Teaching?

Features of structured teaching:• Physical organization• Scheduling• Teaching method

Physical Organization

Size of the room Lighting Location of the bathroom Number of and access to electrical outlets What other classrooms/students are near by

Physical Organization

Specific areas for learning specific tasks Making boundaries Making materials easily accessible Individualization

Classroom Layout for Younger Students

Learning areas for :– Play– Individual and independent work– Snack– Developing self-help skills– Cubbyholes/special boxes– Teacher areas

Example of a Preschool Classroom Layout

Lord, C., Marcus, L. & Schopler, E.

Classroom Layout for Older Students

Areas for:– Leisure– Workshop– Domestic skills– Self help areas– Individual teaching– Time-out areas– Lockers– Teacher’s area

Other Considerations for Classroom Layout

Eliminate Distractions– Blinds/cardboard taped over windows– Place work areas near shelves or storage

cabinets– Blank walls

Other Considerations for Classroom Layout

Make Clear Boundaries by using– Rugs – Bookshelves– Partitions– Tape over the floor– Arrangement of tables

Other Considerations for Classroom Layout

Materials should be clearly marked by using:– Pictures– Color coding– Numbers or symbols

Schedules

Should be:– Clear– Purposeful– Consistent

Purpose:– To organize and predict– To help transition

independently from activity to activity

Two Types of Schedules

General overall classroom schedule Individual schedule Location Format Arrangement

Examples of Daily Schedules

Lord, C., Marcus, L. & Schopler, E.

Teaching Method

Providing verbal directions for tasks:

– Having the child’s attention Eye contact Body orientation Verbal response Stopping other activities

– Minimizing amount of language used

– Accompanying verbal directions with gestures

Nonverbal cues for tasks:

– Visual cues using pictures – Written instruction

Teaching Method

Prompts for new tasks:– Physical– Verbal– Visual– Gestural– Modeling– Situational

Teaching Method

Present prompts systematically:– Clear – Consistent– Provide prompts before the student responds

incorrectly

Reinforcement

Tangibles:

– Food– Toys– Activities– Tokens

Social rewards:

– Praise– Smiles– Hugs

Reinforcement

Used systematically Individualized

– Type of reinforcement– Frequency

Immediately following behavior Reinforcer assessment

Research Supporting Project TEACCH

Evaluation of treatment for autistic children and their parents. (Schopler, Mesibov & Baker 1982)Journal of the American Academy of Child Psychiatry

- 657 past and present students in Project TEACCH- 50% of the participants diagnosed as having autism- the remainder of the participants were

diagnosed as having an unspecified communication disorder

Green, Luce & Maurice 1996

Research Supporting Project TEACCH

Schopler, Mesibov & Baker 1982 (con’t)– Parent questionnaires were sent to the

participants homes– 348 (53%) were returned– Most respondents indicated that project TEACCH

was helpful– The study found an institutional rate of 7% for the

adolescents and adults with autism

Green, Luce & Maurice 1996

Research Supporting Project TEACCH

Limitations of the Schopler, Mesibov & Baker 1982 study

– Wide range of participants Almost half without a diagnosis of autism Some toddlers Other adults

– Procedure for assigning participants was not described– Not clear whether questionnaires were anonymous– Cause for lower institutionalization rate was unclear

Green, Luce & Maurice 1996

Research Supporting Project TEACCH

Effectiveness of a home program intervention for young children with autism. (Cathcart and Ozonoff 1998)Journal of Autism and Developmental Disorders

- two groups containing 11 participants - one treatment group- one no-treatment control group

Research Supporting Project TEACCH

Cathcart and Ozonoff 1998 (con’t)– Treatment group

Provided with approximately four months of home programming focusing on cognitive, academic and prevocational skills

Tested before and after the intervention using the PEP-R

– Non-treatment group Tested at the same four month interval using the PEP-R

Research Supporting Project TEACCH

Limitations of the Cathcart and Ozonoff 1998 study– Children were not assigned randomly to the

treatment or control groups– Examiners administering the dependent

measures were not blind to group assignment– Dependent measure was created by the founder

of the TEACCH program

Research Supporting Project TEACCH

Commitment to philosophy, teacher efficacy, and burnout among teachers of children with autism. (Harris, Jennet & Mesibov 2003)

Journal of Autism and Developmental Disorders

- Compared teachers who use Applied Behavior

Analysis to those who used the TEACCH method

Research Supporting Project TEACCH

Harris, Jennet & Mesibov 2003 (con’t)– Participants completed:

The Autism Treatment Philosophy Questionnaire Teacher Efficacy Scale Maslach Burnout Inventory

– Results indicated a significant difference in philosophical commitment between groups and no differences in teaching efficacy and burnout

Research Supporting Project TEACCH

Limitations of the Harris, Jannett & Mesibov 2003 study– Number and content of items representing the

philosophies of both approaches was insufficient– No research to establish the scales reliability– Survey answers may have been biased

References

Cathcart, K., & Ozonoff, S. (1998). Effectiveness of a home program Intervention for young children with autism. Journal of Autism and Developmental Disorders, 28, 25-32.

Division TEACCH. (July 1999). Information on autism. Retrieved July 2007, from http://www.teacch.com.

Harris, S. L., Jennett, H. K. & Mesibov, G. B. (2003). Commitment to philosophy, teacher efficacy, and burnout among teachers of children with autism. Journal of Autism and Developmental Disorders, 33(6), 583-593.

References

Lord, C., Marcus, L. & Schopler, E. (2001). TEACCH services for preschool children. In J.S. Handleman & S. L. Harris (Eds.), Preschool educational programs for children with autism (pp. 215-232). Austin, TX: PRO-ED, inc.

Mesibov, G. B., Schopler, E. & Shea, V. (2006). The TEACCH approach to autism spectrum disorders. New York, NY: Springer.

Smith, T. (1996). Are other treatments effective?. In G. Green, S.C. Luce (Co-eds.) & C. Maurice (Ed.). Behavioral intervention for young children with autism: A manual for parents and professionals (pp. 46-47). Austin, TX: PRO-ED inc.