Utilizing a range of instructional approaches in general education
Dr. Cathy Pratt, Director
Johanna Lantz, Graduate Assistant
Rachel Loftin, Graduate Assistant
Students with Autism Spectrum Disorders present
a unique challenge to educators. There is considerable heterogeneity
among this population, which means that each individual may need
qualitatively and quantitatively different levels of educational
and behavioral support. As a result of this variability, students
with Autism Spectrum Disorders are educated anywhere along the placement
continuum from specialized programs to general education classrooms.
An abundance of intervention strategies exist,
some of which have not been empirically supported. A feature of
many of the most utilized treatment approaches is their implementation
in clinics or specialized settings, and apparent lack of applicability
to less restrictive educational environments. The purpose of this
paper is to describe selected interventions and consider the compatibility
of these interventions with general education placement.
Interventions for Autism Spectrum Disorders
A wide variety of interventions exist for children
with Autism Spectrum Disorders and can be tailored to meet the needs
of the individual student. Interventions can range from being highly
structured and adult-driven to child-directed, or anywhere in-between.
The listings below are intended to serve only as a brief example
of a few of the more commonly known available interventions, including
discrete trial teaching, pivotal response training, videotaped self-modeling,
and Division TEACCH. The list is not intended to be inclusive of
all potential approaches.
Discrete Trial Teaching
Discrete trial teaching (DTT) is an intervention
method based on the principles of operant learning theory. Promoted
by O. Ivar Lovaas from the University of California, Los Angeles,
discrete trial teaching is used to teach a variety of skills in
domains including cognitive, communication, play, social, and self-help
skills (Leaf & McEachin, 1999). Today there are various interpretations
of the use of discrete trial teaching. Discrete trial teaching is
also referred to as Applied Behavior Analysis (ABA).
Leaf and McEachin described the components used
in discrete trial teaching. According to Leaf and McEachin (1999),
the basic principles of DTT including breaking a skill down to its
component parts, allowing repeated practice, providing prompting
and fading, and using reinforcement. Prompts are utilized and then
faded out, and reinforcement procedures are used. Leaf and McEachin
added that DTT is appropriate to use with all ages and with diverse
Families participating in a strict DTT/ABA program
engage their child in 35-40 hours per week of intensive behavior
intervention, based on operant techniques and the shaping of behavior
through reinforcement of successive approximations, prompting and
fading procedures, and the use of positive reinforcers that are
functional. This highly structured one-to-one teaching approach
focuses on maximizing success and minimizing failure, while using
a variety of reinforcers to maintain motivation.
While utilizing behavior techniques associated
with the science of applied behavior analysis is rather common in
classroom settings, employing the use of strict one-on-one discrete
trial teaching style therapy may be more challenging and limiting.
Initially, skills may need to be taught in a more specialized setting,
but then skills must be introduced and taught within the context
of the general education and other typical settings. For example,
when a child learns to respond to simple social questions (“How
are you?” or “What’s your name?”), the classroom assistant or teacher
will then contrive situations in which the child must use these
phrases with other adults or classmates.
Although a child may need pullout services for
a short period during the day or after school for skill acquisition,
applying these skills in natural settings is crucial for generalization.
If the teacher is kept current with the child’s programming and
understands the procedures associated with discrete trial teaching,
trials can easily be integrated into curriculum.
Pivotal Response Training
Another technique using discrete trial training
is Pivotal Response Training (PRT). Whereas Lovaas incorporates
a more specific and rigid method of discrete trial teaching, pivotal
response training uses pivotal or motivational trials (Koegel, Koegel,
& Carter, 1999). Robert and Lynn Koegel and their colleagues
at the Autism Research Center at the University of California at
Santa Barbara found Lovaas-developed methods of discrete trial teaching
“laborious,” and “behaviors often failed to be exhibited in other
settings or in response to items that were not specifically taught”
(Koegel, Koegel & Carter, 1999). Concerned about the lack of
generalizability of skills taught via discrete trial teaching and
lack of motivation in children with Autism Spectrum Disorders to
learn new tasks (Stahmer, 1999), Koegel and Koegel and colleagues
Pivotal Response Training emphasizes key pivotal
skills, asserting that students who learn pivotal skills will generalize
them to other areas (Koegel, R.L. et al., 1999; Koegel & Koegel,
1995; Koegel, L.K. et al., 1992). Pivotal behaviors are those that
are central to a wide range of functioning, including motivation,
responsivity to multiple cues, child self-initiation, and self-management
(Koegel, R.L. et al, 1989). Increased motivation, for example, may
lead to a dramatic effect upon children’s learning (Koegel, R.L.,
O’Dell, & Dunlap 1988). An increase in motivation may in turn
significantly increase and improve speech in students with Autism
Spectrum Disorders (Koegel, R.L., 1989).
