Originales Revista de Logopedia, Foniatría y Audiología

2007, Vol. 27, No. 4, 173-186

Copyright 2007 AELFA y
Grupo Ars XXI de Comunicación, S.L.
ISSN: 0214-4603

C. C. Gándara Rossi Implementing TEACCH educational

intervention principles and communication
strategies for persons with autism
Charlotte TEACCH Center Intern/
Practicante en el TEACCH
Center de Charlotte

Resumen munication systems. A way to achieve indepen-

The main focus of this article is to provide with a dence is to structure the environment for the stu-
general idea of the TEACCH (Treatment and Educa- dent, and to improve his skills to function in it. This
tion of Autistic and related Communication- handi- is mainly the purpose of Structured Teaching which
capped CHildren) approach to educational inter- translates into using schedules, work and commu-
vention in communication with persons that have nication systems, and educational visual and mani-
an autism spectrum disorder (ASD). The first part pulative activities, developmentally appropriate for
reviews necessary concepts to understand the the person with ASD and for his speech and com-
TEACCH philosophy about communication in munication level.
Autism, referring mainly to explaining communi-
cation not as speech, but as exchange of informa- Key words: Autism, ASD, communication, educational intervention, «Structu-
red Teaching», TEACCH.
tion. This idea gives importance to assessment and
development of communication systems based pri-
marily on nonverbal communication. Then the edu-
cational intervention principles of TEACCH are
briefly explained, they follow this important guide- Principios y estrategias de intervención
line: search for a way to enable the person to educativa en comunicación para personas
understand the world and be independent and con autismo: TEACCH
functional in it.
A third part introduces to Structured Teaching as El objetivo principal de este artículo es dar una idea
the principal way TEACCH approaches intervention, general sobre la intervención educativa en comuni-
and how it responds to the characteristics of cación de personas con un trastorno del espectro
Autism. Later, a brief mention on how Structured autista (TEA) desde el enfoque del programa
Teaching addresses communication issues with TEACCH (Treatment and Education of Autistic and
structuring the environment and ensuring genera- related Communication- handicapped CHildren). El
lization of acquired skills. A fifth part explains the primer apartado revisa algunos conceptos necesar-
important role that careful ongoing assessment ios para entender la filosofía del TEACCH sobre la
plays to establish an effective intervention plan, comunicación en el Autismo, refiriéndose principal-
specially because the scattered development pat- mente a explicar como ésta no es puramente
tern of skills in Autism makes it challenging to set lenguaje, sino un intercambio de información, y la
functional and realistic educational goals. importancia que esto le da a la evaluación y puesta
Finally, the components of Structured Teaching are en marcha de sistemas de comunicación basados
explained, followed by further exploration of com- principalmente en comunicación no-verbal.
Seguidamente, se da una breve explicación de los
principios de intervención educativa establecidos
Correspondencia:
Carmen Carolina Gándara Rossi
por el TEACCH, cuya pauta más relevante es la
3023 Colony Road, Charlotte, búsqueda de una manera que capacite a la persona
28211 NC. EE.UU. con autismo para entender el mundo y ser indepen-
Correo electrónico:
carmen.gandara@gmail.com diente funcionando en él.
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 GÁNDARA ROSSI IMPLEMENTING TEACCH EDUCATIONAL INTERVENTION PRINCIPLES AND COMMUNICATION STRATEGIES FOR PERSONS
WITH AUTISM

Un tercer apartado es dedicado a introducir la nonverbal communication and learning appropriate

Enseñanza Estructurada como la manera central de ways of relating to other people, objects, and
intervención del TEACCH, y cómo ésta responde a las events. No two people with ASD are the same. As its
características del Autismo. Después, se hace una name implies, ASD is a spectrum disorder that
breve mención a la manera en que la Enseñanza affects individuals differently and with varying
Estructurada aborda problemas de comunicación degrees of severity. Additionally, ASD is often found
organizando el ambiente y asegurando la general- in combination with other disabilities» (Autism
ización de las habilidades adquiridas. En un quinto Society of North Carolina, 2004-2007).
apartado se explica el importante papel que juega The focus of this article is to expose the educa-
una evaluación cuidadosa y continuada en el tional intervention principles and a sample of strate-
establecimiento de un plan de intervención efectivo, gies which the TEACCH program uses to address com-
especialmente porque el patrón disperso de desarrollo munication concerns. Primary attention will be given
de habilidades en el Autismo dificulta el establec-
to the Structured Teaching model, being the TEACCH
imiento de objetivos educativos realistas y fun-
way to approach individualized attention to the per-
cionales.
Finalmente, los componentes de la Enseñanza son´s autism. The aim will be specifically to mention
Estructurada son expuestos, seguidos por la expli- strategies for developing functional communication,
cación de los sistemas de comunicación. Una man- and occasional related issues.
era de alcanzar la independencia deseada es estruc- Before stating the intervention principles of
turando el ambiente para el estudiante, y formando educational intervention, necessary concepts and
sus habilidades para que pueda desenvolverse en guidelines on TEACCH´s approach to educational
él. Este es el objetivo principal de la Enseñanza intervention on communication will be described.
Estructurada a través de la utilización de agendas, Characteristics of Autism will then be addressed in
sistemas de trabajo y de comunicación, así como direct relation to communication and differences in
de actividades educativas visuales y manipulativas, thinking, as a base on which to build an explana-
que respondan al nivel de desarrollo de la persona tion of Structured Teaching. Afterwards, commu-
con autismo y a sus posibilidades de habla y comu- nication in Autism and Structured Teaching, will
nicación. be explored followed by a note about assessment as
an important part of intervention. Finally, the com-
Palabras clave: Autismo, comunicación, intervención educativa, «Ense- ponents of Structured Teaching, some strategies
ñanza Estructurada», TEA, TEACCH.
widely used by the program, and the communica-
tion systems will be described.
Structured Teaching responds to a philosophy of
attending to the clients’ needs and reducing anxiety
Throughout this article it will be referred to and frustration, increasing their independence by
Autism Spectrum Disorders (ASD) and Autism indiffe- structuring their environment and taking into
rently, understanding Autism as a lifelong neurologi- account their strengths to build on their skills.
cally-based developmental disorder that affects the
Rev Logop Fon Audiol 2007, Vol. 27, No. 4, 173-186

