Can anyone explain TEACCH please?

[BialystockandBloom]

What does it entail? How is it differentiated for each individual (if at all)?

Is it measurable?

How is it proven to be effective?

It's been specified in ds's statement which we're appealing. He hasn't actually had any yet as the statement only just finalised so won't start till new term. I'm trying to work out how to argue against it but don't actually know how it will work in practice (and can't find that much useful info about it on the internet).

TIA.

[tiredoffightingwithjelly]

Many many moons ago I worked for the autism project in the local authority I live in and TEACCH was used. We took the system into families so that they could work along the same lines as schools with their children. It was a long time ago though and I don't want to give you outdated information but basically it was the use of schedules to give children a better idea of the structure of their time and so they could predict what would happen next. Work then play was reinforced continually.

Objects, pictures or symbols were used dependent on the individual needs oif the child and the process was very regimental. Our LA really brought into the TEACCH method and still have annyal conferences at which professionals from North Carolinia attend to encourage professionals and parents to use the method. I have mixed views but as I say it was a very long time ago and I'm sure there will be people along soon who have more up to date knowledge than me. I don't know if there have been any longitudinal research studies undertaken to evaluate the efficacy of the system but someone else might.

Good Luck :)

[BialystockandBloom]

Thank you

Our LEA has bought into it too, I think - it seems to be the standard provision for every ASD child. From what I gather so far, it doesn't seem to have changed since you were involved in it.

Would visuals/objects be used even with verbal children?

[r3dh3d]

Have a look on "Research Autism" (web site)

Ime (from what I know in our school and talking to parents of kids elsewhere, I'm not trained in it at all) it's been adapted wholesale in the UK because it works, somewhat, and it's not as politically incorrect or as expensive as ABA. ABA has a lot of research backing - a rigorous method is always quick and easy to study, so lots of studies will be done on it! TEACCH is harder to study and I imagine very very variable in the quality of its implementation because a keystone of it is adaptability which must make it v hard to check quality.

It does seem to be very visually based - the issue is it's all about providing supports to help the child cope with/understand their environment which should have the incidental benefit of improving unwanted behaviours. Which is all very well but most of those supports are visual and not all kids with ASD are visual learners. So though a LEA could say "oh it doesn't matter, it doesn't have to be visual, TEACCH is very adaptable" in practice if you take away the visual aids many teachers would struggle for alternatives. DD1's school is big on auditory cues etc, but there's a limit to what they can do with it.

If your TEACCH environment uses PECS the verbal child may well have problems. As I understand it, part of the PECS theory is that a child may have a few words but not be able to progress verbally beyond that because the subtleties of conversation overwhelm them. The idea would be to make them use the words AND the cards on the basis that the cards are easier to teach and then when they are building whole/complex sentences with the cards the words will follow. So long-term the aim is to be verbal, and the theory is the cards get you further, more reliably. But in the early days the spoken request from the verbal child will be ignored which is totally counterintuitive.

Do you have a proposed school? Have you visited them and got their documentation/policies/MLPs etc? I think you may find it easier to show that the school, and the way they are implementing TEACCH is a bad fit for your child, rather than the method per se.

[BialystockandBloom]

Thanks r3dh3d.

The reliance on visuals is my big worry - they have stated that ds is a visual learner in part 2 of his statement, but I have no idea what they are basing this assumption on. Afaik he has not done any formal assessments to ascertain this, so I assume they're saying this as "most" asd children are

He is very verbal, and actually was assessed by the NHS SALT as being within the normal range for language.

However he has social communication difficulties and I think he does in fact have some language delay/disorder but it is complex.

I don't have any idea of how the school will implement it! It's all been frantic, the statement was only finalised a week before the end of term so we had one hectic, unproductive meeting with the school to plan transition, so nothing has been gone into in detail at all. I suppose I'll have time to find out before tribunal though.

Thanks for your help.

[willowthecat]

clinicalevidence.bmj.com/ceweb/conditions/chd/0322/0322_I3.jsp

[Agnesdipesto]

I think you need to be clear whether this is the full North Carolina Teacch approach, or whether it is eclectic provision which is using aspects of Teacch.

