EDUCATING CHILDREN WITH AUTISM IN INTEGRATED SETTINGS
Often, interventions for children with autism spectrum disorders take place in the school
setting. The provision of educational services for children with Autism Spectrum
Disorders (ASD) and other special needs presents a number of challenges, particularly for
young children (age 0 to 6). The state of Iowa has been working to address these
challenges. In 1995, the state of Iowa Area Education Agencies’ Special Education Task
Force on Autism developed a state-wide strategic plan to attend to issues related to
providing special education services to children with autism spectrum disorders. One of
the accomplishments arising from this state wide effort includes the compilation of a set
of best practice guidelines for interventions and programs serving individuals with ASD.
These guidelines establish competencies in which individuals who plan and implement
programs for individuals with ASD must be competent. Please refer to
for the complete set of best practice guidelines, including the ECSE supplement for youth
age birth to six with ASD.
The following is a brief overview of some additional elements that have shaped
interventions for children with ASD.
The passage of several landmark pieces of legislation has significantly impacted and
shaped the delivery of educational services to children with ASD and other disabilities:
The Individuals with Disabilities Education Act and Amendments
Mandates that children with disabilities be provided a “free and appropriate
public education” and that education services be “implemented in the least
restrictive environment” for the child.
LRE legislation is based on the notion that that the general education
environment is appropriate for educating all children, including those with
disabilities or special needs, given that appropriate supports and
accommodations are put in place.
“Special classes, separate schooling or other removal of the eligible
individuals from the general education environment occurs only if the nature
or severity of the disability is such that education in regular classes with the
use of supplementary aids and services cannot be achieved satisfactorily.”
To the maximum extent possible, children with disabilities (including those
with autism spectrum disorders) and children without disabilities should be
integrated in the same setting.
(IDEA 1997-20 U.S.C. 1412(a)(5)(B))
No Child Left Behind Act of 2001
Demands high academic outcomes measured by standardized testing for all
students in the nation’s public school systems.
Requires states and school districts to provide parents with easy to read
information on the demographic characteristics of the student body (including
disability status) and success/performance of each school and district.
NCLB legislation pertains to school aged children. However, early intervention with
young children (age 0 to 6) with autism spectrum disorders is an important component in
preparing these youth to participate in educational programs later. Early intervention
programs can teach the skills and behaviors necessary for young children to achieve
successful outcomes when they reach school age. With such skills, children with ASD
can participate more fully in NCLB requirements.
In sum, balancing the requirements of inclusive special education (IDEA) and the
mandate for high academic achievement (NCLB) poses many challenges for school
districts. However, both the IDEA and NCLB attempt to address the common goal of
high-level educational benefits and outcomes for all students. Furthermore, the intent of
these two laws is to create a unified and cohesive system of education, where all students
have the resources, supports and accommodations necessary to achieve their highest
Information from this section compiled from the following sources:
Kerzner Lipsky, D. (2003) The coexistence of high standards and inclusion. The School
Administrator, 60(3): 32-35.
NCLB Act 2001
Important Court Decisions
Several important court cases have further refined the definition of “Least Restrictive
Environment.” In addition, these cases have provided guidelines for interpreting what
constitutes compliance with the LRE mandate.
Roncker v. Walter
A 1983 decision to guide decision-making about appropriate educational
services for the student with disabilities. It involves the following two-part
(1) Can the educational services that make the segregated setting superior
be feasibly provided in a non-segregated setting? (If so, segregated
placement is inappropriate.)
(2) Is the student being mainstreamed to the maximum extent appropriate?
The test is designed to achieve the appropriate placement for a student with a
disability in the educational setting.
Daniel R. R. v. State Board of Education
In 1989, relying on the Roncker decision, the court developed an additional
test to determine if the LRE requirement is met. The following two-question
test was devised:
(1) Can an appropriate education in the general education classroom with
the use of supplementary aids and services be achieved satisfactorily?
(2) If a student is placed in a more restrictive setting, is the student
“integrated” to the “maximum extent appropriate”?
Hartmann v. Loudoun
A 1997 decision detailing the following:
Mainstreaming is not required when a student with a disability will not receive
an educational benefit from it.