communication, social, adaptive and behavioral

aspects of the person, impairing his or her percep- Preliminary Ideas
tion and interaction with the environment.
The Autism Society of North Carolina considers To be familiar with intervention on language from
that an «Autism spectrum disorder (ASD) refers to TEACCH´s standpoint, we have to keep in mind at
a group of developmental disabilities—including least two basic concepts: 1) Communication is any
classic autism, pervasive developmental disorder- exchange of information between two persons, so to
not otherwise specified (PDD-NOS), and Asperger’s communicate is not necessarily to use speech. 2)
Syndrome—that affect a person’s ability to unders- Initiation is a big issue for a person with autism so we
tand what they see, hear, and otherwise sense. It is have to set the environment to motivate the student
a brain disorder that impacts communication, social to communicate.
interaction, and behavior. Individuals with ASD Furthermore, a speech therapist might find
typically have difficulty understanding verbal and enlightening to know that only 7 % of communi-
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 GÁNDARA ROSSI IMPLEMENTING TEACCH EDUCATIONAL INTERVENTION PRINCIPLES AND COMMUNICATION STRATEGIES FOR PERSONS
WITH AUTISM

cation are words, the remaining 55% is body lan- follow social actions, focusing on the face (eyes,
guage, and 38% tone of voice (Weiner & Mehra- mouth) of the speaker, individuals with autism sta-
bian, 1968). A child with autism might be very ver- red at mouth and clothing, and their gaze was erra-
bal and talkative but might not be informing tic (Klin, Jones, Schultz, &Volkmar, 2003), losing envi-
the interlocutor about functional relevant things, ronmental and social information. For professionals
and might not even make any sense of what he to say someone understands properly, the person
himself is saying. The language might be pure must respond accordingly to the stimuli relevant in
immediate or delayed echolalia or be a way of that moment for that situation, in an appropriate
releasing anxiety. Therefore TEACCH bets for deve- way. This is why assessment has a very big role in
loping a functional communication system and intervention in the TEACCH program, and why the
not primarily or even at all, verbal speech. The TEACCH philosophy tries not to make assumptions of
focus is not as much on the form of the language what the student does or does not understand, unless
as on making the communicative skills the child they can verify it, and if in doubt they try to start
has functional. This includes, for example, pro- teaching from a level they are sure he will unders-
minent use of visual cues, using echolalia (if pre- tand.
sent) as a base for functional speech, and not In order to understand intervention from the
necessarily forcing eye contact but teaching stra- TEACCH approach, we have to address a major con-
tegies to make it seem social so the student can cept that helps understand what Autism is. While
focus on understanding the content of what is Autism is not truly a culture, because it is not lear-
being said. ned, it manifests as one, as it involves a particular
Key to solve initiation problems is to set up the way of understanding and acting in a world. This is
environment for the person with autism to initiate referred as the Culture of Autism. Therefore the role
communication interchanges more easily and in a of the teacher, therapist or parent is to serve as an
more structured predictable way. A person with interpreter who understands both cultures and can
ASD often does not have the necessary awareness translate the rules of a non-autistic world, so that
or motivation for starting a communicative inter- the student can successfully function in it (Mesi-
action, and therefore is very likely to have difficul- bov, Shea & Schopler, 2005). From this follows the
ties relating to other people or even getting his basic goal of Structured Teaching: teach skills to
needs met. Research supports the idea of problems function in our world departing from their own
with initiation, finding a person with autism as strengths, and for that the environment has to be
having more difficulty understanding social and made more comprehensible (Schopler, Mesibov &
emotional information, than a typically developing Hearsey, 1995)
person. This has been described by Baron-Cohen, The communication difficulties a person with
Leslie, and Firth (1985; 1989) as lack of «theory of ASD has are very impairing for leading an indepen-
mind» and, according to Sigman (1994), it leads to dent life, and can cause high anxiety levels and
impairment in shared meaning, communicative frustration for the students and their caregivers.
If we provide a set structure to communicate, we
Rev Logop Fon Audiol 2007, Vol. 27, No. 4, 173-186