In order to implement pivotal response training
in the classroom setting, Koegel and Koegel and their colleagues
recommend incorporating five variables into the existing school
environment. These five variables include teaching interactions
by promoting choice, varying tasks and interspersing maintenance
tasks, reinforcing attempts, using natural reinforcers, and developing
self-initiated learning interactions (Koegel, Koegel, & Carter,
1999). These variables are designed to improve motivation in the
classroom, including widespread benefits across a number of academic
and social behaviors, and with concomitant decreases in disruptive
behaviors (Koegel, Koegel, & Carter, 1999, Kern & Dunlap,
Child choice includes the use of child-chosen
or child preferred materials in teaching tasks. Incorporating choice
as a curricular intervention can decrease undesirable behavior in
the classroom (Kern & Dunlap, 1998). Child choice can be incorporated
into the majority of academic activities (Koegel, Koegel, &
Carter, 1999). This may consist of allowing children to select materials
for a given subject, to choose the order of completing worksheets,
or by allowing the child to choose his or her own seat. Additionally,
parents may be encouraged to incorporate child choice into homework
completion time. An increase in motivation to initiate and complete
homework assignments can be accomplished by allowing children choice
as to the order for completing tasks, the writing implements used,
the location in the house in which the work is conducted, and other
ideas (Koegel, Koegel, & Carter, 1999).
The lack of motivation apparent in children with
Autism Spectrum Disorders may be the result of recurring failure
at tasks (Koegel, Koegel, & Carter, 1999). To reduce the number
of failures in an instructional period, PRT involves randomly and
frequently interspersing new tasks with previously mastered items
(Koegel, Koegel, & Carter, 1999). When introducing a new number
to a child with an Autism Spectrum Disorder, for example, it may
prove helpful to include a review of some numbers the child knows
well. Rather than starting with a review and finishing with the
new item, mixing the novel and mastered items throughout the trial
will likely guarantee at least some success.
Contrary to many behavior interventions, practitioners
of PRT reinforce all attempts in which the child appears to be trying,
even if the response is incorrect. This will increase the likelihood
of future responding to tasks and improve the child’s learning during
social and academic tasks (Koegel, Koegel, & Carter, 1999).
Reinforcing attempts may include using phrases like “good try”.
Some reinforcers are more beneficial to the child than others. Using
naturally occurring, intrinsically reinforcing consequences rather
than arbitrary reinforcers, for example, may increase motivation
and rate of learning (Koegel, Koegel, & Carter, 1999). A natural
reinforcer is one that is directly related to the task at hand.
If a child says, “I want a cookie,” receipt of the cookie is a direct,
natural reinforcer. If the child were to request the cookie and,
as a consequence of appropriately using language, received something
else (e.g., verbal praise), he or she would not likely associate
the consequence with his or her own responding. Receiving a cookie,
however, is a clear result of the verbal request.
Children with Autism Spectrum Disorders often
avoid social and learning opportunities outside of their areas of
intense interest, while typically developing children more often
actively seek out such occasions (Koegel, Koegel, & Carter,
1999). Children with Autism Spectrum Disorders lack spontaneous
initiations, especially question asking and other verbal initiations.
When systematically taught to inquire about highly reinforcing child-choice
items, children with Autism Spectrum Disorders were able to generalize
this skill (Koegel, Koegel, & Carter, 1999).
Pivotal response training is not the only approach
with an emphasis on increasing motivation in children with Autism
Spectrum Disorders. The Treatment and Education of Autistic Children
and Related Communication Handicapped Children (TEACCH), an approach
centered on Structured Teaching, is based at the University of North
Carolina at Chapel Hill. TEACCH describes its approach as “a comprehensive
educational program with an emphasis on developing both motivation
and skills in a wide range of curriculum areas.” TEACCH interventions
target presumed strengths in students with Autism Spectrum Disorders
(Mesibov et al, 1994) and focus on designing accommodations to address
inherent difficulties. Community outings and integrated playgroups
are used to foster generalization of learning to larger group settings.
The TEACCH model is guided by seven principles
(Schopler, 1994). These include promoting adaptation by improving
the individual’s skills and developing environmental adaptations;
emphasizing parental collaboration; conducting formal and informal
evaluations for developing an individualized education program;
utilizing cognitive and behavior therapy as intervention strategies;
enhancing skills and accepting deficits in both children and parents;
using visual cues to compensate for auditory processing problems;
and utilizing a holistic orientation with multi-disciplinary training
(Schopler, 1998; Olley, 1999).
Gary Mesibov, the Director of Division TEACCH,
and his colleagues offer several suggestions for using Structured
Teaching in the classroom setting (1994). Before teaching commences,
structure is established in the instructional environment. Specific
recommendations concern the physical organization of the classroom
(physical lay-out, selecting work areas, and boundaries), creating
schedules, developing individual work systems, implementing visual
structure, and teaching students to follow routines (Mesibov et
al, 1994). These suggestions are discussed in detail below, followed
by a brief description of the Structured Teaching method.
Careful physical organization of the classroom
enables the student with an Autism Spectrum Disorder to better understand
their environments and relationships between events (Mesibov et
al, 1994). Work areas for students with Autism Spectrum Disorders
should be free from distractions (Schopler, Reichler, & Lansing,
1980). Facing students’ desks toward a blank wall may eliminate
many distractions and help students to attend to the relevant dimensions
of their work activities and instruction (Mesibov et al, 1994).
The individual needs of the student should be considered when selecting
a classroom environment. For the student who is learning to use
the toilet independently, for example, it is ideal to place the
child in a classroom near the restrooms. Students with Autism Spectrum
Disorders may benefit from a transitional area, where all of the
activity schedules are placed (Mesibov et al, 1994). Students go
to the transition area to learn what the next activity will be.
For many students with Autism Spectrum Disorders,
clearly outlined boundaries may be useful. This may include pieces
of tape on the floor indicating proper chair placement at a work
station, the use of partitions to separate desks, or designating
the carpeted portion of the classroom as a free-time area. As students
function more independently, the amount of physical structure in
the environment is tapered (Mesibov et al, 1994).
Like physical organization, schedules assist individuals
with autism Spectrum Disorders in understanding their environment.
“Developing visually clear schedules for students that each understands
at his or her own level of ability allows a teacher to communicate
which discrete events will occur during the school day, when they
can be expected to occur, and how they are related to one another
(e.g., first work and then play)” (p.198, Mesibov et al, 1994).
Visually clear schedules assist students with Autism Spectrum Disorders
with sequential memory and time organization, reinforce oral directions
that may be difficult to understand, and compensate for attentional
problems by providing visual reminders of upcoming activities (Mesibov
et al, 1994).
Similar to a schedule, an individual work system
provides each student with the specifics of what he or she should
do while working independently. These systems provide the student
with four pieces of information: what work to do; how much work
to do; how they will know when they have finished; and what will
happen when they are finished (Mesibov et al, 1994). An individual
work system promotes the child’s ability to work independently.
However, work systems should not be misinterpreted as curriculum.
Many children with Autism Spectrum Disorders do
well with visually presented tasks (Mesibov et al, 1994). Visual
tasks are more concrete and easier for the student with Autism Spectrum
Disorders to understand, and students often rely on visual teaching
methods (Scott, Clark, & Brady, 2000). Additionally, students
with Autism Spectrum Disorders may be more likely to attend to instruction
if it is visually interesting (Mesibov et al, 1994). For example,
a student may be more successful with a sorting task if the stimuli
to be sorted include objects with patterns or colors the student
enjoys. Also, color-coding the students’ materials is often helpful.
This may include using yellow electrical tape to designate the child’s
assigned seat for circle time or a yellow hook for the student’s
Visually organizing information helps students
to process information more efficiently (Mesibov et al, 1994). When
asked to clean large windows, for example, the student with Autism
Spectrum Disorders may be overwhelmed and unable to start. Dividing
the large window into four smaller sections makes the space smaller
and more manageable.
Another useful aid in the classroom involves the
use of visual instructions. These visual instructions frequently
include the use of a visual representation of the task and how it
is to be completed, using an item known as a “jig” (Mesibov et al,
1994). Jigs are especially useful for promoting independence in
community-based settings without direct adult supervision. They
provide an unambiguous way of understanding the task expectation.
The establishment of routine is the final method
of incorporating structure into the school environment discussed.
