Q&A with Dr. Cathy Pratt
Autism expert Dr. Cathy Pratt talks about the goals of true inclusion, how teachers can support the sensory, executive functioning, and academic needs of their students with autism, the role of peer and whole-school support in helping kids with ASD succeed, sources for evidence-based teaching resources, and more.
Dr. Cathy Pratt, BCBA-D, is the Director of the Indiana Resource Center for Autism. IRCA is a statewide program that works to build local capacity for families and professionals to address the needs of individuals on the autism spectrum across the lifespan. This is done through training, consultations, coaching, research, and information development and dissemination.
She writes and presents internationally on the following topics: autism spectrum disorders, functional behavior assessment/positive behavior supports, applied behavior analysis, instructional approaches, evidence-based practices, systems change, and policy. Prior to pursuing her doctorate at Indiana University, Dr. Pratt worked as a classroom teacher for students across the autism spectrum and with other disabilities.
What would you say are the primary principles or goals behind the idea of inclusion?
I think that people use the word inclusion inappropriately a lot. They talk about inclusive classrooms or inclusive students or inclusion teachers, and to me inclusion is a philosophy or a belief that all students belong and that all students will benefit from a continuum of services.
What has happened often in special education is we take a categorical approach to placing students. So if a student has this label, then this is the classroom they go to. And the federal law really says that students should be placed in the least restrictive setting and if they’re not successful there, then supports and aids are added to help them be successful in those settings.
But I think unfortunately too often what happens is that students start in the most restrictive setting and they have to earn their way into a less restrictive setting.
How do students with ASD tend to benefit from interacting with non-disabled peers?
You know, one of the primary difficulties for our folks is that they have social challenges. And so placing them in classrooms with other kids who all have social challenges doesn’t really seem to make much sense to me.
I think I lost perspective on what is typical behavior and I might not have pushed my students as much as I needed to. So I think as an educator when you have kids with ASD around typical kids, you have a better sense of what they’re going to face when they’re in society.
And I think that when kids are in really restrictive settings that we overly accommodate them, and as a result we often times accommodate them right out of possibilities. I’ve heard that 60% to 90% of adults with autism are unemployed or underemployed. And there is research that says when individuals are in segregated settings they graduate into segregated settings as adults, and so we’re really not setting folks up for a life in community.
What are the things that administrators can do to set a positive tone for the entire school? What are the things that need to happen at the school level rather than with the individual teacher?
The initiative now is an MTSS (Multi-Tiered Ststem of Support) approach. So you look at MTSS and using strategies that are associated with Universal Design. When I spent a lot of time in schools, I had a really hard time seeing students as either special education or general education. I think kids fall along a continuum. And I think that we have to equip teachers with the tools to be able to address the needs of students along the continuum.
General education teachers really have a great understanding of the curriculum, and special education teachers have expertise in individualizing instruction, classroom management, and behavior supports. And so if they come together as a community, it really benefits all kids.
What can we do to create a welcoming physical environment for children? That’s often a big factor for kids with ASD.
You know, we do a lot around peer supports because I think that much of the time our kids are just isolated — they don’t have any friends. And so when we talk about creating social skills for students and social skills groups, one of the things that research bears out is that an important factor is educating the non-disabled peers.
I was just in a classroom with a child with autism, and her peers have all been educated about her support needs and it is a beautiful thing to watch. And I think students have a very strong sense of social justice when given the chance to show support.
I remember when I was getting my doctorate many years ago, somebody made the comment that 25% of us would experience disability in our life. And I thought that was ludicrous because I didn’t have anybody with a disability in my family or in my life, and then sure enough my mom ended up in a wheelchair for the last 15 years of her life. And what was interesting to me is that people in society did not know how to address her; they didn’t know how to talk to an adult person in a wheelchair.
If you look at our schools right now, you realize that on average 1 in 59 children will have autism. The students in our schools are going to be the future parents, the future business leaders, the future politicians, the future school teachers. And so from the time that they’re in school, it’s really important to start getting them to learn how to interact with people with differences.
And how do we teach them?
There are books, other materials, and videos out there that can help folks understand autism better. But when I think about educating students, it’s not a matter of saying here’s autism, here’s the neurology, but rather talking to kids about the fact that all of us have special needs, all of us have things that make us alike, and all of us are different. And so helping all kids understand that is important.
As I go into schools, I also see teachers really focusing on compassion and teaching kids about compassion which I think will benefit all kids in all settings.
Are there specific peer support strategies or regular practices you can use to help encourage that process of kids accepting one another?
