My presentation will cover what having an autistic spectrum disorder means for a child, service provision at the time of evaluation, the evaluation process and the setting out of findings and recommendations.
A child with an autistic spectrum disorder exhibits deficits in social interaction, communication and flexibility of thinking. He or she also experiences significant difficulties in processing sensory information from the environment. It is reported that 70% of children have a general learning disability. As prevalence rates continue to rise, it is estimated that 60 to 90 individuals per 10,000 of the population may be affected.
The inspectorate evaluation was carried out between 2002 and 2004. At that time there were 161 special classes for children with autistic spectrum disorders which were held in either special schools or attached to mainstream schools. Some 1,500 children with autistic spectrum disorders were included in mainstream schools. These children would have been supported by resource teachers and special needs assistants. There were also 11 early intervention classes for children with autistic spectrum disorders attached to mainstream schools and 11 centres in which applied behavioural analysis was largely or exclusively implemented.
The evaluation process was concerned with the work of the inspectorate in acknowledging, affirming and identifying good practice and promoting continuous development in the education of children with autistic spectrum disorders. There were five phases to the evaluation, each of which consisted of three strands. There was the evaluation in four centres in which applied behavioural analysis was largely or exclusively implemented.
There was also an evaluation of provision in two schools dedicated to children with autistic spectrum disorder and three special schools for children with mild general learning disability, moderate general learning disability, and severe to profound general learning disability who also had autistic spectrum disorder. Provision was also evaluated in ten special classes in seven mainstream schools and for eight individual children of the 1,500 included in such schools.
Reports were furnished to each setting following the evaluation. The model of school inspection then in place was called the "tuairisc scoile" or "school report", distinguishing it from the whole-school evaluation model in which the schools inspectorate currently engages. Owing to the sensitive nature of evaluating a child, no individual reports were furnished in that regard, but schools were provided with extensive feedback on their provision.
Before engaging in the evaluation, the schools inspectorate conducted an extensive literature review to examine the variety of approaches to meeting the learning and teaching needs of children with autistic spectrum disorders. The literature review strongly concluded that there was no definitive evidence to support exclusive use of a single methodology for all children and their families.
However, it emerged very strongly that there were elements of appropriate provision that should be in place when we in the Department try to meet the learning and teaching needs of children with autistic spectrum disorders. I direct members' attention to the pyramid diagram on page 16 of the presentation, which shows the key components that we found should form part of a learning and teaching programme for children with autistic spectrum disorders.
Starting from the apex of the pyramid, they include parental involvement, early identification and intervention, the availability of multi-disciplinary assessment and support, and knowledge and understanding of the implications of autistic spectrum disorders and general learning disability for learning and teaching. That is particularly important in view of its having been reported that 70% of children with autistic spectrum disorders also have a general learning disability. Access to an appropriate curriculum is also important, with a co-ordinated approach to curriculum planning and implementation, and opportunities for integrating children with autistic spectrum disorders with their peers who do not have such disorders.
The three strands of each phase of the evaluation consisted initially of gathering a great deal of information regarding the availability of support services, staff training and qualifications, and pupil profiles in all those settings. The schools inspectorate also undertook evaluations, which involved extensive document reviews in all settings and the observation of learning and teaching. Questionnaires were distributed to parents, teachers, and directors and tutors at ABA centres. Finally, all the data, of which there were a great many from such wide research, were analysed.
The findings and recommendations, which I will go through with members, are from page 16 onwards. There were clear differences in the various settings, for example, in pupils' access to a broad curriculum and in staff training and qualifications, but there were also similarities between them. The findings and recommendations are very largely reported in terms corresponding with the pyramid diagram when it comes to elements of appropriate provision.
On early identification and intervention, on average a diagnosis of ASD was made in all settings when children were aged between three and four. Almost all had availed themselves of a combination of part-time and full-time provision before enrolling in the various settings. In general, children obtained access to ASD-specific early intervention services at between four and a half and six years of age. Most parents stated that they were either very dissatisfied or dissatisfied with the procedures and processes for diagnosis and assessment of ASD.
