Gary B. Mesibov - Böcker

The state of North Carolina has had a longstanding concern and com­ mitment to the understanding and treatment of autistic, communications­ handicapped children and their families. This commitment found expres­ sion in the only comprehensive statewide program for families confronted with this disability, Division for the Treatment and Education of Autistic and related Communication handicapped CHildren (Division TEACCH). Our program staff has been privileged to respond to this commitment by developing and providing the needed services, and to engage in research informed by our clinical experience. Although many of the problems con­ cerning these developmentally disabled children remain to be solved, substantial progress has been made during this past decade of collabo­ ration among professionals, parents, and their government representa­ tives. The TEACCH staff has resolved to mark the effectiveness of this collaboration by holding a series of annual conferences focused on the several major issues confronting these children and their families. The conferences are held in order to bring together the best research knowl­ edge available to us from throughout the country, and to encourage par­ ticipation by the different professional disciplines and concerned parents. In addition these annual meetings form the basis for a series of books based on the conference theme. These books are, however, not merely the published proceedings of the presented papers: some chapters are expanded from conference presentations and many others were solicited from experts in the related areas of research and their service application.

As the oldest statewide program serving autistic people in the United States, North Carolina's Division TEACCH (Treatment and Education of Autistic and related Communication handicapped CHildren) has had a major impact on ser­ vices for these people and their families. As we move into our second decade, we are frequently questioned about all aspects of our procedures, techniques, and program. Of all the questions that are asked, however, the one that comes up most frequently and seems to set our program apart from others concerns the ways in which we work with families. To help answer this question we identified what we have found to be the major components in our parent-professional relationships, and we elaborate on these with the most current research informa­ tion, clinical insights, and community knowledge available through the expertise of our distinguished contributors. Our purpose was to collect the most recent information and to organize the resulting volume along the outlines of the par­ ent-professional relationship found most important in the TEACCH program. Thus, the four main sections of the book include these four major ways profes­ sionals work with parents: as their advocates, their trainers, their trainees, and their reciprocal emotional support source. To the extent this effort was success­ ful, we acknowledge that it is easier to organize book chapters along these dimensions than it is to provide their implementation in the field.

The North Carolina State Legislature's mandate to Division TEACCH has three major components. First, to provide the most up-to-date and cost­ effective services possible for families with autistic or similar language­ impaired children; second, to conduct research aimed toward the better under­ standing of such devastating disorders; and third, to provide training for the professionals needed to pursue these goals. One element in achieving these aims is to hold annual conferences on topics of special importance to the under­ standing and treatment of autism and similar disorders. In addition to training professionals and parents on the most recent de­ velopments in each conference topic, we are publishing a series, Current Issues in Autism, based on these conferences. These books are not, however, simply the published proceedings of the conference papers. Instead, some chapters are expanded conference presentations, whereas others come from national and in­ ternational experts whose work is beyond the scope of the conference, but es­ sential in our attempt at comprehensive coverage of the conference theme. These volumes are intended to provide the most current knowledge and profes­ sional practice available to us at the time.

An important component of Division TEACCH's mandate from the Department of Psychiatry of the University of North Carolina School of Medicine and the North Carolina State Legislature is to conduct research aimed toward improving the understanding of developmental disabilities such as autism and to train the professionals who will be needed to work with this challenging population. An important mechanism to help meet these goals is our annual conference on topics of special importance for the understanding and treatment of autism and related disorders. As with the preceding books in this series entitled Current Issues in Autism, this most recent volume is based on one of these conferences. The books are not, however, simply published proceedings of conference papers. Instead, cer­ tain conference participants were asked to develop chapters around their pres­ entations, and other national and intemational experts whose work is beyond the scope of the conference but related to the conference theme were asked to contribute manuscripts as weil. These volumes are intended to provide the most current knowledge and professional practice available to us at this time.

As a division of the School of Medicine at the University of North Carolina at ChapeI Hili, TEACCH has always been involved in the latest biological research on autism and related developmental disabilities. However, until now there has not been sufficient information to justify aseparate volume on this most important topic. Recent advances both in our under­ standing of the brain and in the technology to facilitate the measurement of neurological functioning have stimulated significant growth, which is reflected in this volume. As with the preceding books in this series, Current Issues in Autism, this volume is based on one of the annual TEACCH conferences held in ChapeI Hili each May. The books are not simply published proceedings of the conference papers, however. lnstead, conference participants are asked to develop chapters around their presentations, and other international experts whose work is beyond the scope of the conference, but related to the major theme, are asked to contribute as weil. These volumes are intended to provide the most current knowledge and professional practice available to us concerning major issues in autism.

