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TEACCH: Treatment and Education of Autistic and related Communication HandicappedCHildren

TEACCH Theory

The Culture of Autism:

The TEACCH approach believes children with Autism Spectrum Disorders have commonpatterns of thinking and behavior. Each child presents with unique individual differences, butthere are certain patterns of thinking, learning and neurobehavioral patterns that tend to arise

(Mesibov, Shea, and Schopler 2005).

Differences in Thinking: The Concept of Meaning: difficulty imposing meaning on their experiences Focus on Details/Prioritization of details: miss the forest for the trees Distractibility: difficulty inhibiting environmental stimuli Concrete vs. Abstract Thinking: difficulty with words having multiple meanings or subtleties Combining or Integrating Ideas: Difficulty integrating ideas/concepts especially when they contain

inconsistencies.

Organization and Sequencing: Difficulty integrating multiple pieces of information or items needed tocomplete a task. Generalization Time: Difficulty with beginning, middle, or end. Difficulty coordinating activities.

Differences in Learning: Visual vs. Auditory Learning: Tend to be visual learners Prompt Dependence: Because of difficulties with integrating information, they tend to become dependant

on others for initiation and completion of activities.

Differences in Neurobehavioral Patterns: Strong Impulses: Exhibit persistence in seeking out desirable things/activities. Excessive Anxiety: May be due both to the disorder and confronting an unpredictable environment. Sensory and Perceptual Differences

TEACCH sees the culture of autism as characteristics upon which functioning within typical

society can be juxtaposed. TEACCH aims to capitalize on a persons strengths and apply themto functional life skills.

Behavioral Approach:

TEACCHs philosophy is rooted in traditional behavioral therapy. However, to increasegeneralization, the approach has evolved into a child-centered, naturalistic teaching method that

is rooted in the cognitive-social learning theory (Mesibov, Shea, and Schopler 2005). It continuesto implement traditional behavioral theory in the form of a highly structured work environment.

However, unlike traditional behavioral theory, TEACCH does not implement discrete trials,structure is implemented in terms of the physical environment, organizational strategies, and the

presentation of materials (Mesibov, Shea, and Schopler 2005).

Lifelong Intervention:

ASD is seen as a life-long disorder, thus intervention must be long-term. TEACCH hasdeveloped family support groups, summer camps for children, and vocational training for adults

with ASD (Marcus and Schopler 2007).

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Principles:

1. Empirical based practice: ongoing investigation, assessment, and revision of intervention methods andinstruments based on sound research methods

2. Improved adaptation: long-term Tx programs that a) teach skills and b) modify environments3. Parent-professional collaboration:parents are co-therapists4. Role of assessment:

a. Formal assessment: how does individual resemble others with ASD?b. Informal assessment: how does individual differ from others with ASD?

5. Structured teachinga. Create a stable, predictable environment through:

i. Physical Structure - organization of environmentii. Individual Daily Schedules - visually salient sequence of activities to communicate

concepts of time, task, and location for tasks at school, work, and home

iii. Work Systems organized spaces communicate what & how much work are to be done- Hume & Odom (2007)

iv. Generalize on-task and on-schedule behaviors across settings Bryan & Gast (2000)6. Skill enhancement: Recognize skills and deficits to design and deliver functional interventions7. Community involvement: Collaborate with state agencies; maintain consistency during life transitions8. Holistic Orientation: see child as unique individual not merely through ones specialized profession

Components:

1. Assessment: individualized, ongoing, emphasizing program commitment, PEP-R2. Direct Intervention: Structured teaching of social, communication, coping, and adaptive behavior skills;

increased independence through graduated guidance; primacy of parental partnerships; incorporation of

specific techniques (e.g., PECS; Social Stories)

3. Consultation: case and program consultations4. Training: teacher training; parent training; ancillary professional training

Settings:

1. Home-based: continuity of structured teaching across settings promotes generalization; natural contextpresent everyday learning opportunities; increases hours of intervention

2. Mainstream Schools: TEACCH is inclusive-friendly (Panerai et al., 2009); visual daily schedulesreduce students prompt dependence and increase independence (Hume & Odom, 2007)

3. Special Schools: in addition to students with ASD, aspects of TEACCH foster independence andcommunication skills in students with multiple disabilities and visual impairment

4. Residential Centers: structured teaching is used to organize environment, help people with ASDunderstand others expectations, and function independently

5. Employment Settings: use of concrete daily schedules, visual strategies, physical organization, worksystems, and material organization promotes greater independence in on-task / on-schedule behaviors.

Visual strategies and preferred activities promote safe occupation of oneself during free time (e.g., breaks).

