Abstract
The population of students diagnosed with Autism Spectrum Disorders has increased significantly during recent years while creating an additional challenge to educators providing special services. In this context, educators are expected to implement the most effective evidence-based programs in their practice. The focus is on improving the students’ intellectual development, communication, social interaction, the response to stimuli, and behavioral patterns. This paper aims to discuss the definition of Autism Spectrum Disorders according to the IDEA 2004, examine the etiology and incidence of autism, and focus on the prevalence. In addition, the paper assesses the effectiveness of the Discrete Trial Teaching and the Treatment and Education of Autistic and related Communication Handicapped Children programs in contributing to the education of students diagnosed with autism.
Introduction
The education of children with Autism Spectrum Disorders is often discussed as a challenging task for instructors. The problem is in the fact that children with autism do not demonstrate an adequate level of intellectual development typical for their age, experience problems with concentration and communication, focus on repetitive behaviors and do not provide appropriate responses (Benton and Johnson 47). Therefore, educators need specific interventions to be implemented and used in the daily teaching process in order to improve the outcomes for these students.
The Discrete Trial Teaching (DTT) and the Treatment and Education of Autistic and related Communication Handicapped Children (TEACCH) are the widely applied evidence-based interventions that need to be discussed with the purpose of assessing their effectiveness in educating students with autism. From this point, this paper aims to discuss the definition of Autism Spectrum Disorders, examine the etiology and incidence of the disorder, focus on the prevalence of autism, and analyze the effectiveness of the DTT and the TEACCH in contributing to the education of students diagnosed with autism.
Autism Spectrum Disorders
Autism Spectrum Disorders (ASD) can be discussed as a category of different developmental disabilities that are commonly known as related to autism because of similar signs and behavioral patterns. These disabilities are included in one category while being represented by the characteristics mentioned in the Individual with Disabilities Education Act (IDEA) of 2004.
Definition of Autism According to the IDEA 2004
In 2004, the IDEA was adopted. In the document, the definition of autism was formulated in the following manner: “Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three that adversely affects a child’s educational performance” (Individual with Disabilities Education Act par. 1). In addition, the specific characteristics of the disorder were also determined in the IDEA 2004, and they included the “engagement in repetitive activities,” “stereotyped movements,” “resistance to environmental change or change in daily routines,” and “unusual responses to sensory experiences” (Individual with Disabilities Education Act par. 1). According to the third section of the definition, autism can also be diagnosed in children who are older than three years, and the focus is on symptoms and signs that are not primarily affected by emotional problems or disturbance.
Etiology and Incidence of Autism Spectrum Disorders
The researchers state that these disabilities are not only developmental but also neurological in their nature (Gutierrez et al. 632). The etiology of ASD is studied intensively, but there are only several hypotheses about the actual causes of ASD in children (Virginia Department of Education 6). Researchers have found that ASD can be caused by biological, neurological, and genetic factors, including the dysfunction of the central nervous system (Schaefer and Mendelsohn 399). The role of the environmental factors is also accentuated and studied in detail (Blumberg et al. 2).
In spite of the fact that there are no special medical tests to determine ASD, psychologists use specific techniques to distinguish ASD among other developmental disorders (Benton and Johnson 47). ASD is diagnosed in early childhood, and the focus is on identifying problems in the social interaction, communication with children and adults, repetitive behaviors, observed patterns, restricted activities, and inadequate responses to stimuli (Mesibov and Shea 570). When observing these behaviors, psychologists and educators can assume the presence of ASD in a child, but the etiology of the disorder is still unknown.
Genetics plays a key role in developing the symptoms of ASD, the researches on the role of the multi-factorial inheritance is continued, and the recurrence risk for children in one family is determined to be lower than 10% (Schaefer and Mendelsohn 399). Additional researches are important to be conducted in the field in order to determine how ASD can be affected and how the occurrence of ASD can be spread in the society because the current data on the incidence of ASD do not represent the trends in the spreading of this disease.
Prevalence of Autism Spectrum Disorders
The population of children diagnosed with ASD has increased significantly during recent decades. The most recent data on the prevalence of ASD in the United States is presented in the report published by the Centers for Disease Control and Prevention in 2014. The data indicated that for eleven sites examined in 2010, “the overall prevalence of ASD among the ADDM sites was 14.7 per 1,000 (one in 68) children aged 8 years” (Centers for Disease Control and Prevention 1). In addition, the “overall ASD prevalence estimates varied among sites from 5.7 to 21.9 per 1,000 children aged 8 years” (Centers for Disease Control and Prevention 1). The results were also classified according to the gender factor.
It was found that “one in 42 boys and one in 189 girls” who lived in the ADDM Network communities had ASD (Centers for Disease Control and Prevention 1). It was noted that white children were more frequently diagnosed with ASD than black children were. However, the researchers also state that the dramatic increases in the prevalence of ASD can be associated with “expanded classification criteria, policy and practice changes, increased awareness, and case confirmation strategies” (Virginia Department of Education 12). These aspects need to be taken into account by educators who work with children having ASD in order to conclude about the level of their development, as well as about social and intellectual abilities.
