TEACCH for Autism Treatment

We have had several inquiries on the subject of TEACCH (Treatment and Education of Autistic and related Communication Handicapped CHildren) and have been following it’s promotion to, and acceptance by,  educational systems having toaddress the needs  of  children with varying degrees of Autism, and TEACCH is fast gaining favor with these mostly public institutions.

It is these institutions, which due  to a growing awareness by parents and stricter enforcement of disability laws, are having to deal with the increasing burden of mainstreaming  more Autistic children, who are welcoming TEACCH with open arms. For those of us familiar with the history and past  record  of  these institutions when it comes to adaptation to change, especially when expensive mainstreaming is involved, not only this sudden enthusiasm is peculiar, it raises caution flag.

A superficial analysis of  TEACCH  reveals what  should be obvious but is being  ignored or misrepresented,  it is not a teaching or learning system  but a behavioral management system, which, when properly implemented delivers more predictable behavior and greater cooperation from the TEACCH subject, an Autistic child.

A deeper scrutiny unveils a troubling picture, not only is TEACCH nothing more then behavior management, it is a throw back to the failed models of behavior management advocated in the Seventies and early Eighties. There are the repeated references to routines, rigid preferably, the need for predictability, accommodating the subject’s ‘resistance to change’, providing organization, using objects of obsession as rewards and so on.

The subjects day is filled with charts and other visual aids, consuming all of their attention, with time these become the focus of the program and a consuming task to the educators implementing it, and things are far worse when the effect on the subject is considered.

Parents, educators and professionals alike will tell you that mainstreaming an Autistic child, even the highest functioning, will typically produce lesser results until you reach a turning point when two events take place, the child’s recognition of his condition and differences from others and, the development of the desire to rectify those differences.

These can only come as mainstreaming exposes a subject to his surroundings in an open, unmasked manner. Not only does TEACCH mentally shield the subject from their surroundings, it curbs social acceptance as well. Not surprising considering the subjects excessive focus on aids and charts and the stigma they carry with their peers.

While the above provides ample reason to reject TEACCH outright it is incorrect implantation which proves to be the most dangerous aspect of the program. I personally observed a very high functioning PDD child, that was in a TEACCH program at a public school for about ten weeks, has become so obsessed with his daily activity chart to the point that the slightest deviation caused  major,  previously unseen confrontations.

As a result, the subject’s mainstreaming time was cut from about 75% to less then 25%. On one occasion, a substitute teacher failed to prepare the activity chart, the ensuing confrontation resulted in the child being sent home for the rest of the day.

Over the summer a different approach was, at the insistence of the parents, developed for the following year , TEACCH was dropped, a none confrontational approach and a patient, mild mannered classroom teacher produced instant improvement, a part time classroom aid was soon needed to relieve the increasing burden to the teacher of a child who is not tightly managed, with the aid accommodating his growing interest in the academic material, which was previously limited by his preoccupation with charts and the like. Mainstreaming is now (middle of school year) 100%, there are no major confrontation with teachers or peers and minor ones are all but gone.

Another concealed hazard of TEACCH is it’s potential use as a tool to restrict and possibly eliminate mainstreaming for at least some participants in public schools, again, a close scrutiny of the language used, the ‘none obstructive activity area’ and reducing visual stimuli, access to charts and activity layouts,  the need for predictability,  the danger of introducing a change in an unmanaged way.

Establishing such needs for an autistic child can be the first step to a self contained classroom, after all, a regular classroom is full of obstructions and obstacles, charts can be easily damaged or lost and may require too much time to prepare, and what can be more unpredictable and prone to change then a classroom full of children. A parent or mental health professional should exercise caution when such terms are introduced in relation to their child or client.

While it is possible that a low functioning Autistic child may benefit from a TEACCH like program, it hold little promise and many pitfalls for middle to high functioning Autistic and PDD children. A better outcome certainly can  be  reached with  a  competent implementation of mainstreaming, a patient, non confrontational style and advance preparation for inclusion time at school and at home.