Division TEACCH, located in the School of Medicine at the University of North Carolina at Chapel Hill, was one of the first programs in the country to understand that autism was an organic rather than a biologic condition.

Designed to advance understanding of the unique needs of high-functioning individuals with autism, this volume details the latest diagnostic and treatment approaches and analyzes the current conceptions of the neurological processes involved in autism.

To promote greater understanding, this book discusses assessment techniques, intervention strategies, and the major controversies of the field. It will serve as a practical overview for students, clinicians, and parents concerned with managing the special needs and often puzzling behaviors of autistic individuals.

This volume, like the other eight in the Current Issues in Autism series, grew from our annual TEACCH conference. The book is not, however, simply a compilation of conference proceedings. Instead, selected con­ ference participants whose work has already achieved national and inter­ national recognition were asked to develop chapters around their pre­ sentations. Other recognized experts in areas relevant to the conference theme were also asked to contribute chapters. Although we were not able to include all of the workers who have contributed to the theme, this volume represents our best effort to pull together for our readers the most current knowledge and state of the art practices. Although aspects of cognition, learning, and behavioral motivation have been touched on for relevance to autism in other books in this series, the growing integration of behavioral and cognitive theories has greatly enriched our educational interventions on behalf of autism. While this volume does not include all the fascinating facets of this recent integration, we believe that it offers useful information to teachers, parents, and re­ searchers on some of the progress produced by their interaction.

This highly readable volume presents a concise but comprehensive overview of all that is known about autism, including its history, diagnosis, biological causes, neuropsychological mechanisms, and treatment. the authors offer an up-to-date review of the most current literature, summarized and organized in a manner that makes it accessible to everyone from clinicians to parents.

This volume is designed to provide a comprehensive overview of autism for the many educated and thoughtful parents, professionals, and other concerned citizens with an interest in these important issues. It has grown out of our assumption that there are many people interested in our field who want the most up-to-date information available without having to locate and read through the growing literature in this area. From our university bases, we are fortunate in having access to state-of-the-art information about autism and related develop­ mental disorders. Our goal in this volume is to synthesize this information and present it comprehensively and objectively. This volume is the culmination of 2 years of hard work identifying, organizing, writing, rewriting, and editing the most up-to-date information available about people with autism, their families, and the state-of-the-art about the nature, causes, underlying mechanisms, diagnosis, and treatment of autism. We hope it will help the many friends, colleagues, families, and interested citizens who have expressed their interest in a publication of this kind. v Acknowledgments A project ofthis scope could not have been completed without the help of many fine friends and colleagues, too numerous to name. As with all of our professional activities we are indebted to our TEACCH colleagues and the many families and professionals we know in North Carolina, around the United States, and throughout the world for their interest, support, insights, and generosity in sharing their ideas and observations. We hope that our final product reflects their many superb contributions.

The precise relationship between high-functioning autism and Asperger Syndrome is still a subject of debate. This volume provides a general overview of the disorder and present diverse opinions on diagnosis and assessment, neuropsychological issues, treatment, and related conditions. A special section features personal essays by individuals diagnosed with autism or Asperger Syndrome. The result is a comprehensive and useful survey of the current state of the field that will be of great interest to clinicians, teachers, researchers, and parents.

This volume, the first in the series, explores the high-functioning group of people within the spectrum of autism disorders. It is the culmination of over a decade of clinical work and research, including the most up-to-date information available about this group at the beginning of the 21st century. The book explores: the history of high-functioning autism; diagnosis of the disorder; assessment; and treatment for the individual and their families. The text is written in a style that is accessible to both seasoned clinicians and concerned lay persons.

