AUTISM SPECIFIC EDUCATION IN SOUTH
AFRICAN PUBLIC SCHOOLS:
PRACTICES AND CHALLENGES
CORINA (JC) BOTHA
A dissertation presented in the fulfilment of the requirements
of the degree
MAGISTER IN OCCUPATIONAL THERAPY
(240 credits)
at the
FACULTY: HEALTH SCIENCES
DEPARTMENT: OCCUPATIONAL THERAPY
UNIVERSITY OF THE FREE STATE
June 2014
Study leader: Dr. R. Van Heerden
Co-leader: Me. A. Van Jaarsveld
Biostatistician: Me. R. Nel
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DEDICATED
To educators employed in Autism Specific Education within South African public
schools.
Thank you for choosing to work with a challenging group of learners irrespective of
limited resources, support and recognition.
Your passion, patience, dedication and creativity are an inspiration.
You make a difference!
“Do more than belong: participate. Do more than care: help. Do more than believe:
practice. Do more than be fair: be kind. Do more than forgive: forget. Do more than
dream: work.”
William Arthur Ward
ii
DECLARATION
I certify that the dissertation hereby submitted for the Magister in
Occupational Therapy degree at the University of the Free State is my
independent effort and has not been previously submitted for a degree at
another University / Faculty.
I furthermore waive copyright of the dissertation in favour of the University of
the Free State.
Signed:
___________________
Corina Botha
June 2014
iii
ACKNOWLEDGEMENTS
My sincere thanks to
Dr. R Van Heerden
My study leader, I thank you for your incredible work capacity, honesty, efficiency and commitment
to quality. Your precision, research experience and discipline serve as an example to me. I
appreciate your availability, hard work behind the scenes and loyalty. Most of all – thank you for
believing in me in times when I lost all hope!
Me. A van Jaarsveld
My co-study leader, I thank you so much for your support, wisdom, advice, humour and
commitment over the past 20 years. You have always been a mentor to me on both a personal
and professional level. I am forever challenged by the standard of excellence you model in
everything you attempt.
Me. R Nel
My biostatistician, I thank you for your specialist input, sharing your experience and for constantly
striving to ensure accurate, valid and reliable data. I learned so much about the statistical aspects
of research from you and I only have the greatest appreciation for your advice, time and patient
assistance.
Me. I Kilbourn
My language editor, thank you for your attention to detail, your professionalism and perfectionism.
Your diligence and extra miles are appreciated.
Me. H Strauss
Thank you for friendliness, professionalism and efficient way in which you coordinated the ethical
approval of my project.
iv
Mr. MJ Mothebe and Me. L Alexander
Free State Director Strategic Planning, Policy and Research and his secretary, I thank you for the
efficient and professional manner in which you assisted me with my application to conduct
research in the Free State Department of Education. I appreciate the extra miles in trying to get
national approval. I am humbled by your humility, integrity and positive attitude towards my
project.
Dr. AT Wyngaard (Western Cape), Dr. D Makhado (Gauteng), Dr. AS Heckroodt (Eastern Cape)
and Dr. NSP Sishi (Kwa-Zulu Natal):
Directors Strategic Planning, Policy and Research, I appreciate your efficiency in approving my
research application in your respective provinces.
Me. NEH Motsoeneng
Free State Department of Education: Motheo District Director, I thank you for your approval of my
research project, bursary and study leave.
Me. NSS Mochoari
Chief Education Specialist: Education Development and Support, I appreciate your approval and
support of this project. Thank you for always having our best interest at heart when representing
us at district level.
Me. NM Dyantyi
Deputy Chief Education Specialist: Motheo Inclusive, I thank you for your leadership, compassion,
teamwork and positive attitude towards my research. It is a privilege to have you as my
supervisor.
Bursary Section Free State Department of Education
Thank you for paying my tuition fees for 2012. I have developed significantly though this project
and would plough the skills I have gained back into my work.
Me. E Mostert
Motheo Education Librarian, thank you so much for assisting me in my search for appropriate
literature. I appreciate your efficiency, positive attitude and flexibility.
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Principals, School Management teams and School Governing bodies
Thank you for allowing me to perform research at your school and for encouraging staff to
participate. Your leadership and efficient management skills facilitated the data collection process.
Educators of Autism Specific Classes
I cannot thank you enough for your participation in this project. The kindness and passion with
which you daily serve a challenging group of learners are inspiring. You are indeed exceptional!
Those living with Autism
The challenges you face in accessing your right to education inspired this project. I hope this
research study would create awareness and fuel action to expand quality Autism Specific
Education in South African public schools.
My colleagues at Motheo Inclusive
Santjie Vermaas, Lalie Du Toit, Martin Brink, Tshedi Khambule, Dipuo Makele and all the others.
Your interest, words of encouragement, assistance and coffee gave me strength to complete my
studies. Santjie, it is such a privilege to work with you. Your care, friendliness, assistance and
mentorship mean the world to me.
My dear friends
Your hugs, chats, prayers and encouragement carried me through. Karen Bezuidenhout and
Hester Steyn thanks for all the great food for body and mind. Karen, thank you for helping me with
the courier services. Ennie Salakuva, your legacy will live in my heart forever – rest in peace. The
special people in my life are too many to mention- I appreciate you all!
My immediate family:
Kaninie, Boeta; Chelly, Riva and JD; Jouberts, Erasmusse and Lötters your interest, love and
support have strengthened me.
My parents
Your love, prayers, involvement, support, availability and constant interest in my wellbeing carried
me through. You are the best parents in the world!
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Jacques Botha
My dear husband, I thank you for encouraging me to use opportunities, for giving me space to
grow, for providing security and supporting me in everything I attempt. I treasure your sense of
humour, kind heart, love, positive attitude, intelligence, loyalty, confidence and calmness. You
bring balance in my life and it is a privilege to have you as a partner.
Louis and Carlise Botha
My dear children, I thank for your endless love, patience and sacrifices throughout this project.
Louis your perseverance, courage and inner strength is an inspiration to me. Carlisie your energy,
humour, multiple schemes and creativity kept me on my toes. The two of you are infinitely
precious!
My Heavenly Father
I thank You for Your boundless love, grace, faithfulness and provision. You preserve, protect,
forgive, comfort and strengthened me every day. Thank You for helping me to face my fears;
overcome significant challenges and for creating opportunities to grow.
“You are my God, and I will praise You; You are my God, and I will exalt You.
Give thanks to the Lord, for He is good; His love endures forever.”
Psalm 118:28-29
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TABLE OF CONTENTS
DEDICATED TO ii
DECLARATION iii
ACKNOWLEDGEMENTS iv
TABLE OF CONTENTS viii
LIST OF TABLES xv
LIST OF FIGURES xviii
ACRONYMS AND ABBREVIATIONS xix
CONCEPT CLARIFICATION xx
SUMMARY AND KEY WORDS xxiv
OPSOMMING EN SLEUTELWOORDE xxvii
CHAPTER 1 – INTRODUCTION AND ORIENTATION TO RESEARCH
1.1. INTRODUCTION 1
1.2. PROBLEM STATEMENT 4
1.3. PURPOSE OF THE OF STUDY 6
1.3.1. Aim 6
1.3.2. Objective 6
1.4. DELIMITATIONS OF THE PROBLEM 7
1.5. METHODOLOGY 8
1.6. THE IMPORTANCE AND VALUE OF THE STUDY 9
1.7. ETHICAL CONSIDERATIONS 11
1.8. OUTLINE OF CHAPTERS 11
1.9. SUMMARY 12
CHAPTER 2 –LITERATURE REVIEW
2.1. INTRODUCTION 13
2.2. OVERVIEW ON AUTISM SPECTRUM DISORDERS 13
2.2.1. Changes proposed by the DSM-5 and possible impact 14
2.2.2. Concerns regarding the possible impact of the DSM-5 21
2.2.3. Diagnostic tools 22
2.2.4. Patho-physiology of Autism Spectrum Disorders 23
2.2.5. Causes of Autism Spectrum Disorders 24
2.2.6. Prevalence of Autism Spectrum Disorders 26
2.2.7. Treatment and intervention 29
2.2.8. Early identification and interventions 29
2.2.9. Medication and alternative approaches 30
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2.2.10. Prognosis of Autism Spectrum Disorders 31
2.2.11. Cost of treatment and care 32
2.3. AUTISM SPECIFIC EDUCATION 34
2.3.1. Impact of the condition itself 35
2.3.1.1. Social interaction deficits 37
2.3.1.2. Implications of social interaction deficits for education 38
2.3.1.3. Socio- communication deficits 41
2.3.1.4. The implications of socio-communication on education 42
2.3.1.5. Restricted, repetitive patterns of behaviour, interests, oractivities 45
2.3.1.6. Implications of restricted, repetitive patterns of behaviour,interests, or activities for education 46
2.3.1.7. Sensory-processing difficulties 48
2.3.1.8. Implications of sensory processing difficulties for education 50
2.3.1.9. Associated factors: unusual patterns of attention 53
2.3.1.10. Implications unusual patterns of attention for education 53
2.3.1.11. Motor deficits 54
2.3.1.12. Implications of motor deficits for education 54
2.3.2. Behaviour and socio-emotional responses as a result of the condition 56
2.3.2.1. Implications of emotional and behavioural challenges foreducation 58
2.3.3. Attitudes towards behaviours 60
2.3.4. Inclusion as a global trend 61
2.3.5. Critical success factors of autism specific education in inclusive settings 62
2.3.5.1. Individualised, well coordinated approach 63
2.3.5.2. Attitude and job satisfaction 63
2.3.5.3. Training, knowledge and skills 65
2.3.5.4. Collective teams and leadership 67
2.3.5.5. Parent involvement and positive parent–educator relationships 67
2.3.5.6. Curriculum and extra-curricular activities 67
2.3.5.7. Multiple, context based assessment strategies 69
2.3.5.8. Research-based interventions and programmes 69
2.4. SOUTH AFRICAN CONTEXT
2.4.1. Introduction of inclusive education in the South African Education system 73
2.4.2. Barriers in the microsystem that affect the implementation of inclusivepolicy 74
2.4.3. Barriers in the mesosystem that affect the implementation of inclusivepolicy 75
2.4.3.1. Specials schools / Resource Centres 76
2.4.3.2. Mainstream and full service schools 76
2.4.3.3. Resources, therapeutic support and extra-curricular activities 77
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2.4.4. Barriers in the exosystem that affect the implementation of inclusive policy 79
2.4.4.1. District-based support teams 79
2.4.4.2. School-based support teams 80
2.4.4.3. School management teams and school governing bodies 81
2.4.5. Barriers in the macrosystem that affect the implementation of inclusivepolicy 82
2.4.5.1. Provincial level 82
2.4.5.2. National level 82
2.5. SUMMARY 85
CHAPTER 3- RESEARCH APPROACH AND METHODOLOGY
3.1. INTRODUCTION 86
3.2. RESEARCH APPROACH AND STUDY DESIGN 87
3.2.1. Quantitative approach 87
3.2.2. Descriptive design 87
3.3. RESEARCH POPULATION 88
3.4. SAMPLING 88
3.4.1. Inclusion criteria 88
3.4.2. Exclusion criteria 90
3.4.3. Determining the size of the research sample 90
3.5. THE COURSE OF STUDY 93
3.6. PILOT STUDY 95
3.7. MEASUREMENT 96
3.7.1. The measurement tool 96
3.7.2. The measurement process 100
3.8. ANALYSIS OF THE DATA 104
3.9. METHODOLOGICAL AND MEASUREMENT ERRORS 105
3.9.1. Sampling errors 105
3.9.2. Non-response errors 105
3.9.3. Measurement errors 107
3.9.3.1. Validity 107
3.9.3.2. Reliability 108
3.10. ETHICAL ASPECTS 109
3.10.2. Approval 110
3.10.2. Responsibility towards participants 111
3.10.3. Commitment to professional ethics 112
3.11. SUMMARY 113
CHAPTER 4- RESULTS
4.1. INTRODUCTION 114
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4.2. PARTICIPATION OF SCHOOLS 115
4.3. DESCRIPTION OF THE STUDY POPULATION 117
4.3.1. Age of educators 117
4.3.2. Gender of educators 118
4.3.3. Provinces and type of schools in which educators were working 118
4.4. THE LEVEL OF TRAINING AND EXPERIENCE OF EDUCATORS 120
4.4.1. Work experience of educators – abroad and within the South Africancontext 120
4.4.2. Phase specific training 121
4.4.3. Educators’ basic training 121
4.4.4. Educators’ formal post basic training 123
4.4.5. Educators’ formal post basic training currently underway 124
4.4.6. Educators’ training in autism specific programmes 125
4.4.7. Service providers responsible for educator training 127
4.4.8. Schools providing training 127
4.4.9. Updates regarding the latest developments in autism specific education 129
4.5. SCHOOL-BASED OPERATIONS 130
4.5.1. Type of school 131
4.5.2. Assessment tools 131
4.5.3. Use of Screening Identification and Support (SIAS) 132
4.5.4. Age groups accommodated at school 133
4.5.5. Admissions criteria 134
4.5.6 Accommodation of special needs in hostel 135
4.5.7. Extra-curricular services offered 137
4.5.8. Reasons for necessity of therapists 140
4.5.9. Therapeutic services offered 142
4.5.10. Therapeutic support to educators 143
4.5.11. Transfer of skills to the home environment: 144
4.5.12. Frequency of parent feedback and specialised training for parents 146
4.5.13. Financial burden for parents regarding specialised services delivered 147
4.5.14. Autism support groups 147
4.6. CLASSROOM MANAGEMENT PRACTISES 149
4.6.1. Languages of teaching 149
4.6.2. Age range of learners 150
4.6.3. Number and gender of learners in class 151
4.6.4. Severity of ASD 151
4.6.5. Autism specific classes versus inclusivity 152
4.6.6. Use of a class assistant 154
4.6.7. Vocational training as part of the curriculum 154
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4.6.8. Curriculums used in autism classes 155
4.6.9. Critical aspects included in curriculum 156
4.6.10. Lesson plans and learning pace 157
4.6.11. Individual support plans and schedules 158
4.6.12. Assessment and monitoring of progress 159
4.6.13. Classroom arrangement to optimise the performance of learners 160
4.6.14. Visual stimuli in the classroom environment 161
4.6.15. Safety of learners during break time 162
4.7. THE USE OF AUTISM SPECIFIC SUPPORT STRATEGIES 163
4.7.1. Utilisation of research-based programmes 163
4.7.2. Educator’s rating of their skill level in diagnostic specific impairments 166
4.7.3. Use of assistive technology and alternative methods 170
4.7.4. Useful class strategies 174
4.7.5. Use of caregivers in class 175
4.8. CHALLENGES AND CRITICAL SUCCESS FACTORS 175
4.8.1. Reasons for decided to work with learners with ASD 175
4.8.2. Educators’ rating of potential challenge 178
4.8.3. Educator experiences of accomplishment 184
4.8.4. Opinions on critical success factors 186
4.9. SUMMARY 191
CHAPTER 5 – DISCUSSION
5.1. INTRODUCTION 192
5.2. DESCRIPTION OF THE STUDY POPULATION 192
5.2.1. Age of educators 193
5.2.2. Gender of educators 193
5.2.3. Provinces and type of schools in which educators were working 194
5.2.4. Conclusions on practices and challenges: demographics 195
5.3. THE LEVEL OF TRAINING AND EXPERIENCE OF EDUCATORS 196
5.3.1. Qualifications and formal training 196
5.3.2. Work experience 198
5.3.3. Training in research-based ASD programmes 198
5.3.4. Training service providers 199
5.3.5. Updates and self-development 199
5.3.6. Conclusions on practices and challenges concerning trainingdevelopment 200
5.4. SCHOOL-BASED OPERATIONS 202
5.4.1. Admissions procedures 202
5.4.2. Hostel accommodation 205
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5.4.3. Extra-curricular services offered and funded 206
5.4.4. Therapeutic services offered 208
5.4.5. Transfer of skills to the home environment 210
5.4.6. Conclusions on practices and challenges concerning extra-curricularservices 210
5.5. CLASSROOM MANAGEMENT PRACTISES 213
5.5.1. Demographics of learners in South African ASD classes 214
5.5.2. Autism Specific Education versus Inclusivity 214
5.5.3. Curriculums and differentiation 215
5.5.4. Individualised support 216
5.5.5. Monitoring and assessment 217
5.5.6. Classroom structure 217
5.5.7. Safety during break 218
5.5.8. Conclusions on practices and challenges concerning classroommanagement 218
5.6. THE USE OF AUTISM SPECIFIC SUPPORT STRATEGIES 220
5.6.1. Utilisation of research-based programmes 220
5.6.2. Educators’ rating of their skill level in diagnostic specific support 222
5.6.3. Use of assistive technology, alternative methods and other strategies 224
5.6.4. Conclusions on practices and challenges concerning the use of autismspecific support strategies 226
5.7. CHALLENGES AND CRITICAL SUCCESS FACTORS 227
5.7.1. Educators’ experiences of accomplishment and reason for working withASD 227
5.7.2. Educators’ rating of potential challenges 229
5.7.3. Opinions on critical success factors 230
5.7.4. Conclusions : challenges and critical success factors 230
5.8. SUMMARY 232
CHAPTER 6 LIMITATIONS, CONCLUSIONS AND RECOMMENDATIONS
6.1. INTRODUCTION 235
6.2. LIMITATIONS OF THE STUDY 235
6.3. CONCLUSIONS 236
6.3.1. Training and experience of educators 236
6.3.2. School-based operations 237
6.3.3. Classroom management practices 239
6.3.4. Autism-specific support strategies 239
6.3.5. Challenges and critical success factors 240
6.4. RECOMMENDATIONS 241
6.4.1. Training and experience of educators 241
6.4.2. School-based operations 242
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6.4.3. Classroom practices and autism specific support strategies 243
6.4.4. Critical success factors and challenges 243
6.5. TO CONCLUDE 244
REFERENCES 245
ADDENDUMS
ADDENDUM A List of schools
ADDENDUM B Submission of minor protocol amendments
ADDENDUM C Afrikaans research questionnaire
English research questionnaire
ADDENDUM D Rational of the research questionnaire
ADDENDUM E Data collection guideline
ADDENDUM F Power Point: regional representatives
ADDENDUM G Regional representative confirmation letter
ADDENDUM H Ethics Approval UFS
ADDENDUM I Approval letters from Provincial Directorates:Free State
ADDENDUM J Inligtings dokument
Information document
ADDENDUM K School permission to participate
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LIST OF TABLES
____________________________________________________________________________
Table 2.1. Summary of the diagnostic criteria for ASD as proposed in the DSM-5 19
Table 2.2. Severity levels of ASD and support required 20
Table 2.3. Prevalence of ASD as indicated by the ADDM Network 2000-2010 28
Table 2.4. The distribution of special schools, learner enrolment and expenditureper learner across different provinces as recorded in 2001 34
Table 2.5. Classroom strategies to enhance social skills in learners with ASD 39
Table 2.6. Classroom strategies to enhance communication skills in learners withASD 43
Table 2.7. Classroom strategies to reduce restricted, repetitive behaviours inlearners with ASD 47
Table 2.8. Classroom strategies to enhance sensory behaviours in learners withASD 50
Table 2.9. Classroom strategies to enhance motor skills in learners with ASD 55
Table 2.10. Classroom strategies to enhance emotional and behavioural support inlearners with ASD 58
Table 2.11. Characteristics of dysfunctional and functional schools 73
Table 3.1. Summary of number of schools and educators for the different ASDschools 93
Table 3.2. Categories of the structured questionnaire 99
Table 3.3. Questions structured in terms of the research objectives 100
Table 3.4. Description of roles in the data collection process 103
Table 3.5. Permission of schools to participate in research 110
Table 4.1. Overview on schools targeted and participated 115
Table 4.2. Age analysis of educators 117
Table 4.3. Age analysis of educators in accordance to quartiles 118
Table 4.4. Gender of educators 118
Table 4.5. Provinces and type of schools in which educators were working 119
Table 4.6. Age and work experience of educators 120
Table 4.7. Phase specific training 121
Table 4.8 Educators’ basic training 122
Table 4.9 Educators’ formal post basic training 123
Table 4.10. Educators’ formal post basic training currently busy with 124
Table 4.11. Educators’ training in autism specific programmes 126
Table 4.12. Service providers responsible for educator training 127
Table 4.13. Type of support offered by schools providing training 128
Table 4.14. Updates regarding the latest developments in autism specific education 129
Table 4.15. Type of school 131
Table 4.16. Assessment tools 132
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Table 4.17. Use of Screening Identification and Support 133
Table 4.18. Age groups accommodated at schools 133
Table 4.19. Admissions criteria 134
Table 4.20. Hostel accommodation in different school types 135
Table 4.21. Accommodation of special needs in hostel 136
Table 4.22. Extra-curricular services offered 137
Table 4.23. Extra-curricular services offered at different schools 138
Table 4.24. Most beneficial extra-curricular services offered 139
Table 4.25. Funding of extra-curricular services offered 140
Table 4.26. Reasons for necessity of therapists 141
Table 4.27. Therapeutic services offered 143
Table 4.28. Therapeutic support to educators 144
Table 4.29. Transfer of skills to the home environment 145
Table 4.30. Parent feedback and specialised training in schools 146
Table 4.31. Frequency of parent feedback and specialised training for parents 146
Table 4.32. Financial burden for parents regarding specialised services delivered 147
Table 4.33. Autism support groups 148
Table 4.34. Educators’ languages of teaching 150
Table 4.35. Age range of learners 151
Table 4.36. Number and gender of learners in class 151
Table 4.37. Severity of ASD 152
Table 4.38. Autism specific classes versus inclusivity in different schools 153
Table 4.39. Use of class assistants in schools 154
Table 4.40. Vocational training as part of the curriculum 155
Table 4.41. Curriculums used in autism classes 155
Table 4.42. Curriculums used in different schools 156
Table 4.43. Critical aspects included in curriculum 157
Table 4.44. Lesson plans and learning pace 158
Table 4.45. Individual support plans and schedules 159
Table 4.46. Assessment and monitoring of progress 159
Table 4.47. Classroom arrangement to optimise the performance of learners 161
Table 4.48. Visual stimuli in the classroom environment: 161
Table 4.49. Safety of learners during break time 162
Table 4.50. Utilisation of research-based programmes 164
Table 4.51. Most popular research-based programmes 165
Table 4.52. Educator’s rating of their skill level in diagnostic specific impairments 167
Table 4.53. Use of assistive technology and alternative methods 170
Table 4.54. Most popular assistive technology and assistive devices 173
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Table 4.55. Useful class strategies 174
Table 4.56. Use of care givers in class 175
Table 4.57. Reasons for decided to work with learners with ASD 176
Table 4.58. Educators’ rating of potential challenges 178
Table 4.59. Severe challenges – breakdown of responses in different schools 181
Table 4.60. Educator experiences of accomplishment 184
Table 4.61. Opinions on critical success factors 187
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LIST OF FIGURES
Figure 2.1. A comparison between the DSM-IV and DSM-5 to indicate the impact of
structural and other changes 17
Figure 2.2. Autism impact on learning through three processes 36
Figure 2.3. Ecological aspects that affect the implementation of inclusive policy in
South African schools 84
Figure 3.1. Steps in the process to determine sample size 91
Figure 3.2. Schematic representation of the course of the study 94
Figure 3.3. The measurement process 102
Figure 4.1. Educators identified versus the response rates in different provinces 116
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ACRONYMS AND ABBREVIATIONS
ABA Applied Behaviour Analyses
ADDM Network Autism and Developmental Disability Monitoring Network
ADI Autism Diagnostic Interview
ADOS Autism Diagnostic Observation Schedule
ASD Autism-Specific Disorder
CAPS Curriculum Assessment Policy Statement
CARS Childhood Autism Rating Scale
CDC Centres for Disease Control and Prevention
DBST District-Based Support Team
DISCO Diagnostic Interview for Social and Communication Disorders
DIR®/Floortime™ Developmental, Individual Difference, Relationship-Based Model
DSM-5 Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition
ELSEN Education for Learners with Special Educational Needs
EMIS Education Management Information System
PDD-NOS Pervasive Developmental Disorder Not Otherwise Specified
PECS Picture Exchange Communication System
SANASE South African National Association for Special Education
SBST School-Based Support Team
SIAS Screening, Identification, Assessment and Support
SPD Sensory Processing Disorder
SNAP Special Needs Adapted Programme
TEACCH Education of Autistic and Communication-Related HandicappedChildren
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CONCEPT CLARIFICATION
Autism-specific education classes: Classrooms that are resourced and equipped to provide
autism spectrum disorder (ASD) specific education and support due to the challenges of including
learners with highly intensive support needs in regular classrooms (Burns 2013:9). In the South
African context, ASD classes refer to classrooms at established schools (ordinary, full-service or
special schools) that offer autism-specific education to accommodate the unique needs of learners
with autism spectrum disorders.
Autism-specific education: The diagnostic and functional profiles of learners with ASD motivate
the need for specialised educational approaches, since conventional special needs programmes
and teaching methods are not appropriate and accessible in respect of their unique needs. The
majority of learners with ASD are not only in need of a specialised curriculum and therapeutic
intervention, but also require a responsive classroom setting that accommodates vital areas of
development (New Brunswick Department of Education 2005:48-49). Although the study
recognises inclusive policy where all learners have the right to access learning in a regular
classroom, learners with ASD require an all-encompassing support programme that are
appropriate to their unique learning needs.
Autism-specific school: Special schools or resource centres are resourced to provide
specialised education, facilities and diagnostic-specific support for learners with ASD (School
Management Team–Unica School for Autism 2012:online). In addition, services may also include
parent collaboration and support, training the community and relevant stakeholders, sharing of
information and facilities as well as contributing to responsible projects and research that promote
awareness of autism
Barriers to learning: Difficulties that occur within all levels of the education system, the learning
site (inflexible curriculums, inefficient school management, teaching strategies, etc.), the social
context (socio-economic status, domestic circumstances, etc.), the environment (inaccessible and
unsafe built environments) or within the learner (disability, personality, health, etc.) which influence
or prevent access to learning (SA 2008(3):8). The complexity of the condition, behaviours that
occur as a result of the condition, and the functional impact of these create barriers for learners
with ASD to learn and develop within typical classroom settings. Systemic barriers within all levels
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of the education system hamper the efficient inclusion of marginalised learners (including those
with ASD). Learners with ASD are from diverse family settings and communities with unique
socio-cultural and economic factors, which may create additional barriers to learning and
development.
Challenges: Within the context of the study, challenges refer to those tasks or situations that
educators experience as difficult to deal with (Oxford Dictionaries 2013:online). These may include
systematic, institutional, managerial, administrative or learner-related factors that may cause
frustration, burn-out and negative attitudes, and may create obstacles in providing appropriate
support to learners with ASD.
District-based support team (DBST): Multi-professional teams of district-based officials who are
responsible for the promotion of inclusive education through training, curriculum delivery, recourse
distribution, identifying and addressing of barriers to learning, leadership, and general
management (SA 2008:3(3),2009:49). District-based support teams are key role-players in
advocating the rights of learners with ASD to education and support, to create and develop
appropriate education support and to uplift systemic barriers that hamper service delivery to
learners with ASD.
Full-service schools: Ordinary or mainstream schools, which are specifically resourced and
transformed to accommodate the diverse learning barriers of learners in need of moderate support
(SA 2001(1):9). Full-service schools offer a mainstream curriculum, curriculum differentiation and
moderate education support and cannot successfully include learners with severe disability
profiles.
Inclusion: Inclusive education is concerned with the child’s right to participate and the school’s
duty to accommodate the child. In school-based settings it refers to the integration of diverse
learners (irrespective of language, race, culture, disability or other individual characteristics) into
the classroom with support and adjustments to make the curriculum more accessible. Inclusion
recognises that all learners can learn with appropriate support and that the school should have
systems in place that provide education which accommodate the needs of all learners (SA
2001(1):17). The study particularly focuses on the rights of learners with ASD to learn and to
develop their full capacity in a school system that is accommodative of their unique learning style
and developmental needs.
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Individual support plan: A plan that is designed for learners who require additional support or
expanded opportunities. These plans are developed by educators in consultation with the parents
and the school-based support team to ensure that the learner is supported according to his/her
unique needs (SA 2008(3):3, 2009(4):49). The use of individual support plans is considered to be
a critical success factor of autism-specific education (Hughes, Katsiyannis, McDaniel, Ryan &
Sprinkle 2011:58).
Mainstreaming: Mainstreaming or integration focuses on changes that need to take place in a
learner in order to fit within a particular education system that provides a standard curriculum and
regular classroom setting. Mainstreaming focuses on a standard classroom routine and is not
concerned with changes in the system to accommodate learners with high-level support needs
(SA 2001(1):17)
Maintream school: Schools that offer a mainstream curriculum are often referred to asordinary
schools (SA 2001(1):1). Both terms (ordinary and mainstream schools) are reflected in literature
but the term mainsream schools will be used with the purposes of this study.
Marginalised learners: Marginalised learners are those who are excluded from their right to basic
education by factors such as income differentiation and social status. Marginalisation is
categorised into four broad clusters, namely: group-based (race, language, religion, etc.); poverty-
related (severe, continued poverty), location (rural, remote or dangerous areas) and individual
(health, disability and special needs). Learners with ASD would mainly fall into the last group or
combinations thereof (Chang, Oberoi, Saifi & Sharma 2014:online).
Motheo District: Motheo (meaning “foundation” or “cornerstone” in Sesotho) is a district of the
Free State province in South Africa. The district is divided into three municipalities: Mangaung,
Mantsopa and Naledi. Mangaung Metro includes Bloemfontein, Botshabelo and Thaba ‘Nchu.
Mantsopa municipality concerns Tweespruit, Ladybrand, Excelsior and Hobhouse. Wepener,
Dewetsdorp and Van Stadensrus form part of the Naledi District. Motheo District was
disestablished on 18 May 2011 and Mangaung became a metropolitan municipality. Naledi and
Matsopa were integrated with neighbouring districts (Motheo District Municipal Council 2011:6).
These changes have not yet been introduced in the Free State Department of Education, and
district-based officials are still serving schools within Mangaung, Naledi and Mantsopa
xxii
National Strategy on Screening, Identification, Assessment and Support (SIAS): The SIAS
strategy deals with the process of identifying, assessing and providing programmes for all learners
in need of additional support to facilitate optimal participation and inclusion. The strategy offers
guidelines on admitting learners in special schools and highlights parent-educator interaction and
collaboration with community stakeholders (SA 2001(1):7, 2008:1). The study also refers to the
use of these national guidelines to determine the support needs of learners with ASD.
Out-of-school learners: This term refers to learners of school-going age who are currently not in
a school as a result of the severity of their disability or complexity of barriers to learning and
development (SA 2001(1):16).
Practices: The Dictionary defines practices as: “The customary, habitual, or expected procedure
or way of doing something” (Oxford Dictionaries 2013:online). Within the context of the study,
practices refer to the operational procedures, activities, methods and daily routines performed in
autism-specific classrooms to optimise participation, development and learning.
School-based support team (SBST): Teams established by schools as an institution-level
support mechanism, whose key function it is to coordinate appropriate and efficient school, learner
and educator support services (SA 2008(3):3, 2009(4):50). School-based support teams therefore
play a key role in the design of classroom support strategies and individual support plans for
learners with ASD.
Special schools: Schools that are equipped to deliver education to learners in need of high-
intensity educational and other support, either on a full- or part-time basis (SA 2009(4):49). These
schools are focused on delivering a specialised non-discriminative service to diverse learners
requiring high-intensity education and support. Special schools should also be transformed to
operate as resource centres that provide support services to ordinary and full service schools (SA
2009:50). Due to the limited number of autism-specific schools in South Africa and the increased
demand, some special schools accommodate learners with ASD either as part of their regular
programme or in autism-specific classes.
xxiii
SUMMARY AND KEY WORDS
KEY WORDS
Practices and challenges, autism-specific education, South African public schools, district-based
occupational therapists.
SUMMARY
Occupational therapists employed in district-based support teams within the South African public
educational system play a key role in assisting disabled learners with educational support.
Learners with Autism Spectrum Disorders (ASD) have difficulty in accessing appropriate education
in public schools in the Motheo District. As a short-term goal to provide the growing number of
ASD learners with access to education, autism-specific classes commenced in three special
schools and two full-service schools within the Motheo District in 2010. Presently, schools in the
Motheo District follow their own strategies regarding the overall management and design of their
autism-specific services, and there appears to be variability in the quality of autism-specific
education. The development of a context-based, accessible, applicable and sustainable service
model is critical. The role of district-based occupational therapists does not only entail the design
of support strategies for marginalised learners, but also the monitoring of quality education to
learners with ASD in public schools.
Since autism-specific education is a new addition to special needs education in the Free State,
there are no sustainable service models, training programmes and self-auditing tools in place for
use in the expansion and maintenance of quality autism-specific education. Hence, there was a
need to determine how other provinces responded to the increased need for autism-specific
education and the structuring of ASD educational services. The primary aim of the research study
entailed an investigation of practices and challenges in South African public schools that offer
autism-specific education with the end goal of contributing to developing tools to monitor quality
education, strategies to support and develop educators and to expand quality ASD education in
the Motheo District.
xxiv
The literature overview highlighted that the global increase in the prevalence of ASD (c.f. 2.2.6)
holds significant implications for the provisioning of specialised educational services. Autism-
specific education is costly due to the high frequency of intervention by specialised staff; the
extensive adjustments to learning material; intensive training programmes; assistive technology;
and the need for individualised support strategies. Internationally, there has also been a shift from
accommodating learners in special schools to provide inclusive education, which accommodates
diverse needs in an ordinary classroom setting. White Paper 6 (2001(1):5) introduced inclusive
education in South African schools, but various systemic barriers within the South African context
complicate the transformation to an inclusive education system. Globally, the inclusion of learners
with high-level support needs remains a challenge. There has been a dramatic increase in the
quantity and range of products marketed for educating learners with ASD. Many of these
programmes and training modules are not affordable, accessible or applicable to South African
public schools. The mentioned challenges contributed to the need for investigating the practices
and challenges of autism-specific education in South African public schools.
A quantitative approach and a descriptive study design were used. The study had five research
objects that focussed on:
(i) The training and experience of educators of ASD classes;
(ii) School-based operations;
(iii) Classroom practices;
(iv) Autism-specific support strategies; and
(v) Challenges and critical success factors of autism-specific education.
Educators of autism-specific classes within the South African public sector were selected as the
study population. The total population of educators who fit the inclusion criteria was surveyed,
since sampling was not appropriate for the small research population. In the absence of an
appropriate standardised measurement tool, a questionnaire was designed. The focus of the
study was to investigate autism-specific education through a wide lens rather than to perform an
in-depth study into a specific aspect of autism-specific education. An expert and evaluation
committee reviewed the questionnaire concerning the appropriateness of the items in terms of the
literature available and alignment with the research objectives. A research methodology was
developed to optimise response rates and to facilitate a standard data collection process across
schools.
xxv
Approval was obtained from the Ethics Committee, Faculty Health Sciences, University of the Free
State (ECUFS no 09/2013). Permission was obtained from all the relevant authorities to conduct
the study at public schools within South Africa that offer autism-specific education. A pilot study
was performed to determine the viability of the study, to ensure that all processes run efficiently
and to achieve objectives. A key objective in the design of the measurement process was to use
methodology that optimised participation of a population that was scattered nationally, to
maximise return rate on questionnaires and to ensure the collection of interpretable data. The
study had a response rate of 75%.
The Department of Biostatistics at the University of the Free State did the analysis and descriptive
statistics were calculated. The study found that some challenges and practices are similar to
global trends, but that the South African context produces unique practices and challenges.
Barriers in the South African education system (e.g. variability in the quality of education and
provisioning of resources) and difficulties in the implementation of inclusive education at national,
provincial, district and school level seemed to significantly affect support to marginalised learners.
Autism support groups play a key role in the development and expansion of autism-specific
education within the South African context. Schools are taking responsibility for the development
of school- and classroom-based practices within the limitations of their infrastructure, funding
model and availability of specialist resources. Educators of ASD classes are pioneers in
developing context-based autism-specific education practices, but they are at risk for occupational
burnout due to challenges in the South African inclusive education system.
The study provided valuable information that would aid district-based occupational therapists in
the design of training programmes, service standards and strategies to develop quality autism-
specific education in the Motheo District.
xxvi
OPSOMMING EN SLEUTELWOORDE
SLEUTELWOORDE
Praktyke en uitdagings, outisme-spesifieke onderwys, Suid-Afrikaanse openbare skole,
distriksgebaseerde arbeidsterapeute
OPSOMMING
Distriksgebaseerde arbeidsterapeute werksaam in die Suid-Afrikaanse openbare
onderwyssisteem speel ʼn belangrike rol in die opvoedkundige ondersteuning van gestremde
leerders. Leerders met Outisme Spektrum Versteurings sukkel tans om toegang te verkry tot
toepaslike onderwys in openbare skole in Motheo Distrik. As ʼn korttermyndoelwit om die
groeiende aantal leerders met Outisme Spektrum Versteurings van onderwys te voorsien is daar
gedurende 2010 outisme-spesifieke klasse by drie spesiale en twee voldiensskole in die Motheo-
Distrik geskep. Huidiglik volg skole in die Motheo Distrik hul eie strategieë m.b.t. die algehele
bestuur en ontwerp van outisme-spesifieke dienste en blyk daar variasie te wees in die gehalte
van outisme-spesifieke onderwys. Derhalwe is die ontwikkeling van ʼn konteksgebaseerde,
toeganklike, toepaslike en volhoubare diensmodel van kritieke belang. Die rol van
distriksgebaseerde arbeidsterapeute behels nie net die ontwerp van ondersteuningstrategieë vir
die gemarginaliseerde leerders nie, maar ook die monitering van gehalte-onderrig aan leerders
met Outisme Spektrum Versteurings in openbare skole.
Aangesien outisme-spesifieke onderwys ʼn nuwe toevoeging is tot spesiale onderwys in die
Vrystaat, is daar huidiglik nie ʼn volhoubare diensmodel, opleidingsprogramme en self-
moniteringsinstumente in plek vir die uitbreiding en instandhouding van gehalte- outisme-
spesifieke onderwys nie. Dit was daarom nodig om te bepaal hoe ander provinsies gereageer het
op die groeiende behoefte aan outisme-spesifieke onderwys en ondersteuningsdienste. Die
primêre doel van die navorsingstudie was ʼn ondersoek rakende die praktyke en uitdagings van
Suid-Afrikaanse openbare skole wat outisme-spesifieke onderwys aanbied. Die oogmerk van die
behoeftebepaling was die ontwikkeling van monteringsinstrumente, ondersteunings- en
ontwikkelingstrategieë vir opvoeders en diensstrukture vir die uitbreiding van kwaliteit outisme-
spesifieke onderwys in die Motheo Distrik.
xxvii
Die literatuuroorsig beklemtoon dat die wêreldwye toename in die voorkoms van Outisme
Spektrum Versteurings beduidende implikasies inhou vir die voorsiening van gespesialiseerde
opvoedkundige dienste. Outisme-spesifieke onderwys is duur a.g.v. die hoë frekwensie van
intervensie deur gespesialiseerde personeel; die uitgebreide aanpassings aan leermateriaal;
intensiewe opleidingsprogramme; ondersteunende tegnologie; en individuele
ondersteuningstrategieë. Internasionaal was daar ʼn skuif van spesiale onderrig na inklusiewe
onderwys, waar diverse leerbehoeftes in ʼn gewone klaskameromgewing geakkommodeer word.
Witskrif 6 (2001:5) beskryf inklusiewe onderwys in Suid-Afrikaanse skole, maar verskeie
sistemiese struikelblokke in die Suid-Afrikaanse konteks bemoeilik die transformasie na ʼn
inklusiewe onderwysstelsel. Wêreldwyd blyk inklusiewe onderrig aan leerders met intensiewe
ondersteuningsbehoeftes ʼn uitdaging te wees. Daar is ʼn dramatiese toename in die hoeveelheid
en verskeidenheid van produkte wat bemark word vir die onderrig van leerders met Outisme
Spektrum Versteurings. ʼn Beduidende hoeveelheid van hierdie programme en opleidingsmodules
is nie bekostigbaar, toeganklik of van toepassing in die Suid-Afrikaanse publieke
onderwyskonteks nie. Die genoemde uitdagings het bygedra tot die ondersoek na praktyke en
uitdagings van outisme-spesifieke onderwys in Suid-Afrikaanse openbare skole.
ʼn Kwantitatiewe benadering en ʼn beskrywende studie-ontwerp is gebruik. Die studie het vyf
navorsingsdoelwitte gehad wat gefokus het op:
(i) Die opleiding en ervaring van opvoeders van outisme spesifieke klasse;
(ii) Skoolgebaseerde bedryfstelsels;
(iii) Klaskamerpraktyke;
(iv) Outisme-spesifieke ondersteuningstrategieë; en
(v) Uitdagings en kritiese suksesfaktore van outisme-spesifieke onderwys.
Opvoeders van outisme-spesifieke klasse binne die Suid-Afrikaanse openbare sektor is gekies as
die studiepopulasie. Die totale populasie van opvoeders wat voldoen het aan die insluitingskriteria
het deelgeneem, aangesien die populasie te klein was vir ʼn steekproef. In die afwesigheid van ʼn
geskikte gestandaardiseerde meetinstrument is ʼn vraelys ontwerp met die doel om huidige
praktyke en uitdagings t.o.v. outisme-spesifieke onderwys in Suid-Afrikaanse openbare skole te
ondersoek. ʼn Ekspert- en evalueringskomitee het die vraelys hersien om die toepaslikheid van die
items i.t.v. die beskikbare literatuur en die navorsingsdoelwitte te verseker. ʼn
Navorsingsmetodologie is ontwikkel ten einde ʼn hoë responssyfer en ʼn standaardbenadering t.o.v.
data-insameling by verskillende skole te fasiliteer. Die fokus van die studie was om outisme-
xxviii
spesifieke onderwys te ondersoek d.m.v. ʼn wyelensbenadering, eerder as ʼn in-diepte fokus op ʼn
sekere aspek van outisme-spesifieke onderwys.
Goedkeuring is verkry vanaf die Etiekkomitee, Fakulteit Gesondheidswetenskappe, Universiteit
van die Vrystaat (ECUFS geen 09/2013). Toestemming is ook verkry van al die betrokke
owerhede om die studie uit te voer by Suid-Afrikaanse openbare skole wat outisme-spesifieke
onderwys aanbied. ʼn Loodstudie is uitgevoer om die lewensvatbaarheid van die studie te bepaal,
om te verseker dat al die prosesse doeltreffend verloop, en dat doelwitte bereik word. ʼn
Belangrike doel in die ontwerp van die metingsproses was om navorsingsmetodologie te ontwikkel
wat optimale deelname van die wydverspreide populasie, maksimale reaksie op die vraelyste en
die insameling van interpreteerbare data te verseker. Die studie het ʼn responssyfer van 75%
gehad.
Die Departement Biostatistiek aan die Universiteit van die Vrystaat het die data-analise uitgevoer
en beskrywende statistiek is bereken. Die studie het bevind dat sommige uitdagings en praktyke
soortgelyk is aan wêreldwye tendense, maar dat die Suid-Afrikaanse konteks unieke praktyke en
uitdagings produseer. Struikelblokke in die Suid-Afrikaanse onderwysstelsel (bv. variasie in die
gehalte van onderwys en die voorsiening van hulpbronne) en probleme rondom die
implementering van inklusiewe onderwys op nasionale, provinsiale, distrik- en skoolvlak ʼn
beduidende invloed het op die ondersteuning aan gemarginaliseerde leerders. Outisme-
ondersteuningsgroepe speel ʼn belangrike rol in die ontwikkeling en uitbreiding van outisme-
spesifieke onderwys in die Suid-Afrikaanse konteks. Skole neem verantwoordelikheid vir die
ontwikkeling van die skool- en klaskamergebaseerde praktyke m.b.t. infrastruktuur, befondsing en
die beskikbaarheid van spesialiteitshulpbronne. Opvoeders van leerders met Outisme Spektrum
Versteurings is pioniers in die ontwikkeling van konteksgebaseerde outisme-spesifieke
onderwyspraktyke, maar val binne ʼn hoë risikogroep vir beroepsuitbranding a.g.v. ernstige
uitdagings in die Suid-Afrikaanse inklusiewe onderwysstelsel.
Die studie het waardevolle inligting verskaf wat distriksgebaseerde arbeidsterapeute in staat stel
tot die ontwerp van opleidingsprogramme, diensstandaarde en strategieë ten einde gehalte
outisme-spesifieke onderwys in die Motheo Distrik te ontwikkel.
xxix
CHAPTER 1
INTRODUCTION AND ORIENTATION
_____________________________________________________________________
1.1 INTRODUCTION
Occupational therapists employed in district-based support teams within the South African
public educational system play a key role in assisting disabled learners with educational
support. Learners with Autism Spectrum Disorders (ASD) currently have difficulty in accessing
appropriate education in public schools in the Motheo District, and the situation is no different
for rest of the Free State. There has been a significant increase in the number of South African
public and private facilities that offer autism-specific education over the past three years, but
demand still outweighs the supply of appropriate ASD educational services. Globally, the rapid
increase in the prevalence of ASD holds significant implications for current and future needs
regarding autism-specific education (c.f. 2.2.6, Centres for Disease Control and Prevention
2013(3):online, Hughes et. al. 2011:56). The diagnostic and functional profiles of learners with
ASD necessitate the need for specialised educational approaches, since conventional special
needs programmes and teaching methods are not usually appropriate and accessible
concerning their unique needs (Burns 2013:9).
The researcher started working at the Free State: Motheo Inclusive in February 2011. During
the execution of heir clinical duties, district-based occupational therapists had difficulty finding
public schools for learners with Autism Spectrum Disorders (ASD) within the Motheo District
and the rest of the Free State. The Motheo Inclusive occupational therapy database retrieved
50 learners who had been awaiting access to autism-specific education (Motheo Inclusive
2013:1). The two district-based occupational therapists found it challenging to support and
advise schools concerning best operational practices, since international approaches and
support strategies are not always implementable in local public schools.
The design and implementation of autism-specific education services is a challenging process
due to the increased ASD prevalence, expensive resources required, variability in the severity
of the condition, and contextual factors. Since autism is a spectrum disorder, it implies
variability in cognitive, functional, academic and clinical profiles, where symptoms may differ in
nature, intensity and severity. Although learners on the autism spectrum have certain common
features, these symptoms present in different and unique combinations (Burns 2013:9 and
1
Wagner 2011:28-29). The characteristics of the condition include constant atypical social
interaction and social communication in various contexts, a restricted range of repetitive
behaviours, and unusual interests. These mentioned impairments cause significant difficulty in
acquiring the skills necessary for independent living (American Psychiatric Association
2013(2):31-32). The condition may also co-occur with other neurodevelopmental disorders
(e.g. intellectual disability, Attention Deficit Hyperactivity Disorder, and language impairments),
co-morbidities (e.g. epilepsy, mental or behavioural disorders) or other medical conditions.
Categories of severity guide the type of educational service different learners may require, but
individual profiles differ and dictate the level of support required (American Psychiatric
Association 2013(2):31-32).
Autism Spectrum Disorders fall within the category of neurodevelopmental disorders, where
symptoms manifest in early childhood and influence development in the areas of
communication, social interaction, sensory processing, behaviour and functional independence
(Ashburner, Rodger & Ziviani 2008:564, Brown & Dunn 2010:475 and Hughes et al. 2011:56).
Since the condition affects a variety of developmental domains, children with ASD mainly
benefit from holistic intervention in an all-encompassing educational programme. They require
a collaborative, multi-professional approach to design and provide intervention strategies
focused at their individualised support needs (Brown & Dunn 2010:475). Hence, the majority of
learners with ASD require a specialised curriculum, therapeutic intervention and a responsive
classroom setting that accommodate critical areas of development. The knowledge, attitude,
skills and experience of educators concerned with autism-specific support influence classroom
practices, such as creating a responsive classroom, a structured class routine, opportunities
for social interaction, positive behaviour support, etc (Roberts 2007:55-60).
Educators require specialised training to improve and maintain expertise (Hanbury 2005:1-2).
Internationally, there has been a dramatic increase in the quantity and range of assessment
tools, training modules, education approaches, intervention strategies, teaching programmes
and assistive technology marketed for educating learners with ASD (Burns 2013:9 and Hughes
et al. 2011:59). Due to the variability of ASD, the vast range of expensive products available
and variability in the scientific evidence to support the efficacy of many programmes, it is
difficult to select tools that would benefit the majority of learners in a class or school (Burns
2013:9-10 and Sapona & Winterman 2002:30). According to professional experience, many of
these programmes and training modules are not affordable, accessible or applicable to public
schools in the Motheo District and the rest of the country.
2
Autism-specific education is costly due to the high frequency of intervention by specialised
staff, the extensive adjustments to learning material, intensive training programmes, assistive
technology and individualised support strategies (SA 2001(1):36-43). Internationally, there has
also been a shift from accommodating learners in special schools to providing inclusive
education, which accommodates diverse needs in an ordinary classroom setting. White Paper
6 (SA 2001(1):5) introduced inclusive education in South African schools, but various systemic
barriers within the South African context complicate the transformation to an inclusive
education system. Globally, the inclusion of learners with high-level support needs remains a
challenge. These implementation challenges seem to be more prevelant in developing
countries. Inadequate resources, poorly developed services structures, inadequate staff
training programmes, funding models anf lack of enabling legislation hampers the
implementation of inclusive policy (Eleweke & Rodda 2002:113).
Nationally, there are only five autism-specific schools within the public sector, and they are
filled beyond capacity. These five schools are in Gauteng, the Western and Eastern Cape, and
not easily accessible for learners in the Free State. In keeping with the inclusive policy, an
autism-specific school is currently not a priority within the provincial operational plan (SA
2001(1):39). The private ASD-specific educational facilities (e.g. SNAP) are costly and not
affordable for parents from lower income groups. As a short-term goal to provide the growing
number of learners with ASD with access to education; autism-specific classes commenced in
three special schools and two full-service schools in the Motheo District in 2010. External
pressure from autism support groups, the Department of Health, Motheo Inclusive Education
and parents instigated the development of these classes. Currently these classes are filled
beyond capacity and classes have waiting lists.
The district-based occupational therapist at the time played a key role in identifying, training
and assisting schools to roll out autism-specific education in established schools. The need for
more autism-specific education facilities is apparent, but not at the expense of quality autism-
specific education. The development of service models, training programmes for educators
and auditing tools to expand and improve quality ASD education are vital considerations
(Sapona & Winterman 2002:30). In collaboration with district-based support teams, schools
had established the mentioned classes on an informal service model, and they had intended to
improve service delivery as the programme developed. Three of the schools attended training
provided by Autism South Africa and/or visited autism-specific schools in an attempt to
reproduce their service models. Since autism-specific schools offer specialised education
resources and facilities for learners with ASD exclusively, their practices would possibly reflect
best practices within the South African context. The reality is that new autism-specific classes
3
are linked to established schools and therefore need to tailor fit their service within the
framework of an already established resource structure and operational framework (SA
2009(4):50). Presently, schools in the Motheo District follow their own strategies regarding the
overall management and design of their autism-specific service. Hence, there appears to be
variability in autism-specific education and support provided within the Motheo District.
The framework and functions of the district-based occupational therapists include classroom-
based, institutional, administrative as well as environmental and health support by assisting
schools with capacity building, developing and monitoring of support programmes, and
resource provisioning (SA 2008(3):104-105). The role of district-based occupational therapist
does not only entail the design of support strategies for marginalised learners, but also the
monitoring of quality support to learners with ASD in public schools (SA 2009(4):43-46). Since
autism-specific education is a new addition to special needs education in the Free State, there
are no sustainable service models, training programmes and self-auditing tools in place for use
in the expansion and maintenance of quality autism-specific education. The development of a
reproducible, accessible, applicable and sustainable service model within the South African
context is critical. Hence, the researcher is interested to see how other provinces responded to
the increased need for autism-specific education and how they structure ASD educational
services. The primary aim of the research study entails an investigation of practices and
challenges in South African public schools that offer autism-specific education with the end
goal of contributing to developing tools to monitor quality education, strategies to support and
develop educators and to expand quality ASD education in the Motheo District.
1.2. PROBLEM STATEMENT
Learners with ASD have difficulty in accessing education in public schools within the Motheo
District. The global increase of autism prevalence rates, the variability in diagnostic profiles,
the complexity of autism-specific education in inclusive settings, and challenges within the
South African educational context add to this dilemma. In an attempt to increase access to
autism-specific education, autism-specific classes commenced at three special schools and
two full-service schools in the Motheo District in 2010. Although there is a need to create more
autism-specific classes in the Motheo District, it is important to roll out a service model and
monitoring tools to optimise the quality of autism-specific education. The design of sustainable,
appropriate service standards and a context-based service model necessitates the
consideration of practices in other South African public schools that offer autism-specific
education. As the first step towards the design of management tools to expand and improve
4
quality autism-specific education in the Motheo District, the researcher identified the need to
investigate current practices and challenges in South African public schools that offer autism-
specific education. The following objectives were identified:
The first objective was to investigate the level of training and experience of educators of
autism-specific classes in public schools nationally. The high level of support required by
learners with ASD motivates the need for specialised training of educators.
The second objective was to investigate school-based operations concerning admission
criteria and procedures of learners with ASD, extra-curricular services, therapeutic support and
parent collaboration. Children with autism benefit the most from holistic intervention in an all-
encompassing educational programme, which includes additional support strategies,
therapeutic support and strategies to involve and collaborate with parents. Not all schools
accommodate learners with ASD so exclusively, and it was aimed to investigate whether there
were variability in admission criteria and procedures.
The third objective was to investigate classroom management practices in terms of the
curriculum, work schedules, monitoring of learner progress as well as activity and
environmental adjustments. Autism-specific education involves classroom-based support
through the planning, development and monitoring of adjusted curriculums, individual support
programmes and adjusted classroom support strategies. The study was aimed to investigate
how ASD educators used their knowledge, skills and experience to fit the needs and individual
profiles of learners with the activity, contextual and environmental demands.
The fourth objective was to investigate use of autism-specific support strategies with reference
to research-based programmes, diagnostic-specific support strategies as well as assistive
technology and alternative teaching strategies. Internationally, there has been a dramatic
increase in the quantity and range of assessment tools, education approaches, intervention
strategies, teaching programmes and assistive technology marketed for learners with ASD.
The researcher wanted to investigate the use of the mentioned products in South African
public schools.