intent and reciprocal interaction. These, at the same

time, drift into problems with joint social attention, can prevent outbursts of anxiety and help on
social attachment, shared understanding, taking behavior management, as well as assure a level of
turns, maintaining conversational topics and inter- comfort and fulfillment for the student and his
preting social cues as tone, rhythm of voice, facial caregivers.
expression and gestures (Schopler, Mesibov & Hear- The mentioned differences due to Autism are
sey,1995, p. 245) based on the thinking, learning, social and lan-
It is also important to realize that understanding guage particularities as a result of different brain
is a complex process, and it is complex to assess its functioning and therefore, perception and proces-
functioning and the quality of the reception of infor- sing of information. It is important to be aware of
mation a certain person has. Understanding does not these differences and how they manifest, in order
only refer to picking up and responding to environ- to make intervention effective, and to better
mental stimuli. Current research found that, while understand and genuinely get to know each stu-
typical children used gaze and joint attention to dent with ASD.
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 GÁNDARA ROSSI IMPLEMENTING TEACCH EDUCATIONAL INTERVENTION PRINCIPLES AND COMMUNICATION STRATEGIES FOR PERSONS
WITH AUTISM

Educational Principles of TEACCH We must take into consideration the difficulty a per-
son with ASD has in understanding the underlying
The most important goal TEACCH has (Schopler, meaning and imposing specific meaning to experien-
Mesibov & Hearsey, 1995) is to improve each indivi- ces, as well as the lack of skill for functionally priori-
dual’s adaptation by a) helping improve his skills, b) tizing and assessing their environment. These stu-
modifying and structuring the environmentto dents typically focus on details and on visual cues.
accommodate to autism deficits. This is called Distractibility also plays a role, both from internal and
«mutual accommodation» in TEACCH terminology. external stimuli.
To help the person with autism achieve indepen- Concrete thinking, understood as the difficulty
dence and adaptation we must consider that indivi- with symbolic and abstract thinking and literal
dualized diagnostic evaluation and assessment understanding of their environment, plus the diffi-
are needed. The instruments for evaluating and asses- culty with generalization of experiences and proce-
sing used by TEACCH, amongst others, inclu- dures to different settings; lead to an unusual rule
de: CARS (Schopler, Reichler & Rocher Renner, 1988), governed life which can be taken in as a strength for
PEP-3 (Schopler, Lansing, Reichler & Marcus, 2004), concrete teaching, but is troublesome in everyday
and informal observations and caregiver reports. changes. Flexibility is dealt within Structured Tea-
After assessment, we look to educate by providing ching by introducing change systematically in sche-
Structured Teaching adjusted to the developmental dules, so that the student can get used to it and
level of the autistic individuals at home, school, or work expect changes to take place in his day.
place. The basic goals of structured teaching are: a) Furthermore, the way a person with ASD organi-
increase and maximize independence and reduce need zes and combines ideas and steps is impacted by dif-
for correction, b) prevent behavior problems. ficulty multitasking, poor analysis and synthesis skills,
An important characteristic of TEACCH´s philo- and difficulty understanding the relationship bet-
sophy is to consider parents as co-therapists. Educa- ween steps (Mesibov, Shea & Schopler, 2005). Added
ting parents is key to intervention because they know to these differences are the need for more proces-
their child better than anyone, and are positively sing time and the tendency for visual and prompt
motivated to advocate for their well-being. It is also dependence. These benefice from structure helping
the best way to generalize skills. Always remember students understand when, how, what, why they do
to teach the student skills useful for parents. whatever we ask them to do.
The TEACCH educational principles are basically The preceding description is not exhaustive with
(Mesibov, Shea & Schopler, 2005): work from the stu- respect to Autism characteristics, but provides a pic-
dent´s strengths and interests so that learning can ture of the impact of Autism on communication.
be functional, make careful and ongoing assessment Nonetheless TEACCH has a philosophy of understan-
a priority, help the students understand the meaning ding (by researching) and describing in detail the
of the world without assuming automatic understan- Autism characteristics as a way to identify with
ding, be empathetic, structure the environment, and clients and respond to their needs. Therefore, in order
Rev Logop Fon Audiol 2007, Vol. 27, No. 4, 173-186

consider negative behavior as lack of understanding to effectively serve the communication needs of
or being overwhelmed by the environment rather clients with autism, we must have an understanding
than noncompliance. of their unique communication strengths and weak-
To have a clear view of why Structured Teaching is nesses.
valid for intervention, explanation of characteristics
of Autism that most directly affect communication,
will now take place. Structured Teaching for Communication

