Meeting Individual Needs: Case Studies

http://autismmythbusters.com/

Introduction

KaPo, who is a 15 years old boy also with moderate mentally handicap. Before we discuss his case, we are better to know more about his characteristics from some observation of classroom teaching. Here is the conclusion of KaPo’s academic report I wrote in last semester.

“KaPo is stubborn and crabbed; he only will to finish the tasks that he wants to do. When we don’t follow his own ‘routine’, he would be unhappy, sometimes he may cry, shout or jump. However, when he is taking drugs, he can calm down easily. So, we hope that he can keep it on and reinforce him to express feeling by using verbal language at home, too. In academic, he is good in mathematics, and he can calculate arithmetic of primary 1 level, but it is still have space to improve in application. Also he loves computer very much and enjoys the lessons.”

KaPo’s characteristics and performance in the classroom

It is obvious that he is autistic, although there is no clearly defined single syndrome (Wing 1996), and no two children with autism have identical characteristics (Koegel, Koegel, Frea & Smith, 1996; Wong & Westwood 2002), but KaPo has most of typical pattern of behavioral deficits and had been assessed in early childhood.

As the above report mentions, KaPo has behavioral and emotional problem. It makes that he cannot concentrate to do the given tasks. Actually, he also has some stereotyped behavior patterns to bother his learning, for example, hand flapping, clapping and always want to wash his hand during the lesson.

Another barriers to KaPo’s learning are that, he just repeating what you are saying and asking. It is a typical echolalia, and it seems to be immediate, because it fulfill what Laski, Charlop and Schreibman (1988) defined, “inappropriate repetitions of words and phrases” (p.394). We are not discussing which categories he should be classified, but it makes difficult to learning and teaching, application and generalization. For example, he cans calculate “12398+9872”, but cannot answers “if you bought 3 apples and then bought 2 apples, how many apples did you buy totally?”

Reflection about the school and the teacher

School: Not only in mainstream school, the curriculum in special school is also facing different types of constraints. Parents’ expectation, prevocational and vocational needs and EMB guidelines, for example, EYE programme, have determined curriculum. In KaPo’s case, if we are too focus on the training for working in shelter workshop after graduated, it narrows the whole development of student, although it is “relevant” and important to his future. Moreover, KaPo have emotional fluctuation when he feels off task. If we just follow what he wants to do, he will learn nothing. I am not challenge the learner-centered approach or the concept of “realistic” in “4R Test” (Brennan 1987), but it is really need to concern that did students really know what they are interest or benefit to themselves, especially they are moderate mentally handicap?

The emotional and behavioral problems have been “created”, when we are using the “real” situation, for example, visiting shelter workshop or practice cleaning job, because he didn’t adopt the environment and also strengthens him to have ritual behavior. Moreover, Practice about the cleaning in EYE programme or school leaver programme; it reinforces washing his hands after touching something dirty. Also, in special school setting, it is difficult to gain acceptance from classmates when the interaction between pupils are weak.

Teacher: Task analysis is usually used in teaching the working skills. It is because students can more easily to understand what the task is doing. Also, when the steps are smaller, teacher can use more simple language to teach students to finish the task. However, it has limitations as Westwood (2003, p53) said, “…a limit to how far one can go with this step-by-step reduction of learning without creating separate tasks which by themselves are meaningless.” Actually, KaPo is usually off task when he didn’t know the “meaning” of the task.

Students with moderate mentally handicap have a few responses, so, when we want to make sure that KaPo is listening and understands the instruction, we would like him to speak once again what we are asking him to do. Echolalia is reinforced. Moreover, when teacher using task analysis approach, questioning is not easy and efficient to apply in the direct-teach and demonstration. It may affect KaPo that leaning to distinguish between question and instruction.

Moreover, most of us use Applied Behavior Analysis (ABA) to reduce the undesirable behavior. Because it is effective, and the research have also provide the evidence (Scheuermann & Webber, 2002; Waterhouse, 2000). We are using positive reinforcement, maybe allow him to play computer after lunch, to stop his problematic behavior. It works, but when he didn’t have the reward, he really depressed and off task more often than we are not using it.

Evaluation of teaching and management program for KaPo

Beside the above matter, some teaching and management program is designed for KaPo.

TEACCH (Treatment and Education of Autisitc and communication-handicap Children):

Whatever it is an intervention strategy or a teaching method, even it is a curriculum and programme, evidence has proved that to be effective, it should be highly structured (Waterhouse, 2000; Smith, 2003). Structured teaching is an important priority because it fits the “culture of autism” (Mesibov, 2002).

TEACCH is respects this culture, in the other words, respects autistic child’s need for structure, routine and predictability in the daily programme in school and home, and uses such devices as a picture time table or schedule to show the child what activity he or she is to do now and what is to come later during other parts of the day (Wong & Westwood, 2002). In short, TEACCH is emphasized structured teaching, and uses a combination of cognitive, behavioral-change strategies (Connor, 1999), visual strategy and also using IEP. So, Individualization, structured learning and environmental adaptation are the defining features of TEACCH (Dempsey and Foreman, 2001).

It is true that KaPo feels more comfortable when structure and organization in the classroom or any other learning environment is provided. It helps student to alleviate or moderate the behavioral and emotional problem caused by poor communication. Moreover, when KaPo is occupied by the working task, it can reduce the time for stereotyped behavior, in long run; it can fade out the rigid behavior.

Self-Management:

Teaching self-management has been effective at improving a variety of behaviors, including appropriate vocational (McNally, Kompik & Sherman, 1984), even generalization (Koegel, Koegel & Parks, 1996).