The fifth objective was to investigate the aspects educators regard as challenges and critical
success factors in managing learners with ASD in public schools. The diagnostic and
functional profiles of learners with ASD necessitate the need for specialised educational
approaches, since conventional special needs programmes and teaching methods are not
appropriate and accessible concerning their unique needs. An investigation of educators’
5
views on challenges and critical success factors of autism-specific education would assist the
researcher in developing service models that considered the views of educators within the
South African inclusive education context.
1.3. PURPOSE OF THE OF STUDY
The purpose of the study will be discussed in terms of the aim and objectives:
1.3.1. Aim
The aim of the study was to investigate current practices and challenges in autism-specific
education within South African public schools.
1.3.2. Objectives
The objectives for this particular study were as follows:
1.3.2.1. To investigate the level of training and experience of educators of autism-specific
classes in public schools nationally.
1.3.2.2. To investigate school-based operations concerning admission criteria and
procedures of learners with ASD, extra-curricular services, therapeutic support and
parent collaboration.
1.3.2.3. To investigate classroom management practices in terms of the curriculum, work
schedules, monitoring of learner progress as well as activity and environmental
adjustments.
1.3.2.4. To investigate the use of autism-specific support strategies with reference to
research-based programmes, diagnostic specific support strategies as well as
assistive technology and alternative methods.
1.3.2.5. To investigate the aspects that educators had regarded as challenges and critical
success factors in managing learners with ASD in public schools.
6
1.4. DELIMITATIONS OF THE PROBLEM
In keeping with the aim of the study, the researcher performed a survey to investigate current
practices and challenges regarding autism-specific education in South African public schools.
The study specifically focused on autism-specific education due to the growing number of
learners with ASD who are unable to access appropriate education within the public sector.
The focus of the study was to investigate autism-specific education through a wide lens rather
than to perform an in-depth study into a specific aspect of autism-specific education. The study
population comprised educators of autism-specific classes in autism-specific, special or full-
service schools within the South African public sector.
Consequently, the study primarily reflects the views of educators directly involved with learner
intervention. The project was not representative of all stakeholders directly or indirectly
involved at schools. Although the importance of functional school management systems was
recognised, the researcher excluded these as a key focus area in the research process. Whole
School Assessment and Quality Assurance use appropriate audit tools to assess school
management systems (SA 2001(1):3-12).
The study was limited to the public sector and did not provide a comprehensive overview on
approaches and service models used in the private sector. The researcher operates in the
public sector and the end goal of the study was to develop tools to monitor quality education,
strategies to support and develop educators and to expand quality ASD education in the
Motheo District. The resources, research-based educational approaches and intervention
programmes often used in private schools may not be accessible or relevant for use in public
schools.
The researcher is a district-based occupational therapist and therefore selected components of
autism-specific education that would be relevant to her work plan and scope of practice. The
focus of district-based occupational therapists is to assist with teacher training, to screen,
identify, assess and support marginalised learners and to assist learners with access to
appropriate education and support (SA 2009(4):43-45).
Leedy and Ormrod (2013(2):5-6) define assumptions as underlying conditions that are
commonly supposed, believed or accepted. These conditions are usually untested, basic
values, or worldviews that are self-evident. The researcher has a number of own assumptions
that are key to the project and that require brief discussion (Leedy & Ormrod 2013(2):6) The
dramatic increase in the number of learners who require autism-specific education has
7
influenced the quality and variety of services available for learners with ASD over the past two
to three years. Hence, variability in terms of the resources and level of specialised skills of
educators is assumed, since not all schools cater exclusively for learners with ASD. The
challenges in the broader South African educational and socio-economic context may impact
on special needs education. The national policy and strategic plans, the availability of
educational resources (financial, human, infrastructure) and systemic challenges (managerial,
institutional and administrative) were assumed to influence service delivery in education.
South African schools are in a transformation process to an inclusive education system (SA
2009(4):1-5) and the researcher assumed that the educational system, resources and
operational procedures would differ from developed countries such as the USA and those in
Europe. The researcher assumed that all public schools are aware and supportive of national
inclusive policy but that implementation is still in a process. Nationally, there is a need for more
autism-specific education facilities and it was presumed that reasonable research projects, that
could contribute to the expansion of appropriate education to learners with ASD, would be
supported by the Department of Education and resource centres / special schools (SA
2009(4):50). All participants, as educators of ASD classes, would be literate and able to
complete questionnaires.
1.5. METHODOLOGY
A quantitative approach and a descriptive study design were used. Educators of autism-
specific classes within the South African public sector were selected as the study population,
since they are primarily responsible for the achievement of learning outcomes and compilation
of individual support plans for learners in their class. The total population of educators who
fitted the inclusion criteria was surveyed, since sampling was not appropriate for the small
research population.
In the absence of an appropriate standardised measurement tool, a questionnaire was
designed to investigate current practices and challenges regarding autism-specific education in
South African public schools (Knobel & Lankshear 2006:161). An expert and evaluation
committee reviewed the questionnaire concerning the appropriateness of the items in terms of
the literature available and alignment with the research objectives. The focus of the study was
to investigate autism-specific education through a wide lens rather than to perform an in-depth
study into a specific aspect of autism-specific education.
8
The questionnaire focused on demographical information, operational practises, classroom
support strategies, diagnostic specific support and specialised interventions to reflect current
practices and challenges in autism-specific education nationally. The questionnaire was
compiled from relevant literature (Leedy & Ormrod 2013(2):196-200) regarding autism-specific
education, national policies on special needs education as well as clinical expertise of district-
based occupational therapists. The questionnaire was pre-tested on a small sample of
participants from the intended population (pilot study) to anticipate problems of comprehension
or accessibility of the questionnaire (Walliman 2006:282).
Regional representatives (occupational therapists) assisted with the distribution and collection
of questionnaires from participating schools. The information letters were forwarded (e-
mail/post/fax) to all participating schools to encourage educators to participate and to provide
opportunity for questions prior to participation in the project. Telephonic contact was made with
principals to schedule an appointment, during which the regional representatives could collect
data from the participating educators. Representatives collected the data in accordance to the
data collection guidelines.
Descriptive statistics, namely frequencies and percentages for categorical data and means and
standard deviations or medians or percentiles for continuous data, were calculated by the
Department of Biostatistics, Faculty of Health Sciences, UFS. The results were interpreted and
recommendations and conclusions were made in accordance to the findings.
1.6. THE IMPORTANCE AND VALUE OF THE STUDY
Cohen, Manion and Morrison (2007:81) suggest that the audience and recipients of research
need to be an important consideration in determining the value of the study. The study
intended to have benefits for Motheo Inclusive, but other districts may also utilise the
information and recommendations from the study in order to develop, expand and improve
autism-specific education and support to educators. The research results provided valuable
contextual information in the development of a service model, management tools and
operational systems to improve the efficiency of autism-specific education in the Motheo
District. A structured service model with a regional, autism-specific footprint may also set the
landscape to expand specialised education for learners with autism within the district and to
the rest of the Free State. The project may also deliver a valuable contribution in other
settings.
9
Developing the role of the district-based occupational therapist in the Directorate Inclusive
Education: Occupational therapists are not only able to contribute to clinical support at school-
based level, but have the practice framework to contribute to the development of context-
based support strategies and management systems at district level (American Occupational
Therapy Association 2008:629).
The researcher is of the opinion that occupational therapists have the skills framework to play
a key role in supporting educators of ASD classes with curriculum differentiation. The elements
of curriculum differentiation include activity analyses, adjustment of tasks to set appropriate
challenges for learners, and the use of the environment as a teaching and therapeutic milieu.
These mentioned elements appear to link well with occupational therapy intervention
approaches (American Occupational Therapy Association 2008:657-659).
Provide an overview on the uniqueness of autism-specific education within the public sector:
The researcher has not been able to find any other study of this kind within her literature
search and research exploration (South African Journal of Occupational Therapy 2012:online).
The study provides a comprehensive overview on the unique contextual issues and practices
concerning autism-specific education in South Africa. The results indicated the current use of
programmes, approaches, additional support and operational models within the public sector.
Theoretical frameworks describe textbook educational strategies and programmes, but the
study provided insight into the practical implementation of these strategies within the context of
public schools. This information will be invaluable in the design of appropriate autism-specific
service models in the public sector (SA 2008(3):104-105).
Create a platform to advocate the rights of learners with ASD to basic education: The study
created a platform to communicate current challenges and needs regarding autism-specific
education to key role players within the Department of Education. Currently curriculum-related
issues are the primary focus within education settings and the study will create an opportunity
to focus on the education needs of a disadvantaged group of learners.
Personal value: The study improved the researcher’s knowledge on autism-specific education.
This knowledge would be utilised in the expansion of quality autism-specific education in
Motheo District.
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1.7. ETHICAL CONSIDERATIONS
In keeping with the obligation to professional ethics prescribed by the Health Professions
Council of South Africa, the Occupational Therapy Association of South Africa as well as the
University of the Free State, the following relevant ethical obligations were adhered to:
approval; responsibilities towards participants; and commitment to professional ethics (Health
Professions Council of South Africa 2008:1-11).
Approval was obtained from the Ethics Committee, Faculty Health Sciences, University of the
Free State (ECUFS no 09/2013). The Free State, Directorate: Strategic planning, Policy and
Research also approved the study. The researcher obtained permission from school
management teams and school governing bodies of the participating schools to conduct
research at their facility (Mouton 2009:241-243). Educators voluntarily agreed to participate in
the research study by completion of the questionnaire (Cohen et al. 2007:55).
1.8. OUTLINE OF CHAPTERS
The dissertation consists of six chapters, arranged as follows:
Chapter 1 – Introduction and orientation: This chapter provides background and a short
introduction to the study. The problem statement is declared and the purpose of the study
discussed in terms of the aim and objectives. The researcher describes the scope, value,
methodology and ethical considerations of the study.
Chapter 2 – Literature overview: The literature review discusses literature relevant to the
study through three phases, namely: issues related to autism spectrum disorders; autism-
specific education in inclusive settings; and an overview on education within the South African
context.
Chapter 3 – Research methodology: This chapter focuses on the details of research
methodology. The study follows a quantitative approach with a descriptive study design. The
discussion on methodology includes the study designs, population, sampling, obstacles in the
study, data collection, pilot study, data analysis, error of measurement and ethical aspects.
Chapter 4 – Presentation of results: This chapter presents the results obtained from the
research questionnaire in the form of tables and figures with brief summaries of the findings.
11
Chapter 5 – Discussion of results: This chapter discusses, interprets and compares the
research results presented in Chapter 4 with the literature presented in Chapter 2. The
discussion aims to identify practices and challenges of autism-specific education in South
African public schools against the backdrop of global trends, as well as the unique education
context in South Africa.
Chapter 6 – Conclusions and recommendations: Chapter 6 discusses the limitations,
conclusions and recommendations of the study. A critical overview on the research process
reveals suggestions for follow-up research and changes to similar research studies. The
researcher also provides recommendations for implementing the results in the design of
operational systems, resources and educator training regarding autism-specific education in
the Motheo District.
1.9. SUMMARY
Chapter 1 discussed the introduction, study aim and objectives, value of the study and the
research process followed. The following chapter provides a comprehensive literature review
regarding relevant aspects of autism spectrum disorders; key components of autism-specific
education; research-based autism-specific interventions; and support strategies and the
transformation to an Inclusive education system within the South African context.
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CHAPTER 2
LITERATURE REVIEW
_____________________________________________________________________
2.1 INTRODUCTION
Chapter 1 highlighted a number of factors that affect the provision of quality autism-specific
education, namely the significant increase in ASD prevalence that consequently raises the
demand for autism-specific education; the complexity of ASD education; and challenges of
expanding quality ASD education within the South African education context. Globally, there is
an increase in educational approaches to enhance the inclusion of learners with ASD in
educational settings. Nevertheless, global ASD educational trends are not always relevant,
accessible and implementable in South African public schools.
The literature discussions in Chapter 2 follow in three phases, namely an overview on Autism
Spectrum Disorders (2.2); autism-specific education (2.3); and the South African context (2.4).
Since the relevance of this project to occupational therapy may be a concern, the last phase of
the literature discussion will also refer to the emerging role of occupational therapists in district-
based support teams. The project aims to view ASD education through a wide lens and the
literature study considers a broad spectrum of issues, rather than an in-depth investigation of
specific aspects.
2.2 OVERVIEW ON AUTISM SPECTRUM DISORDERS
The first phase in the literature review provides an overview on the complexity of ASD and how
healthcare, social and other systemic barriers affect access to autism-specific education. The
discussion includes the following:
2.1.1 Changes proposed by the DSM-5 and the possible impact;
2.2.2 Concerns regarding the possible impact of the DSM-5;
2.2.3 Diagnostic tools;
2.2.4 The patho-physiology of ASD;
2.2.5 Causes of ASD;
2.2.6 Prevalence of ASD;
2.2.7 Treatment and intervention;
13
2.2.8 Early identification and interventions;
2.2.9 Medication and alternative approaches;
2.2.10 Prognosis; and
2.2.11 Cost of treatment and care.
A discussion on the new diagnostic criteria (American Psychiatric Association 2013(2):50-51)
was included in the literature review due to the following reasons:
i) The DSM is used as the framework for the discussion of ASD characteristics and
the implications for education;
ii) The new diagnostic criteria is a burning issue in ASD public and professional
forums;
iii) The latest research concerning ASD is reflected in the DSM-5; and
iv) The new criteria may impact on school-based operations since schools are
currently using the DSM-IV as a clinical guide.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a global authoritarian
guide to the diagnoses of mental disorders and assists clinicians to determine the level of
support learners require (Kupfer 2013:online). Schools have admissions criteria (which include
diagnostic criteria) to ensure that they only admit learners who would benefit from the scope of
the services offered (Ladbrook 2009:49-50).
2.2.1 Changes proposed by the DSM-5 and possible impact
The American Psychiatric Association’s Annual Meeting released the fifth edition of the
Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013 (Kupfer
2013:online). In many ways the DSM-5 has not changed from the previous edition, but these
changes are still driving heated debates (Compart 2012:online).
The previous edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
referred to Autism Spectrum Disorders as Pervasive Developmental Disorders. Pervasive
Developmental Disorders had three main categories of impairment: social interaction,
communication skills and the presence of stereotyped behaviour, interests, and activities. The
condition included five sub-groups of disorders, namely: Autistic Disorder; Asperger’s
Syndrome; Rett’s Disorder; Pervasive Developmental Disorders Not Otherwise Specified
(PDD-NOS); and Childhood Disintegrative Disorder (American Psychiatric Association
2000(1):69-70). These five disorders varied in onset, severity, developmental course and
functional prognosis. Variability occurred within each of these specific diagnostic groups. The
14
presence of other neurological deficits, e.g. epilepsy, intellectual impairment and attention
deficit disorders (Centres for Disease Control and Prevention 2007(1):online), complicated
clinical profiles.
The general approach of the DSM-5 was to streamline and simplify the diagnostic criteria of
ASD, to develop measures to assess the severity of symptoms, to identify the range of
problems associated with the condition (Kupfer 2013:online) and to accommodate current
research (Compart 2012:online). The DSM-5 introduced five major changes, namely:
i) The deletion of the term Pervasive Developmental Disorders and the five
subgroups;
ii) Reduction to two impairment categories in ASD;
iii) Inclusion of sensory behaviours;
iv) A single spectrum, but recognition of individual variability; and
v) Early onset and identification of symptoms (American Psychiatric Association
2013(2):50-51, Kaufmann 2012:online).
These proposed changes and the possible impact on autism-specific education led the
following discussion:
(i) Deletion of the term Pervasive Developmental Disorders and the five subgroups:
An all-encompassing term called Autism Spectrum Disorder replaced the five subgroups of
Pervasive Developmental Disorders (described in the DSM-IV). The term Pervasive
Developmental Disorders is no longer used, and ASD falls within the category of
neurodevelopmental disorders (American Psychiatric Association – DSM-5 Task Force 2013
(2):50). Kaufmann (2012:online) indicates that the DSM-IV (1994) introduced the terms
Asperger’s Syndrome, Rett’s Disorder Childhood Disintegrative Disorder, and Pervasive
Developmental Disorders Not Otherwise Specified, and questions the validity of some of these
diagnostic groups.
Public and professional critics consider the removal of the diagnosis of Asperger’s Syndrome
and PDD-NOS as a major change (Autism Speaks 2013(b):online, Baird 2013:online and
Compart 2012:online). The neurodevelopment task team, targeted to develop diagnostic
criteria for ASD, indicates that there is inadequate scientific evidence to validate a clear
distinction between Asperger’s Syndrome and high functioning ASD (Baird 2013:online).
Several research studies (Ehlers & Gillberg 1998:79-106 and Klin & Volkmar 2000:25-71) have
attempted to resolve the distinction between high functioning autistic disorder and Asperger’s
15
Syndrome. A large empirical systematic review performed by Dissanyake and Macintosh
(2004:421-422) used cluster analyses and comparative reviews to compare the results of
individuals from both diagnostic groups in the following developmental domains: language and
communication; cognition and neuropsychological profiles; motor skills; etiological and
biological factors; onset and prognosis; restricted and repetitive behaviours; and social
interaction. The comparative research indicated few distinctions between Asperger’s
Syndrome and High Functioning Autism and showed significant similarities in associated
features. The conclusion of the study was that there is not sufficient evidence to distinguish
Asperger’s Syndrome from Autistic Disorder, and these disorders are on a continuum. The
researcher therefore uses the terms mild/high functioning ASD for the purposes of the
study.There are researchers who argue that Asperger’s Syndrome should exist as a separate
disorder in the absence of conclusive research. The disorder also shares characteristics with
schizoid personality disorder and non-verbal learning disability that require further investigation
(Ehlers & Gillberg1998:79-106, Dissanayake & Macintosh 2004:434 and Klin & Volkmar
2000:25-71).
(ii) Reduction to two impairment categories in ASD:
The DSM-5 reduced the three impairment categories of the DSM-IV to two main areas of
impairment: social communication and interaction as well as restricted, repetitive patterns of
behaviours, interests and activities. The DSM-5 does not change the description, but
recognises that it is challenging to distinguish social and communication difficulties in practice
and consequently it is more efficient to combine these categories. A delay in language
development is no longer a requirement for diagnosis (Baird 2013:online and Compart
2012:online). Kaufmann (2012:online) compared the DSM-IV and DSM-5 (as seen in Figure
2.1) to indicate the structural changes and other changes.
16
DSM-IV DSM-5
1. Marked impairment in the use of multiple 1. Deficits in social-emotional reciprocity.
non-verbal behaviours e.g. eye gaze, body A. Persistent
A. Impairment in postures , etc. deficits in social
social 2. Failure to develop peer relationships 2. Deficits in nonverbal communicative communication
interaction as appropriate to developmental level. behaviours used for social interaction e.g. and social
manifested by at poorly integrated verbal and nonverbal interaction
least two of the communication. across multiple
following on the contexts as3. Lack of spontaneous seeking to share 3. Deficits in developing and maintaining manifested by
right: enjoyment, interest or achievements with other relationships. the following on
people. the left:
4. Lack of social or emotional reciprocity.
1. Delay in or total lack of the development of 1. Stereotyped or repetitive speech, motor
spoken language (not accompanied by an movements, or use of objects
attempt to compensate through alternative
modes of communication such as gesture or B. Restricted,
mime). repetitive
B. Qualitative 2. In individuals with adequate speech, marked 2. Insistence on sameness, inflexible patterns of
impairment in impairment in the ability to initiate or sustain adherence to routines or ritualised patters of behaviour,
communication conversation. verbal and non-verbal behaviour (such as interests or
by at least one of extreme distress at small changes, difficulty activities as
the following on with transitions, rigid thinking patterns, greeting manifested by
the right: rituals, etc.). at least two ofthe following on
3. Stereotyped and repetitive use of language 3. Highly restricted, fixated interests that are the left, currently
or idiosyncratic language. abnormal in intensity or focus. or historically
4. Lack of varied spontaneous make-believe 4. Hyper- or hypo-reactivity to sensory input or
play or social imitative play appropriate to the unusual interest in sensory aspects of
developmental level. environment.
C. Restricted, 1. Encompassing preoccupation with one or
repetitive and more stereotyped and restricted patterns of
stereotyped interest that is abnormal in either intensity or
patterns of focus.
behaviour 2. Apparently inflexible adherence to specific,
interest and non-functional routines or rituals. Becomes a specifier
activities as
manifested by at 3. Stereotyped and repetitive motor
least one of the mannerisms (e.g. finger flapping).
following on the 4. Persistent pre-occupation with parts of
right: objects.
Figure 2.1. A comparison between the DSM-IV and DSM-5 to indicate the impact of structural and other changes (adapted from Kaufmann 17
2012:online)
(iii) Inclusion of sensory behaviours
The descriptors for “restricted, repetitive patterns of behaviours” in the DSM-5 include sensory
behaviours. Sensory processing (Miller 2013:online) falls within the specialist field of
occupational therapy and positions them as role players in professional teams responsible for
autism-specific programmes within school- and district-based settings.
(iv) Single spectrum but recognition of individual variability
The focus of the diagnosis changed from providing a diagnosis to determining individualised
needs and the impact of the condition on the individual’s life. A continuum indicates the
symptoms and behaviours of individuals with ASD and allows clinicians to indicate
individualised variations (American Psychiatric Association 2013(2):online). The DSM-5
introduced specifiers (Baird 2013:online) that assist clinicians in the identification of the level
and areas of functional domains for individual support. The levels of severity and complexity of
symptoms determine the level of support required by the individual (American Psychiatric
Association 2013(2):52-53). The diagnosis for ASD will now specify Level 1 (requiring support),
Level 2 (requiring substantial support) or level 3 (requiring substantial support). Table 2.1
summarises the revised diagnostic criteria proposed by the DSM-5 and Table 2.2 describes
the different levels of support.
The inclusion of the following ASD specifiers may also assist in describing individualised
difficulties. The descriptive information encompasses: with or without accompanying
intellectual or language impairment; being associated with a known medical or genetic
condition or environmental factor; being associated with another neurodevelopmental, mental
or behavioural disorder; and with catatonia (American Psychiatric Association 2013(2):52-53).
The individualised approach of the DSM-5 may assist district-based teams in their decision
making regarding school placements as well as the design of individual support plans.
(v) Early onset and indication of symptoms
The DSM-5 criteria promote early identification of ASD (Baird 2013:online) but also
accommodate individuals whose symptoms present within the context of increasing social
demands. ASD symptoms must be present from early childhood, even if it is only recognised
later (American Psychiatric Association 2013(2):online).
18
Table 2.1 Summary of the diagnostic criteria for ASD as proposed in the DSM-5
(adapted from Kaufmann 2012:online)
ASD Diagnostic Criteria:
Currently, or by history, must meet criteria A, B, C, and D:
A. Persistent deficits in social communication and social interaction across contexts, not
accounted for by general developmental delays, and manifested by all 3 of the following:
1. Deficits in social-emotional reciprocity.
2. Deficits in nonverbal communicative behaviours used for social interaction.
3. Deficits in developing and maintaining relationships.
B. Restricted, repetitive patterns of behaviour, interests, or activities as manifested by at
least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects.
2. Excessive adherence to routines, ritualised patterns of verbal or nonverbal behaviour, or excessive
resistance to change.
3. Highly restricted, fixated interests that are abnormal in intensity or focus.
4. Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment.
Current severity needs to be specified according to the summary in Table 2.2.
C. Symptoms must be present in early childhood, (but may not manifest completely until
social demands exceed limited capacities).
D. Symptoms together limit and impair everyday functioning.
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Table 2.2 Severity levels of ASD and support required (adapted from American
Psychiatric Association 2013(2):52)
Severity level Social communication Restricted, repetitivebehaviours
Without support structures, deficits Rigidity of behaviour leads to
in social communication are significant interference with
noticed. functioning in various contexts.
Difficulty initiating social interaction Difficulty changing between
Level 1
with practical examples of atypical activities.
Requiring support
and failed responses to social Planning and organisation
contact initiated by others. difficulties affect independence.
Appears to have reduced interest in
social interaction.
Marked deficits in verbal and Rigid behaviour, difficulty in
nonverbal communication skills and adjusting to change and other
evident social impairments even restricted / repetitive behaviours are
Level 2
with support structures. repeatedly to be noticed by a casual
Requiring substantial
Limited initiation of social observer and affect functioning in
support
interaction. Reduced or atypical different contexts.
responses to social approaches or Distressed at and/or trouble with
interaction initiated by others. shifting focus or action.
Severe deficits in verbal and Rigid behaviour, difficulty in
nonverbal communication skills that adjusting to change and other
leads to severe functional restricted / repetitive behaviours
Level 3
impairments. markedly affect functioning in all
Requiring substantial
Very limited initiation of social spheres. .
support
interaction. Minimal responses to Marked distress and/or trouble
social approaches or interaction shifting focus or action.
initiated by others.
Concerns regarding the possible impact of the DSM-5 will be discussed next.
20
2.2.2 Concerns regarding the possible impact of the DSM-5
Critics are concerned that a change in diagnosis may threaten access to certain healthcare
services, social benefits and schools (Lopatto 2012:online). Individuals previously diagnosed
with the mentioned pervasive developmental disorders would still meet the criteria for ASD in
the DSM-5 or possibly another more accurate diagnosis. Individuals currently diagnosed with
Asperger’s Disorder will keep this diagnostic classification. However, future cases would be
diagnosed with Autism Spectrum Disorder (Baird 2013:online).
Critics are also concerned about possible under- or over-diagnosis and therefore the
consequent impact on ASD prevalence (Lopatto 2012:online). A re-examination of 4 453 case
records of children previously diagnosed through the use of the DSM-IV was used to
determine the efficiency of DSM-5 criteria in identifying children with ASD (Bisho, Duncan,
Huerta, Hus & Lord 2012:1056). The review of these case records included 690 children
diagnosed with other conditions, e.g. language disorders. The research results indicated the
use of the DSM-5 reduced incorrect diagnoses and that the DSM-5 identified 91% of those
diagnosed with ASD on the DSM-IV. The children who lost their diagnoses did not present with
severe social impairments, which is a diagnostic requirement for ASD. These results are
positive in the light of increasing concern that inefficient diagnostic criteria may inflate the
already increased prevalence of ASD (Bisho et al. 2012:1056).
The researcher suspects that the changes in the DSM criteria would not have an immediate
effect on autism-specific education in South African public schools. Learners currently
benefiting from or on waiting lists for special schools would not be disadvantaged by these
changes. Previous discussions highlighted that the new diagnostic criteria would not exclude
learners previously diagnosed according to DSM-IV criteria (Baird 2013:online). Although the
DSM-5 plays a key role in the initial diagnosis, it usually does not outline educational activities
a learner would receive (American Psychiatric Association 2013(2):online). Nevertheless,
district- as well as school-based support teams require training to ensure appropriate advice
and counselling to schools and parents. The researcher is also of the opinion that the impact of
the proposed changes would be communicated via relevant support groups, e.g. Autism South
Africa.
21
2.2.3 Diagnostic tools
Although inclusive policy tries to move away from rigid categories of disability, the complexity
and severity of barriers to leaning remain a concern in the education of learners with high level
support needs (SA 2001(1):9-10). Formal diagnosis needs to be done via a medical specialist
(Centres for Disease Control and Prevention 2013(3):online). Within the South African context,
referral to neurodevelopmental and psychiatric clinics in the public sector poses challenges,
since waiting lists are long. School- and district-based support teams make use of diagnostic
tools to assess the severity of symptoms and to get a baseline for referral and admission to
special schools (2008(3):35-46).
Centres for Disease Control and Prevention (2013(3):online) indicate that screening tools
assist in the identification of developmental delays, but do not offer sufficient evidence for a
formal diagnosis. The characteristics of the child, the psychometric properties, sensitivity and
purpose of the tool influence the selection of a screening tool. The American Paediatric
Association (American Academy of Paediatrics 2006:410-413) does not endorse the use of
any screening tools. However, they state that clinicians use the following screening tools
frequently: Autism Behaviour Checklist (ABC); Autism Screening Instrument for Educational
Planning (ASIEP); Pervasive Developmental Disorder Screening Test – Second Edition
(PDDST); Autism Spectrum Quotient – Child Version (ASQ); the Autism Spectrum Screening
Questionnaire (ASSQ); Gilliam Autism Rating Scale – Second Edition (GARS); and the
Asperger’s Syndrome Diagnostic Scale (ASDS).
Diagnostic tools commonly include observations by professionals and the descriptions of the
parents/carers concerning the child’s behaviour (Centres for Disease Control and Prevention
2013(3):online). The following diagnostic tools are commonly used: Autism Diagnosis Interview
– Revised (ADI-R); Autism Diagnostic Observation Schedule – Generic (ADOS-G); Childhood
Autism Rating Scale (CARS); and the Gilliam Autism Rating Scale – Second Edition (GARS-
2). A systematic review (Anderson, Falkmer, Falkmer & Horlin 2013:329) considered the utility,
accuracy, validity and reliability of ASD diagnostic tools, and indicated the ADOS-G and the
ADI-R as gold standard diagnostic procedures. The current study investigated the use of the
screening and diagnostic tools in South African public schools.
The following discussion focuses on the neurophysiological explanation of the symptoms
described in the diagnostic criteria.
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2.2.4 Pathophysiology of Autism Spectrum Disorders
Currently, ASD does not have a collective mechanism at either molecular, cellular or systems
level that guides clear diagnostic categories (Tager-Flusberg 2010:online). The condition
appears to be the result of complex developmental factors that affect functional brain systems
as well as disturbances in the timing of brain development (American Psychiatric Association
2013(2):56-57). Many children with autism also have comorbid conditions which involve the
peripheral nervous, immune, gastrointestinal and energy production systems. This raises
suspicion that autism is not purely a central nervous system condition, but rather a systemic
disorder (Brimacombeb, Chaaban, Wagner, Xue & Zimmerman-Bier 2008:6-13). Efficient
neurodevelopment depends on a balanced immune response, and irregular immune activity
during critical stages of neurodevelopment may also contribute to the mechanism of some
types of ASD. Although there is evidence of links between immune disturbances and autism,
the relationship remains unclear. Research in neurochemistry indicates that individuals with
ASD have abnormal levels of serotonin and other neurotransmitters in the brain (Posey,
Macdougle, Stigler & Sweeten 2009:840).
Neuroanatomical studies suggest alternations of brain development soon after conception
(Donald & Happe 2006:1218-1220). Environmental factors seem to influence these
pathological neurodevelopmental processes (Casanova 2007:422-433). The brains of children
with ASD appear to grow faster after birth, followed by slower growth later in childhood. The
hypothesis of the pathological overgrowth describes a process where there is an overload of
neurons that causes local over-connectivity in key brain areas, followed by disturbed neural
migration in early development (Donald & Happe 2006:1218-1220). Post-mortem studies
showed evidence of atypical patterns of cortical thickness and grey matter in the primary and
secondary sensory cortices. This pathological mechanism includes unbalanced excitatory-
inhibitory networks and disrupted synaptic development, which contributes to comorbidities
such as epilepsy (Geshwind 2009:37-380 and Rezaie & Schmitz 2008:4-11).
A research report by Wass (2011:18-28) indicates that there is over-connectivity of short fibre
tracts that become overused. This theory possibly describes the stereotypical, non-purposeful
behaviours observed in individuals with ASD.
Research by Anderson and colleagues (Anderson et. al. 2001:1134-1146) supports the theory
of under-connectivity where the long fibres in the brain that process and complex information
across the brain are not developing typically. Evidence for this theory has been found in
functional neuro-imaging and brainwave studies, which showed weak functional connections
23
between the frontal lobe and the rest of the cortex, as well as over connectivity in cortex of
adults with ASD (Cherkassky, Just, Keller & Minshew 2007:951-961). Other evidence indicates
under-connectivity within each hemisphere of the cortex, which suggests ASD to be a disorder
of the association cortex (Minshew & Williams 2007:945-950).
Burns (2013:9) indicates that the results from functional brain imaging have implications for
autism-specific education. Autism-specific education is characterised by individualised, one-
on-one programmes to accommodate the unique needs of learners. However, the new
neuroscience research implies that the observed behaviours and learning problems in learners
with ASD are more unique than variable (Burns 2013:10-11). The repetitive behaviours
observed vary from child to child, but have the same underlying problem: over-connectivity in
short fibre activity disrupts the long integrative pathways required for learning. Individuals with
ASD can become outstanding in an isolated skill due to excessive repetition in the absence of
integration. Wass (2011:18-28) indicates that learners with ASD enter the school system with
most of their long, integrating fibres under-developed, and incoming information diverts into
circular paths of unending routes. Learners with ASD therefore do not benefit from traditional
educational approaches since they do not process information efficiently. Interventions that
develop long fibre interactive tracts appear to have the best long-term effect (Wass 2011:18-
28). The University of California has been developing and revising a computer program (Fast
forWord®) to stimulate the development of the long left hemisphere fibres responsible for
acquiring reading, mathematics and writing. The efficacy of this program requires more
research (Burns 2013:9). This program is currently not available in South Africa.
Although functional brain imaging assists in the identification of functional and anatomical
differences in the brains of learners with ASD, the causes of these changes require
investigation (Centres for Disease Control and Prevention 2012(2):online). Centres for Disease
Control and Prevention in the USA indicate that the key to understanding the causes of ASD
possibly lies within an understanding of the risk factors involved (Centres for Disease Control
and Prevention 2012(2):online).
2.2.5 Causes of Autism Spectrum Disorders
There is currently no single cause for autism and both genetic and environmental factors
contribute to the mechanism of the condition. Environmental influences do not appear to cause
or prevent autism by itself, but seem to increase risk in genetically predisposed individuals
(Buxbaum 2009:35-43).
24
Twin and family studies confirm the possibility of a genetic predisposition to autism. Identical
twin studies indicate that if one twin is affected, chances are approximately 90% the other twin
will also have the condition (Dawson 2008:805). Families with one child with ASD have a
possible risk of 5% (or one in 20) of having a second child with the disorder, which is a higher
risk than for the general population. Relatives of children with ASD may show mild impairments
in social and communicative skills or engagement in repetitive behaviour (Centres for Disease
Control and Prevention 2012(2):2). Approximately 10% of children with ASD have a particular
genetic, neurological or metabolic disorder (Boyd, Humphreys, Odom & Sam 2010:77) e.g.
Fragile X Syndrome, Tuberous Sclerosis, Down’s Syndrome and other chromosomal
disorders.
A number of genetic studies suggest that emotional disorders, such as bipolar disorder, occur
more frequently in the families of people with ASD. Many people diagnosed with ASD also
appear to struggle with attention deficit hyperactivity disorder (ADHD), depression and
fluctuating mood (Gillberg, Rastam, Soderstrom & Stahlberg 2004:891). The largest genetic
study of neurodevelopmental and psychiatric disorders found shared genetic risk factors
amongst autism, ADHD, schizophrenia, major depression and bipolar disorder. These
researchers studied genetic information on more than 60 000 people of mostly European
descent. The results showed that mutations in four distinct genetic areas were significantly
more evident in people with any of these five disorders. Two of these mutations were in genes
that seem to be involved in balancing calcium levels in the brain, which plays a role in
communication between cells (Cross-Disorder Group of Psychiatric Genomics Consortium
2013:1371).
Genetic factors strongly appear to affect the risk for developing autism, but the sudden
increase in the prevalence of the condition raises suspicion for the influence of environmental
factors. Environmental risk factors refer to non-genetic influences such as maternal health,
birth complications, nutrition as well as exposure to toxins (Autism Speaks 2013(a):online).
Maternal influenza associated with prolonged episodes of fever and the use of various
antibiotics appears to be potential risk factors for ASD (Atladóttir, Henriksen, Schendel &
Parner 2012:online). Children born to older parents are at slightly higher risk. A study by Kong
and Colleagues (Besenbacher, Frigge, Kong & Masson 2012:online) indicates the significance
of a father’s age concerning genetic mutations that can result into ASD and schizophrenia.
Children who are born prematurely or with low to very low birth weights showed a small risk for
developing ASD. The taking of harmful drugs such as thalidomide and valproic acid during
pregnancy has also been indicated as a possible risk factor (Office of Autism Research
Coordination- Interagency Autism Coordinating Committee 2012:16-18). The childhood
25
vaccine hypotheses lack convincing scientific evidence, but many parents still believe that their
child was typically developing until vaccinated (Centres for Disease Control and Prevention
2012(2):online, Croen, Daniels & Newschaffer 2007:242).
Herbert (2012:online) refers to the sum of the impact of environmental factors as “Total Load”.
Years of toxic exposures – including malnutrition, severe stress, chemical exposure, etc. –
affect metabolism. Depending on current lifestyle and genetic predisposition, chronic illnesses
may develop, e.g. autoimmune conditions, cancer, diabetes, etc. Chronic conditions often have
common underlying problems such as deficits in energy production in the mitochondria,
oxidative stress, and inflammation (Ataíde, Borges, Diogo, Garcia, Grazina, Marquess, Miguel,
Oliveira & Vicente 2005:185). A resent meta-analysis study explored a possible link between
mitochondrial disorder and ASD, since basic cellular abnormality may produce a range of
deficits in various body systems. The study indicated that about 5% of children with ASD have
classical mitochondrial disease and that 72% to 80% of children presented with some form of
mitochondrial dysfunction (Ataíde et al. 2005:185). The cause for the mitochondrial dysfunction
is uncertain since only 23% of children with both ASD and Mitochondrial Disease present with
mitochondrial DNA abnormalities (Frye & Rossignol 2010:290). The “Total Load” theory
indicates that parents can reduce the total load of environmental factors by leading healthy
lifestyles (nutrition, adequate sleep, exercise, etc.), avoidance of exposure to chemicals and
populated environments, etc. Although these factors could not prevent autism as such, it helps
to decrease the total load of possible risk factors that may activate a genetic predisposition
(Herbert 2012:online).
The causes and risk factors for ASD do not directly affect autism-specific education. However,
the focus of occupational therapists in South African education settings has shifted from only
focusing on the clinical needs of learners within school-based and district-based settings to the
empowerment of communities through healthy lifestyle choices (Anderson, Fisher, Flack,
Greenhough, Kendal, Shadwell & Sonday 2012:5-6).
2.2.6 Prevalence of Autism Spectrum Disorders
Centres for Disease Control and Prevention in the USA monitor the prevalence of ASD through
the Autism and Developmental Disability Monitoring (ADDM) Network (Centres for Disease
Control and Prevention 2013(3):online). ADDM Network reports indicate that nearly five times
as many boys are diagnosed with ASD compared to girls (one in 42 compared to one in 189).
Hispanic children (110%) and black children (91%) showed the largest increase in prevalence
rates for 2002-2008. Greater awareness and improved identification amongst these groups
26
possibly contributed to the increased prevalence. Nevertheless, all racial and socio-economic
groups show an increase in the diagnosis of ASD. On average, the diagnosis for moderate to
severe autistic disorder is earlier (four years) compared to the diagnosis of Asperger’s disorder
/ high functioning ASD (six years and two months) (Centres for Disease Control and
Prevention 2013(3):online).
Epidemiological reports from the ADDM Network (Centres for Disease Control and Prevention
2013(3):online) estimate that one in every 68 children in the USA (14.7 per 1 000) fall on the
autism spectrum. Table 2.3. provides a summary of the combined prevalence rates from 2002-
2010 in the USA. Fombonne (2003:35-64) indicates three possible contributing factors to the
increased ASD prevalence, namely changed diagnostic criteria (as introduced by the DSM-IV),
increased public and professional awareness as well as tendencies where a diagnosis is
required to access public support. Two primary factors appear to have contributed to the
increased ASD prevalence in California, USA:
i) More children are diagnosed early in life;
ii) Increase in the diagnosis of children on the milder side of the spectrum (Boyd et al.
2009:90).
Nevertheless, the assessment of whether or not there is a true increase in the incidence of
ASD is complex, since methodological differences across studies need to be controlled tightly
(Centres for Disease Control and Prevention 2013(3):online and Hughes et. al. 2011:56).
27
Table 2.3 Prevalence of ASD as indicated by the ADDM Network 2000-2010 (Centres
for Disease Control and Prevention 2013(3):online)
IDENTIFIED PREVALENCE OF AUTISM SPECTRUM DISORDERS
ADDM Network 2000-2008 (Combined data from all sites)
Number of Prevalence per
Surveillance Year Birth Year ADDM Sites 1,000 Children Estimate
Reporting (Range)
2000 1992 6 6.7(4.5-9.9) 1 in 150
2002 1994 14 6.6(3.3-10.6) 1 in 150
2004 1996 8 8.0(4.6-9.8) 1 in 125
2006 1998 11 9.0(4.2-12.1) 1 in 110
2008 2000 14 11.3(4.8-21.2) 1 in 88
2010 2002 11 14.7(14.3-15.1) 1 in 68
The Autism South Africa Annual Report 2011-2012 estimates that the application of these
prevalence rates to the South African population would be that 11 198 children born yearly in
South Africa would develop ASD. This further implies 933 new cases of ASD monthly in South
Africa (Autism South Africa:Executive Committee 2012:3). Research by Autism South Africa
and Prof L Jacklin (Jacklin in Autism South Africa:Executive Committee 2012:3) in 2010
indicate that less than 1% of children with ASD in South Africa receive any form of formal
education. Dr DJ Griessel from the Department of Paediatrics: University of the Free State
(Griessel 2012, pers. communication November 2012), an expert in the field of autism,
indicated that although no formal ASD prevalence studies have been done in the Free State, a
sharp increase of new diagnoses has been reported. He also reported that prevalence studies
are challenging in the Free State due to the limited healthcare resources and appropriately
trained clinicians in low socio-economic and rural settings. Healthcare workers are encouraged
to develop research networks and databases to efficiently record and monitor learners
diagnosed with ASD.
A total of 46% of children diagnosed in the USA presents with average and above-average
intellectual ability (Centres for Disease Control and Prevention 2013(3):online). Nevertheless,
increases occur in the estimated prevalence of ASD at all levels of intellectual ability. The
functional profiles of the majority of learners currently seen by the Motheo district-based
occupational therapists appear to correlate with the estimates of Alaimo and Heflin (2007:30)
28
where 67-75% presents with intellectual disability. Griessel (Griessel 2012, pers.
communication November 2012) suggests that this tendency is possibly the result of
decreased awareness and identification of mild autism spectrum disorders in South Africa,
especially in rural and low socio-economic communities with limited resources.
The current prevalence estimates hold significant implications for current and future needs
regarding autism-specific education and the Department of Education needs to develop
strategies to expand autism-specific education in public schools. However, critics may argue
that improved treatment and interventions for ASD may assist in decreasing the impact of the
condition on education systems.
2.2.7 Treatment and intervention
Currently there is no cure for autism, and intervention strategies aim to improve the symptoms
of ASD, behaviour and quality of life. Since autism affects all aspects of a child’s development
and capacity to engage in activities, treatments focus on all-encompassing, holistic
programmes to address all aspects of development and behaviour (Rapin & Tuchman
2008:1129-1146). These treatments include early identification and intervention; medication to
improve symptoms and behaviours; therapeutic intervention; education and development
programmes; as well as alternative support strategies (Autism Speaks 2013(c):online).
Therapeutic intervention and ASD-specific programmes will be discussed later in the literature
review. The role of early identification, medication and alternative support strategies follows.
2.2.8 Early identification and interventions
Early identification and autism-specific support programmes that start at the age of three and
younger contribute to better developmental and behavioural outcomes in children with ASD
(Matson, Rieske & Tureck 2011:1319-1320). Ongoing studies link early warning signs to
developmental outcomes in later stages of life (Boyd et al. 2010:78-79). Experts developed
valid screening and assessment instruments for use in toddlers and infants who appear to be
at risk for ASD (Matson et al. 2011:1322-1324). Retrospective (e.g. video analysis) and
prospective studies assist in the identification of behavioural and psychological warning signs
for ASD. These assessment tools will not be discussed for the purposes of this study, since the
Department of Education mainly focuses on learners of school-going age. However, the
Department of Education supports early assessment and intervention since it contributes to
better behavioural and developmental outcomes over time (Boyd et al. 2010: 92). Access to
29
quality, evidenced, early intervention strategies may reduce ASD symptoms due to the benefits
of neuroplasticity during this critical stage of development (Landa 2008:147).
In the absence of extensive evidence-based practices for early intervention with ASD, most
early intervention programmes originated from ASD practices for older children (Boyd et al.
2010:84). The National Professional Development Centre of Autism Spectrum Disorders set
criteria by which they identified evidenced based practices concerning different aspects of
development and behaviour (Boyd et al. 2010:84 and Brown, Frey, Karasu, Odom, Smith-
Carter & Strain 2003:176-181).
Educational support for younger children (2-5 years) with autism remains a challenge and a
long-term objective is to provide affordable, specialised education to learners between the
ages of 3-18 with ASD (SA 2001(5):11-17). Private facilities attempt to create educational
support for learners between the ages of 3-6 years, but these services do not seem to be
accessible to learners from lower socio-economic groups. Early intervention focuses on basic
self-management skills (e.g. toilet training), pre-linguistic skills (e.g. joint attention), socio-
communication, improved behaviour and reduction in the severity of symptoms (Dawson,
Donaldson, Greenson, Munson, Rogers, Smith, Varley & Winter 2010:online). School-aged
learners with ASD with no early intervention often do not meet the admission criteria to enter a
formal school system. Currently, approximately 30% of learners with ASD on the waiting list for
special schools in Motheo cannot enter a formal programme due to severe ASD symptoms,
incontinence and/or a high burden of care (Motheo Inclusive 2013:2). Early intervention
appears to be a critical success factor for school admission and educational prognosis
(Dunlap, Huber, Iovanne & Kinkaid 2003:online).
2.2.9 Medication and alternative approaches
Medical practitioners use a variety of medications to treat the symptoms of ASD that affect
participation in school- and home-based settings. Anticonvulsants, antipsychotics, anti-
depressants and stimulants are commonly used. Comorbid mental, physical, medical and
neurodevelopment conditions co-occur in individuals with ASD (American Psychiatric
Association 2013(2):40). These comorbid conditions include cerebral palsy, epilepsy, attention
deficit disorders, anxiety, depression, sleep disturbances and gastro-intestinal distress (Autism
Speaks 2013(a):online). Many children with autism may have atypical responses to medication
and require close medical follow-up (Oswald & Sonenklar 2007:348-355). There are schools in
the Motheo District that prefer learners with ASD to be on medication to enhance the efficiency
of educational programmes. The researcher observed that learners from low socio-economic
30
and rural areas have limited access to medical intervention. Efficient medical follow-up, access
to appropriate medication and monitoring of the effects of medication appear to be problematic
in these areas.
Some 30 to 90% of families in the USA caring for children with ASD use complementary and
alternative medication. These approaches include melatonin (a natural hormone that regulates
sleep-wake patterns), nutritional supplements (B12 injections, anti-oxidants, probiotics, etc.),
omega 3 fatty acids, as well as casein- and gluten-free diets. The safety and efficacy of these
treatments have not been adequately researched and therefore these treatments should not
replace research-based approaches (Henderson 2013:online).
2.2.10 Prognosis of Autism Spectrum Disorders
The core difficulties of ASD tend to persist throughout life, but the severity of symptoms
appears to improve with age (Rapin & Tuchman 2008:1129-1146). There are only a limited
number of research-based studies available concerning the long-term prognosis of ASD, and
no study could be found that focuses on autism after midlife. Factors that positively influence
long-term prognosis include acquiring language before the age of six years; IQ above 50;
having a marketable skill; as well as having moderate to mild autism traits (Tidmarsh &
Volkmar 2003:17-25). Since autism is a spectrum disorder, one may argue that individuals with
milder traits of autism may have a better prognosis in terms of independent living,
employability and community integration. However, social and communication difficulties
usually persist that affect social adjustment in various contexts (Volkmar & Woodberry-Smith
2005:235-240). Social impairments often have negative outcomes, such as social failure, peer
rejection, high anxiety levels and behavioural difficulties (Bellini, Benner, Hopf & Peters,
2007:153). This may possibly explain why individuals with mild autistic traits and high
functioning autism appear to have an increased prevalence of comorbid psychiatric conditions
such as major depression and anxiety disorders, which may affect their prognosis (Volkmar &
Woodberry 2009:2-11).
Individuals with moderate to severe autism have less promising functional outcomes, and the
majority require care and support. A study on long-term prognosis (Goode, Howlin, Hutton &
Rutter 2004:212-229) focused on 68 individuals with ASD and a performance IQ of 50 and
above during childhood, who were followed up as adults. Results indicated that minority of
adults achieved high levels of independence and remained significantly dependent on family
support, supervision and structure. Participants with a childhood performance IQ of more than
70 had a significantly better outcome compared to those with lower IQs. Individuals within the
31
typical IQ range had variable functional outcomes and IQ did not proof to be a prognostic
indicator (Goode et al. 2004:212-229). A Canadian study indicated similar results and reported
that 56% of adults (with IO’s beyond 70) were employed at some stage in their life, mostly in
volunteer or sheltered labour (Eaves & Ho 2008:739-347).
Unfortunately, the researcher could not find any South African studies related to long-term
prognosis. Given the current unemployment rate, poverty and limited educational access in
South Africa (SA 2011(5):49-51), the researcher suspects that local outcomes may be even
worse compared to first-world countries.
2.2.11 Cost of treatment and care
The previous discussion indicated that autism is a lifelong condition that influences health,
social integration, employability and quality of life of both the affected individual and families.
The burden of care in terms of finances and energy are high for parents and individuals living
with ASD. A study (Beecham, Knapp & Romeo 2009:317) performed in the United Kingdom
estimates the yearly costs of supporting children with ASD are £2.7 billion and for adults
£2.5 billion. The lifetime cost for an individual with ASD and intellectual ability is approximately
£1.23 million and these estimates include place of residence, cost of services and lost
productivity. The challenges in adulthood include residential care, vocational training, job
placement, sexuality, social integration and long-term care (Baker & Sharpe 2007:247-264).
Medical care makes up 10% of the estimated cost; 30% goes to extra education and care,
while loss of economic productivity absorbs 60% of the cost. The challenges are that public
programmes are usually inadequate or inappropriate for children with ASD, and that parents
need to pay privately for these expenses (Ganz 2007:343-349). Due to the challenging
behaviour of children with ASD, it is usually difficult to access childcare, which affects parental
employment. A survey performed in the USA during 2008 indicated that families of children
with ASD had a loss of 14% of their annual income due to expenses related to ASD
(Halterman & Montes 2008:821).
The researcher could not find any South African studies that focus on the financial implications
of having a child with ASD. The high cost of medical care, therapeutic intervention, education
and loss of productivity appear to mostly affect families in rural and poverty-stricken areas. Not
only are these areas limited in terms of appropriate resources, but parents also appear to have
difficulty to access resources and facilities in urban areas (Bentaar 2013:154-155). Families in
low-income groups usually receive a care dependency grant of R1 200 per month for a child
with severe ASD. Those who foster a child receive an additional R750 per month (South
32
African Social Security Agency 2013:online). The huge financial burden on parents is a primary
drive in expanding autism-specific education in public schools. Access to autism education in a
private educational facility (excluding therapeutic intervention) costs approximately R2 500 or
more per month in the Free State (Smith 2014, pers. comm. 24 May 2014). The increased
prevalence of autism does not only hold significant financial implications for families, but also
for the South African economy in general. Increased numbers of individuals with disability do
not only imply an increase in lifelong disability grants, but the poor employability of individuals
with severe ASD also implies loss of economic productivity. The researcher is therefore of
opinion that vocational and social training should be a central feature in the school curriculum
to enhance marketable skills and possible employability.
Autism-specific education is also costly from a specialised education perspective. White Paper
6 indicates that specialised education is expensive due to the high frequency of intervention by
specialised staff; the extensive adjustments to learning material; intensive training
programmes; assistive technology; and individualised support strategies (SA 2001(1):36-43).
Table 2.4 indicates the distribution of special schools, learner enrolment and expenditure per
learner across different provinces as recorded in 2001. An added concern is the significant
portion of disabled learners (including those with ASD) who are not yet identified or do not
have access to special education.
33
Table 2.4 The distribution of special schools, learner enrolment and expenditure
per learner across different provinces as recorded in 2001 (SA
2001(1):13).
AVERAGE ANNUAL COST OF SPECIALISED EDUCATION PER LEARNER
IN SOUTH AFRICA DURING 2001
% of total
Number of
Number of % of learners number of average
learners in
Provinces special in special special expenditure
special
schools schools schools in per learner
schools
province
Gauteng 96 25 451 1.62% 25.26% 11 049
Western Cape 82 9 213 0.96% 21.58% 28 635
KwaZulu-Natal 58 7 631 0.28% 15.26% 21 254
North West 42 4 364 0.46% 11.05% 13 015
Eastern Cape 41 6 483 0.28% 10.79% 13 746
Free State 19 3 127 0.40% 5.00% 22 627
Northern
19 4 250 0.23% 5.00% 16 609
Province
Mpumalanga 15 2 692 0.29% 3.95% 17 839
Northern Cape 8 1 392 0.68% 2.11% 15 749
TOTAL: 380 64 603 0.52% 100.00% 17 388
The high cost of specialised education, the estimate that only 1% of learners with ASD in
South Africa have access to formal education, and increasing prevalence rates hold significant
financial implications for autism-specific education in the public sector.
2.3 AUTISM-SPECIFIC EDUCATION
The second phase of the literature discussion focuses on autism-specific education. The
model of Hanbury (2005:16) is used to discuss the following:
2.3.1 The impact of ASD on learning,
2.3.2 Behaviours and socio-emotional responses resulting from the condition; and
2.3.3 The attitudes of others towards the symptoms and behaviours of learners with ASD.
34
This discussion is followed by an overview of:
2.3.4 Inclusion as a global trend; and
2.3.5 The critical success factors of autism-specific education.
2.3.1 Impact of the condition itself
Hanbury (2005:16) indicates that the “perceived uniqueness” of each child with ASD
complicates the design of a standard educational approach for learners with ASD. Since
autism is a spectrum disorder, it implies variability in functional, academic and clinical profiles,
where symptoms may differ in nature, intensity and severity (American Psychiatric Association
2013(2):50-51, Kaufmann 2012:online). Although learners on the autism spectrum have certain
common features, these symptoms present in different and unique combinations (Hughes et
al. 2011:56). The design of special needs programmes for learners with ASD involves an
integrated reasoning process that shifts from knowing the condition towards understanding the
impact of the condition on each individual (SA 2008(3):26-31). According to Hanbury
(2005:17), Autism Spectrum Disorders impact on the child’s learning through three different
key processes:
i) The impact of the condition itself;
ii) The behaviour that presents as a result of the condition; and
iii) Attitudes of others that develop as a result of the condition and behaviour.