To make communication possible, (Belinchón,

Autism Characteristics as Basis of Structured Rivière & Igoa, 1992) in terms of a functional con-
Teaching versation, two basic structures are necessary (apart
from the anatomical and physiological structures):
Differences in thinking and learning will be spe- first to have basic psychological processes functio-
cifically addressed (Mesibov, Shea & Schopler, 2005). ning correctly, which include attention and
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 GÁNDARA ROSSI IMPLEMENTING TEACCH EDUCATIONAL INTERVENTION PRINCIPLES AND COMMUNICATION STRATEGIES FOR PERSONS
WITH AUTISM

memory for the pragmatic and communicative Assessment as a Key to Intervention

competence, and perception and expression by ges-
tures for the paralinguistic competence; and Before explaining the components of Structured
second a correct language structure and form. All Teaching, we need to understand the procedures for
of these are impacted in a person that has autism, assessment and development of individualized tea-
and lead to issues that have to be addressed in edu- ching programs that TEACCH has established (Scho-
cational intervention. pler, Leansing, & Waters, 1983). This specific way of
Structured Teaching can help with intervention by assessing is important because a student with autism
adapting the environment in a way that diminishes has certain characteristics that make regular deve-
distracters, and by providing cues and visual remin- lopmental and general achievement evaluation ins-
ders that among other functions address memory truments inadequate for getting a good picture of
problems. The TEACCH program, at the same time the student´s skills, given the big role language and
helps the student use the language he or she has in as perception plays in these regular instruments.
functional a way as possible. It also helps make non- TEACCH structures educational intervention framed
verbal gestures understandable by explaining them, in the following three basic steps:
and helping the student use them to enable learning
and independence. Language´s structure and form is «1. A developmental assessment is made of the
addressed by creating an individualized communica- child´s skills and deficits in various areas of learning
tion system that is functional for the student as well function.
as for the caregivers, and can be generalized to dif- 2. On the basis of this assessment, teaching strate-
ferent settings. gies are determined in order to achieve both short-
In regard to this last issue of generalization, term objectives and long-range teaching goals.
Edward Carr (1985, p.43) refers to research on diffe- 3. These objectives are implemented with indivi-
rent methods for assisting the person with autism to dualized educational programs and specific tea-
use learned skills, in as many settings as possible. The ching activities” (Schopler, Lansing, & Waters, 1983,
Multiple Exemplar Training has been found most p.vii)
effective; the training procedure is to have the stu-
dent learn the same skills with the same methods in Assessment is important in the TEACCH curricu-
different settings, guided by different adults and on lum because of the variability of skills amongst
different tasks. It is then demonstrated that the stu- clients and the difficulty in evaluating degree and
dent will more easily work with new situations not quality of understanding and functionality of speech.
involved in the initial training. «The data reveals sig- Systematic evaluation of different skills in various
nificant success in generalizing language instruction developmental areas is part of assessment and
tasks (Carr, 1982; Frisch & Schumaker, 1974; Lutzker TEACCH grades them by level of performance in three
& Sherman, 1974; Shumaker & Serman, 1970; Ste- levels: pass, emerge, fail; the outcomes are then gea-
vens-Long & Ramussen, 1974), across adults (Carr & red to set educational goals. (Schopler & Mesibov,
Rev Logop Fon Audiol 2007, Vol. 27, No. 4, 173-186

Kologinsky, 1983; Garcia, 1974; Stokes, Baer, & Jack- 1985)

son, 1974) and across settings (Carr & Kologinsky, Research has shown that language acquisition in
1983; Griffiths & Craighead, 1972; Handelman, Autism is asynchronous, and various aspects of lan-
1979)». guage function at different levels and are based on
The TEACCH program achieves generalization by different underlying skills. We also know that a con-
educating parents and professionals on their strate- siderable number of students with autism have diffi-
gies. Communication and consistency across care- culty reporting events and communicate only after
givers and professionals are necessary. This way to prompt. (Watson, 1985, p.190)
educate, of course, is a relatively lengthy process. These difficulties, added to the impact of the limi-
It initially involves one to one training of a skill ted ability to understand nonverbal communication
that has been assessed and is either almost maste- (gestures, expressions, social cues) and to the particu-
red or emerging, in one familiar setting. Training is lar way that a child with autism develops language,
then extended to different settings, adults and make it difficult to judge the right way to start set-
tasks. ting goals.
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 GÁNDARA ROSSI IMPLEMENTING TEACCH EDUCATIONAL INTERVENTION PRINCIPLES AND COMMUNICATION STRATEGIES FOR PERSONS
WITH AUTISM