Teacch done properly is a whole environment approach and autism specific education - which is why they are probably say they are using it as you are asking for a different type of autism specific education ABA.

The environment is changed to make it easier for the child (and imo the teacher!) and then very clear prompts are used to guide / support the child. So in a pure Teacch environment (and if you have a NAS school near you you can go and visit and see it) it will mean white walls, no distracting environments, the child will have a workstation and usually required to complete 'work' presented in boxes. So its very clear the child has to do the task in box 1 - then box 2 etc. This is called teaching the child to work independently. There is very heavy use of visual symbols and schedules to tell the child what to do next. The child usually works on their own away from all distractions.

So it is very different than the child led eclectic approaches usually used in mainstream by LAs where they use bits of Teacch eg the use of visuals, schedules, sand timers etc; but don't go for the whole adult / environment directed approach. Often the room is laid out with very clear visual markers as to what each area should be used for.

I am not a fan of the eclectic teacch - DS was exposed to as it was just these generic strategies eg symbols on a keyring, visual timetable, sand timer etc with no adjustment for eg the fact he could speak and follow verbal instructions. ABA uses prompts but fades them out asap. Teaach builds the prompts in and seems to leave them there forever.

My view and I know others on here have different experiences - is that it is useful for children who are lower functioning and would be unlikely to develop the ability to do tasks fully independently - I would still like them to try ABA first to check this out - but I can see it is useful for that cohort who do not succeed with ABA and perhaps have for other reasons eg SLD limited life prospects. But I really do not like it being used for children who have far greater potential and who can learn to access learning independently if taught the skills to do so. My worry about Teaach is what happens when you leave school and go into the real world, and the work is not organised for you, the environment isn't artificial and people don't carry round symbols on velcro. For children who will grow into adults with a high level of dependency then they will always have that support. But for higher functioning children I feel it is disabling them not to teach them how to cope in the real world.

Through ABA DS has learnt to follow verbal instructions, to follow cues from other children, to follow group rather than individual instructions etc etc, he copes brilliantly in a typical classroom environment. So I would prefer him to be taught to live in the world as it really is, not a world which is artificially and permanently changed for him and leaves him still unable to access the real world.

However I have to say I have never seen really good Teacch teaching. DS would never qualify for an NAS school. His IQ is too high and he does not have very challenging behaviour. So I don't actually know how a autism specific school would have used Teacch for a child with a high IQ.

I do know you should check out the CVs and qualifications of the staff who will be teaching Teacch. Teacch proper only accredits people to train others if they are properly qualified. The vast majority of LAs send their staff eg outreach on a 5 day TEACCH course (sometime called structured teaching course), and probably 1 or 2 on an advanced course. But there is no follow up. You do the 5 days course and then call yourself an expert in Teacch and train others to do it. I cannot think of any other discipline where you would sit in college for 5 days and come out supposedly equipped to implement what you have learnt with no supervision or monitoring, no updating, no evaluation and also sufficiently experienced in the approach to become a trainer yourself. eg I have done a course on brain surgery therefore I am equipped to do brain surgery and teach others how to do it. Its ludicrous.

I would ask for the Cvs of your ABA staff and the LA staff eg outreach teachers who will be doing the training. I would look at the Dept of Ed stats for their outcomes eg the SEN attainment gap and see how they fare eg % of children who achieve at SATS levels. You could ask the LA if they keep specific data on the outcomes of children who have had Teacch.

DH emailed North Carolina and asked for details of how someone would become accredited to train others in Teacch and surprise surprise none of the LA staff were so accredited (the same is usually true for PECs they do the basic course but don't get accredited to teach others how to use PECS).

Reserach Autism gives Teacch less credibility in research terms than ABA.
The US National Standards Project - email me if its disappeared offline - says Teacch did not have enough evidence to be considered an established treatment and recommended only established treatments were used and only if this failed would other approaches eg Teacch be used.

When it came out it was a big step forward in helping children to learn who previously were considered incapable of being educated - but I think we have now found better ways. ABA does not work for every child, but it gets considerably higher success rate.

Most LAs are obsessed with Teacch - I suspect because its cheap - a 5 day course rather than for ABA supervisor level 5 years, of ABA consultant 10 years.