Any marginal benefit from mainstreaming would be outweighed by benefits
that could only be obtained in a separate educational setting.
A determination of whether the student is a disruptive force in the general
education classroom is a legitimate issue
IDEA has a preference for mainstreaming, but does not require it in every
circumstance. The receipt of social benefits is a subordinate goal to receiving
From more recent case decisions, such as Hartmann v. Loudoun, there appears to be a
trend where the courts are moving away from defining LRE as inclusion in the general
education setting as a matter of right and law in every circumstance. On the contrary, the
courts have interpreted that the intentions of the IDEA are to ensure that students with
disabilities are integrated with their non-disabled peers “to the maximum extent
appropriate.” With this in mind, decisions regarding placement of a student in the special
education setting or the general education environment must take into consideration a
host of important factors, including the educational benefit to all children.
Information for this section adapted from:
Douvanis & Hulsey (2002). The least restrictive environment mandate: how has it been defined by the
courts? ERIC Clearinghouse on Disabilities and Gifted Education, Digest E629.
Overview of Intervention Methodologies for Autism Spectrum Disorders
Autistic Spectrum Disorders (ASD) or Pervasive Developmental Disorders (PDD) are
characterized by impairments in social and communicative development and a restricted
range of interests and activities. Onset of ASD typically occurs by age three or earlier,
and the severity of symptoms and impairment varies from child to child. At the current
time, it is estimated that more than one in 500 children are affected by ASD nationally.
In Iowa, it is estimated that there are approximately 3000 children affected by ASD.
More specifically, for the youngest children in Iowa, Regional Autism Services data
show that 98 toddlers (age birth to three) with ASD were served in autism specific
interventions in the 2002 to 2003 school year in Iowa. There is no known medical cure
for ASD and there is currently no consensus about the best or most appropriate
intervention strategy for treatment of ASD. (See appendix for overview of intervention
What has been shown through scientific studies as well as anecdotal evidence is that early
intervention is paramount to achieving improved functioning and other positive outcomes
for the individual with ASD. The Individualized Family Service Plan (IFSP) is the main
tool used to identify and obtain the resources and skills necessary to optimize the growth
and development of the young child with ASD. The IFSP process is designed to meet the
needs of the child with ASD as well as empower and support the family unit.
Accordingly, important aspects of intervention and treatment of ASD include parental
support and participation. In addition, when designing treatment strategies for children
with ASD, consideration should be given to characteristics of the child and family that
may influence the intervention program. The IFSP and the intervention strategy may be
changed and modified over time to accommodate changing needs of the child and family.
Finally, there should be communication and partnership between the child’s pediatrician,
educational staff, parents and other key players.
Interventions and educational programming for children with ASD may be quite different
from educational services for typically developing children. Behaviors that typical
children learn on their own, such as social skills, eye contact, communication skills, etc.,
may need to be taught to children with ASD. For this reason, educational goals for
children with ASD may include both academic and non-academic components that are
not part of standard educational curriculum. In addition, because autism and its spectrum
disorders impact children to varying degrees, educational programming for children with
ASD can and should vary to a great degree also. Despite differences between the
methods and focus of intervention programs for children with ASD, educational goals for
children with ASD usually emphasize the following common areas: social and cognitive
development, verbal and non-verbal communication, adaptive skills, motor skill
development, and decreasing difficult behaviors (Educating Children with Autism, 2001).
The Committee on Educational Interventions for Children with Autism, formed at the
request of the US Department of Education’s Office of Special Education Programs,
published a set of recommendations for effective treatment of ASD in the educational
setting. These recommendations were based on empirical findings, information from
representative programs serving children with ASD, and findings from the literature.
According to the committee, successful intervention and treatment programs for young
children with ASD consist of the following elements:
Educational services should begin as soon as a child is suspected of having an
autistic spectrum disorder…Educational services should include a minimum of 25
hours a week, 12 months a year, in which the child is engaged in systematically
planned, developmentally appropriate educational activity aimed toward
A child must receive sufficient individualized attention on a daily basis so that
individual objectives can be effectively implemented…
Assessment of the child’s progress in meeting objectives should be used on an
ongoing basis to further refine the IEP…
To the extent that it leads to the specified educational goals…children should
receive specialized instruction in settings in which ongoing interactions occur
with typically developing children.