It is not appropriate to set an objective for edu- (e.g., requesting, commenting, expressing feelings); b)
cational intervention for a child with autism based Contexts or situations in which communication
only on his or her chronological or developmental occurs (e.g., place, people, activities involved); c)
age, skills in children with autism develop in atypical Categories of meaning or semantic categories that
patterns and are scattered. Therefore, assessment student expresses (e.g., talks about objects, actions);
must be careful, ongoing and based on concrete skills d) Specific words that are used; and e) Form that
(Menyuk & Quill, 1985). communication takes, whether it is a nonverbal
A typically developing child´s first words are gene- system of gestures, pictures, etc., or a verbal
rally related to experiential or social personal situa- system…» (Menyuk & Quill, 1985. pp.191)
tions (e.g. bye-bye, dirty), and their language goes
through certain stages from literal «labeling» of Assessment is directly applicable towards inter-
objects and situations to abstract understanding and vention, underlining the importance of teaching one
expression (stages of specificity, overgeneralization, skill at a time, and working on one dimension for
differentiation, generalization, multiple meaning of each goal.
language). However, research has found that a person Following the example described by Menyuk &
with autism’s first words are typically nouns and Quill, if «the teacher wishes to teach a new word, it
inanimate objects (food, colors, numbers), and their should be one that is in the same semantic category
language develops through the stages in an unusual as one the student already knows, can be used for a
way (Menyuk & Quill, 1985). Some people with ASD communicative function the student already expres-
are likely to stay in the specificity stage and most ses, is taught in a form the student already uses, and
have problems with semantics and functional cate- is taught in a context in which the student already
gorization. knows how to communicate». (Menyuk & Quill,1985,
As cited by Menyuk and Quill (1985), a study done p.197)
with the Peabody Picture Vocabulary Test (Water-
house & Fein, 1982) found that when having diffi-
culty retrieving the correct word, while typical chil- Components of Structured Teaching
dren substitute a word or phrase for its function (e.g.
«to bang on the wall» for hammer) or by the gesture Throughout the explanation of the components of
of pretend usage of the object, children with autism Structured Teaching (Mesibov, Shea, & Schopler,
say a related word (pin for nail), proving that these 2005) examples of how a speech therapist can use
clients categorize by perceptual similarities or fixed structure in their private practice will be described, to
routines rather than on functional attributes (Men- make it more familiar and applicable. Reference to
yuk & Quill, 1985). These findings are relevant to sup- some strategies widely used by TEACCH for specific
porting TEACCH´s communication curriculum first issues throughout the description, will help the rea-
goal: to enhance the ability to communicate in der better their understanding of the TEACCH edu-
everyday situations, not necessarily to emphasize cational intervention style. Please keep in mind that
Rev Logop Fon Audiol 2007, Vol. 27, No. 4, 173-186

correct use of language. addressing to these strategies is because of the rele-

When assessing communication, these informa- vance they can have to educational intervention in
tion becomes relevant because, as Autism is a deve- communication, and other issues of no less impor-
lopmental disorder, we look for educational objecti- tance are left out.
ves that are developmentally appropriate to the
specific child, recognizing that he will not follow a 1. Physical Organization.
typical developmental sequence (Menyuk & Quill, This refers to the way you arrange the physical
1985). It is important to work from existing skills, environment, the furniture and materials to make it
rather than create completely new behaviors. In this meaningful. It translates into fixing the setting with
sense, TEACCH does not have a set curriculum; it is clear, physical and visual boundaries to add meaning
individualized for each student. and minimize distractions. It enables the student to
Communication assessment is multidimensional, focus his attention and efforts on the task. A way to
and «TEACCH´s curriculum includes 5 dimensions to achieve this is by putting visual barriers (like placing
observe: a) Functions or purposes of communication the student facing the wall, and putting two pieces
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 GÁNDARA ROSSI IMPLEMENTING TEACCH EDUCATIONAL INTERVENTION PRINCIPLES AND COMMUNICATION STRATEGIES FOR PERSONS
WITH AUTISM

of furniture to block visibility on each side of their

working table) and developing teaching areas (transi-
tion, group, break/play, snack, independent work,
music, art, etc). From the TEACCH approach, all new
skills are taught one to one.
The transition areas are especially widely used in
Structured Teaching for those students who have
problems changing activities, which is a very com-
mon characteristic of Autism. These areas have the
schedule and permit the student to orient to change.
As an illustrative example of physical organiza-
tion, for a professional of speech therapy that works Figura 1 Independent area clearly organized to
with students that have autism (furthermore, stu- minimize distracters with physical
dents with other handicaps can also benefit from structure.
Structured Teaching), it can be recommended to set © 2007 Division TEACCH.
specific areas. For example a place for working one to
one, like a corner of the room where the therapist is
sitting with his back to the wall and the child is sit-
ting across the table facing the therapist. The thera- There are different types of schedules, used accor-
pist should make sure he reduces decoration on the ding to the developmental level a student has (Fern,
walls as much as possible, the windows should have 1999). If the student has marked impairment in cog-
blinders, he can have easy-to-set-up dividers that nitive abstraction, it is advisable to start with using
minimize distracters in the environment as much as objects as visual cues that will be used in an activity
possible and needed by the student. (e.g. a towel for washing hands), or can be put in
Another pointer would be to have the break/play relation with certain activity (e.g. an empty cracker
area separated from the work area, so as to highlight bag to indicate snack time), this is referred to as Pic-
the difference of work VS play, and to use it as a rein- ture Communication/ Exchange System. This system
force and clarifier of what he is to do in different set- was developed by Andrew Bondy and Lori Frost from
tings. Play area should be away from exits where the the Delaware Autistic Program.
child can wander off and should be a visually limited
space.
It is important to consider that the developmen-
tal level of the student with ASD will make it neces-
sary to vary the approach to physical organization.
The areas in which to divide a setting will be diffe-
rent from a child to an adult, the furniture must
Rev Logop Fon Audiol 2007, Vol. 27, No. 4, 173-186

