Teaching Students Who Are Low-Functioning: Who Are They and What Should We Teach?
Contributed by Dr. Cathy Pratt & Rozella Stewart
During recent years, interest in individuals with autism who are high- functioning has grown as increasing numbers of students who fit that description have been identified. During the same period, those who advocate on behalf of students with severe cognitive disabilities have continued their search for information on teaching, working, and living with individuals perceived as belonging to this more challenging group. Before discussing programming issues, it seems important to first attempt to clarify who these individuals are who are referred to as low-functioning.
The most common tool for identifying this population of students are standardized test scores. It is commonly believed that 70% of students with autism also have cognitive disabilities. However, we need to be careful when using formal instruments to determine levels of cognitive functioning. During the past several years, professionals and family members have become keenly aware that traditional methods for measuring true intelligence, such as standardized tests, are often flawed in ways that can reap highly unreliable results. Although information gained through the process of testing can provide us with valuable information about how a person learns and about areas of difficulty, standardized tests are virtually never a true predictor of future success. Many adults who were considered severely disabled as students, are now able to secure jobs, live in a variety of home environments, and are able to become members of their community when appropriate supports are in place and when taught necessary skills. Labeling a person as low functioning may in effect serve to limit the person's potential by limiting our vision for that person.
Clearly, students with autism who have severe cognitive limitations can be challenging to educators. However, as professionals and family members review the literature on autism, beware of the dichotomy between low- and high- functioning. These two groups often are referred to as if they are two discrete and separate categories of individuals. Realize that there are individuals with autism who may be gifted in certain areas but who are extremely challenged in others. Conversely, students with the label of severe disabilities can possess exceptional talents. In other words, students labeled as high-functioning may be severely disabled by their autism. And those who are labeled as low- functioning may be less affected by the characteristics associated with autism.
Generally, those who are labeled as having a severe cognitive impairment are individuals who have greater difficulty with social skills, and academic performance. They often have few readily recognized and/or socially appropriate means for communicating with others. It should not be surprising then, that these individuals may more readily exhibit challenging behaviors, such as self-injury and aggression. This may be because they simply have not learned a better way to act or to cope with the demands of daily stressors, or may have no better means for communicating with others. These individuals may also engage in more sensory-related activities such as hand flapping, spinning, or rocking.
When designing educational programs for students with autism labeled as severely disabled, professionals and family members are cautioned to remember that programs for specific students are to be individually determined through the individualized education program (IEP) process. There is no IEP for people who are low-functioning versus people who are high-functioning. There are only IEPs for each student. Individualized programs must describe strategies for providing the student with acceptable and understandable ways of communication, teaching situation-appropriate social behaviors, and providing experiences that satisfy sensory needs by promoting desensitization or reducing sensory overload in specific settings and situations.
If a student has greater difficulty learning, it seems that the valuable school years should be spent teaching him/her to participate in important or functional activities. A functional curriculum is comprised of activities the person will need in order to live, work, and recreate in his/her community. Activities such as balancing a check book, recreating at the neighborhood YMCA, eating at a restaurant, maintaining a job, and shopping are targeted. Note that the program a student is engaged in is not a categorical decision. The mandate for an individualized education program is misapplied when one set of goals or a category-driven placement is adopted for all students with a given disability or a perceived level of functioning. Typically, when such practices prevail, the IEP neither guides instruction nor results in acquisition of life skills that are relevant to the student's present or future. No canned curriculum fits all students with autism; no canned curriculum or label-specific placement fits all students who are perceived as functioning on similar levels. It is a simple truth that not all students who have more severe cognitive limitations will choose the same path in adulthood. What students learn in school should reflect this diversity of preferences.
By definition, individuals across the autism spectrum have a restricted repertoire of skills. For those who have difficulty learning, this repertoire may seem further restricted. A good place to begin the discussion about what to teach a student, is to work with the family and the individual him/herself to identify daily life activities in which the individual will be expected to engage. For example, the family and student may desire participation in grocery shopping. The job of the instructional team is to identify all the skills the student will need for grocery shopping. Possible options include:
- Cutting Coupons
- Making a Grocery List
- Identifying Food Labels
- Pushing the Cart Appropriately
- Saying Hello to Friends or Acquaintances
- Initiating a Request for Help in Locating an Item
- Ordering Food from the Deli Counter
- Matching Coupons to Selected Food Items
- Paying for Groceries
As a classroom teacher, the challenge is to teach community life skills in the context of the school setting. An elementary or middle school teacher, could write the following goals to ensure that students with severe disabilities learn these skills in the general education setting:
- During lunch time in the school cafeteria, Susie will request two specific food items using a communication board during 4 out of 5 days.
