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Strategies for a separate peace

Judy Mackie visits Linn Moor special school, where a radical American programme splits autistic and non-autistic children into different class and care groups. The TEACCH experiment has already begun to produce some startling results for pupils and their families

It's mid-week in spring term, yet a visitor in the corridors of Linn Moor special school in Aberdeenshire could be forgiven for thinking Easter has come early.

Sunlight streaming through glass ceiling panels peacefully illuminates the building's wide walkways. Outside, only birdsong disturbs the idyllic Deeside setting.

A glimpse through the classroom windows, however, shows school is in, with small groups of children aged five to 18 engrossed in individual tasks, aided by teachers and classroom assistants.

For a residential school whose students have some of the most complex care and educational needs in Scotland, this tranquil environment is nothing short of remarkable. Like any special school, Linn Moor, which is administered by Voluntary Service Aberdeen, has had its fair share of aggressive outbursts by frustrated or distressed students with severe learning disabilities. But a growing number of unacceptable incidents sounded warning bells with the school, and caused it to re-examine its strategies for the management of challenging behaviour from pupils who can be very difficult to deal with at their worst.

"In recent years, the nature of our referrals has changed quite considerably and we have seen a marked increase in the level of learning disabilities and the complexity of needs among our client group," says principal John Davidson.

"This is partly due to our reputation nationally, but can also be attributed to the Government's policy of inclusion, and the fact that complex conditions such as autism are now more readily diagnosed and more referrals are being made.

"When I took up post 13 months ago, it was becoming clear that the way in which the school was organised needed to be improved to suit the changing needs of our students better. The increase in aggressive behaviour was caused by children with severe learning difficulties not being able to make sense of their environment or communicate their needs... We saw the need to take action."

A major turning point for Mr Davidson and the Linn Moor management committee, was the discovery of TEACCH (Treatment and Education of Autistic and Communication Handicapped Children) - an American communication-based strategy for development of children with autism and learning disabilities. A visit to Sunfield School, near Birmingham, where TEACCH has run successfully for several years, revealed part of the solution: separating autistic and non-autistic children into different class and care groups.

While all the students at Linn Moor have severe learning disabilities, nearly half of the current population - a higher number than ever before - are also within the spectrum of autism.

Traditionally, and with the best intentions, all classes are mixed, and grouped according to ability. TEACCH, however, is based on the principle that the needs of autistic children with severe learning disabilities are, in some cases, almost diametrically opposed to those of non-autistic children with severe learning disabilities, particularly with regard to having a calm and low-stimulation living and learning environment which they need if they are ever to extract value from school.

"We began to understand why the mixed group approach was no longer working with our present school population. Our classroom and home group environments and activities were over-stimulating the autistic children, but under-stimulating the other children, and this was a major factor in the problems we were experiencing," says Davidson.

Focusing on the individual child, with emphasis on a "co-therapist" partnership between teachers, social care staff and parents, TEACCH enables the development of a programme around that child's skills, interests and needs, within the context of a "culture of autism".

One of its key principles is structured teaching and learning which is tailored to suit each child through organising the physical environment, developing schedules and work systems, and making expectations clear and explicit through visual materials.

After carefully monitoring the innovative programme, and with advice from Sunfield, the management team decided early last year to adopt TEACCH as part of its new strategy for developing Linn Moor into a centre of excellence. Other important elements of the strategy were the concept of 24-hour learning across school and care, a positive behaviour management programme, the further development of a whole-school approach to teaching and care, and a commitment to forging stronger partnerships with parents.

TEACCH was also found to be compatible with other approaches used at the school such as Strategies for Crisis Intervention and Prevention (SCIP) which helps staff to manage challenging behaviour through positive programming, calming techniques, early intervention and minimal, incremental physical intervention where appropriate.

Over the next few months, consultation was held with staff, parents and a variety of agencies involved with Linn Moor, including Grampian Primary Care Trust's clinical psychology department, to ensure everyone understood and agreed with the principles of the new strategy.

