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TEACCH and Autism Ranking: Strong positive evidence

TEACCH (an acronym for the Treatment and Education of Autistic and Communication-Handicapped Children) is the term given to describe the various activities undertaken by Division TEACCH, a state-wide community-based programme of services for children and adults in North Carolina, USA.

The TEACCH Autism Program or Model is used to describe some of the educational programmes run by Division TEACCH and by a variety of other providers in the USA and in other countries. 

The TEACCH Autism Program has several key components including

  • an understanding of the culture of autism - the characteristic patterns of thinking and behaviour seen in individuals on the autism spectrum.
  • the development of an individualised person (and family)-centred plan for each client.
  • the use of structured teaching (which consists of four elements: physical structure; visual schedules; work systems; and task organisation).
  • the use of a wide range of cognitive, developmental, educational and behavioural strategies.
  • co-operation between therapists and parents.

In practice, the terms TEACCH, TEACCH model, TEACCH Autism Program and structured teaching are sometimes used interchangeably, which can lead to some confusion.

Elements of the TEACCH Autism Program are used extensively alongside other approaches within other comprehensive, multi-component interventions throughout the world. It also forms a key element of the SPELL approach, used in services run by The National Autistic Society in the UK.

Our Opinion

There is a small amount of high quality research evidence (eleven controlled trials) and a small amount of low quality research (thirteen single-case design studies with three or more participants) into the use of the TEACCH Autism Program for people on the autism spectrum.

This research suggests that the TEACCH Autism Program may provide a range of benefits to some pre-school and primary school children on the autism spectrum. Those benefits include increased social communication and social interaction, along with improved cognition and improved motor skills.  

This research also suggests that the TEACCH Autism Program may reduce stress, and improve the mental wellbeing, of some families of children on the autism spectrum.

There is insufficient evidence to determine if the TEACCH Autism Program provides any benefits in other areas (such as a reduction in repetitive and restricted behaviours, interests and activities) for any children on the autism spectrum.

There is insufficient evidence to determine if the TEACCH Autism Program provides any benefits for adolescents or adults on the autism spectrum.

There is insufficient evidence to determine if any of the four components of structured teaching (physical structure; visual schedules; work systems; and task organisation) by itself provides any benefit for anyone on the autism spectrum.

There is a need for more research into the TEACCH Autism program which uses scientifically robust, experimental methodologies and which includes a wider range of participants.  

That research should investigate whether the TEACCH Autism program is more or less effective than other comprehensive, multi-component, educational interventions (such as the UCLA YAP model and LEAP). It should also investigate which components of the TEACH Autism Program, if any, are more likely to benefit which individuals on the autism spectrum. 

Disclaimer

Please read our Disclaimer on Autism Interventions


Audience

As the name suggests, the TEACCH Autism Program was designed for “Autistic and Communication-Handicapped Children”. However, according to the TEACCH Autism Program website, accessed on 20 July 2017, TEACCH is designed to help everyone on the autism spectrum.

“Structured TEACCHing is appropriate for individuals with ASD at all ages and functioning levels because the general principles are applied flexibly for each individual. That is, visual answers to these questions for a young or developmentally delayed child would look very different from those for a high school student or adult with average intelligence, but the general principles of using visual or written supports to organize time and space would still apply. Structured TEACCHing can help individuals with ASD learn new skills or participate appropriately in any setting, including but not limited to schools, home, community as well as employment.”

Aims and Claims

Aims

According to Mesibov et al (2004),

“Structured Teaching … has two complementary goals: 1) increasing the individual's skills and 2) making the environment more comprehensible and more suited to the individual's needs. In other words, some of the work facilitates changes in the individual, and some involves changes in the environment. To achieve the first goal, we introduce and have the individual practice new skills and behaviors. Of equal importance, however, is the work of developing situational modifications and supports so that the environment is in line with the individual's abilities and ways of understanding and learning.”

