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Team Approach

The TEAM Center: Graduate student Nadia Mishaddin works with 5-year-old Cambria Johnston, who has autism. Cambria is part of UTSA’s first class of students participating in the Teacher Education Autism Model Center. Photos by Mark McClendon

A TEAM Approach

Student teachers and children with autism both benefit from a new center

Sarah Johnston’s household can sometimes feel like a war zone. Her 5-year-old daughter, Cambria, just happens to want everything that her 3-year-old sister, Ainsley, wants. So they fight, but Johnston says these aren’t just any fights.

They are more like knock-down, drag-out battles.

Cambria, who will start kindergarten next year, has autism. "She gets really physical," said her mother. "I think right now they are similar in developmental age. For a while there, Ainsley was just like, ‘whatever.’ Then she decided to fight back over a year ago. And it’s like a war."

Cambria already had a host of therapists to assist her, from speech to feeding therapy. Then social workers suggested that Cambria could also benefit from applied behavior analysis (ABA), which aims to modify negative behaviors by assessing the environmental causes for the behaviors and teaching alternative positive responses.

ABA, which is often used to teach children with autism, is not always covered by insurance, and with recommended treatment time of 20 to 25 hours per week at a typical cost of $50 an hour, it would have been too expensive, Johnston said.

So when she heard about a pilot program at UTSA that pairs graduate students working on certification in ABA with children with autism from the San Antonio area, she quickly signed up. Cambria is now part of UTSA’s first class of students at the Teacher Education Autism Model (TEAM) Center, which opened in January in the basement of the Durango Building at the Downtown Campus. The center works with four children aged five and younger. For one semester, each child receives six hours of therapy a week.

Designed to work like a teaching hospital, the center provides low-cost services while allowing graduate students the opportunity to hone their skills. It also serves as a research lab for determining effective teaching practices.

"It’s been a blessing," Johnston said. "Cambria loves it here."

"The idea is just to make it a playful place."

–Lee Mason, assistant professor of special education

The TEAM Center is one large room with individual work stations set up around the edge, tables for groups of students in the middle and lots of places for children to play. There’s a small trampoline and a slide, but the most-loved item in the room is a wooden jungle gym that features a swinging sack that the children can use to spin and swing.

On one wall is a one-way mirror that allows parents and students to observe the sessions.

"The idea is just to make it a playful place where students can come in and hopefully be motivated by a variety of stimuli for engaging in whatever activities we’re focusing on for those students," said Lee Mason, assistant professor of special education.

Graduate student therapists work with the children on play or social skills and verbal communication. They praise correct responses and ignore inappropriate ones. The children are frequently rewarded with playtime, which is interspersed with lessons. And through it all, the therapists are documenting what the child is doing, how many opportunities were given for the child to complete a task, how much assistance the child needed and how many times the child completed the task.

"The more things we have for [the children] to talk about and engage in, the better off we’ll be in building communication skills and at the same time reducing problem behavior," Mason said.

Team Approach

Autism can affect one in 50 American children, according to the Centers for Disease Control and Prevention. While children with autism can range from low- to high-functioning, most display communication and social skills deficits, and restricted and repeated interests. As many as 25 percent never learn to talk but instead communicate through problem behavior.

"When a child throws a tantrum or engages in self-injury, what are they trying to tell us? A lot of time it is to gain access to a preferred item or to get attention from a parent or teacher," Mason said. "A lot of time it is just to escape demanding situations where we’re asking them to perform a lot of different activities. We often provoke problem behaviors that way."

The goal is to evaluate those behaviors, identify what function they might serve for the child, and then teach a more socially acceptable behavior. It’s not easy work, he added.

In her first week at the center, Emelin Laynez, a graduate student in special education, worked with a 5-year-old boy who frequently threw temper tantrums that included spitting and hitting. Laynez realized the boy was trying to avoid having to complete an assigned task. So she ignored the behavior and continued prompting him to complete more tasks.

"To intervene in this behavior wasn’t easy," Mason said. "Every time he slapped Emelin in the face or spit at her, she had to pretend like it didn’t happen."

But the tactic worked. The next session, the boy did what he was asked. Laynez said the experience reinforced why the TEAM Center is an important place for her to be.

"We weren’t sure how it would be when he came back for the next session, but when he did, he was just like a completely different person," she said. "He did the tasks as we asked him to. It blew my mind. There is a lot for me to learn."

Often, graduate students have studied special education but haven’t applied their skills in a classroom. Working at the center is a crash course that quickly bridges the theoretical to the real with hands-on experience. When a child gets accepted into the program, the staff knows his or her name and age, but nothing more.

"We don’t know the level of severity they are coming in with. We don’t know communication skills or whether they are physically aggressive or engage in self-injury. We don’t even know if they are toilet trained," Mason said. "So students have to be really prepared for almost anything in terms of who they are going to be working with."

But by the time the semester is over, the graduate students will have gained experience working in real-world situations, which will help them toward certification in applied behavior analysis. And the children also will benefit, Mason said.

"We have 15 weeks to work with families and their children," he said. "We will see progress."

Two weeks into her therapy, Cambria is doing well. But her mom said there is more work to do.

"I want her to improve how she acts and behaves and the amount of tantrums she throws," Johnston said, adding that she wants Cambria’s therapist to provoke her daughter’s bad behavior. "I told them to go for it. That’s why we’re here."

–Lety Laurel

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