The schools inspectorate made various recommendations regarding the development of services by health and education authorities to address the gap in early intervention and diagnosis and provide for a multi-disciplinary team approach to assessment at that level, and the compilation of an ASD-specific education plan with not less than 15 hours per week if the child is under four and full school attendance if the child is of school-going age. Educational setting should be determined by parents' informed choice and the child's special educational needs.
The next heading under findings and recommendations concerns the goals of education and the curriculum. We were concerned that there is no single ideal curriculum for children with autistic spectrum disorder. That emerges very much from the literature review. Curricular access has to be planned and differentiated in accordance with each child's needs. Our curriculum should address the triad of impairments: the special educational needs arising from the general learning disability or other co-occurring difficulties such as dyslexia or oppositional defined disorder — during the evaluation we found the latter to be co-occurring difficulties; tend to develop mental and adapted needs; and address the management of behaviour that interferes with the children's learning and which is concerned with the holistic development of the individual. By holistic development we mean that in accordance with the principles of the curriculum, the physical, aesthetic, social, imaginative, spiritual, moral and cognitive development of each child should be fostered through the curriculum.
Children in applied behaviour analysis, ABA, centres had access to a hierarchical skills based curriculum that included a range of approaches. It relied heavily on discreet child-training and individual learning with less emphasis on group and class teaching. Children in all other education placements had access to the primary school curriculum, which was differentiated to meet the needs of individual children. There are also draft curriculum guidelines published by the National Council for Curriculum and Assessment, which are concerned with mediating the curriculum for children with mild general learning disability, moderate general learning disability and severe to profound general learning disability. These guidelines will be utilised in all other educational placements as well.
Recommendations were made with regard to that issue, basically providing all children with access to the curriculum which was seen to be broad and relevant, addressing the triad of impairments, accommodating the special educational needs of the child and other co-occurring difficulties, while tending to develop mental and adaptive needs, address management behaviour and provide an holistic curricular experience. We felt it was also important to include modules relating to the management of behaviour in autism spectrum disorder, ASD, in in-service training.
The next section relates to the professional qualifications, training and development of staff members. Teaching qualifications were not required for staff in ABA centres. In other centres all staff had recognised professional teaching qualifications. Therefore, staff in ABA centres were less familiar with the range of approaches to the learning and teaching of children with autistic spectrum disorders that have been developed such as the TEACCH approach, which is the treatment and education of autistic and related communication-handicapped children, the PECS approach, which is the picture exchange communication system, or the use of social stories. There was a difficulty in that only a few of the resource and class teachers in mainstream schools who were working with individual children with autistic spectrum disorder had a specialist qualification as regards the learning and teaching of children with special educational needs or had attended courses relating to ASD. The recommendations in that regard are involved with intervention learning and teaching programmes for children with ASD. Those doing so should have a recognised teaching qualification and also have access to ASD in-service. Addressing the in-service needs of resource and mainstream class teachers should be undertaken within these guidelines, with appropriate training courses being provided for special needs assistants.
Closely related to what I have just spoken about is the question of staff members' knowledge and understanding of autistic spectrum disorders. It is very important and the literature review points out that understanding the particular needs of individuals with autistic spectrum disorders and listening to the voices of individuals as regards their need for visual structure and opportunities to generalise what they learn in other situations, should be adhered to. Again, that is closely related to staff training and development.
The next issue is the importance of accommodating general learning disabilities and other co-occurring difficulties in planning and implementing programmes. In almost all school settings, due consideration was given to the implications of autistic spectrum disorders and general learning disabilities as well as co-occurring difficulties for children's learning and teaching. The recommendations in this case expressly consider the implications of autistic spectrum disorders, general learning disabilities and co-occurring difficulties for learning and teaching — referring to the draft curriculum guidelines for teachers of students with general learning difficulties during curriculum planning.
