As you may know, we currently have a campaign running in Ireland for the Government to accept ABA as a 4th model of education for children with Autism. The other 3 are mainstream national schools, outreach classes attached to a mainstream school with 6 pupils to one teacher and free standing special schools with 6 pupils to a class.
Many children with autism need the fourth option; Full time comprehensive ABA.
Thanks to a deal between coalition partners in the current government, 14 "pilot" ABA schools have been accepted. Pilot is a misnomer as some of these schools have been running for 7 years or more. They receive funding from the Dept of Education on a yearly basis, with a small stipend towards supervision and administration.
The "deal" has opened up negotiations for these projects to become permanent special schools with support from the Health Service Executive for Clinical posts such as speech and occupational therapy. It will also offer the staff in each unit employee entitlements and job security.
Negotiations are underway to agree on a job description for the tutors employed in the units as they work directly with the pupils on a 1-1 basis introducing new skills. They are mostly third level psychology graduates and a large number have undertaken post-graduate education part time. However, very few have a Diploma of Education that is recognised by our Dept' of Ed; hence the negotiations.
The Education Department like all bureaucracies is trying to make the package fit in the box as they understand it, and are having a hard time stretching to the idea of the 4th Model.
In their minds you can either be a teacher or an assistant; nothing in between.
And a highly qualified Tutor working to a curriculum that is supervised and adapted weekly by an even more qualified supervisor doesn't quite fit with them.
The unions are having a hard time stretching to this idea too.
The other issue is that these lucky 14 "Pilot" schools are concentrated largely into one province of Ireland; leaving vast swathes of the country completely without access to any ABA education.
These schools also have huge waiting lists; leaving a lot of children with a psychologists recommendation for 30 hours of ABA per week;And no way of accessing it for several years.
In to this vacuum a further 12 or so schools emerged using the original "pilot" template to meet the demand for ABA geographically and demographically. Funded by individual tuition grants, parent contributions and community fundraising; the schools applied for "pilot" status but the applications went unanswered.
While the children continue to benefit from this structured and comprehensive intervention with highly qualified tutors and supervisors; the parents and staff must live with the stress of funding and providing this intervention from one month to the next; without security of tenure.
The campaign rests while the negotiations are ongoing.
Personally, my hope is that there will be a full service ABA special school in every county in Ireland. This model of accountable education has been repeatedly shown to improve the outcomes for every child that attends. Yes, more than half progress to mainstream education and that is fantastic. But even for the ones that do not; there is a net benefit in life skills and educational development, self management and coping skills that vastly improves their future outlook and the quality of life for their family.
How and Why Does ABA work?
The ABA template for education utilises a system of data collection, reporting and lesson planning that addresses every aspect of a child's development.
From receptive language, to toileting and grooming, lesson plans are drawn up and every minute of every school day is spent on each child's individual needs.
Simple things like hand washing and tooth brushing are taught until mastered independently, thus reducing the burden on the parents to constantly supervise and manage their child's everyday needs. As we know from our public health service, hand washing is the number one way to prevent cross infection and common illnesses, such as the novo-virus which causes most tummy bugs, and the common cold.
Teaching good oral hygiene from an early age means the child will be saved the trauma of fillings and at worst extractions, which for many children with special needs means a general anaesthetic.
ABA schools are also demonstrably expert when it comes to teaching communication; receptive and expressive, thanks to the way they break down the task to suit the learner's needs.
If a child isn't speaking by the time they enter the school, a communication system is implemented to allow them to express their needs appropriately while developing the foundations for speech.
Compare this to the large number of non verbal adults in residential institutions around the country, who cannot even tell us if they prefer coffee or tea.
In our recognised ABA schools a supervisor will observe and assess a child individually, using up to 25 different criteria broken into many increments. The first category is compliance and the effectiveness of rewards; in other words, what makes the child want to learn?
Once this assessment is produced, a supervisor and tutor can begin to attract the child into the learning environment and with their compliance start to help them learn.
After Compliance comes Visual performance, Receptive communication and Imitation.
