Social and Cultural Foundations of American Education/Special Needs/Autism

This quote from Dr. O. Ivar Lovaas is especially suitable when discussing the treatment of individuals with Autism Spectrum Disorders (ASDs). His opinion is an expert one. Lovaas is known as one of the fathers of Applied Behavior Analysis, a treatment that demonstrates how teaching can modify the behavior of children on the autism spectrum. According to the Centers for Disease Control (CDC), “Many people with ASDs … have unusual ways of learning, paying attention, or reacting to different sensations. The thinking and learning abilities of people with ASDs can vary – from gifted to severely challenged.” How do we teach children with such a wide array of learning abilities? This currently serves as something of an obstacle for educators of children with a disorder on the Autism Spectrum... one that they are striving to overcome.

The Idea of a Spectrum
Autism, a disorder that affects thought, perception, and attention, can encompass a continuum of symptoms. Because the lines between the symptoms can often become blurred, it is necessary to place the disorders that vary in severity onto a spectrum. The Autistic Spectrum Disorders Fact Sheet on www.autism-help.org states that the “idea of a spectrum is that instead of trying to 'box' individuals into a specific disorder, they are seen as part of a spectrum: from the severe end where a child may have a profound intellectual disability, never communicate, and need full-time care, to a child who will experience some difficulties but be able to attend regular schooling and go on to employment, relationships, and the hallmarks of a typical lifestyle.”

Symptoms of a Disorder on the Spectrum
The DSM-IV, the diagnostic manual used to classify disabilities, categorizes autistic disorder under the Pervasive Developmental Disorders. Autism Spectrum Disorders are developmental disabilities that emerge before the age of three. In a child on the autism spectrum, deficits will be noticeable in their social interactions and their communication skills. The flawed social interactions could range from poor eye contact to aversion to human contact. Some examples of communication deficits are speech delay and echolalia, which is the repetition of words previously heard (ie television commercials). The children also exhibit repetitive behaviors or interests, like obsessions with certain objects and rocking or hand-flapping. Unusual reactions to certain sensory experiences, like loud noises or different textures, is another symptom of disorders on the spectrum. 

Characterized by a pattern of impairments of varied severity in:
 * Autistic Disorder
 * 1) social impairment,
 * 2) language and communication, AND
 * 3) repetitive interests and activities.

Characterized by:
 * Asperger’s Syndrome
 * 1) average intelligence without a history of a delay in language development,
 * 2) noticeable impairment in social skills, and
 * 3) restrictive and repetitive interests.

Pervasive Disorder- Not Otherwise Specified (PDD-NOS) Often termed “a diagnosis of exclusion,” a diagnosis of PDD-NOS may be applied when a child “does not show all the symptoms required for a diagnosis of Autistic Disorder or if his or her symptoms are milder in nature (Stone 9).”

Source: Does My Child have Autism? Wendy L. Stone, Ph.D. with Theresa Foy DiGeronimo, M.Ed.

What are the Different Autism Spectrum Disorders?
The spectrum of Autistic disorders includes: Autistic Disorder, Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS, including atypical autism), and Asperger syndrome. Although they are characterized by similar symptoms, these disorders vary in severity, age of onset, and the exact nature of the symptoms. A diagnosis of a condition on this spectrum can, arguably, remain valid throughout a person’s lifetime.

What Causes ASDs, and Is There a Cure?
“What we know about the causes of autism, at this point, is all correlational, and many of the correlations are rather weak (Siegel 18).” As of the creation of this article, the exact causes of autism are still unknown. There have been inquiries into whether vaccinations have caused this massive upsurge in cases of autism, but there a lack of sufficient evidence to confirm or refute this claim. ASDs do not affect any one group in particular; race, ethnicity, or socioeconomic status does not adjust the chance of acquiring an autism spectrum disorder. However, it has been established that ASDs are four times more common in boys than in girls. There is also an increased prevalence in rates of autism for families with previously diagnosed autistic children, suggesting some genetic correlation.

Although there is no precise “cure” for an individual on the spectrum, various methods are being implemented in homes and schools to address the specific treatments of those with ASDs. These include alternative behavioral methods, speech/occupational/physical therapies, and dietary modifications. The gluten-casein free, or GCF, diet is the most popular. It consists of elimination of wheat and dairy products from the diet of individuals on the spectrum. The National Institute of Medical Health is currently performing a clinical trial that will determine the effects of the gluten-casein free diet on children with autism. 

The Rise in Children with ASDs
The CDC, together with the American Academy of Pediatrics (AAP), issued an Autism A.L.A.R.M. and concluded that as many as 1 in 166 children have an ASD. In 2007, CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network published data indicating that 1 in 150 8-year-old children throughout America were on the autism spectrum.

The public schools in America are under pressure to implement innovative teaching methods to address the scope of challenging behaviors and learning difficulties, as more children are being diagnosed with autism. The amount of children with an autism classification in special education is rising at near-epidemic proportions. According to the CDC, the number of 6 to 17-year-old children classified as having an ASD in public special education programs escalated from 22,664 to 193,637 between the years of 1994 and 2004. They received this information from IDEA accounts. The Individuals with Disabilities Education Act (IDEA) decides how states and public agencies will provide early intervention, special education and related services to American children with disabilities. Their records from 2005 show that 6,109,569 children ages 6–21 received services through 13 of the categories in public special education programs. About 3% (193,637) of these were autistic children. 

Definition of Education
Presently, education is the fundamental treatment for people with autism. The definition of education is "the fostering of acquisition of skills or knowledge-- including not only academic learning, but also socialization, language and communication, and reduction of behavior problems-- to assist a child to develop independence and personal responsibility (Lord, McGee 12)." The Surgeon General maintains that immediate, rigorous behavioral and educational intervention can actually help autistic children become capable of learning and develop their social skills. 