As Koegel, Koegel & Parks (1996) stated that many of the most widely used methods of promoting generalization are based on a “teach exemplars” model, in which generalization is programmed to occur in different environments by actually teaching the individual in one environment after another. It is effective, but not practical. Not only because it is time consuming, in KaPo’s case, but also have emotional problem when adopting a new environment.

The second model is called “teach the individual” model, in which the generalization is occurs spontaneously in numerous environments and in the absence of a trained interventions provider after the person is taught a skill in a manner. So, self-management is a “pivotal” behavior (Koegel, Schreibman, Good, Cerniglia, Murphy & Koegel, 1989).

Consider the functional reinforcers, computer or IT should be used as self-management device. It is effective not only because KaPo like to play computer very much, but also because multimedia and interaction can draw him the attention and give him the responses directly. In future, portal computer or PDA can help autistic children to express themselves (using images, sounds, even short film to communicate) and to have better self-management (give them hints or as a reminder).

Conclusion

According to Snell and Brown (2000) child with intellectual disability will have experienced difficulty in making friends and gaining acceptance—particularly if he or she has some irritating or challenging behaviors. Even in the class, many students didn’t like KaPo when he cry and jump. So, to reduce or to eliminate rigid and stereotypic behaviors and maladaptive behaviors are not only for the ways that to foster further development in the child and to promote learning, but also to alleviate family distress. All interventions, teachings, programs, and IEPs are archiving this common goal.

References

1.    Brennan, W. K. (1987), Changing special education now (2nd ed). Milton Keynes: Open University Press.

2.    Connor, M. (1999). Children on the autistic spectrum: Guidelines for mainstream practice. Support for Learning, 14 (2) 80-86.

3.    Dempsey, I. & Foreman, P. (2001). A review of educational approaches for individual with autism. International Journal of Disability, Development and Education, 48 (1), 103-116.

4.     Koegel, R. L., Koegel, L. k., Frea, W. D. & Smith A. E. (1996). Emerging interventions for children with autism: Longitudinal and lifestyle implications. In Koegel, R. L. & Koegel L. K. (Eds.) Teaching children with autism: Strategies for initiating positive interactions and improving learning opportunities (pp. 1-15). Baltimore: Brookes.

5.     Koegel, R. L., Koegel, L. k. & Parks, D. R. (1996). “Teach the Individual” model of Generalization. In Koegel, R. L. & Koegel L. K. (Eds.) Teaching children with autism: Strategies for initiating positive interactions and improving learning opportunities (pp. 67-77). Baltimore: Brookes.

6.     Koegel, R. L., Schreibman, L., Good, A., Cerniglia, L., Murphy, C. & Koegel, K. L. (1989). How to teach pivotal behaviors to children with autism. Unpublished manuscript, university of California, Santa Barbara.

7.     Laski, K., Charlop, M., & Schreibman, L. (1988). Training parents to use the natural language paradigm to increase their autistic children’s speech. Journal of Applied Bahavior Analysis, 21, 391-400.

8.     McNally, R. J., Kompik, J. J. & Sherman, G. (1984). Increasing the productivity of mentally retarded workers through self-management. Analysis and Intervention in Development Disabilities. 4, 129-135

9.     Mesibov, G. B. (2002), TEACCH – What is TEACCH? http://www.teacch.com/aboutus.htm, 10/18/2002

10.  Scheuermann, B. & Webber, J. (2002). Autism: Teaching does make a difference. Belmont, CA: Wadsworth-Thomson.

11.   Smith, D. D. (2003). Introduction to Special Education (5th Edn). Boston: Allyn and Bacon.

12.  Snell, M. E., and Brown, F. (2000). Instruction of Students with Severe Disabilities (5th edn), Upper Saddle River, NJ: Merrill.

13.  Waterhouse, S. (2000). A positive approach to autism. London: Jessica Kingsley.

14.  Westwood, P. (2003), Learning and Learning Difficulties. Hong Kong: University of Hong Kong

15.  Wing. L. (1996). The Autistic Spectrum, London: Constable.

16.  Wong, Y. Y. & Westwood, P. (2002). The teaching and management of children with autism. Hon Kong Special Education Forum, 5 (1), 46-72

Additional readings

17.  Horner, R. H., Junlap, G., Koegel, R. L. (Eds). (1988) Generalization and maintenance: Lifestyle changes in applied settings. Baltimore: Brookes

18.  Poon, K. F. (2002). Meeting Special Needs in Mainstream Classrooms. Hong Kong: Longman

19.  Prizant, B. M. & Rydell, P. J. (1993). Assessment and intervention considerations for unconventional verbal behavior. In Reichle, J. & Wacker, W. (Eds). Communicative approaches to the management of challenging behavior. Baltimore: Brookes

20. Quill, K.A. (1995). Teaching children with autism. Delmar.

21.  Robert, L., Koegel & Koegel, L. K. (1996). Teaching children with autism. Baltimore: Brookes

22. Rutter,M.(1985). The treatment of autistic children. Journal of Child Psychology and Psychiatry and Allied Disciplines, 26:193-214.

23. Rydell, P. J. & Prizant, B. M. (1995). Assessment and intervention strategies for children who use echolalia. In Quill, K. A. (ed). Teaching children with autism (pp105-132). NY: Delmar.

24. Schopler, E. & Reichler, R. J. (1979). Individualized assessment and treatment for autistic and developmentally disabled children (2nd ed). Austin, TX: PRO-ED

25. Worthington, A, (1999). The Fulton special education digest. London: Fulton

2003/12/31