I was just in a classroom recently and the teacher was teaching about compassion for all students, regardless of their needs or support needs.
Sometimes we will hook them up with another student who we know is going to be kind with them. We look at the physical accommodations for them. You know, sometimes these kids will need special seating or a special position in the classroom. We do a lot with visual supports to help kids, because all of it is about lessening the anxiety for students.
I know some of our students will go into a sensory room or they’ll have a break room in the classroom or another place in the building. For our kids who really need support, we think about having somebody who could be a champion for that child in that building. And lastly, we make sure that we have delivered curriculum in a way that the student feels successful.
You mentioned visual supports. What would be some useful visual supports for students?
The visual supports are very individualized and we have a full catalog of visual supports on our website. One of the things that helps reduce anxiety for our students is to have a schedule to help them understand what the expectations are. But depending on each child’s needs, we look at our visual support options and find the ones that work for that child.
And not only do we use those for the kids with autism. A lot of these supports that we put into place universally because children with autism are not the only ones in our schools who have difficulties with anxiety. We go in through the door of autism, but we also look at how these strategies work for all kids.
What is the Incredible Five Point Scale?
The Incredible Five Point Scale was developed by autism education specialist Kari Dunn Buron. It’s a visual support using colors for a scale of one through five — say, for example, “1” is blue and “2” is yellow. You can use the scale to help kids understand voice volume or to help them with self-management. For example, a child will be able to say I’m at "1" today, I can do the work. Or, I’m at "3" today and I’m feeling a little anxious, and so I need to be able to take a break. It's a very concrete way to give kids a way to communicate.
Can you share some practical things that teachers can employ in their classroom to help ease anxiety?
It starts with the schedule. And one of the things that I tell our teachers is that it’s good to have a schedule on the board for all kids and to make sure that the schedule actually matches what’s going on in the classroom. And then as you take kids through transitions it’s really important that everyone is prepared, so that when the child goes to that transition the materials are ready for them — instead of the teacher having to spend time getting everything together.
So, again, just articulating for kids what the day is going to look like so that they have some predictability. Change is inevitable and unexpected things will happen. But what is predictable is if there’s a schedule there that the child knows is accurate; they can depend on that.
What can teachers do to reach out to families to get help, advice, and support?
At the beginning of the year we send out a letter to families and ask them to send a letter to the school telling the teaching staff about their child. And not about their disability but about their child, because I think too often what happens is that we define children by their disability and not by who they are. And so I encourage families to do that.
And then I encourage teachers to build a relationship. And you’re not going to build a relationship if you only get together with teachers at the Case Conference Meeting, which is very stressful for families. And as a teacher (I was a teacher for many years), what I found to be incredibly helpful was is to call parents randomly and focus on the things that are going well or give them information about things that they can do at home.
I’ve had parents when I was teacher who were just kind of amazed that I would call them and tell them good things about their children because they were so used to only hearing the bad things.
There’s one teacher that I work with — and this is a really brilliant idea that he has — he writes a letter home to the parents of all of his students each week. It’s the same letter, but revisits what they worked on during the week and then offers suggestions for how they can implement things at home as well.
Let’s say you have a child who is passionate about or really strong in one particular area, how do you build on that area of strength, value it, and and capitalize on it inside the classroom?
Our students on the spectrum have specific interests and strength areas. So I have a friend who is really interested in weather, and if his teacher had used concepts around weather to teach him about math or reading that would have been a strong major motivator for him.
So you want to know what these children are really interested in and then teach to that to motivate them to learn — make it meaningful for them.
Let me give you another example. I went to see a young man whose area of interest was state capitals. And the teacher wanted to make sure that he was included and felt included in the classroom. So she made the decision to have units on states. And the first question that she would ask would be about the state capital.
And this young man knew the state capital of every state and she would announce that "tomorrow we’re going study Delaware," and then they all knew that the first question was going to be about the state capital. So they would talk to this to young man with autism and find out the answer, and it kind of made him a rock star of that classroom, and helped him feel successful.
How can teachers create spaces for relief from sensory overload when you’ve got a whole classroom of children?
In the area of mental health they talk about having fidgets, and that’s something that we’ve talked about in the area of autism as well. I think a lot of kids benefit from having fidgets. We know that some kids benefit from having different kinds of seating so they can move around in. I was just with a child who is on a stool that she can rock on a little bit.
I think all students at times may need breaks. So those are going to be realistic things. And then once an individual is assessed (this is very individualized), some of our kids will use weighted vests or weighted blankets or really tight Under Armour® shirts that help them with their sensory needs.
