it would have been extremely difficult to develop similar programs if fully qualified teachers had provided equivalent services.

The burden of recruiting, organizing, and maintaining a cadre of student therapists requires commensurate management skills and sometimes requires time and personal funds from parents. Many families find it difficult to achieve their goals in terms of intensity of treatment because of the complexities of dealing with student-therapist schedules and attrition (Smith et al., 2000). How to maintain an existing pool of paraprofessionals and how to better integrate the transmission to them of training and knowledge, and how to maintain the balance between stability that should be available in school and center-based systems and the flexibility possible in some home-based and integrated programs are important questions.


Significant questions include: Who are the professionals who can be counted upon to provide assistance? Where are such professionals prepared, and who is doing the preparation? As for curriculum and intervention strategies, there are diverse opinions.

One controversy is whether to train specialists for children with autistic spectrum disorders (these specialists may come from a range of backgrounds and are generalists across disciplines within this specialty), or to consider autistic spectrum disorders a unique topic within discipline-specific training (e.g., training of speech and language pathologists or psychologists). Models of both approaches are available: the TEACCH program is an example of the generalist model (Marcus et al., 2000), and the Denver Model (Rogers et al., 2000) is an example of building on separate, but integrated, interdisciplinary approaches (see Chapter 12). Similarly, advocacy groups such as the Autism Society of America and state parents’ and educational programs provide broad-based educational opportunities, while professional organizations (e.g., American Speech and Hearing Association) provide information that is more targeted to particular professions. The two models should be considered complementary.


The content of training programs reflects the diversity of approaches in the field of autism. There is little research comparing the relative effectiveness of personnel preparation models. Some programs have a specific philosophy and approach (e.g., UCLA, LEAP, TEACCH; see Chapter 12); others present more eclectic points of view. Some programs have extensive databases of specific activities (see McClannahan and

The National Academies of Sciences, Engineering, and Medicine
500 Fifth St. N.W. | Washington, D.C. 20001

Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement