Autism: Individual approach yields results
By Karen Kane
Is it a neurodevelopmental disorder or a biomedical disease?
Does it have a treatable cause or should “remedies” be limited to therapies for the behavioral symptoms?
Is it increasing in incidence, being more accurately diagnosed, or a combination of both?
When it comes to autism and its related-spectrum disorders, there’s much discussion and little agreement with one exception: The number of children with the diagnosis has increased exponentially in the past decade and the public school system in Pennsylvania is being put to the test in meeting the needs of these special students.
The spectrum is broad
When you’ve met one child with autism you’ve met … one child with autism.
It’s an oft-quoted warning to anyone in the education community. While there are some general behaviors in common — communication deficits, social skill difficulties, repetitive behaviors or obsessive interests — by and large, the autism spectrum disorder is highly individualistic.
“The unique characteristics of autism set this group of children apart in their learning needs from other special education students and even from each other,” said Michelle Lubetsky, a teacher trainer and consultation coordinator for the Allegheny Intermediate Unit, which provides special education services to the county’s 42 school districts, with the exception of the Pittsburgh Public Schools.
“Yes, there are three main areas of challenge for each person with autism, but the range within each area is so broad. It’s so complex,” she said.
Virginia Deasy, special education supervisor for the Baldwin-Whitehall School District, calls it “truly the most challenging area we face as special educators. You have the science and the strategy, but then there’s the art of education and you really need both. You can have the technique but you need the know-how of application.”
And while all special education children have special needs, educators agree that the expression of autism often hides a child’s talents and abilities, making it particularly perplexing to help that child achieve his potential.
Autistic support classrooms
The current trend in Pennsylvania’s public schools is to educate autistic students in a self-contained autistic support classroom.
Of a sampling of local districts, about half were running such classes, including Seneca Valley, Keystone Oaks and Gateway.
For Keystone Oaks, it was a matter of effective planning in light of booming numbers.
“We could see through our interactions with the Allegheny Intermediate Unit early intervention program (for children ages 3 to 5) that the population of students with the autism diagnosis was increasing. We knew we needed to be able to make some long-term plans for their education,” said Kathy Foster, who coordinates the district’s special education services for kindergartners through fifth grade.
An autistic support classroom was created at a cost of $68,000 for the 2005-2006 school year at Myrtle Elementary in Castle Shannon. Though a few of the 17 elementary students with an autism diagnosis attend their home elementary schools at either the Aiken school in Green Tree or the Dormont school, most attend the magnet Myrtle location.
Carrie Sheariss, teacher, runs the classroom.
Though she holds degrees in both regular and special education, the district sent Ms. Sheariss after her hiring in August 2005 for special training at the Watson Institute in Leet, a private school for students with special needs and a leader in autism education techniques. Also, a Watson representative was retained for periodic consultation.
Though the classroom is in operation all day, the student flow is dependent on the students themselves.
“Every one of them spends time in a regular education classroom but the amount varies day to day and by student,” she said.
While Ms. Foster said the district believes inclusion — the concept of “including” special education students in the regular education classroom — is an important component of the autistic student’s education, the autism support classroom is equipped specifically for that population’s special needs.
Susan Wuenstel of Green Tree agrees. Her 9-year-old son, Joshua, attends the special classroom, which she called “a little slice of heaven…I can see him go in there and exhale.”
She said the room offers a communication lab in “pragmatic speech” that helps address components of his problems — speech dysfluency; occasional anger eruptions; fine motor challenges. “That’s a need I couldn’t get met in any other way,” she said, noting that her son is paired with other autistic children and given activities that strengthen their particular communication weaknesses.
Ms. Sheariss keeps the visual distractions in her classroom to a minimum: a calendar on the wall, a few social skills posters that offer reminders such as covering the mouth when sneezing and raising the hand to speak. “Visual stimuli can be overwhelming for kids with autism,” she said.
She has “centers” stationed throughout the room with designated tasks to be performed at each: a library center for reading, a listening center for music, a sensory center with sand and squeeze-balls; a game center; a computer center; a puzzle center.
“When I look around my room, I see a place where the students know where to go. A very structured environment with places for interaction so I can carry through a clearly defined ideal of what’s coming next,” she said, noting that a sense of control, predictability and familiarity is critically important to her students.
Not for everyone
Though the trend toward autistic support classrooms appears to be gaining favor (Moon Area is considering one for next year), some districts see them as unnecessary, if not counterproductive.