Because these individuals struggle to understand the requirements
of specific situations and often cannot easily or effectively organize
themselves, students with Autism Spectrum Disorders benefit from
learning systematic and consistent ways of completing tasks (Mesibov
et al, 1994). As with the window-washing example, children with
Autism Spectrum Disorders are often immobilized when confronting
demands. Learning to approach assignments in a left-to-right, top-to-bottom
sequence gives them a systematic approach to a multitude of tasks.
Independently, students with Autism Spectrum Disorders develop and
follow their private routines or compulsions. It is useful to redirect
this tendency toward productive activities (Mesibov et al, 1994).
Once structure is established in the classroom,
tasks can be taught in a structured manner. The use of clear directions,
prompts, and reinforcers are essential to Structured Teaching (Mesibov
et al, 1994). For students who have difficulty processing receptive
language, telegraphing language is recommended (Mesibov et al, 1994).
For example, rather than saying, “Tom, Come on. Put these blocks
back into the container over there. You know what to do. Then, put
it back on the shelf. Go ahead. You can’t go play with the toys
until you’re done”, the teacher may simply say, “Clean up. Then
play”. Telegraphed speech is more likely to be understood by the
student with an Autism Spectrum Disorder and can be individualized
to each student’s level of functioning (Mesibov et al, 1994).
Verbal, physical, modeling and gestural prompts
are also recommended to increase student success. Prompts should
be used consistently and clearly before the student makes an incorrect
response. When possible, prompts should be gradually eliminated
and ultimately the student should respond unaided (Schreibman, 1994).
If this does not occur, the student may become prompt dependent
and unable to correctly respond without the established prompt.
When working with students with Autism Spectrum Disorders, unintentional
prompting often occurs (Mesibov et al, 1994). The student may respond
to unintended cues, rather than to the issued directive. For example,
a teacher widens her eyes when presenting a picture of a “big” circle
and attempts to elicit the response of “big ball” from the student.
The student says “big” because she sees her teacher widen her eyes
and not because of the picture.
Finally, Structured Teaching involves motivating
students to work with desired activities or items. The necessary
amount of external reinforcement is individual to the child. Some
students with Autism Spectrum Disorders are highly motivated by
completing assignments for their own sake, but most require further
Like pivotal response training, TEACCH encourages
the use of natural reinforcers (Mesibov et al, 1994) and recommends
coupling tangible reinforcers with social reinforcers and verbal
praise. In order for the child to associate the reinforcer with
the behavior, the reinforcer must initially occur immediately following
the desired behavior. As the student progresses, the schedule and
type of reinforcer can evolve (Mesibov et al, 1994).
In contrast to the previous instructional approaches,
Videotaped Self-Modeling (Videotaped Self-Modeling) is based on
the principles of social learning theory. The age, sex, and similarity
of a model to the observer are important factors in modeling (Bandura,
1969). Optimal characteristics of models include similarity to the
subject in terms of race, age, attitudes and social background;
display of similar problems and concerns as the subject; and exhibition
of slightly higher levels of competence. Given these optimal characteristics,
it follows that using an image of ones’ self as a model would be
an effective means of altering behavior. This is the rationale behind
the Videotaped Self-Modeling approach.
Buggey (1995a) defines Videotaped Self-Modeling
as “…a procedure by which children are allowed to view themselves
functioning at a slightly higher level than their normal ability
through the creative use of videotaping and editing procedures”
(p.39). The process involves identifying a target behavior for change
and then determining an alternative appropriate behavior. The child
is then videotaped in either a role-playing situation or in the
natural setting. The tape is edited to show only the desired alternative
appropriate behaviors. If a desired behavior occurs at a very low
frequency, it may be necessary to use role-playing in order to have
an adequate sample of positive behavior (Buggey, 1999).
Videotaped Self-Modeling is particularly appealing
to use with people with Autism Spectrum Disorders because it does
not require human interaction (children with autism tend to relate
to objects better than people), it utilizes visual learning, it
is predictable, and it is easy to control (Buggey, Toombs, Gardener,
and Cervetti, 1999). Charlop-Christy, Le, and Freeman (2000) compared
the effectiveness of video modeling to in vivo or live modeling.
Each of the five participants had different target behaviors. For
four of the children, video modeling led to quicker acquisition
and better generalization of skills compared to in vivo modeling.