That said there are special ed teachers out there who are naturals and use teacch and like it and learn on the job and develop their own system for the individual child and do get good results. But they are few, and usually only found in special schools. In mainstream it is not teacch your child will be getting, but a very very watered down version and usually not individualised to the child.

And yes I would suspect visuals would very definitely be used even for a verbal child. They were with mine.

The other problem with Teacch is that organisations like NAS use it in their schools and depsite saying they do not advocate one particular approach, clearly do as they recommend SPELL (you guessed it based on Teacch).

However if you went to North Carolina you may well see something approaching good practice. But I doubt you will find much of it in the UK.

You need to quote SCAMP study for ABA. Look on research autism.

An argument for ABA rather than Teacch is that some children progress through ABA to a point where they can learn in a typical classroom alongside their peers with or without support. As I understand it children who do Teacch tend to always need support - LAs expect those children to have support throughout school. So there is an argument of perhaps 3-4 years intensive ABA -v- a school lifetime of less expensive support. The downside to this is you do not know if your particular child will be one of the ones who will graduate from services.

Another argument is that you know ABA works well, whereas Teacch is untested. This is difficult as tribunals will often send you off to try cheaper options first. DS had what I call Teacch-lite for 18 months and learnt nothing this way at all. The LA said it was because we did not engage with it - this was not true - although we did object to the really bonkers stuff like not using speech, when he could talk. But I would say this was teacch done really really badly - but I think in UK in mainstream it usually is done really really badly.

[willowthecat]

oh dear link did not work - not sure what problem is as i have never subscribed

[willowthecat]

the link does sort of work but you are only allowed to load it once

[Vinniesbisqwits]

my ds SS uses TEACCH and pecs but not for my DC as he just doesnt need it so its not used for him at all it does not replace speaking the idea of pecs for many verbal dcs is more for expression like an extention IYSWIM the only way in which visuals are used is in his and the whole classes time table of what the day will bring some dcs also have a vertical time table on their desk and they have one on the classroom wall for each dc hes a visual learner but can read very well its used as a reminder they can refer to rather than keep asking what are we doing next or later . I really would not worry this does not at all put them back.
when your dc was assesed did they not do the disco or ados? if they did then they must have found him to be a visual learner or have the school said this in a report. to get an ASD dx he must have the triad of impairments and visual learning is usually one of the traits amongst the triad or possibly they feel a visual timetable will be good for your dc if he has a problem with change and coping with unstructured times of the day?

[Vinniesbisqwits]

should have also said my DS has a high IQ although at SS and has progressed fantastically in the last 8 months with the TEACCH and SALT used so I do think its more a matter of how well they use it if trained properly and in our case pecs are not used at all but they are for other pupils.

I agree it would possibly worry me if say a TA without ASD/AS training was expected to impliament TEACCH with no training and little support.

[EllenJaneisnotmyname]

Teachh worked well with the DC with ASD at my DS's special school, but that was only up to the end of reception. PECS also taught him the benefits of communication. He could say (or rather scream) 'crisp' or 'biscuit' but he didnt direct it at anyone. With PECs he would actually direct his requests at us and the power of being able to make choices was very beneficial in reducing his frustration. We used it a lot at home for about 6 months. (Lots of sticky back plastic!)

Once my DS made the transition to MS, Teachh was effectively dropped as it just didn't fit into a MS class. They continued to use a workstation for Reception when he was still split placement but stopped in Y1 as he could work just as independently as the other DC, (with minor prompting from TA which he needed with the workstation anyway.) We also had a workstation at home but he used to whizz through the activities!

The MS school started using a class visual timetable due to my DS, and found it so useful (for all the children) that they still use one throughout infants. My DS initially had his own personal copy with extra information, breaking down the activities into smaller chunks. Eg snack time for the class was carpet time, toilet, wash hands, line up to collect snack, carpet time, for DS. He used the class one from Y1.

It certainly can work, but that's not to say it's the best thing for every child. My DS was non verbal at 3.6 and came on loads after PECs and Hanen, both introduced by a very good SALT, who worked at the special school as well as at the communication and interaction clinic with the specialist Paed. I'm sure that ABA would have worked just as well. Sometimes it can depend on how 'teachable' your DC is. (Hope that's not too controversial.)