adapt to their needs. The physical structure may be

faded or adjusted as students learn to function
more independently. «Individualization occurs
through the process of reassessment and restructu-
ring» (Faherty, 1998, p.1)

2. Schedules.
A schedule is a visual instruction that tells which
activity will take place and in what order, this
allows the student to know and expect the occu-
rrence of events. It can be comparable to an agenda Figura 2 Schedules in transition area. Note that
of what is going to happen throughout the day. one of the visual cues is marked out as to
help with prevision of a change in the day.
They are usually arranged from left to right and © 2007 Division TEACCH.
from top to bottom.
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 GÁNDARA ROSSI IMPLEMENTING TEACCH EDUCATIONAL INTERVENTION PRINCIPLES AND COMMUNICATION STRATEGIES FOR PERSONS
WITH AUTISM

Through exchanging pictures and obtaining an nal, not necessarily better in form. Within the sche-
object, the child develops symbolic thought. This type dules we must alternate types and degrees of activi-
of approach to communication serves the important ties.
purpose of helping with initiation and interaction, Now, the way to individualize the schedules is to
with least verbal exchange (Fern, 1999). So it takes assess according to each person the type of visual cue
into account the relative visual and concreteness (object, picture, written, combination), the length of
strengths the student with autism has, to enable the schedule (short activity transition schedule, first-
functional communication. then schedule to focus on what they are working
The second type of schedule uses pictures and now to get to the next activity, part day, full day), the
photographs as a transition cue, and holds the way the student gets to his schedule (it can be
advantage of being more «portable» but the student brought to him, we could give him a visual cue to
has to be able to understand the picture as meaning- indicate it was time to get to his schedule or a verbal
ful and representative of certain event. A step higher cue), the way they manipulate it (carry the object
is the written and icon type of schedule, which inclu- from the schedule to the activity area or put it in a
des a list of things with the visual representation of box or paper pocket for this purpose, turn over the
them at the side. And at last the plain written sche- picture, cross off what they are about to do, or when
dule, which is very effective for higher functioning they are done with the activity). The therapist can
persons with autism. personalize it according to the person’s interests (e.g.
The way the student uses it is by removing the Lion King decorations on schedule if that is a specific
relevant object or picture, or marking out the written interest).
words corresponding to the activity they are about to After reviewing the types of schedules it could be
undertake. After this the student matches or puts the recommended for a professional that works with
cue on a finished box in the corresponding activity patients with autism to have some standard, already
area, in the case of the object and picture (Fern, made materials to assess and restructure a tentative
1999). When the student is done, he returns to his schedule for his clients. These added to the set areas
schedule (most of the students have a cue for mentioned earlier in physical organization can make
remembering to check their schedule). a difference in approaching communication issues.
The students can eventually go on a higher abs- Needless to say, and according to research (Scho-
traction level if they are ready, but remember that pler, Brehm, Kinsbourne, & Reichler, 1971), students
the target is for the communication to be functio- with ASD respond better to a most structured class,
than to permissiveness. So a way to be ready to have
your private practice to work with a lower functio-
ning child with autism would be to have basic objects
that respond to activities that would take place in a
session. The visual object cues could be organized in a
plastic pocket shoe holder or tagged with Velcro (e.g.
a cup for snack, a car for play, a block for one to one
Rev Logop Fon Audiol 2007, Vol. 27, No. 4, 173-186

teaching, a card for independent work). Or have the

same cues in pictures organized in a determined
sequence, or just a simple piece of paper with a list
for higher functioning students with autism.
A great possibility schedules hold is to educate on
flexibility and coping with change. You can introduce
systematically a cue for a change in the schedule
every day, and explain it to the student so that he
Figura 3 Leisure area separated from work area learns that things can vary, be comfortable with it
by physical structure, to help the and gather ways to cope with difficult situations
student know what is expected of him in
each place. without being overwhelmed. A way to introduce
© 2007 Division TEACCH. these changes is to have, for object schedules, an
additional pocket where we introduce something dif-
180 32
 GÁNDARA ROSSI IMPLEMENTING TEACCH EDUCATIONAL INTERVENTION PRINCIPLES AND COMMUNICATION STRATEGIES FOR PERSONS
WITH AUTISM