This volume is designed to provide an overview of Asperger’s Syndrome/High Functioning Autism for professionals, parents, and others concerned about these conditions. It is part of the library series that has been created for the many people interested in the field of autism spectrum disorders who want up-to-date, authoritative infor- tion without having to locate and read through the original sources. Our goal in this series is to review, synthesize, and organize the inf- mation so that it can be presented comprehensively and clearly. This volume is the culmination of over a decade of clinical work identifying, organizing, writing, and editing the most current infor- tion available about this high functioning group of people with autism spectrum disorders from current reputable sources. The book explores the history and emphasizes the diagnosis, assessment, and treatment of these people and their families. We hope that we have done justice to this extensive literature so that it can be of use to these people th- selves as well as to their many friends, colleagues, and families, and to the interested citizens who are seeking more information about this intriguing area of inquiry.

TEACCH (Treatment and Education of Autistic and related Communication-handicapped CHildren) has grown over the past three decades from a small clinic for children to an internationally recognized treatment and support modality for individuals of all ages with autism spectrum disorders. In The TEACCH Approach to Autism Spectrum Disorders, the program’s founders and their colleagues explain its methods and philosophy based on an understanding and respect for "the culture of autism."The TEACCH program focuses on persons with autism and the development of instruction and supports based on each individual’s skills, interests, and needs. It draws from the research literature in psychology and neuropsychology to create activities and environments that are organized to emphasize meaningfulness—an approach that has proved crucial to an autistic individual’s ability to learn, comprehend, and apply learning across situations.The TEACCH Approach to AutismSpectrum Disorders explains how:- TEACCH targets critical areas in executive functioning, engagement, communication, and social skills.- Strategies can be tailored to an individual’s unique developmental and functional level.- Parents become involved in all phases of intervention as collaborators, cotherapists, and advocates.- The program can be introduced and adapted for individuals of all ages, from preschool children to adults.- Professionals can be trained in the program and its methods.This progressive program offers individuals with autism, their families, teachers, and therapists both optimism and useful strategies, without minimizing the condition or its effects. All clinicians working with people with autism will find The TEACCH Approach to Autistic Spectrum Disorders a valuable resource.

The North Carolina State Legislature's mandate to Division TEACCH has three major components. First, to provide the most up-to-date and cost­ effective services possible for families with autistic or similar language­ impaired children; second, to conduct research aimed toward the better under­ standing of such devastating disorders; and third, to provide training for the professionals needed to pursue these goals. One element in achieving these aims is to hold annual conferences on topics of special importance to the under­ standing and treatment of autism and similar disorders. In addition to training professionals and parents on the most recent de­ velopments in each conference topic, we are publishing a series, Current Issues in Autism, based on these conferences. These books are not, however, simply the published proceedings of the conference papers. Instead, some chapters are expanded conference presentations, whereas others come from national and in­ ternational experts whose work is beyond the scope of the conference, but es­ sential in our attempt at comprehensive coverage of the conference theme. These volumes are intended to provide the most current knowledge and profes­ sional practice available to us at the time.

The precise relationship between high-functioning autism and Asperger Syndrome is still a subject of debate. This volume provides a general overview of the disorder and present diverse opinions on diagnosis and assessment, neuropsychological issues, treatment, and related conditions. A special section features personal essays by individuals diagnosed with autism or Asperger Syndrome. The result is a comprehensive and useful survey of the current state of the field that will be of great interest to clinicians, teachers, researchers, and parents.

TEACCH (Treatment and Education of Autistic and related Communication-handicapped CHildren) has grown over the past three decades from a small clinic for children to an internationally recognized treatment and support modality for individuals of all ages with autism spectrum disorders. In The TEACCH Approach to Autism Spectrum Disorders, the program’s founders and their colleagues explain its methods and philosophy based on an understanding and respect for "the culture of autism."The TEACCH program focuses on persons with autism and the development of instruction and supports based on each individual’s skills, interests, and needs. It draws from the research literature in psychology and neuropsychology to create activities and environments that are organized to emphasize meaningfulness—an approach that has proved crucial to an autistic individual’s ability to learn, comprehend, and apply learning across situations.The TEACCH Approach to AutismSpectrum Disorders explains how:- TEACCH targets critical areas in executive functioning, engagement, communication, and social skills.- Strategies can be tailored to an individual’s unique developmental and functional level.- Parents become involved in all phases of intervention as collaborators, cotherapists, and advocates.- The program can be introduced and adapted for individuals of all ages, from preschool children to adults.- Professionals can be trained in the program and its methods.This progressive program offers individuals with autism, their families, teachers, and therapists both optimism and useful strategies, without minimizing the condition or its effects. All clinicians working with people with autism will find The TEACCH Approach to Autistic Spectrum Disorders a valuable resource.