(Educating Children With Autism, 2001; pages 220-221)
The committee also identified six kinds of interventions that should have priority in
educational programming for children with ASD:
Functional, spontaneous communication should be the primary focus of early
Social instruction should be delivered throughout the day in various settings,
using specific activities and interventions planned to meet age-appropriate,
individualized social goals.
The teaching of play skills should focus on play with peers, with additional
instruction in appropriate use of toys and other materials.
Other instruction aimed at goals for cognitive development should also be
carried out in the context in which the skills are expected to be used, with
generalization and maintenance in natural contexts as important as the
acquisition of new skills.
Intervention strategies that address problem behaviors should incorporate
information about the contexts in which the behaviors occur; positive, proactive
approaches; and the range of techniques that have empirical support.
Functional academic skills should be taught when appropriate to the skills and
needs of a child.
(Educating Children with Autism, 2001; page 221)
In sum, the educational program should be tailored to meet an individual child’s needs in
the least restrictive environment possible and be designed with input from a team
including parents, family members, school staff and other professionals.
Iowa Survey Results
In an attempt to locate and disseminate information about unique integrated social and
learning opportunities for children with autism spectrum disorders in the state of Iowa,
Child Health Specialty Clinic’s Autism Services Coordinator distributed surveys to each
of Iowa’s 12 Area Education Agencies and the Des Moines Public School District. The
surveys included questions about integrated programs for children from birth to eight
years old in school districts across the state. To be considered an integrated program, the
amount of time the child spent in the integrated setting had to account for at least 50% of
the child’s participation in instructional or related services. Specific information solicited
from respondents to the survey included the name and location of integrated programs,
the age groups of children served, the number of children with autism spectrum disorders
accommodated in the program, a description of the peers in the integrated setting (i.e.
typically developing or at risk), the ratio of children to adults as well as the availability of
associates, and finally, the types of instructional methodology offered to the children (i.e.
TEACCH, PECS, floor time, etc.).
All AEA’s responded to the survey with the exception of the Des Moines Public Schools.
Of the AEA’s that responded, six indicated that they were not aware of any unique
integrated programs in their area (AEA 1, 4, 12, 13, 14,and 16). The remaining six
AEA’s (AEA 7, 8, 9, 10, 11, and 15) indicated that there was at least one unique
integrated program in their region. Please refer to attached chart, “Iowa’s Unique
Integrated Programs for Children with Autism Spectrum Disorders,” for specific
information about these integrated programs. All information collected refers to
programs in existence at the time of the 2002-2003 school year. Programs may be
financed by the AEA, located at a university, or be offered by the community.
* This document was compiled by Shonna Negus, Social Work Intern for Child Health Specialty Clinics in
partnership with Sue Baker, Autism Services Consultant, University of Iowa Hospitals/Department of Education. For
more information or questions, call 319-356-4619.
Specific Intervention Strategies in Autism
Treatment and Education of Autistic and Communication Handicapped Children
(TEACCH) is a statewide program in North Carolina that was first developed in the
1970’s. The main goal of this model is to help children increase their communication
skills, social awareness and decision-making skills so that they become more independent
and can attain the most meaningful level of functioning possible in the community. The
structured teaching program is based on the assumption that the environment should be
adapted to the child with Autism, and it makes use of a variety of techniques and methods
that are used in varying combinations depending on the person’s needs and capabilities.
The aim of intervention is to support the individual throughout the lifespan. TEACCH
curriculum is focused on cognitive, fine-motor, eye/hand integration, organizational
skills, self-help, coping skills, communication, language and social skills, among others.
The approach is highly structured and utilizes charts, organizational aids, and schedules
to assist the student.