A B C

Figura 4 Schedules. 4.a) Part day object schedule stating that fist they will eat, then they will work and last they will
play. 4.b) Part day picture and written schedule. 4.c) Whole day symbol schedule.
© 2007 Division TEACCH.

ferent every day. For picture schedules we could put student that controls what is going on in his environ-
an additional piece of Velcro beside the one that ment. Other strategies used to help communication
holds the activities for the day, and put something and deal with behaviors are taking frequent breaks
different instead of the regular activity. And for writ- from what is hard for the student, physical exercise,
ten schedules we can color code differently the acti- reducing sensory stimulation, and encouraging com-
vity that will change every day, and write aside what munication.
we will work on instead. We have to train the student Only as a brief citation, and to give the reader a
to recognize these markers. better idea of the TEACCH way of intervention, men-
Schedules are great communication tools and tion will be made of some standard strategies used
help the student organize and be aware of what is in behavior management and to explain difficult sce-
Rev Logop Fon Audiol 2007, Vol. 27, No. 4, 173-186

going to happen. An also important outcome of edu- narios or situations for the student with ASD to
cating people with ASD to use schedules, is that they understand: apart from the prevention, it is impor-
develop necessary skills to function in adult life, like tant to remember during behavior not to use exces-
following instructions as independently as possible, sive language and reduce the risk of injury; after the
and work in an orderly manner (Schopler, Mesibov & behavior, communicate verbally and visually to edu-
Hearsey, 1995). Schedules also make up for the pro- cate on coping skills and understanding the core of
blems of impaired memory, organization and time the behavior. The Emotion Meter and the Decision
usage, difficulties with receptive language, increase Zone are strategies used with higher functioning stu-
self motivation towards working routines, and pre- dents, as well as Carol Grays´ Comic Strips and Social
vent the therapist or caregiver to have to repeat steps Stories, or Kari Buron Dunn´s Incredible 5-Point Scale
of procedures over and over. which explain situations through drawings or written
Schedules are a component of the way TEACCH word. In the case of the Emotion Meter and the
approaches behavior management, aiding to prevent Incredible 5-point Scale we educate on what the
behaviors, by decreasing the level of anxiety in the emotional/ physical manifestations are and how to
33 181
 GÁNDARA ROSSI IMPLEMENTING TEACCH EDUCATIONAL INTERVENTION PRINCIPLES AND COMMUNICATION STRATEGIES FOR PERSONS
WITH AUTISM

recognize the edge to a meltdown (e.g. first I feel Mike´s cue for independent work is a block that he
anxious and my throat feels funny, then I get really puts in a can on the bookshelf beside the indepen-
hot and my chest feels so pressured, and then I start dent work table. On the table Mike finds his work
screaming to block everything out) and teach them system, it is a row of five (tells Mike how much
to relax (Faherty, 2000). work he has to do) big colored Lagos on top of
which he will gradually fit a block the same color
3. Work systems. placed in front of each basket containing an acti-
Work systems are intended to give the student a vity (tells what material to use for the independent
strategy to complete the work that needs to be done work), as he goes along making them. These baskets
independently. When constructing a work system you are placed in a bookshelf beside the table. Mike
have to clarify to the student: how much work he grabs a Lego in front of a basket, matches it on the
needs to do, what work, when he will be finished and table, makes the sorting activity, and puts it in a
what happens after that (Mesibov, Shea & Schopler, finished basket to the right of the table (tells him
2005). when he is done, because there are no more activi-
At times people confuse schedule with work ties on the book shelf).
system, the first tells the student what general activi- On a therapist office you can have a similar set-
ties he is going to do throughout the day and in what ting for teaching a desired independent skill (e.g.
sequence, the work system tells the student what he matching letters). As you can see, structure and
is going to do when he gets to each activity or work physical organization speaks for itself, and helps to
area. make communication processes easier for both par-
To individualize a work system the therapist can ties.
use different visual cues (moving tasks to a finished Work Systems are very useful for teaching inde-
box, matching the cue from the task to the work pendence in self care skills, like brushing teeth, was-
system, or by a list of written steps or activities), the hing plates, doing laundry, etc.
organization can also vary (the work system can be
set from top to bottom or from left to right). We also 4. Task organization
have to make it clear and teach the student how to Physical structure and organization is very impor-
manipulate the work system (e.g. the student can tant to take advantage of the visual strengths and
place a task or card in a finish place, or mark off from teach students to look for visual relevant information
a written list the activities he is working on). An in the task.
important thing to keep in mind is to include a tran- Tasks must be visually organized, management
sition cue that responds to a personal motivation or of space and containers are used to focus atten-
interest for bringing him back after he is done with tion and limit the materials. To make the informa-
independent work, to the schedule and indicating to tion clear we can use labeling, color coding, high-
the student what happens next. lighting, and limit the quantity of materials laid
out. Additionally, visual instructions give the stu-
dent cues to putting together separate parts of the
Rev Logop Fon Audiol 2007, Vol. 27, No. 4, 173-186