The state of North Carolina has had a longstanding concern and com­ mitment to the understanding and treatment of autistic, communications­ handicapped children and their families. This commitment found expres­ sion in the only comprehensive statewide program for families confronted with this disability, Division for the Treatment and Education of Autistic and related Communication handicapped CHildren (Division TEACCH). Our program staff has been privileged to respond to this commitment by developing and providing the needed services, and to engage in research informed by our clinical experience. Although many of the problems con­ cerning these developmentally disabled children remain to be solved, substantial progress has been made during this past decade of collabo­ ration among professionals, parents, and their government representa­ tives. The TEACCH staff has resolved to mark the effectiveness of this collaboration by holding a series of annual conferences focused on the several major issues confronting these children and their families. The conferences are held in order to bring together the best research knowl­ edge available to us from throughout the country, and to encourage par­ ticipation by the different professional disciplines and concerned parents. In addition these annual meetings form the basis for a series of books based on the conference theme. These books are, however, not merely the published proceedings of the presented papers: some chapters are expanded from conference presentations and many others were solicited from experts in the related areas of research and their service application.

Division TEACCH, a statewide program in North Carolina, serves people with autism and their families through the School of Medicine at the University of North Carolina at Chapel Hill.

Division TEACCH, located in the School of Medicine at the University of North Carolina at Chapel Hill, was one of the first programs in the country to understand that autism was an organic rather than a biologic condition.

This volume, like the other eight in the Current Issues in Autism series, grew from our annual TEACCH conference.

As a division of the School of Medicine at the University of North Carolina at ChapeI Hili, TEACCH has always been involved in the latest biological research on autism and related developmental disabilities. However, until now there has not been sufficient information to justify aseparate volume on this most important topic. Recent advances both in our under­ standing of the brain and in the technology to facilitate the measurement of neurological functioning have stimulated significant growth, which is reflected in this volume. As with the preceding books in this series, Current Issues in Autism, this volume is based on one of the annual TEACCH conferences held in ChapeI Hili each May. The books are not simply published proceedings of the conference papers, however. lnstead, conference participants are asked to develop chapters around their presentations, and other international experts whose work is beyond the scope of the conference, but related to the major theme, are asked to contribute as weil. These volumes are intended to provide the most current knowledge and professional practice available to us concerning major issues in autism.

An important component of Division TEACCH's mandate from the Department of Psychiatry of the University of North Carolina School of Medicine and the North Carolina State Legislature is to conduct research aimed toward improving the understanding of developmental disabilities such as autism and to train the professionals who will be needed to work with this challenging population. An important mechanism to help meet these goals is our annual conference on topics of special importance for the understanding and treatment of autism and related disorders. As with the preceding books in this series entitled Current Issues in Autism, this most recent volume is based on one of these conferences. The books are not, however, simply published proceedings of conference papers. Instead, cer­ tain conference participants were asked to develop chapters around their pres­ entations, and other national and intemational experts whose work is beyond the scope of the conference but related to the conference theme were asked to contribute manuscripts as weil. These volumes are intended to provide the most current knowledge and professional practice available to us at this time.

As the oldest statewide program serving autistic people in the United States, North Carolina's Division TEACCH (Treatment and Education of Autistic and related Communication handicapped CHildren) has had a major impact on ser­ vices for these people and their families. As we move into our second decade, we are frequently questioned about all aspects of our procedures, techniques, and program. Of all the questions that are asked, however, the one that comes up most frequently and seems to set our program apart from others concerns the ways in which we work with families. To help answer this question we identified what we have found to be the major components in our parent-professional relationships, and we elaborate on these with the most current research informa­ tion, clinical insights, and community knowledge available through the expertise of our distinguished contributors. Our purpose was to collect the most recent information and to organize the resulting volume along the outlines of the par­ ent-professional relationship found most important in the TEACCH program. Thus, the four main sections of the book include these four major ways profes­ sionals work with parents: as their advocates, their trainers, their trainees, and their reciprocal emotional support source. To the extent this effort was success­ ful, we acknowledge that it is easier to organize book chapters along these dimensions than it is to provide their implementation in the field.

Designed to advance understanding of the unique needs of high-functioning individuals with autism, this volume details the latest diagnostic and treatment approaches and analyzes the current conceptions of the neurological processes involved in autism.