AUTISM

AUTISM

August 11, 2012

Be here now

Dr. Anthony C. Hollander

I have been hearing all sorts of comments and expressions lately that have been making my head spin. Given the level of “autism awareness” combined with all of the emphasis on training of staff/educators, and the emphasis on parent training and counseling, I never would have thought that these comments would be so widespread.

Should we give a lot of structure, or sit back and see what happens? Hesitate, or don’t hesitate? Well, how about this one: “Hire the person, but what can you expect from someone that only makes minimum wage?” Or how about this one: “We only have the child for six hours a day.” (In my private practice I see most of the children I work with less time in one year then the staff sees the child in one week.) Or this one: “There is only so much we can do, because the child has autism.” Have you been hearing these kinds of expressions lately? Or am I the only one?

When I started the Summer Intensive Program, it was the largest community-based consumer-run program of its kind in the country. I had over 100 people working for me for nothing more than a significant training program, coupled with the best darn letter of recommendation that anyone could ever get. At the height of the program, we had the same number of people working for something like $0.57 an hour - way less than minimum wage! The people in my programs had to undergo a full month-long training session. The paperwork demands were, up until the most recent IEP publications, the most demanding of any other location in the country. We also took the children that no one else would take: the most violent, most dangerous.

There were very serious potential staff interview sessions, with actual video tapes to be seen as part of the interview, along with all sorts of background, academic standing, and personal recommendations combined. People had to know up front exactly what they were trying to get themselves into, and what their work demands would be before they came to work. We also took in people who had no direction in life, no idea what they wanted to do. It turns out that these people that we hired became the original one-to-one person and worked their butts off all summer long. It also turns out that these one-to-one people were the single most important part of our programs. They were the people that actually did the work that we all talked about needing to be done. It got to the point where I was having people from all walks of life, even physicians, coming to the program for training. To this day, I have a tremendous amount of respect for anyone who would be willing to work one-to-one with this population. That’s why I have conducted tons of training sessions, not only for support personnel, but for the bus drivers, nurses, substitutes, student teachers, home aides, camp aides, etc.

My parents gave me some advice: “Be here now.” In other words, don’t let other things get in the way of your chosen responsibilities.


What can we expect from someone who is only making minimum wage? Should we expect the person to be with the child he/she is assigned to? Should we expect the person to attend to the behavior of the child, or ignore the child? Should we expect the person to take data, or only when they feel like it, or not at all? Should we expect the person to do the work for the child? In one classroom that shall remain nameless, I actually sat next to an aide who was asleep in a chair (and the teacher did nothing). In another room the aide was reading the newspaper - hopefully looking for another job.

We need better training and better on-going supervision. We need to train teachers on how to do supervision with their aides. I continually see new teachers with aides who intimidate the teacher into backing off on giving instructional support, and critical, judicious feedback about what is taking place between the aide and the child.

Failure to provide ongoing support and training, and failure to move people around when necessary can also cause a major morale problem within the classroom. This morale problem can spread quickly into other areas of the facility because everyone is always looking at what the other person is doing (or getting away with), and begins to think to themselves, “why should I do this when the other person is not putting forth the effort?” This takes a really good aide and turns that person into another disgruntled, poorly motivated person.

Yes, we should provide a great deal of structure for the child since that provides that basic foundation of learning. Yes, we should continue to provide excellent instruction for all children, even those on the spectrum despite their frequent need to call out answers as part of their syndrome. Yes, we should teach the child to look before they act, especially in safety situations, or in social situations to avoid harm, or failure when they are really trying to make friends. Yes, we should teach the child the joy of being spontaneous, and the right and ability to simply have some fun. This is the part a childhood that most of these children are not able to fully grasp given all of their internal inter-connectivity problems, and all of their confusion and worry about what takes place around them. We should do all of this in accordance with a plan. A simple, easy plan that is easily taught, not to the child, but to the staff. This way, we can ensure that we are consistently consistent, rather than being inconsistently inconsistent (and contributing to even more confusion on the child’s part). This plan has to be supervised and monitored almost on a minute by minute basis by the teacher and other professional staff to learn if it is working or not. If not, we can make swift and effective changes to promote continued growth on the part of the child, and the staff.

My parents gave me some advice: “Be here now.” In other words, don’t let other things get in the way of your chosen responsibilities.

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