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A Brief Review of the National Education Association’s
“The Autism Puzzle

 Robert W. Montgomery, Ph.D., BCBA-D

   


The National Education Association (NEA), the largest education labor union in the United States, has recently published a guide for educators on Autism Spectrum Disorders (ASD) with the express intent of:

- “provid[ing] educators with a general understanding of ASD,

- explain[ing] the characteristics exhibited by students with ASD,

- suggest[ing] evidence-based effective strategies for students with ASD,

- [and] identify[ing] resources where additional information on ASD can be found.

The NEA’s guide The Autism Puzzle is a 44 page document (with 34 pages of actual content) is an undeniably aesthetically beautiful document.  It is available via download from the NEA’s website (www.NEA.org) in Adobe Acrobat format.  The contributors to the development of the document include members of the NEA’s IDEA Special Education Resource Cadre, teachers and other school personnel from a variety of public school systems around the U.S., and “content expertise” from an individual from the National Association of School Psychologists and another from the American Speech Language and Hearing Association, and the Autism Society America's former Director of Information and Referral Services Ayda Sanver. The scope of the document is broad and includes sections on:

  • The Puzzle of Autism: What Educators Need to Know
  • Features and Strategies for Intervention
  • Communication
  • Sensory Integration and Regulation
  • Socialization/Social Skills
  • Behavioral Issues
  • Restricted Interests
  • Future Directions/Research Areas

Public schools, under various federal laws and regulations, are the only public agencies that are obligated to serve all children regardless of disability or need.  The public schools therefore represent the single largest provider network for therapy and treatment in the United States .  According to its own statistics, the NEA represents 2.7 million elementary and secondary teachers, related service providers, education support professionals, college faculty, school administrators, retired educators, and students preparing to become teachers. Therefore, the NEA stands in a position to have significant and wide-sweeping impact on the identification of children in the Autism Spectrum and the services that they receive throughout the United States.  The materials prepared and distributed by the NEA on this subject poses the potential of having a profound impact on current and future practices within our nation’s public schools.  As one “Blog” on special education put it:

            “While it is by no means as authoritative as other texts, the fact that the NEA has officially endorsed these guidelines has an undeniable authority that schools would be hard pressed to dismiss.” (http://specialedlaw.blogs.com/home/2006/03/nea_guidelinses.html)

Therefore, an examination of just what the NEA has put into its new guide for educators is not only warranted but prudent for anyone dedicated to serving children with ASDs.

The first challenge of the NEA’s document is its failure to consistently distinguish between the usage of the term “Autism Spectrum Disorder” or ASD meaning all 5 specific diagnoses under the Pervasive Developmental Disorders (PDD) category and the use of ASD to mean traditional Autism or Autistic Disorder (299.00).  This issue encompasses both a lack of clarity on the usage of the term “ASD” and the accuracy of the information attributed to those with “ASD”.  The difficulty is evident in the very first sentence of the Introduction which states: “The above scenario may sound familiar to any classroom teacher because students like Michael, a student with Autism Spectrum Disorders (ASD).” (p. 1)  While it might sound trite, Michael is not a student with “Autism Spectrum Disorders” but rather a student with a specific Autism Spectrum Disorder.  Later in the introduction section the document states that all people with ASD have the same early symptom manifestations:

“Recent research has shown that students with ASD exhibit four early indicators. These include:

• Lack of eye contact

• Lack of joint attention (i.e., attention to the same item or topic as another person)

• Lack of reciprocal conversation (i.e., ability to engage in verbal turn taking)

• Atypical sensory/motor processing” (p. 3)

While the above statements may hold true for children identified as having Autistic Disorder or even Pervasive Developmental Disorders-Not Otherwise Specified (PDD-NOS) it does not consistently hold true, nor does the research support the idea that, it is true of children diagnosed with Aspergers Disorder or Childhood Disintegrative Disorder – two other diagnoses within the PDD category being referred to by the NEA as “ASD”.  This theme of referring to “ASD” and yet having content relevant specifically to Autism or PDD-NOS is neither isolated nor trivial.  “The Autism Puzzle” is specifically intended to be a general overview and information source for America ’s millions of educators and yet it is rife with errors of oversimplification or lack of specificity in addressing the spectrum of disorders represented by the term used throughout the document - “ASD”.