Virginia Deasy of the Baldwin-Whitehall School District said her district favors the combined use of a learning support classroom with a technique known as “pushing in” by the special education teacher versus the longtime practice of “pulling out” the special education student from the regular classroom into the special ed classroom.
“It really amounts to co-teaching. We expect the special ed teacher to push into the regular ed classroom to co-teach some classes,” she said, noting the practice is employed more heavily with secondary autistic students.
The primary buildings make most use of the learning support classroom, which is used for small-group or one-on-one instruction.
“We’ve found that a learning support classroom can serve students with a wide variety of disabilities,” Ms. Deasy said, due to the general expertise of the special ed teacher as well as specialized consulting services the district retains. She sees an autistic support classroom as unnecessary.
Rita Neu, who supervises special education in the North Hills School District, said the decision not to establish an autistic support classroom “is purposeful on our part.” She said the North Hills philosophy is to have the autistic student in the regular classroom a much as possible “with a lot of support services available.”
“We believe they have a right to be included with their non-disabled peers so they have role models of kids to help them,” she said. “If you put a lot of autistic children together, they model each other. You don’t see as much progress,” she said. “We are all more alike than we are different and we believe in a highly-inclusive program with a lot of interaction among the students.”
She said every effort is made to keep the children in their home schools where they may be pulled from class on an as-needed basis to receive support services in a resource room. A paraprofessional, or teacher’s aide, is on hand to support the regular education teacher as needed.
Dr. Neu likened today’s ideal regular education classroom to those of earlier years. “Each classroom is like a one-room schoolhouse. You’re teaching kids who are high achievers and students with minimal skills. But they all have the right to be in the classroom with each other,” she said.
In the Seneca Valley District in Butler County, 12 autistic students are transported outside the district for their education and 78 remain in their home schools. Of the 78, about two dozen are in one of three self-contained autistic support classrooms (two at Connoquenessing Valley Elementary and one at Evans City Middle School ), and the rest — both elementary and secondary — are receiving services as needed from itinerant autistic support teachers, learning support staff, or emotional support teachers.
“If there’s one thing we know, there’s no ‘one size fits all’ to these students,” said Darlene Leone, assistant director of special education at Seneca.
Pennsylvania’s top expert in autism said doing it right can take several forms as long as the educators are trained and the child’s learning style is considered.
Nina Wall-Cote, director of the Pennsylvania Bureau of Autism Services in Harrisburg, said a parent should look for well-trained teachers and clinicians working with their child, regardless of the type of classroom or setting the child is in.
“Some children do very well in inclusive settings, a regular ed classroom with support. Some children seem to do better in an environment that is less overwhelming, classes that are smaller. The important thing is that the programs are individualized to suit the learning style of the individual student,” said Ms. Wall-Cote, the mother of an autistic teenaged son, a therapist and an advocate.
Teacher training
If for no other reason than the skyrocketing numbers, the impact of autism on the public school system is more dramatic with each year. That impact is reflected not only in more special needs classrooms and building modifications, but also in the level and type of training teachers are receiving.
With a 2,000 percent increase statewide in the past decade and with diagnoses about doubling in the southwest region over a three-year period, the need to arm teachers with knowledge is rising concurrently.
As Allegheny County’s go-to source for special education information, training and services, the Allegheny Intermediate Unit is feeling the pressure.
“A year ago, we had three school districts participating in our annual autism team training series. This year, that number rose to 10 and we had to cut it off. It’s reflective of school districts’ realization that they need more student-focused training to deal with this disorder and the increasing number of students with the diagnosis,” said Ms. Lubetsky.
The AIU itself has seen the need for more training of its own employees. It has 19 teachers who work off-sitein one of the three special education schools operated by the AIU (Pathfinder in Bethel Park, Mon Valley School, or Sunrise in Monroeville,) or “embedded” in the three public school districts that retain AIU staff to run their on-site autistic support classrooms (East Allegheny, West Mifflin, and Woodland Hills).
Those AIU teachers received special training last year in research-based approaches to autism.
“It had to do with the numbers and the luxury of hindsight,” said Ms. Lubetsky of the decision to commission intensive training for their autism teachers. As experience with autistic students increases due to increasing numbers and longer periods in the school system, educators are stockpiling more tricks of their trade.
Last year, all the staff — principals as well as regular and special education teachers — in two elementaries of the North Hills School District spent three full days at the AIU receiving specialized training in dealing with autistic students. “We’ve spent a lot of time and money on staff development because the entire staff understands the importance of ‘owning’ all these children. They are ours,” said Dr. Neu, the special education supervisor for North Hills.