Research Base: sample, please see references! TEACCH demonstrated greater effectiveness than a non-specific approach over a three-year period in

mainstream and special education schools and residential settings and is appropriate for inclusive

classrooms - Panerai et al. (2009; 2002)

! TEACCH home-based intervention aids cognitive and developmental skills -Ozonoff & Cathcart (1998)! TEACCH is used with adults to achieve greater independence in residential and employment settings

-Van Bourgondien & Schopler (1996)

! TEACCH has been adapted (use of tactile in place of visual organization and cues) for use with MDVIpopulations Taylor & Preece (2010)

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Appropriate ages:

" The four main components of TEACCH (assessment, direct intervention, consultation,and training) are appropriate with clients of any age from preschool to adulthood, and

any ability level including those with high functioning autism and Aspergers disorder.

" Structured teaching can be incorporated at home (for a preschooler), at school (for a school-agedchild), and in the work place (for an adolescent or adult).

Roles of Family

Parent-professional collaboration is a main principle of TEACCH Parents work with the TEACCH professionals at every step.

" Initial diagnostic evaluation/ Assessment" Home teaching" Counseling" Support sessions" Establishing appropriate school placement, need for medication, future home and work

placements, and other services

TEACCH provides support to parents through training, support groups, and parent-mentor programs.

Many researchers have found that parents report TEACCH to be effective and to enhancethe quality of life for both the parents and their children/adult children with autism.

Facilitation of Learning

Is accomplished by structured teaching There are three specific components to the structured teaching approach (all emphasize

visual modality)

o Physical Structureo Individual Daily Scheduleo Work Systems

Visual structure is critical because it governs how information is organized and presentedto help the child be as successful and independent as possible (Schopler et al., 1995).

This is done using a variety of visual cues:

o Templateso Step-by-step instructionso Highlightingo Labeling

The three structured teaching components can be implemented in all age groups, for alldevelopmental levels.

Structured teaching is not just for use in classrooms, but at home and at places of work For the comfort and independence of people with autism, daily environments should be

physically organized with a schedule and a work system

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References:

Bodfish, J.W. (2004). Treating the core features of autism: are we there yet? Mental Retardation and

Developmental Disabilities Research Reviews,10, 318-326.

Bryan, L.C., & Gast, D.L. (2000). Teaching on-task and on-schedule behaviors to high-functioning children

with autism via picture activity schedules.Journal of Autism and Developmental Disorders, 30(6),

553-556.

Hume, K. & Odom, S. (2007). Effects of an individual work system on the independent functioning of

students with autism.Journal of Autism and Developmental Disorders, 37, 1166-1180.

Iovannone, R., Dunlap, G., Huber, H., & Kincaid, D. (2003). Effective educational practices for studentswith autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 18(3),

150-165.

Koenig, K., De Los Reyes, A., Cicchetti, D., Seahill, L., & Klin, A. (2009). Group intervention to promote

social skills in school-age children with pervasive developmental disorders: reconsidering

efficacy.Journal of Autism and Developmental Disorders, 39, 1163-1172.

Marcus, L., & Schopler, E. (2007). Clinical manual for the treatment of autism. (Eric Hollander Ed.)

Arlington: American Psychiatric Publishing, Inc.

Mesibov, G., Shea, V., & Schopler, E. (2005). The TEACCH approach to autism spectrum disorders.New

York: Kluwer Academic.

Mesibov, G., & Shea, V. (2010). The TEACCH program in the era of evidence-based practice. Journal of

Autism and Developmental Disorders, 40, 570-579.

Mesibov, G. (1997). Formal and informal measures on the effectiveness of the TEACCH programmme.Autism: The International Journal of Research and Practice, 1(1), 25-35.

Ozonoff, S. & Cathcart, K. (1998). Effectiveness of a home program intervention for young children with

autism.Journal of Autism and Developmental Disorders, 28(1),25-32.

Panerai, S., Ferrante, L., & Zingale, M. (2002). Benefits of the Treatment and Education of Autistic andCommunication Handicapped Children (TEACCH) programme as compared with a non-specific

approach.Journal of Intellectual Disability Research, 46(4), 318-327.

Panerai, S., Marinella, Z., Trubia, G., Finocchiaro, M., Zuccarello, R., Ferri, R., & Elia, M. (2009). Special

education versus inclusive education: the role of the TEACCH program. Journal of Autism and

Developmental Disorders, 39, 874-882.

Probst, P. & Leppert,T. (2008). Brief report: Outcomes of a teacher training program for autism spectrumdisorders.Journal of Autism and Developmental Disorders, 38, 1791-1796.

Rao, S.M. & Gagie, B. (2006). Learning through seeing and doing: visual supports for children with

autism. Teaching Exceptional Children, Jul/Aug, 26-33.

Taylor, K. & Preece, D. (2010). Using aspects of the TEACCH structured teaching approach with studentswith multiple disabilities and visual impairment. The British Journal of Visual Impairment, 28(3),

244-259.

Van Bourgondien, M.E. & Schopler, E. (1996). Intervention for adults with autism.Journal of

Rehabilitation, Jan/Feb/Mar, 65-71.