Effective Instructional Programs
Common Elements of an Effective Treatment Program for Children with an ASD (Stone 113)
 * Early intervention, involving families in each phase of the assessment and educational processes
 * Customized goals based on information received from assessments
 * Concentration on the "core deficits" of autism: social skills, language and communication, imitation, and age-appropriate play
 * Structured, supportive teaching approach and predictable environment
 * Consistent monitoring and reevaluation of goals
 * Encourages students to take a broad view of skills learned, that they may apply them in alternative settings (generalization)
 * Takes initiative and uses positive approach, pertaining to behavior management
 * Offers students "opportunities for structured interactions with typically developing peers"
 * Prepares students for possible mainstreaming into regular ed classrooms, and/or transitioning to new learning environments

Individualized Education Plan
When a child who has been diagnosed with an ASD enters the school system, their parents should contact the local special education department and meet with an Individualized Educational Plan (IEP) team. The IDEA has determined that this team should consist of: the child's parents or caregivers; at least 1 of the child's regular education teachers; at least 1 special education teacher; a representative of the local educational agency; someone capable of interpreting the results of the evaluations, and how they affect the child's education; other individuals the parent or agency believe have valuable input regarding the child; and "whenever appropriate, the child with a disability." The goal of this meeting is to determine the individual educational needs of the ASD student. This should be done by distinguishing the child's areas of strength and determining his or her areas of challenge. The IEP should exist as the means "for planning and implementing [a]ppropriate educational objectives for children with autistic spectrum disorders [that] should be observable, measurable behaviors and skills ... [These goals] should be able to be accomplished within 1 year... Progress should be monitored frequently and objectives adjusted accordingly (Lord, McGee 218)."

Structured Teaching
Because individuals with autism process visual information more effortlessly than verbal information, the use of visual cues is a sensible method of instructing in the autism classroom. Autism consultant Susan Stokes' article Structured Teaching: Strategies for Supporting Students with Autism, addresses the primary components of Structured Teaching: 1) the physical structure of the classroom; 2) the use of visual schedules; and 3) the structured teaching method. She defines Structured Teaching as: "a system for organizing their environments, developing appropriate activities, and helping people with autism understand what is expected of them." It is imperative that the arrangement and subsequent organization of the students' physical environment is taken into account. According to Susan Stokes, "Physical structure provides environmental organization for people with autism. Clear physical and visual boundaries help the person to understand here each area begins and ends. The physical structure minimizes visual and auditory distractions."

Physical Structure: The classroom should be painted a muted color, and there should be minimal visual distractions (ie walls cluttered with posters). The designated areas in a classroom should have clear, definite boundaries. This can be achieved with furniture placement. The children should attain a better perception of their environment and allow them to become less dependent on adult direction.

Visual Schedules: Visual schedules focus on the ability of many children with ASDs to process visual information. It sequentially organizes the student's schedule in a visual timetable. This gives the student an idea of what is expected of them. For children with anxiety about transitions, the visual cues will allow them to predict what will come next. There should be a general class schedule, as well as an individual schedule for each student. This allows the student with alternative scheduling (ie: Speech Therapy, Occupational Therapy, Physical Therapy, Behavioral Counseling, etc.) a chance to visualize his or her personal schedule.

Teaching Method: Because all of the details that go into completing their work can overstimulate a child on the spectrum, it is best to isolate only those with significance to the task at hand. The use of visual instructions to organize the steps of the task, visual organization to present only the necessary materials in an organized fashion, and visual clarity to emphasize the details and minimize the distractions are critical components of the structured teaching method. These fundamental building blocks can potentially allow for an increase in the child's independence not only in school, but also at home and/or work (Stokes).

Curriculum Management
Keeping your curriculum varied to cover those students suffering from any form of Autism is a very challenging but very important part of teaching. Making your lesson plans varied allows for you, as a teacher, to incorporate more students into your classroom.There are a few tips that teachers can be sure to follow that will make any lesson plan more varied to help Autistic children learn in mainstream classrooms. For starters, using a whiteboard for organization helps Autistic children to see the information displayed clearly. Keeping the information on the board to a minimum and color coding the information helps the students greatly. Another way for helping students battling with Autism is with picture cards. Adding the visual aspect to learning helps the students to learn faster and better.

Physical Education with Autism
Research has shown that vigorous exercise decreases stereotypic behaviors, hyperactivity, aggression, self injury and destructiveness in individuals with Autism and those who are mentally disabled. Stereotypic behaviors and hyperactivity interfere with the educational process in the classroom. Parents, Teachers and Schools should include a rigorous exercise program in students Individualized Educational Plan (IEP). A vigorous workout typically consists of 20-30 minutes of aerobic exercise; a mild workout has little effect on behavior. Therefore, students do not get an adequate amount of exercise during recess to have an effect on behavior. To reduce stereotypic behavior problems in the classroom and at home, try an inexpensive and safe exercise program rather than expensive and harmful drugs.

Conclusion
When it comes to educating children with ASDs, the fundamental rule appears to be that there is no best method. There are several measures that can be taken, however, to ensure that a child gets the best treatment they can receive. This begins with instituting a team that will set a plan for the child, an IEP complete with educational and personal goals that should be able to be achieved within a school year. It continues with implementing an educational plan tailored for that particular student. Individualizing the plan by considering the advantages and disadvantages of alternative methods for the specific child seems to be the conscientious decision. The amount of energy and perseverance that must go into teaching children on the autism spectrum can seem overwhelming. However, the benefits of tailoring a child's education to suit their individuality are remarkable. The potential for attaining their goals and developing the capability to learn self-sufficiency is "there for the teaching."

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