Autism is a lifelong developmental disorder that affects, often severely, a person’s ability to communicate and socially interact with others. It is four times more prevalent in males than females and currently, autism is believed to affect 1 in every 250 people, (NAS 2003). The rate of people being diagnosed with autism has increased substantially over the past two decades which may be due in part to improved diagnostic techniques and changes in the criteria for diagnosing autistic spectrum disorders (ASD).
The causes of autism are still unknown but it is believed, and research shows, (NAS. 2003) that the disorder is caused by genetic factors associated with brain development which occur before, during or very soon after birth. Since the initial identification of autism there have been many claims of a cure. However, autism is currently considered to be incurable although there are many interventions that can be effective in improving the quality of life of those with the disorder. These interventions can offer help with behavioural and emotional difficulties or difficulties with language that the person is encountering. One intervention in particular, the Treatment and Education of Autistic and related Communication Handicapped Pupils (TEACCH), offers ways of structuring the curriculum and the classroom in order to reduce stress, promote learning and aid with behavioural and emotional difficulties (Mesibov, 1997).
This essay will focus on structured teaching, as practised in the TEACCH programme in North Carolina, including its philosophy and implementation and the research evidence for its effectiveness. In the second part of the essay I will introduce and report on a pupil known to me with whom this intervention is being used. I will also consider the effectiveness of TEACCH with this pupil. While there are claims about the significance of a range of interventions such as Applied Behavioural Analysis, Facilitated Communication and Options, these are often at variance with each other, (Jordan, Jones and Murray, 1998). Additionally, Howlin and Rutter (1987) critically reviewed many of these interventions and they found that although long term outcomes were not necessarily improved by following any particular intervention. Appropriate treatment could minimise or prevent secondary problems such as over stimulation and joint attention difficulties that might otherwise arise. This has been supported by Mesibov (2004).
It would not be fitting, unless an intervention is supported by substantive evidence, to recommend or suggest that one is better than another or is more likely to succeed. Rather, it should be understood that there will always be a combination of issues that influence the choice of intervention. These issues could be the home surroundings, the reaction of the child to the situation or the wellbeing of the child and their individuality. Some evidence suggests that there also needs to be structure of some type to reduce stress, encourage learning and address the welfare of the child (Sines, 1996; Short, 1984 cited in Moore, 1998 and LaGreca & Mesibov, 1981). This is mostly provided, for those with autism, through visual and structured learning, as recommended in the TEACCH programme, (Mesibov, 1988 see also Jordan & Powell, 1997).
What is TEACCH? Although no single educational or treatment approach has been shown to be uniquely successful with all pupil’s with autism, there are some principles, developed through the years, which have proved particularly helpful in educational support for pupils. The TEACCH programme has gained popularity and is widely used in approaches to autism in the UK, USA and across Europe (Schopler & Mesibov 1995, see also Fletcher-Campbell 2003).
The TEACCH programme is a university-based project founded by Eric Schopler at the University of North Carolina at Chapel Hill (Schopler, Reichler, Lansing & Waters 1980). Project TEACCH incorporates behavioural principles in treating pupils with autism, but differs from other interventions in several fundamental ways. Most significantly, TEACCH focuses on maximising the skills of pupils with autism while drawing on their relative strengths, rather than attempting “recovery” from the disorder. The programme is designed around providing structured settings or class rooms in which pupils with autism can develop their skills.
Teachers establish individual workstations where each child can practice various tasks, for example visual-motor activities sorting objects by colour or size. Visual cues are often provided in an effort to compensate for the deficits in the auditory processing which is frequently a characteristic of autism. Like some other programmes, TEACCH emphasises a collaborative effort between treatment, staff and parents. Parents are thus encouraged to establish routines and cues in the home similar to those provided in the classroom environment (Gresham, Beebe-Frankenberger, & MacMillan, 1997).
The educating of pupils with autism more often incorporates an understanding of the perceived environment in which people with autism live. Such an appreciation of autism involves related disciplines such as those of medicine, education, speech and occupational therapies, and requires a multidisciplinary approach, (Mesibov 2004). “Our job as educators of people with autism is fundamentally to see the world through their eyes and to use this perspective to teach them to function in our culture as independently as possible”. (Mesibov, 1988 cited in Seach, Lloyd and Preston, 2002, p17.)
Therefore the challenge to schools could be to devise and maintain inclusive, coordinated, relevant programmes dedicated to improving understanding of autism and developing and implementing relevant support services. TEACCH philosophy and Implementation. The educational philosophy of TEACCH states that the person is the priority (Schopler, 1989) and the programme puts emphasis upon the importance of individuality. TEACCH claims to provide each individual with their maximum level of autonomy and independence and to have evolved from a number of viewpoints including medical, psychological, educational and social. Indeed a possible reason why it is such a popular intervention could be that it purports to be able to adjust according to any new research in the field of autism so that it is never a static programme, (Mesibov, 1997)
The TEACCH philosophy maintains that education forms the backbone of the programme. It is applicable to high functioning and more severe forms of autism and it can be implemented from very early diagnosis and be carried through into adulthood. TEACCH though cannot be reduced to a single technique or method. Instead it makes use of several methods in various combinations according to each individual’s needs and emerging capabilities.