They added that video modeling was cheaper and less time consuming
than in vivo modeling. Charlop-Christy et al. (2000) further explained
that children with autism tend to enjoy watching television, and
consequently are more motivated to learn off a video than from a
Videotaped Self-Modeling has been used to effectively
treat a variety of disorders and problem behaviors from disruptive
classroom behaviors (Kehle, Clark, Jenson, & Wampold, 1986;
Lonnecker, Brady, McPherson, and Hawkins, 1994) to academic skills
(Schunk & Hanson, 1989). Studies have investigated the use of
Videotaped Self-Modeling with children with Autism Spectrum Disorders.
For example, Buggey et al. (1999) conducted a study to see if the
use of Videotaped Self-Modeling would increase appropriate verbal
responding in a sample of three children with autism and found an
increased level of appropriate responding after the Videotaped Self-Modeling
treatment in all participants. Bellini (2000) used Videotaped Self-Modeling
with role-playing and training in recognizing thoughts and feelings
to improve the social skills and reduce anxiety and depression in
a fourth grade student with PDD-NOS. Posttest measures indicated
lower levels of anxiety and depression, and increased social interaction
in the child diagnosed with a pervasive developmental disorder.
Other research that examined the use of Videotaped
Self-Modeling indicates that the use of this intervention strategy
may not be appropriate for preschool age children. Buggey (1995b)
investigated the use of Videotaped Self-Modeling to improve the
expressive language development of two preschool children with language
delays. One child showed no significant improvements; however, the
other participant did make significant qualitative and quantitative
improvements. Clark, Beck, Sloane, Goldsmith, Jenson, Bowen, and
Kehle (1993) conducted a study to see whether Videotaped Self-Modeling
would decrease aggressive and noncompliant behaviors in preschool
children. Clark et al. (1993) were unable to find significant differences
in the behavior of preschoolers after Videotaped Self-Modeling treatment.
According to Bandura (1971), four processes are involved in delayed
modeling: attention, retention, motor reproduction, and motivation.
Considering the skills necessary to model a behavior, it may not
be developmentally appropriate to use Videotaped Self-Modeling with
preschool age children because of their short attention span, cognitive
immaturity, and under-developed motor skills.
The majority of research using Videotaped Self-Modeling
indicates that this method is effective in eliciting positive behavioral
changes. In most Videotaped Self-Modeling studies, positive behavior
was achieved quickly and was still evident in follow-up evaluations.
In addition, the desired responses were generalized across situations
(Buggey, 1999). According to Buggey (1995a), “children’s confidence
and self-rated ability on a task tends to increase as a function
of viewing their own success” (p.41).
Videotaped Self-Modeling has been shown to be
effective in eliciting behavioral change in the classroom settings
(Kehle, Clark, Jenson, & Wampold, 1986; Lonnecker, Brady, McPherson,
& Hawkins, 1994). It is particularly appropriate for use in
school settings for several reasons. First, it typically does not
require specialized training of teachers or staff. Second, because
the child is filmed in the classroom setting, the generalization
of skills is more likely to occur. Third, research indicates that
Videotaped Self-Modeling can be used effectively to address a variety
of behaviors from academic skills to aggression. Fourth, it does
not require a lot of time or effort on the part of the teacher to
implement. Finally, Videotaped Self-Modeling is considered a positive
behavioral support, because inappropriate behaviors are ignored,
while positive behaviors are emphasized (Buggey, 1999).
Summary and Conclusions
The skill and ability to merge effective practices
to benefit children with Autism Spectrum Disorders in the general
education setting is the art of good teaching. And many of the strategies
promoted for students across the autism spectrum, will benefit other
children as well. Robert and Lynn Koegel (1995) have complied a
highly useful list of clinical factors professionals should consider
when choosing intervention approaches and when working with students
with Autism Spectrum Disorders:
There is variability in symptomatology and responsiveness
to intervention across children; therefore, all intervention should
be individualized.The earliest possible intervention should be considered
to aid in the prevention of the emergence of severe problems.
Intervention should take place primarily in the
The child’s motivation to overcome his or her
disability should be promoted.
Analyses of the functions of the child’s behavior
need to be conducted.
Full school and community inclusion needs to be
planned and implemented throughout the life span.
Parental participation is important.
Generalization and maintenance of intervention
gains need to be planned and evaluated.
Coordination among individual providers, educators,
and parents enhances the child’s progress.
The child’s independence needs to be promoted.
The social significance of the intervention for
the child’s and the family’s quality of life needs to be considered.
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