A rolling programme of in-house training, led by Sunfield's Jackie Wadlow, was organised, involving an unprecedented and valuable mix of teachers, classroom assistants, social care and senior social care workers, parents, and a management committee member.

"Despite some initial concerns, the mixed training has been a great success and has broken down a lot of barriers between the different groups involved," says deputy principal for care, Marlene Arthur. "There has been a real feeling of everybody working together for the children, which we as a school would always want to encourage, and parents have told us that working so closely with us has also helped to strengthen and empower the Parents of Linn Moor support group. Supportive networks are increasingly obvious across school and home and between families."

The new approach was launched in January. Structurally, the school is split into two groups of autistic children and two groups of non-autistic children, who stay in their respective class and home groups.

In addition, a new high support unit has been created, which supports four youngsters with particularly severe and complex learning disabilities as well as challenging behaviour, and whose dedicated support staff now, for the first time, work across both education and care. A teacher and social worker jointly lead the team.

For a school whose population requires a high level of consistency and routine, the changes have been radical. But the careful planning has paid off and, to the delight of everyone involved, the benefits are already being felt. Kath Threadgold, deputy principal for education, says: "What we're seeing now as a result of TEACCH and the positive behaviour management programme, is the beginnings of a very calm, ordered school, which has greatly reduced stress and therefore the incidence of aggressive outbursts in the children. We're all working together on providing a 24-hour care and education programme for each child, which will help them achieve their maximum potential in terms of educational and social development."

One of the biggest breakthroughs in fostering a calmer environment for learning, has been the introduction of visual timetabling into class and home group. Following the principles of TEACCH, this involves the use of symbols to "clue in" the students about what is expected of them in any given situation. By breaking down every domestic and educational activity into step-by-step pictorial schedules, carefully tailored to suit each child, order and structure is given to the day, enabling both autistic and non-autistic groups to make better sense of their environment and therefore feel less anxious. Another innovation has been to screen off some of the students' work stations, to discourage distractions and give them their own space, and to section off areas of the floor for specific activities and choosing time.

Thanks to the use of visual timetabling and screened-off work stations and activity areas, one youngster, who until recently needed the support of two adults at all times and found it impossible to sit still, now needs only one member of support staff to sit quietly and engage in learning activities, which were previously inaccessible.

Another child, who had great difficulty in moving from class to home group, is now hurrying happily between the two, having found the way via a trail of cut-out symbols and photographs left on the floor by staff.

The symbols also serve as useful communication tools for students, who can show them to staff to bring attention to their feelings and needs. Staff are beginning to see clear evidence of children using symbols for this purpose.

"The fact that we're now all working to very structured visual programming is very helpful to both children and staff," adds Kath Threadgold.

"We're all following the same package, using the same symbols, and in education terms, we're able to use them as indicators to enable the children to move towards working independently. That was quite difficult to put into place when both groups were mixed up together."

Parents "clued in" to the school's strategy are also able to use the same skills and techniques at home, and indeed, the children will benefit in a range of social situations within the wider community.

Staff are visiting parents at home to help them to learn the strategies which are now used at Linn Moor.

"One of the really positive and rewarding aspects of the new approach is that it will enhance the children's social skills, ensuring participation in specific community activities which, because of the complexity of their difficulties, have sometimes in the past proved to be problematic", says John Davidson.

"TEACCH is proving a very useful tool in enabling us to develop the notion of the 24-hour curriculum, so that we can provide opportunities everywhere for children to learn and develop the skills and the acquisitional knowledge which is identified in their individual education and care plans."

Mr Davidson is full of praise for the hardworking staff group at the school: "This re-organisation could not have happened without the tremendous support that we have received from the staff team. There is a great deal of commitment within the school to develop the highest quality of service for our children and the enthusiasm of our staff to embrace the changes has been extremely impressive."

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