Claims 

There have been various claims made for the TEACCH Autism Program or for programmes which follow the TEACCH model.  For example, 

  • Braiden et al (2012) claimed that “Results indicate a statistically significant decrease in parental stress and increase in children's expressive and receptive language skills from pre-testing to post-testing.”
  • D’Elia et al (2014) claimed that “Findings suggest that a low intensity home and school TEACCH program may provide benefits for children with ASD by reducing autistic symptoms and maladaptive behaviors. Furthermore, a decrease in parental stress indicates that parents' involvement in the rehabilitation program is a crucial factor and contributes greatly to treatment efficacy.”
  • Ozonoff and Cathcart (1998) claimed that “Results demonstrated that children in the treatment group improved significantly more than those in the control group on the PEP-R subtests of imitation, fine motor, gross motor, and nonverbal conceptual skills, as well as in overall PEP-R scores.”
  • Panerai et al (1998) claimed that “Results showed an increase in working skills and functional communication abilities.  In addition, the structured teaching seemed to reduce the disadaptive behaviors allowing an easier management of behavior problems.”
  • Tsang et al (2007) claimed that “…the program promoted such children’s pivotal learning abilities like imitation, perception, fine motor, eye-hand coordination and gross motor skills (i.e., CPEP-R scores), as well as cognitive functioning.”

Key Features

TEACCH (an acronym for the Treatment and Education of Autistic and Communication-Handicapped Children) is the term given to describe the various activities undertaken by Division TEACCH, a state-wide community-based programme of services for children and adults in North Carolina, USA.

The TEACCH Autism Program or Model is used to describe some of the educational programmes run by Division TEACCH and by a variety of other providers in the USA and in other countries. 

The TEACCH Autism Program has several key components including

  • an understanding of the culture of autism - the characteristic patterns of thinking and behaviour seen in individuals on the autism spectrum.
  • the development of an individualised person (and family)-centred plan for each client.
  • the use of structured teaching (which consists of four elements: physical structure; visual schedules; work systems; and task organisation).
  • the use of a wide range of cognitive, developmental, educational and behavioural strategies.
  • co-operation between therapists and parents.

In practice, the terms TEACCH, TEACCH model, TEACCH Autism Program and structured teaching are sometimes used interchangeably, which can lead to some confusion.

Elements of the TEACCH Autism Program are used extensively alongside other approaches within other, multi-component interventions throughout the world. It also forms a key element of the SPELL approach, used in services run by The National Autistic Society in the UK.

Autism Culture

According to Mesibov and Shea (2010), “The TEACCH approach ….  is based on evidence and observation that individuals with autism share a pattern of neuropsychological deficits and strengths that we call the ‘Culture of Autism’.”

They go on to list eight specific characteristics of that culture:

1. Relative strength in and preference for processing visual information (compared to difficulties with auditory processing, particularly of language). 2. Heightened attention to details but difficulty with sequencing, integrating, connecting, or deriving meaning from them 3. Enormous variability in attention (individuals can be very distractible at times, and at other times intensely focused, with difficulties shifting attention efficiently). 4. Communication problems, which vary by developmental level, but always include impairments in the initiation and social use of language (pragmatics). 5. Difficulty with concepts of time including moving through activities too quickly or too slowly and having problems recognizing the beginning or end of an activity, how long the activity will last, and when it will be finished. 6. Tendency to become attached to routines and the settings where they are established, so that activities may be difficult to transfer or generalize from the original learning situation, and disruptions in routines can be uncomfortable, confusing, or upsetting. 7. Very intense interests and impulses to engage in favored activities and difficulties disengaging once engaged. 8. Marked sensory preferences and aversions.”

Personalised plan

A key part of the TEACCH approach is the development of an individualised person (and family)-centred plan for each client. That plan is based on regular assessments of “each individual's skill levels, talents, special interests, personality, feelings, quirks, and potential.” 

According to Mesibov and Shea (2010) that plan might include

“(a) structuring the environment and activities in ways that are understandable to [that ] individual; (b) using [that] individual’s relative strengths in visual skills and interest in visual details to supplement relatively weaker skills; (c) using [that] individuals’ special interests to engage them in learning; and (d) supporting [their] self-initiated use of meaningful communication.”

Structured Teaching

TEACCH is designed to make the most of an individual's strengths within a very structured environment (sometimes known as structured teaching).

The four major components of structured teaching are 

i) Physical structure: the organisation of the physical environment

According to Hume (2011), 

“Physical structure refers to the way each area in the classroom environment is set up and where materials and furniture are placed. A physically structured classroom provides organization for students and helps the staff, students, and classroom visitors understand what activities are occurring in each area of classroom at any given time.”

ii) Visual schedules: visual information depicting where/when/what the activity will be.

