The TEACCH method is one of the few therapies recommended by the Haute Autorité de Santé to support people with autism. What are the foundations of this cognitive-behavioral method? What are the differences with the ABA method? What results can we expect? We take stock with the certified therapist Marguy Majeres.
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| Autism: What is the TEACCH method |
The origins of the TEACCH method
Still little known in France, the TEACCH method was created in North Carolina (USA) by the psychiatrist Eric Schopler. From the end of the 1960s , he decided to move away from the psychoanalytic approach which considered that autism was above all an emotional disorder caused by a lack of the bond of attachment between mother and child. .
"He took the opposite course by including the parents as co-therapists. In 1972, the research program stopped but Eric Schopler was able to continue thanks to the donations of parents who were convinced of the benefit of the method ", explains Marguy Majeres. Today, anyone with autism can use the program for free in North Carolina.
What is TEACCH? | What is Structured teaching?
The foundations of the TEACCH method
- Target emerging skills
The first pillar of the method consists in setting very individualized goals according to the level of development of the individual. “We're going to focus on emerging skills, those that are being learned, with a little help, rather than focusing on failures,” says the specialist. For this, a very precise assessment is carried out from the start of the support.
- Work with family, school or business
The second pillar is based on a partnership with the family, but also the school or even the company, aiming to adapt the environment according to the profile of the person. This structuring will be based on the culture of autism, that is to say that we will take into account cognitive and sensory peculiarities such as hyperacusis by offering a sound environment that is as calm as possible, for example.
People with autism are often very visual, and can lose their focus if something bother them, such as a scratch on a table. So we will try to strip as much as possible of the space by removing possible distractors in order to help the person concentrate on the task at hand, "she illustrates.
- Structure time, space and activities
This structuring will concern both space, but also time and activity itself. Depending on the degree of autism, the structuring will be more or less important. For example, for some, pictograms will be used to describe the sequence of actions of the day.
This schedule will always be left in the same place so that the person can use it as soon as they change activities. "People with autism have difficulties during transitions, such as changing location. They like repetition, routine, which is why we introduce these elements that will provide benchmarks," explains Marguy Majeres. But this schedule can also take the simple form of reminders via a connected watch in the case, for example, of a student suffering from a mild autistic disorder and who would have difficulty getting organized.
The activity itself can also be structured, such as sorting blue or red objects into blue or red cubes, which will help the person access the concept.
- Trace the origin of "challenge" behaviors
Another important point in the TEACCH method is the concept of the iceberg. It helps to manage what we call "challenging behaviors", those moments of crisis where a child with autism will for example start hitting everything around him because he will not be able to manage a frustration or an unpleasant feeling. .
"TEACCH focuses on understanding the behavior we see (tip of the iceberg), drawing on both the culture of autism and what we know about the individual peculiarities of the child in question ( (submerged part of the iceberg) The intervention will be pro-active: what did he not understand in the activity? What sensory stimulus invaded him? How to make things understandable for him? What should I teach this child so that he can show it to me differently? ", Illustrates the therapist.
What similarities and differences with the ABA method?
The ABA method, also recommended by the HAS, is also increasingly structuring the environment of people with autism. These two methods tend to strengthen skills and stress the importance of generalizing them (using them in different contexts, note). However, the major difference is found in the lesser use of reinforcers (kinds of rewards, editor's note) which are widely used in the ABA method to encourage the person to do the task requested. "TEACCH rather tries to make the activity understandable and motivating so that the person does it alone," says Marguy Majeres.
Another point of divergence according to the specialist: the ABA method would focus more on a search for normalization, for example by trying to support the person so that they no longer need their visual schedule to function. "For TEACCH, if this structuring allows the person to be autonomous in their daily life, we are not going to take away this support", continues the specialist.
It should also be noted that the TEACCH method is not exclusive. It can very well be used in addition to the ABA, PECS or Makaton method. "It may even happen that we dig into these different methods, always with the objective of improving the understanding and autonomy of the individual," says our interlocutor.
A method that concerns all degrees of the autism spectrum
Autistic Spectrum Disorders bring together people with a wide variety of profiles, with or without associated intellectual disabilities, verbal or non-verbal, and who will have more or less difficulty integrating into society. For its part, the method can be suitable for any type of autism. It can start very early and accompany the person until the end of their life.
For some verbal and non-deficit people, this might mean learning to manage interactions with others, stress, and emotions. Often, the TEACCH method is reduced to the structuring of the environment, but it's not just that: the structuring is designed to allow the learning of new skills ", insists the specialist.
Originally, the TEACCH method was created for people with autism, but it works for anyone with communication disorders, comprehension difficulties, attention difficulties or sensory peculiarities.
Between 20 and 25 hours of follow-up per week
An intervention of 20 to 25 hours per week would allow the child to develop his learning via the TEACCH method. But since the therapy involves everyone around the subject, it can be not only a therapist but also a parent or a schoolteacher. In addition, therapy aims for the person to be able to train independently over time.
TEACCH: What results can we expect?
A large-scale investigation is underway in the United States to analyze the trajectory of a cohort of accompanied adults since the 1980s. In the meantime, as with other TBIs, it is difficult to give any results. We know that for some subjects, especially if they are accompanied very early (ideally from 2 years old), the results can be very encouraging. It also depends on the degree of autism. In all cases, progress can be observed.
The TEACCH method aims first and foremost to empower people, whether in their daily life or at work. For some, a job in a company will be possible while for others it will be an ESAT job. The second big goal is for the person to be able to communicate in the most effective way possible, whether verbal or using the visual tool. And of course, to make her feel happy in her life.
What support ?
The method can be supported by the MDPH if the professional who practices TEACCH evolves in the paramedical world such as an occupational therapist, psychologist, neuropsychologist, psychomotor therapist ... Each file is studied on a case-by-case basis and the care expenses can be compensated by The AEEH (Disabled Child Education Allowance) or AAH (Disabled Adult Allowance) and its supplements at different levels depending on the person's degree of disability.