Newsday (New York)
December 9, 2007 Sunday
LI LIFE; Pg. G04
THE BATTLE TO CONNECT;
Half Hollow Hills teachers use reinforcement-and-reward strategies to teach their STUDENTS WITH AUTISM
BY CHRISTINA HERNANDEZ / NEWSDAY
Jackson Louie, a 9-year-old with dark, shaggy hair and chubby cheeks, sits across from student teacher Jaclyn Lee. A thick three-ring binder, in which Lee writes constantly, is on the desk between them.
"Where do you go to sleep?" Lee asks.
"In the bedroom," Jackson says softly, without making eye contact.
"Where do you go to sleep?"
"In the bedroom."
They repeat the exchange three more times. Jackson, who has autism, has earned a penny.
Jackson, a fourth-grader at Signal Hill Elementary School in Dix Hills, is working for pennies. Five pennies and Jackson gets to spend a few minutes playing a favorite art game on a classroom computer.
Jackson and the five other boys in his class, ages 8 to 10, spend about half of each school day sitting across from instructors like Lee, who use reinforcement-and-reward strategies to teach the many children with autism in the Half Hollow Hills Central School District.
Autism diagnoses are exploding across Long Island and the nation. The number of school-age children classified as such in Nassau and Suffolk has jumped by 50 percent during the past three years, to more than 3,000. Half Hollow Hills is among a growing number of districts teaching more of their children with autism in-house. Many districts refer severe cases to BOCES programs or private schools, for which they pay tuition; special-education tuition at BOCES ranged from $27,717 to $50,834 in 2005-06, according to the most recent state data.
Lauded by the state
In 2003, the state designated Half Hollow Hills a model program in the education of children with autism. Parents have since flocked to the district. The number of school-age children with autism has more than doubled, from 81 in the 2003-04 school year to 169 this year, district officials said.
Half Hollow Hills, whose total enrollment of 10,296 is the fifth-largest on Long Island, educates by far the most students with autism of any Island district, according to the State Education Department.
Its program, which began in its current form in 2002 and runs according to federal regulations from kindergarten through the end of high school or the year when the student turns 21, has produced results. While success is measured individually, Half Hollow Hills' students with autism have done well on the New York State Alternate Assessment, a test for students with severe cognitive disabilities.
During 2005-06, assistant superintendent Patrick Harrigan said, 53 students - most of whom had autism - took the math test, and 39 scored at level 4, the highest level. Tests in English, social studies and science had similar results, he said.
"Parents don't have to trade off high-level professionals for their neighborhood schools," Harrigan said.
At Half Hollow Hills, educating children with autism is a "district-wide effort," he said, involving everyone from hall monitors to the superintendent.
Bus drivers receive pointers for transporting the children, such as giving brief declarative directions such as "sit down" instead of lengthy lectures, behavior consultant Lisa Davi said. Cafeteria workers hang photos of meal choices by the lunch line for students who can't communicate verbally, she added.
But it is in the classroom where the most intensive interactions take place.
Kristin Napolitano's class, where Jackson is a student, is decorated with a sign that says "World's Best Class." The room is sometimes loud, but not chaotic. It's a place where asking instructors for tickles is part of a lesson on initiating actions and making requests, and students are on a first-name basis with teachers.
It is also a place where small, hard-won accomplishments are made each day.
Jackson and his classmates have some of the most significant impairments among the district's students with autism. The developmental disability, federal authorities say, affects approximately one in every 150 children; for decades, autism was believed to affect one child in every 2,000 to 2,500.
The disability is characterized by impaired social interaction and communication, as well as unusual behaviors, and it is three times more common among boys than girls.
The boys in Napolitano's class do not speak much and have difficulty participating in conversations. Without stimulation from a teacher's voice or an activity, they quickly lapse into their own world, singing, shouting or laughing for seemingly no reason. When a student lets out a long yell - a self-stimulatory behavior characteristic of autism - his peers don't react. Neither do the teachers.
More teachers than kids
In this class, one of three at Signal Hill and nine in the district, instructors often outnumber students. The room typically is packed with four full-time paraprofessional teaching assistants, a student teacher and Napolitano. Speech, occupational and physical therapists, and Davi, are frequent visitors.
The number of instructors is necessary, Napolitano says, because of the intense attention the students require and the demands of the teaching method, Applied Behavior Analysis, which gained popularity in the late 1980s, when a study found it beneficial for some children with autism.