This superficiality present in the portrayal of “ASD” is present throughout the NEA document in deeper and very important ways, as demonstrated by the description in the “Behavior” chapter of “Functional Behavior Analysis” (FBA).  Cliché assertions regarding such functionally complex behaviors as aggression are routinely offered throughout the section on behavior:

“Aggressive, acting-out behaviors usually result from heightened levels of anxiety due to unexpected changes in the routine or schedule or an inability to transition to a non-preferred activity.” (p. 25).

Additionally, there is a presumption throughout the document that only positive interventions will be developed as a result of the FBA process and that ignoring of inappropriate behaviors will be effective.  This implicit presumption that all inappropriate behavior in children with “ASD” is maintained via socially mediated contingencies and therefore is subject to extinction via planned ignoring is naïve at best and detrimental to effective educational programming of children at worst.  In a guide for teachers and school staff on what ASDs are and how to address the needs of people with ASDs the failure to convey any understanding that many children with ASDs are not motivated by, nor are their behaviors maintained by, social attention is a profound and fundamental failure that calls into the question the level of understanding and information conveyed throughout the document.

While the guide is obviously and expressly intended for educators not familiar with these student populations with a focus on general educators specifically, it is imperative that those unfamiliar with the area of Autism Spectrum Disorders receive adequate and technically accurate information.  This is of particular importance when there is a good chance that many reading the document will never receive more specific or detailed instruction on ASDs and may therefore proceed to provide educational services to children based solely on the information contained in the NEA guide.  The variety of misleading, superficial, and inaccurate statements throughout make this prospect particularly ominous.  From a behavior analytic perspective one such glaring error is the failure to accurately distinguish between behavioral excesses and behavioral deficits.

“Students with ASD may exhibit all or some of the following behavioral deficits:

• Ritualistic and compulsive (i.e., highly repetitious activities);

• Impulsivity (i.e., disruptive behaviors related to the student’s sensory needs combined with a lack of understanding of how behavior impacts others);

• Stereotypic behaviors (i.e., behaviors involving physical movements that seemingly serve no purpose);

• Aggression (i.e., aggression may be towards self or others);

• Inappropriate social interactions (i.e., range of behaviors from complete indifference to others to socially inappropriate when dealing with others).

            (pp. 25-26).

Despite both IDEA 1997 and the 2004 reauthorization requirements for use of Functional Behavioral Assessments, the recommendations for interventions for the above behavioral excesses and deficits are uniformly superficial and formulaic.  All interventions mentioned for stereotypy are sensory in nature (p. 26).  For aggression the interventions recommended are all either directed at lowering the student’s stress or increasing the clarity of the adult communication directed at the student.  These recommendations are consistently superficial thereby conveying, implicitly, a simplistic set of assumptions regarding the nature of the behaviors and conveying a false sense of ease in intervening to the naïve reader. (p. 26).

This document further takes the concept of simplicity to the level of simplistic in the section on Restricted Interests (Section 7).  This important section is less than a page in length.  It addresses a set of concerns that does not clearly convey to the reader that autism disorders are truly a spectrum of varying combinations and intensities of behavioral excesses and deficits in wildly different combinations even within a single diagnosis such as Autistic Disorder let alone across the various disorders from Autism to Aspergers.  The section achieves an amazing degree of overgeneralization for such a short section and ends with the following recommendations for addressing the restricted interests of students with ASD:

“The following intervention techniques and strategies can be used to ease the restricted interests of students with ASD:

• Allow breaks for students to pursue their own topics of interest during the day. These periods lower the students’ anxiety level and enhance their productivity during work times; however, they need a clearly delineated time period and strict enforcement of the time limits.

• Introduce new activities incrementally. Allow sufficient time for guided practice before demanding independence. “(p. 27)

The guide concludes with quotes from the leaders of two professional associations regarding the need for the guide and its impact.  Susan Gorin, the Executive Director of the National Association of School Psychologists, is quoted as saying:

The Puzzle of Autism tells it like it is and succinctly informs the entire school community to capably address the complex social, communication, and learning needs of students with autism. (p. 43)

While a guide that meets the goal set forth by Ms. Gorin of “succinctly inform[ing] the entire school community to capably address the complex social, communication, and learning needs of students with autism” is desperately needed within America’s public schools, the NEA guide “The Autism Puzzle” falls far short of achieving that goal.  Its combination of superficiality, lack of clarity, and mixture of opinion with fact is misleading and can only serve to impair the dissemination of accurate and effective information to the public educators responsible for serving children with Autism Spectrum Disorders.  It is essential that those committed to sound and empirically validated treatments be familiar with the contents of this significant document in order to be prepared to clarify and educate those who come into contact with it about available scientifically validated interventions for ASDs.

 

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