According to Hume (2011),

“A visual schedule communicates the sequence of upcoming activities or events through the use of objects, photographs, icons, words, or a combination of tangible supports. A visual schedule tells a student WHERE he/she should be and WHEN he/she should be there. Visual schedules are designed to match the individual needs of a student, and may vary in length and form.”

iii) Work systems: visual information informing an individual what to do while in a specific area

According to Hume (2011), 

“A work system is an organizational system that gives a student with ASD information about what is expected when he/she arrives at a classroom location. A work system is defined by Division TEACCH as a systematic and organized presentation of tasks and materials that visually communicates at least four pieces of information to the student”. 

Those four pieces of information are 1. The tasks/steps the student is supposed to do. 2. How many tasks/steps there are to be completed. 3. How the student knows he/she is finished. 4. What to do when he/she is finished. 

iv) Task organisation (also known as visual structure): visually clear information on what the task is about

According to Hume (2011),

“Visual structure adds a physical or visual component to tasks to assist students in understanding HOW an activity should be completed.”

“Visual structure has three components: Visual Instructions: Tells the student where to begin and the sequence of steps to complete an activity. Visual Organization: How the space and materials are limited or arranged. Visual Clarity: Emphasizes or draws attention to important or relevant information”

Range of other teaching strategies

The TEACCH Autism Program also makes use of a wide variety of cognitive, developmental, educational and behavioural strategies. For example, according to the TEACCH Autism Program website, accessed on 20 July 2017, therapists may use behavioural reinforcement as a way of building skills or prompting desired behaviours.

“To utilize reinforcement as an effective teaching tool, a teacher must be systematic in her use of it. The type and frequency of reinforcement for individual students should be planned prior to activities. (Some students may need constant and frequent reinforcement while others can handle more intermittent reinforcement.) The type of reinforcer must be appropriate and natural to the activity the student is doing and to the level of student understanding. (For example, if a student does not understand how a token system works, then this will not be an effective reinforcer. If making requests is the behavior being reinforced, then do not reinforce a request for juice with an m&m. The appropriate consequence or reinforcer is to get juice.)”

Cooperation between therapists and parents

Parents are encouraged to work closely with professionals. For example, according to Short (1984), parents are trained as co-therapists for their children so that techniques can be continued at home.  

“Parent training is based on principles from behavioral and developmental theory. Emphasis is placed on: (a) developmental assessment of skills; (b) communication at a developmental level appropriate to the child’s ability to comprehend; (c) presenting tasks at a pace that the child can handle; (d) appropriately arranging and presenting materials in the teaching setting; (e) the effective use of reinforcement and time-out”.

In addition, according to Mesibov et al. (2004), parents are encouraged to act as cross-cultural interpreters for their children. 

“Parents, teachers, therapists, and others who use Structured Teaching methods function as cross-cultural interpreters, helping people with ASD understand the expectations and skills needed to function in our culture, and also helping non-autistic people understand and adapt to the needs of their students, offspring, clients, employees, etc. with ASD.”

Cost and Time

Cost

The major costs of using the TEACCH Autism Program are the salaries and associated costs of the staff of the organisations which provide it. 

There may also be costs for any training that is undertaken (which may include travel, accommodation and learning materials), and any equipment and materials used. The latter may include modifications to the physical environment in the school or home, the creation of visual schedules etc.

In the UK, some local education authorities will pay for children to attend schools which follow the principles of the TEACCH Autism Program, such as the schools run by The National Autistic Society.  In the USA, some providers such as Division TEACCH, will accept Medicaid, Medicare, Tricare, BCBS, State Health Plan as well as all qualified insurance plans.

Time

The amount of time it takes to follow the TEACCH Autism Program will depend to a certain extent on the specific service being run by each provider and on the needs of the individual participants. For example, some children attending schools that follow the TEACCH model may be in full time (day or residential) education for many years.

Risks and Safety

Hazards

There are no known hazards for the TEACCH Autism Program, although it has been criticised by some people. For example, according to the Autism Gateway website accessed on 16 August 2017, 

“There have been criticisms that the TEACCH approach is too structured, that children with ASD, particularly those individuals who are less affected, become too focused on the charts, organizational aids, and schedules, and that it discourages mainstream behavior (meaning that they may only respond to specific stimuli as taught in their curriculum and not everyday situations). Others feel that, in an environment conducive to learning, ultimately the child with ASD understands what is expected and how to respond.”

