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Procedia - Social and Behavioral Sciences 84 (2013) 1679 – 1683

3rd World Conference on Psychology, Counselling and Guidance (WCPCG-2012)

The Effectiveness of Treatment- Education Methods in Children


with Autism Disorders
Reza NasoudiGharehBolagh a *, Hadi Zahednezhadb, SanazVosoughiIlkhchib
a
Department of Psychology, Mohaghegh Ardabil University, Ardabil, Iran.
b
Young Researchers Club, Tabriz Branch, Islamic Azad University, Tabriz, Iran

Abstract

of treatment
education method (TEACCH) on autistic children. 19 student who were selected by available sampling method randomly divided
into intervention and control group and compared using the (GARS) and (M- CHAT) scales. The data analyzing by MANOVA
showed that, there is a significant difference between groups. The finding of this study indicated that TEACCH method may be
able to reduction of symptoms of autism children.

© 2013 The Authors. Published by Elsevier Ltd. Open access under CC BY-NC-ND license.
© 2013 Published by Elsevier Ltd. Selection and peer review under the responsibility of Dr. Melehat Halat
Selection and peer-review under responsibility of Prof. Dr. Huseyin Uzunboylu & Dr. Mukaddes Demirok, Near East University, Cyprus
Keywords Autism, treatment education method, GARS, M-CHAT

1. Introduction

Autism spectrum disorders (ASD), which consist of Autistic disorder, Asperger syndrome and PDD Not
otherwise specified (PDD, NOS) are a subset of Pervasive Developmental Disorders (PDD). Obviously, ASDS are
characterized by abnormalities in social interaction and communication, as well as respective and stereotyped
behaviors. In fact, ASDS have been in traduced as multi factorial disorders, from as tendency of genetic to
environmental factors are involved in causing them (American Psychiatric, 2002).
The population of children with autism has increased significantly over the past decade. The prevalence of autism
estimated at a rate as high as 6 cases peer 100. The desire for children with autism to function in the least restrictive
set thing and achieve their full potential has increased the demand for effective treatment, including psychotropic
medications (Siegel&Beaulieu , 2011). Approximately 45% of children with autism are prescribed psychotropic
medication with a global market-value for autism therapeutics ranging between 2.2 and 3.3 billion. Children with
autism also have high rates of non-prescribed unregulated use of chemical compounds, sometimes known as
complementary and alternative medicines (CAM) (Johnston& Myers, 2007).
Nevertheless, several treatments have been performed to improve ASDS including behavioral, medical
biological, sensory-motor and relationship development interventions (Mohammadi, Salmanian, Akhondzadeh,
2009).
Children with autism display a variety of symptoms in varying degrees of severity. Individual children will show

* Corresponding author name. Tel.: +0-000-000-0000


E-mail address: author@institute.xxx

1877-0428 © 2013 The Authors. Published by Elsevier Ltd. Open access under CC BY-NC-ND license.
Selection and peer-review under responsibility of Prof. Dr. Huseyin Uzunboylu & Dr. Mukaddes Demirok, Near East University, Cyprus
doi:10.1016/j.sbspro.2013.07.013
1680 Reza Nasoudi Ghareh Bolagh et al. / Procedia - Social and Behavioral Sciences 84 (2013) 1679 – 1683

education and community experience all contribute to hoe the autism will manifest in the individual. Behaviors
indicative of autism can be divided into four categories according to Jonzen (1996). These are language/
communication behaviors, responsive to sensory stimuli and developmental discrepancies. Impairment in the
ability to use language or communicate could take on several forms.
One of the programs developed for children with autism is the treatment and education for autistic and related
communication handicapped children(TEACCH), developed at the university of north Carolina at Chapel Hill
-based approach that depends strongly on collaboration
between teachers and parents. Since 197, TEACCH has been a mandated program for children with autism in the
state of North Carolina and popular world wide (Heflin & Simpson, 1998).
TEACCH used structured teaching to train children in the areas of social skills, living skills, vocational skills,
leisure skills and communication skills. The four major components to structured teaching are physical organization,
task organization, visual schedules and work systems.
The effectiveness of the TEACCH program is emphasized on several researches. Lee (2009), Butler (2007),
Peerenboom (2003), Timothy (2003), Lal&shahane (2000), Ozonoff&Cathcart (1998), showed that the percentage
-help and motor skill have been raised in their IEPS.
Also Paneriai, Zingale, Trubia, Finocchiaro, Zuccarello, Ferri&Elia (2009), Wertheimer (2007), Tasang, Shek, Lam,
Tang & Cheung (2007), Vanbourgondiem, Reichle, Schopler (2003), Schlopler, Mesibove, Hearsey (1995) indicated
that, the effectiveness of the TEACCH appeared to be confirmed showing positive outcomes in a natural setting,
and revealing its inclusive value. According to this literature and considering high records, we hypothesized that
TEACCH would reduce communication, social interaction problems and stereotyped behaviors. So this treatment
would be significantly related to positive treatment outcome.