The problem is in the fact that the prevalence of ASD is also evaluated with references to the changes in the number of students who are selected as requiring the special education courses and services. As a result, the researchers note that changes in policies regarding the ASD criteria can influence these teaching processes significantly (Kim et al. 1). In 2007, students with ASD, who received the special education services, represented about 4% of those disabled students who received the similar services in the United States (Virginia Department of Education 13). In Sweden, the increases in the ASD prevalence are also explained with references to the extrinsic factors and the observed changes in the use of diagnostic tools (Idring et al. 1767). From this point, the changes in the prevalence depend on alternations in diagnosing ASD and the formulations of the definition of autism proposed to medical workers, psychologists, and educators.
Evidence-Based Instructional Strategies for Autism
Approaches to educating students with ASD differ significantly from the traditional methods and strategies used in teaching. As a result, educators are expected to implement special academic interventions developed for teaching students with ASD. The focus is on addressing the intellectual disability and problems in the demonstrated behaviors (D’Elia et al. 615). The interventions developed to increase the intellectual potential and improve the behaviors of students can be structured and adapted to the school settings or developed to imitate the natural environments for students with disabilities.
The Discrete Trial Teaching (DTT) and the Treatment and Education of Autistic and related Communication Handicapped Children (TEACCH) programs are the most actively implemented evidence-based interventions, and the focus is on comparing these programs in terms of their effectiveness to improve the adaptation, development, and education of students with ASD.
Discrete Trial Teaching and the Strategy’s Effectiveness
The DTT is discussed as one of the most popular interventions for students with ASD that is characterized by the high level of positive outcomes related to the students’ linguistic development, as well as improvement of communication and adaptation skills (McKenney and Bristol 8). The DTT is an example of the structured intervention that is oriented to improving the students’ reactions to stimuli. The typical procedure associated with the DTT includes the demonstration of the activity or task explanation; the actual task performance; the correction of mistakes; the reinforcement of the required action, reaction, or response; and the provision of the reward (McKenney and Bristol 9).
Educators need to pay attention to the students’ abilities to concentrate on the task and follow the instructions. It is also noted by researchers that the DTT can be discussed as the “most warranted” strategy “when a student has not demonstrated the ability to learn incidentally in small- or large-group settings” (McKenney and Bristol 9). The problem is in the fact that educators are often deprived of the opportunity to follow the DTT procedures strictly in public schools, and the implementation of the DTT in this situation cannot guarantee the expected results.
In order to increase the effectiveness of the DTT implementation in the education process, teachers need to receive the adequate training and consultation to develop their skills in proposing the procedures for the work with students. According to Downs and Downs, the benefits of the DTT are in providing “simple instructional cues, prompting, positive reinforcement, and a continuous formative assessment to shape behavior and improve children’s learning” (212). When these procedures are used effectively, and the teachers are perfectly trained, it is possible to expect positive changes in the behaviors of students with ASD.
Nevertheless, the researchers pay attention to the fact that the effectively developed DTT program is often poorly applied to practice, and all the proposed recommendations for the intervention need to be followed in detail (Gutierrez et al. 631; Thomson et al. 599). The efficient training of teachers can increase the effectiveness of the DTT application significantly, as it is reported by teachers and independent assessors (McKenney and Bristol 8; Sarokoff and Sturmey 126). If the DTT is implemented not appropriately, there is no efficacy in relation to the education of students with ASD.
TEACCH and the Strategy’s Effectiveness
The TEACCH is also a structured education program that is based on the active involvement of relatives in the educational process. The proposed sets of interventions are directed to provide the continuous support to students with ASD, to improve the adaptive behaviors, and expand the patterns of the social responses and interactions. The TEACCH also includes the elements of the behavioral therapy to support students when they work on changing their repetitive behaviors. The researchers and practitioners state that the TEACCH is an effective intervention because it is also based on changing the environment according to the needs and interests of a student with ASD (D’Elia et al. 617).
The main focus is on daily routines and developed schedules to improve the behavioral patterns (Panerai et al. 875). The educators who integrate the TEACCH in their practice also accentuate the significant role of using the visual information to teach students because their perception of the auditory and verbal information is limited (Mesibov and Shea 571). In addition, teachers can work individually with students and address their needs in relation to differences in attention and concentration.
Researches on the effectiveness of the TEACCH indicate that the intervention is appropriate to improve the daily activities of students with ASD, increase the level of their social involvement, and facilitate the cognition and perception (D’Elia et al. 616). High results are associated with the fact that parents involved in the education process contribute to the creation of the positive atmosphere for the students’ development and social adaptation (Panerai et al. 875). In spite of the fact that educators often perceive the TEACCH as non-appropriate for wide school settings, the findings of studies demonstrate that it is possible to adapt the program to different environments in order to achieve the high results in relation to the students’ education.
Conclusion
The recent studies on the prevalence of ASD in the United States indicate the unusual increases in the number of children diagnosed with autism. These trends can be viewed as outcomes of changes in the policies and criteria used to determine ASD. As a result, the number of students requiring the special education services also increases, and it is important to provide these students with programs that are evidence-based and most effective in individual cases. The Discrete Trial Teaching and the Treatment and Education of Autistic and related Communication Handicapped Children interventions are the most actively implemented programs to teach students with ASD.
The analysis of the interventions’ effectiveness demonstrates that these programs are equally effective to foster the academic and social development of students with autism. However, it is possible to recommend the application of procedures in concrete cases according to strict guidelines and pay more attention to the training sessions before using the interventions in the practice. Educators need to choose what intervention to adapt to the school or home settings and how to guarantee the use of all guidelines and procedures in practice in order to achieve the high results.
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