The researcher chose Hanbury’s model, since it considers the complex interaction between
the child and the learning context. The model also fits in with the inclusive approach where
barriers to learning include learner-specific and external factors.
35
Condition
Figure: 2.2 Autism impact on learning through three processes: (i) the impact of the
condition itself; (ii) the behaviour resulting from the condition; and (iii)
attitudes that develop from (i) and (ii) (Hanbury 2005:17).
Learners with ASD present with difficulty in social interaction, socio-communication, restricted
interests and behaviours, sensory processing difficulties, unusual patterns of behaviour and
motor deficits that create barriers to learning and development (American Psychiatric
Association 2013(2):50-5). An overview on each of the key features of ASD, the implications of
these traits for education, and a table that summarises classroom strategies to enhance these
deficits are provided.
The discussion on the impact of the condition itself focuses on the following aspects:
2.3.1.1 Social interaction deficits;
2.3.1.2 The implications of socio-communication and social interaction deficits for
education;
2.3.1.3 Socio-communication deficits;
2.3.1.4 The implications of socio-communication for education;
2.3.1.5 Restricted, repetitive patterns of behaviour, interests or activities;
2.3.1.6 The implications of restricted, repetitive patterns of behaviour, interests or activities
for education;
2.3.1.7 Sensory processing difficulties;
2.3.1.8 The implications of sensory processing difficulties for education;
2.3.1.9 Associated factors: unusual patterns of attention;
2.3.1.10 The implications of unusual patterns of attention for education;
36
2.3.11 Motor deficits; and
2.3.12 The implications of motor deficits for education.
2.3.1.1 Social interaction deficits
Individuals with ASD present with deficits in social interaction in different contexts and settings.
These challenges usually present in following three areas: social-emotional interaction; non-
verbal communication; and the development and maintenance of relationships. Although these
deficits may range in severity, all individuals struggle with these three components of social
interaction. Social interaction is usually severely affected in learners with moderate to severe
ASD (American Psychiatric Association 2013(2):50).
Learners with moderate to high functioning autism may be able to match certain nonverbal
cues with feelings when presented in an isolated situation. However, they struggle to integrate
and interpret these when presented simultaneously or in a group setting. These learners
usually engage in basic, automatic social interaction (e.g. basic greetings and general topics),
but have difficulty to initiate and sustain more complex discussions (Smith-Myles 2005:1).
Smith-Myles (2005:1) indicates that difficulties with social interaction are best observed in
interactions with peers; stressful situations; unstructured situations without predictable routine;
new situations; changed routines; and in the presence of sensory stressors. Since learners
with ASD misinterpret situations, feel out of control in unstructured settings and may process
sensory stimuli differently, they often become distressed (Mayo Clinic Staff 2010:online).
Learners with ASD struggle to express their own fears, stress and anxiety efficiently. Most
learners do not have the verbal skills to express their needs, stressors and excitement, and
cannot use nonverbal skills (tone of voice, pitch, body language, etc.) to efficiently
communicate their experiences within a certain social context (Minaham & Rappaport
2013:34).
Play creates opportunities for children to explore with thoughts, to engage in a fantasy world,
to imagine themselves in future situations and to practise social interaction. The severe
impairments in socio-emotional interaction, communication, sensory processing and inflexible
thinking present fundamental barriers to typical play development in learners with ASD.
Children with ASD therefore need to learn how to play by engaging more appropriately with
objects and people in their environment. The challenge is that impairments in social interaction
make it difficult for learners with ASD to take turns, handle conflict and show appropriate
37
emotional responses. Inflexible thinking hampers appropriate interaction and play due to the
preoccupation with certain themes and restricted behaviours (Hanbury 2005:19).
Increased social awareness does not always develop as they get older, since the complexity of
social contexts also increase with time. Learners with high functioning ASD may mask some of
their deficits with jargon and a well-developed vocabulary. However, they experience high
levels of anxiety in social contexts as well as an inability to build peer relationships (Minaham
& Rappaport 2013:34). Learners with more severe symptoms of ASD may show a total lack of
interest in other people and may present with severely challenging behaviour in social contexts
that they perceive as stressful (American Psychiatric Association 2013(2)51-52).
2.3.1.2 Implications of social interaction deficits for education
There are a number of play-related classroom activities that require imagination, flexibility and
adaptive behaviour, e.g. story time, role-play, group work, etc. Engagement with toys and
playground apparatus is also restricted since they tend to play with parts of toys or play
inappropriately (e.g. line toys up, break toys to play with the wheels, etc.). Smith-Myles
(2005:76) refers to the rules of the social context in a school as the hidden curriculum, which
includes teacher expectations; knowing how to make friends; class rules; and how to adjust
social behaviour from one context to another. Educators do not directly teach these rules
which typically developing learners know intuitively. The lack of consistency in social rules is
challenging for learners with ASD and they therefore require structure and routine to help them
adjust (Bellini et al. 2007:153-154).
Hence, learners with ASD need to acquire a number of social skills in order to cope with the
social demands of the classroom, playground and other contexts. These skills include the
following (New Brunswick Department of Education 2005:45):
i) Waiting;
ii) Taking turns in activities;
iii) Transitions from one context or task to another;
iv) Initiating and finishing activities and conversations;
v) Flexibility; and
vi) Being quiet when expected.
Educators require a multifaceted approach of instruction, interpretation of social behaviour and
coaching to assist children with ASD to develop these skills (New Brunswick Department of
Education 2005:42-47, Smith-Myles 2005:80-85). Table 2.5 provides an overview on some
38
classroom strategies (functional assessments, research-based programmes, environmental
adjustments, classroom strategies and assistive technology) to enhance social skills in
learners with ASD.
Table 2.5 Classroom strategies to enhance social skills in learners with ASD
(compiled by the researcher).
CLASSROOM STRATEGIES, ASSESSMENT AND SUPPORT:
SOCIAL SKILLS
Functional assessment
The educator needs to identify target social skills through observation in different contexts. Video
modelling appears to be a successful tool in identifying social strengths and weaknesses. The
process involves the assessment, listing, prioritisation and setting targets (Cook, Earles-Vollrath &
Ganz 2011:10).
Research-based programmes and approaches
Direct Instruction: Teaching of social skills as a specific subject, where educators teach skills in a
specific sequence and hierarchical order. This structured instruction may include aspects such as
starting a conversation; staying on topic; taking turns in conversation; using body language;
personal space; understanding humour and abstract language; expressing feelings and needs; as
well as using appropriate greetings. Educators often develop curriculums from traditional
curriculums, e.g. Barker’s Social Skills Training for Children and Adolescents with Asperger’s
Syndrome (Smith-Myles 2005:80-81).
Social Stories™: Social Stories™ assists children with ASD with the social information they
require to cope in a certain situation. Carol Gray developed the concept in 1991 to describe
situations that are difficult for children with ASD, to acknowledge attempts to improve behaviour,
and to promote social behaviours. Social Stories™ explains “a situation, skill, or concept in terms
of relevant social cues, perspectives, and common responses in a specifically defined style and
format” (Gray 2012:online).
The story should consist of behaviours that the child does well, but should also provide guidance
on all possible behavioural triggers in order to guide the child on how to respond in each situation
(Kincaid, Powell-Smith & Sansosti 2004:194). The story should consider the cognitive level of the
learner, prompting and practising of the desired skill (Lynch, Simpson & Spencer, 2008:58). Gray
(2012:online) designed criteria for the development of a story, which vary from 5-10 sentences.
Social Stories™ should:
(i) Specifically define the behaviour of concern;
(ii) Identify an applicable substitute behaviour;
(iii) Incorporate pictures and drawings to assist the child to identify with the desired behaviour;
39
(iv) Include sentences that indicate the purpose of the story and supply options for expected
behaviours
Extensive research regarding social stories has not been done. However, it seems to be a
promising behavioural intervention system for learners with ASD, since it assists in the facilitation
of social behaviours and decrease of antisocial behaviours (Kincaid et al. 2004:198-204 and Lynch
et. al. 2005:149).
The Developmental, Individual Difference, Relationship-Based Model
(DIR® / Floortime™): This is a comprehensive, interdisciplinary approach that focuses on the
individual needs of children with disability, especially ASD. Dr SI Greenspan and Dr S Wieder
(Greenspan & Wieder 2006(2):1-10) developed the model. The approach includes social-emotional
capacities; thinking and learning processes; and motor and cognitive processes (Hughes et al.
2011:60). The aim of the model is to build a foundation for social, emotional and intellectual
capacitates instead of targeting isolated skills and behaviours. This process includes the
stimulation of the capacity to attend, remain calm-alert, engage with others, initiate and respond to
different types of communication, social affect, shared social problem-solving, and to play
creatively. Only a few controlled research studies focused on Floortime™, but these all support
positive outcomes for learners with ASD (Hughes et al. 2011:61). A play training programme that
incorporates Floortime™ found that 45,5% of the children involved in the study made significant
progress in their functional development through the programme. Some 80% of parents involved in
the project approved the programme (Greenspan & Wieder 2001(1):11-19). Since the
DIR®/Floortime™ has a primary focus on social interaction, emotional development and
relationships, it may complement a behavioural teaching programme. Although it appears to be
effective in individual therapy sessions, the researcher is uncertain about the practical
implementation of the programme in public schools.
Environmental adjustments and support
Round table: Learners sit in a circular formation in order to enhance their interaction (New
Brunswick Department of Education 2005:42-47).
Classroom strategies and assistive technology
Power card strategy: The use of a small card as a visual aid to help understand situations,
reinforce behaviour and help reach target behaviour. The card usually includes a picture and a
summary of the solution, e.g. the steps in greeting a person (Smith-Myles 2005:85)
Acting and role-play: Role-play is where children learn to interpret emotions and practise social
skills (LaMarca 2008:online). Social skills can also be practised through board games and informal
play (Koegel, Koegel, Lang & Matos-Fredeen 2011:5)
Self-esteem building: Celebrating all achievements, recognition of positive behaviours, and a
focus on what the learner is doing well. Giving compliments and teaching the child to compliment
others (Smith-Myles 2005:86).
40
Self-awareness: This category includes visually-based activities that assist learners to identify and
label their emotions; indicate the intensity of the emotion; redirect negative thoughts into positive
thoughts; identify environmental stressors; and select a strategy to calm them down (Smith-Myles
2005:87).
Video modelling: Video self-modelling involves learning new skills by watching videos of others.
The combined use of video modelling, direct instruction and guidance in natural environments
appear to have the best results. The technique appears to improve social interaction, conversation
skills, daily living and play skills, and reduce problem behaviour (Cook et al. 2011:10,17)
Support of existing friendships: Educators and families should encourage play dates, helping
learners to understand one another’s emotions, opportunities for enjoyment of cooperative games,
etc. (New Brunswick Department of Education 2005:47).
A discussion regarding the impact of socio-communication deficits in education follows in the
next section.
2.3.1.3 Socio- communication deficits
Although delayed onset of language is currently not a diagnostic criterion for ASD, most
individuals with ASD present with varying levels of language deficits. These deficits range from
receptive and expressive difficulties; absence of speech; echoed speech; and overdeveloped
vocabularies (American Psychiatric Association 2013(2):50 and Kaufmann 2012:online).
Approximately one-third (35-40%) of children with autism are nonverbal (Hughes et al.
2011:56). Thus, these learners struggle to communicate; process and integrate information
from the environment; establish and sustain relationships; and participate in new
environments. Hanbury (2005:18) indicates that learners with ASD struggle to engage in
ordinary classroom settings since they battle to interpret discussions; read the social
situations; express themselves; or respond appropriately to stimuli in the environment.
Learners with high functioning ASD have difficulty comprehending abstract language, e.g.
idioms, analogies and metaphors. These deficits do not only affect their social interaction, but
also impacts negatively on academic success since they tend to misinterpret abstract
concepts. Although language ability may appear intact from a grammatical and vocabulary
perspective, the use of abstract language and pragmatics remains impaired (Smith-Myles
2005:1-2).
41
2.3.1.4 The implications of socio-communication on education
Communication skills are complex and do not develop naturally in learners with ASD.
Educators and families struggle to teach and improve these skills in learners with ASD.
Although educators could teach communication skills in simulated environments, the best
practice is to develop these skills in natural settings where they have application value (Koegel
et al. 2011:3-4).
Learners with ASD who are verbal have limited opportunity for communication during a school
day. Hence, educators should create opportunities for communication as part of the classroom
routine (Koegel et al. 2011:3-4). Learners need to learn how to listen to instructions and
strategies such as joint attention is often a prerequisite for developing communication and
language skills (Abbott, Dawson, Estes, Liaw, Munson, Osterling & Toth 2003:271). Educators
should provide verbal instructions with visual supports and adjust verbal communication to
provide clear and direct messages. Learners should be motivated to express their needs
verbally (e.g. need for water) and opportunities for choices should be created (Chiang
2009:165, Koegel et al. 2011:online). A variety of strategies uses the learner’s current fixations
and manner of communication as a starting point to initiate oral speech. Many learners
struggle with echolalia and would repeat television commercials and echo back what other say
to them. The approach is then to make functional associations with phrases by linking the
verbal expression with objects, pictures, etc. (New Brunswick Department of Education
2005:12-13).
Since communication is such a complex field, educators need the support of a multi-
professional team and the input of the speech and language therapists is particularly helpful in
this regard. Collaboration and integrated goal-setting between the therapist, educators and
parents are vital in the acquisition of speech and language skills (New Brunswick Department
of Education 2005:92). Learners with more severe communication deficits require intensive
intervention. Table 2.6 provides an overview on some classroom strategies (functional
assessments; research-based programmes; environmental adjustments; classroom strategies;
and assistive technology) to enhance communication skills in learners with ASD.
42
Table 2.6 Classroom strategies to enhance communication skills in learners with
ASD (compiled by the researcher)
CLASSROOM STRATEGIES, ASSESSMENT AND SUPPORT:
COMMUNICATION AND LANGUAGE
Functional assessment
A speech therapy assessment is the golden standard. However, educators could also perform a
functional assessment where they target the following language and communication skills: listening
skills; receptive and expressive language skills; and non-verbal communication. Identification of the
learner’s strengths to use the skills in the improvement of weaker areas, e.g. good matching skills,
can be helpful in the use of a communication board (New Brunswick Department of Education
2005:12-13).
Research-based programmes and approaches:
The Makaton Language Programme is a multimodal approach used to train language and literacy
through a mixture of speech signs and graphic symbols in accordance to a learner’s individualised
needs. The name Makaton has been compiled from three key role-players: Margaret Walker (a
speech therapist who developed Makaton), and to visitors from the Royal Association for Deaf with
the names Katherine Johnston and Tony Comforth (Makaton 2013:online). Margaret Walker
(1977:3) performed the initial research in 1972, and this guided the development of the Makaton
Core Vocabulary. The research on Makaton Core Vocabulary initially focused on institutionalised
deaf, cognitively impaired adults at Botsley Park Hospital in Surrey, UK. The Core Vocabulary
consists of approximately 450 concepts that are trained though eight stages. The first stage
focuses on communicating basic needs, but complex, abstract vocabulary follows in later stages
(Grove & Walker 1990:15-28). The Makaton Vocabulary Development Project changed to become
the Makaton Charity in 2007 (Makaton 2013:online). Makaton appears to have a positive impact on
the speech and language development of children with learning disability (Duffy & Sheehy
2009:11).
The Picture Exchange Communication System (PECS): Lori Frost and Andy Bondy developed
the system in the 1980s based on their intervention with children with ASD. The approach focuses
on utilising visual strengths and a capacity to learn better in a structured, systematic way while
accommodating for deficits in language development. The design of PECS takes the learner
through six phases, namely (Bondy & Frost 1994:1-19):
(a) Initiating communication;
(b) Expanding the utilisation of pictures;
(c) Choosing a message in PECS;
(d) Introducing a sentence structure in PECS;
(e) Teaching the child to answer simple questions; and
43
(f) Teaching commenting.
The complexity of tasks increases during each stage and reaching generalisation of behaviour is a
critical success factor to ensure that behaviour has functional benefits in daily life. Generalisation of
behaviour follows during the second stage when the teacher takes less initiative for
communication. Discrimination of different symbols follows in the third stage (Bondy & Frost
1994:1-19). The Picture Exchange Communication System appears to have benefits for learners
with ASD The use of objects as symbols appears to be successful in the facilitation of
communication skills in learners with ASD (Carr & Felce 2006:780-787 and Lund & Thorba
2008:719-730).
Environmental adjustments and support
Help the learner understand that everything in the environment has a name by labelling furniture
and objects in the environment (Smith-Myles 2005:21).
Classroom strategies and assistive technology
Alternative augmentative communication refers to communication methods that compensate or
replace speech or written language due to severe speech and language impairments (Lee & Low
2011:23). Strategies to convey message may include:
Low Tech
- Use of gestures and body movements (e.g. shaking the head to indicate yes or no);
- Use of concrete objects (e.g. bring a glass to ask for something to drink);
- Use of picture representations (e.g. the Picture Exchange Communication System)
- Use of communication boards;
- Use of the voice without using regular words (e.g. saying “lala” to indicate the need to sleep);
and
- Use of recognised sign language (e.g. South African Sign Language, etc.).
These strategies need to be considered in hierarchical order, starting from more abstract to
concrete (highly abstract signing; written sentences and phrases; drawings; photographs; gestures;
miniature objects; and concrete full-sized objects) (New Brunswick Department of Education
2005:40-41).
High Tech
- Use of a communication device (e.g. speech generating devices, voice output communication
aids, tablet computers with adapted components and software, etc.) (New Brunswick
Department of Education 2005:41).
Learn to listen:
- Structured lessons in listening; and
- Reinforcing components of listening (New Brunswick Department of Education 2005:37).
44
Develop language comprehension:
- Use of visual aids (photographs, pictures, objects, etc) and object picture matching;
- Use of gestures and signing symbols with verbal communication (visual over verbal);
- Following of one-step commands (Low & Lee 2011:23 and New Brunswick Department of
Education 2005:37).
Develop verbal expression:
- Encourage and reinforce attempts to communicate;
- Expand vocabulary with visual aids;
- Use concrete objects to assist expression;
- Classroom discussions; and
- Use alternative/augmentative communication systems where required (New Brunswick
Department of Education 2005:40).
Music Therapy: A randomised control study by Gold and colleagues (Elefant, Gold & Wigram
2010:9) focused on the effect of music therapy on individuals with autism. Study results indicated
positive, short-term effects concerning verbal and nonverbal skills, but behaviour outcomes
showed no significant improvements. The use of music therapy to enhance language and
communicate skills in learners with ASD requires more research.
The impact of restricted, repetitive patterns of behaviour, interests, or activities on education
follows next.
2.3.1.5 Restricted, repetitive patterns of behaviour, interests, or activities
Learners with ASD engage in restricted, repetitive non-functional speech (echolalia, repetition
of phrases, etc.), movement patterns (hand flapping, rocking, etc.) or object use (obsessive
spinning of objects). A factor analytical study by Aman and Lam (2007:855) studied restricted,
repetitive behaviours in ASD and indicated five different factors:
i) Ritualistic behaviour;
ii) Restricted interests;
iii) Compulsive behaviour;
iv) stereotyped behaviour; and
v) Self-injurious behaviour.
There are two groups of repetitive stereotyped behaviours (Blanchard, Blanchard, Bolivar,
Defensor, Oasay, Pearson & Pobbe 2011:online) namely “higher level behaviours” that include
insistence on sameness, restricted interests and preoccupations, and “lower level behaviours”
that refer to repetitive movements. Higher-level repetitive stereotyped behaviours relate more
specifically to autism than lower level behaviours and may be on a spectrum with obsessive-
45
compulsive traits (Blanchard et al. 2011:online). Although the high-level restrictive, repetitive
behaviours in ASD share some similarities with obsessive compulsive disorders (e.g.
preoccupations, strict adherence to rituals, resistance of change in routines and environments
and insistence on sameness), there are differences. Individuals with ASD engage more
commonly in repetitive ordering, hoarding, telling and asking, repetitive sensory-motor actions
and self-injurious behaviours (Kyrios, Prior & Zandt 2007:online). Self-injurious behaviour is
considered to be “lower level” behaviour and to date the most efficient intervention strategy is
various combinations of behaviour modification (LoVullo & Matson 2008:61).
2.3.1.6 Implications of restricted, repetitive patterns of behaviour, interests, or
activities for education
Learners with ASD have excessive devotion to routines and ritualised patterns of verbal and
nonverbal behaviours (American Psychiatric Association 2013(2):50). Hence, these learners
resist changes in their environment and routines. These behaviours posses many challenges
to educators since change is inevitable in any classroom setting. Learners with ASD usually
respond to these changes with challenging socio-emotional behaviours, e.g. tantrums.
Learners with ASD also present with severely fixated, restricted interests. This limited mental
flexibility and adjustability make it difficult for them to move from one classroom activity to
another (Hanbury 2005:81).
Hanbury (2005:81) indicates that developing flexible thinking in learners with ASD is one of the
greatest challenges, since there is variability in the type, level and intensity of rigidity in
thinking. These may range from spinning a piece of string to expert knowledge in certain areas
(dinosaurs, trains, etc.). An understanding and efficient use of the learner’s restricted interest is
usually the best starting point for developing flexible thinking and then to add a new dimension
to the activity or thoughts (New Brunswick Department of Education 2005:30).
Since learners with autism resist change, they require routine, structure, predictability
consistency and thorough preparation for change. Table 2.7 provides an overview on some
classroom strategies (functional assessments, research-based programmes, environmental
adjustments, classroom strategies and assistive technology) to reduce restricted, repetitive
patterns of behaviour in learners with ASD.
46
Table 2.7 Classroom strategies to reduce restricted, repetitive behaviours in
learners with ASD (compiled by the researcher)
CLASSROOM STRATEGIES, ASSESSMENT AND SUPPORT:
RESTRICTED, REPETITIVE PATTERNS OF BEHAVIOUR
Functional assessment
The assessment entails an understanding of the learner’s unique interests, responses to
environmental stressors, learning style and individual needs (New Brunswick Department of
Education 2005:16-17).
Research-based programmes and approaches
The Treatment and Education of Autistic and related Communication Handicapped Children
(TEACCH): Eric Schopler developed the concept of TEACCH in 1971. TEACCH involves the use
of structured teaching through visual support to maximise the independent functioning of a child
with ASD and educational facilities use this technique frequently. The programme consists of four
vital components, namely (Hume & Odom 2007:1166-1180):
i) Physical structure and organisation of the workspace;
ii) Schedules indicating details about the required task;
iii) Work systems that provide detailed expectations of individuals during the task; and \
iv) Task organisation describing the learning task.
Environmental adjustments and supports
A well-structured and organised classroom proves to be beneficial for learners with ASD, since it
offers the structure, predictability, visual support and limited sensory distractions required for
leaning. A structured classroom provides guidance for classroom expectations and assist learners
to organise themselves. Examples of general organisation may include: well-defined areas for
different activities; visual supports to reinforce classroom expectations; adequate spacing of at
least 60 cm between learners; and colour-coded or labelled classroom materials. Individualised
environmental adjustments need to be built into the individual support plan, since strategies could
then be monitored and revised more efficiently (Smith-Myles 2005:21-25).
Classroom strategies and assistive technology
Daily routines(Smith-Myles 2005:23-24):
- Structured daily routines displayed in visual schedules of charts; and
- Individual preparation of learners regarding the activities of the day through visual-over-verbal
communication.
Visual supports (Smith-Myles 2005:23-24):
47
- Posting of daily schedules, cards with classroom rules;
- Creating individualised mini-schedules, choice boards, steps in personal and class routines,
activity checklists, etc.;
- Labelling and colour-coding of books, material, etc.; and
- Visual cues to support oral information or teacher directions
Organisational skills:
- Use personal schedules, checklists and calendars with pictures; and
- Use picture cues and desk pads with Velcro to order material (Smith-Myles 2005:23-24).
Preparation for change:
- Prepare for potential changes in work schedules and environment by using pictures, schedules,
and social stories (Hanbury 2005:82-83).
Restricted range of interests (New Brunswick Department of Education 2005:52):
- Limit perseveration by setting firm expectations; provide opportunities for learners to focus on
their interests; and
- Incorporate and develop on interest in activities and topics
Academic difficulties (New Brunswick Department of Education 2005:52):
- Ensure that learners understand information copying and repeating of information does not
necessarily indicate comprehension;
- Grading: Concrete to more abstract – same vs new;
- Use of activity-based learning and practical examples;
- Use of graphic organisers;
- Breaking down tasks into smaller steps or present it in another way;
- Provision of direct instruction as well as modelling; and
- Avoidance of verbal overload
Technological and other devices (New Brunswick Department of Education 2005:45):
- Data projectors and interactive white boards to facilitate visual structure during teaching.
- A Time Timer® is often used to provide feedback to learners regarding the time they need to
spend on a structured task.
The impact of sensory processing difficulties on education follows next.
2.3.1.7 Sensory-processing difficulties
The DSM-5 recognises sensory processing difficulties as a contributing factor to repetitive,
restricted behaviours in ASD. Learners with autism have unique sensory processing patterns
that include unusual responses to sensory experiences. These children may be hypersensitive
48
to a certain type of sensory stimulus (e.g. auditory), which may lead to a severe overreaction
or withdrawal (Angley, Baker, Lane & Young 2010:112). Behaviours may include sensory
sensitivity (e.g. covering of the ears to block out sounds; averse responses to touch; and
avoidance of certain food textures); hypo-responsiveness to stimuli (e.g. pain or temperature)
or seeking behaviours (rocking, making noises, etc.). These difficulties in sensory processing
affect social interaction, attention, arousal and the capacity to adjust in different contexts
(Brown & Dunn 2010:474-475).
A retrospective review by Dunn and Tomcheck (2007:190) indicated that 95% of learners with
ASD assessed on the Short Sensory Profile had deficits in sensory processing and scored
significantly lower on 92% of the items compared to learners without ASD. The greatest
differences between the two groups (learners with ASD and those who were typically
developing) were in the following sections: under-responsiveness / sensory seeking; auditory
filtering; and tactile sensitivity. A model-based cluster analyses (Angley et al. 2010:119)
indicated three sensory processing subtypes in ASD:
i) Sensory-based inattentive seeking;
ii) Sensory-based with movement sensitivity; and
iii) Sensory modulation with taste and smell sensitivity.
The first cluster links well with the findings of Dunn and Tomcheck where under-
responsiveness / sensory seeking, auditory filtering and tactile sensitivity are associated with
difficulties in attention. Learners in this group often present with inattention, distractibility,
hyperfocused attention and impulsivity (Dunn & Tomcheck 2007:190). Auditory processing
difficulties occur commonly in children with ASD. The previously mentioned study by
Tomcheck and Dunn (2007:196) indicated that 77.6% of the learners with ASD struggled with
auditory filtering, and background noise tended to distract them. Children also responded
poorly to language, which further indicates difficulty with auditory processing. Auditory filtering
difficulties, sensory under-responsiveness, and sensory seeking are associated with academic
underachievement in the children with ASD (Ashburner et al. 2008:564).
Learners with ASD seem to learn well through visually-based approaches that assist them to
focus on relevant stimuli; to condense content to the essential; to make abstract concepts
concrete; and to shift attention in a structured way (Cook et al. 2011:8). Visual support (visual
scripts, schedules, photographs, line drawings, words, visual task analyses, etc.) as well as
video modelling have been proven efficient in increasing work completion for learners,
increasing social skills, improving communication and decreasing problem behaviours (Fettig,
Meadan, Michna, Ostrosky & Triplett 2011:29-35). Research by Mostofsky (2012:1-3) indicates
49
that when forming internal models of behaviour, children with autism are more reliant on
intrinsic generalisation, which depends on intrinsic proprioceptive feedback. They rely less on
extrinsic generalisation, which depends on the visual system. The inclusion of proprioceptive
inputs should therefore be a key element in the planning and design of classroom strategies
and individual support plans.
2.3.1.8 Implications of sensory processing difficulties for education
Since sensory processing is a complex field, educators and parents may benefit from
collaborating with a sensory integration trained occupational therapist. Various profiling
measures, e.g. Sensory Profile, School Companion and Sensory Processing Measure, provide
insight in the interaction between neurological thresholds and behaviour. It has been
mentioned that learners with ASD struggle with sensory modulation difficulties which affect
their arousal, attention, emotional responses and general behaviour in class (Henderson,
Koenig, Moya, Pheiffer & Sheppard 2011:76). Hence, they may be distracted by a cluttered
desk or by the movements of another learner who is sitting too close. They struggle to
organise themselves and to adjust activities and environments (Hanbury 2005:68). Educators
therefore need to find strategies to best accommodate the sensory needs of individual
learners. Table 2.8 provides an overview on some classroom strategies (functional
assessments, research-based programmes, environmental adjustments, classroom strategies
and assistive technology) to enhance sensory behaviours in learners with ASD.
Table 2.8 Classroom strategies to enhance sensory behaviours in learners with
ASD (compiled by the researcher)
CLASSROOM STRATEGIES, ASSESSMENT AND SUPPORT:
SENSORY PROCESSING
Functional assessment
An occupational therapist trained in Sensory Integration may provide the educator with a profile on
the learner’s sensory processing, modulation and behaviours. However, sensory overload checklists
(Hanbury 2005:68) and indicators for sensory behaviours that often occur in learners with ASD are
available for educators (New Brunswick Department of Education 2005:35).
Research-based programmes and approaches
Sensory Integration and Sensory Processing: Dr. AJ Ayres pioneered the development of the
conceptual model and practice framework of sensory integration, which originated as a speciality
field of occupational therapy. The conceptual model and practice framework entails a comprehensive
50
sensory integration assessment and interpretation of clinical findings to design a child-directed
intervention plan, which aims to improve functional performance. Sensory integration treatment
involves challenging the child through sensory-based activities (just-right challenges). The
successful mastering of these challenges leads to the mastering of new skills that contribute to
adaptive response and active engagement in a wide range of occupations (Henderson et al.
2011:76). Various other researchers contributed to the field of sensory integration and Dr Lucy Miller
currently pioneers research in Sensory Processing Disorders and ASD (Miller 2013:online). Although
there are general strategies available to assist educators in managing sensory difficulties in learners
with ASD, literature recommends collaboration between educators and therapists to optimise
outcomes.
Tomatis® method: Tomatis® is a sound sensory stimulation technique that involves auditory
stimulation as well as vibration though the cranium. Sound perception contrasts through the filtering
of music (usually Mozart) to create the Tomatis® effect. The professional treatment sessions involve
active and passive listening sessions aimed at improving auditory processing, perception, listening
and communication (Tomatis® 2013:online). The researcher could not find a recent reliable study
regarding the efficacy of the technique for learners with ASD.
Environmental adjustments and support
Visual structure: Visual structure includes a reduction of non-purposeful visual stimuli (e.g.
classroom posters) and grey desk dividers to decrease distractibility (Smith-Myles 2005:23-24).
- Avoid auditory overload caused by environmental stimuli (New Brunswick Department of
Education 2005:33):
- Minimise loud, distressing sounds and background noise;
- Music and “white noise” to mask background noise;
- Earplugs if noise or reaction is intense;
- Opportunities and space for quiet time (time-out tents and sensory rooms); and
- Grey dividers to decrease the distractibility of learners during the performance of structured tasks
Trampolines are often used in classrooms to increase the activity levels of learners with low
registration (Kensignton 2011:online).
A Sensory Room resourced with sensory activities and equipment to calm or stimulate learners with
ASD. Although there are various guidelines publically available for educators to set up and manage
sensory rooms (The National Autistic Society Task Team 2013:online) the researcher is of opinion
that the processes should be guided by a therapist trained in sensory integration.
Classroom strategies and assistive technology
Sensory overload charts and individual support plans: The unique sensory processing and
51
behavioural patterns of each child should be considered in the compilation of individual support
plans to assist with behavioural analyses, environmental support and improvement of general class
room performance (Hanbury 2005:68).
Opportunities to explore with different sensory stimuli: This includes e.g. finding objects in
water. sand, rice, jelly, etc. Provide opportunities for learners to explore and learn cause and effect.
A wide variety of products is available for visual, tactile, proprioceptive, auditory, gustatory and
olfactory stimulation (Autism Speaks 2013(b):online). Although vestibular proprioceptive and tactile
brushing products are also available, the researcher is of the opinion that educators should not use
vestibular activities without proper training.
Weighted vests: Educators and therapists often use weighted vests to assist learners with ASD with
calming, decrease of repetitive body movements, decrease hyperactivity and increase attentiveness.
Carter and Stephenson (2009:114) reviewed seven studies regarding the clinical application of
weighted vests and the results indicate that there is currently little scientific evidence to support
clinical efficiency. Literature recommends further research and more reliable research
methodologies. As South African study (Bester, Buckle an Franzsen 2011:41) investigated the effect
of wearing weighted vests on the in-seat behaviour of learners with ADHD within the school context.
Evidence from the study indicated that the inseat behaviours and attention to task of the target group
improved with the use of weighted vests in the classroom. In the absence of a standardised protocol
the study suggested a vest that is calibrated to 10% of the child’s body weight. Wests should be
worn for 45 minutes at a time during the school day. It is uncertain whether weighted vests would
have the same effect on learners with ASD. The study concluded that a weighted vest may be useful
tool in the classroom sinc it does not impact on the normal classroom routine. However, the vests
shold be used in collaboration with a sensory integration trained therapist who could also advice on a
complementary sensory diet. A variety of weighted toys, blankets, cushions, deep pressure wraps
and clothing products are available (Autism Speaks 2013(b):online).
Sensory cushions: Therapists use various alternative seating devices (therapy balls, wedged balls,
therapy cushions) to promote in-seat behaviour and productivity during desktop tasks. A study by
Deitz and Umeda (2011:159) assessed the effect of therapy cushions on in-seat and task-on
behaviour in a case study of two learners with ASD. Although the cushions made no significant
impact on the mentioned behavioural outcomes, it suggested that therapy cushions possibly do not
provide intense sensory feedback (Deitz & Umeda 2011:159). Therapy balls that promote more
dynamic adjustments and movements appeared to be more efficient (Schilling & Schwartz
2004:432).
Strategies for modulation: Learners with autism present with sensory processing difficulties and
use different sensory modalities to help them modulate (Brown & Dunn 2010:483). Many of these
strategies may not be socially acceptable or have cost implications, e.g. chewing of clothing and
stationery, breaking objects when fidgeting, etc. A variety of sensory tools, toys and products are
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available for oral-motor stimulation, fidgeting toys, etc. (Autism Speaks 2013(b): online).
Art and crafts: Art and crafts provide learners with opportunities for visual and tactile stimulation
using different textured materials, finger paint, etc. Additional benefits include the development of
social skills, group awareness by sharing materials, creative expression and decision-making
(Ullmann 2013:online).
The following section will discuss other factors commonly associated with ASD and that impact
on learning and educational profiles.
2.3.1.9 Associated factors: unusual patterns of attention
Learners with ASD demonstrate unusual patterns of attention, which affect their social,
communication and academic skills. Learners often present with behaviour where they fixate
their attention to a part of an activity or selected stimuli in the environment and then avoid
relevant or vital other stimuli. Joint attention difficulties occur where learners struggle to share
attention between two people or tasks. They also have difficulty in shifting their attention from
one task to another, which contributes to their restrictive, rigid patterns of behaviour (New
Brunswick Department of Education 2005:18-19). Sleep disorders (prolonged sleep, sleep
fragmentation, daytime sleepiness) occur commonly in this group of learners and affect their
concentration skills during the day. Efficient diagnosis and treatment of sleep disorders are
vital to optimise daytime performance (Ming & Walters 2009:online).
In addition to the classical diagnostic criteria of ASD, learners experience the symptoms of
inattention, hyperactivity and impulsivity seen in Attention Deficit Hyperactivity Disorder
(ADHD). Symptoms of inattention include: poor attention to detail; difficulty sustaining
attention; poor response to direct verbal instructions; poor task completion; difficulty organising
tasks; distractions by external stimuli; and losing focus on objects (American Psychiatric
Association 2013(2):59). Hyperactive impulsive symptoms include: fidgeting; challenging in-
seat behaviour; inappropriate running and climbing; disturbance of others; and increased
psycho-motor activity (American Psychiatric Association 2013(2):59). Learners with severe
symptoms of both ASD and ADHD often present with lower cognitive functioning, social
processing difficulties, motor deficits, poor executive functions and delays in adaptability
(Landa & Rao 2013:online and Murray 2010:online). These behaviours affect the child’s
capacity to focus on activities, to cooperate in the classroom and to benefit from the
educational programme.
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2.3.1.10 Implications of unusual patterns of attention for education
Attention problems in the classroom usually present as poor task orientation, distractibility,
poor organisation, and difficulty with sustained attention. The researcher has discussed the
relationship between sensory processing difficulties (Deitz & Umeda 2011:152), rigid thought
processes and poor organisational skills as well as the teaching strategies to improve these
aspects. Sensory strategies; visual structure; a reduction of environmental distractions; routine;
clear expectations regarding task completion; breakdown of activities into smaller achievable
components, and frequent redirection to tasks are mentioned as strategies to enhance
concentration skills (New Brunswick Department of Education 2005:71). Chairs with postural
straps are used at times to enhance in-seat behaviours in learners with hyperactive
behaviours. However, therapy balls appear to be more efficient since it addresses the possible
need for vestibular-proprioceptive inputs (Schilling & Schwartz 2004:423). The use of these
assistive strategies appears to require more research.
2.3.1.11 Motor deficits
Dyspraxia and sensory discrimination deficits are key features of ASD and affect postural
control, limb coordination, integration of movement and the efficient use of objects (Schaaf
2009:4). A study (Apostu, Denckla, Dziuk, Gidley-Larson, Mahon & Mostofsky 2007:739)
investigated to which extent dyspraxia contributes to the motor deficits seen in learners with
ASD. This specific study indicated that dyspraxia does not account for all motor deficits and
that there are other neuro-motor factors that also play a role. However, learners with high
functioning ASD tested significantly lower on dyspraxia tests, compared to typically developing
learners within a similar IQ range. Difficulty with dyspraxia also contributed to deficits in
communication, social interaction and behaviour.
A retrospective review performed by Brimacombeb and colleagues (Brimacombeb, Ming &
Wagner 2007:565) focused on the prevalence of motor deficits in ASD with specific reference
to hypotonia, toe-walking, gross motor deficits, dyspraxia and ankle mobility. The results of the
mentioned study indicate that hypotonia occurred in 51% and apraxia in 34 % of the 154 cases
reviewed, with a reduction in symptoms of both these conditions with increased age. It is
however uncertain whether the decreased prevalence of motor difficulties in older children with
ASD is the result of natural improvement/development over time, the effects of early
therapeutic intervention or a combination of both. Toe-walking occurred in 19% of cases while
deficits in ankle mobility appeared to be rare (Brimacombeb et al. 2007:565).
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2.3.1.12 Implications of motor deficits for education
Classroom activities (e.g. cutting, writing, pasting, threading, counting, painting, etc.) involve
visuo-motor skills such as postural control, in-hand manipulation, bilateral integration and
sequencing skills, mature grips and in-hand manipulation skills. It has been mentioned that
most learners with ASD struggle with these components and frustration may also contribute to
difficult behaviours. Clumsiness, motor planning difficulties and poor motor control also affect
personal management skills such as dressing, grooming, toileting, etc. (New Brunswick
Department of Education 2005:71). Table 2.8 provides an overview on some classroom
strategies (functional assessments, research-based programmes, environmental adjustments,
classroom strategies and assistive technology) to enhance motor skills in learners with ASD.
Table 2.9 Classroom strategies to enhance motor skills in learners with ASD
(compiled by the researcher)
CLASSROOM STRATEGIES, ASSESSMENT AND SUPPORT:
MOTOR
Functional assessment
Occupational- and physiotherapy assessments may be useful in determining the sensory-motor
and neurological processes contributing to motor deficits in learners with autism. Sensory-motor
checklists are also available to guide educators regarding the fine and gross motor development of
learners with ASD (New Brunswick Department of Education 2005:95-96).
Research-based programmes and approaches
Therapeutic horseback-riding is often used to improve postural control and decrease sedentary
activities in children with autism. An experimental study by Bass and colleagues (Bass, Duchowny
& Llabre 2009:1261) reviewed the effect of therapeutic horseback-riding on social skills and the
results showed benefits for social interaction and physical endurance levels.
Physical exercise: A systematic review (Ashbaugh, Ence, Koegel, Lang, Regester, & Smith
2010:576) focused on the effects of physical exercise in learners with Autism Spectrum Disorders.
The results of the systematic review indicated that fatigue because of physical exercise reduced
stereotype type movement and self-stimulatory behaviours. Positive effects were also noted
regarding accuracy and proficiency in classroom activities. The study identified four important
considerations for the design of exercise programmes for learners with ASD:
i) Rigorous exercise (jogging, biking, etc.) seem to be more efficient than milder exercise;
ii) Learners appear to benefit more from several exercise sessions during the day than one
session;
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iii) Physical exercise presented as part of age-appropriate, structured games appeared to
encourage participation; and
iv) Visual prompts and praise are required to re-enforce participation.
Physical exercise should involve a number of activities, e.g. jogging, ball skills, arm and body
movements, etc. Further research is required regarding the link between physical exercise and
stereotype movements as well as the best practices to each physical exercise.
Water exercise swimming programmes appear to have benefits for social interaction, aquatic
skills and fitness of learners with ASD (Pan 2010:9)
Environmental adaptations and support
Structured, safe play areas that provide opportunities for running, climbing, etc. (The National
Autistic Society Task Team 2013:online).
Classroom strategies and assistive technology
Compensating for clumsiness and poor in-hand manipulation (New Brunswick Department of
Education 2005:71):
- Velcro work sheets and games;
- Velcro desk organisers to keep stationery on the table;
- Dycem mats to keep worksheets and books in situ;
- Thick whiteboard markers and wipe-off boards; or
- Typing on computers instead of writing
The following discussion will deal with the behavioural difficulties that develop as a result of the
condition:
2.3.2 Behaviour and socio-emotional responses as a result of the condition
The mentioned features of ASD (socio-communicative difficulties; rigidity; sensory-motor
difficulties; difficulty to organise thoughts and associated features) affect learning and
development. These difficulties also have a secondary impact, which is noticed through the
effect of the impairments on behaviour. Autism is a behaviour-defined condition and therefore
behavioural analyses are essential in developing educational support strategies (Adreon
2005:59-60). The current section discusses the behaviour and socio-emotional responses as a
result of the condition, while the implications for education will be discussed in the next section.
56
Children with autism often present with an overwhelming state of fear, which may be a direct
result of their difficulties in interpreting their physical and social context. Since their capacity to
learn is restricted by the condition itself, learners with autism struggle to understand their
environments and are often fearful of the unknown. Difficulties in sensory processing may also
affect the way in which they perceive and experience their environments, which in return may
lead to atypical responses to situations that appear to be harmless. Children with ASD appear
to make strong sensory associations with certain objects and experiences, which could elicit
additional fear responses in the future. Fear, anxiety and tension are therefore not only a
consequence of the condition but a further barrier to learning (Hanbury 2005:20). Literature
also make mention of learners who show no fear and recognition for potential dangers in their
environment. These learners may present with atypical sensory seeking behaviours, which
may lead to injury (Dunn & Tomcheck 2007:191). Children with autism avoid stressful
situations by means of flight responses, which may include running away, refusal to
participate, self-absorption or obsession. These behaviours may occur in isolation or in varying
combinations and usually provide the child with some control over the situation. The fears and
frustration that learners with ASD experience often result in aggressive behaviour. Fighting is
usually the last resort in children with ASD whose needs are not met, and this limits social
interaction even further (Hanbury 2005:20-21).
Educators need to understand the factors that contribute to behaviour, the cycle of tantrums
and strategies to enhance self-awareness, regulatory and calming activities. Adreon
(2005:61:69) describe a cycle of tantrum, rage and meltdown in learners with ASD that usually
present in three phases:
i) Rumbling;
ii) Rage; and
iii) Recovery.
During the rumbling phase, learners usually present with muscle tension, poor cooperation,
fidgeting, changes in voice volume, tapping, tears, etc. During this phase educators need to
remain calm by the use of a quiet voice, deep breaths, flexibility and limited verbalisation. The
aim is prevention of the rage phase by trying to understand the child’s response and analysis
of what triggers the symptoms. A time-out tent, space or house base is often used to
temporarily remove the child from the situation (Adreon 2005:67). The rage phase includes
emotional, explosive behaviour; screaming; tantrums; kicking; self-injury; aggression; hitting,
etc. The most important goal during this phase is the safety of the child and others, protection
of property and to help the child regain control in a dignified manner. During this stage, the
anxiety levels of educators also increase and it is vital for them to be calm and in control. Other
57
children need to be removed from the situation if necessary, or the learner needs to be moved
to a quiet area where he can recover (Adreon 2005:68). A number of recovery behaviours are
observed in these children, which include withdrawal into an own world, being emotionally
fragile, sleeping, or denial of the behaviour. During this stage the educator needs to remain
calm and should try to redirect the learner into a structured activity (Adreon 2005:67).
2.3.2.1 Implications of emotional and behavioural challenges for education
Since learners with autism lack insight in social rules and behavioural expectations, they
struggle to adhere to educator-imposed classroom rules and reprimands. They also respond
differently to praise and recognition due to their limited awareness of views and emotional
experiences of others. The challenges in social interaction do not only affect functioning in the
classroom, but also affect engagement in playground and sport activities. Classmates and
peers may also be disturbed and negatively affected by the behaviour of learners with ASD.
While some may be fearful; others may respond with teasing and bullying. Learners with ASD
are already struggling with social interaction and these conflicting attitudes towards them
create further obstacles in building relationships. A key factor in working with learners with
autism is therefore to promote and sustain positive attitudes by creating a better understanding
of the condition and the dynamics involved (Hanbury 2005:22-24).
Positive behaviour support (Fisher 2011:32-35), social skills intervention (Bellini et al.
2007:153-154) and alternative augmentative communication strategies (Lee & Low 2011:20)
should be central features in addressing behavioural difficulties. Educators also need to
translate their expectations and classroom rules in a way that learners with ASD can
understand. Table 2.10 provides an overview on some classroom strategies (functional
assessments, research-based programmes, environmental adjustments, classroom strategies
and assistive technology) to enhance emotional and behavioural support in learners with ASD.
Table 2.10 Classroom strategies to enhance emotional and behavioural support in
learners with ASD
CLASSROOM STRATEGIES, ASSESSMENT AND SUPPORT:
EMOTIONAL AND BEHAVIOUR
Functional assessment
The behavioural assessment is aimed at identifying the root of the problem. The process involves
the gathering of information, which includes a description of the function, occurrence,
consequences, intensity, and frequency of the behaviour (New Brunswick Department of Education
58
2005:64).
Research-based programmes and approaches
Applied Behaviour Analysis (ABA) is a systematic process where observable behaviour is
studied and modified through manipulation of the environment. The theory of ABA is described as
an ABC model, which characterises the different aspects of behaviour. The A (antecedent)
describes the stimulus or events that preceded the behaviour. The B (behaviour) describes the
child’s response to the behaviour. The C (consequence) indicates the outcome of the behaviour. A
critical success factor of ABA is to provide consistent, intense and constant feedback and
modification of a child’s behaviour. Initially, intensive one-on-one instruction is recommended (20-
30 hours per week) and parent involvement is critical to optimise the transition of learner
behaviours across different environments (e.g. school, home, etc.). The aim is to gradually replace
negative behavioural patterns with learned behaviours and to facilitate learned behaviours to
become more automatic (Hughes et al. 2011:60).
Environmental adaptations and support
Avoid sensory overload: Adjust the environment to prevent sensory overload.
Visual structure: Maximise structure in the environment through visual aid.
Relaxation area: Provide a space for the learners to retreat or calming down (e.g. a time-out tent
or space)
Safe classroom and playground environment: Since not all learners have insight in safety
precautions, risk management and environmental adjustments (e.g. security gates, safety glass,
etc.) are required to ensure the safety of learners (New Brunswick Department of Education
2005:58).
Classroom strategies and assistive technology
Positive programming interventions:
 Use tokens and positive feedback to reinforce appropriate behaviours; and
 Provide opportunities to relax and clam down in order to prevent sensory overload and negative
behaviours due to fatigue (New Brunswick Department of Education 2005:59).
Reinforce education expectations and class rules
General education expectations are divided into four groups:
i) Response to educator;
ii) Peer interaction;
iii) Self-regulation; and
iv) Classroom performance.
Educators employ different strategies to communicate with learners (sign language, pictures,
59
tutors, etc.) to get learners with ASD to respond to them. A variety of behavioural modifications
also assists in creating structure, routine and some understanding of expected behaviours.
Opportunities for structured peer interaction through which classroom rules are reinforced in a
concrete manner also play a role in understanding behavioural expectations. Self-regulation
strategies include task completion, participation in classroom activities and efficient self-regulation
strategies. Classroom performance refers to those behaviours that influence general classroom
conduct such as the use of classroom resources and working independently (Smith-Myles
2005:12-16).
The effect of the ASD symptoms and behaviours resulting from the conditions on the attitudes
of educators will be discussed next.
2.3.3 Attitudes towards behaviours
Educators have basic expectations of classrooms behaviours, irrespective of the setting in
which they are teaching. Self-control, cooperation, discipline and the capacity to follow
educator related instructions are described as critical behavioural expectations. Nevertheless,
intolerable classroom behaviours include: self-injurious behaviours, tantrums, refusal to obey
classroom rules, physical aggression, damage to property, ignorance of warnings, loudness
and disturbance of others (Smith-Myles 2005:2-5). The behaviour that occurs because of ASD,
as well as secondary behaviours that occur in response to interaction with the environment,
poses challenges to educators since it is not aligned with expected classroom behaviour. The
challenging behaviour of learners with ASD often leaves educators feeling unskilled. (Hanbury
2005:24). However, a positive attitude towards these learners and willingness to learn more
about the management of the condition are vital to the success of teaching this challenging
population. The role of the educators’ attitude as a critical success factor in autism-specific
education is discussed in 2.3.5.2 (Attitude and job satisfaction). A study by Robertson and
colleagues (Chamberlain, Kasari & Robertson 2003:online) focus on the attitudes of educators
towards including learners with ASD, and the results indicated better social adjustment and
less behavioural challenges when educators display positive attitudes towards them.
Many educators perceive learners with autism as unmanageable, rude and beyond their scope
of expertise. Historically, the special needs education system excluded learners with special
needs from mainstream schools both internationally and in the South African context. Schools
referred learners who were not typically developing (including those with ASD) to special
classes and special schools. Inclusive policy rejects the concept of special schools and
focuses on the child’s right to basic education and the school’s duty to accommodate the child.
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Currently, there is more pressure on educators to manage diverse functional profiles and
behaviours within an ordinary classroom setting (Olson 2011:6-8). Inclusive education as a
global trend will be discussed next.
2.3.4 Inclusion as a global trend
Globally, increased research, changes in socio-political norms and pressure from human rights
groups have forced education systems to align with principles of democracy. International
theories and best practices for the education of learners on the autism spectrum have changed
accordingly and there is a strong focus on inclusion and co-teaching programmes (Simpson
2005:150). However, there is still great variability in educational approaches for learners with
ASD, which ranges from one-on-one educational programmes to full and partial inclusion.
Although inclusive policy moves away from the concepts of special schools, the system
recognises that learners with severe and complex barriers to learning have intensive support
needs and require individual support programmes (SA 2008(3)8-9).
Inclusive principles move the responsibility of providing efficient support for each learner back
to the educator in the classroom. Educators need to implement curriculum modifications or
adaptations to accommodate the needs of the learner. These adaptations may include
adjustments to the content, differentiated teaching methods, modified assessment strategies,
etc. (Sisonke Consortium 2006(a):13, 134). Research by Olson (2011:1-2) indicates that there
is a strong correlation between the educator’s attitude towards inclusion and the efficiency of
including learners with disability. These findings were also supported by local research
(Roberts 2007:54-60) where teacher’s perspectives on the mainstreaming of students with
ASD was studied. The study also indicates several other factors that affect the implementation
of classroom adaptations that include the self-efficacy of the educator; external support
structures; the type and severity of the disabilities; and the ease of implementation of
strategies.
Inclusive education is intended to be cost-efficient, improve academic progress and to develop
the education system by changing school and teaching practices to accommodate the needs
of all learners. However, critics indicate that the implementation of inclusive practices is
challenging and that learners with disability usually do not receive the specialised support they
require (Alper et al. 2010:38,53 and Frederickson & Jones 2010:1094). Not all learners are
suitable candidates for inclusion due to their disruptive classroom behaviours. The successful
inclusion of learners with high-level support needs into existing special schools and
mainstream schools is challenging, since conventional special needs programmes and
61
teaching methods are not appropriate and accessible concerning their unique requirements
(Wagner 2011:27-28). Although mainstream schools may provide opportunities for increased
social interaction, there is often lack of individualised support programmes that could assist
learners to adjust and integrate efficiently in the school system. Current research regarding
inclusion of learners in mainstream schools focuses more on negative experiences such as
peer isolation, increased anxiety, bullying as well as limited academic support (Frederickson &
Jones 2010:1094 and Moreno, Rodriguez & Saldaña 2011:online). The inclusion of learners
with ASD into mainstream settings is significantly challenging in schools without specialised
resources. In the absence of support structures and ASD networks, educators in mainstream
settings show negative attitudes towards teaching learners with ASD in mainstream settings
(Adeniyi, Fokolade & Tella 2009:online). The challenges regarding the implementation of
inclusive policy in the South African context are discussed in 2.4.1 (introduction of inclusive
education in the South African education system).
Globally, the high cost of special needs education necessitates the need for strategies that
could facilitate the successful inclusion of learners with ASD and other disabling conditions
(Daily 2012:online).
2.3.5 Critical success factors of autism-specific education in inclusive settings
Dunlap and colleagues (Dunlap et. al. 2003:online) describe a number of critical success
factors of autism-specific education: Individualised support for learners and families;
systematic instruction; structured learning environments; specialised curriculums; and a
functional approach to behaviour. Boutot (2013:online) views the following aspects as critical
success factors: understanding learners with ASD; promotion of positive peer interaction;
utilisation of behavioural strategies that promote successful learning; the development of a
plan to assess challenging behaviour; the utilisation of strategies to accommodate individual
needs; and respect for the learner’s right to dignity and autonomy.
