Education of Individuals with Autism

Though autism is a familiar term in the early twenty-first century, it was only recognized in the 1940s as a severe disability. Since that time, there has been extensive interest in and professional activity concerning autism. Children with autism have difficulty communicating, playing, and establishing relationships with others. Autism, often referred to as a neurological disorder, is usually evident by age three, reported in all countries, and affects between 2 and 21 individuals per 10,000, with 4 to 5 times more males than females diagnosed. About 80 percent of children with autism also meet the criteria for mental retardation, with significant limitations in IQ and adaptive behavior scores.

History

In 1943 Leo Kanner described those with autism as being unable to relate to themselves or others, with the term autism derived from the root auto for self. Since then, autism had been defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, as a pervasive developmental disorder having three classic behavioral features for its diagnosis: "the presence of markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activity and interests" (p. 66). Currently the term autism spectrum disorders is used to refer to a comprehensive though controversial classification, which includes individuals with some characteristics of typical autism, but who may not be diagnosed with autistic disorder. Autism spectrum disorders range along a continuum of severity, from less severe forms such as pervasive developmental disorder/not otherwise specified (PDD-NOS) and Asperger's syndrome, to more severe forms that also are distinct from autism, such as childhood disintegrative disorder and Rett syndrome. Currently there is no biological diagnostic test for autism; diagnosis is based on behavioral indices. A diagnosis typically qualifies a child for special education services under the Individuals with Disabilities Education Act (IDEA) during infancy and the preschool years. The current incidence figures for autism have varied through the 1990s and into the twenty-first century, leading many to believe that actual incidence is higher than previously calculated.

Schools' Responses and Methods of Teaching

Children with autism have extensive, long-term educational needs that require thorough planning by a multidisciplinary team, ongoing monitoring of progress, and a wide range of service options. Of the three treatment approaches under study for those with autism, many educational/behavioral approaches have the strongest research basis. Pharmacological approaches are not viewed as being appropriate or effective for all, and must be used cautiously and in combination with sound educational treatments. Biomedical-neuroscience approaches are experimental with no validated treatments existing currently. There have been no controlled comparisons of educational or combined interventions despite the fact that some interventions claim "recovery" or cure with little scientific data to support such claims.

Authorities agree that students with autism benefit from individualized and often intense educational services beginning early in life. The most promising educational interventions for these children have the following characteristics: (1) behaviorally based; (2) carefully planned and monitored instruction involving task analyses of skills, individualized incentives, goals embedded in routines and activities, and adequate intensity and quality; (3) ongoing, planned opportunities for interaction with typical peers; (4) need-based supports and intervention for families; (5) services delivered in many different settings to meet support needs and promote generalization; (6) broad curricular content that addresses all developmental needs; and (7) proactive use of positive behavior support for challenging behavior. Children with autism typically require the services of special educators, general educators, and speech and language pathologists; occupational or physical therapists often address children's movement and sensory limitations. A collaborative team approach is necessary to plan, problem-solve, implement, and monitor the individualized education programs (IEPs) of these students.

Goals and Purposes of Education

Educational goals for students with autism usually aim for skills in communication, social interaction, appropriate behavior, choice making, and functional academic abilities. As these students grow older they need to reduce their dependence on others and extend their abilities to include supported functioning in the home, school, and neighborhood, using the nearby community, building social relationships with peers, engaging in leisure activities, and learning to work (paid or voluntary) with the necessary supports. Given sound intervention that starts early, the educational outcomes for these students can be highly effective, though there is much heterogeneity in their improvement.

Relationship of Autism to IDEA

Students with any of the pervasive developmental disorders typically qualify for special education services. The U.S. Department of Education reports that in 1998 to 1999 there were 53,561 students between the ages of six and twenty-one with labels of autism enrolled in public schools in the United States–.09 percent of the school population. Of these, 18 percent spend 80 percent or more of their day in general education classrooms, while 65 percent are in special education classrooms most or all of the day, and 17 percent in separate settings. Many schools are unequipped to address the comprehensive educational needs of this population. Litigation, which has characterized recent special education services for these students, has often judged their IEPs to be inadequate for achieving reasonable educational benefits.

Issues Educational Trends and Controversies

There is consensus about the recommended educational practices for students with autism. Analyses of the empirical basis of educational interventions are available, along with guidelines for selecting treatments (e.g., causes no harm, developmentally appropriate, scientifically validated). Unfortunately, because most individuals with autism have lifelong, pervasive support needs, families and educators, out of a sense of urgency, may adopt interventions based on testimonials rather than empirical support. Critical aspects of intervention also remain unknown, including the impact of family factors on outcomes and the relationship between an individual with autism, the appropriate treatment protocol, and the expected outcomes. Finally, there is a vast discrepancy between what is known about effective educational interventions and what is available for children with autism across settings, cultures, and income levels.