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Pat Fennell, Laurie
Eckenrode, and Kathy Hearsey
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The three of us have been working with children
and adults with autism spectrum disorders and other special needs for decades. I
started my career in the early 1970’s before there was even a law in the USA that
guaranteed a free and appropriate public education to each child regardless of
disability.
My first teaching job was in a residential
school for children with emotional handicaps. Many of these children considered
emotionally disturbed at that time would now be diagnosed with autism spectrum
disorder (ASD). Knowledge that autism was a developmental issue resulting from
the way the brain developed rather than an emotional problem caused by
“refrigerator mothers” was just emerging.
My second teaching job was in a mental health program
for school-aged students who were not allowed in a public school because of
extreme physical, cognitive, or behavioral issues. Most of the students with
the challenging behaviors would have a diagnosis of ASD today.
There were no treatment models for these
students with ASD. It was much trial-and-error problem solving to determine how
we could help our students learn while also helping them manage their emotions
more effectively than by being aggressive or self-injurious.
One of our students was 14 years old and had
never been in a structured educational program. His face slapping was so severe
when he began in our program that his arms had to be restrained constantly. Our
kindness to him, our asking him to do something, our rewards for keeping his
hands down, our restraining his arms were not effective in changing this
difficult behavior.
Luckily, we figured out that he loved to work on
manipulative tasks that were understandable and that he could complete
independently. This meaningful work is what changed his behavior. Even though
he did not begin his educational program until 14 years old, he still learned
many visual, fine motor, language, and life skills. He also felt competent and
successfully entered a supported employment program when older.
This student and others at the program who would
probably be diagnosed with ASD today taught us that the typical rewards and
punishers were ineffective in changing their behaviors. Telling them what to do
did not work either.
Manipulative activities engaged them better than
social or language-based ones. They often enjoyed repeating activities that
they understood and could complete independently. When so engaged, their
difficult behaviors were seldom seen. (You might want to check out some
manipulative tasks for beginning or early learners in our first book, Tasks Galore.)
We also discovered that they enjoyed routines. We
focused on their completing 1-on-1 work and independent practice of learned
tasks. We did find that, if group activities were conducted in similar ways
each day; included turn-taking with manipulative activities; and initial group
times were very short, the students were less anxious. Over time, they were
more likely to participate.
Even though the students preferred sameness and
repetition, we needed to make changes to their manipulative tasks or group
activities so that they would continue to progress. We learned to make these
changes slowly and within the context of established routines. For example, during
group time, we would introduce new activities or songs gradually to teach a new
concept or theme. To help the students accept the change without becoming
anxious or inattentive, we first established a “What’s New?” time. Because “What’s New?” was familiar, something
different could be introduced more effectively.
We saw much improvement in behaviors and skills;
however, behaviors remained obvious during transitions, language-based
activities, and free time.
We were privileged to have Gary Mesibov, a UNC
postdoctoral fellow in psychology at the time, consult to our program. Dr.
Mesibov eventually became co-director of the TEACCH program alongside Dr. Eric
Schopler. In collaboration with Dr.
Robert Reicher, Dr. Schopler
was a pioneer in proving that children with ASD did not suffer from mental
disorders. He also proved that parents of autistic children could be effective
collaborators in the treatment and education of their children.
In 1981, I became a
psychoeducational therapist at the TEACCH program. There I had the wonderful
opportunity of working with a multitude of skilled clinicians,
teachers, and parents. Among these were Laurie and Kathy.
Everyone at TEACCH continued the problem solving about
how to help these students. We had the honor of watching the children grow into
adolescents and then into adults. We also had the honor of learning from their
parents what was most challenging, important, and effective at home. The
insights gleaned from the students and parents taught us what worked and didn’t
work. Watching the children grow up
taught us what they needed to learn in order to function in life. Based on
these experiences, Dr. Mesibov was instrumental in conceptualizing how autism
was like a different culture with its unique patterns of thinking and behavior.
This idea taught us that in order to teach the students effectively, their
culture needed to be respected and understood. Their strengths recognized.
To be continued