The following critical success factors of Autism-specific Education will be discussed:
2.3.5.1 Individualised, well-coordinated approach;
2.3.5.2 Attitude and job satisfaction;
2.3.5.3 Training, knowledge and skills;
2.3.5.4 Collective teams and leadership;
2.3.5.5 Parent involvement and positive parent-educator relationships;
2.3.5.6 Curriculum and extra-curricular activities;
2.3.5.7 Multiple, context-based assessment strategies; and
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2.3.5.8 Research-based interventions and programmes.
2.3.5.1 Individualised, well-coordinated approach
An individual support plan (also referred to as an individual education plan) is the centrepiece
of a special education programme and describes the support targets that are critical in meeting
the learners’ unique needs. These support needs may include learner-specific interventions
such as a behavioural programme; grading and adjustment of learning material; environmental
and classroom adaptations; the use of assistive technology; and specialised teaching
strategies (Hughes et al. 2011:58). Although educators are mainly responsible for the
coordination of individual support plans, the design of the plan should involve a collaborative
approach of all the stakeholders involved (parents, therapists, school management team,
carers, etc.) (Sisonke Consortium 2006(b):55).
2.3.5.2 Attitude and job satisfaction
The importance of a positive attitude of educators towards inclusion and learners with ASD has
been mentioned (cf. 2.3.3). It is, however, vital to consider the factors that influence the
attitudes and job satisfaction of educators teaching learners with ASD.
A comparative study performed in Iran (Ahmadi, Arsalani, Mohammadi & Zarafshan 2013:20)
focused on job burnout, job satisfaction and general mental health amongst three groups of
educators teaching learners with
i) ASD;
ii) Hearing loss; and
iii) Severe intellectual impairment.
The study focused on the interaction between the following variables: age; general mental
health; career background; level of education; job satisfaction; and occupational burnout.
Findings indicated that general mental health difficulties and occupational burnout were
significantly higher in the group of educators of ASD learners compared to the other two
groups. Poor working conditions and limited benefits were indicated as contributing factors to
poor job satisfaction and burnout. Females also have a higher tendency to develop general
health issues and job burnout compared to males. However, most educators of ASD classes in
Iran are female and this limited gender comparisons (Ahmadi et al. 2013:20-27). The majority
of educators (71%) in South Africa are female (Burger & Van den Berg 2010:17), but the
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researcher could not find any statistics regarding the gender ratio’s concerning educators
working with ASD.
The study also indicated that with increased career experience, general mental health
problems and job burnout decrease, and those educators are less likely to leave the field
(Ahmadi et al. 2013:20-27). However, decreased self-efficacy, emotional exhaustion and poor
job satisfaction increased the risk of mental health problems. Educators with positive attitudes
towards their jobs, supervisors and general work conditions showed less signs of burnout and
increased job satisfaction. Level of education, age, and career background were dismissed as
predicting factors for burnout, poor job satisfaction and mental health difficulties. However,
studies that indicate younger educators are at higher risk for occupational burnout are also
mentioned (Ahmadi et al. 2013:20-27).
A study by Moreno and colleagues (2011:online) focused on the factors that affect positive
attitudes towards the education of learners with special needs. The factors included: the need
for training; support; perceptions regarding resources; and experience. The study indicated
that the majority of educators showed positive attitudes towards the learners they teach,
relationships with their families, and their ability to have a positive impact on the development
of children with ASD. The availability of a support network at school was indicated as one of
the strongest predictors for having a positive attitude towards teaching learners with ASD.
Educators with experience in ASD and those who had access to adequate human recourses
(e.g. support staff) showed more positive attitudes towards teaching learners with ASD.
Although some educators indicated positive attitudes towards being in a mainstream setting,
insufficient specialised recourses in mainstream schools affected attitudes negatively.
Involvement in an ASD network or membership to an autism-specific support group or
association also increased positive attitudes.
A Norwegian study (Skaalvik & Skaalvik 2009:1068-1069) indicated the following factors that
contributed to burnout, decreased job satisfaction and self-efficacy: time pressure and high
administrative loads; insufficient teacher-parent relations; reduced teacher autonomy and a
supportive culture in schools; as well as trust, emotional and cognitive support from school
leadership. A Nigerian descriptive survey (Adeniyi et al. 2009:online) indicated that female
educators, those with professional qualifications, and those who are married, showed more
positive attitudes towards learners with special needs. This study also highlights the impact of
demographical factors, individual personality traits and the social circumstances of educators
on their attitudes.
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A study performed in the South African context (Burger & Van den Berg 2010:33) analysed the
earnings of educators to determine whether they were adequately compensated. Currently, the
average age of educators in the private and public sector is 41 years (Burger & Van den Berg
2010:17), that there is a tendency that the average age of educators is declining due to the
limited financial prospects and other incentives for more experienced educators. The study
revealed that educators are paid better than the average worker in other labour sectors,
possibly because of their higher level of education. Teachers at the start of their careers are
overpaid, while those at the top of their earning are underpaid. Experienced educators only
stay in the profession because of favourable working conditions, personal factors or other
incentives. The researcher was interested to determine whether educators of ASD classes
experienced accomplishment and what they perceived as challenges in the South African
education context.
Hanbury (2005:24) indicates that there is a strong relation between an understanding the
condition and attitudes towards learners with autism. The following discussion focuses on the
role of training, knowledge and skills in managing learners with ASD.
2.3.5.3 Training, knowledge and skills
Educators can only design individual support plans and adapt the classroom setting if they
understand the condition, how it affects each learner and the strategies available to better fit
the learner’s needs with the activity, contextual and environmental demands (Wagner
2011:29). Hanbury (2005:1-2) indicates that classroom practices (creating a responsive
classroom, a structured class routine, opportunities for social interaction, positive behaviour
support, etc.) are predominantly influenced by the knowledge, attitude, skills and experience of
educators concerning autism-specific support. School-based teams do not only need to be
trained in understanding the needs of specific diagnostic groups, but should also understand
the principles of inclusive education in order to transform from traditional approaches to an
inclusive education system (Olson 2011:11,12).
In spite of a dramatic increase in the prevalence of ASD and the availability of programmes,
there appear to be a decline in literature focusing on educator training and effectives. There
are a number of ways in which educator training could be implemented, including: distance
training such as video conferencing; intensive one-week training courses; in-service training;
and peer socialisation. Nevertheless, training is costly and time-consuming and it is often
difficult for schools to release staff for training and research due to the costs and unavailability
of replacement staff (Koegel et al. 2011:6-7). Teachers in special schools appear to have a
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lower demand for training, but it is argued that they are in well resourced, specialised units with
better access to ASD support networks and in-service training. Educators in mainstream
schools show a six times higher need for training, and lack of access to specialised training
affected attitudes negatively (Adeniyi et al. 2009:online and Moreno et al. 2011:online).
The South African education system appears to have unique challenges concerning the
training of educators. The significant number of under- and unqualified educators in South
Africa increases the number of marginalised learners and poor education outcomes in low
performing schools. A recent publication on eNews Channel Africa (Hawker 2013:online)
indicated that there were 7 076 unqualified educators on the payroll of the Department of
Education during September 2013. Kwazulu-Natal appeared to be mostly affected (Hawker
2013:online) and a newspaper publication in 2011 (South African Press Association
2011:online) indicated a total of 4 303 underqualified educators in the area. These educators
only had a matric certificate and no formal post-matric education. The South African Council of
Educators is collaborating with various stakeholders to upgrade unqualified educators to have
at least a three-year post-matric qualification (South African Council of Educators 2013:online).
The training of un- and under-qualified educators is a costly and challenging task since many
unqualified educators have been in the system for decades. Nevertheless, there have been
significant improvements of educators who have postgraduate qualifications compared to 1994
(Hawker 2013: online).
Greame Bloch in Hawker (2013:online), a South African educational analyst, indicates that the
basic educational qualifications of educators are only part of the problem, since educational
outcomes in schools are still poor despite improvements in post-basic qualifications. Poor
commitment to self-development and lack of responsibility concerning the progress of learners
are two major concerns. Bloch in Hawker (2013:online) reports that a university degree or
diploma is not enough to ensure high standards of practice and that educators need to take
responsibility to continuously develop professionally and personally. The minimum qualification
for educators working in Finland, where there is a literacy rate of 99%, is a master’s degree,
majoring in special education. In addition, educators also need to qualify in a professional
competence programme that allows them to teach the subjects taught in mainstream classes.
They also need to follow additional training programmes in special education to equip them in
the management of diverse support needs (The Trade Union of Education in Finland
2008:online)
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Obtaining information on basic qualifications, postgraduate studies, autism-specific educator
training and the strategies for self-development of educators in South Africa have been
targeted as an objective in the study.
2.3.5.4 Collective teams and leadership
The efficiency of classroom-based activities is strongly influenced by the commitment of school
management teams and educators to implement research-based practices (Koegel
2011:online). School management teams play a central role in designing operational systems,
training and support, monitoring of classroom practices and the provision of appropriate
resources to autism-specific educators. Collaboration between educators, consistency in
staffing, and providing positive role models to learners are mentioned as golden standards for
success in autism-specific education (New Brunswick Department of Education 2005:89,
Wagner 2011:28-29). School management teams also play a significant role in designing
strategies to involve parents and to create opportunities to develop positive parent-educator
partnerships (Geldenhuys & Wevers 2013:8-9).
The barriers regarding leadership and support in schools and at district, provincial and national
level are discussed in 2.4.3 (Barriers in the mesosystem that affect the implementation of
inclusive policy).
2.3.5.5 Parent involvement and positive parent-educator relationships
Parent involvement, integrated goal-setting and transfer of learning skills to the home
environment are critical in providing an integrated educational approach (Bellini & Pratt
2010:online, Wagner 2011:29). Regular communication and collaborative planning, goal-
setting and review sessions with parents are suggested. Efficient home and school
coordination has proven to facilitate the achievement of target behaviours and facilitates
positive behavioural changes (Koegel et al. 2011:online). Parent involvement includes
assistance with homework; attending school-based activities, communication with educators
and general support of school activities. Sapona and Winterman (2002:34) indicate that
frequent, direct communication with parents regarding the individual support plan of their child
should take place once a quarter, and six weekly feedback sessions are recommended.
Routine collaboration with parents increases trust in the school programme and educators
(Wagner 2011:29). Parents have personal experience in handling their child with ASD and
schools should consider their inputs as a primary resource in the design of individual support
plans. Parents should also be allowed in the selection of intervention strategies and to
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implement these at home and other community settings. A collaborative teacher-parent
approach assists learners to generalise skills across contexts (Bellini & Pratt 2010:online).
Current challenges concerning parent involvement and positive parent-educator relationships
are discussed in section 2.4.2 (Barriers in the microsystem that affect the implementation of
inclusive policy).
2.3.5.6 Curriculum and extra-curricular activities
Education systems have the responsibility to equip children for the challenges of adulthood
and to provide the tools needed to develop learners for participation in purposeful life activities
(Bazyk & Case-Smith 2010:713). Education is therefore not only concerned with achievement
in academic domains but should also be focused on developing an increased sense of
independence, personal responsibility and capacity to contribute to the community (New
Brunswick Department of Education 2005:48-49). The majority of learners with ASD are not
only in need of a specialised curriculum, but also require additional support strategies that
accommodate critical areas of development. Positive behaviour support (Fisher 2011:32-35);
social skills intervention (Bellini et al. 2007:153-154); alternative augmentative communication
strategies (Lee & Low 2011:20); as well as self-care, self-monitoring and vocational skills (New
Brunswick Department of Education 2005:48-49) should be central features in the autism-
specific education process. Each developmental stage poses different contextual and
functional challenges to learners with ASD and a curriculum that accommodates the
developmental needs from early ages (three years) to 18 years is recommended (National
Autism Centre Task Team 2009:online).
The National Curriculum Statement has recently been complemented with the Curriculum
Assessment Policy Statement, which has been phased into all the different educational phases
(foundation, intermediate and senior phase, as well as further education and training) (SA
2011(5):29-30). The South African National Association for Special Education (2011:online)
has adapted the CAPS foundation phase curriculum to accommodate learners with severe
cognitive impairments. Learners are therefore exposes to basic lieteracy, reading and writing
skills. Since learners with ASD do not always benefit from conventional special needs
programmes, many schools make use of custom-designed curriculums to improve the
behaviour and development of learners. An objective of the study was to determine which
curriculums are currently used for learners with ASD.
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2.3.5.7 Multiple, context-based assessment strategies
Clear objectives with valid, reliable outcome measures are essential to accurately monitor the
progress of learners with ASD (Simpson 2005:144). Simpson (2005:144) indicates that not all
educational approaches come with clearly defined learning objectives and reliable methods to
achieve these goals. This also affects outcomes measurement since it is unclear when, how,
by whom and how frequently these assessments need to be performed. Learners with ASD
often struggle with formal assessments and standardised tests due to the complexity of their
barriers to learning. In addition, criteria and observation lists are used in natural environments.
Nevertheless, these assessments are also influenced by a variety of variables and contextual
factors. Koegel and colleagues (2011:online) indicate that various contexts and sources should
be considered in the compilation of learning objectives. An assessment process with four steps
is required to increase the accuracy of assessments:
i) Review of learner records;
ii) Interview with carers, teachers, etc.;
iii) Observation in natural environments; and
iv) The use of standardised instruments and outcomes measures.
2.3.5.8 Research-based interventions and programmes
In recent years, there has been a dramatic increase in the quantity and range of focused
interventions, comprehensive treatment models and teaching programmes proposed for
learners with ASD. These programmes also include strategies that have limited scientific proof
regarding their efficiency (Simpson 2005:140-141). Internationally, the most popular research-
based educational practices for learners with ASD include: Applied Behaviour Analyses (ABA);
the Developmental, Individual Difference, Relationship-Based Model (DIR/Floortime); the
Picture Exchange Communication System (PECS); the Treatment and Education of Autistic
and Related Communication Handicapped Children (TEACCH); and Musical Interaction
(Hughes et al. 2011:59-63). The Makaton Language Programme is also widely used as a
structured multimodal approach to teach language and literacy skills by the use of speech,
signs and graphic symbols (Duffy & Sheehy 2009:91).
Interventions are developed from different professional frameworks which focus on improving
dimensions of the condition such as behaviour, communication, emotional control, etc.
Different approaches have been found effective in improving the functioning of individual
learners. However, no single approach is effective with all children and could be considered as
a answer/cure for autism (Koegel et al. 2011:online). According to Hanbury (2005:16-17) a
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combination of elements from different approaches, which considers the interaction of different
parts of the syndrome, appears to be the most effective intervention strategy. An analytical
overview (Koegel et al. 2011:online) focused on research-based practices for reducing
challenging behaviour, enhancing communication and improving social interaction, followed by
an investigation of challenges in implementing these practices. The results of the review
indicated that educators do not consider research-based evidence as an important factor for
selecting a teaching strategy, but rather factors such as focus on ease of implementation,
personal views and the availability of resources to support the strategy. Educators do not
implement strategies in its purest form, but rather make adjustments to ensure compatibility
with current practices and programmes. Although Koegel and colleagues (2013:online) are
supportive of an eclectic approach, it is argued that customised usage of research-based
programmes may affect the efficacy and validity of these evidence-based practices.
Simpson (2005:140-141) shares a similar view and raises concern regarding the common use
of strategies and methods that lack efficacy and scientific support. Educators, other
professionals and parents need to critically question the efficacy, anticipated outcomes,
possible risks and outcomes measures when selecting intervention strategies for learners
(Simpson 2005:143). A critical evaluation of interventions and treatments for learners with ASD
indicated that the following strategies are considered to be scientifically based practices:
Applied Behaviour Analyses; Discrete Trail Teaching; and Pivot Response Training (Simpson
2005:146). Promising practices include: Sensory Integration; Picture Exchange
Communication System (PECS); the Treatment and Education of Autistic and Related
Communication Handicapped Children (TEACCH); and Augmentative Alternative
Communication. Interventions with limited scientific support include: Gentel Teaching; the
Developmental, Individual Difference, Relationship-Based Model (DIR®/Floortime™); Fast
forWord®; power cards; and music and art therapy (Simpson 2005:146).
Nevertheless, there are conflicting reports regarding the efficiency of different programmes.
Simpson (2005:146) did not consider DIR®/Floortime™ to be an evidence-based practice, but
positive outcomes for learners with ASD are reported (Hughes et al. 2011:61). A play training
programme that incorporates Floortime™ found that 45,5% of the children involved in the
study made significant progress in their functional development through the programme, while
80% of parents involved in the project approved the programme (Greenspan & Wieder
2001(2):11-19). The Fast forWord® programme is now also considered to be promising in the
light of new neuro- anatomical evidence (cf. 2.2.4). The programme appears to have promise
concerning attention, receptive and expressive language skills, speech intelligibility and
pragmatic skills (Burns 2013:10-11).
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Personal experience suggests that many of the programmes are not accessible or applicable
to the South African context due to financial and contextual barriers. The Childrens Disability
Centre developed an eclectic approach called Fishbowl, which provides structured guidelines
to parents and educators regarding the management of learners with moderate to severe ASD.
Autism South Africa presents a new programme called Hands-On Autism (Autism South Africa
2014:online). Due to the cost-effectiveness of training and the strategies offered, the
programme appears to be popular. Training sessions are offered countrywide and assist many
schools to start autism-specific classes (Autism South Africa 2014:online). Tiny Handz is a
training programme that was compiled in 2008 by the mother of a deaf child who used her
hands and facial expressions as a tool of communication. Recognised South African Sign
Language is incorporated in the training programme. The Tiny Handz training offers Sign
Language courses for carers, families, teachers and therapists who work with young children
in the special needs spectrum (Will 2013:online).
The Special Needs Adapted Programme (SNAP) was developed in Cape Town because of the
increasing demand for an education system to assist learners who require specialised support
regarding learning and development. The programme is based on the critical success factors
of early intervention and is aimed to empower, support and involve parents in the education
and development of their child. The need for an individualised one-on-one approach also
became apparent due to the increased learner-educator ratios because of the increased
demand for autism-specific education. SNAP offers parent consultations; one-on-one tutoring;
foundation phase schooling; social interaction classes to enhance social skills; support groups;
training; and outreach programmes (Van Risjwijk 2012:online). Due to the cost of the
programme, it is currently used more in private educational settings.
2.4 SOUTH AFRICAN CONTEXT
Contextual dilemmas regarding autism-specific education need to be viewed at the backdrop
of the bigger education system in South Africa. The Department of Basic Education is facing
serious challenges as prioritised in the Strategic Plan for 2011-2014 (SA 2011(5):9-16). These
focus areas include: improved Grade 12 results; better results on the annual national
assessment (especially for grades 3, 6 and 9); improved results in the Trends in International
Mathematics and Science Study (TIMSS); reduction in the number of learners who drop out of
school; strengthening of poorly performing schools; and the implementation of the Curriculum
Assessment Policy Statement for all learning phases (SA 2011(5):20-23).
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Socio-economic (poverty, child-headed households, foster children, teenage pregnancies, etc.)
and healthcare dilemmas (HIV/Aids, substance abuse, etc.) contribute to challenges in
education and significantly increase the numbers of marginalised learners. The education
system in South Africa is under severe pressure and policy-makers align resources according
to these perceived priorities (SA 2011(5):49-51). Although the Department of Education
recognises the challenges of learners with Autism Spectrum Disorders, national priorities guide
the provision of resources.
Spaull (2012:online), a researcher from the Department of Economics at the University of
Stellenbosch, performed a study where the current South African schooling system was
compared to those of other African countries. The South African government spends 20% of
the total budget on education, of which 78% is paid towards educators’ salaries. Nevertheless,
the education system does not contribute to social mobility, since learners from poverty-
stricken areas do not have positive future prospects. The current system continues to produce
inequality, since functional schools are not accessible to the poor from a geographical and
financial viewpoint. Statistical analysis of the national assessment results indicates that the
average South African learner does not exist from a statistical perspective. The results indicate
that 75% of learners score significantly below average while 25% scores significantly higher
than the average. Spaull (2012:online) indicates that there isn’t a single education system in
South Africa, but rather two systems that differ considerably. Consequently, the South African
education system remains unequal and inefficient. Table 2.11 describes the differences
between the performing and underperforming schools.
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Table 2.11 Characteristics of dysfunctional and functional schools (Spaull
2012:online).
DYSFUNCTIONAL SCHOOLS (75%) FUNCTIONAL SCHOOLS (25%)
Poor accountability Good accountability
Incompetent school management Capable school management
Deficient culture of learning, discipline and order Culture of learning, discipline and order
Inadequate educator content knowledge Adequate educator content knowledge
High educator absenteeism Low educator absenteeism
Slow curriculum coverage, limited homework and Adequate curriculum coverage, weekly
continuous assessment homework and continuous assessment
High grade repetition and dropout Low grade repetition and dropout
(Gr. 10-12) (Gr. 10-12)
Extremely low performance on standardised Adequate performance on standardised
assessments assessments
The same scenario seems to apply for special schools. Special schools in deep rural areas
often have insufficient infrastructure, limited access to specialists and appropriately qualified
staff. Consequently, the quality of education in these schools is also a concern (SA 2007(2):5-
7). The abovementioned discussion highlights that a significant number of learners in public
schools are marginalised because of their social circumstances, educational barriers as well as
barriers in the education system as a whole. The challenges in implementing an inclusive
education system within the South African context are discussed next.
2.4.1 Introduction of inclusive education in the South African education system
The implementation of inclusive policy is a challenging process and strategic areas of change
have not been efficiently implemented yet (SA 2011(5):10-16). Implementing an inclusive
education system implies a radical transformation of the education system as a whole
(Sinsonke Consortium 2006(a):13). A qualitative, phenomenological study by Geldenhuys and
Wevers (2013:1) focused on ecological factors that hamper the implementation of inclusive
policy in schools in the Eastern Cape. These researchers adopted Bronfenbrenner’s Ecological
Framework to explain the challenges of implementing inclusive policy within the South African
context, and the current study proposes the same structure. The framework is divided into five
subsystems: the micro-, meso-, exo-, macro- and chronosystem. The chronosystem refers to
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changes that occur in one of the first mentioned systems (Geldenhuys and Wevers 2013:1).
Barriers in the microsystem (2.4.2), the meso- and exosystem (2.4.3) the macrosystem (2.4.4)
will be discussed next.
2.4.2 Barriers in the microsystem that affect the implementation of inclusive policy
The microsystem refers to the individual’s immediate context with regard to family relationships
and close friends (Geldenhuys & Wevers 2013:3). Active, frequent and direct parent
involvement has previously been indicated as critical success factors for learner progress and
academic success (cf. 2.3.5.5). Nevertheless, research in the South African context
(Geldenhuys & Wevers 2013:8-9 and Ladbrook 2009:119) refers to unsupportive home
environments, insufficient parenting skills, and poor parental involvement in school activities.
Parents show little support for parent meetings, fundraising events, response to school
communication and other events. Contributing factors to this tendency include family
breakdowns, single parents and working mothers. Decreased levels of accountability and a
delegation of responsibilities to aftercare services are also mentioned as areas of concern
(Ladbrook 2009:120-124). In disadvantaged communities, unemployment; poor literacy and
education levels; poverty; lack of parenting skills; and perceptions that the child’s education is
the responsibility of schools contribute to poor parental involvement. Child-headed households,
increasing numbers of foster children, and children staying with family while parents work in
other cities affect parent support and involvement (Geldenhuys & Wevers 2013:8-9). Limited
respect, empathy and insight in the needs of learners with special needs cause further barriers
to learning and development. Schools often expect a culture of uninvolved parents and do not
display constructive efforts to increase parental involvement (Geldenhuys & Wevers 2013:8-9).
The researcher could not locate a South African study that focuses on the involvement and
support of parents of learners with ASD.
A descriptive survey (Blumberg, Boyle Rice, Schieve & Visser 2007:115) focus on the
relationship between autism and the stress of parenting. The results of the study indicated that
stress levels of parents with newly diagnosed children with ASD and whose child struggled
with access to specialised services were significantly higher than those of parents whose
children did not require special services. Factors that contribute to stress levels include:
i) The severity of behavioural and cognitive symptoms;
ii) The child’s current level of functioning; and
iii) The parent’s perception of the severity of symptoms and burden of care.
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The study further revealed that parents of children with ASD may have unique support needs
and that support services need to be designed to address the specific needs of parents
(Blumberg et al. 2007:120). Given the South African context where parents struggle to access
specialised services and support, it may be assumed that parents experience high stress
levels.
Autism South Africa and other autism support groups provide regional support services to
parents (Autism South Africa 2014:online). Although these support groups offer opportunities
for emotional support, skills training and empowerment; many parents indicate that they are
unable to attend these sessions since they cannot access alternative care for their child. Action
in Autism is non-profit organisation and actively supports, raises funding, and fights for the
rights of individuals with ASD. Through parent involvement, lobbying and advocacy
campaigns, Action in Autism has convinced the KwaZulu-Natal Department of Education to
commence autism-specific classes at 13 schools. An autism indaba was held with the KZN
Department of Education in 2010, which stimulated the initiative to provide autism-specific
education at 72 special schools in KZN by 2014. Unfortunately, the implementation this project
is also falling behind due to limited resources within the Department of Education (Action in
Autism 2014:online).
The researcher is of opinion that parents in the Motheo District are often supportive of actions
that advocate better service delivery to learners with ASD, but that they are less actively
involved once their child has accessed these services.
2.4.3 Barriers in the mesosystem that affect the implementation of inclusive policy
The mesosystem refers to the interaction of more than one microsystem in which the
developing child actively engages, e.g. the school, home situations, circle of friends, the
neighbourhood, etc. For the purposes of this study, special, mainstream and full service
schools are discussed (Ladbrook 2009:38). The Strategic Plan: 2011-2014 (SA 2011(5):49-53)
acknowledges the significant variability in service delivery at schools and the urgent need to
support and develop underperforming schools in disadvantaged communities. Former Model C
schools are better resourced and situated in urban areas, where the socio-economic situation
is usually better compared to township schools. There also appear to be contextual differences
between these schools (Ladbrook 2007:124). The efficient implementation of inclusive policy is
dependent on efficient infrastructure; management and leadership; qualified and committed
educators; as well as parental and community involvement. The discussion on the
mesosystem involves specials schools / resource centres (2.4.3.1), mainstream and full
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service schools (2.4.3.2), and resources, therapeutic support and extra-curricular activities
(2.4.3.3).
2.4.3.1 Specials schools / resource centres
As discussed earlier, the conceptual shift from a medical model (special needs) to a social
model (inclusivity) has affected the roles of special schools. In addition to providing specialised
support for learners with high levels of support, special schools have a new role of serving as
resource centres. This new role includes the provision of expertise and support to
neighbourhood schools, especially full service schools (SA 2001(1):3,21-22). Special schools
are uncertain regarding their new role as resource centres (Ladbrook 2007:45, 52).
Hay and Kgothule (2013:34-35) highlight that there is lack of a collaborative vision for
education. South African special schools have their own vision statements and admissions
criteria by which they define services offered, as well as the requirements learners need to
meet in order to benefit from the school programme. Admissions criteria play a key role to
ensure that only learners with high level support needs from diverse communities are
accommodated in special schools (SA 2007(2):7-8). Schools and parents cannot refer learners
directly to special schools and recommendation for placement is done through district-based
support teams who ensure that admissions policies abandon discrimination and unequal
opportunities (SA 2007(2):8-9). District-based support teams usually accommodate learners
within their district first and therefore it is challenging for learners from another district, country
or province to access educational services.
2.4.3.2 Mainstream and full service schools
Full service schools are mainstream schools that are equipped and supported to
accommodate learners with mild to moderate barriers to learning within an inclusive setting.
The identification and phased conversion of a number of mainstream schools (starting with 30
schools in each district) are key strategies in the development of an inclusive education system
(Sisonke Consortium 2006(a):140-145). Educators in full service schools and mainstream
schools experience the following challenges regarding the implementation of inclusive policy in
South African public schools (Ladbrook 2009:6):
i) Inadequate knowledge, skills and training regarding inclusive policy;
ii) Inadequate infrastructure and human resources;
iii) Negative learning culture caused by poverty and emotional deprivation;
iv) Stress factors that impact on job satisfaction; and
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v) Negative attitudes towards inclusion.
Factors that cause stress to educators are large class sizes; cultural and language differences;
lack of parental and community involvement (cf. 2.4.2); increase in the demand to fulfil many
roles for learners (e.g. parent, councillor, nurse, etc.); unsafe learning environments; and high
administrative loads (Ladbrook 2009:59-69).
Educators have different levels of training (Hawker 2013:online), experience and personal
views that affect their attitude towards learners with disabilities. Lack of in-service training and
support often leads to low confidence levels, insecurity and negative attitudes towards learners
with complex needs (Eloff, Engelbrecht, Oswald & Swart 2003:307). Inadequate mentorship
and support, limited assistive devices, limited access to educational programmes and teaching
aids, poor infrastructure and insufficient facilities as contributing factors to negative attitudes
regarding inclusive education. Lack of specialised professional support (therapists,
psychologists, social workers, etc.) also increases stress levels since educators do not have
specialised skills to handle learners with high level support needs (Ladbrook 2009:103-118).
Ladbrook (2009:110) highlighted educators’ views that inclusion without appropriate support
puts marginalised learners at risk.
2.4.3.3 Resources, therapeutic support and extra-curricular activities
Schools vary in terms of the availability of resources, additional services provided, level of
curriculum differentiation and school management. Schools with community involvement
through their school governing bodies, parent involvement and fundraising teams usually offer
a wider range of additional services (e.g. therapeutic intervention, parent training and support,
hi-tech assistive devices, etc.) and extra-curricular activities (e.g. horseback-riding, drama, art,
etc.) to their learners (SA 2007(2):9-16). Not all schools provide hostel accommodation and,
considering the high burden of care of learners with ASD, hostel accommodation may pose
additional challenges, costs and efforts. Learners with ASD usually have rigid routines, food
preferences and nutritional needs which may also complicate hostel accommodation (Cutler et
al. 2004:1611) Hostels at some special schools in the Motheo District have waiting lists of five
years. The Department of Education has strict guidelines in place to ensure the safety and
efficient management of marginalised learners in hostels (SA 2007(2):17). The researcher
could not allocate scholarly articles regarding the challenges of providing hostel
accommodation for learners with ASD. Nevertheless, it is assumed that the financial burden
and logistical challenges are also higher for parents who need to accommodate their child in a
specialised ASD facility far from home.
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A collaborative, multi-professional approach is required to design and provide intervention
strategies focused at individualised support needs of learners with ASD (Brown & Dunn
2010:475). Access to therapeutic resources differs and is strongly influenced by operational
frameworks, the availability of resources and school management models. Within the South
African context, special schools are variably resourced with therapeutic equipment and staff
(SA 2007(2):13-17). None of the public full-service or mainstream schools in the Motheo
District is resourced with on-site therapeutic resources. However, some schools have
employed therapists through school governing bodies or have access to private therapeutic
resources. District-based support teams are intended to play a key role in assisting schools
with support strategies for learners, but district offices are significantly under-resourced
(Ladbrook 2009:90-92).
The roles of therapists has also changed from removing a child from the classroom in order to
provide one-on-one therapy, to moving into classrooms and equipping educators with
curriculum differentiation strategies. Occupational therapists, for example, need to provide
training regarding environmental adaptations, assistive technologies, the adjustments of
classroom activities, assessment strategies and teaching methods to accommodate the needs
of all learners (Anderson et al. 2012:5). The intervention approach of the occupational therapist
consequently shifts from remediation to promotion, modification and prevention (American
Occupational Therapy Association 2008:627). Occupational therapists have to adjust their
approach and clinical reasoning from focussing on individualised treatments to accommodate
a systems and community focus. School-based teams (including occupational therapist) are
often resistant to these changes and continue to focus on the traditional approaches where
learners are removed from the classroom for individual or group sessions. Occupational
therapists have the responsibility to communicate their new role to educators and to equip
themselves to align with inclusive policy (Anderson et al. 2012:5-6).
Although the researcher is supportive of the conceptual shifts, the implementation of
therapeutic strategies in classrooms must be implemented with care. The following aspects
require consideration:
i) Educators do not have specialist training in all areas of development and may
apply strategies to the disadvantage of learners;
ii) Educators may be burdened by the extra responsibilities;
iii) Resources should be in place to ensure the efficient support and monitoring of
educators regarding the application of classroom strategies; and
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iv) Educator support could not substitute all the benefits of one-to-one therapeutic
intervention.
2.4.4 Barriers in the exosystem that affect the implementation of inclusive policy
The exosystem refers to systems in which learners and educators do not necessarily
participate in but influence the operations of settings in which the child interacts (Geldenhuys
and Wevers 2013:5). The roles of district-based support teams (2.4.4.1); school-based support
teams (2.4.4.2) as well as school management teams and school governing bodies (2.4.4.3)
are discussed next.
2.4.4.1 District-based support teams
District-based support teams (DBST) promote inclusive education through training, distribution
of resources, providing support strategies to barriers of learning and operational efficiency.
These teams consist of remedial educators (learner support facilitators); educational
psychologists; social workers; speech therapists; and occupational therapists. The
professionals should have specialised skills and experience in inclusive education (SA
2001(1):47). A primary function of the DBST is also to work closely with SBSTs to plan, advise
and implement appropriate support programmes for individual learners as well as groups of
learners (Ladbrook 2009:52-53, SA 2001(1):47).
The challenges at district level include the following (Geldenhuys & Wevers 2013:12-13,
Ladbrook 2009:90-92):
i) The majority of therapists and educational psychologists in district-based support
teams are not representative of all the racial and language groups in South Africa, which
impacts on service delivery;
ii) District members are not actively advocating inclusive policy and tend to continue
with traditional assessment procedures;
iii) Under-qualified and inexperienced educators are often promoted to district level,
which hampers the delivery of expert support;
iv) Inadequate leadership at district level affects the implementation of efficient
management and operational procedures; and
v) Inadequate resources and services structures to deliver efficient support to
educators and marginalised learners.
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District-based support teams indicate a number of challenges that affect their service delivery,
and these include (Motheo Inclusive 2014:1-4):
i) Limited resources (transport, equipment, consumables, etc.);
ii) Limited structure, support and guidance from higher levels;
iii) Inadequate human resources, considering the large number of schools and
learners that need to be served;
iv) Limited insight from other sections regarding the role of inclusive education; and
v) Schools showing resistance to change.
Amongst other duties, the district-based occupational therapists are currently driving ASD-
specific issues within Motheo Inclusive, and a key duty is to facilitate quality, specialised
education to learners who require high levels of support. The researcher is of the opinion that
the emerging role of the occupational therapist at district level creates opportunities for active
marketing of the profession; developing community-based practice frameworks for
occupational therapists within South African education; and reinforcing the significance of
occupational therapists, not only as clinicians but also advocates, consultants and managers.
2.4.4.2 School-based support teams
In accordance to White Paper 6, school-based support teams need to be established to
develop well-coordinated learner and educator support services at school level. Schools need
to develop systems to identify and attend to school-, educator- and learner-specific needs.
District-based support teams support schools through intervention strategies for learners and
curriculum differentiation (SA 2001(1):29). However, schools need to present evidence of
support provided by the school and how they intend to implement strategies recommended by
district-based support teams. Although most schools have school-based support teams, the
functionality of these teams varies significantly, with the majority being dysfunctional
(Geldenhuys & Wevers 2013:12). The following aspects are considered challenges in
establishing efficient school based support teams (Geldenhuys & Wevers 2013:7, Ladbrook
2009:116-117):
i) Limited support from school management teams;
ii) Inadequate support from district-based support teams;
iii) Limited teamwork and expertise amongst educators;
iv) Insufficient involvement of parents and community members; and
v) Inadequate knowledge, skills and commitment of educators to implement inclusive
strategies.
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2.4.4.3 School management teams and school governing bodies
Empirical investigations (Geldenhuys & Wevers 2013:11 and Ladbrook 2009:88-89) indicate
that senior management teams in mainstream schools portrayed negative attitudes towards
the inclusion of learners with complex barriers to learning, and prefer a system where they
could be referred for special education. These negative attitudes and lack of leadership to
implement inclusive strategies in mainstream schools also impact negatively on the
functionality of school-based support teams and the attitudes of educators (Geldenhuys &
Wevers 2013:12). However, Ladbrook (2007:155) indicated that educators from schools with
managers that encouraged democratic decision-making, teamwork, integrated planning and
training showed more positive attitudes towards assisting learners with more complex barriers
to learning.
School management teams indicate the following challenges in implementing inclusive
strategies:
i) Inadequate support and insufficient service delivery by district-based support
teams;
ii) Limited human and other resources in all levels of the education system;
iii) Stressed educators who have limited capacity to absorb changes and additional
challenges;
iv) Inadequate training and infrastructure to efficiently support learners with
individualised needs; and
v) Language of teaching and learning that creates additional barriers (Geldenhuys &
Wevers 2013:11-12).
Educators indicated that school governing bodies are not active enough in policy development,
maintenance and creation of infra structure, assistance with provision of assistive devices and
insufficient networking with stakeholders in the community (Geldenhuys & Wevers 2013:12).
South Africa has the highest rate of absenteeism in the South African developing community
countries, with 10% of educators absent from work for an average 19 days per year. The high
rate of absenteeism amongst educators nationally reflects poor school management, inefficient
administration, serious neglect of duties as well as a lack of responsibility and professionalism
(South African Government News Agency 2013:online).
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2.4.5 Barriers in the macrosystem that affect the implementation of inclusive policy
Macrosystem refers to the roles and responsibilities of the National Department of Education
and Provincial Head Offices in the formulation of policies and implementation, which include
efficient implementation strategies and financial resources (Ladbrook 2009:37). The discussion
on barriers in the macrosystem refers to provincial (2.4.5.1) and national (2.4.5.2) level.
2.4.5.1 Provincial level
Decreased knowledge and skills regarding the true meaning of inclusive policy at national and
provincial level hamper the efficient role of White Paper 6 (Dalton, Kahonde & Mckenzie
2013:online). Officials in provincial offices appear to have different understandings of how
policy should be implemented, which results in conflicting information at lower levels.
Provincial teams are also far behind in the implementation of approved curriculums; special
needs programmes; the development of resource centres at full-service schools; as well as the
monitoring of learner progress in inclusive settings. Special schools have long waiting lists and
many learners who cannot access schools (Ladbrook 2009:46).
2.4.5.2 National level
National policies and strategic guidelines on inclusion highlight the right of learners with
disabilities to receive appropriate support and specialised education within the public sector.
The policy framework does, however, recognise implementation challenges and that
contextual factors impact strongly on the transformation process. (SA 2001(1):11-17).
Ladbrook (2009:46) considers the following four aspects as challenges on macro level that
impact on the efficient implementation of inclusive policy:
i) Slow implementation of White Paper 6;
ii) Insufficient development of a network of skilled support educators;
iii) Limited financial support and resources for efficient implementation of strategic
plans; and
iv) Significant delays in the development of full service schools and resource
centres/special schools.
The National Strategy on Screening, Identification and Support (SIAS) has been developed to
assist schools to determine the level and intensity of learner support needed. SIAS also
provide guidelines regarding the assessment process and the type of support that is required
82
at different levels. The SIAS process therefore also indicates whether a learner is a candidate
for special education, as well as the type of support that is needed within the specialised
setting (SA 2008(3):1-2). The SIAS process is used with little success, since the efficiency of
the support guidelines is dependent on the availability of resources and efficient training of
educators (Geldenhuys & Wevers 2013:12). Many educators are also uncertain about their
roles in the SIAS process because of insufficient training (Geldenhuys & Wevers 2013:12).
The need became apparent that the system requires adjustment to ensure that it would meet
the contextual realities of all provinces. Refinement of the SIAS document has been discussed
at the interprovincial inclusive meeting held in February 2013, and an implementation plan was
discussed which included strategies for the provision of resources and training at provincial,
district and school levels. The implementation plan is far behind schedule, since
implementation is dependent on adequate resources and service networks in communities
(Free State 2013:1-4).
Figure 2.2 provides a summary of the complex dynamics that hamper the efficient
implementation of inclusive principles in South African public schools (Geldenhuys & Wevers
2013:7).
83
MACROSYSTEM:
CONSTITUTION OF SOUTH AFRICAN WHITE PAPER 6 CURRICULUM AND
SOUTH AFRICA SCHOOLS ACT ASSESSMENT
POLICIES:
 Prohibits any form of  Prohibits any form of  Framework for inclusive  Curriculum guidelines
discrimination discrimination education and assessments do not
 Practically not  Promotes equality and  Implementation is make adequate
implemented to learners quality education for all challenging at school provision for learners
C with  barriers to learning  Implementation is a level with complex barriers to
in schools challenge at school  Uncertainty regarding learning.
H level. curriculum  Do not complement Inadequate knowledge differentiation. White Paper 6
 Educators uncertain
R about the process
O EXOSYSTEM
N SCHOOL SCHOOL-BASED SCHOOL GOVERNING DISTRICT BASEDMANAGEMENT TEAMS SUPPORT TEAMS BODIES SUPPORT TEAM
O  Limited insight and  Varying levels of  Limited policies  Mostly dysfunctional
commitment towards the functionality  Limited mobilisation of  Fragmented and under-
S needs of learners with  Limited implementation parents resourcedbarriers to learning of the Screening,  Limited adjustment to  Limited support to
 Decreased Identification, school buildings schools
Y communication and Assessment and  Limited provision of  Limited specialised
collaboration Identification Strategy assistive devices service delivery at
S  Limited training schools Limited support to  Limited guidance and
learners and other team training at schools
T members
E MESOSYSTEM
LACK OF COOPERATION BETWEEN MICROSYSTEMS
M
MICROSYSTEM
HOME PEERS SCHOOLS COMMUNITIES
 Unsupportive home  Discrimination  Inappropriate buildings  Poor collaboration
situations  Labelling  Lack of resources  and between parents,
 Negative lifestyle  Rejection support neighbours, schools, etc.
examples  Bullying  Outdated views and  Fear of criminal activities
 Absent parents  Stereotyping approaches towards  Socio-economic and
 Denial of parents barriers to learning socio-political challenges
 Unsympathetic to needs  Lack of differentiated  Municipal and other
of children teaching services not optimal
 Low literacy and  Inappropriately trained
education educators
 Insufficient parenting  Stressed, negative
skills educators
Figure 2.3 Ecological aspects that affect the implementation of inclusive policy in
South African schools (Geldenhuys & Wevers 2013:7)
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2.5 SUMMARY
The first phase of the literature review focused on the new diagnostic criteria for ASD; possible
causes for the condition; the global increase in ASD prevalence; prognostic factors; and
burden of care. Although these factors do not directly affect autism-specific education, it
provides and understanding of the complexity of the disorder and the need for intensive
healthcare, social and educational support. The second phase reviewed the diagnostic specific
impairments of the condition, the unique manifestation of symptoms in individuals and the
implications for education. Research-based educational strategies, critical success factors and
challenges in the implementation of autism-specific education within inclusive settings were
discussed. Globally, the increased prevalence of ASD has stimulated the development of
various educational approaches and programmes with varying levels of scientific support and
cost implications. The worldwide need for research-based practices and efficient outcomes
measurement in educational settings were highlighted.
The third phase dealt with the unique challenges within the South African context, which affect
the efficient implementation of global ASD educational trends and best practices. The
constitutional right to education is recognised, but the South African education system
currently fails to provide appropriate education and support to all learners with ASD. The
implementation of inclusive education is significantly hampered by lack of infrastructure, non-
functioning and limited availability of support structures at various levels, inadequate training,
and poor infrastructure. Attention was also given to the complex dynamics that hamper the
efficient implementation of inclusive principles in South African public schools. Urgent
intervention, commitment and collaboration are required at all levels in the education system to
enhance quality education and support for marginalised learners. The increasing demand for
autism-specific education necessitates the development of an evidence-based, cost-efficient
service model that is relevant to contextual challenges in South Africa.
Chapter 3 will discuss the research methodology regarding current practices and challenges in
providing autism-specific education within the South African context.
85
CHAPTER 3
RESEARCH APPROACH AND
METHODOLOGY
_____________________________________________________________________
3.1. INTRODUCTION
The previous chapter discussed the literature in three phases, namely issues related to Autism
Spectrum Disorders; autism-specific education in inclusive settings; and an overview on
inclusive education within the South African context. The literature overview highlighted that
learners with Autism Spectrum Disorders (ASD) have difficulty in accessing education in the
South African public sector. Increased autism prevalence rates, the variability in diagnostic
profiles, the complexity of autism-specific education and challenges within the South African
educational context added to this dilemma. In order to develop high quality, context-based
operational and training models, district-based occupational therapists require an
understanding of current service models, training needs, availability of resources and
challenges experienced by public schools that offer autism-specific education. Hence, the
research study aimed to determine autism-specific education practices and challenges in
South African public schools.
The current chapter focuses on the research approach and methodology. Solid fundamental
research principles and a strong methodological approach are crucial to any study’s value
(Bhattacherjee 2012:5). The discussion on methodology includes the research approach, study
design, population, sampling, pilot study, data collection, data analysis, error of measurement
and ethical considerations.
86
3.2. RESEARCH APPROACH AND STUDY DESIGN
The researcher made use of a quantitative research approach and a descriptive study design.
3.2.1. Quantitative approach
A quantitative research approach is best to obtain quantitative information through using a
formal, objective and systematic process (Cohen, Manion & Morrison 2007:14-15) to
determine current practices and challenges in autism-specific education. The researcher
required statistical evidence to determine the practices and challenges that commonly occur in
South African schools providing autism-specific education within the South African public
sector.
3.2.2. Descriptive design
Descriptive research describes characteristics about the research population or the
phenomenon that the researcher is studying (Leedy & Ormrod 2010(1):182). Leedy and
Ormrod (2013(2):189) describe survey research as a form of a descriptive, quantitative
research where the researcher gains information from individuals or groups of people by the
use of structured questions. The researcher used a descriptive approach since the study did
not involve any modifying of the situation, but aimed to describe practices and challenges in
autism-specific education in South African public schools.
Descriptive designs have certain limitations, but these did not have a significant effect on
reaching the aims and objectives of this particular study:
 Descriptive study designs do not determine the effect of one variable on another.
Although the data description of the educational context is factual, accurate and systematic,
the researcher would not able to describe what caused the situation (Knobel & Lankshear
2006:164). The results only display current practices and challenges in autism-specific
education in South Africa and do not describe any relationships between different variables in
the study or the cause of the situation.
 The descriptive survey approach captures events within a specific time frame and it
could not be accepted that the results of the study would still be representative of practices
and challenges in autism-specific education in public schools in years to come (Leedy &
Ormrod 2013(2):190).
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3.3. RESEARCH POPULATION
The term research population refers to all the individuals or objects who possess certain
attributes that are relevant to the purpose of the study. The population is therefore all the
individuals or objects with common, defined characteristics that set boundaries on the study
units (Walliman 2006:276). The research population in this study refers to educators of autism-
specific classes in South African public schools and the aim was to determine the practices
and challenges they experience. The researcher selected educators of autism-specific classes
as the research population, since not all schools have access to multi-professional teams
consisting of therapists, psychologists and other special needs experts. Educators are
primarily responsible for the design and implementation of individual support programmes,
curriculum differentiation and educational programmes to optimise the learning experience for
each learner.
3.4. SAMPLING
Sampling is the selection of a subdivision of individuals from within a research population to
estimate characteristics of the research population as a whole. In an ideal setting, samples are
population microcosms. Sample designs needed to be precision-made and accurately
grounded to obtain a sample that would be truly reflective of the entire population of concern. A
priority in the research process was for the sample to have the attributes that ensured the
accomplishment of the research purpose (Walliman 2006:277). The researcher therefore
developed criteria to ensure that the study would be reflective and representative of the
attributes of autism-specific educators intended by the purpose of the study. Section 3.4.1
(Inclusion criteria) and section 3.4.2 (Exclusion criteria) discuss the inclusion and exclusion
criteria (Bhattacherjee 2012:65-66).
The researcher had to survey the total population that fitted the selection criteria (Leedy &
Ormrod 2013(2):215). Section 3.4.3 (Determining sample size) describes the systematic
process that guides the reasoning process behind surveying the population as a whole.
3.4.1. Inclusion criteria
Inclusion criteria refer to a set of characteristics, conditions or standards that determine
whether a research study would allow an individual or subject to participate (Ballo, Cordaro &
88
Torsello 2013:online). The aim of the study was to determine the practices of and the
challenges experienced by educators of autism-specific classes. The researcher therefore
aimed to include the full spectrum of publicly employed educators of autism-specific classes to
describe practices and experiences within the South African context. The study
accommodated the diversity within the public autism-specific educator population. However,
defining inclusion criteria increases the chances of generating reliable, reproducible results
and decreases the probability of exploitation against vulnerable individuals. The main attribute
that educators had to posses concerning the relevance of the study was that they had to be
employed at a school that fitted the selection criteria (Ballo et al. 2013:online). Personal
attributes (e.g. age, race, qualification, years of experience, etc.) did not determine the
participation of educators but the school context established participation.
The researcher aimed to include educators from schools that fitted the following selection
criteria:
3.4.1.1. The Department of Education should recognise the school as a public school:
The study population targeted all autism-specific schools as well as special schools and full-
service schools that offered autism-specific education within the public sector.
3.4.1.2. The school needed to offer autism-specific education: Admissions criteria had to
make specific mention of ASD. The study included schools that offered autism-specific
education irrespective of the severity of the disabilities. Since autism is a spectrum disorder,
the researcher was interested in the different approaches offered for the full spectrum of ASD.
The school therefore had to offer the following:
(i) An all-encompassing approach, which was not only focused on a specialised
curriculum but had individual support programmes that focused on the learners’
development as a whole.
(ii) An autism-specific programme that accommodated the specific and special needs of
ASD learners.
3.4.1.3 The school had to have been practicing autism-specific education for a period of two
years or longer: A period of two years was selected, since autism-specific education was
introduced in the Free State only 2010 (approximately three years ago). The researcher
wanted to reflect on the practices and challenges of South African public schools that had
similar or more experience than schools in Motheo District.
89
3.4.1.4 The school had to fall within South African borders: The school had to fall within
a South African province: Free State, KwaZulu Natal, Northwest, Mpumalanga, Northern Cape,
Western Cape, Eastern Cape, Gauteng and Limpopo.
3.4.2. Exclusion criteria
Exclusion criteria are those characteristics that disqualify potential subjects or individuals from
participation in the study (Ballo et al. 2013: online). The researcher did not exclude educators
regarding their personal attributes (e.g. age, race, gender, culture, etc.) since the study wanted
to describe the practices and challenges of all educators of autism classes within the public
sector. Again, exclusion from participation would be determined by the educational setting the
educators were employed at. The exclusion criteria excluded educators of autism-specific
classes who were not employed within the South African public education sector.
The study excluded educators employed at any of the following educational settings:
3.4.2.1 Private schools and non-profit organisations: Private facilities utilise different
educational models, resource structures and financial systems. The training, challenges and
classroom practices of these educators may therefore vary from what was available in the
public sector.
3.4.2.2 Mainstream schools, full service and special schools: The study excluded schools that
excluded autism-specific programmes.
3.4.2.3 Adult centres that accommodated learners beyond the age of 18 years: The
Department of Education focuses on school-aged youth and the study excluded adult
centres.
3.4.3. Determining the size of the research sample
Determination of sample size is the process of selecting the number of participants to include
in a statistical sample. The sample size used in a study is determined based on the cost of
data collection, and the need to have sufficient statistical control. There are various formulas
for calculating the required sample size based upon whether the data collected is to be of a
categorical or quantitative nature (Bhattacherjee 2012:65-69). The steps used by the
researcher in indentifying the research population are summarised in Figure 3.1.
90
Figure 3.1: Steps in the process to determine sample size
The first step in the determination of the sample size was to identify the population of
educators that provide autism-specific education. The Education Management Information
System (EMIS) listed 378 ELSEN schools nationally that offered specialised support to
learners within the public sector. The system indicated the focus of special schools (e.g.
cerebral palsy, learning disability, severe mental disability, etc.) but did not specify diagnostic
profiles, learner numbers, staffing allocations and the provision of autism-specific support. The
system flagged five special schools as autism-specific special schools (Department of Basic
Education Directorate Education Management Information System 2011:online). Although the
EMIS information was helpful in the identification of public autism-specific schools, it did not
supply adequate information regarding special schools and mainstream public schools that
offer autism-specific education.
The second step in determining the sample size was to consult the Provincial Directorates on
Inclusive Education to assist in the identification of schools that offer autism-specific education
and to identify schools that fitted the inclusion criteria. Although this process was helpful in
three provinces, the researcher required accurate profiles on schools in order to implement the
selection inclusion efficiently. The researcher struggled to identify accurate resources
regarding full-service schools that offered autism-specific education. The Southern African
National Association for Special Education (SANASE) recommended the involvement of
Autism South Africa since they manage a database on educational facilities (public and
91
private) that offered autism-specific education. Autism South Africa also offered training to
parents, educators and support groups in the different regions and collaborated with education
service providers on a regular basis.
The third step in determining the sample size was to consult with Autism South Africa to obtain
lists of all the schools that either offered autism-specific education or participated in training.
Again, the identification of full-service schools remained a challenge. The lists from Autism
South Africa provided adequate information to filter public schools that offer autism education
but did not provide any operational information.
The fourth step in the process was then to follow up on the contact details of these filtered
schools (web pages, telephonically, etc.) to determine admissions criteria and the services
offered at schools.
Lastly, the researcher designed a Microsoft Access database to facilitate the identification of
schools that fitted the inclusion criteria. The design of the database included fields for the
demographics of schools as well as tick-boxes for the inclusion criteria. The data query
assisted in the final filtering of schools that were suitable for the purpose of the study (Motheo
Inclusive 2013:2).
Leedy and Ormrod (2013(2):215) suggest that the larger the sample size, the better. Hence,
for smaller populations (N=150 or fewer), it is suggested that the entire population be
surveyed. In keeping with this directive, the entire population had to be surveyed and sampling
was inappropriate in this particular study. The researcher had to survey the total population of
educators employed at schools that fitted the inclusion criteria. There were no schools in
Mpumalanga that fitted the inclusion criteria and Autism South Africa confirmed that they refer
learners in this area to the autism-specific schools in Gauteng. A detailed list of schools and
number of educators are available in Addendum A: List of Schools.
92
Table 3.1: Summary of number of schools and educators for the different ASD schools
Providers of autism-specific education
in the public sector Number of schools Number of educators
Public: autism-specific schools 5 42
Public: special schools with autism-specific
classes 26 81
Public: full-service schools 3 7
Total: 34 130
Table 3.1 reflects that the number of full-service schools that participated in the study was
significantly less compared to autism-specific and special schools that participated. The
following factors could have contributed to this tendency:
i) EMIS did not have accurate data available regarding the number of full-service
schools and the type of services offered.
ii) Full-service schools focused on learners with moderate barriers to learning and
who have the capacity to cope with a mainstream curriculum. It may therefore be
possible that learners with higher functioning ASD may be in these schools, but were not
specifically diagnosed as such.
iii) Full-service schools may not yet be adequately resourced to accommodate
learners from diverse diagnostic categories.