One of the reasons that many autistic children fail to develop speech is the absence of the innate ability to imitate. Something that we see in typically developing babies before they are out of the crib, does not come easily to the autistic infant, perhaps because of the range of sensory distractions.
But by observing their interests and breaking down the task of physical imitation to suit the learner, and rewarding each positive step, an ABA tutor can teach a pupil to imitate independently. Believe me, I have seen this first hand and I have the Data, and the Daughter to prove it!
From there the child can begin to learn to communicate appropriately, whether by sign, Picture Exchange or speech and thereby reduce all of the inappropriate behaviours they were using to get all their needs met. Because although they lacked the basics of language, these kids would have been very effective communicators up to this point.
There is nothing that gets Mum's attention like turning on the tap and spraying the entire kitchen (Pay attention to me and make that great noise you make when I do something fun!)
Or leaving a poo in the middle of the living room (I needed the toilet!)
or smearing that poo all over the carpet
(we need to spend more time together; with you cleaning up my poo)
or hitting, biting, scratching or slapping yourself or someone else, hard
(I need to get my own way, Now!)
These behaviours really affect the quality of life of the family of that child. They are often less prevalent in the controlled environment of the classroom so there may not be the same imperative to address them. But they can destroy home life.
By putting in place an effective communication system these behaviours can be replaced, reduced and eventually eliminated.
When a program is being developed in an ABA setting; the learner is the basis for success. That is, if a task is analysed and the steps to teach it do not work, then the tutor and supervisor sit down and break it down or tailor it further until the child "gets it" and moves on to the next step. Every aspect of the program is accounted for in data collection and analysis, and the skill must be demonstrated to be mastered before moving on.
In the 6-1, state school's "qualified teacher" setting the lesson is taught, but not necessarily learned by all 6 pupils in the class. Now here is a key difference between special ed' and mainstream teaching:
If a mainstream teacher is inspected, they will be held accountable for a majority of their pupils achieving a minimum standard or grade. If they continually fail to teach the majority of their class, they will be removed from the post.
A teacher in a special ed' class has no such responsibility. If any pupil in their class is found not to be progressing, it is assumed to be the fault of the child. That is; their "learning disability" will not allow them to progress.
Now! that is not to say that all special ed' teachers are "cruising" regardless of their pupil's ability to progress. Many, probably most, will work as hard as they can to ensure that every pupil in their class is learning.
But there is no statuary obligation to ensure the child's development, and therefore there is no legislative back up to help them achieve this aim. The state is under no obligation to provide clinical support to these teachers such as consultancy from Speech, Occupational or Behavioural therapists. The state is not obliged to provide dedicated training or supervision for these teachers, or to provide them with similarly trained assistants.
In 2001 a task force appointed by our education department recommended that children with higher learning needs be placed in classes of 4-1, "with 2 special needs assistants, thus giving an adult/child ratio of almost one to one" " such an arrangement would allow more time for 1:1 instruction and would greatly enhance the opportunity for social training" Ref: Task Force for Autism 2001 (Section 8.6.2)
Every state special ed teacher I have spoken to agrees with this. However, in the absence of legislation to ensure that children in State run Special Ed schools are progressing, the Department of Education failed to implement this finding.
The Department of Health consistently fails to recruit, retain and supply anything approaching an adequate number of clinical therapists to support these teachers.
The ABA model as practiced by the Pilot and Applicant schools I have described above; does not negate the need for qualified clinical support. The programmes implemented benefit from key recommendations of speech and occupational therapists in consultation with the supervisors and tutors.
However, the level of training and expertise that these tutors bring to the ABA model means they are less reliant on intensive clinical support. Even limited access to clinical consultation will be replicated consistently across the tutors and results will be measured to ensure effectiveness.
Some kids just need this model of intensive and consistently managed support.
This is Ireland's chance to become one of the first countries in the world to offer state sponsored comprehensive Applied Behavioural Intervention centred education for all children who need it, regardless of age or geographic location.
Let's make History. Let us become the clever but compassionate country.
Give us this 4th Model, as we have come to call it, which will reach more of the children for more of the time; ensuring that even the kids with very high needs have a chance of an improved quality of life and access to their wider community when they mature.
Which is all any parent can hope for.