Stephen C. Luce

Training Teachers to Use Naturalistic Communication Strategies in Classrooms for Students With Autism and Other Severe Handicaps

There is a growing body of literature suggesting that effective communication intervention for children with autism and other severe handicaps should be focused in the child’s natural environment. ...

Providing Effective Transitional Programming to Individuals with Autism.

Legal mandates, widely postulated professional perspective, and improved teaching techniques have strongly influenced the kind of care provided individuals with significant developmental disabilities such as autism. Children and adults who would have been separated from their families and peers two decades ago are now expected to live in natural settings identical to the settings in which other members of their families live. The conversion of services to correspond with the ever increasing lifestyle expectations for persons with developmental disabilities is described from an organizational perspective with reference to serving these individuals in special education classrooms, residential settings, or other human service settings. Systems we have found effective in moving individuals through a continuum of services are described. Specific examples of implementation strategies in a large comprehensive treatment center for individuals with developmental and neurological disabilities are provided. An example of a wide-scale conversion of an agency that resulted in more progressive transition programming is discussed.

Preparing the Client for Transition to the Community

Within the last two decades there have been phenomenal advances in the development of effective procedures used with handicapped children (Ross, 1981) and adults (Krasner, 1982). Despite these exciting advances, mental health professionals are in much turmoil regarding a number of fundamental issues of client care.

Development of a continuum of services for children and adults with autism and other severe behavior disorders

The development of a 12-step continuum of services for individuals with autism is described. The operation and funding of outreach parent training; homebased early intervention; preschool, vocational, and adult intermediate care; and school consultation programs are outlined. The use and importance of evaluative data on both treatment outcome and staff skills are emphasized.

Use of a Concurrent Treatment Design to Analyze the Effects of a Peer Review System in a Residential Setting

An experiment was carried out in which the recording practices of individual case managers at a residential treatment facility were improved using feedback from the overnight therapists at the facility. The overnight therapists, who were not associated with the daytime management of the individual clients, conducted weekly reviews of the data that were compiled by case managers during the day. Four particular standards were observed across each case manager, and specific written feedback was delivered to the case manager who was responsible for compiling the data for each child. The written feedback referred to the presence and accuracy of particular details for each program, including introductory cover pages, labeled experimental conditions, operational definitions, and adequate interobserver agreement. The experiment analyzed and verified the feedback procedure through concurrent treatment of different elements across I I cases. The results suggested that significant changes in the recording practices of therapists can be accomplished through feedback generated by the night therapists of the agency.

Inpatient Behavior Therapy with Autistic Youth

In comparison to other disabilities, autism is a very rare life-long disability that is typically observed prior to a child’s third birthday. Afflicting only about one in 3,000 live births, this disorder has received a level of scrutiny and interest that far exceeds its prevalence. One might conclude from such a high level of attention that there would be a well-established approach to questions on etiology, assessment, and treatment. Unfortunately, little agreement exists on any of these issues. Unlike some of the other developmental disabilities, the cause of autism is unknown, its characteristics are similar to those of other diagnostic categories (e.g., mental retardation, schizophrenia), and its troubling behaviors have been shown to be largely unresponsive to traditional medical interventions and psychotherapeutic approaches.

Peer Review and Human Rights Committees

The protection of clients’ rights to safety and effective treatment is a basic goal of any human service agency. These rights are ensured through effective organizational, staff-training, and management practices. Professional peer reviews and human rights committee reviews are two activities that are undertaken to (1) underscore the protection of clients’ rights during the clinical decision-making process, and (2), assure the consumers, the trustees of the agency, and the public that the basic rights are protected.

State-of-the-Art Programming in Massachusetts: A Brief Description of the May Institute

The May Institute is a private, non-profit human service agency serving persons with autism and other severe developmental disabilities. The Institute began as the parents’ School for Atypical Children in 1955 and was founded by Dr. and Mrs. Jacques M. May as a center dedicated to the understanding and rehabilitation of autism. Dr. May, who was famous as a physician, author, and researcher with the World Health Organization, established the program in the town of Chatham about 145 km. from Boston on scenic Cape Cod in Massachusetts. Having fathered twin autistic sons, Dr. May was interested in establishing a treatment center focusing on study of the autistic child which contrasted to the treatment of the day which was parent-centered. The Mays found such an approach which linked autism to parental personality traits, counter productive.