3.5. THE COURSE OF STUDY
Figure 3.2 provides a schematic representation of the course of the study which include the
activities prior to the study, the itself as well as analysis and production of the dissertation.
93
PRIOR TO STUDY
 Approval from the Department of Education Provincial Directorates: Research and
strategic planning
 Permission from school principals and school governing bodies to allow
educators to participate
 Final ethical approval
STEP 1
 Pilot study
 Corrections post the pilot study
 Prepare questionnaires and gifts
STEP 2
 Confirmation letter from regional representatives
 Forward the data collection procedure and questionnaires to regional
representatives
 Appointments with schools for data collection
 Weekly contact with regional representatives to follow up on progress
STEP 3
 Receive data back from regional representatives
 Process claims from regional representatives
 Prepare for data analysis
STEP 4
 Review and interpret results
 Write up the dissertation
 Review by study leaders and correction of draft documents
 Language editing
 Final technical editing
Figure 3.2. Schematic representation of the course of the study
94
3.6. THE PILOT STUDY
The researcher performed a pilot study after the approval of the Ethics Committee of the
University of the Free State: Faculty of Health Sciences, and other relevant committees. Leedy
and Ormrod (2013(2):112) refer to a pilot study as a short tentative research process to
investigate certain procedures, measurement tools or the process of analyses. Hence, the
researcher used a pilot study to determine the viability of the study, to ensure that all
processes run efficiently and to achieve objectives. The pilot studied focused on two aspects:
Firstly, the researcher had used a self-designed questionnaire as the tool for data collection
regarding this study. The questionnaire was pre-tested on a small sample to determine
whether all questions were accessible and comprehensible (Walliman 2006:282). The second
aspect entailed the assessment of whether the suggested data collection process was
workable, given the resources available and the operational processes at schools (Walliman
2006:282).
The researcher selected three schools to participate in the pilot study (an autism-specific
school, a special school and a full-service school with autism-specific classes). Schools were
selected to best represent diversity in terms of culture, educational backgrounds, geographical
location and type of school. The study targeted one educator from each school for the pilot
study.
The pilot study indicated the following:
Questionnaire: The three educators had no difficulty in completing the questionnaire. They
indicated that the questionnaire was user-friendly and accessible. Since the educators did not
propose any changes to the questionnaire, the data obtained during the pilot study were
analysed and interpreted as part of the main study.
Data collection process: The data collection process required minor amendments that did not
affect the aims or design of the study. These minor adjustments included:
One school indicated that it would be difficult for them to have all the educators together for a
session to collect data all at once. It was therefore suggested that educators would have the
opportunity to complete the questionnaires during the day and that the completed
questionnaires should then be collected by the end of the day. However, the researcher asked
educators not to discuss the questionnaire with one another to prevent the contamination of
95
data. The researcher did not want to exclude these schools from the study since the study
population was small.
The proposed adjustments (as well as other minor amendments) were communicated to the
Ethics Committee (Ecufs 09/2013) according to the required format for the submission of
protocol amendments (Addendum B: Submission of Minor Protocol Amendments).
3.7. MEASUREMENT
Measurement refers to a process where data of any phenomenon are limited to interpret and
compare to a particular standard. Research methodology provides a reflection on the planning,
structuring and execution of research to comply with demands of truth, objectivity and validity
(Leedy & Ormrod 2010(1):21,91-93). The researcher aimed to design methods of data
collection that optimised response rates as well as the usability, reliability and validity of data
obtained from the questionnaires.
The selection of a measurement tool and data collection methodology is dependent on the
type of research design, the availability of resources, the population being studied, the type of
data to be collected as well as logistical factors (Knobel & Lankshear 2006:160-1611). Given
that the study ran nationally, the researcher had to consider limited resources (finances, time
and human recourses) in the selection of a measurement tool and data collection process. The
researcher consider personal interviews and class observations as a way of measurement, but
these measurements would have posed significant challenges in terms of cost and time
efficiency. In keeping with these constraints, survey research (through a self-designed
questionnaire) remained the optimal choice pertaining to this particular study.
3.7.1. The measurement tool
Quantitative research usually involves the use of measurement tool drawn from pools of
recognised data collection tools and methods, e.g. standardised tests, interviews and
observation schedules, survey questionnaires and inventories. However, measurement tools
may also include purposefully developed instruments that researchers create themselves in
accordance to the needs and circumstances of their study (Knobel & Lankshear 2006:161).
In the absence of an appropriate standardised measurement tool, the researcher designed a
questionnaire to determine current practices and challenges regarding autism-specific
96
education in South African public schools. The numbered questionnaire is available as
Addendum C: Research Questionnaire. The questionnaire is available in English and
Afrikaans; the official languages of teaching in the National Department of Education
(2010:online). The researcher designed the questionnaire in English and then had it translated
to Afrikaans. Back-translation is a strategy used to improve the validity and reliability of
research questionnaires that are available in different languages (Hasanic 2004:online); as
such, the study used back-translation where an independent translator, who translated the
Afrikaans questionnaire back into English, verified the quality of the translation. The expert and
evaluation committees also scrutinised the questionnaires to ensure that the English and
Afrikaans questionnaire had the exact same meaning. Both the expert – and evulation
committee consisted of relevant experts in ASD, education, biostatistics and occupational
therapy.
The questions did not focus on in-depth evaluation of a certain topic, but rather on clustering
related concepts. The study did not focus on specific practices and challenges in South African
Schools that offer autism-specific education, but rather to determine a wide range of context-
based practices and challenges. The researcher excluded details on school management and
facilities in the questionnaire since another section within the Department of Education (Whole
School Assessment) assesses these aspects. The questionnaire fit with the area of service
delivery addressed by district-based occupational therapists that included training, assessment
of learners, classroom adjustments, provision of individual support strategies, activity
adjustment and provision of assistive technology.
Cohen et al. (2007:320) describes three important components in the design of a research
questionnaire:
Decisions regarding question content: The researcher attempted to cover each of the five
research objectives efficiently with the range of questions asked and provided a rationale for
the relevance of each question (Addendum D: Rationale of Research Questionnaire). Since
the educators were responsible for autism-specific education, the researcher included basic
programmes, terminology and operational procedures that are described in special needs
policies and autism-specific guidelines (Cohen et al. 2007:322). Both the English and Afrikaans
questionnaires were piloted (see 3.1. pilot Study).
Decisions regarding question wording: The researcher, as well as the evaluation and expert
committees, scrutinised the questionnaire for biased wording and misleading or unstated
assumptions. The researcher used terminology from policy guidelines of the Department of
97
Education with special reference to the Inclusive Education and Training System (Cohen et al.
2007:322-324).
Decisions regarding form of response to the question: The researcher aimed to reduce the
writing by limiting word-based question types (open-ended questions). The bulk of the
questionnaire was designed by the use of dichotomous, multiple-choice questions and rating
scales. Fortunately, the data levels (nominal and ordinal) fitted well within the quantitative
approach and descriptive design of the study (Cohen et al. 2007:325-329). The researcher
avoided or limited the use of constant sum questions and rank ordering since educators may
have difficulty to differentiate and prioritise their responses. These types of questions may
affect the flow of the questionnaire, the speed of completion and may lead to frustration
(Cohen et al. 2007:325-329). Table 3.2 provides a summary regarding the types of questions
used in the different categories.
98
Table 3.2: Categories of the structured questionnaire
Category: Type Data Level Nr ofquestions
Demographical: Characteristics of educators Dichotomous Nominal 1
teaching ASD classes e.g. gender, age, etc. Multiple Choice Nominal 2
Open-ended Word-based 3
Rating scale Ordinal 1
7
Autism-specific training: Training in research- Dichotomous Nominal 16
based programmes, continued professional Multiple Choice Nominal 2
education and sources of training. Open-ended Word-based 3
Rating scale Ordinal 1
7
Admission criteria and extra-curricular Dichotomous Nominal 3
support: Assessment tools, admissions criteria, Multiple Choice Nominal 3
extracurricular activities and hostel Open-ended Word-based 3
accommodation. 9
Therapeutic services and parent collaboration: Dichotomous Nominal 6
Availability and type of therapy services, parent Multiple Choice Nominal 3
collaboration and support Open-ended Word-based 3
12
Curriculum, additional support and classroom Dichotomous Nominal 3
compilation: Grouping of learners, types of Multiple Choice Nominal 3
curriculums and access to diagnostic support. 6
Work schedules and monitoring of progress: Dichotomous Nominal 4
Accommodation of individualised needs and Open-ended Word-based 2
atypical learning style of learners in terms of the 6
lesson plans, Individual Support Plans and
monitoring of progress.
Class- and playground environment: Multiple Choice Nominal 2
Structuring of the environment to accommodate Open-ended Word-based 1
the atypical learning style, enhance attention and 3
opportunities for social interaction.
Research-based programmes and diagnostic Open-ended Word-based 1
specific support: The use of research-based Rating scale Nominal 2
programmes by educators employed at autism- 3
specific classes in South African public schools.
Assistive technology and alternative methods: Dichotomous Nominal 1
The utilisation of assistive devices and assistive Open-ended Word-based 1
technology to enhance functional outcomes Rating scale Nominal 2
4
Challenges in and critical success factors of Dichotomous Nominal 1
ASD education: Views regarding the challenges Open-ended Word-based 2
and critical success factors of autism-specific Rating scale Nominal 1
education. 4
Table 3.3 provides a summary regarding the types of questions used to cover the five research
objectives.
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Table 3.3: Questions structured in terms of the research objectives
Objective: Type Data Level Nr ofquestions
Objective 1: To determine the level of training Dichotomous Nominal 4
and experience of educators of autism-specific Multiple Choice Nominal 5
classes in public schools nationally. Open-ended Word-based 5
Rating scale Ordinal 1
Ratio data Ratio 1
16
Objective 2: To determine school-based Dichotomous Nominal 9
operations concerning admissions criteria and Multiple Choice Nominal 7
procedures of learners with ASD, extra-curricular Open-ended Word-based 6
services, therapeutic support and parent 24
collaboration
Objective 3: To determine classroom Dichotomous Nominal 8
management practices in terms of the curriculum, Multiple Choice Nominal 6
work schedules, monitoring of learner progress as Open-ended Word-based 3
well as activity and environmental adjustments. Ratio data Ratio 3
20
Objective 4: To determine the use of autism- Dichotomous Nominal 1
specific support strategies with reference to Open-ended Word-based 3
research-based programmes, diagnostic specific Rating scale Ordinal 3
support strategies as well as assistive technology 7
and alternative methods.
Objective 5: To determine the use of autism- Open-ended Word-based 3
specific support strategies with reference to Rating scale Ordinal 1
research-based programmes, diagnostic specific 4
support strategies as well as assistive technology
and alternative methods.
Other: Demographical and other relevant Dichotomous Nominal 1
information Multiple Choice Nominal 1
Ratio data Ratio 2
4
Decisions regarding the place of the question in the sequence: The researcher attempted to
group items together in sections that would be user-friendly and structured from the educators’
point of view. The rationale to the questionnaire (Addendum D) describes the analysis of
different sections to embody the study objectives (Cohen et al. 2007:325-329).
3.7.2. The measurement process
Leedy and Ormrod (2013(2):88) indicate that the methodology used in a research study needs
to consider the type of data required to be collected in the resolution of the problem. The
researcher strived for objectivity and therefore needed to design a systematic process of
100
measuring the phenomena studied. A key objective in the design of the measurement process
was to use methodology that optimised participation of a population that was scattered
nationally, to maximize return rate on questionnaires and to ensure the collection of
interpretable data.
The researcher investigated the possibility of using technology in the form a web-based survey
since the project ran nationally. However, many educators did not have access to computers
or were not skilled in computer technology, which might have hampered participation. Kruger,
Mitchell and Welman (2005:152-153) as well as Leedy and Ormrod (2010(1):189) indicate that
a postal survey has advantages in terms of expenditure and ease of application since
respondents could be reached in different regions at relatively low cost. The anonymity of
postal surveys is higher than other survey methods and consequently there is a chance that
participants answer questionnaires with greater honesty. The fact that respondents in different
areas of the country could have been reached at relatively low cost was an important
consideration in this study.
Unfortunately, postal surveys have two major disadvantages. Firstly, Kruger, Mitchell and
Welman (2005:153-154) point out that researchers have little control over the conditions in
which questionnaires are completed and this may lead to variable quality of completion.
Secondly, postal surveys tend to have low response rates. Since low response rates and
poorly completed questionnaires were potential obstacles in this particular study, the
researcher identified regional representatives (occupational therapists) who assisted in the
data collection process. The occupational therapists, selected as regional representatives,
chose to participate voluntarily. Should they have been unable to honour the commitment, it
had been agreed that the regional representative could have been replaced with another
therapist.
The researcher decided on a methodology that would best accommodate the nature of the
data to be collected, the resources available and to deliver a methodology that could be
replicable in a follow-up study. Figure 3.3 depicts a flow chart of the measurement process,
while Table 3.4 displays the roles and responsibilities of all involved in the study. The data
collection process started after review and approval of the research protocol by the expert,
evaluation and ethics committees. A pilot study preceded the data collection process to ensure
that all aspects of the data collection process were efficient.
101
Prepare for analises
analises
Figure 3.3 The measurement process
102
Table 3.4: Description of roles in the data collection process
Description of roles Responsibleperson
1. The researcher e-mailed the data collection document (Addendum Researcher
E) and PowerPoint presentation (Addendum F) to the regional
representatives, who described their role in the data collection
process. The researcher compiled the PowerPoint presentation
(with voice recording) to ensure that all the regional
representatives received standard information regarding the
research procedure. The PowerPoint presentation encouraged
regional representatives to participate, thanked them for sacrifices
and explained their key role in the research process.
2. The researcher followed up on any questions and queries posed Researcher
by the regional representatives via e-mail or telephonic follow-up.
3. The researcher requested the regional representatives to e- Researcher
mail/fax their confirmation forms to her in order to verify Regional
participation (Addendum G: Regional Representative Confirmation representatives
Letter).
4. The researcher identified possible dates for data collection with Researcher
the regional representatives. Regional
representatives
5. The information letters were forwarded (e-mailed / mailed / faxed / Researcher
personally delivered) to all participating schools to encourage Principals of
educators to participate and to provide opportunity for questions participating
prior to participation in the project. Educators were provided with schools
adequate time to make an informed decision regarding
participation.
6. The researcher made telephonic contact with principals to Researcher
schedule an appointment during which the regional Principals of
representatives could collect data from the participating participating
educators. The researcher requested principals to allocate a 60 schools
minute timeslot and quiet venue for the data collection process.
However, in schools where this could not be arranged, the
researcher informed the regional representative to hand out and
brief the participants regarding the questionnaire. The researcher
and regional representative were telephonically available for
questions. The regional representatives collected the completed
questionnaires, sealed in envelopes, by the end of the day.
7. The researcher couriered the questionnaires and self addressed Researcher
envelopes to the regional representatives (approximately two
weeks before the date scheduled for data collection).
8. The researcher confirmed appointments with the regional Researcher
representatives.
9. Representatives collected the data in accordance with the data Regional
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collection procedure document and description on the PowerPoint representatives
presentation – for more details, refer to Addenda E and F. Participating
educators
10. Participants completed the questionnaires and the researcher Participating
considered the completion of the questionnaire as voluntary educators
participation. After completion of the questionnaire, each
participant sealed the completed questionnaire in the envelope
provided with the questionnaire.
11. The regional representatives collated the questionnaires (in the Regional
sealed envelopes) and couriered the package back to researcher representatives
in the self-addressed courier bag provided. The regional
representatives were not allowed to remove the questionnaires
from the individually sealed envelopes to optimise confidentiality.
12. The researcher phoned the regional representative to ask whether Researcher
they had experienced difficulty during the data collection process. Regional
This allowed the researcher to gain insight into the possible representative
variables that could have affected the data collection process.
13. The regional representatives completed a travelling claim form Researcher
and sent it to the researcher for processing. Regional
representative
14. Data prepared for analysis. Researcher in
collaboration with
the biostatistician
15. Schools and regional participants were thanked in writing for their Researcher
participation.
3.8. ANALYSIS OF THE DATA
Statistical analysis was conducted to summarise and interpret the data that was collected. The
choice of a particular statistical procedure depended on combinations of various factors, which
included the study design, the type of variables and characteristics of the study (Knobel &
Lankshear 2006:164).
The Department of Biostatistics, University of the Free State, conducted the analysis.
Descriptive statistics, namely frequencies and percentages for categorical data and medians or
percentiles for continuous data, were calculated. Medians and percentiles were calculated as
the data had a skew distribution.
104
3.9. METHODOLOGICAL AND MEASUREMENT ERRORS
Survey results are subject to error, which could be divided into sampling and non-sampling
errors.
3.9.1. Sampling errors
Leedy and Ormrod (2013(2):217) describe a bias as a condition or sets of conditions that
influence or distort data and affect the integrity of facts. Sampling biases occur due to
inefficient randomisation in the sampling process to select participants from a population to
partake in a research study. A sample selection itself could be bias, since not all individuals in
a population had an equal chance of being selected for the study. The researcher realises that
there could have been room for error in identifying all the schools that offer education
nationally due to the limitations in the Education Management Information System.
The inability of provincial databases to reflect the number and profiles of public schools that
offer autism-specific education may have been a further influencing factor. Nevertheless, the
researcher implemented means to gather detailed and accurate information on facilitities that
offer autism-specific education in the public sector. The researcher visited Autism South Africa
to obtain their comprehensive database on schools that offer autism-specific education. The
researcher also made contact with an expert member of SANASE to assist in the identification
of facilities that fit the study’s inclusion criteria. The researcher made telephonic contact with
schools and followed up on their websites to determine admissions criteria and operational
profiles. Since autism-specific education is a niche component within special needs education,
the population of educators that fitted the inclusion criteria of the study was approximately 130
educators and therefore sampling was inappropriate.
3.9.2 Non-response errors
Non-response errors refer to failure to obtain complete data from all the participants selected
for the study. Lankshear and Knobel (2006:167) indicate that low response rates are a concern
in survey studies, since the generalisation of findings is questioned. The respondents who
participated in the study may have had different views from those who did not return their
questionnaires. A low response rate increases the possibility of a biased, under-representative
sample.
The possibility of a low response rate was a concern in this study due to the following reasons:
105
 The researcher is an occupational therapist and educators may be resistant to
support a research project performed by a non-educator.
 School principals and school governing bodies might have refused participation if
the project did not benefit the school directly, or when the purpose of their participation was
unclear to them.
 Educators had high administrative loads and the completion of the research
questionnaires might have been perceived as a burden.
 The researcher was not in close contact or had professional relationships with all
the schools in the country. Kruger, Mitchell and Welman (2007:154) indicated that researchers
obtain more pleasing response rates from special target populations when they have some
loyalty towards the organisation or person undertaking the survey. Although all the participants
are employed at the Department of Education, different provincial and district-based structures
manage them.
The researcher implemented the following strategies to maximise response rates:
 E-mail / telephonic contact with principals: The researcher needed the consent of
schools prior to involving educators in the study. The researcher tried to encourage schools to
participate by recognising them as specialists in the niche field of autism-specific education
whose expert opinion were vital to the success of the study.
 Use of regional representatives: Research representatives assisted in having face-
to-face contact with schools, which might have assisted in motivating educators in
participating. The researcher did not have links with all the schools and educators involved in
the study, but hoped that the regional representatives would encourage educators to
participate. The researcher would have better control over the tracking of the mailed
questionnaires as well as the distribution of questionnaires.
 Implement principles from literature that may facilitate response rates: Leedy and
Ormrod (2013(2):196-200) indicate that the design of the questionnaire should be user-
friendly, quick to administer and professional to encourage potential participants to take part.
Other guidelines include being gently persistent in motivating for participation, considering
timing and recognising the sacrifice of participating by offering a small token of appreciation.
106
The researcher provided each participant with a pen, sweet and ASD ribbon to thank them for
the time an effort in supporting research in autism-specific education. The results of the study
would also be offered to schools, should they be interested.
 Involving Autism South Africa: Autism South Africa supported research due to the
increased demand for autism-specific education.
3.9.3. Measurement errors
Validity and reliability reflect the degree to which errors may have occurred in the
measurement process. Validity refers to the meaningfulness of the results and determines the
extent to which a measurement instrument measures what it is intended to measure. Reliability
refers to the consistency of a measurement tool to produce similar results in consistent
conditions (Knobel & Lankshear 2006:161). Reliability errors are usually errors in the use of
the instrument and include unpredictability in the use of the instrument. Validity errors reflect
biases in the instruments itself and therefore cause constant errors (Leedy & Ormrod
2013(2):92-93). The researcher tried to increase the validity and reliability of the measurement
by the following:
3.9.3.1. Validity
Validity is how well a measurement tool measures what it claims to measure (Leedy & Ormrod:
2013(2)89). Already developed measurement tools have the advantage of having the key
properties of reliability and validity described in a manual (Knobel & Lankshear 2006:161-162).
The researcher was unable to find an already developed tool that fitted the purpose of this
specific research study, and therefore needed to custom design a measurement tool. Leedy
and Ormrod (2013(2):89-90) indicate that the validity of measurement instruments may have a
variety of forms, depending on the situation. Criterion validity refers to the degree to which the
results of an instrument compare with a similar measurement (Leedy & Ormrod 2013(2):89).
Unfortunately the researcher could not access another comparable questionnaire that was
designed for the same purpose and that could have been used to establish criterion validity.
The construction of a quality self-developed measurement tool that results in reliable and valid
measures is a carefully systematic development process (Leedy & Ormrod 2013(2):189). The
researcher aimed to follow the steps in developing a reliable, valid custom-made measure as
described by Knobel and Lankshear (2006:163) as well as Leedy and Ormrod (2013(2)197-
200). These steps included the identification of the purpose and target population, relevant
107
aspects to be measured, indentifying the importance of these selected measures as well as to
evaluate and revise individual items. The researcher also compiled a rationale to motivate the
need for each item in terms of the purposes of the study (Addendum D). In accordance with
face validity, the questionnaire appeared to measure the features described in the different
categories and in relation to the study objectives.
Content validity refers to the level to which a measuring tool demonstrates a significant sample
of the area being measured (Leedy & Ormrod 2013(2):89). An expert- and evaluation
committee reviewed the questionnaire concerning the appropriateness of the items in terms of
the literature available and alignment with the research objectives. The researcher made
amendments to the questionnaire and submitted the final version to the ethics committee. The
questionnaire was pre-tested in a pilot study to anticipate problems of comprehension,
accessibility and appropriateness of the questionnaire (Walliman 2006:282). The pilot study did
not reveal any changes that had to be made to the questionnaire.
3.9.3.2. Reliability
Since the study was performed nationally, the researcher implemented the following strategies
to facilitate the correct and consistent use of the measurement tool during the data collection
process:
The use of regional representatives
Regional representatives provided the researcher with better control over the data collection
process. The researcher limited biases by the use a standard approach in data collection
across regions and schools. The use of regional representatives had the following benefits:
 The researcher had better control over the tracking of the mailed questionnaires as
well as the distribution of questionnaires.
 The researcher used a network of occupational therapists as regional
representatives, since they share the same profession as the researcher. Participants were
able to ask questions, which aided improved completion of questionnaires.
 A standard data collection process was followed in each area, which decreased
possible errors in measurement.
108
Although regional representatives participated voluntarily (and they could be replaced with
another regional representative) the researcher needed to build in measures to maintain their
commitment to participate in the study. The regional representatives played a key role in the
success of the research project, and the following measures motivated their participation:
a. PowerPoint presentation (with voice recording): The researcher forwarded the
mentioned presentation to each representative and provided the background, purpose and
value of the study. The key role of the regional representatives to the success of the study was
recognised and they were commended for their valuable contribution. The researcher
developed a guideline and PowerPoint presentation explaining the data collection process to
ensure that regional representatives employed a similar approach in the distribution of the
questionnaires.
b. Regular feedback and involvement: The researcher wanted regional representatives to
feel part of the project and had weekly contact with the representatives, starting a month prior
to the data collection process, to keep them interested and involved. The researcher selected
therapists who she knew are passionate about autism-specific education and would have liked
to contribute in this regard.
c. Gift voucher: The regional representatives received a gift voucher of R100 and
payment for all travelling costs.
3.10. ETHICAL ASPECTS
Researchers have a moral commitment and right to search for the truth, but not to the expense
of other individuals in society or the environment. Researchers are therefore obligated to
professional ethics towards society, the subjects of science, and the environment. Research
involves the acquisition of information based on mutual trust relationships, where the rights
and best interest of those involved need to be protected (Morisson & Scott 2007:87-89).
In keeping with the obligation to professional ethics prescribed by the Health Professions
Council of South Africa (Health Professions Council of South Africa 2008:online) and the
University of the Free State: Faculty Health Sciences (2012:online) the researcher will now
discuss the following relevant ethical obligations:
 Approval
109
 Responsibilities towards participants
 Commitment to professional ethics
3.10.1. Approval
3.10.1.1 The researcher submitted the protocol to the Ethics Committee of the Faculty of
Health Sciences, University of the Free State, for consideration and approval (ethics number:
ECUFS 09/2013). The approval letter is available as Addendum H: Ethics Approval UFS.
3.10.1.2 The Free State, Directorate: Strategic Planning, Policy and Research approved
the study. Although the Ethics Committee did not expect the researcher to gain approval from
all the provinces, the researcher nevertheless applied for approval at all the different offices.
The following provinces provided approval for research: Free State, Western Cape, Eastern
Cape, Gauteng and KwaZulu Natal. The researcher agreed in writing to all the conditions
stipulated in the approval letters. The approval letters from the different provincial directorates
are available as Addendum I.
3.10.1.3 The researcher requested permission from school management teams and
school governing bodies of the participating schools to conduct research at their facilities. The
school received an information document (Addendum J: Information Document) to orientate
them towards the study, as well as a form to allow educators to participate (Addendum K:
School Permission to Participate).
Table 3.5 indicates that the study targeted 34 schools for the study, of which 28 schools’
(82.3%) management teams signed consent forms. The researcher has evidence regarding
the various e-mails and telephone calls to the six non-responsive schools (17.6%) to
encourage participation in the project.
Table 3.5 Permission of schools to participate in research
Type of school Consent No consent
No of No of No of No of
schools educators schools educators
Autism-specific schools 4 40 1 2
Special schools 21 73 5 8
Full service schools 3 7 0 0
28 120 6 10
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3.10.2. Responsibility towards participants
Participants
Social and medical research establishments created key principles to protect the rights of
research participants (Mouton 2009:241-243).
These basic rights of research participants include the following:
 The right to privacy and voluntariness
 The right to full disclosure (informed consent)
 The right to anonymity and confidentiality
 The right not to be harmed
The educators had adequate time to consider participation (longer than a week) and received
a comprehensive information document to explain the nature of the study and their expected
role. The information document stated that approval for research was obtained from all
relevant authorities. Guidelines provided by the Health Professions Council of South Africa:
General Ethical Guidelines for Health Researchers (2008:5) stipulates that research
participants should receive sufficient information about the nature and effect of the research.
Potential participants should be encouraged to ask all the questions they need to enable them
to make an informed choice about their participation.
The information document (Addendum I: Information Document) considered the right of
participants to full disclosure of the research study including their rights as research
participants. These include the following:
 The right to privacy and voluntariness: Research participants had the right to
abstain from participating in the study, or to withdraw from participating in the study without
suffering prejudice. Educators voluntarily agreed to participate in the research study by
completion of the questionnaire (Cohen et al. 2007:57).
 The right to confidentiality: Educators completed questionnaires confidentially and
the questionnaire had no potentially indentifying information. Participants sealed their
questionnaires individually in envelopes to increase the confidentiality of responses. The
researcher disclosed the results discreetly and would only publish the results after consultation
111
with the Department of Education. The names of schools would not be mentioned in any
publications. The researcher guaranteed that the collection, storing, use or presentation of
sensitive information considered the respect, the privacy and confidentiality of participants and
schools. The Department of Education would assist in recommending journals for possible
publication (Cohen et al. 2007:63).
 The right not to be harmed in any manner: The researcher reassured potential
participants that they were protected against physical, psychological and emotional harm.
There was no risk or disadvantage involved in participating. (Cohen et al. 2007:55).
 Benefits of participation: There were no incentives or rewards for participation. The
researcher offered to provide participants with the results of the research study. Each
participant received an Autism South Africa ribbon, a sweet and a pen for their time as a
courtesy gesture after responding to the questionnaire. (Cohen et al. 2007:55).
Regional representatives
The regional representatives received an information letter and Power Point presentation with
voice recording to describe the aim of the study, their role in the data collection process, and to
indicate the advantages and possible risks in assisting with the study. They completed a
confirmation letter (Addendum G: Regional Representative Confirmation Letter) to verify that
they have been thoroughly informed and that they were willing to participate voluntarily.
3.10.3. Commitment to professional ethics
The researcher committed to maintain objectivity and integrity in the conduction of the
research process (Mouton 2009:238-241) by adhering to:
i) Technical standards and conditions set by the Department of Education;
ii) Indicating limitations and methodological constraints that could have influenced the
validity of findings and conclusions of the research study;
iii) Comprehensive reporting of findings without misinterpreting of results or fabrication
of data; and
iv) Application of ethical publishing practices by rejecting any form of plagiarism and
recognising all sources consulted.
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3.11. SUMMARY
Chapter 3 provided a detailed discussion on the research methodology used for the study to
determine the practices and challenges concerning autism-specific education in South African
public schools. The researcher used a quantitative research approach and descriptive design.
The study population consisted of educators that provide autism-specific education in South
African public schools. The researcher designed inclusion and exclusion criteria to describe
the population and to define the phenomena measured.
Since autism-specific education is a niche area within special needs education, the population
of educators that matched the inclusion criteria of the study was small. Sampling was therefore
not appropriate and the researcher involved all ASD educators from schools that fitted the
inclusion criteria. Measurement was done through a self-designed questionnaire developed
from literature, operational policies and the researcher’s experience. The measurement
process was designed to increase response rates, to avoid measurement errors, and to
consider recourses and contextual barriers. Ethical considerations regarding approval,
informed consent, responsibility towards the rights of prospective participants and the
researcher’s commitment to an ethical research process were discussed.
Chapter 4 presents the demographical profiles of educators, as well as the results of the study.
113
CHAPTER 4
RESULTS
_____________________________________________________________________
4.1 INTRODUCTION
The previous chapter provided a discussion on the research methodology. Chapter 4 presents
the research results of the study. Given the descriptive nature of the study, the researcher
mainly used tables and discussions to reflect the results obtained from the questionnaire. The
tables display the results in terms of descriptive statistics, namely frequencies and
percentages for categorical data and medians or percentiles for continuous data. It is important
to note that the number of responses on multiple-choice and open-ended questions could
exceed the number of educators who responded, since educators had the opportunity to
indicate more than one choice or opinion regarding a particular question. The researcher used
an asterisk (*) to indicate data that had been analysed from word-based or open-ended
questions. Some of the results were analysed in terms of the type of schools, namely autism-
specific schools, special schools and full-service schools. The purpose of the analysis was not
to compare but to describe the practices and challenges within the South African education
context. The results in some of the tables were highlighted in shades of blue to assist readers
in understanding the results. Again, the intention was not to compare variable with one
another, but rather to highlight trends concerning practices and challenges.
The research objectives as described in the rationale of the research questionnaire
(Addendum D: Rationale of the research questionnaire) guided the discussion of the results.
The research results are presented in the following sequence:
4.2 Participation of schools;
4.3 Description of the study population;
4.4 The level of training and experience of educators;
4.5 School-based operations;
4.6 Classroom management practices;
4.7 The use of autism-specific support strategies;
4.8 The aspects educators regarded as challenges and critical success factors in
managing learners with ASD in public schools; and
4.9 A summary.
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The following section provides a brief overview on the participation of schools in the research
project:
4.2 PARTICIPATION OF SCHOOLS
A total of 34 schools were identified for the study, of which 28 school management teams
(82.3%) signed consent forms. Since six schools did not provide consent, the potential
participants declined from 130 educators to 120 educators. Hence, the researcher distributed
120 questionnaires. Two autism-specific schools (representing 19 educators) and three special
schools (representing five educators) gave consent for the educators to participate, but no data
were retrieved from these schools. The mentioned schools indicated that they had been
extremely busy and continually rescheduled data collection appointments. Only 24 of the 28
schools that provided consent participated, and 90 of the 120 educators responded. Hence,
the study had a response rate of 75%. The results discussed in the tables will always refer to
the responses of these 90 educators (n=90) who participated, unless otherwise indicated.
Table 4.1 Overview of schools targeted and participated
Type of school
Autism-specific school 5 42 4 40 3 19
Special school 26 81 21 73 18 64
Full-service school 3 7 3 7 3 7
Total 34 130 28 120 24 90
Table 4.1 provides an overview of the schools indentified for the study, those that provided
consent, as well as those that participated. Generally, the participation from autism-specific
schools was lower than expected, and only 19 educators from three schools participated. A
total of 64 educators from 18 special schools participated. The three full-service schools
(seven educators) identified for the study gave consent and all seven educators participated.
115
Educators
participated
Schools
participated
Educators:
schools
identified
Schools’
consent
Identified
educators
Identified
schools
Response
Rates in
different %
provinces
Mpumalanga 0
Western Cape 36
Gauteng 48
Limpopo 75
North West 83
KZN 89
Eastern Cape 93
Northern Cape 100
Free State 100
Figure 4.1: Educators identified versus the response rates in different provinces
Figure 4.1 indicates the response rates of educators from schools in the different provinces.
The Free State and the Northern Cape had a 100% response rate, while the Western Cape
had the lowest rate at 36%. No school from Mpumalanga fit the selection criteria and therefore
no educators from this province participated (cf. 3.4.3) The low response rate from the autism-
specific schools, who had the most educators, in the Western Cape and Gauteng appeared to
have contributed to the lower response rates in these two provinces.
The following section provides a detailed description of the population.
116
4.3 DESCRIPTION OF THE STUDY POPULATION
In order to describe practices and experiences proficiently in the South African context, the
researcher aimed to include the full spectrum of publically employed educators working with
learners with ASD. The researcher did not include the personal attributes of educators (e.g.
age, race, qualification, years of experience, etc.) in the design of inclusion criteria.
Nevertheless, it is of value to describe the unique characteristics of ASD educators within
South African public schools. This section would deal with the following:
4.3.1 Age of educators;
4.3.2 Gender of educators; and
4.3.3 Provinces and type of schools in which educators are working.
Section 4.4 deals with the training, experience and qualifications of educators.
4.3.1 Age of educators
A total of 89 educators (98.9%) responded to a ratio-data question to determine their age.
Table 4.2 Age analysis of educators (n=89)
Variable Min Lower Median Upperquartile quartile Max
Age analysis of educators 25 38 46 53 63
Table 4.2 indicates the minimum age of educators as 25 years and the maximum age as 63
years. The median age was 46 years with a lower quartile of 38 years and an upper quartile of
53 years. The results suggest that the majority of educators were in middle adulthood.
117
Table 4.3 Age analysis of educators according to quartiles (n=89)
Variable n %
Lower quartile (25-37 years) 22 24.7
Middle quartile (38-53 years) 45 50.6
Upper quartile (54-63 years) 22 24.7
Total n=89 100%
Table 4.3 shows the distribution of educators’ ages within the three quartiles. The responses in
the three quartiles were as follows: 24.7% (n=22) of educators in the lower quartile; 50.6%
(n=45) of educators in the middle quartile; and 24.7% of educators in the upper quartile.
4.3.2 Gender of educators
A total of 89 educators (98.9%) responded to a dichotomous (yes/no) question concerning
gender.
Table 4.4 Gender of educators (n=89)
Variable n %
Female 85 95.5
Male 4 4.5
Table 4.4 indicates that 85 educators (95.5%) responded to be female.
4.3.3 Provinces and type of schools in which educators were working
Table 4.5 provides a summary of the different provinces in which the 90 educators who
participated in the study worked, as well as the type of school in which they worked.
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Table 4.5 Provinces and type of schools in which educators were working
Total number of Educators from Educators from Educator fromVariable educators autism-specific special schools full-serviceschools schools
n n n n
% % % %
Free State 19 0 15 4(21.1) (0) (78.9) (21.1)
KwaZulu-Natal 16 0 16 0(17.8) (0) (100) (0)
Eastern Cape 13 10 3 0(14.5) (76.9) (23.1) (0)
Western Cape 13 1 12 0(14.5) (7.7) (93.3) (0)
Gauteng 11 8 3 0(12.2) (72.7) (27.3) (0)
Northern Cape 10 0 10 0(11.1) (0) (100) (0)
North West 5 0 5 0(5.5) (0) (100) (0)
Limpopo 3 0 0 3(3.3) (0) (0) (100)
Total 90 19 64 7
The majority of educators were from special schools (n=64), while 19 were from autism-
specific schools and seven from full-service schools. In addition to information provided in the
table, 59 of the 64 educators were employed at special schools that offered services to
learners with severe intellectual impairment. Provinces without autism-specific schools (i.e.
Free State, North West and KwaZulu-Natal) indicated that they accommodate learners with
ASD in existing special schools. The possible reasons for the limited number of full-service
schools identified for the study were discussed in Chapter 3 (cf. Table 3.1) and only the Free
State and Limpopo indicated to have full-service schools that offer autism-specific education
and that fit the inclusion criteria of the study.
The following section will provide more information regarding the qualifications, training and
experience of educators.
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4.4 THE LEVEL OF TRAINING AND EXPERIENCE OF EDUCATORS
This section deals with the first research objective, namely to determine the level of training
and experience of educators of autism-specific classes in public schools nationally.
4.4.1 Work experience of educators – abroad and within the South African context
A total of 11 educators (12.2%) responded affirmatively when asked whether they have worked
abroad with learners with ASD. The results suggest that the majority of educators (87.8%)
gained their experience within the South African context.
Table 4.6 Age and work experience of educators
Variable n Min Lower Upperquartile Median quartile Max
Age in years 89 25 38 46 53 63
Years since qualified 87 1 6 17 27 40
Years experience in
ASD teaching 85 0 3 5 8 27
Table 4.6 depicts the age, years since qualified and years in ASD teaching. Section 4.3.1 (Age
of educators) displays the age range of educators. A total of 87 educators (96.7%) responded
to a ratio data question asking educators about the year in which they completed their studies.
Four educators (4.6%) indicated that they completed their qualification only in 2012. One
educator reported that she had completed her studies in 1973, and her 40 years of experience
represented the maximum number of years of experience. The median work experience was
17 years, which sets 1996 as the year in which these educators qualified. The lower quartile
for years since qualified was six years (2007) and the upper quartile was 27 years (1986).
Some 87 educators responded (96.7%) when asked to indicate how many years experience
they had of autism-specific teaching, and reported a median of five years (a lower quartile of
three years and an upper quartile of eight years). One educator (1.1%) indicated that she had
started in an autism-specific class during 2012, while the maximum years of teaching an
autism-specific class was 27 years. The results of the study imply that educators started with
autism-specific education after gaining experience in other fields of education.
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4.4.2 Phase-specific training
A total of 90 educators responded to the multiple-choice question to determine the phase-
specific training educators received.
Table 4.7 Phase-specific training (n=90*)
Variable Responded
n %
Foundation phase 53 58.9
Intermediate phase 24 26.7
Senior phase 19 21.1
For all phases 7 7.8
Table 4.7 indicates that the majority of educators (n=53, 58.9%) were trained for foundation
phase education. Intermediate phase training consisted of 24 responses (26%); the senior
phase of 19 responses (21.1%); and seven educators (7.8%) indicated that they had been
trained for all phases. The results suggest that the number of educators trained for foundation
phase is more than double that of the intermediate and senior phases.
4.4.3 Educators’ basic training
A total of 87 educators (96.7%) responded to the multiple-choice question concerning their
basic training.
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Table 4.8 Educators’ basic training (n= 87*)
Variable n %
Grade 10: Certificate in Education
Grade 10 + 2 years training 2 2.3
Grade 10 + 3 years training 1 1.2
Grade 12: Diploma or Degree in Education n %
Grade 12 + 3 years training 31 35.6
Grade 12+ 4 years training 28 32.2
Grade 12 + B. Ed degree 18 20.7
Grade 12 + B. Ed. Psychology degree 6 6.9
Other n %
Grade 12 +Speech Therapy qualification 1 1.1
The results were clustered into three groups, namely: Grade 10 and a certificate in education;
Grade 12 and a diploma or degree in education; and other qualifications.
The results suggest that the majority of educators had Grade 12 with a diploma or degree in
education.
One educator had training in another profession, namely speech therapy (n=1; 1.1%).
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4.4.4 Educators’ formal post-basic training
Some 86 educators (95.6%) responded to the dichotomous question (yes/no) concerning their
completion of a post-basic qualification, to which 43 educators (50%) responded affirmatively.
Table 4.9 Educators’ formal post-basic training (n=43*)
Variable Responded
n %
Support and special education 35 40.7%
Other specialties 8 9.3%
Table 4.9 indicates the responses of these 43 educators to the multiple-choice question
concerning the type of formal post-basic training they had completed. The responses represent
two clusters, namely support and special education, and other specialities.
A total of 35 educators (38.9%) completed formal post-basic education in support and special
education, and the cluster included the following:
(i) Honours in Support and Remedial Education (n=12; 27.9%);
(ii) Advanced Certificate in Education (n=8; 18.6%);
(iii) Diploma in Support and Remedial Education (n=5; 11.6%);
(iv) Master’s in Education (n=4; 9.3%);
(v) PhD in Education (n=2; 4.7%);
(vi) B. Ed. Honours in Inclusive Education (n=2; 4.7%); and
(vii) Advanced Certificate in Education: Foundation Phase (n=1; 2.3%).
Eight educators (8.9%) indicated that they had completed post-basic training in the following
other specialties:
(i) BA Honours in Drama (n=1; 2.3%);
(ii) Alternative Augmentative Communication (n=3; 7.0%);
(iii) General Nursing Diploma (n=1; 2.3%);
(iv) Honours in Communication (n=1; 2.3%); and
(v) Spiritual Counselling (n=1; 2.3%).
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One educator (n=1; 2.3%) completed a B. Ed. Honours in curriculum, a BA Honours in
Psychology and a Diploma in Education Management.
The majority of educators appeared to have been trained in support and special education,
with Honours in Support and Remedial Education as the most frequently supported post-basic
training.
4.4.5 Educators’ formal post-basic training currently underway
A total of 89 educators responded to a dichotomous question (yes/no), asking whether they
were currently undertaking postgraduate training, to which 15 educators indicated involvement
in further studies. However, only 12 of these 15 educators specified the type of training they
were doing.
Table 4.10 Educators’ formal post-basic training currently underway (n=12*)
Variable Responded
n %
Support and special education 4 26.7
Education management 4 26.7
Other specialities 4 26.7
A multiple-choice question was used to ask educators about the postgraduate training they
were involved in. Table 4.10 clustered the responses of these 12 educators into three groups,
namely support and special education (n=4; 26.7%); other specialities (n=4; 26.7%); and
education management (n=4; 26.7%).
The cluster of Support and Special Education included the following:
(i) Advanced Certificate in Education (n=2; 13.3%);
(ii) B. Ed. Honours in Inclusive Education (n=1; 6.7%); and
(iii) PhD in Education (n=1; 6.7%).
The cluster on other specialties included the following:
(i) B. Ed. Alternative Augmentative Communication (n=2; 13.3%);
(ii) M. Ed. Alternative Augmentative Communication (n=1; 6.7%); and
(iii) M. Ed. in Psychology (n=1; 6.7%).
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Education Management Studies included:
(i) Diploma in Whole School Development (n=1; 6.7%); and
(ii) B. Ed. Honours in Law and Policy (n=3; 20.0%).
A total of 12 educators (13.3%) indicated that they were involved in post-basic training, and
only four of these were busy with training in support and education. The other eight educators
were involved in studies not specifically related to autism-specific education.
4.4.6 Educators’ training in autism-specific programmes
Educators responded to a multiple-choice question to determine the autism-specific
programmes in which they had received or completed training.
125
Table 4.11 Educators’ training in autism-specific programmes (n=90*)
Variable Responded
n %
Children Picture Exchange Communication System
(PECS) 55 61.1
Treatment and Education of Autistic and related
Communication Handicapped Children (TEACCH) 51 56.7
Tiny Handz (Sign Language) 42 46.7
Makaton Language Programme 41 45.6
Fishbowl (Autism South Africa Training Programme) 33 36.7
Other programmes 31 34.4
Special Needs Adapted Programme (SNAP) 25 27.8
Applied Behaviour Analysis (ABA) 17 18.9
Developmental, Individual Difference, Relationship-
Based Model (DIR® / Floortime™) 4 4.4
Table 4.11 indicates that more than 55% of educators were trained in the Children Picture
Exchange Communication System (n=55; 61.1%) and Treatment and Education of Autistic and
Related Communication Handicapped Children (n=51; 56.7%). Between 27% and 37% of
educators indicated that they were trained in South African developed programmes: Tiny
Handz (n=42; 36.7%), Fishbowl (n=33; 36.7% and the Special Needs Adapted Programme
(n=25; 27.8%).Less educators appeared to be trained in Applied Behaviour Analysis (n=17;
18.9%) and Developmental, Individual Difference, Relationship-Based (n=4; 4.4.%).
In an open-ended question, 31 educators (34.4%) named these other programmes in which
they had received training: Non-Punitive Restraint (n=2; 2.2%); ASD certificate of competence
(n=1; 1.1%); Studio 2 (n=1; 1.1%); Studio 3 (n=6; 6.7%); Alternative Augmentative
Communication (n=7; 7.8%); Social Stories™ (n=1; 1.1%); Apple software (n=2; 2.2%); and
informal ASD courses (n=11; 12.2%).
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4.4.7 Service providers responsible for educator training
A total of 49 educators (54.4%) responded to the multiple-choice question to determine the
service providers responsible for the training of the educators in autism-specific classes.
Table 4.12 Service providers responsible for educator training (n= 49*)
Variable n %
Another school 12 24.5
Accredited external trainers 11 22.4
Internal training 10 20.4
Autism South Africa 9 18.4
District-based support team 4 8.2
Universities 2 4.1
Other 1 2.0
The results in Table 4.12 display that between 18% and 25% of educators had been trained by
another school, accredited external trainers, school-based internal training programmes or by
Autism South Africa. Less than 10% of educators indicated district-based support teams (n=4;
8.2%) and universities (n=2; 4.1%) as training service providers. One educator (2.0%)
indicated another source of training, but did not specify the source.
4.4.8 Schools providing training
Some 86 educators (95.6%) responded to a dichotomous (yes/no) question asking whether
their school provided autism-specific training to other schools, to which 36 educators (41.9%)
answered affirmatively.
127
Table 4.13 Type of support offered by schools providing training (n=36*)
Variable Responded
n %
Informal 23 63.9
Formal 10 27.8
Outreach 1 2.8
Table 4.13 displays the responses of 36 educators who responded to an open-ended question
concerning the type of training their school offered. The results were clustered into three
groups: informal training, formal training and outreach. Again it should be noted that the
numbers of the breakdown and cluster do not correlate since educators could indicate more
than choice.
Informal training consisted of the following responses:
(i) Lectures and training for individuals and groups of educators on managing learners with
ASD in the classroom (n=21; 58.3%); and
(ii) Study groups and professional working groups with the aim of training on best practices
(n=9; 25.0%).
The cluster on formal training consisted of the following responses:
(i) Intensive two-week training programme (n=2; 5.6%);
(ii) TEACCH training to parents, tutors, educators and therapists (n=5; 13.9%);
(iii) PECS training to parents, tutors, educators and therapists (n=2; 5.6%);
(iv) Studio 3 (n=1; 2.8%) training; and
(v) Vera training (n=4; 11.1%).
The third cluster referred to outreach programmes and programmes provided to educators
from disadvantaged schools (n=1; 2.8%). Informal training to individuals and groups of
educators on managing ASD in the classroom appeared to be the primary source of training
provided by schools that offered training.
128
4.4.9 Updates regarding the latest developments in autism-specific education
A total of 76 educators (84.4%) responded to an open-ended (word-based) question
concerning their strategies to keep updated with the latest developments in autism-specific
education.
Table 4.14 Updates regarding the latest developments in autism-specific education
(n=76*)
Variable Responded
n %
Formal training and workshops 49 54.4
Journals, newsletters and books 28 31.1
Internet and social media 26 28.9
In-service training and professional working groups 22 24.4
ASD associations 15 16.7
Individual research and reviews 8 8.9
Parent meetings and support groups 4 4.4
Do not keep up with trends 1 1.1
Table 4.14 displays the eight clusters concerning strategies to keep updated regarding the
latest developments in autism-specific education. A total of 49 educators (54.4%) indicated
that they kept updated by attending formal training and workshops, which included workshops
and seminars (n=48; 53.3%), and the SNAP training course (n=1; 1.1%).
Some 28 educators (31.1%) indicated that they used mainly journals, newsletters and books to
keep updated, while 26 educators (28.9%) responded that they remained updated by the use
of the Internet (n=25; 27.8%), blogs and international chat rooms (n=1; 1.1 %), and radio
broadcasts (n=1; 1.1%). A total of 22 educators (24.4%) reported being updated by the use of
in-service training and professional working groups, which included:
(i) Professional working and study groups (n=5; 5.6%);
(ii) In-service training and school-based support (n=14; 15.6%);
(iii) Visits to autism-specific schools (n=3; 3.3%);
129
(iv) Learning through practical experience (n=3; 3.3%); and
(v) Strategies provided by district-based support teams (n=1; 1.1%).
Fifteen educators (16.7%) replied that ASD associations assisted in keeping them updated.
These ASD associations were ASD regional support group meetings (n=5; 5.6%) and Autism
South Africa (n=12; 13.3%). Eight educators (8.9%) replied that they kept updated by
performing research (n=3; 3.3%) and reviews of current research in the field of ASD (n=5;
5.6%). Parental meetings (n=3; 3.3%) and support by district-based support teams (n=1; 1.1%)
assisted four educators (4.4%) to develop professionally. Only one educator (n=1; 1.1%)
reported not keeping up with the latest trends in ASD education.
The results suggested that the majority of educators remained updated by attending formal
training and workshops; through journals, newsletters and books; by means of the Internet and
social media, as well as with in-service training and professional working groups.
4.5 SCHOOL-BASED OPERATIONS
This section deals with the second research objective, namely to determine school-based
operations concerning admissions criteria and procedures of learners with ASD, extra-
curricular services, therapeutic support and parent collaboration. The following results are
discussed:
4.5.1 Assessment tools;
4.5.2 Screening identification and support;
4.5.3 Age groups accommodated at school;
4.5.4 Admissions criteria;
4.5.5 Accommodation of special needs in hostels;
4.5.6 Extra-curricular services offered;
4.5.7 Reasons for the necessity of therapists;
4.5.8 Therapeutic services offered;
4.5.9 Transfer of skills to the home environment; and
4.5.10 Autism support groups.
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4.5.1 Type of school
A total of 89 educators (98.9%) responded to a multiple-choice question concerning the type of
school where they worked.
Table 4.15 Type of school (n=89)
Variable n %
Special school 59 66.3
Autism-specific school 23 25.8
Full-service school 7 7.9
The results in Table 4.15 seemed to indicate that the majority of educators (n=59, 66.3%) who
participated were employed at special schools; only 23 educators (25.8%) from autism-specific
schools participated. Although educators from full-service schools had a 100% response rate
(cf. Figure 4.1 discussion) they only represent 7.9% of the educators who participated.
4.5.2 Assessment tools
Table 4.16 indicates the response rates of educators to a multiple-choice question regarding
the use of screening and diagnostic tools. Generally, the question regarding the use of
assessment tools had a low response rate for both screening tools (<30.5%) and diagnostic
tools (<43%). Three educators from special schools commented that educators from autism-
specific classes were not involved in the initial screening and assessment of potential
candidates for the school.
131
Table 4.16 Assessment tools (n=90*)
Variable Responded
Screening Tools n %
Autism Behaviour Checklist (ABC) 27 30.0
Autism Spectrum Screening Questionnaire (ASSQ) 7 7.8
Autism Screening Instrument for Educational Planning
(ASIEP) 6 6.7
Pervasive Developmental Disorder Screening Test –
Second Edition (PDDST) 6 6.7
Autism Spectrum Quotient – child version (ASQ) 2 2.2
CHAT 2 2.2
Variable Responded
Diagnostic Tools n %
Childhood Autism Rating Scale (CARS) 38 42.2
Autism Diagnostic Observation Schedule (ADOS) 16 17.8
Asperger Syndrome Diagnostic Scale (ASDS) 3 3.3
Gilliam Autism Rating Scale – Second Edition (GARS) 2 2.2
School has a self-developed assessment tool 1 1.1
Table 4.16 depicts that the Autism Behaviour Checklist (n=27, 30%) appeared to be the
screening tool that was used most frequently. The Childhood Autism Rating Scale (n=38,
42.2%) appeared to be the most used diagnostic tool. Sixteen educators (17.8%) reported to
use the Autism Diagnostic Observation Schedule, and less than eight percent of the educators
who responded indicated that they used the other screening and diagnostic tools.
4.5.3 Use of Screening Identification and Support (SIAS)
A total of 74 educators (82.2%) responded to a dichotomous (yes/no) question concerning the
use of the Screening Identification and Support Guidelines (SIAS) at their school.
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Table 4.17: Use of Screening Identification and Support (SIAS) (n=74)
Variable Yes NoResponses Responses Total
n % n % n
Autism Specific
Schools 14 93.3 1 6.7 15
Special Schools 40 75.5 13 24.5 53
Full Service School 4 66.7 2 33.3 6
58 - 16 - 74
Table 4.17 displays that 58 educators indicated the use of the Screening Identification and
Support Guidelines at their school. Nevertheless, 16 educators indicated that they did not use
SIAS at their school. A breakdown of these results in terms of the type of schools suggests
that educators used the SIAS guidelines in autism-specific (n=14), special (n=40) and full-
service schools (n=4).
4.5.4 Age groups accommodated at school
A ratio data question enquired about the age groups for which the school provided autism-
specific education.