The boys must be kept engaged and lessons tailored to each one's level. Every student's answer must be followed by a teacher's response, either a positive like "good job" or a flat "no." And every child's response must be recorded in the binders. That's how progress is tracked.
Data is even recorded at recess, Napolitano said, to chart progress on social goals, such as answering another student who says hello.
The work is tedious but essential. Patience is mandatory.
"It's a science," Davi said. "We analyze the data daily to come up with future targets."
Learning goals differ for each child. And success is measured in the smallest steps, in the most mundane tasks - like being able to distinguish between a nickel and a quarter.
When goals are achieved, students are rewarded with "reinforcers" - prizes chosen by students, which might range from a handful of candy corn to a few minutes on the classroom trampoline.
The ultimate goal for most students with autism at Signal Hill is to be "mainstreamed" - placed into social or classroom settings with other students at their age or academic level. Napolitano's students are mainstreamed with fourth-graders for art, music, library, gym, lunch and recess to expand their social opportunities.
Only one student in Napolitano's class is mainstreamed into an academic class. He attends second-grade math every day, accompanied by a paraprofessional.
Most of the students do their academic work in Napolitano's room.
One recent morning, paraprofessional Rachel Kelly was working on simple arithmetic problems with a student with brown hair and a blue T-shirt. The district declined to identify him for privacy reasons.
To find the answer to six plus three, the boy puts his pencil point on the six and counts, "One, two, three, four, five, six." He moves the pencil to the three on the other side of the plus sign: "Seven, eight, nine."
"Do you want to do some more math?" Kelly asks.
"Yes," the boy says, smiling.
Kelly talks constantly to the boy as she fills a blank sheet of white paper with more problems. "Great waiting," she says, to reinforce positive behavior and keep the boy engaged as he stares into space. "I like how you're waiting."
Testing skill levels
Later, Amy Fattibene, a speech language pathologist, joins them to work on a "probe" - a trial run of a new program. The purpose, Napolitano said, is to test the child's skill level before beginning the new lesson. Each student has about 20 programs in his binder at a given time, she said.
This program is called "Where is it?"
The boy is asked to identify which of three items on his desk - pretzels, popcorn or Goldfish crackers - is missing after Fattibene covers his eyes and Kelly moves the item to a table across the room. After identifying the missing object, the boy has to ask where to find it and then go get it.
"The idea of seeking information is a gigantic step for them in terms of their communicative function," Fattibene said.
But the student becomes confused. He reads his prompt, written on a strip of paper, as "Where is it J," mistaking a question mark for the letter J. And although the item is moved to the same table for each trial, the boy needs help finding it each time.
Applied Behavior method
Still, the teachers decide to include the new program in the boy's binder. But Fattibene said it might need tweaking, a common practice in the Applied Behavior Analysis method, which puts the burden on the teacher, not the student, to ensure the child is learning.
It can take days or even weeks for a child with autism to master one skill. This means that lessons stretch outside the gray half-walls of each child's cubby.
Parents are intimately involved. They get regular training from Napolitano so they can continue the work at home.
Jackson's mother, Janine, 44, said she spends about an hour a day going over lessons learned in school. In addition, she tries to incorporate skills he is developing or has mastered into everyday life. When Jackson was learning the command "go get" in school, for example, his mother would ask him, out of the blue, to "go get" his shoes.
Napolitano also sends home the binders every day for review, and each child has a communication notebook in which Napolitano often writes to parents. They are welcome to write back.
And every 10 weeks, parents meet for one hour with Napolitano, Davi, the child's therapists and the school psychologist to discuss progress.
More help is provided by after-school programs, such as the one organized by Support Our Autism Rainbow in which Jackson is enrolled. About 20 children with autism are paired with general- ed peers to work on social skills, according to the group's president, Caryn Rosenberg, 45, of Dix Hills.
It's a complex process, one in which every part is critically important to the education of children with autism.
Janine Louie is pleased with the way the pieces fit together. And she's happy with Jackson's progress. "Once he learns, it's such a huge accomplishment," she said.
Jackson is not mainstreamed into any academic classes yet, but his mother hopes he will be one day. "It's not a perfect world," she said, "but if my child were typical, it wouldn't be a perfect world, either."
Copyright 2007 Newsday LLC
