4.0 TEACCH

4.1 Introduction

Integration approaches, seek to enable people with autism to live as members of the community. The most common example is that TEACCH (Treatment and Education of Autistic and related Communication-handicapped Children), pioneered by the University of North Carolina, US.

4.2 What is TEACCH?

Division TEACCH was started in 1966 as part of the Department of Psychiatry of the School of Medicine at the University of North Carolina in the USA. It has an extensive training programme for professionals and is also in use in other areas of the country as well as other parts of the world. Furthermore, the now retired director of TEACCH, Eric Schopler, has been a very influential figure in the field of autism for many years.

It began as a Child Research Project to provide services to children with autism and their families. In 1972 the North Carolina General Assembly passed legislation, which enabled Division TEACCH to become the first comprehensive state wide community based programme of services for children and adults with autism and other similar developmental disorders.

Today, TEACCH provides a wide range of services to a broad spectrum of toddlers, children, adolescents, adults and their families. This includes diagnosis and assessment, individualised treatment programmes, special education, social skills training, vocational training, school consultations, parent training and counseling and the facilitation of parent group activities.

TEACCH also maintains an active research programme and provides multidisciplinary training for professionals dealing with children/adolescents/adults with autism and their families.

The primary aim of the TEACCH programme is to help prepare people with autism to live or work more effectively at home, at school and in the community. Special emphasis is placed on helping people with autism and their families live together more effectively by reducing or removing 'autistic behaviours'.

4.3 The TEACCH mission

The TEACCH mission is:

• To enable individuals with autism to function as meaningfully and as independently as possible in the community;
• To provide exemplary services to individuals with autism, their families and those who serve and support them;
• As a member of the University community, to generate knowledge; to integrate clinical services with relevant theory and research; and to disseminate information about theory, practice, and research on autism through training and publications locally, nationally and internationally.

4.4 The TEACCH concept

The principals and concepts guiding the TEACCH system have been summarised as:

• Improved adaptation; through the twin strategies of improving skills be means of education and of modifying the environment to accommodate deficits.
• Parent collaboration: parents work with professionals as co-therapists for their children so that techniques can be continued at home.
• Assessment for individualised treatment: unique educational programmes are designed for all individuals on the basis of regular assessments of abilities.
• Structured teaching: it has been found that children with autism benefit more from a structured educational environment than from free approaches.
• Skill enhancement: assessment identifies "emerging" skills and work, then focuses upon these. (This approach is also applied to staff and parent training).
• Cognitive and behaviour therapy: educational procedures are guided by theories and behaviour suggesting that difficult behaviour may result from underlying problems in perception and understanding.
• Generalist training: professionals in the TEACCH system are trained as generalists who understand child, and do not specialise as psychologists, speech therapists etc

4.5 How is the assessment made?

Educational strategies are established individually on the basis of a detailed assessment of the learning abilities of the person with an autistic spectrum condition, trying to identify potential for acquisitions rather than deficits.

The assessments are called PEP's (Psycho Educational Profiles) and try to identify areas where the person 'passes', areas where the skill isn't there yet, and areas where the skill is emerging.

These areas are then put in an education programme for the person. This assessment is multi-dimensional. This is a must since there is a great variability of skills, even in the same autistic person, from one area of competency to another.

These assessments were developed initially by Eric Schopler and colleagues and modified with time. The various items of the test are organised by developmental 'domains', covering:

• Imitation;
• Perception;
• Fine motor skills;
• Gross motor skills;
• Eye-hand recognition;
• Cognitive performance; and
• Cognitive verbal.

In each domain, the progression of difficulty follows normal development scales that have been validated on very large populations. The manual for the PEP contains thorough advice on how to administer the test, taking into account the specificity of autism.

4.6 Behavioural modification differences

The strategies put forward by TEACCH do not work on the behaviour directly, rather on underlying conditions that will foster learning experiences.

They also make use of recent cognitive psychology research results about some differences in particular areas of the brain processing in autistic people versus other people.

When behaviour problems occur, they are not treated directly either. The approach calls for efforts to understand the underlying reasons for the behaviour problem, such as:

• Anxiety;
• Physical pain;
• Difficulty with task;
• Unpredictable changes; and
• Boredom, etc.

The idea is twofold:

1. By giving the person means to better understand their environment, the environment becomes more predictable and less intimidating. This may require proposing a simpler environment in the early phases of development and progressively reintroducing complexity as the child progresses towards more and more autonomy.
2. By giving means of communication to the person, the comprehension and expression capabilities will enable them to better understand what is being told/asked and to express their needs and feelings by means other than behaviour problems.

However, direct Behavioural Modification isn't completely ruled out. It is reserved for those behaviours that endanger the person and for which the above strategy didn't work and is, in any case, rarely used.

4.7 Does it work?

The data available on TEACCH comes from studies focused on stability of IQ's. Based on these studies, substantial increases in IQ are common among children first evaluated at ages 3 to 4, with the largest change found among children who were non-verbal and had IQ score in the range 30-50.

However, these good increases still left many of the children within the range that indicates difficulties.

Contact

United Kingdom:
The Society for the Autistically Handicapped
Mr. K. Lovett
199-201 Blandford Avenue
Kettering, Northamptonshire, UK
NN16 9AT.

Tel/Fax: +44 (0) 1536 523274
Web: http://www.autismuk.com/

United States:
Division TEACCH Administration and Research
CB 7180, 310 Medical School Wing E
The University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, 27599-7180, USA

Tel: +001 (919) 966 2173
Web site: http://www.teacch.com/