Contraindications

There are no known contraindications (something which makes a particular treatment or procedure potentially inadvisable) for the TEACCH Autism Program.

Suppliers and Availability

Suppliers 

Division TEACCH at the University of North Carolina is the main provider of TEACCH-based services within the USA. It provides a range of services for pre-school children, school-aged children and adults. It also provides training and accreditation to other suppliers in the USA and other countries. 

Outside the USA there are no equivalents to the complete TEACCH service. In the UK many schools have incorporated elements of TEACCH and Division TEACCH staff sometimes run seminars and training programmes in the UK. Other organisations (such as The National Autistic Society) also run training programmes on TEACCH.

Credentials

There are no formally recognised, TEACCH-specific training qualifications. Teachers and other professionals involved in TEACCH, such as speech and language therapists, will have a range of different credentials and qualifications.

Other people, including parents and other members of the family, may also be involved. They do not need any formal qualifications, although many will have studied the materials provided by Division TEACCH or The National Autistic Society or attended one or more of their courses.

Related Suppliers and Availability


History

Division TEACCH began in 1966 as a Child Research Project at the Department of Psychiatry, in the School of Medicine, at the University of North Carolina. 

Eric Schopler and Robert Reichler initially called their programme the “Parents-as-Cotherapists model” (emphasising the importance of parents in delivering the intervention). It was only later that it came to be known as the TEACCH model and/or structured teaching.

In 1972 the North Carolina General Assembly passed legislation which enabled Division TEACCH to become the first comprehensive state-wide community-based programme of services for children and adults on the autism spectrum and other similar developmental conditions.

The TEACCH model has since been adopted and adapted by various organisations thought the world.  For example, in the UK many schools (including the schools run by The National Autistic Society) incorporate many of the principles of the TEACCH model into their day to day practice. Other organisations have designed named programmes based on the TEACCH model (such as the Forward Steps Early Intervention Programme run by Barnardo’s in the UK).

 

Current Research

We have identified more than 20* studies of TEACCH published in English-language, peer-reviewed journals. These studies included more than 700 children and adults on the autism spectrum, although more than 300 of these children came from just two studies (Boyd et al, 2014 and Mandell et al, 2013).

The study by Boyd et al (2014) compared TEACH with LEAP (Learning Experiences - An Alternative Program for Preschoolers and Parents) and with standard teaching. It included 198 pre-school children and was delivered by teachers in 74 different classrooms in four different states within the USA over the academic year. It reported that each of the three interventions produced significant benefits such as improvements in autism characteristics and severity, communication skills and reciprocal social interactions. 

The study by Mandell et al (2013) compared TEACCH with STAR (Strategies for Teaching based on Autism Research, a comprehensive, multi-component programme based on applied behaviour analysis).  It included 119 primary school students and was delivered by teachers in 33 different classrooms in the School District of Philadelphia in the USA over the academic year. It reported that both TEACCH and STAR produced significant benefits including a clinically meaningful increase in IQ. 

The other studies were all much smaller and were delivered in a range of countries (Hong Kong, Italy, the UK and the USA), in a range of settings (family homes, schools, specialist centres or residential services) and by a range of practitioners (teachers, parents, health care professionals). The duration of the intervention varied from 4 weeks to two years.

Some of these studies examined programmes described as the TEACCH model or program; some of the studies examined specific, named versions of the TEACCH program for pre-school children (such as the Family Implemented TEACCH for Toddlers programme); some of the studies examined specific, named programmes for pre-school children which were described as “based” on the TEACCH model (such as the Barnardo's Forward Steps Early Intervention Programme).

Most of the studies examined programmes designed to achieve a wide range of outcomes. However some of studies were designed to teach a more limited range of activities (such as Orellana et al, 2017 which examined compliance with a clinical dental assessment).

Most of these studies reported a number of benefits including improvements in social communication (language skills); adaptive functioning (imitation of others, compliance with instructions; play); cognition (non-verbal IQ), motor skills (hand eye coordination), independence and overall quality of life. Some of the studies (such as Siaperas et al, 2007) reported reductions in challenging behaviours.  Several of the studies (such as Bristol et al, 1993) reported improvements in the mental health of the parents of the children studied.

