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 пЃ¬ пЃ¬ пЃ¬ 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 пЃ¬ Dr. Eric Schopler (1927-2006) вЂ“ пЃ¬ Gary Mesibov вЂ“ вЂ“ пЃ¬ пЃ¬ пЃ¬ Developed the вЂњculture of autismвЂќ 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 пЃ¬ пЃ¬ пЃ¬ пЃ¬ пЃ¬ пЃ¬ Statewide (based in North Carolina) Comprehensive Community based Emphasis on family involvement TEACCH philosophy Funding The TEACCH Method пЃ¬ 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 пЃ¬ пЃ¬ пЃ¬ пЃ¬ пЃ¬ Diagnostic Evaluations Individualized Curriculum Social Skills Training Vocational Training Parent Counseling and Training Diagnostic Evaluations пЃ¬ пЃ¬ пЃ¬ 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: пЃ¬ пЃ¬ пЃ¬ A clinical psychologist Three psychoeducational therapists A pediatrician Formal Testing Included in the Assessment Process пЃ¬ пЃ¬ пЃ¬ пЃ¬ пЃ¬ Wechsler Preschool and Primary Psychoeducational Profile (PEP-R, Schopler) Autism Diagnostic Interview Vineland Childhood Autism Rating Scale Individualized Curriculum Based on Structured Teaching Recognizes: пЃ¬ пЃ¬ пЃ¬ 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 пЃ¬ пЃ¬ пЃ¬ пЃ¬ Individual interests Highly structured groups Typically developing peers Conversational guidelines Vocational Training пЃ¬ пЃ¬ Farming Supported Employment Parent Counseling and Training пЃ¬ пЃ¬ пЃ¬ пЃ¬ 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: пЃ¬ пЃ¬ пЃ¬ пЃ¬ пЃ¬ Receptive language Expressive language Sequential memory Organization Controlling Behavior пЃ¬ пЃ¬ пЃ¬ Social skills Hypersensitivity to sensory input Distractibility What is Structured Teaching? Features of structured teaching: вЂў Physical organization вЂў Scheduling вЂў Teaching method Physical Organization пЃ¬ пЃ¬ пЃ¬ пЃ¬ пЃ¬ 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 пЃ¬ пЃ¬ пЃ¬ пЃ¬ Specific areas for learning specific tasks Making boundaries Making materials easily accessible Individualization Classroom Layout for Younger Students пЃ¬ Learning areas for : вЂ“ вЂ“ вЂ“ вЂ“ вЂ“ вЂ“ 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 пЃ¬ Areas for: вЂ“ вЂ“ вЂ“ вЂ“ вЂ“ вЂ“ вЂ“ вЂ“ Leisure Workshop Domestic skills Self help areas Individual teaching Time-out areas Lockers TeacherвЂ™s area Other Considerations for Classroom Layout пЃ¬ Eliminate Distractions вЂ“ вЂ“ вЂ“ Blinds/cardboard taped over windows Place work areas near shelves or storage cabinets Blank walls Other Considerations for Classroom Layout пЃ¬ Make Clear Boundaries by using вЂ“ вЂ“ вЂ“ вЂ“ вЂ“ Rugs Bookshelves Partitions Tape over the floor Arrangement of tables Other Considerations for Classroom Layout пЃ¬ Materials should be clearly marked by using: вЂ“ вЂ“ вЂ“ Pictures Color coding Numbers or symbols Schedules пЃ¬ Should be: вЂ“ вЂ“ вЂ“ Clear Purposeful Consistent пЃ¬ Purpose: вЂ“ вЂ“ To organize and predict To help transition independently from activity to activity Two Types of Schedules пЃ¬ пЃ¬ пЃ¬ пЃ¬ пЃ¬ General overall classroom schedule Individual schedule Location Format Arrangement Examples of Daily Schedules Lord, C., Marcus, L. & Schopler, E. Teaching Method пЃ¬ Providing verbal directions for tasks: вЂ“ Having the childвЂ™s attention пЃ¬ пЃ¬ пЃ¬ пЃ¬ вЂ“ вЂ“ Eye contact Body orientation Verbal response Stopping other activities Minimizing amount of language used Accompanying verbal directions with gestures пЃ¬ Nonverbal cues for tasks: вЂ“ вЂ“ Visual cues using pictures Written instruction Teaching Method пЃ¬ Prompts for new tasks: вЂ“ вЂ“ вЂ“ вЂ“ вЂ“ вЂ“ Physical Verbal Visual Gestural Modeling Situational Teaching Method пЃ¬ Present prompts systematically: вЂ“ вЂ“ вЂ“ Clear Consistent Provide prompts before the student responds incorrectly Reinforcement пЃ¬ Tangibles: вЂ“ вЂ“ вЂ“ вЂ“ Food Toys Activities Tokens пЃ¬ Social rewards: вЂ“ вЂ“ вЂ“ Praise Smiles Hugs Reinforcement пЃ¬ пЃ¬ Used systematically Individualized вЂ“ вЂ“ пЃ¬ пЃ¬ Type of reinforcement Frequency Immediately following behavior Reinforcer assessment Research Supporting Project TEACCH пЃ¬ 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 пЃ¬ Schopler, Mesibov & Baker 1982 (conвЂ™t) вЂ“ вЂ“ вЂ“ вЂ“ 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 пЃ¬ Limitations of the Schopler, Mesibov & Baker 1982 study вЂ“ Wide range of participants пЃ¬ пЃ¬ пЃ¬ вЂ“ вЂ“ вЂ“ 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 пЃ¬ 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 пЃ¬ Cathcart and Ozonoff 1998 (conвЂ™t) вЂ“ Treatment group Provided with approximately four months of home programming focusing on cognitive, academic and prevocational skills пЃ¬ Tested before and after the intervention using the PEP-R пЃ¬ вЂ“ Non-treatment group пЃ¬ Tested at the same four month interval using the PEP-R Research Supporting Project TEACCH пЃ¬ Limitations of the Cathcart and Ozonoff 1998 study вЂ“ вЂ“ вЂ“ 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 пЃ¬ 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 пЃ¬ Harris, Jennet & Mesibov 2003 (conвЂ™t) вЂ“ Participants completed: пЃ¬ пЃ¬ пЃ¬ вЂ“ 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 пЃ¬ Limitations of the Harris, Jannett & Mesibov 2003 study вЂ“ вЂ“ вЂ“ 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 пЃ¬ пЃ¬ пЃ¬ 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 пЃ¬ пЃ¬ пЃ¬ 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.