You just have to look for clues with each child and find individualized solutions. That’s information that you get from watching the child and also interviewing the parents to find out what’s going on. And there are various sensory assessment tools as well, such as the Winnie Dunn Sensory Profile.
Do you have any specific guidance for teachers in helping children with autism stay on track towards becoming proficient readers and writers?
Students on the autism spectrum are very good at rote memorization. So they can learn to read words. The difficulty is answering questions about the stories that they’re reading. For these kids, repetition is really helpful as well as making it very relevant and meaningful to their lives. So find an area of interest for them and have them read around that.
In terms of writing, many of our students have difficulty with paper and pencil activities. And so if they have to write things out long-hand then often they’re not able to produce as much material. So, we often suggest moving to technology quickly. If they’re writing and they’re having to use paper and pencil activities you’ve got two things going on: one, is they’re going to have to be giving you content in their ideas, and two, they’re going to have to be actually going through the mechanics of writing, which is difficult for them.
And again you want to think about how to make it very concrete. So if you tell students on the spectrum, ‘Write about something that interests you”, it is very hard for them to figure out what that means. And so it’s really helpful to give them a couple of ideas. “Do you want to write about politics or do you want to write about weather?” “Do you want to write about your favorite toy or do you want to write about an animal?”
So you give them things that they can choose from instead of these very wide open questions.
And when you talk about assistive technology you’re thinking about things like speech-to-text.
I’m actually just thinking about keyboarding — just a computer. Because just dealing with a pencil can be hard.
Are there some practical strategies for teachers in modifying an instructional curriculum?
There are a lot of different ways to modify instruction. You can look at reducing the number of items that students have to do, you can think about simplifying, or you can think about having students work in a group. It depends on the content. For example, if a child is going to be doing math problems, do they really need to do all 30 math problems or can they just do a few of them?
Sometimes our folks need a little bit more time. Sometimes if they’re taking testing they may need to be in a quieter area. So we just look at different kinds of accommodations for the individual child.
One of the things that kids with autism may have a hard time kind with is executive functioning. So if, for example, they are in junior high or high school and they move to one class to the next, having the ability to figure out what they need to have with them to move from one class to the next can be challenging, and they may be a bit slower.
Again, these are generalizations — some kids do really well. But I know of students who if they have to go from point A to point B to point C to point D in a school, it’s very difficult for them to then get to their locker and change out books. So we have to think of strategies to have books available in different locations so they don’t have to carry all 10 books with them the entire day.
And some of our kids will need different kinds of locks for lockers because they can’t open them very easily. It’s also really good for our kids to have a go-to person — someone they know that they can actually connect with if they’re feeling like they’re having a difficult time.
That person could be a social worker, it could be an administrator, and sometimes it’s the janitor. In our schools, we have been doing a lot of training. We have autism leaders in almost all of our special education districts, and our teachers know that there is someone that they can go to for support.
So that’s something that a principal should be thinking about — is there someone in this school who can be a reliable ally of children with autism?
One of the questions that we get over and over from teachers is how they can best select authoritative and research-based resources to support their practice when they have questions. Where should they turn?
There is a website from the National Professional Development Center on Autism Spectrum Disorder. The purpose of that center is to provide evidence-based practices for classroom settings, not for clinical settings. And there are more than 20 evidence-based practices on the website, where teachers can find the research behind it as well as information about how to actually implement the practices.
How have your ideas about teaching children with autism evolved over time?
I’ve been doing this for a lot of years and I think I’ve learned from every child that I’ve worked with. And having autism leaders around the state of Indiana, I feel like I have a community of colleagues that learn from each other. And we bring in people from other places. We’re always trying to bring in folks who will raise our expertise, but I think that the kids have been my true teachers.
What I’ve learned is that if you don’t have a relationship with a child you’re not going to be effective. And that if you can find out how to connect with a child, find out how to figure out what the touch point is for him, and then build that relationship, then you’re going to be a very effective teacher.
Is there something you’ve read that was particularly influential for you that you wish every teacher could read?
You know, I’m kind of in an unusual situation in that I have a lot of friends on the spectrum. And I think that the books that have been most helpful for me are the books that are written by people like Temple Grandin, Liane Holliday Willey, and Stephen Shore — those are the books that have been helpful for me. Because I don’t have autism and am trying to determine what is most beneficial for people with autism — to do that without asking them to me seems disrespectful and not a good idea.
So I would recommend reading some of these autobiographies.