Some of these studies reported limited or mixed results. For example, Van Bourgondien et al (2003) reported that TEACCH led to an improvement in the quality of life of the participants in a residential programme for adults.  However, they also reported that TEACCH “did not show either statistically or clinically significant changes in the developmental levels of participants over time”.

*Please note:

  • We have not included studies which looked only at individual elements of the TEACCH model (such as physical structure; visual schedules; work systems and task organisation).
  • We have not looked at studies of the TEACCH-based, supported employment programme run by Division TEACCH.

Status Research

There are a number of limitations to all of the research studies published to date. For example

  • Many of the studies used single-case designs (such as multiple baseline or case series) and most included 20 or fewer participants. For example, the study by Probst et al, 2010 was a case series of only 3 participants.
  • Some of the group studies (such as Welterlin et al, 2012) had fewer than 30 participants.
  • Most of the group studies (such as Tsang et al, 2007) were non-randomised and non-blinded. 
  • Some of the studies (such as Short, 1984) did not independently verify the diagnosis of autism using established diagnostic tools like the ADOS or ADI-R (which were not available when Short wrote his study). 
  • Some of the studies (such as D'Elia et al, 2014) did not provide fidelity measures, meaning it is not clear how closely the intervention did or did not follow the TEACCH model. 
  • Some of the studies (such as Siperas et al, 2007) did not use standardised outcome measure but relied on simple observational measures (such as a frequency check-sheet designed to summarize the frequency of certain challenging behaviours over a month).
  • Most of the studies (such as such as Ozonoff and Cathcart) did not provide long term outcome data, meaning it is not clear how long any benefits of the intervention lasted.
  • According to its authors, the study by Boyd et al (2014) had a number of limitations. These included the fact that the researchers used raw versus standard scores for some measures; the researchers were reliant on school officials to nominate classrooms/teachers to participate in the study; there were some pre-treatment differences between groups; the assessors were not blind to the children’s group assignment; and the control condition used may represent the ‘‘best’’ of standard practice and may differ substantially from the modal level of quality that reflects ‘‘business-as-usual’’ classroom practices.
  • According to its authors, the study by Mandell et al (2013) had a number of limitations. These included the fact that the randomisation was not successful with regard to ethnicity; fidelity was measured through video at monthly intervals; the comparison group comprised a rigorous and promising intervention, rather than “teaching as usual; the study was overly reliant on the Differential Ability Scales as an outcome measure, which may miss important components of academic achievement.
  • Many of the studies (such as Van Bourgondien et al, 2003) were undertaken by researchers who were not independent of the interventions being studied.  Those researchers may therefore have been biased towards the intervention, however unconsciously.
  • Very few of the studies appeared to involve people on the autism spectrum or their parents and carers in the design and development of the studies, although some did involve parents in the evaluations.

For a comprehensive list of potential flaws in research studies, please see ‘Why some autism research studies are flawed’

Ongoing Research

We have identified the following studies into TEACCH that are currently underway.  If you know of any other studies we should include please email info@researchautism.net with the details. 

Future Research

Summary of Existing Research

- Individual research studies

There is a small amount of high quality research evidence (eleven controlled trials) and a small amount of low quality research (thirteen single-case design studies with three or more participants) into the use of the TEACCH Autism Program for people on the autism spectrum.

This research suggests that the TEACCH Autism Program may provide a range of benefits to some pre-school and primary school children on the autism spectrum. Those benefits include increased social communication and social interaction, along with improved cognition and improved motor skills.  

This research also suggests that the TEACCH Autism Program may reduce stress, and improve the mental wellbeing, of some families of children on the autism spectrum.

There is insufficient evidence to determine if the TEACCH Autism Program provides any benefits in other areas (such as a reduction in repetitive and restricted behaviours, interests and activities) for any children on the autism spectrum.

There is insufficient evidence to determine if the TEACCH Autism Program provides any benefits for adolescents or adults on the autism spectrum.

There is insufficient evidence to determine if any of the four components of structured teaching (physical structure; visual schedules; work systems; and task organisation) by itself provides any benefit for anyone on the autism spectrum.

- Research Reviews

There have been relatively few research reviews of TEACCH. 