Social skills
While teaching techniques, theories and strategies vary, an underlying foundation is the recognition that educators need to think a bit unconventionally about their mission with the autistic pupil population.
Across the board, experts agree that autism education is as much about the need for social skills instruction as it is about reading, writing, and arithmetic.
“Unfortunately, we don’t tend to look at social development in a hierarchy as we do with academics,” said Ms. Lubetsky of the Allegheny Intermediate Unit. While the typical student may not suffer dramatically because of this, the same isn’t true for the autistic student.
For example, most children with autism have trouble making eye contact while conversing, sometimes inhibiting the normal ebb and flow of conversation. Most are unable to pick up social cues that come naturally to the typical child, leading to literal and often inaccurate or incomplete understanding. Many have what appears to be a low level of tolerance for frustrating tasks, resulting in anger eruptions or emotional “meltdowns.”
Ms. Lubetsky contends there can be a damaging disconnect between the tendency to believe that a youngster making A’s should be able to “sit still and behave” and the reality that many autistic students are highly intelligent yet functioning on a 2-year-old level in terms of social development.
The potentially devastating consequence: “You see an A on the paper and the expectations go way up. When they don’t behave in accordance with those expectations, they are deemed uncooperative, defiant or unruly,” Ms. Lubetsky said. That perception can be devastating to a fragile child’s school career.
North Hills’ Dr. Neu described the social skills aspect of the autistic student’s training as tricky, not just for the educators but for the students themselves.
“That social component is often the biggest hurdle for them to surmount. Reading other people’s body language. Understanding what the other kids are talking about,” she said.
Most school districts in Pennsylvania, including North Hills, employ one-on-one small group support in social skills.
Making the building fit
A child in a wheelchair needs an elevator to move from the first to the second floor of his school, unless it’s equipped with ramps. True.
Well, a child with autism may need some physical adaptations as well, contended Steve Smith, principal at Seneca Valley’s Haine Middle School in Cranberry.
He said school districts are inclined to want to make “the child fit the school,” but it’s a proposition “that just doesn’t work with the student who has autism.”
A former elementary teacher who has a master’s degree in special education and is in the midst of doctoral studies, Mr. Smith was serving as principal at the district’s Connoquenessing Valley Elementary in Zelienople when the decision was made to take over two elementary autistic support classrooms at the school that were being run by Intermediate Unit 4 which serves Butler, Lawrence and Mercer counties. That was in 2005-2006.
The first thing he did was “look at the physical environment of the building.”
While the classrooms were “pretty good,” Mr. Smith quickly determined they were in need of “tweaking.”
“I thought we needed to create a room that would give kids a sensory break,” he said. The Exploration Station — A Sensory Safe-Haven opened in 2006-2007 as a refuge for students who need to get away from their classroom for either more stimulation or less. Though it’s used most heavily by the school’s autistic students, it is open to any one.
Situated on a curtained stage within a large group instructional room, the sensory support room is entered through a doorway draped with a colorful shower curtain. Inside, soft music plays; the floor has rugs; the overhead lights are softly colored; there’s a corner with a rocking chair softly lit by a table lamp; a corner with a mini-trampoline; an alcove for bubble-blowing; a tent with pillows inside; a puzzle table; a sand table; a crescent-moon shaped “pillow” that rocks.
The equipment for the room was donated following appeals to the community through Mr. Smith’s monthly newsletter. The school Parent-Teacher Organization gave $1,000 as seed money. Residents sent in items on Mr. Smith’s wish-list. This year, Chris Bench’s Girl Scout Troop 492 of Cranberry donated hundreds of dollars worth of pictures, puzzles, bean socks and other materials.
Now, the room is used each morning for the autistic support students in what Mr. Smith calls a “movement ed” session, an exercise program aimed at “getting the wiggles out” before the students get down to business in their classroom, he said. After that morning session, the room is used on an as-needed basis by students looking to “just get away,” he said.
Sometimes, it only takes a few minutes, said Sue Sherman, the autistic support teacher and a former employee of the Watson Institute.
“They can be working really hard sometimes and, all of a sudden, they need to take a break. We used to take a walk in the hall, which could be disruptive to the other students. Now, we can come here. One student may need to spend some time manipulating the Legos. Another may want to relax in a rocking chair or be by himself in the tent. That brief change in the environment can be so helpful,” Ms. Sherman said.