Table 4.18 Age groups accommodated at schools
Variable n Min Median Max
Lower limit – age range in years 78 2 5 11
Upper limit – age range in years 79 10 18 25
Table 4.18 indicates five years as the median of the lower age range with the minimum age at
two years and the maximum age as 11 years. The upper age range had a median age of 18
years with a minimum age of 10 years and a maximum age of 25 years.
In addition to the results in Table 4.18, further analyses indicated that 13.0% of learners
admitted to autism-specific schools were younger than five years, of which 12.5% were in
special schools and 3.5% in full-service schools. Analysis of the upper limit indicated that only
133
5.4% of learners were older than 18 years and that they were all from special schools. The
results tended to indicate that schools accommodate learners mainly between the ages of 5
and 18 years.
4.5.5 Admissions criteria
A multiple-choice question was used to determine the pre-requisites for admission to schools,
and the response rate was generally low (<60%).
Table 4.19 Admissions criteria (n=90*)
Variable Responded
n %
Continence training complete 51 56.7
Formal diagnosis of ASD by medical specialist 50 55.6
Screening by school panel 45 50.0
Recommendation by district 43 47.8
Age restrictions 38 42.2
Functional language and communication skills 9 10.0
Language policy 8 8.9
Other 2 2.2
Table 4.19 depicts that 50% and more of educators indicated continence (n=51; 56.7%), formal
diagnosis (n=50; 55.6%) and screening by a school panel (n=45, 50.0%) as prerequisites for
admission. Recommendation by the district-based support team (n=43; 47.2%) and the age of
the learner (n=38; 42.2%) were reported as admissions criteria. Functional language skills
(n=9; 10%) and a language policy (n=8; 8.9%) did not appear to be vital prerequisites for
admission. Two educators indicated other criteria as an option, but they did not specify the
criteria.
134
4.5.6 Accommodation of special needs in hostel
Some 87 educators (96.7%) responded to a dichotomous question (yes/no) concerning hostel
accommodation offered at their school, and 53 educators replied that their school had hostel
facilities.
Table 4.20 Hostel accommodation in different school types (n=87)
Variable Yes NoResponses Responses Total
n % n % n
Autism-specific schools 17 77.3 5 22.7 22
Special schools 34 58.6 24 41.4 58
Full-service schools 2 28.6 5 71.4 7
53 - 34 - 87
Table 4.20 indicates that hostel accommodation was offered in autism-specific- (n=17; 77.3%),
special (n=34; 58.6%) and full-service schools (n=2; 28.6%).
Table 4.21 summarises the responses of educators to an open-ended (word-based) question
regarding the different strategies used to accommodate the individual needs of learners
concerning the hostel routine. The results were grouped into five clusters as displayed in Table
4.21.
Table 4.21 Accommodation of special needs in hostel (n=90*)
Variable Responded
n %
Individual support plans and strategies 28 31.1
Staff training and support 15 16.7
Grouping and team work 12 13.3
Structured routine and schedule 11 12.2
No accommodation for ASD 3 3.3
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A total of 28 educators (31.1%) replied that they used individual support plans and strategies in
the following ways:
(i) The housemother accommodated the sensory needs (e.g. sensitivity to noise) of learners
within limits (n=24; 26.7%);
(ii) The use of visual schedules to guide and orientate learners (n=7; 7.8%);
(iii) Learners received training regarding personal management skills, which increased their
independence (n=3; 3.3%);
(iv) Learners wore communication boards (necklaces) to facilitate communication with hostel
staff (n=1; 1.1%); and
(v) Hostel staff participated in the compilation of individual support plans (n=3; 3.3%).
Fifteen educators (16.7%) indicated the use of staff training and support. Hostel staff received
training regarding ASD (n=9; 10%) and educators assisted hostel staff with support strategies
for individual learners (n=7; 7.8%).
Results indicated that hostel staff grouped learners according to age and developmental
needs, with assistants allocated to each group (n=6; 6.7%). Only one educator indicated that
learners needed to share rooms due to financial constraints, and five educators indicated that
the learners participated in domestic activities e.g. cleaning their rooms, cooking, etc. Thus two
educators (2.2%) were of opinion that the hostel programme played a positive role in improving
social and life skills in learners with ASD due to the teamwork and exposure to domestic
chores.
Eleven educators (12.2%) indicated that the learners followed structured routines and
schedules e.g. set bedtimes, menus, etc. Results indicated that 13.3% of hostel staff used
efficient grouping of learners and teamwork (n=12) as a strategy to accommodate the needs of
learners.
Three educators (3.3%) reported that their school offered hostel facilities, but that they did not
accommodate learners with ASD.
136
4.5.7 Extra-curricular services offered
Table 4.22 summarises the responses of educators on a multiple-choice question that
determined the extra-curricular activities offered for learners with ASD.
Table 4.22 Extra-curricular services offered (n=90*)
Variable Responded
n %
Swimming 48 53.3
Art 41 45.6
Social skills 40 44.4
Horseback-riding 33 36.7
*External therapy 30 33.3
Music therapy 28 31.1
Pottery 19 21.1
Drama 18 20.0
Ball skills (soft- and play-ball) 5 5.6
*Therapy not provided by school-based therapists.
Table 4.22 displays that swimming (n=48; 53.3%), art (n=41; 45.6%) and social skills (n=40;
44.4%) appeared to be three activities that were offered the most at schools. Horseback-riding
(n=33; 36.7%), therapy by external therapists (n=30; 33.3%) and music therapy (n=28, 31.1%)
seemed to be offered by one-third of schools that offered ASD education. Some 20% of
educators indicated that pottery (n=19) and drama (n=18) were offered at their schools, while
only 5.6% of educators (n=5) reported the use of ball skills.
137
4.5.7.1 Extra-curricular services offered at different schools
Table 4.23 provides a summary of the extra-curricular services offered in the different types of
schools, namely autism-specific, special- and full-service schools.
Table 4.23 Extra-curricular services offered at different schools (n=90*)
Variable Autism-specificschools Special schools Full-service schools
n n n
% % %
Swimming 7 36 4(30.4) (61.0) (57.1)
Art 12 23 5(52.2) (39.0) (71.4)
Social skills 8 29 2(34.8) (49.2) (28.6)
Horseback-riding 8 21 3(34.8) (35.6) (42.9)
*External therapy 8 18 4(34.8) (30.5) (57.1)
Music therapy 11 14 3(47.8) (23.7) (42.9)
Pottery 7 12 0(30.4) (20.3) (0)
Drama 4 14 0(17.4) (23.7) (0)
Ball skills (soft- and 2 3 0
play-ball) (8.7) (5.1) (0)
*Therapy not provided by school-based therapists.
Table 4.23 suggests art (n=12, 52.2%), music therapy (n=11; 47.8%), social skills (n=8;
34.8%), horseback-riding (n=8; 34.8%) and therapy by external therapists (n=8; 34.8%) to be
offered by the most at autism-specific schools. Swimming (n=36; 61.0%), social skills (n=29;
49.2%) and art (n=23; 39.0%) were reported by educators of specials schools as extra-
curricular services offered, while drama (n=14; 23.7%) and ball skills (n=3; 5.1%) had less
responses. Educators from full-service schools reported the use of art (n=5; 71.4%), therapy
by external therapists (n=4; 57.1%), swimming (n=4; 57.1%), and music therapy (n=3; 42.9%)
as extra-curricular activities. Pottery, drama and ball skills appeared to be offered autism-
specific and special schools, but not by full-service schools.
138
4.5.7.2 Most beneficial extra-curricular services offered
A total of 75 educators (83.3%) responded to an open-ended (word-based) question
concerning the extra-curricular activities that they perceived as most beneficial to learners with
ASD.
Table 4.24 Most beneficial extra-curricular services offered (n=75*)
Variable n %
Social skills 32 42.7
Horseback-riding 26 34.7
Music therapy 26 34.7
Swimming 23 30.7
Art 20 26.7
*External therapy 12 16.0
Drama 4 5.3
Pottery 4 5.3
Ball skills (soft- and play-ball) 2 2.7
*Therapy not provided by school-based therapists.
Table 4.24 displays social skills (n=32, 42.7%), horseback-riding (n=26, 34.7%), music therapy
(n=26, 34.7%), swimming (n=23, 30.7%), art (n=20, 26.7%) and external therapy (n=12, 16%)
as the activities that educators perceived to be most beneficial. Drama (n=4, 5.3%), pottery
(n=4, 5.3%) and ball skills (n=2, 2.7%) received less responses.
4.5.7.3 Funding of extra-curricular services offered
Some 75 educators responded to a multiple-choice question to determine whether schools or
parents funded extra- curricular activities.
139
Table 4.25 Funding of extra-curricular services offered (n=75*)
Variable School Funded Private Funded
n % n %
Horseback-riding 16 21.3 17 22.7
*External therapy 17 22.7 12 16.0
Music therapy 19 25.3 11 14.7
Art 35 46.7 8 10.6
Pottery 1 1.3 4 5.4
Social skills 40 53.3 3 4.0
Swimming 43 57.3 2 2.7
Drama 15 20.0 1 1.3
*Therapy not provided by school-based therapists.
Table 4.25 indicates that swimming (n=43; 57.3%), social skills (n=40; 53.3%), art (n=35,
46.7%) and drama (n=15, 20.0%) were mostly funded by the school. Four educators
responded that pottery (5.4%) was funded privately, while only one educator (1.3%) reported
that the school funded pottery. Seventeen educators (22%) indicated horseback-riding to be
funded privately, but 16 educators (21.3%) reported that the school funded the activity. Music
therapy (n=19, 25.3%) and external therapy (n=17, 22.7%) appeared to be funded the most by
schools. However, 16.0% of educators (n=12) reported that external therapy was privately
funded and 14.7% (n=11) indicated that private funding covered the costs of music therapy.
4.5.8 Reasons for necessity of therapists
A total of 87 educators (96.7%) responded to a dichotomous (yes/no) question regarding the
necessity of therapists (as indicated in Table 4.27.) at schools that offered autism-specific
education; 85 (97.7%) of these responded positively, while only 2.3% (n=2) did not feel that it
was necessary to provide therapeutic services.
140
Table 4.26 Reasons for necessity of therapists (n=87*)
Variable Responded
n %
Specialised support 38 44.7
Integrated, multi-professional approach 29 34.2
Training and support of educators 25 29.4
Optimising education outcomes 13 15.3
An open-ended (word-based) question was used, where educators had to motivate their
responses regarding the need for therapists at their school. The researcher grouped the
results into four clusters, and Table 4.26 displays these clusters.
A total of 38 educators (44.7%) indicated that learners with ASD required specialised support
offered by therapists. The cluster for specialised support consisted of three primary views:
(i) Therapists have specialised skills and focus on specific developmental aspects of
individualised learners (n=38; 38.0%);
(ii) Gross motor intervention as addressed by physiotherapists has benefits in classroom
performance (n=6; 7.1%); and
(iii) Learners with ASD often require specialised assistive devices or specialised
compensatory strategies (n=1; 1.2%).
Overall, the results suggested that the specialised skills of therapists and the individualised
focus on specific developmental aspects of learners made them essential at schools that offer
ASD education.
A total of 29 educators (34.0%) indicated that learners with ASD required integrated, multi-
professional approaches and this cluster consisted of two primary views:
(i) Learners with ASD have intensive support needs and require specialised intervention in
various developmental domains (n=24; 28.0%); and
(ii) Learners with ASD benefit the most from an integrated, multi-professional intervention
(n=7; 8.2%).
141
The intensive support and specialised intervention required by learners with ASD appeared to
be a key factor that necessitates therapists as part of integrated, multi-professional teams in
schools that offer autism-specific education.
A total of 25 educators (29.4%) indicated that therapists needed to assist with the training and
support of educators. This cluster consisted of four primary views:
(i) Educators did not have specialised skills to manage all the impairments and deficits
associated with the condition (n=12; 14.1%);
(ii) Therapists assisted with classroom and individualised strategies, which added value to
teaching (n=17; 20.0%)
(iii) Therapists were actively involved in compiling individual support plans (n=2; 2.4%); and
(iv) Therapists assisted with parent feedback, training and support strategies (n=1; 1.2%).
The results suggested that assistance provided by therapists in the classroom and the
strategies to support individualised learners appeared to be key contributors in having
therapists at schools that offer ASD education.
Thirteen educators (15.3%) were of the opinion that therapeutic intervention optimised
education outcomes and they indicated three primary reasons:
(i) Therapeutic intervention made a difference in the functional skills of learners (n=3;
3.5%);
(ii) Learners who receive speech and occupational therapy showed improvement in
communication and personal independence, which aided academic progress (n=8;
9.4%);
(iii) Therapy added value, but only a number of learners benefited due to limited resources
(n=2; 2.4%).
4.5.9 Therapeutic services offered
Table 4.27 displays the responses of educators when asked in a multiple-choice question to
report on the different therapeutic services offered and funded by the school.
142
Table 4.27 Therapeutic services offered (n=90*)
Variable Autism-specificschools Special schools Full-service schools
n n n
% % %
⃰ Occupational therapy 19 43 1(82.6) (72.9) (14.3)
⃰ School nursing 15 42 1(65.2) (71.2) (14.3)
Physiotherapy 4 30 0(17.4) (50.9) (0)
Speech therapy 17 16 1(73.9) (27.1) (14.3)
Psychology 10 21 1(43.5) (35.6) (14.3)
Social work 2 11 1(8.7) (18.6) (14.3)
Dietetic service 0 0 0(0) (0) (0)
⃰ Total of occupational therapists in all schools (n=63; 70%) and school nursing (n=58, 64.4%)
Some 63 educators reported that their school offered occupational therapy (70%), and 58
indicated school nursing services (64.4%). None of the educators indicated that their school
offered dietetic support. Educators from autism-specific schools reported to offer occupational
therapy (n=19, 82.6%), school nursing (n=15, 65.2%) and speech therapy (n=17; 73.9%), while
physiotherapy (n=4; 17.4%) and psychology (n=10, 43.5%) appeared to be less offered.
Educators from special schools reported to have occupational therapy (n=43, 72.9%), school
nursing (n=42, 71.2%), physiotherapy (n=30, 50.9%), psychology (n=21, 35.6%), speech
therapy (n=16, 27.1%) and social work (n=11, 18.6%). Only one educator from a full-service
school reported to have occupational therapy, nursing, speech therapy, psychology and social
work services at their school. No educators from full-service schools reported physiotherapy
services.
4.5.10 Therapeutic support to educators
A total of 88 educators (97.8%) responded to a dichotomous (yes/no) question concerning the
support they received from therapists – 80 of the educators (90.9%) indicated that they did
receive such support. Eight educators (9.1%) replied that they did not receive any support from
therapists, since their school did not have school-based therapists. Six of these educators
were from full-service schools and two from special schools.
143
Table 4.28 Therapeutic support to educators (n=80*)
Variable Responded
n %
Therapy with individual learners 63 78.7
Groups sessions 50 62.5
Support in class 43 53.7
Workshops 31 38.7
Parent feedback 4 5.0
Table 4.28 summarises the responses of these 80 educators when asked in a multiple-choice
question to indicate the type of support they received from therapists. The responses were
clustered into five groups concerning the following types of support:
(i) Therapy with individual learners (n=63, 78.7%);
(ii) Group sessions (n=50, 62.0%);
(iii) Support in class (n=43, 53.7%);
(iv) Workshops (n=31, 38.8%); and
(v) Assistance with parent feedback (n=4, 5.0%).
The results suggest that therapists mostly provided therapeutic support through individual
therapeutic sessions, therapeutic groups, and the provision of support strategies to educators
on how to handle individual learners in the class. Therapists also appeared to play a role in the
structured training of educators by presenting workshops. Therapists seemed to have a limited
role concerning parent feedback.
4.5.11 Transfer of skills to the home environment
A total of 86 educators (95.6%) responded to the dichotomous (yes/no) question concerning
the participation of parents in the educational programme at the school; for which 55 educators
(64.0%) indicated parent involvement.
144
Table 4.29 Transfer of skills to the home environment (n=76*)
Variable Responded
n %
Individual counselling and feedback 47 52.2
Homework, letters and communication book 16 17.8
Formal structured training in groups 12 13.3
Parent meetings and support groups 9 10.0
Limited parent involvement and training 9 10.0
A total of 76 educators (84.4%) responded when asked how they transferred skills to the home
environment. Table 4.29 indicates that 47 educators (52.2%) supported the first cluster
concerning individual counselling and feedback to parents. This cluster included the following
responses:
(i) Parent counselling regarding individual support plans, school goals and daily schedules
(n=45; 50.0%);
(ii) Home visits (n=4; 4.4%); and
(iii) Drama and role-play (n=1; 1.1%).
The second cluster included the use of homework, letters and communication books, and 16
educators (17.8%) supported this cluster. The third cluster dealt with formal, structured training
of parents in groups, and 12 educators (13.3%) responded that they used this strategy.
The fourth cluster included parents meetings and support groups. Nine educators (10.0%)
indicated that they used these methods to transfer skills to the home environment. The fifth
cluster dealt with the responses of educators who indicated that parent training and
involvement were a limitation in their programme and nine educators supported (10.0%) this
cluster.
Individual counselling and feedback appeared to be used by the majority of educators.
145
4.5.12 Frequency of parent feedback and specialised training for parents
A total of 83 educators (92.2%) responded when asked whether the school offered specialised
training to parents, to which 49 educators (59.0%) indicated that their school did not offer such
training.
Table 4.30 Parent feedback and specialised training in schools (n=83)
Variable Yes NoResponses Responses Total
n % n % n
Autism-specific schools 9 45.0 11 55.0 20
Special schools 20 35.7 36 64.3 56
Full-service schools 5 71.4 2 28.6 7
34 - 49 - 83
Table 4.30 provides a breakdown of the responses received from educators in autism-specific,
special and full-service schools. The results concerning parent feedback and training in
schools were as follows: autism-specific (n=9, 45.0%), full-service (n=5, 71.4%) and special
schools (n=20, 35.7%).
Table 4.31 Frequency of parent feedback and specialised training for parents (n=89)
Variable n %
Quarterly 52 58.4
Annually 16 18.0
More frequently than monthly 15 16.9
Monthly 3 3.4
Never 1 1.1
Biannually 1 1.1
If required to contact parents 1 1.1
146
A total of 89 educators (98.9%) responded to a multiple-choice question concerning the
frequency of parent feedback and specialised training for parents. Table 4.31 displays the
frequency of parent feedback and information sessions. The results indicated that 58.4% of
educators (n=52) provided quarterly feedback; 18% of educators (n=16) reported annual
feedback; and 16.9% of educators (n=15) specified feedback more frequently than monthly.
Three educators (n=3.4%) reported monthly feedback, while few educators indicated that they
never provided feedback (n=1; 1.1%), gave biannual feedback (n=1; 1.1%) or feedback if
required (n=1; 1.1%).
4.5.13 Financial burden for parents regarding specialised services delivered
Some 84 educators (93.3%) responded when asked in a dichotomous (yes/no) question
whether parents paid extra for specialised services delivered at schools.
Table 4.32 Financial burden for parents regarding specialised services delivered
(n=84)
Variable n %
Parents do not pay for specialised services 69 82.1
Parents pay for specialised services 15 17.9
Table 4.32 displays that the majority of educators (n=69; 82.1%) replied that parents do not
have to cover the costs of specialised services.
4.4.14 Autism support groups
A total of 76 educators (84.4%) responded to a dichotomous (yes/no) question concerning the
affiliation of their school with Autism South Africa, to which 68 educators (89.5%) confirmed
affiliation. Eight educators (10.5%) replied that their school had no affiliation with Autism South
Africa.
147
Table 4.33 Autism support groups (n=38*)
Variable Responded
n %
Autism South Africa regional support groups 21 23.3
Other autism associations 10 11.1
Support and study groups 7 7.8
Table 4.33 displays the three groups of responses of educators when asked in an open-ended
question to indicate their membership at autism support groups.
Firstly, 21 educators (23.3%) responded to supporting Autism South Africa regional supports
groups. This cluster consisted of the following responses:
(i) Autism South Africa (n=12; 13.3%);
(ii) Free State Autism South Africa parent support group (n=5; 5.6%);
(iii) Eastern Cape Autism South Africa: parent support group (n=2; 2.2%);
(iv) Pretoria Cape Autism South Africa: parent support group (n=1; 1.1%); and
(v) Northern Cape Autism South Africa: parent support group (n=1; 1.1%).
The second cluster included all other ASD-related support groups, and ten educators (11.1%)
responded in this regard. ASD related support groups consisted of the following:
(i) Association for Autism (n=2; 2.2%);
(ii) South African Association for Learning and Educational Difficulties (n=2; 2.2%);
(iii) Moonlight Foundation for Autism (n=1; 1.1%);
(iv) Interface (n=4; 4.4%);
(v) Inclusive Solutions (n=1; 1.1%);
(vi) Alternative Augmentative Communication Support (n=1; 1.1%); and
(vii) Autism Assist (n=1; 1.1%).
Thirdly, seven educators (n=7; 7.8%) responded positively to the cluster on support and study
groups. This cluster consisted of two main groups, namely the ASD study group at the
University of KZN, Department of Psychology (n=2; 2.2%), and internal training programmes at
schools (n=5; 5.6%).
148
4.6 CLASSROOM MANAGEMENT PRACTICES
This section deals with the third research objective, namely to determine classroom
management practices in terms of the curriculum, work schedules, monitoring of learner
progress as well as activity and environmental adjustments. The following results are
presented in this section:
4.6.1 Languages of teaching;
4.6.2 Age range of learners;
4.6.3 Number and gender of learners in class;
4.6.4 Severity of ASD;
4.6.5 Vocational training as part of the curriculum;
4.6.6 Curriculums used in autism classes;
4.6.7 Critical aspects included in curriculum;
4.6.8 Lesson plans and learning pace;
4.6.9 Individual support plans and schedules;
4.6.10 Assessment and monitoring of progress; and
4.6.11 The safety of learners during break time.
4.6.1 Languages of teaching
A total of 90 educators (100%) responded to a multiple-choice question concerning their
language of teaching.
149
Table 4.34 Educators’ languages of teaching (n=90*)
Variable n %
English 29 32.2
Afrikaans and English 24 26.7
Afrikaans 17 18.9
Sesotho 5 5.6
Afrikaans, English and Setswana 5 5.6
IsiZulu 4 4.4
IsiXhosa 3 3.3
Setswana 1 1.1
Sesotho and Setswana 1 1.1
English and IsiXhosa 1 1.1
Table 4.34 indicates English (n=29, 32.2%), Afrikaans (n=17, 18.9%) and combinations thereof
(n=24, 26.7%) as the main languages of teaching in ASD classes. The results concerning
African languages were as follows: Sesotho (n=5, 5.6%), IsiZulu (n=4, 4.4%), IsiXhosa (n=3,
3.3%) and Setswana (n=1, 1.1%). Combinations of African and other languages included
Afrikaans, English and Setswana (n=5, 5.6%); Sesotho and Setswana (n=1, 1.1%); and
English and IsiXhosa (n=1, 1.1%).
4.6.2 Age range of learners
When asked to respond on the age range (e.g. 6-9 years) of the learners in an educator’s
class, 87 educators (96.7%) responded to the lower age range and 86 educators (95.6%) to
the upper age range.
150
Table 4.35 Age range of learners
Variable n Min Lower Upperquartile Median quartile Max
Lower age range 87 2 6 8 11 16
Upper age range 86 4 10 13 15 21
Table 4.35 displays that the youngest learner within the lower age range was 2 years of age,
and the oldest 16 years. The lower age range had a median age of 8 years. The youngest
learner in the upper age range was 4 years and the oldest 21 years, with a median age of 13
years. Hence, it appeared as if the majority of learners in ASD classes were between 8 and 13
years.
4.6.3 Number and gender of learners in class
Table 4.36 displays the responses of educators concerning the number and gender of learners
in their class.
Table 4.36 Number and gender of learners in class
Variable n Lower quartile Median Upper quartile
Number in class 88 7 8 10
Male 87 5 7 8
Female 87 2 1 2
The lower quartile indicated seven learners, a median of eight learners and an upper quartile
of ten learners in a class. Hence, the majority of classes had between seven to ten learners
with ASD. A total of 87 educators reported on the gender ratios of learners in their class. Given
the median of eight learners per class, of which seven were male, the gender ratio suggests
one female for every seven males.
4.6.4 Severity of ASD
Educators responded to a multiple-choice question to determine the options, or combinations
thereof, that best described the learners with ASD in their class.
151
Table 4.37 Severity of ASD (n=90*)
Variable Responded
n %
Severe 52 57.8
Moderate 52 57.8
Mild 32 35.6
Table 4.37 displays that 57.8% of educators (n=52) reported that they had learners with severe
ASD, while 57.8% of educators (n=52) reported moderate ASD, and 32 educators (35.6%)
reported that they have learners with mild symptoms. In addition to the information supplied in
Table 4.37, all educators from full-service schools (n=7) indicated they had learners who were
mildly or moderately autistic.
4.6.5 Autism-specific classes versus inclusivity
A dichotomous (yes/no) question was used to determine whether learners with autism
spectrum disorders were included with others who did not have the condition. A separate
dichotomous (yes/no) question asked educators to indicate whether their school had classes
that exclusively accommodate learners with autism.
152
Table 4.38 Autism-specific classes versus inclusivity in different schools
Including learners with ASD with others not having the condition
Variable Yes responses No responses Total
n % n % n
Autism-specific school 9 40.9 13 59.1 22
Special school 42 73.7 15 26.3 57
Full-service schools 6 85.7 1 14.3 7
57 - 29 - 86
Exclusively accommodating learners with ASD
Variable Yes responses No responses Total
n % n % n
Autism-specific school 15 75.0 5 25.0 20
Special school 44 74.6 15 25.4 59
Full-service schools 3 42.9 4 57.1 7
62 - 24 - 86
Table 4.38 indicates that 57 educators (65.5%) responded affirmatively when asked whether
learners with ASD were included with other learners who did not have the condition. The
results from special schools (n=42; 73.3%) and full-service schools (n=6, 85.7%) suggested
that >70% of educators who responded reported that learners with ASD were included with
other learners. Nine educators from autism-specific schools (40.9%) indicated that learners
with ASD were included with those who do not have the condition.
Some 62 educators (71.4%) responded positively when asked whether they had classes that
exclusively accommodated learners with ASD. The results from autism-specific schools (n=15;
75.0%) and special schools (n=44; 74.6%) indicated that >70% of learners were exclusively
accommodated in classes. Three educators from full-service schools (42.9%) reported that
their classes accommodated exclusively learners with ASD.
153
4.6.6 Use of a class assistant
A total of 87 educators (96.7%) responded to a dichotomous question asking whether they had
a class assistant.
Table 4.39 Use of class assistants in schools (n=87)
Variable Yes responses No responses Total
n % n % n
Autism-specific school 22 95.6 1 4.4 23
Special school 45 79.0 12 21.0 57
Full-service schools 3 42.9 4 57.1 7
70 - 17 - 87
Table 4.39 indicates that the majority of educators (n=70; 80.5%) had class assistants, while
17 educators (19.5%) indicated that they did not have assistants. A total of 95% of educators
in autism-specific- (n=22) and 79% of educators in special schools (n=45) indicated that they
had class assistants, while fewer educators (n=3; 42.9%) from full-service schools reported
resources in this regard.
4.6.7 Vocational training as part of the curriculum
Some 86 educators (95.6%) responded when asked to indicate with a dichotomous (yes/no) if
their school offered vocational training programmes.
154
Table 4.40 Vocational training as part of the curriculum (n=86)
Variable Yes responses No responses Total
n % n % n
Autism-specific schools 16 69.6 7 30.4 23
Special schools 35 61.4 22 38.6 57
Full-service schools 4 66.7 2 33.3 6
55 - 31 - 86
Table 4.40 displays that 55 educators (64.0%) indicated that vocational training was included
in their curriculum. Autism-specific schools (n=16; 69.6%), special schools (n=35; 61.4%) and
full-service schools (n=4; 66.7%) reported positively to the offering of vocational training
programmes.
4.6.8 Curriculums used in autism classes
Table 4.41 displays the responses of educators to a multiple-choice question concerning the
curriculums they used in autism classes.
Table 4.41 Curriculums used in autism classes
Variable Responded
n %
Self-developed curriculum 41 45.6
ELSEN curriculum developed by SANASE 39 43.3
CAPS with differentiation 24 26.7
No curriculum 16 17.8
Self-developed curriculums were reported to be used by 45.6% of educators (n=41), and
43.3% of educators (n=39) indicated the use of the ELSEN curriculum. The Curriculum
Assessment Policy Statement (CAPS) was used by 24 educators (26.7%), while 16 educators
(17.8%) indicated no curriculum being used.
155
Table 4.42 Curriculums used by educators
Autism-
Variable specific Special Full-service
schools schools schools
Total
n n n
% % % n
Self-developed curriculum 13 24 3(56.5) (40.7) (42.9) 40
ELSEN curriculum developed 12 25 2
by SANASE (52.2) (42.4) (28.6) 39
CAPS with differentiation 5 15 4(21.7) (25.4) (57.1) 24
No curriculum 5 8 3(21.7) (13.6) (42.9) 16
Table 4.42 displays a breakdown of the different curriculums used in autism-specific, special
and full-service schools. The results suggested that autism-specific schools used mostly self-
developed curriculums (n=13, 56.5%) or the ELSEN curriculum (n=12, 52.2%) developed by
SANASE. Educators from special schools reported the use of ELSEN curriculum (n=25;
42.4%), a self-developed curriculum (n=24; 40.7%), CAPS with differentiation (n=15; 25.4%),
or no curriculum (n=8; 13.6%). The results from full-service schools were CAPS with
differentiation (n=4; 57.1%), self-developed curriculum (n=3; 42.9%), no curriculum (n=3;
42.9%) and the ELSEN curriculum (n=2; 28.6%).
4.6.9 Critical aspects included in curriculum
Table 4.43 displays the responses of educators when asked in a multiple-choice question to
report on what they perceived to be key aspects in the curriculum.
156
Table 4.43 Critical aspects included in curriculum (n=90*)
Variable Responded
n %
Social interaction 89 98.9
Emotional management 86 95.6
Communication skills 83 92.2
Functional independence 83 92.2
Use of tools and daily objects 81 90.0
Sensory processing 76 84.4
Academic skills 73 81.1
Working skills (task completion, listening to
instructions, etc.) 71 78.9
Vocational and self-help skills 11 12.2
Except for vocational and self-help skills (n=11; 12.2%), the majority (>n=71) of educators
perceived all the aspects provided as essential components of an ASD curriculum.
4.6.10 Lesson plans and learning pace
Table 4.44 summarises the responses to an open-ended question concerning the adjustments
to lesson plans to accommodate the learning pace of all learners.
157
Table 4.44 Lesson plans and learning pace (n=90*)
Variable Responded
n %
Individual support plans and strategies 55 61.1
Curriculum differentiation and structured programmers 32 35.6
Support in groups 10 11.1
Daily and weekly schedules 4 4.4
Secondary teacher and class assistants 2 2.2
The responses of educators were grouped into five clusters, which are displayed in Table 4.44.
A total of 55 educators (61.1%) responded that they had developed individual support plans
and strategies in accordance to individual needs, while 32 educators (35.6%) reported that
they used curriculum differentiation and structured programmes. This cluster consisted of the
following strategies:
(i) Continuous repetition of concepts (n=6; 6.8%);
(ii) TEACCH (n=1, 11%);
(iii) Curriculum differentiation (n=24; 26.7%); and
(iv) Error analysis as a guideline of concepts to support learners who fall behind (n=2; 2.2%).
The other three clusters included support in groups (n=10; 11.1%); daily and weekly schedules
(n=4; 4.4%); and a secondary teacher or class assistant to guide learners who require more
assistance (n=2; 2.2%).
4.6.11 Individual support plans and schedules
Table 4.45 displays the responses of educators concerning the use of individual support plans
and schedules.
158
Table 4.45 Individual support plans and schedules
Variable Response YesRate Responses
n % n %
Individual support plans (ISP) 84 93.3 80 95.2
Stakeholders involved in design of
ISP 81 90.0 71 87.6
Daily schedules 83 92.2 75 90.4
Weekly schedules 83 92.2 69 83.1
A total of 84 educators (93.3%) reported that they used individual support plans, and 90% of
educators indicated that other stakeholders were involved in the design of their individual
support plans. Daily and weekly schedules were reported to be used by 92.2% of educators
(n=83).
4.6.12 Assessment and monitoring of progress
An open-ended question was used to determine the strategies educators use for the
assessment and monitoring of progress of learners. The results were clustered into two main
groups, namely non-standardised and standardised assessments.
Table 4.46 Assessment and monitoring of progress (n=90*)
Variable Responded
Non-standardised assessments n %
Continuous, individualised assessment and monitoring 38 42.2
Observation checklists and behavioural schedules 20 22.2
Control lists in accordance with ISP and curriculum 45 50.0
Variable Responded
Standardised assessments n %
Formal school-based assessments with differentiated
assessment 9 10.0
159
Table 4.46 displays that the cluster of non-standardised assessments represented three
groups, namely control lists; continuous, individualised assessments; and observation
checklists and behavioural schedules.
A total of 45 educators (50.0%) replied that they develop control lists in accordance to
individual support plans and the curriculum. The cluster consisted of the following:
(i) Individualised assessment according to individual learning styles (n=17; 18.9%);
(ii) The use of concrete objects and materials (n=3; 3.3%);
(iii) Checklists for individual learners, developed from individual support plans and the
curriculum (n=31; 34.4%);
(iv) The head of department monitored individual control lists and individual support plans
(n=2; 2.2%); and
(v) Quarterly assessment of learners regarding specific aspects of the individual support plan
(n=2; 2.2%).
A total of 38 educators (42.2%) indicated that they used continuous, individualised
assessments, which included the following:
(i) Continuous assessment of daily work and monitoring at the end of the week (n=29;
32.2%);
(ii) Adjusted work sheets (n=5; 5.6.%);
(iii) Practical work with hand-over-hand contact (n=1; 1.1%);
(iv) Recording of daily progress and compilation of progress reports (n=6; 6.7%); and
(v) Case conference and team meeting discussions concerning learner progress in academic,
social, sport and cultural activities (n=2; 2.2%).
Twenty educators (22.2%) reported that they used observation checklists and behavioural
schedules to assess and monitor the progress of learners.
Only nine educators (10.0%) indicated that they used standardised, formal school-based
assessments, which included formal tests and examinations (n=3; 3.3%); continuous
assessment; and formal standardised assessments twice a year (n=6; 6.8%). Nevertheless,
the responses concerning the use of standardised assessments came mainly from full-service
schools.
160
4.6.13 Classroom arrangement to optimise the performance of learners
A multiple-choice question was used to determine the classroom arrangement in ASD classes.
4.47 Classroom arrangement to optimise the performance of learners (n=90*)
Variable n %
Learners sit round a table 57 63.7
Learners sit in stimulus-free workstations 53 58.9
Learners sit on a mat 51 56.7
Learners sit in an ordinary classroom structure with their
desks in rows 13 14.4
Combinations of above 11 12.2
Table 4.47 displays that educators mostly positioned learners around a table (n=57; 63.7%), in
stimulus-free workstations (n=53, 58.9%) and on a mat to optimise learning (n=51; 56.7%).
Thirteen educators (14.4%) reported to use ordinary classroom settings and 11 educators
(12.2%) indicated combinations of different arrangements.
4.6.14 Visual stimuli in the classroom environment
Table 4.48 displays the responses of educators when asked to describe the visual stimuli used
in the classroom. A total of 84 educators (93.3%) responded to this multiple-choice question.
Table 4.48 Visual stimuli in the classroom environment (n=84*)
Variable n %
Stimulus-rich (e.g. colourful pictures) 55 65.5
Stimulus-free 19 22.6
Displays only vital information, e.g. daily schedules 10 11.9
The results appeared to indicate that the majority of the 84 educators who responded (n=55;
65.5%) reported stimulus-rich classrooms. Nineteen educators (22.6%) responded the use of
stimulus-free classrooms, while 10 educators (11.9%) indicated that they displayed only vital
information, e.g. daily schedules.
161
4.6.15 Safety of learners during break time
An open-ended (word-based) question requested educators to indicate the strategies they
used to ensure the safety of learners during break times.
Table 4.49 Safety of learners during break time (n=90*)
Variable Structured: Non-Structured:Responded Responded
n % n %
Supervision 28 31.1 61 67.8
Environment 20 22.2 5 5.6
Table 4.49 displays the two clusters of responses, namely structured and non-structured
strategies concerning supervision and environmental adaptations.
A total of 28 educators (31.1%) indicated structured supervision as a strategy to ensure the
safety of learners during break times. The latter included the following:
(i) Constant, intensive supervision with a 1:3 adult-learner ratio (n=21; 23.3%);
(ii) A buddy system where school prefects took responsibility for learners (n=5; 5.6%);
(iii) Supervision at bathrooms (n=1; 1.1%);
(iv) Grouping of learners to ease efficient supervision (n=2; 2.2%);
(v) Structured games (n=3; 3.3%).
Twenty educators (22.2%) indicated that they used structured environmental adaptations,
which included quarterly checks and repairs of playground equipment, as well as secure,
fenced play areas with constant supervision.
Non-structured supervision included a schedule for break time duty, where educators
supervised learners in general (n=60; 66.7%) and where learners received training regarding
safety issues and restricted play areas (n=3; 3.3%). Five educators (5.6%) reported that they
used non-structured environmental adjustments, and strategies included the removal of
potentially harmful objects from the playground, e.g. electrical plugs, sharp sticks, etc. The
majority of educators (n=61; 67.8%) reported that they used non-structured supervision to
ensure the safety of learners during break time.
162
4.7 THE USE OF AUTISM-SPECIFIC SUPPORT STRATEGIES
This section deals with the fourth research objective, namely to determine the use of autism-
specific support strategies with reference to research-based programmes, diagnostic-specific
support strategies as well as assistive technology and alternative methods. This section
includes a discussion on the following aspects:
4.7.1 The utilisation of research-based programmes;
4.7.2 Educators’ rating of their skills level in diagnostic-specific impairments;
4.7.3 Educators’ rating of their skills level in diagnostic-specific impairments;
4.7.4 The use of assistive technology and alternative methods; and
4.7.5 The use of class assistants.
4.7.1 Utilisation of research-based programmes
Table 4.50 indicates the responses of educators concerning the frequency of use of research-
based programmes.
163
Table 4.50 Utilisation of research-based programmes (n=90*)
Response
rate Daily Weekly Monthly Never
Variable n n n n n% % % % %
Treatment and Education of
Autistic and related 58 48 3 3 4
Communication Handicapped (64.4) (82.7%) (5.2) (5.2) (6.9)
Children (TEACCH)
Children Picture Exchange 66 45 14 4 3
Communication System (PECS) (73.3) (68.2) (21.2) (6.1) (4.6)
Makaton Language Programme 54 37 9 0 8(60.0) (68.5) (16.7) (0) (14.8)
Tiny Handz (Sign Language) 47 34 4 1 8(52.2) (72.3) (8.5) (2.1) (17.0)
Developmental, Individual
Difference, Relationship-Based 64 33 10 5 16
Model (71.1) (51.6) (15.6) (7.8) (25.0)
Fishbowl (Autism South Africa 42 24 6 5 7
Training Programme) (46.7) (57.1) (14.3) (11.9) (16.7)
Social Stories™ 59 20 29 9 1(65.5) (33.9) (49.2) (15.3) (1.7)
Special Needs Adapted 39 16 7 6 10
Programme (SNAP) (43.3) (41.0) (17.9) (15.4) (25.6)
Applied Behaviour Analysis 34 15 5 5 9
(ABA) (37.8) (44.1) (14.7) (14.7) (26.5)
The percentages referred to in Table 4.50 were not calculated in terms of the 90 educators
who participated in the study, but in terms of the response rate for each individual variable.
These percentages indicated may therefore appear to be high, and must be interpreted with
care. Table 4.50 depicts the daily use of programmes as follows: TEACCH (n=48; 82.7%);
PECS (n=45; 68.2%); the Makaton Language Programme (n=37; 68.5%); Tiny Handz (n=34;
72.3%); DIR® / Floortime™ (n=33; 51.6%); Fishbowl (n=24; 57.1%); SNAP (n=16; 41.0%); and
ABA (n=15; 44.1%).
A total of 29 educators (49.2%) reported the weekly use of Social Stories™, while only 20
educators (33.9%) reported daily use. The results suggested that programmes were used
mostly on a daily basis, and that fewer educators reported weekly or monthly use. Educators
also reported that they never used the following programmes: DIR® / Floortime™ (n=16;
25.0%); SNAP (n=10; 25.6%); ABA (n=9; 26.5%); Makaton Language Programme (n=8;
14.8%); Tiny Handz (n=8; 17.0%); TEACCH (n=4; 6.9%); PECS (n=3; 4.6%); and Social
Stories™ (n=1; 1.7%).
164
Educators responded to an open-ended question to determine the four programmes they
found most beneficial in the management of learners with ASD.
Table 4.51 Most popular research-based programmes (n=90*)
Variable n %
Treatment and Education of Autistic and Related
Communication Handicapped Children (TEACCH) 41 45.6
Children Picture Exchange Communication System (PECS) 40 44.4
Makaton Language Programme 27 30.0
Social Stories™ 19 21.1
Tiny Handz 19 21.1
Fishbowl 18 20.0
Applied Behaviour Analyses (ABA) 9 10.0
Developmental, Individual Difference, Relationship-Based
Model (DIR® / Floortime™) 5 5.6
Special Needs Adapted Programme (SNAP) 3 3.3
Other strategies n %
Communication boards and cards 5 5.6
SIGN 2 2.2
Personal experience – do not use specific programmes 2 2.2
Board Maker 1 1.1
Eclectic approach 1 1.1
Table 4.51 suggested TEACCH (n=41; 45.6%) and PECS (n=40; 44.4%) to be the highest
rated research-based programmes. Some 30% of educators recommended the Makaton
Language Programme (n=27), 21.1% supported Social Stories™(n=19) and Tiny Handz
(n=19), while Fishbowl was supported by 20% of educators (n=18). The following programmes
were rated by fewer educators: Applied Behaviour Analysis (n=9; 10%); Developmental,
Individual Difference, Relationship-Based Model (n=5; 5.6%); and Special Needs Adapted
Programme (n=3; 3.3%). Educators also mentioned other programmes that they found
165
beneficial: Board Maker (n=1;1.1%); communication boards (n=5; 5.6%); SIGN (n=2; 2.2%); no
programmes but only personal experience (n=1; 2.2%); and an eclectic approach (n=1; 1.1%).
4.7.2 Educators’ rating of their skills level in diagnostic-specific impairments
When asked to rate their skills level concerning diagnostic-specific impairments, educators
replied well with a response rate beyond 90% on all aspects.
166
Table 4.52 Educators’ rating of their skills level in diagnostic-specific impairments (n=90)
AUTISM TRAITS Responses Uncertain Developing Confident
Variable n n n n% % % %
Sensory processing
Destructive behaviours 83 7 49 26(92.2) (8.3) (59.0) (31.3)
Preoccupation with smelling, tasting or feeling objects 84 4 47 31(93.3) (4.8) (55.9) (36.9)
Self-stimulatory behaviours 83 6 45 30(92.2 (7.2) (54.2) (36.1)
Defensiveness (overreaction to sensory stimuli, e.g. touch) 83 6 40 35(92.2) (7.2) (48.2) (42.2)
Passive learners who do not participate in activities 83 4 40 37(92.2) (4.8) (48.2) (44.6)
Planning, body and object use
Inability to relate parts of a task to the end product 81 3 46 31(90.0) (3.7) (56.8) (38.3)
Clumsiness in the use of tools 84 3 44 36(93.3) (3.57) (52.4) (42.9)
Clumsy learners with poor control of movements 84 6 35 42(93.3) (7.14) (41.7) (50.0)
Poor planning and organisation of tasks 82 3 32 45(91.1) (3.7) (39.0) (54.9)
Social interaction and communication
Decreased social sensitivity 82 8 38 35(91.1) (9.8) (46.3) (42.7)
167
AUTISM TRAITS Responses Uncertain Developing Confident
Variable n n n n% % % %
Limited language skills 84 5 36 41(93.3) (5.9) (42.9) (48.8)
Inappropriate eye contact 83 2 31 47(92.2) (2.4) (37.4) (56.6)
Poor social interaction with friends and adults 84 6 29 46(93.3) (7.1) (34.5) (54.8)
Rigidity
Decreased adjustment to change in class routines 84 4 35 44(93.3) (4.8) (41.7) (52.4)
Preoccupation with certain toys, characters, etc 84 8 34 41(93.3) (9.5) (40.5) (48.8)
Emotion and behaviour
Inappropriate fear and anxiety 81 5 42 33(90.0) (6.2) (51.9) (40.7)
Challenging behaviour, including tantrums, aggression, severe crying 84 5 41 38(93.3) (5.9) (48.8) (45.2)
Withdrawal from classroom activities 83 8 31 43(92.2) (9.6) (37.4) (51.8)
Activity level and focus
Hyperfocus on tasks with difficulty to move to the next task 83 3 45 34(92.2) (3.6) (54.2) (41.0)
Hyperactivity where the learner moves excessively 83 6 39 37(92.2) (7.2) (47.0) (44.6)
168
Table 4.52 indicates that educators (n=40-49; 48.2-59.0%) rated their skills regarding sensory
processing aspects as still developing. Between 31-44.6% of educators (n=26-37) indicated
that they were confident concerning their skills in sensory processing. In addition to the
information in Table 4.52, 17 educators indicated uncertainty regarding their skills in the
management of sensory processing difficulties (two educators from autism-specific schools, 15
educators from special schools and no responses from full-service schools). Fifteen of these
educators reported that they had an occupational therapist at their school (two educators from
autism-specific schools and 13 educators from special schools) who could assist with skills
development concerning sensory processing.
The results regarding planning, body and object use indicated that educators rated themselves
skilled regarding assisting learners with planning and structuring tasks (n=42; 50%) as well as
to assist clumsy learners with poor body control (n=45; 54.9%). However, educators also
responded that they required skills regarding the assistance of learners who are clumsy in the
use of objects (n=46; 56.8%) and those who struggle with relating parts of a task to the end
product (n=44; 52.4%).
Educators (48%-56%) appeared confident in handling social interaction and communication
difficulties. However, 46.3% of educators indicated that they require more skills in handling the
social sensitivity of learners. Between 48-52 % of educators reported that they handled the
rigidity of learners with ASD with confidence. Nevertheless, just over 40% indicated that they
require more training in this regard.
Inappropriate fear and anxiety (n=33; 40.7%), challenging behaviour (n=41; 48.8%), and
withdrawal from classroom activities (n=31; 37.4%) were indicated as emotional and
behavioural aspects in which educators required development. Nevertheless, educators also
reported that they were confident in handling the following: inappropriate fear and anxiety
(n=42; 51.9%); challenging behaviour (n=38; 45.2%); and withdrawal from classroom activities
(n=43; 51.8%).
Some 47-54.2% of educators reported that their skills regarding managing activity level and
focus were still developing, while 41.0% to 44.6% indicated that they were confident in this
regard.
169
4.7.3 Use of assistive technology and alternative methods
Educators rated the frequency of use (daily, weekly, monthly or never) of assistive devices and alternative methods in a multiple-choice question.
Table 4.53 Use of assistive technology and alternative methods
Variable Totalresponses Daily Weekly Monthly Never
n % n % n % n % n %
Visual structure
Velcro worksheets 69 76.7 39 56.0 12 17.4 5 7.3 13 18.8
Velcro sequence cards to indicate steps in activities 73 81.1 50 68.5 6 8.2 6 8.2 11 15.1
Visual schedules in files 70 77.8 46 65.7 13 18.6 2 2.9 9 12.9
Visual schedules displayed against the wall 74 82.2 65 87.8 8 10.8 1 1.4 0 0
Line drawings, pictures and photos 78 86.7 51 65.4 17 21.8 8 10.3 2 2.6
Data projector 59 65.6 3 5.1 12 20.3 0 0 44 74.6
Interactive whiteboard 66 73.3 10 15.2 14 21.2 3 4.6 39 59.1
170
Technology and physical structure
Computer workstations 70 77.8 15 21.4 29 41.4 7 10.0 19 27.1
Chairs to restrain learners with heightened activity levels 63 70.0 7 11.1 12 19.1 3 4.8 41 65.1
Sensory strategies
Weighted vests 63 70.0 6 9.5 9 14.3 4 6.4 44 69.8
Sensory room 66 73.3 16 24.2 17 25.8 7 10.6 26 39.4
Trampolines in class 80 88.9 24 34.3 18 25.7 4 5.7 24 34.3
Time-out tent 62 68.9 19 30.7 8 12.9 6 9.7 29 46.8
“Chew toys” for learners who need oral stimulation 64 71.1 18 28.1 7 10.9 4 6.3 35 54.7
Communication
Picture files 74 82.2 40 54.1 22 29.7 2 2.7 10 13.5
Communication boards 70 77.8 44 62.9 14 20.0 1 1.4 11 15.7
Safety
Protective clothing for learners with self injurious behaviour 57 63.3 2 3.5 2 3.5 1 1.8 52 91.2
Other
Other 4 4.4 2 50.0 0 0 0 0 2 50.0
171
The percentages referred to in Table 4.53 were not calculated in terms of the 90 educators
who participated in the study, but in terms of the response rate for each individual variable.
These percentages indicated may therefore appear to be high, and must be interpreted with
care. Table 4.53 displays that educators reported that they mostly used Velcro sequence cards
(n=50; 68.5%); Velcro worksheets (n=39; 56.0%); visual schedules in files (n=46; 65.7%);
visual schedules displayed against the wall (n=65; 87.8%); and line drawings, pictures and
photos (n=51; 65.4%) on a daily and weekly basis to assist learners with visual structure.
However, educators (n=11-13; 15.1-18.8%) indicated that they never used Velcro in their
classrooms. The majority of educators reported that they never used interactive whiteboards
(n=39; 59.1%) and data projectors (n=44; 74.6%).
A total of 44% of educators (n=29) responded that they used computer workstations, at least
on a weekly basis, and 65% of educators who responded (n=41) indicated that they never
used restrain chairs. Nevertheless, restrain chairs seemed to be used by some educators on a
daily- (n=7; 11.1%) or weekly basis (n=12; 19.1%) to assist with the management of
hyperactive learners.
When asked about the use of sensory strategies, 69.8% of educators (n=44) reported that they
never used weighted vests, and 24 educators (34.3%) reported that they never used
trampolines. However, there were educators who indicated the use of trampolines on either a
daily (n=24; 34.3%), weekly-(n=18; 25.7%) or monthly basis (n=4; 5.7%). A total of 35-59% of
educators indicated that they never used sensory rooms (n=26; 39.4%), time-out-tents (n=29;
46.6%) and “chew toys” (n=35; 54.7%).
Educators reported the use of picture files (n=40; 54.1%) and communication boards (n=44;
62.9%) on a daily basis to enhance communication in learners with ASD. Some 52 of 57
educators (91.2%) responded that they never used protective clothing to ensure the safety of
learners with self-injurious behaviour.
172
Table 4.54 Most popular assistive technology and assistive devices (n=90*)
Variable n %
Visual schedules in files 54 60.0
Velcro worksheets 26 28.9
Trampolines in class 22 24.4
Sensory room 18 20.0
Communication boards 16 17.8
Picture files 15 16.7
Velcro sequence cards to indicate steps in activities 14 15.6
Time-out tent 14 15.6
Computer workstations and iPads 13 14.4
Line drawings, pictures and photos 8 8.9
Interactive whiteboard 5 5.6
Weighted vests 5 5.6
Visual schedules displayed against the wall 2 2.2
Chairs to restrain learners with heightened activity levels 2 2.2
“Chew toys” for learners who need oral stimulation 2 2.2
Data projector 1 1.1
Protective clothing for learners with self injurious behaviour 0 0
Other n %
Workstations 5 5.6
Whiteboards and notice boards with pictures and drawings 4 4.4
Adjusted worksheets 1 1.1
Structure and individualised guidance 1 1.1
173
Table 4.54 displays the results of educators when asked in an open-ended question to indicate
which of the previously mentioned assistive technologies and assistive devices they perceived
as most beneficial. Visual schedules (n=54; 60.0%) had the highest response rate, while
protective clothing (n=0, 0%) did not appear to be a popular strategy. Velcro worksheets
(n=26; 28.9%), trampolines in class (n=22, 24.4%) and sensory rooms (n=18, 20%) were
supported by more than 20% of educators.
4.7.4 Useful class strategies
Table 4.55 summarises the responses of educators when asked to name other useful
strategies that they used in class. The question had a low response rate (<20%).
Table 4.55 Useful class strategies (n=90*)
Variable Responded
n %
Play (structured and unstructured) 17 19.0
Individual structure and support 13 14.4
Discipline and behaviour 12 13.3
Music and singing 11 12.2
Socio-communication 7 7.8
Visual structure and construction 7 7.8
Sensory-motor activities and support 7 7.8
Flop-proof activities 6 6.7
Visual over verbal 3 3.3
The responses were clustered into nine groups. Structured and unstructured play (n=17, 19%);
individualised structure and support (n=13, 14.4%); discipline and behavioural strategies
(n=12, 13.3%); as well as music and singing (n=11, 12.2%) were recommended as useful
strategies by more than 12% of the educators who responded.
174
4.7.5 Use of caregivers in class
The researcher used a dichotomous (yes/no) to question to educators on whether their school
allowed learners to bring their own caregivers to class.
Table 4.56 Use of care givers in class (n=77)
Variable n %
Not allowed 51 66.2
Allowed 26 33.8
Table 4.56 displays that 26 educators (33.8%) indicated that caregivers were allowed in
classes. The majority of educators (n=51, 66.2%) indicated that the school did not allow
learners to bring their own caregivers to school.
4.8 CHALLENGES AND CRITICAL SUCCESS FACTORS
This section deals with the fifth research objective, namely to determine the aspects educators
regard as challenges, and critical success factors in managing learners with ASD in public
schools. This section displays the results on the following aspects:
4.8.1 Reasons for working with ASD;
4.8.2 Educators’ rating of potential challenges;
4.8.3 Educators’ experiences of accomplishment; and
4.8.4 Opinions on critical success factors.
4.8.1 Reasons for deciding to work with learners with ASD
A total of 90 educators (100%) responded to an open-ended question concerning their
decision to work with learners with ASD.
175
Table 4.57 Reasons for deciding to work with learners with ASD (n=90*)
Variable Responded
n %
Attitude, personal attributes and choice 47 52.2
Personal and professional development 25 27.8
Operational requirements 17 18.9
Awareness of and exposure to disability and special needs 11 12.2
Independence, quality of life and community integration 7 7.8
Table 4.57 displays the five clusters of responses concerning the reasons of educators for
deciding to work with learners with ASD.
