"He who saves a single life, it is as though he has saved the entire world."- Talmud
A Unique Program
By Dr. Nancy A. Shamow
Ann Landers once wrote that life is what happens to you when you are busy planning everything else. As I sit in my office in ASCENT's new State of the Art facility which opened on September 9, 2002 in Deer Park, NY, I can't help but recall 1998. I was approached by an attorney representing a small group of parents who were desperate to find appropriate education for their children diagnosed with autism. Meeting with the group, I came across familiar faces--attendees of an Outreach Program I provided as Principal of the Nassau Suffolk Services for Autism's Martin C. Barell School, a program I designed and helped start in 1993. My voluntary efforts at the Outreach Program stemmed from a responsibility to promote ABA (Applied Behavioral Analysis), a methodology I strongly believe is the only research validated treatment for autism. I was now sitting across from ASCENT's families who were frustrated by their children's failure, and disappointed with the absence of available openings in schools that provide effective treatment. They were parents, like so many others, who once dreamed of a bright and happy future for their children and who now watched in anguish as their children retreated into a world of silence. Some mortgaged their homes or sold their engagement rings to start a school that would replicate NSSA'a program. I decided to accept the challenge of starting a new school.
ASCENT's program began for a small group of preschoolers and one school age child in May of 1998 as a cooperative in the home of a parent. A small corner of the basement served as my office, where I developed IEPs, curriculum, and progress reports and continued my work in support of our application to the State Education Department to start ASCENT's school. While we convinced the Nassau County Department of Mental Health, Mental Retardation and Developmental Disabilities to approve and fund home based services for the preschoolers, no funding was available for school age children. These home schooled children excelled while the school age children who remained in their existing programs saw little or no gains. Facing an unresponsive State Education Department, ASCENT reached out to volunteers with respected expertise in their fields to develop a professional Board of Trustees. Never before touched by autism, these respected Board members continue to provide esteemed governance. With community support and under the direction of the Board of Trustees, ASCENT obtained a Charter from the New York State Board of Regents in 1999. Slowly allowing for more children to join ASCENT, we hired teachers, and filled the house while parents spent considerable time searching for an empty facility. ASCENT moved to its Glen Head location in July, 1999.
The program was independently evaluated during the 2000-2001 school year by Dr. Jan Handleman, Director of the Douglass Developmental Disabilities Center of Rutgers University. His report described ASCENT as a "model program for the education of children with autism" which provides a "…nurturing environment where sensitivity is given for the delicate relationship between the Board, the staff, the children, the families and the community." Soon after Dr. Handleman's evaluation, ASCENT learned that we would have to vacate our Glen Head premises. As compelling as the founding story is, the intricacies involved and inspirations derived from designing our new facility in Deer Park has expanded our vision.
It is my dream and passion and that of ASCENT's parents, its governing Board and its staff and volunteers that drives us to become a model program for children with autism. ASCENT's highly structured, skill-oriented, instructional program is based upon the research proven principles of applied behavioral analysis. ASCENT provides children with a positive learning environment where the responsibility for effective learning rests with the teacher and not the child. The focus of education is on teaching new skills by providing individualized systematic instruction and predictable routines, objectively measuring outcomes and evaluating progress. The 1:1 instructor to student ratio at ASCENT services the severe learning deficits of children with autism. Discrete trial teaching is only one of several teaching formats used at ASCENT. Compared to traditional classroom instruction, discrete trial teaching provides students with multiple opportunities to practice skills. Skills taught in these learning environments are then generalized to a variety of more natural settings. Incidental teaching is used to expand and foster spontaneous language. Language promoted in this context is more likely to be reinforced and maintained.
While autism is characterized by learning deficits in many areas, speech and language deficits are often the most salient. Teaching speech requires the development of prerequisite motor imitation skills. At ASCENT, children learn to imitate gross and fine motor movements as well as oral motor movements of the lips, mouth, jaw and tongue. More advanced verbal imitation skills (e.g., sounds, blends, words, phrases and sentences) and language (naming and describing objects, labeling actions, giving directions, asking and answering questions, and using full contextually appropriate sentences) is then taught. Practice in controlling breathing may be given to increase volume, elongate sounds and facilitate blending of consonants and vowels to form words.
While speech and language development is a major focus of ASCENT's education program, participation in family life is also emphasized. Engagement in productive and socially meaningful behavior is promoted by teaching skills that include the child in family activities (e.g., table setting, snack preparation and trips to the grocery store). Teaching independent skills to children allows opportunities to practice and maintain more appropriate repertoires of behavior without adult supervision. Independent engagement in self-care, work and leisure activities are taught using picture or written activity schedules. Conversational language (e.g., requesting objects, commenting and protesting) is integrated into the context of a child's day using time delay procedures, modeling, verbal prompts or written scripts and video modeling. Parent education is an essential component of ASCENT's program. Teaching sessions are provided at home and at school, where parents can observe and work with their children up to five days per week for 1.5 hours daily. Parent education allows parents to teach new skills and generalize gains made in school to the natural environment. Empowering parents with these skills fosters greater independence for their children.
Children who are ready to begin a transition process attend a transition classroom setting during the portion of time they can be successful. Staff trained in direct observation, data collection and treatment implementation accompany these students to assess their skills in performing independently in this setting. Data are collected during structured academic/preacademic activities during classroom activities and include on-task, appropriate language, deviant behavior and positive interactions with peers. They return to ASCENT's mock Kindergarten classroom for the remainder of the day to acquire skills that allow them to attend the transition setting for progressively longer periods.
As professionals servicing children with disabilities it is important for teachers to design learning environments that support the growth of more appropriate repertoires. The loss of time and reinforcement opportunities spent engaging in nondirected activities for which there is no empirical validity is an extravagance children with autism can ill afford. At ASCENT, parents and teachers address the urgency of children's needs and provide learning environments and opportunities that enhance the development of new skills.