Teaching Autistic Teenagers: Some approaches; more needed
October 17, 2008 by Kristina Chew, PhD
Filed under Adolescence, Education, Psychology
A long article to appear in the October 19th’s New York Times Magazine describes the D.I.R./Floortime approach for teaching autistic children and, specifically, autistic teenagers. A Decatur, Georigia, school, The Community School is profiled. D.I.R./Floortime is contrasted to Applied Behavior Analysis (ABA), which is based on the principles of behavioral science and is widely used to teach autistic children. The goal of D.I.R./Floortime is said to be a “kindling of a student’s curiosity, intelligence, playfulness and energy, the lessons can take on a spontaneous, electric quality” and the “essence” said to be that “a person learns best when self-motivated, when an inner drive sparks the acquisition of skills and knowledge.”
It’s the case that ABA—which the New York Times Magazine describes, rather succinctly, as using “well-established techniques of reward and punishment to shape a student’s actions” and equates with “rote learning”—-has been a crucial method of teaching my son, and I don’t just meaning for addressing behavior problems.” ABA is how Jim taught Charlie to ride his bike; it’s helped Charlie to learn to play the piano and cello, read music, talk. ABA has a troubled history and I think of it as a most imperfect “science” that can be effective when combined with constant awareness of a child’s sensory needs and communication challenges; recognition of the dignity and competence of a child; the ability to be flexible and keep learning fun. When Charlie struggles to learn or do something new, Jim and I focus on what we can change in our teaching and in our approach, just as we adapt and revise our teaching of students in the college classroom.
That may not sound like what people think of when they hear “ABA,” but that’s what we’ve found to be a good teaching mindset for Charlie. Teaching (at least from what I’ve learned from my own years of teaching involves, again, flexibility and the willingness to combine approaches, to try new things, and to realize when one needs to make changes to best teach one’s students. Charlie’s best teachers have always had teaching him as their most important goal, over and above adhering to any one teaching methodology.
The New York Times Magazine says this about the challenges of teaching autistic teenagers:
With the skyrocketing diagnoses of A.S.D.’s in recent years, parents and school systems are challenged as never before to find techniques to keep these teenagers engaged, productive and nondespairing. Boys with A.S.D. (they outnumber girls four to one) who were difficult to console, to teach, to restrain at age 4 or 8 can be nearly impossible for parents and teachers to manage and to steer at 14 and 18. While a 25-pound toddler’s tantrum is wearying, a 150-pound teenager’s tantrum is dangerous. Puberty and young adulthood take many of these young people unawares.
How best to serve this population remains a subject of debate, because autism is a “final common pathway” diagnosis, meaning children arrive here from different points of origin, are troubled by a wide variety of issues and respond to different strategies. “You meet one child with autism and, well, you’ve met one child with autism,” says Linda Brandenburg, the director of school autism services at the Kennedy Krieger Institute in Maryland. Given the wide range of expression in autism and related disorders, there is no one-size-fits-all intervention. “We now know that there are several different models that seem to work — some more behavioral, some more developmental, some more eclectic,” Dr. Fred R. Volkmar, director of the Yale Child Study Center, told me. “What we really need to be doing, what the law says, is design programs around the kids rather than force kids into a program.”
My son Charlie, as I regularly note, is now an adolescent and well on his way puberty; he’s in the midst of many new changes for him in many ways. He really strugles to talk so communicating strong, complicated and new feelings and sensations is not at all easy. The New York Times Magazine talks about how difficult it can be to console, to teach, to restrain” a 4 or 8 year old and describes the same in older children as “dangerous.” Yes, it’s not easy and every day I wake to a new adventure with Charlie, new challenges, new worries, new hopes. Autistic adolescents and teenagers don’t have to be “dangerous” and difficult behaviors can be addressed in ways that always keep in mind a child’s dignity and presume competence.
I don’t think they’ll be a consensus anytime soon on the best way to teach autistic children and teenagers. And it’s a discussion that needs to happen.
