Therapies for Children With Autism Spectrum Disorders

communication difficulties, difficulties with time, attachment to routines, intense interests and
impulses, and marked sensory preferences and aversions. 184
By applying physical structure, indicating sequences of events, organizing individual tasks,
and work/systems within a classroom environment children with autism are thought to engage in
more developmentally appropriate behaviors that ultimately promote learning. TEACCH
approaches often include a heavy reliance on visual supports (e.g., picture schedule) and
arranging the physical environment to support individual learning.
Content of the literature. We identified 15 studies evaluating educational interventions overall
(Table 15). 185-200 Four of those studies 185-188 evaluated implementation of iterations of the
TEACCH program. Among studies assessing TEACCH, one was good quality, one was fair, and
two were poor.
Summary of the literature. Four studies assessed various outcomes associated with
implementation of components of the TEACCH curriculum (Table 15). One prospective cohort
study 187 evaluated the TEACCH program over 12 months for 18 children involved in a TEACCH
classroom, with 16 receiving other types of individualized training (age range, 3-5 years).
Evaluations of cognitive/developmental level, nonverbal intelligence, and adaptive behavior,
were assessed using the Chinese version of the Psycho Educational Profile, The Merrill-Palmer
Scale of Mental Tests, and the Hong Kong-Based Adaptive Behavioral Scales respectively at
baseline, six months after initiation of treatment (Posttest 1), and again at 12 months (Posttest 2).
The intervention group demonstrated statistically significant improvement compared with the
control group on the Chinese version of the Psycho Educational Profile Developmental Scale in
perception, fine motor skills and gross motor skills (p≤0.05) after controlling for age, IQ, and
pretest scores at Posttest 1. However, the control group showed more progress than the
intervention group in the daily living domain and the Hong Kong-Based Adaptive Behavioral
Scales sum of domains standard score (p≤0.05). Although significant improvements were see in
the intervention group at 12 months for all scales and subscales in the Chinese version of the
Psycho Educational Profile, Merrill-Palmer Scale of Mental Tests (total raw scores and mental
age), and the Hong Kong-Based Adaptive Behavioral Scales the 12 month data are not provided
for the control group.
The second prospective cohort study compared the effects of TEACCH in a residential center
(n=11, mean age = 9.66 years), a specific school setting (n=13, mean age = 8.66 years), and
included a comparison group in an inclusive mainstream classroom (n=10, mean age 9.09
years) 185 The main components of the TEACCH intervention groups included arranging the
environment with visual aids, individualized communication systems, self-care skills training,
and daily living skills related intervention. Cognitive/developmental level and adaptive behavior
were evaluated for each participant twice with a 3-year interval between evaluations, using the
Psycho Educational Profile and the VABS respectively. Both TEACCH groups showed
significant improvement on adaptive measures, but the mainstream classroom group did not. The
mainstream group improved significantly on the Psycho Educational Profile perception measure
only; both TEACCH groups demonstrated cognitive improvements on the Psycho Educational
Profile on a variety of additional subscales.
Two case series of TEACCH were identified, one focused on a psycho-educational training
program for parents 188 and the other on teachers. 186 Both had poor quality scores on our
assessment. Each included 10 children with ASDs. After the parent training, children improved
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