Virues-Ortega et al carried out a very useful meta-analysis of TEACCH in 2013. This concluded that TEACCH might provide some benefits to some people on the autism spectrum but that any conclusions should be considered preliminary. However, their analysis was published before the large scale studies by Boyd et al in 2014 and Mandell et al in 2013, so some of their conclusions may no longer be valid. They stated, 

“In summary, the present meta-analysis suggests that (a) TEACCH effects over perceptual, motor, verbal and cognitive skills may be of small magnitude; (b) effects over adaptive behavioral repertoires including communication, and activities of daily living may be within the negligible to small range; (c) effects over social behavior and maladaptive behavior may be moderate to large; (d) the evidence base currently available does not allow to identify specific characteristics of the intervention (duration, intensity, and setting) and the target population (developmental age) that could be driving the magnitude of effects; and (e) effects are, in general, replicated across age groups, although the magnitude and consistency of intervention effects are greater among school-age children and adults. Again, it is important to acknowledge that these preliminary conclusions are grounded in very limited data. Namely, only two of the meta-analyzed studies were randomized controlled trials (RCT), all studies had small samples, only one study monitored treatment fidelity, and only two studies conducted blinded assessments. Moreover, several outcomes showed evidence of excessive heterogeneity and potential for publication bias. Therefore, our conclusions should be considered preliminary.”

Howley carried out a very useful narrative review of TEACCH in 2015. She noted three significant gaps in the research evidence.

“First, the focus on measuring observable behaviours results in a clear gap in the evidence in relation to what children are learning and why they are learning what they are learning. Second, social validity of structured teaching components, and in particular, the views of those implementing the approach, are worthy of more in-depth analysis when investigating the research evidence neglects to thoroughly consider an important part of the picture, largely ignoring the impact of the approach upon the inner experiences and well-being of individual learners. Consideration of each of the above would add to the empirical evidence in order to fully understand the ‘bigger picture’.” 

Recommendations for Future Research

There is a need for more research into the TEACCH Autism program which uses scientifically robust, experimental methodologies and which includes a wider range of participants.  

That research should investigate whether the TEACCH Autism program is more or less effective than other comprehensive, multi-component, educational interventions (such as the UCLA YAP model and LEAP). It should also investigate which components of the TEACH Autism Program, if any, are more likely to benefit which individuals on the autism spectrum. 

That research should be undertaken by researchers who are independent of the interventions being studied. That research should also involve people on the autism spectrum and their parents and carers in the design, development and evaluation of those studies.

Studies and Trials

This section provides details of scientific studies into the effectiveness of TEACCH as an intervention for people on the autism spectrum which have been published in English-language, peer-reviewed journals. If you know of any other studies we should include please email info@researchautism.net with the details. Thank you.

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Related Studies and Trials


Other Reading

This section provides details of other publications on autism and TEACCH. If you know of any other publications we should include please email info@researchautism.net with the details. Thank you.

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Related Other Reading


Additional Information

Some researchers have suggested that there are more similarities than differences between the TEACCH Autism Program and some other comprehensive, multi-component educational interventions (including programmes based on the principles of applied behaviour analysis). For example,

  • According to Boyd et al (2014), in their comparison of LEAP, TEACCH and standard teaching practices “All three programs were found to produce statistically significant changes in children’s outcomes across the school year. This finding may shift the field’s thinking around [comprehensive treatment models] designed for students with ASD. Perhaps it is not the unique features of the models that most contribute to child gains; instead it is the common features of the models that most influence child growth… Early analysis of the overlap of scores on the fidelity measures indicate that perhaps those components common to the intervention approaches (e.g. classroom organization, teacher interaction with students and families) account for outcomes more than components that are unique to each approach (e.g. peermediated instruction in LEAP classrooms, structured work systems in TEACCH classrooms)”
  • According to Mandell et al (2013), “While STAR and Structured Teaching have many differences, some similarities emerged during the training that were not apparent from reading the manuals or communication with the trainers. Specifically, the classroom organizational and scheduling/transition strategies in Structured Teaching were very similar to the use of functional routines in STAR. The primary differences between the two programs therefore were the use of one-to-one instructional strategies and a highly specified curriculum in STAR.”

Related Additional Information


Updated
12 Dec 2017
Last Review
01 Nov 2017
Next Review
01 Nov 2020