[BialystockandBloom]

Thanks for further replies.

willow I can't access that document I'm afraid - any ideas?

agnes I took this to be as you said, an eclectic approach. The statement does not say anything about who, when or how TEACCH is to be implemented, simply "The delivery of TEACCH to ensure that x is suitably motvated to begin an activity, continually supported to meet the challenge witin an activity, and positively reinforced for completing an activity. And the use of a workstation to support him in working towards these objectives".

What you say about the reliance on such an artificial structured environment is precisely my concern - whereas ABA (particularly verbal behaviour which we do, hwich is pretty much all NET) is the opposite.

Did you refer to the SCAMP report as part of your evidence? It doesn't seem particularly positive about ABA - in fact says "the size of the
advantage for the EIBI group of children did not appreciably increase at 24 months" and that "EIBI led to few reductions in the diagnostic symptoms of autism or in problem behaviours"

vinnie he did ADOS test when diagnosed, but I can't remember anything about any assessment of learning ability/style (will revisit report). He's never had his IQ measured - perhaps it would be worth doing this?

The difficulty with all of this, and part of the reason why we are appealing the statement in the first place, is that the provision seems so unsuitable and inappropriate for ds. Part 2 is pretty misleading and unrepresentative of him in any case, but part 3 doesn't even bear much relation to part 2 even as it stands. The suggestion of TEACCH (without specifiying how/by whom/when) is just one example of this.

[willowthecat]

the link is a bit odd - i can access it when I open the browser for the first time but not again - maybe it is just luck

[Vinniesbisqwits]

It should be an area covered in his ados so perhaps it just fleetingly mentions it and does not go into much detail (although it really should) but it will be part of that assesment , My dcs IQ has been tested but I dont think its a necessity but you might find useful yourself.

Your dcs statement sounds like its far too non specific with little quantified and writen as if a standard one for all ASD statement, which is no good at all, it should all be workable in the environment or changes made to make it so, It really must be a document that reflects his needs his educational and physical but also taking into account his intrinsic personallity.


I do hope you manage to get all aspects you require put in there in a managable way thats completely workable for your dc , because a well writen statement and helpful qualified as much as possible friendly approachable staff implementing it makes all the difference and will be reflected in our dcs, my dc has changed within the last 8 months and is simply a happier little man .

[Vinniesbisqwits]

i tried that link it worked first time but does say you have to subscribe 48 hrs at least to view it

[willowthecat]

yes is very odd - sometimes i get the subscribe message and other times the article itself. If you google TEACCH and British Medical Journal maybe you will have more luck

[Vinniesbisqwits]

I ound this link its info from the BMJ about TEACCH on Boots web MD

[Vinniesbisqwits]

opps sorry got distracted here:

www.webmd.boots.com/children/autism-teacch

[willowthecat]

not the same one as mine

[Vinniesbisqwits]

haha no but it wont allow me to look at that one

[willowthecat]

put teacch bmj in google - it is the first link that comes up

[willowthecat]

for me anyway

[dolfrog]

willowthecat

BMJ have a strange registration system, thier main filter is for professionals access, or a pay barrier, most professionals organisations, universities etc gain access by paying for a group access plan, such as "Athens" there are others, which is standard for most research journals.
And I have had the same problem of being able to access a BMJ paper one day but not the next. I think they have a multiple level of membership as well which complicates things. lol
There are many research paper which are available Free Full Text, or can be found or obtained via some indirect routes.

[willowthecat]

thanks - that makes a kind of sense, blink and you miss it etc but i have definitely seen it a few times today while testing

[Vinniesbisqwits]

I did willow it comes up either access denied or asks me to pay for 48 hrs its ok like dolfrog say's there are other papers just as informative .

DS is at a SS with TEACCH and doing very well, perhaps peoples expectations often when using certain methods or therapies is a little askew and often they have too high expectations what can be done , at least certainly with the speed they seem to expect instant changes , a lot of changes are far more subtle and over long periods of time, its not a race and we must all remember the story of the turtle and the hare perhaps.