2. Materials and methods

2.1. Sample

The statistical population involves all children with autism disorders accepted in Tabriz autism school in the
second six months in 2011 (100 children according to investigations). The sampling method is available sampling.
Nineteen children in age range of 6-14 year were selected. Fourteen boys and five girls by disorder in middle and
mild stages were studied. The research is an experimental study conducted by pretest and post test design and
control group. The selected children were divided into experimental and control groups randomly. In the experiment
group TEACCH was applied as independent variable; but control group did not receive any special treatment with
specified goals.
In order to obtain information the data were collected by following tools:

2.2. Instruments

Gilliam Autism Rating Scale GARS: GARS was used in order to collection of the data and measuring of the
research variables. According to the definition of ASA and APA based on DSM-IV this scale was designed by
James E. Gilliam (1994) for diagnosis of autism in 3-23 year individuals (Perimbome 2003).This scale consists of
42 items involving three subscales(stereotyped behavior ,communication and social interaction).In addition this
scale involves 14 questions about developmental disturbances. The score of this section is ignored because of
constant pretest and post test scores. Also GARS is designed for completion by the parents, teachers or other
competent individuals (individuals with permanent communication with the subject for two weeks).This scale did
not need to special training and scoring and often the raters could complete it in five to ten minutes. GARS sub
scales scores are converted into standard scores and these scores are converted into autism Indicator (AI).When
standard scores of 8 and subscale score upper than 8 indicate scores of 90 and upper than 90 besides other tools as
autism Quotient (AQ) middle and upper than middle probability of suffering with autism is considered. While scores
Reza Nasoudi Ghareh Bolagh et al. / Procedia - Social and Behavioral Sciences 84 (2013) 1679 – 1683 1681

less than 8 and subscale score less than 8 besides AQ indicate scores of 90 less than middle probability of suffering
with autism is considered. Maximum and minimum scores of each scale are 42 and 0 respectively. Total score is in
range of 142 and 0.this scale was tested and standardized in 1094 children with autism from 46 states of America
and Canada. Reliability of the test based on Cronbach Alpha indicates alpha coefficient of %90 for Stereotyped
behavior, %89 for communication and %93 for social interaction, %88 for development disturbances and %96in
autism symptom (Panerai and et all,2009 and Perimboome,2003).The validity of the test was confirmed by
comparison with other evaluation systems and autism evaluation tools for educational designs (Scolper et al, 1995).
Modified checklist for Autism in Toddlers (M-CHAT): Modified checklist for Autism in Toddlers (M-CHAT) is
used for diagnosis of autism in the children. This checklist consists of 23 yes/no questions designed based on 9
main items of the old CHAT checklist. This checklist was conducted for screening of 1293 children. Development
and educational disorder was diagnosed in 58 children and 39 children were diagnosed by autism. This checklist has
significant discrimination power in screening of suffered and normal children in recognition of 6 cases related to the
social relations. The studies of M-CHAT checklist indicate its positive psychological characteristics like sensitivity,
positive and negative predictive power and etc. Robins, Fein and Barton (2001) reported reliability of this checklist
% 83 by Crinbach Alpha coefficient. Also Ballroom and Foyer (2011) in a study on big sample of the children with
autism in Mexico showed appropriate validly.

2.3. Data analysis

The data analyzing by MANOVA showed that, there is significant difference between groups

3. Result

According to table 1 the difference between pre test and post test indicates reduction of the scores of the subjects
in post test of three variables.

Table1.

Variables N Min Max Mean Std. Deviation


Stereotyped 10 6 40 19.4 10.875
behavior pre test
Communication 10 13 35 24.8 7.052
pre test
Social interaction 10 10 39 26.4 8.745
pre test
Stereotyped 10 2 36 10.4 10.627
behavior post test
Communication 10 5 23 13 5.811
post test
Social interaction 10 4 22 13 5.12
post test

MANOVA in experiment and control groups


According to table 4 and based on summary of information, when (a-adjusted square of R=0.832) square
R=0.844, b= (adjusted square of R=0.942) square R=0.946, c= (adjusted square of R=0.844) square R=0.855 it can
be concluded that TEACCH method affects significantly on all dependent variables.

Table 2
Result of MANOVA analysis in experimental and control group
1682 Reza Nasoudi Ghareh Bolagh et al. / Procedia - Social and Behavioral Sciences 84 (2013) 1679 – 1683

Type III sum of


source df Mean squares F sig
square
Negation D1 A1873/807 2 936/903 70/322 0/001
D2 B2548/259 2 1271/129 229/255 0/001
D3 C2958/157 2 1479/475 76/899 0/001
Intercept D1 245/157 1 245/175 18/401 0/001
D2 405/604 1 405/604 72/981 0/001
D3 738/292 1 738/292 38/374 0/001
0/001
group 1873/807 2 936/903 70/322

4. Discussion and Conclusion

It can be said that the hypothesis of effectiveness of TEACCH method on Stereotyped behavior, communication
and social interaction in children with autism compared with control group was confirmed. The effectiveness of
TEACCH method on reduction of Stereotyped behavior in children with autism in this research is in agreement with
results of Schopler, Mesibov&Hearsey(1995).These authors could reduce Stereotyped behaviors in children with
autism significantly by using SPA method as one of the TEACCH approaches interfered (based on emphasize on
environment organization and structuring).
Efficacy of TEACH method in reduction of communicational difficulties in children with autism is in agreement
with research of Ozonoff&Cathcart(1998).They concluded that this method increases significantly social
communication skills (capability of speech and non speech comprehension) in children with autism compared with
control group. Also Meechung, Mosconi and Matthews (2006) by using SST educational programs (combination of
video feedback, positive empowerment and counter system) as an interference of the TEACCH method found that
communication skills in children with autism have been increased significantly by this education.
Efficacy of TEACH method in the reduction of social interaction difficulties in children with autism in this
research is in agreement with research of Ozonoff&Cathcart (1998), Paneriai and et al (2009)Tsang and et al (2007).
They concluded that this method increases significantly interactional skills learning (imitation and capability of
speech and non speech comprehension) in children with autism.

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