- During art class, Jimmy will cut coupons from the local newspaper for 15 minutes once a week.
- During math class, Jill will identify the amount needed for 10 specific food items using the next dollar strategy with 90% accuracy.
- During break time, Mark will greet two classmates in the hallway each week by pointing to Hello, how are you? on his communication board.
- Scott will trace 5 words which represent grocery items twice weekly during writing class.
When the student reaches high school, instruction should increasingly occur in real world settings. If grocery shopping is the desired activity, then the student should learn in a grocery store. Teaching students to shop for groceries in a mock classroom grocery store rarely prepares them for shopping in a real grocery store. Students with autism tend to learn cues which occur in specific context. They cannot easily generalize learned skills across significantly different settings. Students also may become dependent on adult coaches whom they come to perceive as part of the learned tasks, on sequences of events which characterize mock situations, and on other factors that frustrate their efforts to generalize skills from contrived to real-life circumstances. Recruiting peers who can model appropriate behaviors and coach individuals with autism in learning skills appropriate to natural settings is often useful in reducing dependancy and in fostering self-initiation, self-confidence and greater flexibility as new challenges are met.
For students who may have greater difficulty learning, the following suggestions may be helpful to consider:
- Train staff! In addition to workshops, conferences or other training events, there is a wealth of information on autism. Information about what and how to teach students who are severely disabled is also useful. Books written by those who have autism can provide valuable insight into those who have greater difficulty communicating.
- Work closely with parents so that skills practiced in the school setting can be practiced in the community with family members.
- Use a team approach to make sure that the communication and sensory needs of these students are being addressed in ways that are natural to environments frequented by the student.
- Take time to teach each skill. Students may need repeated opportunities to learn and to practice a skill. Even when a skill seems mastered, students need to practice from time to time. It is also important that significantly more emphasis is placed on what a student is to do, rather than on what he/she is not to do. Accentuate the positive; remember that success begets success. A focus on failure reaps futility and future avoidance.
- Identify the type of supports individuals will need, and do not remove supports when a task is mastered. If a student needs visual cues to learn a task, he/she may always need visual cues associated with the task. If the students need a visual sequence board for the activity, do not take it away once the activity is mastered.
- It may be difficult to engage students for prolonged periods of time. Be prepared to shift activities, and to provide both easy and difficult tasks so that the student will be challenged while experiencing success. A typical day should include significantly more opportunities to perform easy tasks which promote security, than to engage in new and challenging tasks.
- Provide students with clear information about the beginning and ending times of an activity, and about the expectations of the task. Avoid taking apart and/or redoing a task that the student perceives as finished. If additional practice is needed, intersperse it throughout the day rather than requiring sequential trial repetitions.
- Embed communication into all aspects of the school day. Make sure students who are nonverbal have augmentative communication systems that are readily available throughout the day. Communication devices must also contain relevant messages for students. For example, the picture for toilet is probably not as motivating as a picture that depicts a student's need for time alone.
- If a student is engaging in difficult behavior, conduct a thorough assessment to determine why the behavior is occurring. Utilize positive behavior support approaches which focus on teaching students alternative ways of responding to difficult situations.
- Take time to teach essential skills in places and at times when skills are needed. For example, take time to teach students to put their coats on when it is time to go outside. Have them learn to take out and put away during natural activity sequences. Avoid the tendency to do essential life tasks for students while rushing to get to less essential tasks. Generally, avoid doing for the student what he/she can be taught to do for him/herself.
All students can learn. As educators and as family members, it is our job to ensure that an environment conducive to learning is provided and that student's valuable time is used wisely. This is true regardless of the functioning level of the student.
Pratt, C. & Stuart, R. (1997). Teaching students who are low functioning: Who are they and what should we teach. The Reporter, 2(3), 6-9.