The first cluster on attitude, personal attributes and choice summarised the responses of 47
educators (52.2%). The cluster consisted of the following:
(i) Interested in working with learners with special needs (n=26; 28.9%);
(ii) Passionate about learners with ASD and prefer to work with them (n=20; 22.2%);
(iii) Personal qualities, e.g. patience, flexibility, creativity, etc., to efficiently manage learners
with ASD (n=5; 5.6%); and
(iv) Previous experience with learners with high level support needs (n=6; 6.7%).
The second cluster referred to personal and professional development; 25 educators (27.8%)
supported this cluster, which consisted of the following responses:
(i) Enjoyed the daily challenge of managing the diverse behaviours and deficits of learners
with ASD (n=17; 18.9%);
(ii) Learners with ASD had unique characteristics which provided diversity in the job (n=9;
10%);
(iii) Teaching an ASD class provided opportunities to practically implement specialised
qualifications (n=3; 3.3%);
(iv) Working with learners with ASD stimulated professional development and personal
improvement (n=5; 5.6%);
(v) Challenged reasoning skills and perspectives about education and life in general (n=1;
1.1%); and
(vi) The progress of learners provided job satisfaction (n=1; 1.1%).
176
The third cluster dealt with operational requirements, which motivated educators to work with
learners with ASD. Seventeen educators (18.9%) supported this cluster, which consisted of the
following responses:
(i) The school accommodated learners with a variety of diagnostic profiles (n=3; 3.3%);
(ii) There is a great demand for autism-specific education (n=15; 16.7%); and
(iii) It was requested by the school to attend training and to start a class (n=3; 3.3%).
The fourth cluster summarised responses, which dealt with the awareness of and exposure to
disability and special needs. Eleven educators (12.2%) supported this cluster, consisting of the
following responses:
(i) Personal experience in raising a child with ASD (n=3; 3.3%);
(ii) Personal experiences with disability, which increased compassion for the needs of
learners with high level support needs (n=2; 2.2%);
(iii) Creation of awareness and an understanding of ASD (n=1; 1.1%);
(iv) Tutored learners with ASD, which provided confidence for teaching (n=4; 4.4%); and
(v) Worked abroad and the experienced gained equipped them for autism-specific education
(n=3; 3.4%).
The fifth cluster included the responses of seven educators (7.8%) who indicated that the
improved independence, quality of life and community integration of learners with ASD inspired
them. This cluster consisted of the following responses:
(i) To make a difference and positive impact in the lives of learners with ASD (n=4; 4.4%);
(ii) To not only stimulate academic skills but to improve life skills, independence and
community integration (n=1; 1.1%); and
(iii) Learners with ASD needed to be connected with their physical- and social contexts (n=3;
3.3%).
The results suggested that educators perceived attitudes, personal choice as well as the
personal and professional development they gain as the most important reasons for deciding
to work in ASD education.
177
4.8.2 Educators’ rating of potential challenge
When asked to rate potential challenges they experienced, educators responded with a response rate of over 85%.
Table 4.58 Educators’ rating of potential challenges
Responses Severe Moderate Minor
Variable n % n % n % n %
Traits and behaviours related to the condition
The severity and complexity of autism symptoms 79 87.8 38 48.1 32 40.5 9 11.4
Slow progress of learners 83 92.2 34 41.0 30 36.1 19 22.9
Training and specialised skills
Limited training in autism-specific education 82 91.1 44 53.7 27 32.9 11 13.4
Limited skills in designing individual support plans 80 88.9 25 31.3 33 41.3 22 27.5
Limited skills in handling challenging behaviours in class 82 91.1 27 32.9 34 41.3 21 25.6
Operational challenges and resources
Inappropriate curriculums 82 91.1 44 53.7 18 22.0 20 24.4
Limited access to research-based programmes 79 87.8 39 49.4 30 38.0 10 12.7
Too many learners in a class 79 31 41.8 17 21.5 29 36.7
Limited access to resources e.g. Velcro, paper, etc. 80 88.9 17 21.3 18 22.5 45 56.3
Integrated teams
Limited chance to work with a multi-professional team 80 23 28.8 27 33.8 30 37.55
178
Responses Severe Moderate Minor
Variable n % n % n % n %
Limited support from therapists and professionals 81 25 30.9 20 24.7 36 44.4
Inefficient discussion of cases 81 90.0 20 24.7 23 28.4 38 47.0
Limited insight and cooperation from parents 81 88.9 28 34.6 38 46.9 15 18.53
Support from management
Limited support from school management teams 80 88.9 12 15.0 28 35.0 40 50.0
Limited support from the Department of Education 81 90.0 39 48.2 23 28.4 19 23.4
Limited opportunity for debriefing 79 87.8 26 32.9 19 24.1 34 43.0
179
Table 4.58 displays the responses of educators when asked to rate the severity of potential
challenges they experience. The results suggested that educators rated limited training in
autism-specific education (n=44; 53.7%); inappropriate curriculums (n=44; 53.7%); limited
access to research-based programmes (n=39; 49.4%); limited support from the Department of
Education (n=39; 48.2%); and the complexity of autism symptoms (n=38; 48.1%) as the most
severe challenges. The slow progress of learners (n=34; 41.0%), too many learners in a class
(n=31, 41.8%) and limited support from therapists (n=25, 30.9%) were also reported to be
severe challenges. However, 18 educators (22.2%) replied that access to multi-professional
teams were not a challenge at their school.
Educators rated traits and behaviours related to the condition; training and specialised skills;
limited access to integrated teams, including therapists and parents; and limited support by
school management teams as moderate challenges. Nevertheless, 20 educators (25.0%) rated
support by school management teams as no challenge.
Educators (n=21; 26.3%) rated limited access to resources not being a significant challenge.
All of these educators worked at autism-specific and special schools. Other minor challenges
included the following: limited access to resources (n=24; 30.0%); limited access to
consumable resources (n=24; 30.0%); inefficient case discussion (n=22; 27.2%); and limited
opportunity for debriefing (n=23; 29.1%).
When reviewing the clusters of challenges, it appeared that traits and behaviours related to the
condition, training and specialised skills, some operational aspects and limited support from
district-based management were the most severe challenges.
180
Table 4.59 Severe challenges – breakdown of responses in different schools
Variable Autism-specific Special Full-serviceschools schools schools Total
n % n % n % n
Traits and behaviours related to the condition
The severity and complexity of autism symptoms 10 47.6 27 52.9 1 16.7 38
Slow progress of learners 12 54.6 21 38.9 1 16.7 34
Training and specialised skills
Limited training in autism-specific education 9 40.9 34 64.2 1 16.7 44
Limited skills to design individual support plans 6 27.3 19 37.3 0 0 25
Limited skills to handle challenging behaviours in class 7 31.8 20 37.7 0 0 27
Operational challenges and resources
Inappropriate curriculums 13 59.1 30 50.6 1 16.7 44
Limited access to research-based programmes 12 54.6 26 51.0 1 20 39
Too many learners in a class 8 40.0 25 48.0 0 0 33
Limited access to resources, e.g. Velcro, paper, etc. 6 28.6 11 21.2 0 0 17
Integrated teams
Limited chance to work with a multi-professional team 6 28.6 16 30.8 1 16.7 23
Limited support from therapists and other professionals 5 23.8 19 35.9 1 16.7 25
Inefficient discussion of cases 4 19.1 16 30.2 0 0 20
Limited insight and cooperation from parents 8 38.1 18 34.0 2 33.3 28
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Variable Autism-specific Special Full-serviceschools schools schools Total
n % n % n % n
Support from management
Limited support from school management teams 4 18.2 8 15.7 0 0 12
Limited support from the Department of Education 12 15.2 24 45.3 3 50.0 39
Limited opportunity for debriefing 6 27.3 20 40.0 0 0 26
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Table 4.59 provides a breakdown of what educators in different schools perceived as severe
challenges. Thus the second column of Table 4.58 was further analysed in order to reflect
challenges in different schools. The percentages referred to in Table 4.59 were not calculated
in terms of the 90 educators who participated in the study, but in terms of the response rate for
each individual variable. These percentages indicated may therefore appear to be high, and
must be interpreted with care.
Educators from autism-specific schools indicated the following as their most severe
challenges:
(i) The traits and behaviours related to the condition (n=10-12; 47.6-54.6%);
(ii) Limited training and specialised skills (n=7-9; 31.8%-40.9%); and
(iii) Limited support from the Department of Education (n=12; 15.2%).
Fewer educators from autism-specific schools indicated access to integrated teams (n=6-8;
28.6%-38.1%) as a severe challenge. The responses concerning operational challenges and
resources were as follows: inappropriate curriculums (n=13; 59.1%); limited access to
research-based programmes (n=12; 54.6% ); too many learners in a class (n=8; 40.0%); and
limited access to resources (n=6; 28.6%).
Educators from special schools indicated the following as their most severe challenges:
(i) The traits and behaviours related to the condition (n=21-27; 38.9%-52.9%);
(ii) Limited training and specialised skills (n=19-34; 37.3-64.2%); and
(iii) Access to integrated teams (n=16-18; 30.2-34.0%).
The responses concerning operational challenges and resources were as follows:
inappropriate curriculums (n=30; 50.6%); limited access to the curriculum (n=26; 51.0%); too
many learners in a class (n=25; 48.0%); and limited access to resources (n=11; 21.2%). Some
24 educators (45.3%) reported limited support from the Department of Education and limited
opportunity for debriefing (n=20; 40.0%) as severe challenges concerning support from
management.
Educators from full-service schools reported limited insight from parents (n=2; 33.3%) and poor
support from the Department of Education (n=3; 50.0%) as severe challenges. The following
aspects were also rated as severe challenges:
(i) Traits and behaviours related to the condition (n=1; 16.7%);
(ii) Limited training in autism-specific education (n=1; 16.7%);
(iii) Limited access to research-based programmes (n=1; 16.7%);
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(iv) Limited chance to work in a multi-professional team (n=1; 16.7%); and
(v) Limited support from therapists and other professionals (n=1; 16.7%).
4.8.3 Educator experiences of accomplishment
A total of 86 educators (96%) responded to a dichotomous (yes/no) question enquiring
whether they experienced accomplishment when working with learners with ASD, to which 82
educators (95.4%) indicated positive experiences while three educators (3.5%) indicated
negative experiences. One educator (1.2%) indicated a mixed experience.
Table 4.60 Educator experiences of accomplishment (n=82*)
Variable Responded
n %
Learner progress – sense of achievement 43 52.4
Positive impact on the lives of learners and carers 30 36.6
Unique manifestation of ASD – element of surprise 20 24.4
Passion, purpose and calling 8 9.8
Member in a team of experts 8 9.8
Professional and personal development 5 6.1
Support and acknowledgement from senior management team 4 4.9
Burnout and frustration – resources and burden of care 2 2.4
A total of 82 educators responded when asked in an open-ended question to motivate their
responses regarding their experiences of accomplishment. Table 4.60 displays the eight
clusters of responses.
A total of 43 educators (52.4%) responded to the first cluster, which indicated that the progress
of learners provided a sense of achievement. This cluster consisted of the following responses:
(i) The progress of learners (both academically and developmentally) provided a sense of
achievement and success (n=36; 43.9%);
(ii) Learners often surprised with unexpected achievements in spite of severe impairments
(n=4; 4.9%);
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(iii) Efficient teamwork and integrated planning provided a feeling of success (n=3; 3.7%);
and
(iv) It was rewarding to make social contact with a learner (n=5; 6.1%).
The second cluster summarised the responses of 30 educators (36.6%), where
accomplishment was experienced when the positive impact of autism-specific education was
noted in the lives of learners and their caregivers. This cluster included the following
responses:
(i) Knowing that the progress of the child also benefited all those living and working with the
child (n=1; 1.2%);
(ii) The positive attitudes and feedback of parents regarding their child’s progress served as
motivation (n=2; 2.4%);
(iii) Making a difference in the current and future situation of learners with ASD provided
purpose in the work place (n=11; 13.4%);
(iv) Although progress was often slow, small improvements made a significant impact in the
lives of learners and their families (n=18; 21.9%); and
(v) It was rewarding to reassure parents that their child was in a school where they could
improve their functional independence and optimise their potential (n=1; 1.2%).
The third cluster dealt with the unique manifestation of ASD in different individuals, which
created an element of surprise. This cluster included the following responses:
(i) The uniqueness of learners with ASD was inspiring (n=11; 13.4%);
(ii) It was rewarding when the child responded positively to individualised support strategies
(n=8; 13.5%); and
(iii) The excitement of consistently exploring the possibilities on a daily basis (n=4; 4.9%).
The fourth cluster included the responses of eight educators (9.8%) who indicated that working
with ASD provided experiences of accomplishment since it was their passion, calling and
purpose.
The fifth cluster included eight educators (9.8%) who responded that they experienced
accomplishment in working with ASD when they worked as members in a team of experts. The
responses in this cluster included the following:
(i) Training and team support created a sense of belonging to a greater group of specialists
(n=5; 6.1%); and
(ii) Efficient teamwork and integrated planning contributed to a sense of accomplishment
(n=3; 3.7%).
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The sixth cluster dealt with the responses of five educators (6.1%) who indicated that they
experienced a feeling of accomplishment since they developed professionally and personally
by learning new skills and aspects about ASD on a daily basis.
Four educators (4.9%) responded in the seventh cluster, which indicated that the support and
acknowledgement from senior management provided them with experiences of
accomplishment. This cluster consisted of the following responses:
(i) Senior management acknowledged the need for autism-specific education and recruited
staff to run these classes (n=1; 1.2%); and
(ii) Support and recognition from the school management team provided encouragement
(n=3; 3.7%).
The eighth cluster included the responses of two educators (2.4%) who indicated burnout and
frustration as a result of the diversity and high level of support required by each learner (n=1;
1.2%), and limited resources, such as class equipment, human resources, training, etc., which
added additional stress (n=1; 1.2%).
4.8.4 Opinions on critical success factors
Table 4.61 provides a summary on what educators perceived as critical success factors for
autism-specific education.
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Table 4.61 Opinions on critical success factors (n=90*)
Variable Responded
n %
Personal attributes of educator 24 26.7
Attitude, expectations and commitment from educator 22 24.4
Knowledge, skills and practical experience 21 23.3
Insight, integration and reasoning of educator 17 18.9
Autism-specific curriculum and teaching framework 15 16.7
Diagnostic-specific support within an all encompassing
programme 13 14.4
Adequate resources 13 14.4
Individual support plan and tailor-made education 9 10.0
Cooperation of all stakeholders 8 8.9
Discipline, routine, structure and consistency 8 8.9
Parent involvement and transfers of skills to the home
environment 7 7.8
Inclusive education and diversity management 7 7.8
Small classes (educator-learner ratio of 1:6) 6 6.7
Specialised training and support 6 6.7
Support from school- and district-based management team 5 5.6
Sense of humour and a relaxed class atmosphere 2 2.2
Integrated, multi-professional approach 1 1.1
Medication 1 1.1
The researcher divided the responses into eighteen clusters. The first cluster included the
responses of 24 educators (n=24; 26.7%) which dealt with the personal attributes of educators
as critical success factors in autism-specific education. The responses included personal
attributes of the educator, e.g. patience, flexibility, creativity, empathy, etc. (n=23; 25.6%); and
that the educator must accept learners unconditionally (n=1; 1.1%).
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The second cluster dealt the attitude, expectations and commitment from educators as critical
success factors of autism-specific education. Some 22 educators (24.4%) supported the
cluster, which consisted of the following:
(i) Positive attitude and commitment from the educator (n=18; 20%);
(ii) Educators needed to embrace diversity and appreciate the uniqueness in which the
condition manifested in each child (n=2; 2.2%); and
(iii) To have high expectations regarding progress (n=3; 3.3%).
The third cluster summarised the responses of 21 educators (23.3%) regarding the knowledge,
skills and practical experience of educators as critical success factors in autism-specific
education. This cluster consisted of the following responses:
(i) The knowledge, skills and practical experience regarding the use of different support
strategies for different learners (n=19; 21.1%); and
(ii) Educators needed to be knowledgeable and skilled in the use of different programmes
and other classroom challenges (n=6; 6.7%).
The fourth cluster dealt with the insight, integration and reasoning skills of educators as critical
success factors in autism-specific education. Seventeen educators (18.9%) supported the
cluster, which consisted of the following responses:
(i) Understanding the individualised needs of each learner by obtaining background
information, identifying barriers to learning, strengths, current intervention, etc. (n=13;
14.4%); and
(ii) To place yourself in the learner's shoes and try to teach in a way and at a pace they can
manage (n=2; 2.2%).
The fifth cluster summarised the responses of 15 educators (n=15; 16.7%) who referred to the
necessity of an autism-specific curriculum and teaching framework. This cluster consisted of
the following responses:
(i) Autism-specific classes, since the needs of learners with autism were unique (n=1;
1.1%);
(ii) Integrated programmes that focused on skills that promote independence and social
integration (n=12; 13.3%); and
(iii) To have a programme that gives structure and routine, but also has variety to challenge
learners (n=3; 3.3%).
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The sixth cluster dealt with diagnostic support within an all-encompassing programme, and
thirteen educators (14.4%) supported this cluster, which included the following responses:
(i) Opportunities for social interaction with peers (n=5; 5.6%);
(ii) Focus on the improvement of functional skills, e.g. toilet training, communication and
language development (n=6; 6.7%);
(iii) Behavioural analysis and strategies to reinforce constructive behaviours (n=2; 2.2%);
(iv) Visual structure: schedules, pictures, photos, drawings, picture books, etc. (n=2; 2.2%);
(v) Improvement of socio-emotional skills in a safe environment (n=2; 2.2%) and sensory
strategies to ensure optimal arousal (n=1; 1.1%).
The seventh cluster outlined the responses of 13 educators (n=13; 14.4%) who supported
adequate resources such as human resources, equipment, programmes, etc. as a critical
success factor in providing autism-specific education. This cluster consisted of the following
responses:
(i) Access to researched support strategies (n=6; 6.7%);
(ii) Resourced with computers and skilled to use the programmes efficiently (n=4; 4.4%);
(iii) Resourcing of classes with autism-specific programmes and equipment (n=5; 5.6%); and
(iv) Provision of music resources (n=1; 1.1%).
The eighth cluster dealt with the importance of individual support plan and tailor-made
education strategies as a critical success factor in autism-specific education. Nine educators
(10%) supported this cluster that consisted of the following responses
(i) Integrated support plan that focuses on individualised needs and developmental goals
(n=7; 7.8%);
(ii) Understanding that there was no standard approach or quick fix, and that creativity was
required to individualise support strategies (n=1; 1.1%); and
(iii) Constantly adjusting strategies in search for the most efficient support strategy for each
learner (n=1; 1.1%).
The ninth cluster dealt with views that all stakeholders involved with autism-specific education
needed to cooperate, and eight educators (8.9%) supported this view. The tenth cluster
indicated discipline, routine, structure and consistency as critical to the success of autism-
specific education, and eight educators (8.9%) supported this view.
The eleventh cluster included active parent involvement and transfer of skills to the home
environment. Seven educators (7.8%) supported this cluster. The twelfth cluster dealt the
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importance of inclusive education and diversity management as critical in autism-specific
education. Seven educators (7.8%) supported this cluster, which consisted of the following:
(i) The educator needed to embrace diversity and appreciate the uniqueness with which the
condition manifested in each child (n=2; 2.2%); and
(ii) An inclusive approach where learners also got exposure to typically developing learners
(n=5; 5.6%).
The thirteenth cluster summarised the responses of six educators (6.7%), who indicated that
small classes with an educator-learner ratio of 1:6 was a critical success factor of autism-
specific education. The responses included the following:
(i) Smaller groups of children (one educator to six learners) in order to address
individualised needs (n=4; 4.4%);
(ii) Class assistants to help with individual learners (n=2; 2.2%).
Six educators (6.7%) supported the fourteenth cluster concerning specialised training and
support as critical success factor for autism-specific education. This cluster consisted of the
following responses:
(i) Educators needed to be empowered with assessment tools and strategies to monitor
progress efficiently (n=2; 2.2%);
(ii) Specialised training was essential, but not always accessible in the South African
context;
(iii) Educators needed to use electronic media to review global trends (n=4; 4.4%).
The fifteenth cluster included views that support and involvement from school- and district-
based management were vital in having successful autism-specific education. Five educators
(5.6%) supported this cluster which consisted of the following responses:
(i) Support from Inclusive Education regarding curriculum adaptation and implementation
(n=2; 2.2%); and
(ii) Support and insight from the senior management team and other educators regarding
the challenges of autism-specific education (n=4; 4.4%).
Two educators (2.2%) contributed to the sixteenth cluster, which included a sense of humour
and a relaxed class atmosphere as critical to the success of autism-specific education. The
seventeenth cluster dealt with an integrated, multiple professional approaches as a critical
success factor for autism-specific education. Only one educator supported this cluster. Lastly,
one educator (1.1%) responded that learners with ASD required medication to have success in
autism-specific education.
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The majority of educators appeared to view the personal attributes, attitude, expectations and
commitment from educator as well as knowledge, skills and practical experience as critical to
the success of autism-specific education.
4.9 SUMMARY
Chapter 4 presented the results in terms of the five research objectives as described in the
rationale of the research questionnaire. Given the quantitative approach and the descriptive
study design of the study, the researcher presented the results through brief discussions, a
graph and primarily tables. Chapter 5 will include the interpretation and comparison of results
with relevant literature.
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CHAPTER 5
DISCUSSION
_____________________________________________________________________
5.1. INTRODUCTION
Chapter 4 presented the research results of the data collected using graphs, tables and short
discussions. Chapter 5 focuses on the interpretation and discussion of the study results.
Results are discussed and compared with relevant literature in order to make appropriate
conclusions concerning the practices and challenges of autism-specific education in South
African public schools. In keeping with the structure in Chapter 4, the research objectives were
used as a guide for the discussion of the results. The conclusions follow at the end of each
section, and integrated discussions, practices and challenges are not presented separately.
The results are presented in the following sequence:
5.2 Description of the study population;
5.3 The level of training and experience of educators;
5.4 School-based operations;
5.5 Classroom management practices;
5.6 The use of autism-specific support strategies;
5.7 The aspects educators regarded as challenges and critical success factors in
managing learners with ASD in public schools; and
5.8 A summary.
The following section provides a detailed description of the population that participated in the
study.
5.2. DESCRIPTION OF THE STUDY POPULATION
The researcher did not include the personal attributes of educators (age, race, qualification,
etc.) in the design of inclusion criteria. However, limited demographical aspects concerning
ASD educators within South African public schools are discussed to provide insight in
contextual factors. This section deals with the following:
5.2.1 Age of educators;
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5.2.2 Gender of educators;
5.2.3 Response rates, provinces and type of schools in which educators were working; and
5.2.4 Conclusions on practices and challenges: study population.
5.2.1. Age of educators
Table 4.2 suggests that the majority of educators that participated in the study were between
the ages of 40-60 years and Table 4.3 indicates the middle age quartile as 38-53 years/. The
median age of 46 years for educators teaching learners with ASD was slightly higher than the
median age of 41 years for other South African educators (Burger & Van den Berg 2010:17).
Although there appeared to be a trend for a decrease in the average age of South African
educators, due to more favourable earnings at the beginning of their careers (cf. 2.3.5.2) this
did not seem to be the case for educators of ASD classes at present. Personal factors,
professional skills and opportunities for self-development (cf. Table 4.57) appeared to have
guided the career choices of educators in ASD classes and that financial benefits (Burger &
Van den Berg 2010:17) were possibly not the deciding factor for teaching in autism-specific
education (cf. 5.7.1).
5.2.2. Gender of educators
A total of 85 of the 89 educators who responded (95.5%) reported to be female. Hence, the
majority of educators who participated in the study reported to be female (cf. Table 4.4). These
findings compare with the results of Nigerian (Adeniyi et al. 2009:online), Norwegian (Skaalvik
& Skaalvik 2009:1068-1069) and Iranian (Ahmadi et al. 2013:20-27) studies, who found that it
is mostly female educators who teach in autism-specific education. The percentage of females
(95.5%) educating learners with ASD was 24.5% higher than the 71% of female educators
employed in mainstream South African schools (cf. 2.3.5.2).
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5.2.3. Provinces and type of schools in which educators were working
The majority of educators who participated (cf. Figure 4.1) were from the Free State, KwaZulu-
Natal and the Eastern Cape. Although there appeared to be less autism-specific services
offered in the Northern Cape, Northwest and Limpopo, these provinces had response rates
beyond 75%. No school from Mpumalanga fitted the selection criteria and no educators from
this province participated (cf. 3.4.3). Gauteng and the Western Cape appeared to be the best
resourced in terms of special schools (cf. Addendum A, Table 2.4) and four of the five autism-
specific schools nationally are located within these regions. Currently, these autism-specific
schools appeared to be in a transitional phase of becoming resource centres and seemed to
play a key role in the development of educators who started ASD services at their school (cf.
2.4.3.1). Although, the majority of educators employed at autism-specific schools were from
the Western Cape and Gauteng, the response rates (Addendum A, Figure 4.1) from these
schools were lower than expected. School principals indicated that staff members were under
pressure due to high operational demands (cf. 4.2). Some 19 educators from autism-specific
schools participated, from the following provinces: Eastern Cape (n=10), Gauteng (n=8) and
Western Cape (n=1).
The philosophy and financial models of White Paper 6 (cf. 2.4.3.1) do not seem to be
supportive of building new special schools (including autism-specific schools). However, the
Screening, Identification, Assessment and Support (SIAS) guidelines (cf. 2.4.5.2) recognise
that learners with intensive support needs would continue to be accommodated in special
schools (cf. 2.3.4). The majority of learners currently in ASD education presented with
moderate (n=52) and severe (n=52) ASD and required high-level support (cf. Table 4.37). A
total of 64 (71.0%) educators who participated were from special schools and provinces
without autism-specific schools (Free State, Northwest, Northern Cape and KwaZulu-Natal).
Schools in these provinces mainly accommodate learners in ASD classes at existing special
schools (cf. Table 4.5). Hence, the growth concerning autism-specific education appeared to
be most prevalent within special schools where ASD classes were linked to existing service
structures. Some 24 of the 26 special schools identified for the study accommodated learners
with severe intellectual disability (cf. Addendum A). This finding seemed to correlate with the
reports from educators (cf. Table 4.37) that the majority of learners presented with moderate
and severe ASD traits (which include severe deficits in most developmental domains).
Only seven educators from full-service schools in Limpopo and the Free State participated in
the study. The challenges in identifying full-service schools that offer autism-specific education
have been discussed in Chapter 3 (cf. 3.4.3). Full-service schools are intended to
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accommodate learners with mild to moderate support needs, but the successful
implementation of full-service schools in the South African context appear to be a challenge
(cf. 2.4.3.2).
Full-service schools are mainstream schools that are resourced and supported in order to
accommodate learners with mild to moderate support needs. The successful transformation of
mainstream schools into full-service schools is a challenging process and strategic areas of
transformation have not yet been efficiently implemented (SA 2011:10-16). The successful
inclusion of learners with high level support needs into existing full-service schools and
mainstream schools is challenging, since conventional special needs programmes and
teaching methods are not appropriate and accessible concerning their unique needs (Wagner
2011:27-28). Although mainstream schools may provide opportunities for increased social
interaction, there is often lack of individualised support programmes that could assist learners
to adjust and integrate efficiently in the school system. Current research regarding inclusion of
learners in mainstream schools focuses more on negative experiences such as peer isolation,
increased anxiety, bullying as well as limited academic support (Moreno et al. 2010:1094).
Hence, full-service schools are currently not resourced to accommodate autism-specific
education and only a few schools countrywide offer the service.
5.2.4. Conclusions on practices and challenges: demographics of educators of ASD
classes according to the results of the study
Conclusions regarding the demographics of educators who participated in the study would be
integrated with the discussion in section 5.7.4 (conclusions concerning challenges and critical
success factors).
5.2.4.1. Special schools (especially those for the intellectually challenges) play a key role in
the provision of autism-specific education by linking ASD classes to existing service
structures:
The increased prevalence of ASD has put the five autism-specific schools in the country under
significant pressure and consequently the system responded by linking ASD classes to
existing service structures (cf. 5.2.3). The majority of educators (n=64) who participated in the
study were from special schools, of which 90% were from schools that accommodate learners
with severe intellectual disability. The majority of educators indicated to have learners with
moderate to severe ASD in their classes. However, educators reported to have learners across
the spectrum (cf. 5.5.1).
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5.2.4.2. Full-service schools play a minor role in the provision of autism-specific education to
learners with mild to moderate autistic traits:
The limited number of full-service schools identified for the study, implementation challenges
concerning full schools and in the inclusion of learners with ASD in mainstream setting limit the
provision of autism-specific education in these settings (cf. 5.2.3).
5.2.4.3. Access to autism-specific education varies across provinces:
Autism-specific schools are mainly in the Western Cape, Eastern Cape and Gauteng.
Mpumalanga, Limpopo and Northwest have limited educators and resources concerning ASD
education (cf. 5.2.3).
5.3. THE LEVEL OF TRAINING AND EXPERIENCE OF EDUCATORS
This section deals with the first research objective to determine the level of training and
experience of educators of autism-specific classes in public schools. Appropriate training, an
understanding of the condition and continued professional development are critical to the
success of autism education (Koegel et al. 2011:online), as well as the job satisfaction of
educators (Moreno et al. 2011:online). Under- and unqualified educators with limited
commitment to self-development have been mentioned as a challenge in some South African
schools (Hawker 2013:online). The researcher therefore aimed to determine whether South
African educators were adequately qualified, experienced, trained in autism-specific
programmes and committed to self-development in order to deliver quality autism-specific
education.
The following aspects are discussed in this section: qualifications, formal training (cf. 5.3.1);
work experience (cf. 5.3.2); training and professional development (cf. 5.3.3); training in
research-based programmes (cf. 5.3.3); service providers (cf. 5.3.4); updates and self-
development (cf. 5.3.5); and conclusions on practices and challenges concerning training
development (cf. 5.3.6).
5.3.1. Qualifications and formal training
The majority of educators (cf. Table 4.8) had completed grade 12 and a three-year diploma or
degree in education, including: Diploma in Education (35.6%); Higher Education degrees
(32.2%); B.Ed. degrees (20.7%); and B.Ed. Psychology qualifications (n=6, 8.0%). These
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findings were aligned with the recommendation of South African Council of Educators (South
African Council of Educators 2013:online) that advocates that all educators should at least
have a three-year education qualification post grade 12. Although these qualifications may be
adequate in the South African context, first-world countries such as Finland, require a master’s
degree and majoring in special education as the entry level to teaching in specialised
education (cf. 2.3.5.3). In addition, educators also need to qualify in a professional competence
programme to ensure that they are equipped in the management of diverse support needs
(The Trade Union of Education in Finland 2008:online). Hence, the South African education
system does not have the same standards for teaching in special education compared to first
world countries with best practices.
Three educators (3.5%) reported that they had completed grade 10 and a basic certificate in
education (cf. Table 4.8). Given the complex nature of ASD education and the level of
specialist knowledge required to optimally educate learners with ASD (Hanbury 2005:17),
these educators would possibly require additional support to deliver high quality ASD
education. One educator had trained as a speech therapist (cf. Table 4.8). Although, the
qualification may be a benefit in terms of the management of speech, language and
communication deficits, the researcher is of opinion that this professional may require support
concerning educational frameworks of practice. Although the developmental support of
learners is important, the implementation of the curriculum, curriculum differentiation and
subject specific knowledge are also critical success factors of autism-specific education (cf.
2.3.5.6).
Educators mainly reported to be trained for foundation (n=53) and intermediate phase (n=24)
education (cf. Table 4.7). This finding could possibly be explained by the fact that the majority
of educators (n=64; 71.1%) were from special schools that accommodate learners with severe
intellectual disabilities (cf. Table 4.4). These schools mostly use differentiated curriculums that
focus on foundation phase skills (cf. 2.3.5.6). Learners in ASD classes were mainly between
the ages of 8 and 13 years (cf. Table 4.35) and qualifications in foundation and intermediate
phase education would be appropriate for these age groups.
A total of 35 educators (38.9%) reported to have completed a postgraduate qualification in
support and special education (cf. Table 4.9). Considering that ASD is a specialised field within
support and special education, the results suggest that more than 60% of educators did not
have any postgraduate training that would have contributed to their knowledge and skills
regarding the education of learners with ASD. One educator had training in Alternative
Augmentative Education, which is related to ASD education (cf. 2.3.5.6). However, seven
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educators had postgraduate training not related to ASD education. Only 16 educators
indicated that they were busy with postgraduate training (cf. Table 4.10), of which only four
were busy with studies in support and special education. Given the complex nature of autism-
specific education and the need for professional development expressed by educators, one
would argue that more educators would be involved in postgraduate studies. The reasons why
educators were not engaged in postgraduate studies require further investigation.
5.3.2. Work experience
A total of 11 educators (12.2%) reported to have worked abroad with learners with ASD and
had exposure to ASD education practices in other countries. The majority of educators (78.8%)
gained their experience in the South African context (cf. 4.4.1). The median years qualified as
an educator was 17 years, while the median for teaching in an ASD class was five years (cf.
Table 4.6). The results suggested that the majority of educators gained experience in other
fields of education prior to working in ASD education. Although there were educators with as
much as 27 years’ experience in ASD education, the majority of educators had between three
and eight years of experience (cf. Table 4.6). Traditionally educators had to work at autism-
specific schools in order to work with learners with ASD. The significant increase in the
prevalence of ASD (Centres for Disease Control and Prevention 2013(3):online) since 2008,
possibly created new opportunities for ASD education at special and full-service schools.
Since many educators were pioneering autism-specific education at their schools, they would
require mentorship and support from senior management teams and the Department of
Education. However, support from senior management was indicated as a moderate challenge
and support from the Department of Education as a severe challenge (cf. 2.4.4, cf. Table 4.59).
Hence, the results of the study indicates that there was an increase in the number of educators
who are gaining experience in ASD education, but mentorship and support appear to be a
challenge due to limited support from senior management teams and the Department of
Education (cf. Table 4.60, cf. 2.4.4).
5.3.3. Training in research-based ASD programmes
Training in ASD research-based programmes is integrated with the discussion on utilisation of
research-based programmes (cf. 5.6.1).
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5.3.4. Training service providers
Only 49 educators (54.4%) responded to the multiple choice question to determine the service
providers responsible for the training of the educators in autism-specific classes. Educators (cf.
Table 4.12) reported to be trained by another school (n=12), accredited external trainers
(n=11), internal programmes (n=10) at their school or by Autism South Africa (n=9). District–
based support teams (n=4) and universities (n=2) did not seem to contribute significantly to the
training of educators (cf. Table 4.12). Educators experienced limited training in autism-specific
education as well as the limited support by the Department of Education as a severe challenge
(cf. Table 4.59). Other South African researchers (Geldenhuys & Wevers 2013:12-13 and
Ladbrook 2009:90-92) support this finding. Hence, schools appeared to take the lead in
autism-specific training due to limited support at district, provincial and national level. The
content, format and quality of training offered by schools require more investigation since a
standard approach is not guided by the Department of Education.
In contrast with findings that educators in special schools indicate a lower demand for training
since they are in well-resourced units (Adeniyi et al. 2009:online and Moreno et al.
2011:online), educators in special schools – including autism-specific schools – reported a
high demand for training (cf. Table 4.60.). Autism-specific and special schools appeared to
take on responsibility to support one another, but it may be argued that educators in these
settings do not get optimal exposure to new information and research-based approaches.
A total of 23 educators (cf. Table 4.13) reported that their school offered informal training,
which consisted mainly of individual and group support on managing ASD in the classroom
(n=21), as well as professional working groups that train on best practices (n=9). Only one
educator indicated that their school was involved with outreach programmes to full-service
schools. In accordance to White Paper 6, special schools should act as resource centres to
support schools in the area (SA 2001:3(1),21-22), however few schools appear to run outreach
programmes to mainstream and full-service schools.
5.3.5. Updates and self-development
Globally, there appears to be a decline in educator training and monitoring of effectiveness of
these training programmes in practice (cf. 2.3.5.2), possibly due to financial and operational
constraints. Globally, schools employ distance training and other cost-efficient strategies such
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as video conferencing, intensive one-week training courses, in-service training and peer
socialisation (cf. 2.3.5.2). A total of 49 educators indicated that they kept updated with the
latest developments in ASD education by attending formal training and workshops. Some 28
educators indicated that they used journals, newsletters and books to keep updated, while 26
educators made use of the internet and social media. Video conferencing did not appear to be
a training strategy used within the South African context. Forty-four educators (cf. Table 4.59)
reported limited ASD training as a severe challenge. Hence, educators appear to take
responsibility for their self-development due to limited structured training opportunities.
Other schools appeared to be the main source of training to educators in ASD classes (cf.
Table 4.12), but only 20 educators indicated in-service training and professional working
groups as a source of professional development (cf. Table 4.12). Autism associations (n=15)
appeared to play a role in the self-development of educators (cf. Table 4.12), especially
through training in the Fishbowl course (cf. Table 4.11). The majority of educators (n=68)
reported that their schools were members of Autism South Africa and the regional support
groups (cf. Table 4.33). Parent meetings and support groups appeared to play a minor role in
the self-development of educators (cf. Table 4.14). Hence, other schools and autism support
groups play a key role in the continued professional development and support of educators
teaching learners with ASD.
Simpson (2005:143) indicated that educators need to critically question the efficacy,
anticipated outcomes, possible risks and outcomes measures when selecting intervention
strategies for learners. Although one-third of educators reported self-development through
journal articles, books and electronic literature, only eight educators indicated that they made
use of research and scientific reviews concerning their professional development (cf. Table
4.14). Hence, educators appear to consider any possible resources for self-development in the
absence of formal, structured trainings in evidenced-based practices.
5.3.6. Conclusions on practices and challenges concerning training development
5.3.6.1. Educators teaching learners with ASD within the South African context have variable
standards of qualifications and levels of specialisation:
The majority of educators in ASD classes confirm to the recommendations of SACE to have
grade 12 and a three-year qualification in education. Only 38.9% of educators had appropriate
post-basic qualifications, while only four educators were engaged in further studies. Best
practices in first-world countries prescribe a basic three-year qualification post grade 12,
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majoring in special education, a master’s degree and additional professional development
programmes as a prerequisite for teaching in special education (cf. 5.3.1). Hence, educators
teaching learners with ASD within the South African context have variable standards of
qualifications and levels of specialisation.
5.3.6.2. School-based professional working groups, autism support groups and educators
themselves take responsibility to create opportunities for professional development
and training:
Professional working groups, school-based interest groups and autism support groups are
currently providing training for educators (cf. 5.3.4). Educators reported to use professional
journals, newsletters, working groups and electronic media as sources of self-development of
educators due to limited structured training opportunities (cf. 5.3.5). The Department of
Education as well as tertiary training institutions play a minor role in the support and
professional development of educators teaching learners with ASD (cf. 5.3.4). Hence, schools
and autism support groups take responsibility for creating opportunities for informal
professional development in the absence of structured support from the Department of
Education and accredited tertiary training institutions.
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5.4 SCHOOL-BASED OPERATIONS
The literature overview indicated that socio-economic (poverty, child-headed households,
foster children, teenage pregnancies, etc.) and healthcare dilemmas (HIV/Aids, substance
abuse, etc.) contribute to challenges in education and increase the number of marginalised
learners significantly. The National Department of Education faces serious challenges as
prioritised in the Strategic Plan for 2011-2014 (SA 2011(1):9-16), and resources are allocated
in accordance to these priorities (cf. 2.4). Literature on the South African education system
indicated differences in the infrastructure, management, services and performance of schools.
Special schools in deep rural areas often have insufficient infrastructure, limited access to
specialists and few appropriately qualified staff (SA 2007(2):5-7). This study was of descriptive
nature and did not aim to compare autism-specific education services and resources in urban
and rural areas, but rather to describe service delivery concerning autism-specific education as
a whole.
This section deals with the second research objective, to determine the services delivered by
schools that offer autism-specific education in the South African context. This was done by
determining how the resources and services offered by schools vary (SA 2007(2):9-16). The
following results are discussed:
5.4.1 Admissions procedres;
5.4.2 Accommodation of special needs in hostel;
5.4.3 Extra-curricular services offered;
5.4.4. Therapeutic services offered;
5.4.5 Transfer of skills to the home environment; and
5.4.6 Conclusions concerning school-based operations.
5.4.1 Admissions procedures
Although district-based support teams are supposed to be primarily responsible for the
placement of learners in special education (SA 2001(1):47), schools often have their own
assessment teams who perform assessments to determine whether a learner would optimally
benefit from the support services offered at the school. School-based multi-professional teams
make use of standardised assessments, academic screenings and informal observations (cf.
2.2.2, 2.2.3, 2.4.2.1). The researcher was interested in determining the assessment tools used
in schools, the usage of SIAS guidelines (SA 2008(3):1-2), age groups accommodated in
schools, and pre-requisites for admissions.
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5.4.1.1 Assessment tools
Educators reported the Autism Behaviour Checklist as the screening tool that was mostly
used, and the Childhood Autism Rating Scale as the most used diagnostic tool (cf. Table 4.16).
These mentioned tools are also used and recommended internationally (American Academy of
Paediatrics 2006:410-413). Hence, it is positive that schools use tools that are aligned with
recommended practices. Although the Autism Diagnostic Observation Schedule – Generic
(ADOS-G) is indicated as a gold standard diagnostic procedure (cf. 2.2.3), educators (n=16,
17.8%) in the South African context did not appear to use the tool frequently. The researcher
suspected the cost of training and the intensive administration procedure of the tool may be
factors that influence the use of the ADOS-G as the preferred tool. The response rate to the
question concerning the use of assessment tools was low (cf. 4.16). The following may be
possible reasons for the low response rate:
(i) School-based psychologists and therapists may perform diagnostic specific
assessments, while educators perform academic screenings
(ii) Educators of ASD may not be included in school-based assessment teams; or
(iii) Schools are not using diagnostic specific assessment tools.
Since there is uncertainty regarding the use of assessment tools in school-based settings, this
aspect may require further investigation.
5.4.1.2 Use of Screening Identification Assessment and Support (SIAS)
The SIAS guidelines are intended to efficiently determine barriers to learning, the level of
support required by learners and to design comprehensive support strategies (SA 2008(3):1-
2). A total of 58 educators (64.4%) indicated that the Screening Identification and Support
Guidelines were used at their school (cf. Table 4.17). Since SIAS is a national document that
guides the implementation of inclusive principles in schools, it is a concern that not all schools
have put the guidelines into practice yet. The results appeared to support the findings of
Geldenhuys and Wevers (2013:12), who reported that the SIAS process is used with limited
success since the efficiency of the support guidelines is dependent on the availability of
resources and efficient training of educators. Limited leadership, support and training provided
by the Department of Education were reported as challenges (cf. Table 4.59, cf. Table 4.60).
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5.4.1.3 Age groups accommodated at school
Early identification and support are critical success factors for efficient autism-specific
education and positive educational outcomes (Boyd et al. 2010:92). As mentioned, learners
with ASD are often identified late (cf. 2.2.8), placed on waiting lists at schools or have limited
or no access to formal education. Since ASD is a lifelong condition, learners require support
throughout their school career to optimise social adjustment, community integration and
vocational skills (Rapin & Tuchman 2008:1129-1146). The researcher was therefore interested
in identifying the age groups accommodated at schools.
Educators reported that their schools mainly accommodated learners between the ages of 5
and 18 years (cf. Table 4.18). However, the mean age of learners currently in ASD classes
was between 8-13 years (cf. Table 4.35). The results also suggested limited access for
children of 5 years (and younger). Preschool learners require support to ensure compliance
with admission criteria and the requirements of formal education (cf. 4.5.4). Limited
opportunities for learners older than 14 years concerning vocational training (cf. 4.5.4) were
also indentified in this study. However, literature supports the fact that limited vocational
training and job opportunities are challenges for all South African learners (SA 2011(5):49-51).
5.4.1.4 Admissions criteria
Admissions criteria assist district- and school-based support teams with objective guidelines to
ensure fair and equitable access to special schools. Only learners with high-level support
needs would be considered for admissions to special schools. Special schools continue to
design their own admissions guidelines to ensure that newly referred learners would optimally
benefit from the programmes offered (SA 2007(2):7-8).
The results of this study suggest the following criteria as vital for admission to an ASD class:
i) Continence and independence in toileting: learners with ASD usually take much
longer to master continence training and independence in toileting (Abbott et al. 2003:online).
A total of 51 educators reported that continence was a prerequisite for admission at their
school (cf. Table 4.19), and 51 educators (cf. Table 4.56) reported that their school did not
allow learners to bring their own caregiver, who could potentially assist with continence
management, to school. Hence, continence and independence are part of the admissions
criteria, and schools generally do not allow personal caregivers to assist with toilet training at
school.
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ii) Formal diagnosis of ASD by a medical specialist: Inclusive policy tries to move
away from a medical model where a diagnosis dictates access to specialised education (cf.
2.2) and is part of the admissions criteria to an ASD class. However, 50 educators reported
that their school considered the clinical profile, medical history and diagnostic specific criteria
in deciding whether a learner would benefit from their ASD programme (SA 2007(2):7-8).
iii) Screening by a school panel and recommendation by the district based support
team: White Paper 6 (SA 2001(1):47) indicates that district-based support teams should be
primarily responsible to oversee placements in special schools. Only 43 educators indicated
that recommendation by the district-based support was part of their admissions criteria (cf.
Table 4.19). District-based support teams appear not to be effective in the implementation of
this function across all districts (cf. 2.4.4.1). Screening by a school-based panel was reported
by 50% educators (n=45) to be part of the admissions criteria (cf. Table 4.19).
iv) Age restrictions: Some 38 educators reported age restrictions as part of their
admissions criteria (cf. Table 4.19). Educators reported that their schools mainly
accommodated learners between the ages of 5 and 18 years (cf. Table 4.18) but the majority
of learners in ASD classes were between 8-13 years (cf. Table 4.35). These findings are
similar to the researcher’s experience where special schools in the Motheo District indicate 14
years as the cut-off age for new admissions to special schools. Unfortunately, this was not
asked in the questionnaire.
v) Functional communication skills: Educators (n=8; 8.9%) from schools that offer
mainstream curriculums indicated functional communication skills as admissions criteria (cf.
4.5.5).
5.4.2 Hostel accommodation
The researcher has not been able to find any scholarly articles regarding the hostel
accommodation of learners with ASD. Since most special schools are in urban areas, learners
from rural areas would require hostel accommodation to access specialised education (cf.
2.4.2.3, SA 2007(2):3). Given the complex symptoms of ASD – which include resistance to
change, sensory processing difficulties and poor social interaction – it may be challenging to
accommodate these learners in hostels (cf. 2.2.1). Hence, the strategies hostel staff used to
accommodate these complex behaviours and functional profiles of learners with ASD were a
point of interest for the researcher.
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A total of 53 of 87 educators (62%) reported that their school had hostel facilities (cf. Table
4.20.) and this implied that there were schools that did not offer any hostel accommodation.
The rapid increase in the prevalence of ASD and the increased demand for ASD education (cf.
2.2.6) consequently raised the need for more hostel facilities at schools that offer autism-
specific education. Educators from autism-specific (n=17; 77.3%) and special schools (n=43;
58.6%) reported hostel accommodation, but full-service schools (n=2, 28.6%) seemed to offer
limited facilities in this regard (cf. Table 4.20). The hostels at special schools in the Motheo
District have waiting lists of five years (cf. 2.4.3.3), which seemed to be an additional factor
that would limit access to autism-specific education. The researcher has not specifically asked
to indicate whether schools have waiting lists for hostel accommodation and this aspect may
thus require further investigation. However, it is assumed that learners with severe ASD traits
and who are from rural areas may experience more difficulty in accessing specialised
education. These learners would also struggle to access full-service schools in their
community due to their high-level support needs.
Table 4.21 implied that hostels could accommodate learners with ASD if appropriate strategies
are implemented. The strategies mentioned by educators did not seem to differ significantly
from the critical success factors of autism-specific education (Boutot 2013:online and Dunlap
et al. 2003:online) and these included:
(i) Individual support plans and individualised strategies;
(ii) Staff training and support;
(iii) Grouping of learners and teamwork; and
(iv) A structured routine and schedule (cf. Table 4.21).
Three schools indicated that they offer hostel accommodation, but that they did not
accommodate learners with ASD. Unfortunately, they did not specify the reasons for not
admitting learners with ASD in the hostel (cf. Table 4.21). Since there appears to be limited
research concerning the accommodation of learners with ASD in hostels, it may be an
interesting topic for further research.
5.4.3 Extra-curricular services offered and funded
Autism Spectrum Disorders do not only affect learning, but impact on the development of skills
in all spheres of life (American Psychiatric Association 2013(2):69-70). Schools that offer
autism-specific education often provide extra-curricular services to accommodate all areas of
development. Nevertheless, these additional services require additional resources (cf. 2.4.2.3).
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Since most public schools are under-resourced (Geldenhuys & Wevers 2013:11-12), schools
possibly focus on extra-curricular activities that have maximum benefit for learners at the
lowest possible cost. The researcher was therefore interested to determine the extra-curricular
services schools offered, how these were funded and how educators perceived the impact of
these services.
A total of 48 educators (53.3%) indicated that their schools offered swimming (cf. Table 4.22)
and the majority of these educators (cf. Table 4.23) were from special (n=36, 61%) and full-
service schools (n=5, 57.1%) who accommodated learners with lower burdens of care. Only
seven educators (30.4%) from autism-specific schools reported swimming as an activity they
presented. Although swimming was indicated as the activity that was mostly offered, only 23
educators (26.7%) rated swimming as a beneficial activity to learners with ASD (cf. Table
2.24). Pan (2010:9) described the benefits of swimming for learners with ASD, but no literature
was accessed that compared the benefits of swimming to other activities.
More than 40% of educators indicated that they offered art and social skills at their school (cf.
Table 4.22). In this study, full-service schools (n=5; 71.4%) appeared to present art as an
extra-curricular activity. However, art seemed to be offered less in special (n=29, 49.2%) and
autism-specific schools (n=12, 52.2%.), and only 30.7% of educators rated art as a beneficial
activity (cf. Table 4.23, cf. Table 4.24). Social skills appeared to be used less in full-service
schools (n=2, 28.6%) possibly since the majority of learners in these schools are typically
developing (cf. Table 4.23). Nonetheless, the use of social skills was also low in autism-
specific schools (cf. Table 4.23) and the reasons may require further investigation. The of
majority of educators who responded (n=32; 42.7%) rated social skills as the activity that
added most benefit (cf. Table 2.24). Since ASD is a condition that affects mostly social
interaction, social skills training seems to add additional benefit as an extra-curricular activity
(Bellini et al. 2007:153-154). However, the results of the study indicated that schools did not
always present the activities that educators perceived as most beneficial.
Horseback-riding, therapy by external therapists and music therapy were reported as extra-
curricular activities by more than 30% of educators (cf. Table 4.22). Full-service schools (n=4,
57.1%) appeared to offer more external therapy (cf. Table 4.23), possibly since they were not
resourced with school-based therapists. Educators perceived horseback-riding (n=26; 34.7%)
and music therapy (n=26; 34.7%) as beneficial to learners with ASD (cf. Table 2.24). However,
therapy (n=12; 16%) was rated much lower (cf. Table 2.24). Pottery and drama were offered
by 20% percent of schools, while ball skills were only reported to be presented by 5.6% of
schools (cf. Table 4.22). Pottery, drama and ball skills were mainly presented in autism-
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specific and special schools, but not in full-service schools (cf. Table 4.23). Educators did not
perceive these three activities as particularly beneficial to learners with ASD (cf. Table 4.24).
Literature (cf. 2.3.5.6) describe the use of all the mentioned activities, but no study could be
located that compared the benefits and long-term effects of these activities with one another.
The financial burden (cf. 2.2.11) of having a child with ASD is high for parents as well as
schools that offer specialised education. Swimming, social skills, art, music therapy, external
therapy and drama were mostly funded by schools (cf. Table 4.25). Pottery appeared to be
funded privately, and horseback-riding seemed to be covered by some schools while other
schools made use of private funding (cf. Table 4.25). The majority of educators (n=69) replied
that parents do not have to cover the costs of specialised services delivered at schools (cf.
Table 4.32). Nevertheless, this possibly put more strain on schools concerning fundraising,
since the Department of Education focuses resources in accordance to national priorities as
indicated in National Department of Education: Strategic Plan for 2011-2014 (SA 2011(5):9-16,
cf. 2.4)
The results of the study indicate that special, autism-specific and full-service schools focused
on different extra-curricular activities. The type, frequency and intensity of these activities
appeared to depend on the availability of funding, school infrastructure, school management,
parental support and community involvement. Educators’ perceived benefit of activities to
learners with ASD did not seem to affect the activities presented at schools.
5.4.4 Therapeutic services offered
Learners with ASD require a differentiated curriculum and a collaborative, multi-professional
approach to enhance outcomes in different developmental domains (Brown & Dunn 2010:475).
The majority of educators (n=85; 94.4%) reported that it was necessary to provide therapeutic
services at schools that offer ASD education. The intensive support and specialised
intervention required by learners with ASD appeared to be a key factor that necessitates
therapists as part of integrated, multi-professional teams in schools (cf. Table 4.26). Educators
reported not to have the specialised skills to manage all the impairments and deficits
associated with ASD (cf. 4.5.8). Therapists play a role in the training and support of educators
by:
(i) Providing hands-on assistance and support strategies in the classroom;
(ii) Contributing to individual support plans; and
(iii) Assisting with parent feedback, training and support strategies (cf. 4.5.8).
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A total of 13 educators were of opinion that the involvement of therapists optimised educational
outcomes, since functional gains appeared to aid academic progress (cf. Table 4.26).
More than 60% of autism-specific and special schools (cf. Table 4.27) indicated that they are
resourced with occupational therapy (>70%) and school nursing (>60%). The reasons for the
higher representation of occupational therapy and nursing services require further
investigation. Autism-specific schools (cf. Table 4.27) appeared to have speech therapists
(74.9%) and psychologists (43.5%), while physiotherapy (17.4%) and social work resources
(8.7%) appeared to be less. Educators in special schools reported to have physiotherapy
(50.9%), psychology (35.6%), speech therapy (27.1%) and social work services (18.6%).
Hence, it appeared as if special schools had a wider range of therapeutic services offered.
