Educating autistic students: A parent's perspective

With chronic problems like autism, health care providers all too often underestimate the commitment required by families to help their children become the best they can be. In this issue, two parents graciously share with us stories of how the whole family and the community help their children and what these special children need to grow. We are deeply grateful to these parents as their words tell the tale far more powerfully than any academic article. We hope that you, the reader, will share these pieces with parents, teachers, hockey and soccer coaches, and others in the community who help. With autism, it truly does take a village to raise a child. Noni MacDonald MD FRCPC Co-Editor-in-Chief Istarted attending conferences on autism early in the game – shortly after my three-year-old son was diagnosed. One of the first of these offered a plethora of talks about the disorder: its epidemiology, its diagnostic features, appropriate programming for affected preschoolers, and so on. Among the speakers was the mother of a young adult with autism, who gave a retrospective account of raising her son from the time of his diagnosis to his recent years in a group home setting. I vividly recall the description of her overwhelming sense of relief when he finished school. Though full-time responsibility for her son then fell completely on her shoulders, the relief was understandable given her horrendous journey trying to negotiate her son's way through the education system – and she was a trained teacher! Now my own son has finished school and it is my turn to bathe in that immense relief at being free from the ‘help’ of educators. Yet this is almost 20 years later. How can it be that families still endure the same nightmarish experiences at the hands of school systems decades later? In writing about what good education for those with autism should look like, I could talk about the best teaching strategies such as ‘task analysis’ – breaking tasks down into their tiniest component steps to be taught incrementally until a task is mastered. I could emphasize the importance of visual learning techniques – copious use of pictures, written words and demonstrations. I could caution against the ‘talking head’ style of instruction (unfortunately, the most prevalent and ineffective), where teachers disseminate information orally at the front of a classroom. I could highlight the fine and gross motor challenges of people with autism (so often overlooked in the intricate maze of social-communication deficits), which mandate regular hand-on-hand instruction to guide muscles through a task's required movements, whether that be learning to point, fingering guitar strings or swimming the front crawl. I might emphasize the importance of initially steering students through a lesson with all necessary support (whether that be hand-on-hand assistance, written instructions, pictorial prompts, verbal cues or some combination of supports) and the equal importance of gradually, very gradually, withdrawing that support as students master the skills evermore independently. I could emphasize that the easiest teaching strategy is the most neglected – that of bestowing a continuous stream of praise on a student as he/she works through any assignment. A “well done” or “good job” given only at the end, no matter how enthusiastically expressed, provides about as much reinforcement as a broken crutch. I would stress that lessons should be structured with a high level of guaranteed success, through a cautious selection of goals and means to achieve those goals. Learning from mistakes may work well for some types of students, but should be severely restricted in the case of autistic students, who, encountering more than their fair share of failure each day, can be terribly discouraged by even small errors. I would press home the importance of including daily programming for anxiety reduction (whether by a mini trampoline session, muscle relaxation or focusing on soothing images), for is there any autistic individual who does not often experience anxieties so high as to detract from his or her development? I might caution against structuring an unbalanced day, one filled with skills a student needs to learn but not enough of those already mastered – skills that engender a sense of accomplishment, the prospect of which will make school enticing rather than fearsome. Many autistic individuals have some encompassing preoccupations and interests of abnormal intensity. I would encourage incorporating such interests and preoccupations into different subjects to ease the challenge of staying focused, so that a love of, say, music, translates into the stuff of math problems (involving the number of keys on a piano, or ticket prices to a concert, or length of a piccolo), into language arts programs (reading about pop stars, writing about buying new CDs, or learning grammar through sentences about music), and art activities (constructing a papier maché horn, compiling a collage on musicians, building a guitar using recycled cardboard tubes and boxes). I would encourage learning with concrete materials – coins and bills to acquire money skills, for example. I would be adamant that no program would be complete without regular speech therapy and structured social training that incorporates other students. I could dwell on the importance of high schools gradually increasing time spent outside of school, whether that be in community recreation programs, cooperative work placements or volunteer positions, so that when school is finished, autistic students no longer graduate to the living room sofa with little to do other than watch televison. I would direct educators to some excellent materials which fit the needs of autistic students like a glove, such as the Specific Skills Series by SRA/McGraw-Hill (USA), targeting the cognitive functions that are particularly challenging for this group (like identifying inferences, following directions, drawing conclusions, using the context and getting the main idea) through 10 books of exercises on each concept from a picture level to a grade 8 reading level. I could elaborate on each of these kernels of educating autistic students well, but that will not prevent the next generation of mothers from heaving sighs of relief when their autistic sons and daughters are finally released from school. It is not for lack of good programming materials or instructional methodologies on all aspects of teaching autistic students that schools are failing our families so miserably. There is plenty of information about materials and methodologies readily available. The problem lies elsewhere. Teachers are graduating from university faculties of education with skills totally incommensurate with the responsibilities they assume in the classroom, certainly as regards teaching autistic students, but even for teaching students in general. In a July 2003 survey by the Ontario College of Teachers, teachers rated courses at faculties of education as the least important source for acquiring teaching skills. Eighty-six per cent of them rated on-the-job experience as the most valuable source of their teaching skills. This is completely unacceptable. To achieve excellence in their profession, teachers need to commence their careers with a strong foundation of pedagogical skills, a foundation enhanced, not established, by on-the-job experience. Society would not condone engineers learning how to construct bridges on the job, or dentists learning how to extract teeth on the job, or eye doctors learning how to do laser surgery on the job; it should not condone teachers learning how to teach on the job. Appropriate university education on how to instruct autistic students will create a generation of better teachers for all students, because the best methods of instruction for autistic students are quite simply the best teaching methods, period. In any case, with the burgeoning number of pupils diagnosed with autism, all teachers can expect to encounter this population during their careers. Teachers-in-training need thorough instruction in all the areas to which I have alluded, but are particularly in need of improved behaviour management skills. Current teachers display a limited ability to recognize early expressions of anxiety, and lack the full array of strategies to quell anxieties once they start to escalate. Even worse, they often respond to challenging behaviours by punishing, reprimanding, or using other negative reinforcement, which tends to accelerate stress-driven conduct. For teachers to master state-of-the-art skills rather than simply learning about them, they will have to practise them repeatedly in role-playing and numerous other exercises, so that it becomes second nature to do task analysis, for example, and to interact with students in a manner that diffuses rising anxieties. Until there is a thorough revision of both the content and instructional methodologies of training programs for educators, parents will not find the support within the education system they so desperately need.

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