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A synthesis of six related TEACCH-based outcome studies for Autism Spectrum Disorders (ASD)

A synthesis of six related TEACCH-based outcome studies for Autism Spectrum Disorders (ASD). Paul Probst , Department of Psychology, University of Hamburg. Symposium paper presented at the XXX International Congress of Psychology, Capetown, South-Africa, 22-27 July, 2012.

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A synthesis of six related TEACCH-based outcome studies for Autism Spectrum Disorders (ASD)

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  1. A synthesis of six related TEACCH-based outcome studies for Autism Spectrum Disorders (ASD) Paul Probst, Department of Psychology, University of Hamburg Symposium paper presented at the XXX International Congress of Psychology, Capetown, South-Africa, 22-27 July, 2012 update: 25.07.2012, Author's note: Due to severe family health problems, this presentation is going to be completed not before the middle of August, 2012; probst@uni-hamburg.de , Homepage: http://www1.uni-hamburg.de/Paul.Probst/

  2. THEORETICAL BACKGROUND 1. State-of-the-art autism concept • Autism-Spectrum Disorders (DSM 5/ ICD-11-Draft, 2010) • Deficits in Social Communication and Interaction • Restricted Patterns of Behavior, Interests, and Activities • Onset in early childhood (1-3 yr.) • Etiology: Neurodevelopmental disorder with strong genetic component influencing early brain development; • Prevalence: total: 0.4 % [conservative estimation] • Tertiary prevention: i. e. preventing disability progression and associated suffering by alleviating behavioral symptoms and strengthening compensatory abilities;

  3. 2. Caregiver-Stress-Coping- Tertiary Prevention Model (adapted from Pakenham et al., 2005; Antonovsky, 1993: "Sense of Coherence"/ SOC) • TERTIARY INTERVENTION: • Individual (ASD)-Focused (Need for SOC) • Caregiver-Focused (Need for SOC ) INDIVIDUAL with ASD: * Enhancing abilities * Reducing obstruct. deficits Caregiver Adaptive RESSOURCES Caregiver COPING: Problem-/ Emotion-Focused Family/ Classroom/ Group home/ Workshop/ FUNCTIONING DEMANDS & STRESSORS APPRAISAL of Stressors

  4. 3. CONCEPT of TEACCH • Structured Teaching, & Educational Guiding • Visually structuring (e. g. visual schedules, choice boards) • Clear verbal and nonverbal directions/ instructions • Prompting and behavior shaping • Consequence-based interventions (natural reinforcements, mild punishments, such as strict "No") • Social-communicative, self-management and daily living skills training • Professional-CaregiverCooperation • InternationalProgramDissemination professional training;

  5. AIMS OF THE SYNOPSIS STUDY: Can key components of the TEACCH program be generalized to German-speaking countries in terms of effectiveness and social acceptance METHODS • Participants: children and adults with ASD; parents; teachers and educators • Instruments: behavioral observation, questionnaires, interviews • Data analysis : quantitative and qualitative procedures • Selective outcomes of four autism intervention studies are reported

  6. RESULTS: Study 1

  7. Study 1-Figure 1 Pictorial Schedule for L 1= Foto & Name-Card for L 2= Go-to-your-Work- Place-Card 3= Recreation-Card= "Go to your Choice-Board!"

  8. Study 1-Figure 2 Two Element-Pictorial Schedule for L [see bottom line] * Listening-to-Favourite-Music-Card; * Flapping-Glove-Card (favourite activity)

  9. RESULTS: Study 1-continued: OUTCOMES

  10. RESULTS: Study 2

  11. Study 2: Figure 1: Individualized Work system for person T: T follows a Left-to-Right Routine: (1) Taking working materials from the shell on the left (organized in a Top-Down-Order); (2) carrying out the task (e. g. matching picture cards) on the desk; (3) putting the completed task to the box to his right

  12. Study 2: Figure 2: Typical matching task for T

  13. RESULTS: Study 2-continued: OUTCOMES

  14. RESULTS: Study 3

  15. RESULTS: Study 3-continued: OUTCOMES

  16. RESULTS: Study 4

  17. RESULTS: Study 4-continued: OUTCOMES

  18. CONCLUSIONS • Overall, the results of all four small-scale studies indicate evidence for positive outcomes of TEACCH-based interventions across multiple individuals, ages, settings and outcome measures • Limitations: (1) threats to internal validity (sample size, control groups); (2) threats to external validity (selective samples, single-study) • Cautiously viewed, TEACCH-based interventions: (1) lead to clinically and educationally relevant effects across different settings; (2) show sufficient social validity across different caregivers; (3) support the assumption that they are also practicable in German-speaking countries, and compatible with local tertiary health care interventions • Further research is urgently needed, in particular for controlled replication studies

  19. Thank you for your attention! • Acknowledgement to Collaborators: • Tobias Leppert, Ph.D • Florian Jung, M.S. • Jan Micheel, M.S. • Iain Glen, M.S • Petia Gewohn, M.S, Christoph Faecks, M.S, Stefanie Brakemeier, M.S, Marzena Radzij, MS, Julia Spreitz; • Petra Steinborn, M.Ed • Parents, Teachers, and Educators • Children, adolescents and adults with ASD Email: probst@uni-hamburg.de • Probst, Jung, Micheel & Glen (in print). Tertiary prevention [...]. Life Span and Disability, xx, • Probst & Leppert (2008): Brief report: Outcomes of a teacher training program [...]. Journal of Autism & Dev.elopmental Disorders, 38, 1791-1796

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