*3.7.1. Purpose of the technique*

The Treatment and Education of Autistic and Communication-Handicapped Children (TEACCH) program is intended to assist children in completing daily tasks by providing instructions that are clear and understandable in an environment that is highly structured and supportive [63]. TEACCH is considered a structured teaching program that recognizes the characteristics commonly associated with autism spectrum disorder, specifically communication problems, preference for visual information, sensory-related difficulties, attention variability, intense interests/impulses, and time management issues [64]. By offering a highly structured teaching environment focused on each child's individual ASD characteristics and the task at hand, learning development can occur. TEACCH is considered to be a multi-disciplinary approach, focused on collaboration between a variety of service providers, including teachers, therapists, family, and community [65].

diagnosed with autistic disorder or pervasive developmental disorder – not otherwise specified over a 2 year period. The group was split evenly into a control group that did not receive TEACCH and an experimental group that received the TEACCH intervention 2 h per week at school and 2 h per week at home. Results for the main outcome indicators of severity of autism, language, and adaptive functioning showed no significant difference between the control group and the experimental group. Results for the secondary outcomes of parental stress and psychopathological comorbidity indicated significant differences between the control group and the experimental group. Both secondary outcomes indicated greater improvement in the experimental group. The authors indicate that the lack of significance in primary outcomes could possibly be attributed to the low intensity of the TEACCH intervention, which is not standard protocol. The positive secondary outcomes indicate potential of the TEACCH program in decreasing parental stress and child

Occupational Therapy's Role in the Treatment of Children with Autism Spectrum Disorders

http://dx.doi.org/10.5772/intechopen.78696

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With home-based TEACCH being a major component of the program, it is important to determine the efficacy of that particular approach. Weterlin and associates conducted a study on the efficacy of the Home-TEACCHing Program (HTP) on toddlers with ASD [67]. The sample included twenty 2–3 year old children and their parents. Children and their parents were randomly assigned to either the treatment (HTP) group or the waitlist (WL) group. WL group members were informed that they would receive the treatment at the conclusion of a 12 week wait period. This study yielded three major findings: (1) HTP improved children's independent work skills; (2) Parents were able to structure the physical environment to improve child outcomes; (3) Parents improved their effective prompting, including using visual prompts. Although the sample size was small, findings demonstrate support for the

Overall, research to date on effectiveness of the TEACCH program is very encouraging. Therapists use the components of TEACCH to assist children with ASD in learning tasks. Specifically, therapists using this technique will structure the physical environment (including visual cues), and organize the task with explicit directions in order to assist the child in

The Cognitive Orientation to Occupational Performance (CO-OP) is a task-oriented, problemsolving approach that uses cognitive skills to improve occupational performance. It is typically a verbally based approach that emphasizes teaching clients to incorporate self-talk and problem-solving to address difficulty with the execution of various motor skills [69]. According to Missiuna and associates, elements of CO-OP include concepts related to problem-solving, learning theory, motor learning theory, cognitive strategies, client-centered practice, goal setting, and motivation [69]. CO-OP has been observed to be highly individualized, starting with clinician generated verbal guidance, followed by the development of client internal selfdialog, and finally independent application of problem-solving strategies ([70], p. 190).

behavioral/emotional problems.

use of the Home-TEACCHing Program.

*3.8.1. Purpose of the technique*

learning new skills that aid in improved functional outcomes.

**3.8. Cognitive orientation to occupational performance (CO-OP)**