Jeff Stimpson
Jill Cornfield
Kristina
You mentioned some time ago that Charlie’s spontaneous speech was more fluent than his ‘trained’ for want of a better word. There seemed to be some clash between what came naturally and what came via ABA.
Seems to me that if problems are going to arise with whatever teaching method, it’s going to be years after the event. So yeah, we need the range of methods and they need to be based on something a bit more concrete than somebody’s bright idea or antiquated psychological theory.,which is AFAIK currently all of them.
Kristina,
My son is 21 now and I have been through it. There is only so much that can be done with an autistic child through ABA or any other behavioral teaching method. So now what?
There has to be a medical change. ABA et al try to break through the blocks that are in the way of autistic learning. Only a medical change will remove them. It can be done but not while the focus is on “I didn’t do it” research.
While I agree with you that there should be discussions on the best way to teach autistic children and teenagers, I’m not sure that looking for one “best” way is the answer. Even in “regular” classrooms now (at least in our area), teachers are using a mix of visual, auditory, and kinesthetic styles…most of the teachers that we’ve had do a questionnaire with their kids at the beginning of the year that gives them at least a vague idea of how each child learns best, and then tries to match teaching strategies to children.
In my experiences learning styles are even more disparate among autistic children and teenagers- what works for one child can be actively harmful or useless for another. I know that I’ve mentioned our horrible experience with my son and ABA, while my daughter who did ABA with the same therapists at the same time responded to it very well.
My personal preference would be that there would be a recognition of at least a few different methods of teaching/therapies that were well-researched, and a consensus reached that they would work for at least some children. Although I’m a huge fan of the phrase “do what works”, unfortunately that can sometimes imply things like dolphin therapy and HBOT
We’ve been lucky to have teams of professionals and teachers who are all pretty on the ball, prefer scientifically valid studies, and want to help me make the best decisions for our kids. In the long run, I’ve found what works best for my kids is taking bits and pieces of different things- ABA, floortime, OT- including sensory diets and things like Snozelen rooms, social stories, speech, music therapy, etc. I think that I would be uncomfortable in a world where there was a consensus on only “one” thing (unless we find something new that we haven’t found yet that truly does work for all children and teenagers).
Hopefully at some point our discussions in the autism world can move past vaccines into things that can truly make a difference for the autistic people in our lives.
@Jen,
Yes to everything you’ve said (including the last paragraph)—–by “best” I didn’t mean that one methodology might be found that works “best,” but what you write—
ABA’s worked “best” for Charlie with a lot of flexibility and willingness and open-mindedness to incorporate different ways of thinking and teaching.
@alyric, I’ve been thinking about Charlie’s spontaneous speech vs. what he was taught to say—-there’s a lot of the spontaneous speech but the meaning is not always as clear to any listener. Often the “rote” phrases taught to Charlie tend to be ones he says really really fast and without always seeming to know what they mean.
@Ed,
Certainly it’s always important to consider the effects of what Charlie’s eaten on him—-from the biomedical interventions that we’ve known of and tried, I’m not sure that any of them could provide complete or lasting solutions. But then, we’ve found that educational solutions have had the most long-lasting effects for Charlie (for Charlie, not sure of course about everyone else!).
@Kristina,
You understand that you are helping to make a point. Cystic fibrosis is genetic and it is recognized as a medical condition. Autism is shoved into a psychiatric category. For the medical community, it is locked behind the blood brain barrier and untreatable. This is why, with the numbers as high as they are, precious little medical research is being done.
This is also why the fight over vaccines has been so toxic. So much of the little research that has been done has been dedicated to proving that vaccines did not cause the rise in autism. It has made all of the statements on the antivax side false and all of the statements on the provax side true. Neither is correct and that makes the autism medical research base a house built on a foundation of sand.
It is also why I understand the desperation that leads so many parents to try other treatments. If medicine had anything with even reasonable efficacy, most of the alternatives would melt away.
While the experts decry the alternative medicine and the backlash against vaccines, their lack of progress has plowed and sewn the field where these things grew.