Introduction
Autism is a developmental condition that is behaviorally defined. The symptoms related of the syndrome occur on a continuum spreading from mild to severe (Gresham, Beebe-Frankenberger and Mcmillan, 1999). It is also viewed as a pervasive developmental disorder that leads to impaired development in social interaction and communication among patients (Grandin, 1986).
TEACCH-Treatment and Education of Autistic and Communication related handicapped Children originated at the University of Carolina Chapel Hill in 1970 by Eric Schopler and fellow researchers. The service dwells on training, research and evidence related practice targeting both adults and children (Mesibov, G., and Shea, V., 2009 p.570-579).
TEACCH Intervention
TEACCH is a holistic technique that focuses on structured teaching based on evidence and observation which entails physical organization, scheduling and teaching methods. Mesibov notes that, individuals with autism have a common pattern of neuropsychological deficits and strengths that are called – the culture of autism (Mesibov et al., 2005). TEACCH recommends using four kinds of structures; using a physical structure where elements as furniture arrangement, visual cues and client activities are used to monitor behavior.
Furthermore, it reduces environmental sources of distraction by seating away from enhancing objects, which aims to structure individual behaviors. Secondly, by sequencing of events of the day, through organization or schedule of activities understandable to clients, the condition may be reduced to lower levels. Mostly, objects help students to make transitions to the next activities. Those with developmentally advanced abilities use pictures or written words that are used as schedules. Thirdly, organizations of individual tasks basing on visual methods to monitor structuring in students or clients are also employed in this technique. Fourthly, a sequence of activity tasks by students/clients is organized to increase the amount of time that the individual is engaged in productive activities (Mesibov and Shea 2009 p. 550-570).
Evidence-Based Research Intervention
Evidence-based research (EBP) has transformed from Empirically validated treatment (EVT) in Psychology and Empirically supported treatment (EST), which arose as a means of documentary benefits of adult psychotherapy, to evidence-based research (Mesibov and Shea 2009). The American Psychological Association (APA), developed a broader concept as an integration of the best available research and clinical expertise within the context of characteristics, culture, values and preferences (APA, 2006). It aims to develop interventions that improve the conditions of autistic clients.
Procedure
In the TEACCH program, important characteristics are observed. Students with impaired auditory processing in the form of language rely on visual information structuring. Besides, those students with difficulties in attention to details rely on activities that enhance sequencing, integration, connecting and deriving meaning out of them. Those with significant variability in attention are provided with activities that strengthen their abilities to focus. It aims at those who are easily digressed or those with high attention and difficulty in shifting focus (Mesibov and Shea 2009).
Teaching tools may also target those with difficulties to conceptualize time. They move through activities too fast or sluggishly from the beginning to the end. There are also those with the inability to communicate, whose social life is impaired. Those suffering from Asperger Syndrome, may have a low preverbal level, activities targeting communication would focus on the development of preverbal level communication targeting the use of language (Whetherby et al 1997 P.515).
The tendency to get attached to routines and settings are diagnosed and activities that may be difficult to transition or generalize situations detected. Some patients experience maladjustive impulses and interests that may be intense. They experience the inability to disengage from favored activities once engaged. It also corrects sensory preferences and aversions (APA 2006). The structuring in autism describes the organization of time, space and consequences of events to make learning activities clearer and easier to perform ((Gresham et al 1999).
Evidence-based
Mesibov’s comparison of symptoms of depression in two groups of mothers; those on the TEACCH program and control groups is used as an experiment to treat depression among mothers. Those on the TEACCH program reported a significantly lower depression as compared to the control group (Mesibov, 2009). Conversely, Ozonofff and Cathcart compared children with autism under the TEACCH home-based program and a control group, it emerged that the children had improved their psychological and educational profile (Ozonoff and Cathcart 1998).
Emerging Practice
Researchers on Autism fraternity have begun to diversify TEACCH methodologies. For instance, as noted by Schopler, descriptive literature about adults with autism have begun to examine and focus on areas as the enjoyment of humor, sexual behavior, perceptions of the population, feelings of loneliness and other social challenges (Schopler, E., and Bourgondien 1996). Besides, autism studies have broadened from the experimental laboratory setting to real-world practice as residential programs, social groups, summer camps, individual and group counseling.
Available Research
In a study, Rutter and Bartak compared skills and behavior of 50 children aged 7-9, they attended three educational programs with different philosophies; autistic specific psychotherapeutic program, a cross-categorical model combining psychotherapy and special education and autistic specific structured education. The findings found that children in a structured program demonstrated more on-task behavior and higher achievement (Rutter and Bartak 1973). Bodfish concluded in his study that, there was clear empirical support for the benefits of structure and predictability in the environment (Bodfish 2004). In 1999, the American Academy of Child and Adolescent Psychiatry found that structure was an important element of educational intervention. The National Research Council in 2001 recommended repeated planned teaching opportunities.
Additional Information
There is a need for further research into both components of the TEACCH approach and overall program effectiveness. Clinical expertise is now expanding the evidence in the field to improve the TEACCH approach.
Reference List
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. Washington D.C: APA.
Bodfish, J. W. (2004). Treating the Core Features of Autism: Are We There Yet? Mental Retardation and Developmental Disabilities Research Reviews , 10, 318-326.
Bourgandien, V., & Schopler, M. (1996). Intervention for Adults with Autism. Journal of Rehabilitation , 62, 65-71.
Grandin, T. (1986). Emergence: Labelled Autistic. New York: Warnerbrooks.
Gresham, F., Beebe-Frankenberger & Mcmillan, M. (1991,). A SelectiveReview for Children with Autism: Description and Methodological Considerations. School of Psychology Review , 28, 559-580.
Mesibov, G., & Shea, V. (2009). The TEACCH program in Era of Evidence – Based Practice. Journal of Autism and Development Disoders , 40, 550-570.
Ozonoff, S., & cathcart, K. (1998). Effectiveness of Home Program Intervention for Young Children with Autism. Journal of Autism and Developmental Disorders,28 , 25-32.
Rutter, M., & Bartak, L. (1973). Special Education Treatment of Autistic Children: Acomparative Study -II. Follow up Findings and Implications for Services. Journal of Child Psychology and Pyschiatry , 14, 241-270.
Whetherby, A., M. et al (1997). Enhancing Language and Communication Development: Theoretical Foundations. New York: Wiley.