(Insert image 5)
To illustrate what has been described in a very task in a determined sequence. A way to achieve
simple example, we could say that Mike, a low this is having picture or written instructions, or a
functioning 12 year-old with ASD could have an sample of the product.
object schedule in which the therapist gave him a TEACCH is known for some of the educational
car (his personal restricted interest) as a cue to intervention materials used: the shoe box tasks and
check his schedule. The schedule is only part day; the folder tasks are big for working on developing a
cues are organized on a standing piece of carton wide variety of independent working skills (for more
(to help catch the eye) from top to bottom and are: information on tasks see Task Galore: Eckenrode,
one to one work, play time, bathroom, independent Fennell & Hearsey, 2005). The key to success on these
work and snack, bathroom, structured play, lunch. tasks is precisely organization as a way of communi-
The cues are objects tagged with Velcro to the car- cating what is expected from the student.
ton; they are put in a basket on the right of the Task organization also achieves attention focus by
schedule after checking the schedule each time. highlighting the relevant parts of the task and their
182 34
 GÁNDARA ROSSI IMPLEMENTING TEACCH EDUCATIONAL INTERVENTION PRINCIPLES AND COMMUNICATION STRATEGIES FOR PERSONS
WITH AUTISM

and bring it to the interlocutor who immediately res-

ponds accordingly to the request.
The first step towards communication is asses-
sing at what level of communication the student
might be, and choosing the way he is going to
communicate: by objects, pictures or signs. The use
of these is not arbitrary, the pictures might be dif-
ficult to handle because of fine motor difficulties,
or might not be of interest to the student; sign lan-
guage is not very frequently used by students with
ASD because of the problems of imitation motor
Figura 5 Independent work area with a matching-
planning, but it can make a difference if the stu-
Legos work system. The student takes dent can manage a couple of signs to get his needs
the matching Lego and puts it on the met (Fern, 1999).
corresponding one on the table, does the In assessing language(Mesibov, Shea, & Schopler,
activity, puts it in the finished box and 2005), very basic markers are to work out how or
goes on to the next. The work, its
quantity, order and what is expected what system the child can use to communicate inde-
from the student is clearly stated by the pendently (type of visual cue that is adequate for
visual structure. him), where the child needs to communicate (set-
© 2007 Division TEACCH. tings), what the child wants to communicate
(request, refusal, getting attention, commenting,
giving information, seeking information, expressing
feelings, social routines).
relationship, avoids error or multiple trials because of Subsequently you have to teach him to direct his
clarity of task, and limits the information given by requests to someone that can help him. Making com-
blocking out the unnecessary, it also reduces sensory municative intents intentional is vital to addressing
distracters (Mesibov, Shea, & Schopler, 2005). communication effectiveness; this can be attained by
Visual task organization is similar to a plan or putting presses, like arranging the environment so
jig, where the steps are clearly stated by the task that the student can not get what he needs on his
layout. own but has to ask for it (Mesibov, Shea, & Schopler,
To make Structured Teaching effective, the stu- 2005).
dent has to manage certain routines, so as to work in Once the relation between object/picture/sign and
a sequence knowing that first he has to do something meaning is made, they can help the student unders-
and only after that, he will get to the next activity. He tand the choices he has, what is going to happen,
has to know how to check his schedule and what he the past and the future, his feelings and other´s fee-
will achieve with that, he also needs to know how to lings, how to do things independently, how to act in
follow his work system, and how to work activities
Rev Logop Fon Audiol 2007, Vol. 27, No. 4, 173-186

difficult situations (Fern, 1999). Once the child has

form left to right and from top to bottom (Schopler, learned the meaning of several visual helpers, we can
Mesibov, & Hearsey,1995). make a Choice Board (which has visual cues only
around one area of choice, e.g. games or food), from
where he can choose what he wants to transmit or
Communication Systems request. Be sure to have on the Choice Board only the
items that are available.
A communication system consists of visual cues The therapist has to be aware of going slowly and
from which the child with ASD chooses. By learning reassessing. He should try to involve as many caregi-
to handle the cues he will communicate his needs, vers and settings as possible in the utilization of the
wants and thoughts. The student will have access to Communication System that has shown to be effec-
all the cues in an organized manner in the Communi- tive with that particular child. He also has to make
cation Board (Fern, 1999). Here he will find the visual sure it is motivating, visual, meaningful and part of a
cue that represents the activity or object he wants, routine (Fern, 1999).
35 183
 GÁNDARA ROSSI IMPLEMENTING TEACCH EDUCATIONAL INTERVENTION PRINCIPLES AND COMMUNICATION STRATEGIES FOR PERSONS
WITH AUTISM

dence and acquisition of functional skills for unders-

tanding and living in the world.
The development of a functional communication
system is high priority in the TEACCH curriculum,
mainly because it leads into a better understanding
of the world from the standpoint of the person with
ASD, reduces anxiety, helps control the environment,
and enables learning and fulfillment of the person.

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