ABA, discrete trial, ABLLS
A number of intervention modalities for children with ASD are based on a theory of
Applied Behavior Analysis (ABA). Although ABA is a theory, many times it is also
used to refer to a specific treatment approach and is frequently used interchangeably with
discrete trial or Lovaas techniques. Applied Behavior Analysis (ABA) isolates specific
behaviors, particularly socially significant behaviors such as reading, academics, social
skills, communication, and adaptive living, and seeks to systematically improve those
behaviors. The method uses an ABC model where every task or trial that the child is
asked to complete consists of an antecedent (a directive for the child to perform a certain
task), a behavior (a particular response from the child), and a consequence or a reaction
from the therapist with either positive or negative reinforcement. The ABA/Discrete trial
training approach recognizes the need for one on one instruction with a trained
professional. There is much evidence (anecdotal and empirical) showing the success of
this type of intervention including increases in social skills and IQ levels. In addition,
studies have demonstrated that gains are maintained long term.
Picture Exchange Communication System (PECS) is an intervention based on the
assumption that there is a difference between talking and communicating. Many students
with ASD have an impaired ability to communicate with others. Some children with
ASD develop verbal language, but others may never talk. This intervention model begins
with teaching the student to exchange a picture of a desired item or activity with the
therapist or teacher, who immediately honors the request. As this is mastered, the student
is then taught to differentiate between symbols and eventually the child is able to put
together multiple symbols into simple “sentences.” This method allows the child with
autism, particularly those who are not very verbal, to communicate with others in a
These models focus on interactions between the adult and the child that arise naturally in
an unstructured situation. The interactions involve materials that are highly desired or
preferred by the child. Everyday instances are seen as opportunities for teaching. The
approaches are child centered, allowing the child to select and initiate activities with the
adult then responding to the child’s requests through a series of prompts. The method
targets skills in the natural environment, making learning part of the natural exchange
between child and adult. The focus is on creating learning situations where the child has
shared control over the learning environment. With repetition of similar interactions,
incidental teaching has been shown to increase learning in children with ASD.
Relationship Methods/Floor Time/Relationship Development Intervention with
The method, Floor Time, was developed by Stanley Greenspan and shares similarities
with play therapy. Unlike many other types of interventions that focus on cognitive
development, Floor Time addresses emotional development. Greenspan describes six
stages of emotional development that children must progress through in order to achieve
more advanced learning. Children with autism may have difficulty reaching these
developmental stages. Floor time interventions are implemented to help the child move
up this developmental ladder. Floor time utilizes child directed interactive experiences
in a low stimulus environment. The model targets emotional development and is based
on assumptions that interactive play where the adult follows the child’s lead will cause
the child to want to relate to the outside world and assist the child in mastering
Relationship Development Intervention (RDI) developed by Steven Gutstein addresses
the teaching of friendship skills (differing from social skills instruction) that lead to the
ability to have friends and intimate relationships. This systematic intervention program
utilizes an invitational model, inviting the child to allow guidance to new and exciting
meanings and involvement with the world. The RDI curriculum is composed of six
levels and 24 states with each of the levels representing a dramatic developmental shift in
the central focus of relationships.
This intervention relies on providing students with autism meaningful interaction with
their non-disabled peers. Peers may be used to model appropriate social skills and other
positive behaviors or tasks such as cooperation and verbalization. In addition, the non-
disabled peers may be coached to appropriately teach and redirect their peers with ASD.
In this manner, the child with ASD is taught to exhibit appropriate social, play and
communicative responses. Research suggests that this intervention has led to
improvements in social skills, cooperation, conversation, academic skills and others. In
addition, it appears that skills learned from peer training may be generalized to other
settings. It is particularly effective in inclusive settings where the majority of students
are typically developing. However, this type of peer mediation approach is complex to
deliver and requires socially skilled peers as well as highly trained staff.
Information for these summaries was compiled from the following sources:
Behavioral and Communication Approaches, retrieved from the Autism Society of America Website
Lord, C. & McGee, J.P. (2201). Educating Children With Autism. National Research Council.
Washington, DC: National Academy Press.
Overview of Strategies to Use with Young Children, by Sue Baker, Autism Services Program.
Review of Autism Treatments, retrieved from the Association for Science in Autism Treatment website