A commendable emphasis is placed in ABA centres on the importance of parental involvement. Parents had access to continuing support and training from the centres and were provided with regular information about their children's progress. In other educational placements the involvement of parents in their children's education was acknowledged, promoted and facilitated, inter alia, through the use of home school journals, involvement in the children’s individual education plans, parent-teacher meetings and the provision of progress reports. We recommend that the role of parents should be acknowledged strongly in all educational placements for children with autistic spectrum disorders.
In regard to whole-school planning, co-ordinated approaches to curriculum planning are particularly important, especially for children with autistic spectrum disorders who require a consistent approach in their education across all settings. There were no school plans available in ABA centres, as defined in the Education Act . However, planning for individual children's education programmes was systematic, coherent and detailed. Cohesive links between long-term planning, short-term planning and classroom practice were evident. A school plan was available in all other educational provision, which defined schools' educational philosophy and aims and how they proposed to achieve them. The school plans defined the planning, implementation and teaching of the curriculum, as well as the organisation of the schools' resources, and they contained a range of policy and practice documents. In almost all instances, coherent links between the content of the school plan and the teachers' long-term, short-term and individualised planning were evident. Our strong recommendation was that there should be a school plan compiled in all educational placements.
Due to the very different needs of all children with autistic spectrum disorder, individual planning is particularly important. Planning for the children's individual learning and teaching programmes in ABA centres was systematic, coherent and detailed, and was contained in an individual education plan. In all other settings, there was a two-pronged approach to individual planning. There was an individual education plan and also a process of curriculum differentiation, to which teachers with a professional qualification would be very adept. Differentiation was put in place with regard to the level and pace of the lesson, the children's identified interests, their responses, the structure and sequence of lessons, the mode of questioning, teaching approaches and the use of resources. This is particularly important as there is no one ideal curriculum for children with autistic spectrum disorders. A teacher needs to be very adept at these differentiation skills, in order to mediate the curriculum for all children.
There was a range of assessment procedures in the centres in which ABA was used. These involved direct observation, video observation and discreet trials. In other educational placements, children's progress was regularly assessed and monitored through a variety of assessment tools, namely, multi-disciplinary assessment, teacher observation, teacher-designed tasks, the retention of samples of children's work, curriculum profiles, check lists, questionnaires, consultation with pupils, standardised tests, reading logs, screening tests and progress reports. Rather than having a focus on quantitative assessment, we would advocate that a continuum of assessment should be there to meet the needs of every child.
From the literature review, children with autistic spectrum disorders respond particularly to information and communication technology. The role of ICT in meeting children's needs associated with the triad of impairments and in facilitating curriculum access is very clear in the literature. In ABA centres, there was less emphasis on the use of ICT in these two areas. In schools, the emphasis was on promoting ICT to augment the curriculum. However, we recommend that it should be used both to augment the curriculum and in addressing the social, communication and inflexibility of thinking deficits of the triad of impairments. It is important that children with autistic spectrum disorder be included with their non-ASD peers and to have clear procedures for promoting inclusion. It is not just good enough expect that a child will develop by placing him or her in an inclusive setting. There must be clear plans, targets and so on.
There was a great variety in the level of support services available in all educational placements. However, geographic location was an important factor in the availability of supports. Where an adequate multi-disciplinary support service was available, it was observed to contribute in a positive manner to the content of children's IEPs, the management of children's behaviour and staff members' awareness of the implications of the triad of impairments for the children's learning and teaching. All principles of the mainstream schools where children were enrolled in ordinary classes were satisfied with the availability of the supports provided by the National Educational Psychological Service. Our recommendations were very strong in providing children with ASD with access to an adequate, systematic and co-ordinated multi-disciplinary support service, considering the findings and recommendations of professional supports in planning and implementing children's learning programmes. If a child has been assessed by an occupational therapist, a physiotherapist, or a psychologist, these recommendations should be taken on board when planning the child's individual education programme, and they should inform the programme in a multi-disciplinary and cohesive manner.