Full-services schools seemed to have limited therapeutic resources since they possibly have to
fund their services privately (cf. Table 4.25). Although learners with ASD often have specific
food preferences and nutritional needs (Cutler et al. 2004:1611), none of the schools offered
dietetic support. A possible reason may be that schools do not offer meals as a standard
service and focus on education as a core function.
White Paper 6 introduced changes in the roles of therapists, which moved from removing the
child from the classroom for one-on-one therapy to moving into the classroom and equipping
educators with strategies to support learners (Anderson et al. 2012:5). The majority of
educators (n=80, 88.9%) indicated that they received support from therapists (cf. Table 4.28).
However, between 23% and 36% of educators in autism-specific and special schools indicated
(cf. Table 4.59) that they had limited chance to work with therapists or that they received
limited support from therapists. The reasons for this severe challenge may be related to:
(i) ineffective use of therapeutic resources at schools;
(ii) the perceptions of educators concerning the roles of school-based therapists; or
(iii) limited therapeutic resources at schools.
Therapists provide therapeutic support through individual therapeutic sessions, therapeutic
groups and the provision of support strategies to educators on handling individual learners in
the class (cf. Table 4.28). One-third of educators indicated that therapists equipped them via
formal workshops, while only four educators indicated that therapists were involved in parent
feedback (cf. Table 4.28). Although educators recognised the role of therapists in equipping
educators, they still appeared to perceive the primary role of therapists as one-on-one
therapeutic interaction. The role of therapists in empowering parents and communities also
appeared underutilised.
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5.4.5 Transfer of skills to the home environment
Parent involvement, integrated goal-setting and transfer of learning skills to the home
environment are critical in providing an integrated educational approach (Wagner 2011:29 and
Bellini & Pratt 2010:online). Parents of learners with ASD face significant challenges and
require intensive support (cf. 2.2.11, 2.3.5.4, 2.4.1). Some 55 educators (64.0%) indicated that
they offered parent feedback and training at their school (cf. Table 4.30). Given the importance
of parent involvement as a critical success factor of ASD (cf. 2.3.5.5), one would have
expected more schools to offer the service. However, these results may also reflect the
findings of other researchers (Geldenhuys & Wevers 2013:8-9 and Ladbrook 2009:119)
concerning unsupportive home environments, insufficient parenting skills and poor parental
involvement in the South African context.
Individual counselling and feedback appeared to be the primary method of transferring skills to
the home environment (cf. Table 4.29). Homework, letters and a communication book, formal
training and parent meetings were also indicated as strategies that were less used (cf. Table
4.29). Literature indicates that frequent, direct communication with parents regarding the
individual support plan of their child should take place at least once a quarter (Sapona &
Winterman 2002:34). A total of 52 educators (57.8%) reported that they provide quarterly
feedback, while 18 educators (20.3%) indicated monthly or more frequent feedback sessions
(cf. Table 4.31). Hence, more than 40% of educators did not appear to meet best practices
concerning parent feedback.
5.4.6 Conclusions on practices and challenges concerning extra-curricular services
offered according to the results of this study
Literature mentioned differences in the infrastructure, access to specialised resources, service
delivery and performance of supposed functional and dysfunctional schools. Differences
between schools in urban and rural areas have also been pointed out (c.f. 2.4). The researcher
has not distinguished between schools in terms of their location and functionality, but aimed to
describe extra-curricular services for learners with ASD at public schools within the South
African context as a whole. Recommendations regarding comparative studies concerning
service delivery rural versus urban or functional versus dysfunctional schools will be addressed
in Chapter 6. Nevertheless, the researcher acknowledges that complex socio-political, socio-
economical, healthcare and other systemic barriers affect the services delivery of schools.
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5.4.6.1 Barriers in the South African education system and implementation of inclusive
education affect operational systems, resources and services at schools:
Literature made mention of barriers in the provisioning of basic education and the
implementation of inclusive education at all levels that affect the service delivery of schools (cf.
2.4). The results of the study support the findings of other researchers that the SIAS guidelines
are used with limited success in the South African context (cf. 5.4.1.2). The functions of
district-based support teams, as well as national and provincial teams, are variably
implemented and affect service standards in terms of admission procedures, the provision of
resources and support services (Geldenhuys & Wevers 2013:1213).
5.4.6.2 Schools have similar admissions criteria and admissions procedures concerning
autism-specific education:
The mentioned admissions criteria appear to create challenges in its own and rigid
implementation of these criteria could contribute to the marginalisation of out-of-school
learners with ASD.
The majority of educators indicated the following as admissions criteria:
i) Continence training and independence in toileting: Children with ASD usually take
longer to master continence and independence in toileting. A total of 57% of schools reported
that learners are not allowed to bring caregivers to school to assist with toileting and
continence management (cf. 5.4.1.4).
ii) Formal diagnosis of ASD by a medical specialist: White Paper 6 tries to move away
from the medical model, but diagnostic criteria continue to play a role (cf. 5.4.1.4). Learners
with limited resources struggle to access specialised medical services. The effect of the new
DSM-5 criteria may affect admissions criteria (cf. 2.2).
iii) Screening by a school panel: Schools continue to perform their own assessment to
determine whether a learner is a candidate for their school (cf. 5.4.1.4). However, district-
based support teams are responsible for the placement of learners in special schools. This
finding is supportive of the inefficient implementation of inclusive policy and procedures.
iv) Age restrictions: Schools indicate that they accommodate learners between the
ages of 5-18 years (cf. 5.4.1.4) but the mean age of learners in the ASD classes was between
8-13 years. Hence, learners younger than five years and older than 13 years appeared to have
less ASD-specific support.
v) Functional communication and language skills: Full-service schools reported
functional communication and language skills as a pre-requisite for admissions (cf. 5.4.1.4).
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5.4.6.3 The extra-curricular services offered depend on the type of school, availability of
funding, school infrastructure and parent involvement:
A total of 54 educators reported that their school offered hostel accommodation. These
educators were mainly in autism-specific and special schools (cf. 5.4.2).
5.4.6.4 Learners with ASD can be accommodated in hostels using specific strategies
but access to hostel facilities are limited:
Hostel accommodation appeared to be limited (especially in full-service schools) and waiting
lists at hostels require further investigation. Not all school hostels appear to be willing to
implement these strategies, possible since it requires additional effort and operational models
(cf. 5.4.2).
5.4.6.5 The efficiency and value of extra-curricular services offered at schools require further
research:
The type, frequency and intensity of extra-curricular activities seemed to depend on the
availability of funding, infrastructure, school management, parent support and community
involvement. The extra-curricular services offered by schools differed from the services
educators perceived to be most as most beneficial to learners with ASD. No study could be
located that compared the benefits and long-term effects of these activities (cf. 5.4.3).
5.4.6.6 Educators are in need of therapeutic services at schools that offer autism-
specific education:
The majority of educators reported that it was necessary to provide therapeutic services at
schools that offer ASD education, and that they received support from therapists. Support
strategies included individual therapeutic sessions, therapeutic groups, the provision of
classroom strategies, formal workshops and involved in parent feedback (cf. 5.4.4).
5.4.6.7 There is variability in the availability and utilisation of therapeutic resources:
Although, the necessity of therapists was recognised, not all schools have access to adequate
therapeutic resources. Schools seemed to be better resourced with occupational therapy and
school nursing compared to other professional services. No dietetic services were provided.
Educators appeared to focus on the traditional roles of therapists (cf. 5.4.4).
5.4.6.8 Parent involvement and transfer of skills to the home environment within the South
African are not in line with best practices:
Some 55 educators (64.0%) indicated that they offered parent feedback and training at their
school. Given the importance of parent involvement as a critical success factor of ASD, all
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schools should offer the service. Other researchers have also described unsupportive home
environments, insufficient parenting skills and poor parental involvement in the South African
context. Individual counselling and feedback appeared to be the primary method of transferring
skills to the home environment. The frequency of feedback is not aligned with best practices
(cf. 5.4.5).
5.5 CLASSROOM MANAGEMENT PRACTICES
Learners with ASD have atypical learning styles; unique learning needs; challenging
behaviours; and they process information from the environment differently (Hanbury 2005:16).
The condition affects all aspects of development, and educators should therefore focus not
only on curriculums and classroom strategies that accommodate the diagnostic specific
factors, but also on individualised learning needs (cf. 2.3). Curriculum differentiation
(appropriate content and teaching methodology); scheduling of education outcomes;
monitoring; measurement and control of progress (differentiated assessment methods); and
strategies to accommodate individual learning styles (individual support plans, environmental
adjustments, teaching aids, assistive devices, adjusted activities, etc.) are critical to the
success of autism-specific education (cf. 2.3.5). Globally, the high cost of specialised
education forces the policy makers in education to review different service models and
education approaches to offer quality specialised education and lower costs (cf. 2.3.4). Due to
the limited resources in the South African education context, the delivery of quality education
within a complex socio-economical context amplifies these challenges (cf. 2.4).
This section deals with the following aspects:
5.9.1 Demographics of learners in South African ASD classes;
5.9.2 Autism-specific education versus inclusivity;
5.9.3 Curriculum differentiation;
5.9.4 Individual support;
5.9.5 Monitoring of programmes;
5.9.6 Classroom structure;
5.9.7 Safety during break; and
5.9.8 Conclusions on practices and challenges concerning classroom management
practices.
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5.5.1 Demographics of learners in South African ASD classes
The majority of educators were from schools where English (32.2%), Afrikaans (18.9%) and
combinations thereof (26.7%) were the languages of learning and teaching (cf. Table 4.43).
African languages as the language of teaching were not well represented in this study,
possibly since Afrikaans and English are the official languages of learning and teaching
(National Department of Basic Education 2010:1-2). The majority of schools (cf. Table 4.18)
indicated that they accommodate learners between the ages of 5 and 18 years. However, the
median ages of learners in ASD classes were described as between 8 and 13 years (cf. Table
4.35), which are in keeping with the researcher’s experience.
The number of learners in a class was reported to be between 7 and 10 with, 8 as the median
(cf. Table 4.36). Although these ratios appeared to be aligned with the critical success factors
of autism-specific education, it is lower than the suggested 16 learners from a cost perspective
(SA 2001(1):39). The gender ratio of girls versus boys was indicated as 1:7 (cf. Table 4.36).
These findings are aligned with the epidemiological reports from the ADDM Network (Centres
for Disease Control and Prevention 2013(3):online) which estimates that the prevalence of
ASD in boys is significantly higher than in girls.
The majority of educators appeared to have learners with moderate to severe ASD in their
classes (cf. Table 4.37). The results of this research indicate a high demand for more classes
that accommodate learners with severe ASD symptoms and accompanying intellectual
disability. A total of 59 educators (66.3%) were employed at special schools for learners with
severe intellectual impairments (cf. Table 4.15). The results of this study seem to correlate with
the findings of Alaimo and Heflin (2007:30) that 67-75% of the learners with ASD (in
developing countries) present with intellectual disability. In contrast, the ADDM Network
indicates that 46% of children diagnosed in the USA presents with average and above-average
intellectual ability (Centres for Disease Control and Prevention 2013(3):online). According to
the results of this study, 32 educators (cf. Table 4.37) reported learners with mild ASD in their
classes, which possibly suggests that learners across the spectrum are in need of specialised
support and education.
5.5.2 Autism-specific education versus inclusivity
The educational approaches for learners with ASD vary and ranges from one-on-one
educational programmes to full and partial inclusion (cf. 2.3.4). Given that autism-specific
schools focus exclusively on learners with ASD, 15 educators reported that they only
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accommodate learners with ASD (cf. Table 4.38). However, nine educators from autism-
specific schools reported that learners with ASD were included with those who do not have the
condition.
Educators from specials schools (cf. Table 4.38) reported that they offered classes that include
diverse functional profiles (n=42) as well as classes that exclusively accommodate learners
with ASD (n=44). Special schools that cater for learners with severe intellectual challenges
offer services mainly to learners with intellectual disability, and the primary diagnoses may
vary. Since many learners with ASD do not appear to benefit from the conventional education
programmes, autism-specific education is provided to ensure that the learning needs of
learners are met. Full-service schools reported the use of classes inclusive of diverse
functional profiles, but three educators (42.9%) reported that they exclusively accommodate
learners with ASD in separate classes (cf. Table 4.38).
These findings are in keeping with the opinions of Frederickson & Jones (2010:1094) that not
all learners are suitable candidates for inclusion. The successful inclusion of learners with high
level support needs into existing special schools and mainstream schools is challenging, since
conventional special needs programmes and teaching methods are not appropriate and
accessible concerning their unique needs (Wagner 2011:27-28). Therefore, a variety of one-
on-one, full and partial inclusion approaches appeared to be used globally (cf. 2.3.4). Hence,
the functional profile and individualised needs of the learner would dictate the choice of an
appropriate approach.
5.5.3 Curriculums and differentiation
Schools play a key role in preparing learners for the challenges of adulthood and should
include programmes that improve diagnostic specific impairments; developmental deficits;
functional independence; social skills; and community integration (cf. 2.3.5.6). In the results of
this study, 55 educators (64.0%) reported that their school offered vocational training in their
curriculum (c.f. Table 4.40). Autism-specific, special and full-service schools indicated that they
offer vocational training as part of their curriculum (cf. Table 4.40). However, only 11 educators
(cf. Table 4.43) rated vocational skills as critical in the curriculum of ASD learners. Learners in
ASD classes were reported to be between the ages of 8 and 13 years (cf. Table 4.35) and
educators possibly argue that vocational training is not critical to learners within this age group.
Social interaction; emotional management; communication skills; functional independence; use
of tools and daily aspects; academic skills; as well as working skills (task completion, listening
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to instructions, etc.) were rated as vital components of an ASD curriculum (cf. Table 4.43).
These findings are in keeping with global views (cf. 2.3.5.6).
The majority of educators (cf. Table 4.41) who responded reported using self-developed
curriculums (n=41) or the ELSEN curriculum developed by SANASE (n=39). Educators from
autism-specific schools (cf. Table 4.42) reported using self-developed curriculums (n=13) or
the ELSEN curriculum developed by SANASE (n=12). Since autism-specific schools focus
more on learners with intensive support needs and more severe ASD traits, learners may
benefit mostly from tailor-made curriculums. Self-developed curriculums (n=24) and the
ELSEN curriculum developed by SANASE (n=25) were also mainly used in special schools (cf.
Table 4.41). However, 15 educators from special schools also reported the use of a
differentiated CAPS curriculum. Since full-service schools manage learners with mild to
moderate ASD traits, the majority of educators (n=4) reported the use of a differentiated CAPS
curriculum. Curriculum differentiation for learners with ASD in full-service schools requires
further investigation.
5.5.4 Individualised support
Since learners with ASD present with different combinations of impairments and are in need of
individual support; educators often require additional assistance in class to ensure that they
accommodate and monitor the progress of all learners (cf. 2.3.5.1). Some 70 educators (cf.
Table 4.39) responded that they have class assistants. Autism-specific (n=22) and special
schools (n=45) appeared to be well-resourced with class assistants, possibly since they
manage learners with intensive support needs. Only three educators from full-service schools
seemed to use class assistants (cf. Table 4.39). Since full-services schools only accommodate
learners with mild to moderate support needs, the need for class assistants may be less. More
than 65% of educators (n=51) reported that their schools did not allow learners to bring their
own caregivers (cf. Table 4.56), possibly since schools could not be held accountable for the
job descriptions, performance, safety and development of external assistants.
Learners with ASD have unique learning styles and require individualised approaches to
ensure that learning needs are met (cf. 2.3.5.1). Individual support plans (n=55) and curriculum
differentiation within structured programmes (n=32) were reported as strategies that were
mostly used to accommodate the learning pace of individual learners (cf. Table 4.44).
Individual support plans (n=80) were also reported to assist educators in the planning of
individual strategies. A total of 80 educators (90%) indicated that other stakeholders were
involved in the design of these individual support plans (cf. Table 4.45). These findings support
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global views that an integrated, outcomes-driven individual support plan is key in the success
of autism-specific education (cf. 2.3.5.1).
South African educators (cf. Table 4.45) reported to use daily (n=83, 92.2%) and weekly
schedules (n=75, 90.4%). Learners with ASD have excessive devotion to routines and
ritualised patterns behaviours, and resist changes in their environment and routines (American
Psychiatric Association 2013(2):50). This behaviour poses many challenges to educators,
since change is inevitable in any classroom setting (Hanbury 2005:81). Weekly and daily
schedules are suggested to be efficient strategies to provide learners with routine, structure,
predictability, consistency and thorough preparation for change (Smith-Myles 2005:23-24).
5.5.5 Monitoring and assessment
Simpson (2005:144) indicates that not all educational approaches come with clearly defined
learning objectives and reliable methods to achieve these goals. The minority of educators
(n=9) reported that they use standardised assessments to measure the progress of learners
(cf. Table 4.46). This is in keeping with the findings of Koegel and colleagues (Koegel et al.
2011:online) that learners with ASD often struggle with formal assessments and standardised
tests due to the complexity of their barriers to learning. The majority of educators (cf. Table
4.46) used the following:
(i) Checklists based on individual support plans and the curriculum (n=45; 50%);
(ii) Continuous, individualised assessment (n=38, 42.2%); and
(iii) Observation checklists and behavioural schedules (n=20; 22.2%). Koegel and colleagues
(Koegel et al. 2011:online) also suggest the use of various contexts and sources in the
compilation of learning objectives. Simpson (2005:144) indicates that outcomes
measurement is a challenging process since it is unclear when, how, by whom and how
frequently these assessments need to be performed. An in-depth study concerning
outcomes measurement in ASD education will be recommended.
5.5.6 Classroom structure
The structuring of the classroom plays a role in optimising socialisation amongst learners, or to
create stimulus-free workstations that assist learners to focus on tasks (cf. Table 2.5 and Table
2.8). Educators (cf. Table 4.47) reported positioning learners around tables (n=57); in stimulus-
free workstations (n=53) ;or on a mat (n=51), which are in keeping with global strategies (cf.
Table 2.5 and Table 2.8). Ordinary classroom structuring (n=13) did not appear to be widely
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used and the researcher suspected that this arrangement would be used more in full-service
schools.
Although learners with ASD appear to benefit from visual structure, many learners also
struggle with distractibility and a short attention span (cf. 2.3.1.9). The researcher was
therefore interested in determining how educators used visual stimuli to optimise learning in
the classroom. A total of 55 of 84 educators (cf. Table 4.48) reported that they had stimulus-
rich classrooms, which appears to be in contrast with opinions that stimulus-rich environments
distract learners (cf. Table 2.8). The content and type of information educators visually display
require more investigation.
5.5.7 Safety during break
Learners with ASD often have atypical play skills; sensory processing difficulties; motor
deficits; attention deficits; cognitive impairment; and behavioural challenges, which may
increase their risk for injury in unstructured settings (cf. 2.3.1.7, 2.3.1.9, 2.3.1.11). The
researcher was therefore interested to determine what strategies educators employed to
ensure the safety of learners during break time. Unfortunately, no previous research studies
could be found on the topic. The strategies reported by educators were divided into structured
and unstructured supervision and environmental strategies (cf. Table 4.49). Structured
supervision (n=28) included specific adult-learner ratios or formal buddy systems. Structured
environments (n=20) indicated strategies such as secure, fenced play areas, safety checks
and repairs on playground equipment. Only five educators reported the use of unstructured
environmental adjustments such as the removal of potentially harmful objects in the
environment. The majority of educators (n=61) indicated the use of unstructured supervision
where educators supervised learners in accordance with a break time schedule (cf. Table
4.49).
5.5.8 Conclusions on practices and challenges concerning classroom management
practices according to the results of this study
5.9.8.1 Afrikaans, English and combinations thereof are the main language of instruction of the
educators who participated in the study:
Few schools presents ASD education in African languages, which may be a challenge for
learners with African home languages (cf. 5.5.1).
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5.9.8.2 Autism-specific education classes had on average 7 to 10 learners, with significantly
more boys than girls:
Providing specialised education for 7 to 10 learners is a very costly service model. However,
educators reported a ratio of 1:6 as ideal, and indicated high numbers of learners as a
challenge. The gender ratio of one female for every seven males is in keeping with
international findings (cf. 5.5.1). However, this complicates the selection of gender-appropriate
activities in class.
5.9.8.3. Class assistants are mostly used in autism-specific – and special schools:
A total of 70 educators reported to have class assistants. Autism-specific and special schools
appeared to be better resourced in this regard (cf. 5.5.4).
5.9.8.4. In keeping with global trends, schools used a variety of educational approaches
(partial inclusion and ASD classes) to accommodate the needs of individual learners:
Educators indicated using a variety of educational approaches (partial inclusion and ASD
classes) in relation to the needs of individual learners (cf. 5.5.3).
5.9.8.5. There is variability in the use of curriculums and curriculum differentiation
strategies for learners with ASD within the South African context:
The type of school dictated the use of curriculum. Autism-specific mainly used self-developed
curriculums and the ELSEN curriculum developed by SANASE. Educators from special
schools reported to use self-developed curriculums and the ELSEN curriculum developed by
SANASE, and differentiated CAPS appeared to be mostly used. Full-service schools mainly
used differentiated CAPS (cf. 5.5.3).
5.9.8.6. The practices concerning individual support plans, daily and weekly schedules
are similar to global practices:
The majority of educators reported the use of individual support plans (ISP). Some 90% of
educators reported that other stakeholders were involved in the design of the ISP. The majority
of educators reported using daily and weekly schedules (cf. 5.5.4).
5.9.8.7. The classroom structuring of ASD classes is in keeping with recommended
practices:
Educators reported positioning learners around tables in stimulus-free workstations, or on a
mat, which are in keeping with global strategies. Ordinary classroom structuring (n=13) did not
appear to be widely used. Educators did, however; report stimulus-rich classrooms, which are
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in contrast with recommendations that learners with ASD require stimulus-free areas to avoid
visual distractibility (cf. 5.5.6).
5.9.8.8. The majority of educators indicated the use of unstructured supervision during
break time:
The majority of educators indicated the use of unstructured supervision, where educators
supervised learners in accordance with a break time schedule (cf. 5.5.7).
5.6 THE USE OF AUTISM-SPECIFIC SUPPORT STRATEGIES
Educators require specialised knowledge, skills and resources to optimally enhance the
development, behaviour, learning and functional independence of learners with ASD (cf.
2.3.5.2). In recent years, there has been a dramatic increase in the quantity and range of
focused interventions, comprehensive treatment models, teaching programmes and classroom
strategies proposed for learners with ASD (cf. 2.3.5.7). These approaches include the use of
ASD programmes, assistive technology, alternative teaching strategies, environmental
adjustments, and specialised human resources. Since limited training opportunities and access
to resources appeared to be challenges within the South African education context (cf. Table
4.58), the researcher was interested in determining the practices and challenges concerning
diagnostic specific support.
The discussion includes the following aspects:
5.6.1 Utilisation of research-based programmes;
5.6.2 Educators’ rating of their skills level in diagnostic-specific support;
5.6.3 Use of assistive technology, alternative methods and other strategies; and
5.6.4 Conclusions on practices and challenges concerning the use of autism-specific support
strategies
5.6.1 Utilisation of research-based programmes
Few educators seemed to use researched-based programmes on a monthly basis. The
majority of educators appeared to either use the same programmes on daily or weekly basis,
or would never use a programme at all (cf. Table 4.50). More than 50% of educators (cf. Table
4.11) were trained in the Children Picture Exchange Communication System (PECS) (n=55;
61%) and Treatment and Education of Autistic and Related Communication Handicapped
Children (TEACCH) (n=51; 56.7%). Globally, these two programmes are trained, used and
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recommended for autism-specific education (cf. 2.3.5.8). Educators rated TEACCH (n=41;
45.6%), PECS (n=40, 44.4%) and Makaton Language Programme (n=27, 30.0%) as the three
most popular international, science-based programmes (cf. Table 4.51). Nevertheless,
educators appeared to be trained in (cf. Table 4.11) and used (cf. Table 4.50) a wide range of
programmes.  According to Hanbury (2005:16-17) a combination of elements from different
approaches, which considers the interaction of different parts of the syndrome, appears to be
an effective intervention strategy, whereas customised programmes have the disadvantage of
decreased scientific value (cf. 2.3.5.8).
The Tiny Handz programme (n=42; 46.7%), the Fishbowl programme (n=33, 36.7%) and the
Special Needs Adapted Programme (n=25; 27.8%) are South African developed programmes
(cf. 2.3.5.7) in which educators reported to be trained (cf. Table 4.11). Although the Makaton
Language programme (n=41; 45.6%) is considered to be an international research-based
programme for ASD (Duffy & Sheehy 2009:91), an equal number of educators reported to be
trained in Tiny Handz (cf. Table 4.11). Educators indicated that they used South African
developed programmes on a daily or weekly basis (cf. Table 4.50) and approximately 20% of
educators reported Tiny Handz (n=19) and Fishbowl (n=18) as the most popular programmes
(cf. Table 4.51). South African developed programmes appeared to gain increasing support,
possibly due to the affordability, accessibility and relevance to the South African context, given
the reality of limited resources and training opportunities (cf. 2.4.3.1, 2.4.3.2). The researcher
was unable to access any scholarly literature concerning the scientific value of these South
African developed programmes.
The Applied Behaviour Analysis is considered to be a scientifically based programme
(Simpson 2005:146), but it appeared to be less used (cf. Table 4.50) and trained (cf. Table
4.11) in the South African context. A total of 31 educators (34.4%) reported training in the
following other programmes (cf. Table 4.11): Non-punitive restraint (n=2; 2.2%); ASD
certificate of competence (n=1; 1.1%); Studio 2 (n=1; 1.1%); Studio 3 (n=6; 6.7%); Alternative
Augmentative Communication (n=7; 7.8%); Social Stories™ (n=1; 1.1%); Apple software (n=2;
2.2%); and informal ASD courses (n=11; 12.2%). Alternative Augmentative Communication (cf.
2.3.5.8) and Social Stories™ (Gray 2012:online and Kincaid et al. 2004:194) are mentioned in
literature as commonly used in autism-specific education. However, not all these programmes
have been proven to have scientific value in autism-specific education.
Five educators (cf. Table 4.11) reported to be trained in the use of the Developmental,
Individual Difference, Relationship-Based Model (DIR® / Floortime™), but 33 educators
indicated that they used the programme on a daily basis (cf. Table 4.50). Nevertheless, only
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five educators rated the programme as most beneficial to learners with ASD (cf. Table 4.51).
Social Stories™ (cf. Table 4.50) seemed to be used daily (n=20), weekly (n=29) or monthly
(n=9). However, only one educator indicated to be trained in the use thereof (cf. 4.4.6). Some
19 educators rated Social Stories™ as beneficial to learners with ASD (cf. Table 4.51).
Although educators indicated that they used DIR® / Floortime™ and Social Stories™, few
educators appeared to have received formal training in the use of these programmes. Hence,
this study indicates that educators used programmes for which they did not necessarily receive
training, or considered using programmes that added the most benefit to learners. These
findings are aligned with the results in international studies (Koegel et al. 2011:online and
Simpson 2005:141-142) and is possibly not unique to the South African context.
5.6.2 Educators’ rating of their skill level in diagnostic specific support
Hanbury (2005:1-2) indicates that classroom practices (creating a responsive classroom, a
structured class routine, opportunities for social interaction, positive behaviour support, etc.)
are predominantly influenced by the knowledge, attitude, skills and experience of educators
concerning autism-specific support. In spite of a dramatic increase in the prevalence of ASD
and the availability of programmes, there appears to be a global decline in literature focusing
on educator training and effectiveness (cf. 2.3.5.3). Given the limited training opportunities in
the South African context, the identification of educators’ rating of their skills level in
diagnostic-specific impairments was a vital consideration.
Table 4.52 indicates that more than 50% of educators reported that they were developing skills
in:
(i) Sensory processing and praxis;
(ii) Motor control;
(iii) Socio-emotional control and behaviour; and
(iv) Activity level and focus.
Some 7-10% of educators indicated uncertainty regarding their skills in:
(i) Destructive and self-stimulatory behaviours;
(ii) Sensory defensiveness;
(iii) Decreased social sensitivity;
(iv) Poor social interaction;
(v) Preoccupation with objects and activities;
(vi) Withdrawal from classroom activities; and
(vii) Hyperactive behaviours.
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Many of the abovementioned dysfunctions appeared to be related to sensory processing and
praxis difficulties (cf. 2.3.1.7). Sensory behaviours were included in the descriptors for
“restricted, repetitive patterns of behaviours” in the DSM-5 and fall within the specialist field of
occupational therapy (cf. Miller 2013:online). This specialist knowledge of occupational
therapists positions them to equip educators concerning sensory processing and the
challenges it presents regarding participation in daily activities. The majority of schools (cf.
Table 4.27) were resourced with occupational therapists, which may create an opportunity to
equip educators regarding the use of sensory strategies.
Poor socio-emotional control and behaviour (cf. Table 4.52) were also indicated as areas in
which educators required more training. Autism is a behaviour defined condition and therefore
behavioural analysis is essential in developing educational support strategies (Adreon
2005:59-60). Educators need to understand the factors that contribute to behaviour, the cycle
of tantrums and strategies to enhance self-awareness and calming (Adreon 2005:61:69). Table
2.10 describes classroom strategies to enhance emotional and behavioural support in learners
with ASD. Applied Behaviour Analysis (ABA) is mentioned as a systematic process where
behaviour is studied and modified through manipulation of the environment. Only 17 educators
(cf. Table 4.11) had received training in Applied Behaviour Analysis, while 15 educators (cf.
Table 4.50) used the programme on a daily basis. Hence, educators participating in this study
indicated a need for structured programmes and strategies to manage challenging behaviour
and socio-emotional control.
Educators also expressed a need for training in the management of destructive and self-
injurious behaviours, as well as hyperactive behaviour. More than 50% of educators reported
that they were developing skills in:
(i) Sensory processing and praxis;
(ii) Motor control;
(iii) Socio-emotional control and behaviour; and
(iv) Activity level and focus.
Attention Deficit Hyperactivity Disorder (ADHD) often co-occurs in learners with ASD, which
complicates the disability profile. Learners with both ADHD and ASD present with lower
cognitive functioning, social processing difficulties, motor deficits, poor executive functions and
delays in adaptability (Murray 2010:online and Landa & Rao 2013:online). Self-injurious
behaviour is considered to be repetitive behaviour restricted to the “lower level” (LoVullo &
Matson 2008:61) and is complex to manage in learners with ASD. Although training in these
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areas is vital, the researcher is of the opinion that many educators will continue to struggle with
the management of learners with both ASD and ADHD as well as those with self-injurious
behaviours due to the complexity of these behaviours.
5.6.3 Use of assistive technology, alternative methods and other strategies
Due to the intensive support needs of learners with ASD, they often require assistive
technology, alternative methods and other strategies to assist them in compensating for
functional deficits and to optimise learning. Children with ASD appeared to learn well through
visually-based approaches that assist learners to focus on relevant stimuli, to condense
content to the essential, to make abstract concepts concrete, and to shift attention in a
structured way (Cook et al. 2011:8). Visual support (visual scripts, schedules, photographs,
line drawings, words, visual task analyses, etc.) have been proven efficient in increasing work
completion for learners, increasing social skills, improving communication and decreasing
problem behaviours (Fettig et al. 2011:29-35). Between 39-51 educators reported to use visual
aids (Velcro worksheets and sequence cards, visual schedules, line drawings, pictures and
photos) on a daily basis (cf. Table 4.53). However, the majority of educators (>59%) indicated
that they do not use hi-tech assistive technology such as data projectors (n=44) and interactive
whiteboards (n=39). A total of 15 educators reported daily use and 29 educators indicated
weekly use of computer workstations. Nevertheless, 19 educators indicated that they never
use computer workstations.
In addition to the classical diagnostic criteria of ASD, learners can experience the symptoms of
inattention, hyperactivity and impulsivity seen in ADHD. Hyperactive impulsive symptoms
include fidgeting; challenging in-seat behaviour; inappropriate running and climbing;
disturbance of others; and increased psychomotor activity (American Psychiatric Association
2013(2):59). These behaviours affect the child’s capacity to focus on activities, to cooperate in
the classroom and to benefit from the educational programme. Chairs with postural straps
(New Brunswick Department of Education 2005:71) are used at times to enhance in-seat
behaviours in learners with hyperactive behaviours. The majority of educators (n=41) reported
that they never used restrain chairs, but seven educators reported daily use and 12 educators
weekly use of restrain chairs (cf. Table 4.53). Hence, restrain chairs did not appear to be
commonly used, but there are educators who used this when required.
Learners with ASD struggle with sensory modulation difficulties, which affect their arousal,
attention, emotional responses and general behaviour in class (Henderson et al. 2011:76).
They can be distracted by a cluttered desk or by the movements of another learner who is
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sitting too close. Except for the use of trampolines and sensory rooms, the majority of
educators indicated that they never use sensory strategies (cf. Table 2.8). The low usage of
sensory strategies and devices may be linked to the fact that educators reported that they
were uncertain or still in the process of developing skills in the management of sensory
processing difficulties (cf. Table 4.52). Another possibility is that school-based occupational
therapists are responsible for the implementation of sensory strategies and that educators may
be less involved in this regard. Both these suggestions require further investigation.
Although delayed onset of language is not a diagnostic criterion for ASD in the DSM-5, most
individuals with ASD present with varying levels of language deficits. These deficits range from
receptive and expressive difficulties, absence of speech, echoed speech and overdeveloped
vocabularies (American Psychiatric Association 2013(2):50 and Kaufmann 2012:online).
Approximately one-third (35-40%) of children with autism are non-verbal (Hughes et al.
2011:56). Educators indicated that they made use of picture files (n=40) and communication
boards (n=44) to assist them in communicating with learners with ASD. These devices are also
recommended in literature (Lee and Low 2011:23) and used with research-based programmes
e.g. the Makaton Language Programme (New Brunswick Department of Education 2005:12-
13, 37).
Clumsiness, dyspraxia, poor motor control, impulsivity and decreased sensory processing
appeared to be some of the factors that increased risk of injury in learners with ASD. Many
learners also present with self-injurious behaviour. However, results in Table 4.53 indicated
that the majority of educators indicated that they did not make use of protective clothing.
Results in Table 4.54 display that the majority of educators indicated that visual schedules in
files (n=54) were by far the most popular assistive device. Velcro worksheets (n=26) and
trampolines in class (n=22) also appeared to be popular. Results in Table 4.55 indicate that
few educators (<20%) responded when asked to name other useful strategies in class.
Educators recommended structured and unstructured play, individualised structure and
support, discipline and behavioural strategies, as well as music and singing as useful
strategies.
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5.6.4. Conclusions on practices and challenges concerning the use of autism-specific
support strategies according to the results of the study
5.6.4.1 The training, perceived value and usage of PECS, TEACH and the Makaton
Language Programme appeared to be similar to global trends:
Since educators reported limited access to research-based programmes and accredited
training programmes; the credibility of the training in South Africa and the efficiency in the use
of techniques require further investigation (cf. 5.6.1).
5.6.4.2 Training, development and implementation of South African developed
programmes are reported:
The scientific value of these programmes requires more research since it has only been
recently introduced (cf. 5.6.1).
5.6.4.3 Educators indicated that they were trained in and using a wide range of programmes
on a daily basis:
Educators appeared to use an eclectic approach, with elements from different approaches.
The disadvantage is that the customised and selective use of research-based programmes
decreases the scientific value of the approach. The scientific use of research-based
programmes requires further investigation (cf. 5.6.1).
5.6.4.5 Educators reported that they require more training, skills and classroom support
strategies concerning the deficits related to ASD:
Further development was indicated concerning management strategies in: sensory processing
and praxis; motor control; socio-emotional control and behaviour; as well as activity level and
focus (cf. 5.6.2).
5.6.4.6 Educators reported high usage of low-tech visual aids on a daily basis, but limited
usage of high-tech assistive technology:
Educators reported high usage of low-tech visual aids (Velcro worksheets and sequence
cards, visual schedules, line drawings, pictures and photos) on a daily basis. Computer
workstations appeared to be used, but other devices (interactive whiteboards and data
projectors) were seldom used. Variability in the availability of hi-tech devices appears to occur
(cf. 5.6.3).
5.6.4.7 The efficient use of sensory strategies and devices is influenced by the knowledge and
skills of educators:
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Educators reported to use devices such as trampolines and sensory rooms, but they also
indicated that they require more training regarding the management of sensory strategies and
devices (cf. 5.6.3).
5.7 CHALLENGES AND CRITICAL SUCCESS FACTORS
Autism-specific education is challenging because of the complex symptoms, atypical learning
styles, and behaviours not aligned with expected classroom behaviour. The challenging
behaviour and severe learning disabilities of learners with ASD often leave educators feeling
unskilled (Smith-Myles 2005:2-5). General mental health difficulties and occupational burnout
appeared to be significantly higher in educators of ASD learners (Ahmadi et al. 2013:20).
South African ASD educators seem to deal with contextual challenges, which include systemic
barriers and operational difficulties (cf. 2.4) The researcher was therefore interested to
determine the challenges of ASD educators, to investigate whether they experience
accomplishment in their jobs and what they perceive as critical to the success of ASD
education.
This section deals with the following aspects:
5.7.1 Educators’ experiences of accomplishment and reason for working with ASD;
5.7.2 Educators’ rating of potential challenges;
5.7.3 Opinions on critical success factors; and
5.7.4 Conclusions concerning challenges and critical success factors.
5.7.1 Educators’ experiences of accomplishment and reason for working with ASD
Educators with positive attitudes towards their jobs, supervisors and general work conditions
appear to have fewer signs of burnout, and increased job satisfaction (Ahmadi et al. 2013:20-
27, cf. 2.3.3). Educators who show positive attitudes towards the learners they teach, and
towards their ability to have a positive impact on the development of children with ASD, appear
to facilitate better social adjustment and fewer behavioural challenges (Robertson et al.
2003:online). The results of this study indicated that 82 educators (95.4%) in ASD classes (cf.
4.8.3) experienced accomplishment in their jobs. Some 52% of educators reported positive
attitudes towards learners with ASD, personal attributes and choice (cf. Table 4.57) as reasons
why they decided to work in ASD education. Hence, these results are in agreement with the
findings of other researchers (Ahmadi et al. 2013:20-27, cf. 2.3.3) that a positive attitude
towards learners and jobs appears to be vital to job satisfaction.
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Factors that contribute to positive attitudes of educators towards the education of special
needs include: adequate resources; the availability of a support network at school; and
involvement in an ASD network or membership to an autism-specific support group (Ahmadi et
al. 2013:20-27 and Moreno et al. 2011:online). The results in the current study indicated
adequate access to consumable resources (cf. Table 4.58); the availability of a school support
network (cf. Table 4.1, cf. Table 4.14); and affiliation with autism support groups (cf. Table
4.33) in schools. These mentioned support structures possibly contributed to the experiences
of accomplishment of ASD educators who participated in this study. However, the severe
challenges concerning limited opportunities for training, operational challenges, lack of
therapeutic support, limited support by the Department of Education and restricted
opportunities for debriefing (cf. Table 4.58) can influence the attitudes of educators in the
future.
Educators teaching learners with ASD often have a strong need for training, support and
development (Rodrígues et al. 2011:online), and increased knowledge, skills and experience in
ASD education were also described as critical success factors for ASD education (cf. 2.3.5.3).
A total of 25 educators (27.8%) indicated personal and professional development as a reason
for deciding to work in ASD education (cf. Table 4.57). Although educators indicated a need for
training and development, 44 educators reported limited training in ASD education as a severe
challenge (cf. Table 4.58). Hence, there appeared to be conflict between educators’ need for
training and the availability of training opportunities within the South African context.
Some 17 educators (cf. Table 4.57) reported that operational requirements because of the
increasing demand for ASD prompted school management teams to start autism-specific
education at their schools. It was uncertain whether their involvement in the ASD education
was compulsory or by choice. The researcher is of the opinion that existing ASD classes at
schools should be requested to expand their ASD services due to an increasing demand for
services. In keeping with the critical success factors of ASD education and the job satisfaction
of educators, schools need to select educators for ASD classes who are positive towards
learners with ASD, and have the personal attributes and preference to work with these
learners.
Educators also indicated the progress of learners (n=43), the positive impact of ASD education
on the lives of learners and carers (n=30); as well as the unique manifestation of ASD (n=20)
as factors that contributed to their experiences of accomplishment at work (cf. Table 4.60).
Two educators indicated negative experiences concerning their accomplishment when working
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with learners with ASD, and one educator indicated a mixed experience. The high burden of
care of the learners and limited resources at their schools were reported as the main reasons
for their frustration (cf. Table 4.60). These findings appeared to be aligned with the results of
Moreno and colleagues (2011:online), who indicated that perceptions regarding resources and
limited experience in handling learners with ASD may contribute to negative attitudes
concerning special needs education. Other factors that may contribute to negative experiences
are time pressure, high administrative loads, decreased teacher-parent relations, decreased
teacher independence, team approach in schools and lack of support from school leadership
(Moreno et al. 2011:online and Skaalvik & Skaalvik 2009:1068-1069). Operational challenges
in schools (cf. Table 4.58), decreased parent involvement (cf. Table 4.30, cf. 2.3.5.5), and
decreased support from leadership (cf. Table 60, cf. 2.4.3) may affect the job satisfaction of
ASD educators in future.
Educators working with learners with ASD and their intensive support needs are at higher risk
for burnout and poor job satisfaction (Ahmadi et al. 2013:20-27). Educators employed at
autism-specific (n=6) and special schools (n=20) indicated limited opportunity for debriefing as
a severe challenge. Although the majority of educators indicated a sense of accomplishment
concerning their work, the situation may change in future given increasing operational
demands, limited support and resources.
5.7.2 Educators’ rating of potential challenges
Educators rated the traits and behaviours related to ASD as a severe challenge (cf. Table
4.58), which is in keeping with global views (cf. 2.3). The successes in the improvement of
diagnostic-specific symptoms and functional independence were indicated by participants as
providing them (n=43; 52.4%) with a sense of accomplishment. However, slow learner
progress appeared to cause burnout and frustration (cf. Table 4.60). Educators in full-service
schools (cf. Table 4.59) did not seem to perceive the traits and behaviours of ASD as a severe
challenge, possibly because they mainly deal with learners who presented with mild
symptoms. The personal factors (attitude, level of experience with learners with ASD, personal
attributes, etc.) seemed to influence the perception of educators concerning the complexity of
traits and behaviours (cf. 2.3.3). An analysis of these factors is beyond the scope of this study
and requires further investigation.
Some 44 educators indicated limited training in autism-specific education as a severe
challenge (cf. Table 4.58), in contrast with findings of international researchers (Adeniyi
2009:online and Moreno et al. 2011:online) where educators in special schools showed a
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lower demand for training compared to educators in mainstream settings. Educators in South
African special schools (cf. Table 4.59) showed a high demand for training in autism-specific
education. The practice of autism-specific classes being linked to existing special schools may
contribute to the need for training, since educators may be specialists in special needs
education but not necessarily in autism-specific education.
More than 50% of educators in autism-specific and special schools indicated inappropriate
curriculums and limited access to research-based programmes as a severe challenge (cf.
Table 4.58). A variety of curriculums and strategies for differentiation appeared to be used in
schools (cf. Table 4.41). Guidance regarding curriculum implementation, adaptation and
differentiation are managerial functions at school, district, provincial and national level (cf.
2.4.3, 2.4.4.). However, limited leadership and support from management (at all levels) were
reported as severe challenges concerning the implementation of inclusive policy within the
South African context (cf. Tables 4.58 and Table 4.59). Educators in autism-specific and
special schools who deal with learners with intensive support needs indicated the increasing
numbers of learners in classes as a severe challenge (cf. Table 4.59). The majority of classes
had 7-10 learners (cf. Table 4.36), while educators perceived an educator-learner ratio of 1:6
to be ideal (cf. Table 4.61). The increasing demand for ASD education, limited resources and
high cost of specialised education appeared to be a challenge in the South African context.
Parent involvement was perceived to be a critical success factor of ASD education
(cf. 2.3.5.4), but educators that participated in the study (cf. Table 4.59) reported limited insight
and cooperation of parents to be a severe- (n=28; 34.6%) or moderate challenge (n=38;
46.9%). Schools also seemed to struggle involving parents through direct and regular
feedback (cf. Table 4.29, cf. Table 4.30, cf. Table 4.31). These findings are also in keeping
with the results of other research studies in the South African context (cf. 2.4.2).
Educators in full-service and special schools indicated that they perceived the limited support
from the Department of Education as a severe challenge (cf. Table 4.59). Since autism-specific
services only recently commenced at these schools, there may be an increased need for
vision, structured leadership and guidance concerning best practices within the South African
context.
5.7.3 Opinions on critical success factors
Educators reported 18 clusters of critical success factors (cf. Table 4.61) and these critical
success factors are similar to views of other researchers and specialists in the field of autism-
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specific education (Boutot 2013:online, Dunlap et al. 2003:online, Hanbury 2005:24 and
Hughes et al. 2011:58). The researcher is of the opinion that the results in Table 4.61 could be
clustered in the following five sub-divisions of critical success factors:
Firstly, the results indicated critical success factors that were educator-focused. These critical
success factors were supported by approximately 20% of educators and included:
(i) Personal attributes;
(ii) Attitude, expectations and commitment;
(iii) knowledge, skills and practical experience; and
(iv) Insight, integration and reasoning of the educator.
Educators also viewed their choice to work with learners with ASD as well as their personal
attributes as reasons for working in autism-specific education (cf. Table 4.57). Hanbury
(2005:1-2) and other authors (Wagner 2011:29) also highlighted the critical role of the
educators in understanding the impact of the condition on each child, the factors that
contribute to the behaviour of the child, as well as the attitude of educators towards learners
and their unique learning needs.
Secondly, 7-15 educators mentioned critical success factors related to the curriculum and
teaching programmes. These factors are also supported in the literature (cf. 2.3.5.5) and
included an autism-specific curriculum and teaching framework (New Brunswick Department of
Education 2005:48-49); diagnostic-specific support within an all encompassing programme
(Bazyk & Case-Smith 2010:713); an individual support plan and tailor made education
(Hughes et al. 2011:58); as well as inclusive education and diversity management (Boutot
2013:online). Nevertheless, there are authors (Frederickson & Jones 2010:1094 and Wagner
2011:27-28) who recognise the challenges of including learners with ASD into mainstream
settings and therefore do not recognise inclusion as a critical success factor for ASD education
(cf. 2.3.4). This study had only a small sample of full-service schools and did not focus on
inclusive practices in mainstream schools. A research study regarding the inclusion of learners
with ASD in mainstream settings may provide more information regarding practices in the
South African context.
Thirdly, the results indicated the role of operational processes and management as critical to
the success of autism-specific education. These factors are also supported in the literature and
included adequate resources (Moreno et al. 2011:online); cooperation of all stakeholders (cf.
2.3.5.5); parent involvement and transfer of skills to the home environment (cf. 2.3.5.4); an
integrated, multi-professional approach (cf. 2.3.5.1); and support from school- and district-
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based management teams (cf. 2.3.5.3, Koegel et al. 2011:online). Although educators viewed
the necessity of operational processes and management as critical to the success of autism-
specific education, it appeared as if this area posed significant challenges to educators within
the South-African context (cf. 2.4.2, 2.4.3). Results in Table 4.58 indicated moderate to severe
challenges regarding most aspects of operational challenges and resources, integrated teams
and support from management. The efficiency of classroom-based activities is strongly
influenced by the commitment of school management teams and educators to implement
research-based practices (Koegel et al. 2011:online). Thus, the next group of critical success
factors (i.e. classroom-based strategies) would possibly be influenced by the mentioned
operational and management challenges.
Fourthly, the results indicated the role of classroom strategies as critical to the success of
autism-specific education. These strategies included discipline; routine; structure and
consistency; a sense of humour and relaxed class atmosphere (Dunlap et al. 2003:online); and
small classes with an educator learner ratio of 1:6. Although learners with ASD have high
intensive support needs, the high cost of specialised education may challenge educators to
have more learners in their classes (cf. 2.2.11, 2.4.1, Daily 2012:online). Literature also made
mention of multiple, context-based assessment strategies (cf. 2.3.5.6); research-based
intervention strategies in the classroom (cf. 2.3.5.6); promotion of positive peer interaction; and
analysis of challenging behaviour (Boutot 2013:online) as critical success factors. These
factors did not appear to be prominent in the current study.
Only one educator mentioned the use of medication as a critical success factor for successful
ASD intervention. Although medication (cf. 2.2.9) may improve the behaviour and capacity of
individual learners to engage in learning, the researcher is of the opinion that this could not be
generalised as a critical success factor for all learners with ASD.
5.7.4 Conclusions: challenges and critical success factors according to the results of
this study
5.7.4.1 The profile of ASD educators differs from other educators in the South African context:
The majority of educators who participated in the study were experienced, female educators
between the ages of 40-60 years, which is in agreement with global findings. More
experienced educators leave the profession due to limited financial prospects later in their
careers. Currently, this does not appear to be case for ASD educators (cf. 5.2.1, 5.2.2).
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5.7.4.2 The majority of educators who participated in the study indicated that they experience
job satisfaction.
The majority of educators (n=82, 95.4%) in ASD classes reported to experience
accomplishment in their jobs. Positive attitudes towards learners with ASD, personal attributes,
preference, professional development and personal growth were primary reasons for working
in ASD education (cf. 5.7.1).
5.7.4.3 Educators employed in autism-specific education are at high risk for occupational
burnout:
Literature indicated that educators of ASD are at high risk for occupational burnout. Factors
that influence the job satisfaction of educators were indicated as personal factors; adequate
resources; the availability of a support network at school; and involvement in an ASD network
or membership to an autism-specific support group. Educators reported these factors as
challenges at their schools (cf. 5.7.1).
5.7.4.4 The critical success factors for autism-specific education indentified by the educators
who participated in the study are similar to those identified in international literature.
The critical success factors identified in the study are similar to what is described by other
researchers and authoritarians in ASD education. Critical success factors were related to the
following four domains:
(i) Educator-focused;
(ii) Curriculum-focused;
(iii) Operational processes and management; and
(iv) Classroom management strategies (cf. 5.7.3).
5.7.4.5 Challenges concerning autism-specific education are divided into two groups, namely
global challenges and challenges specific to the South African context.
i) Global challenges: Global challenges were mainly derived from literature and include:
 The increased prevalence of ASD, which raises the demand for ASD education
(cf. 2.2.6);
 The recent introduction of the DSM-5, which causes debates and insecurity (cf. 2.2.2);
 Challenges concerning the inclusion of learners with ASD in mainstream settings (cf.
2.3.4); and
 The practical implementation of the critical success factors of autism-specific education
are challenging (cf. 5.7.3).
ii) Challenges in the South African context: Educators reported the following challenges:
 Limited training in autism-specific education;
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 Inappropriate curriculums and limited access to research-based programmes;
 Increasing numbers of learners in classes;
 Limited chance to work with or limited support from therapists;
 Limited parent involvement; and
 Lack of management, leadership and support at district, provincial and national level
(cf. 5.7.2).
5.7.4.6 There appears to be an interaction between the challenges and practices of autism-
specific education in the South African context that requires further investigation:
A challenge in a specific area, e.g. limited access to international research-based programmes
seemed to stimulate the development of a new practice, e.g. the development of context-
based programmes. Nevertheless, the implementation of new practices, e.g. a context-based
programme, appeared to create new challenges in itself, e.g. the scientific value of the newly
developed programme has not been researched.
5.8 SUMMARY
Through the interpretation and discussion of the results presented in Chapter 4, the practices
and challenges relevant to each study objective were identified. The results in the study
confirm global practices and challenges concerning autism-specific education. The critical
success factors for autism-specific education seem to be uniform, irrespective of contextual
factors. Global challenges include the increasing demand for the expansion of autism-specific
education; the complexity of managing learners with ASD; costs of specialised education; and
decreasing operational resources. However, there are practices and challenges that are
unique to the South African context. Limited resources appeared to have stimulated the
development of context-based educational approaches, training programmes, support
structures and ASD education facilities. Socio-political and socio-economical challenges, and
challenges within the South African education system seem to create unique barriers
concerning ASD education in South African public schools. These barriers include, amongst
others, the implementation of inclusive practices; limited structure and support from the
Department of Education concerning curriculums differentiation and standardised operational
procedures; and variability in the provisioning of resources.
Chapter 6 will focus on the limitations of the study, the final conclusions and recommendations
of the study.
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CHAPTER 6
LIMITATIONS, CONCLUSIONS AND
RECOMMENDATIONS
_____________________________________________________________________
6.1. INTRODUCTION
The previous chapter interpreted and discussed the results referring to relevant literature.
Valuable findings have been made concerning practices and challenges of autism-specific
education in South African public schools. In this chapter the limitations (6.2), conclusions
(6.3), recommendations (6.4), summary (6.5) and the conclusions will be discussed.
6.2 LIMITATIONS OF THE STUDY
The delimitation of the problem (cf. 1.4) discussed factors that limited the scope of the study. In
addition, the following factors can also be viewed as limitations to the study:
Although, the majority of educators employed at autism-specific schools were from the
Western Cape and Gauteng, the response rates (cf. Figure 4.1) from these schools were lower
than expected. School principals indicated that staff members were under pressure due to high
operational demands (cf. 4.2). The lower response rate form autism-specific schools is a
possible limitation in the study since it can be assumed that these schools would reflect best
practices in terms of autism-specific education (cf. 5.2.4.). The low representation of autism
specific schools were also affected by inaccuracies in the number of educators at an autism
specific school in Gauteng which possibly affected the numbr of educators targeted for the
study. Some of the study results, however, were broken down in terms of autism-specific-,
special- and full-service schools to display the practices and challenges in different settings.
Currently, the expansion of autism-specific schools to other provinces is not a national priority
and the resources and operational practices of autism-specific schools may not be relevant to
full-service and special schools (cf. 2.4, cf. 5.2.4.3). Special- and full-service schools are
linking autism-specific education to existing operational frameworks (cf. 5.2.3). Fortunately,
educators from special schools were well represented in the study and their service models
are more relevant to autism-specific services in the Motheo District (cf. 5.2.3).
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The low representation of full-service schools can also be perceived as a limitation in the
study. However, although few full-service schools that offer autism-specific education were
identified, all the identified educators participated. The low presentation of full-service is
therefore not a limitation in the study, but a reflection of the limited role full-service schools are
playing concerning autism-specific education within the South African context.(cf. 5.2.3,
5.2.4.2).
6.3 CONCLUSIONS
The aim of the study was to identify the practices and challenges concerning autism-specific
education within South African public schools. Through the interpretation and discussion of the
study results, it was possible to make conclusions that provided valuable insights regarding the
complexity of autism-specific education within the South African context. The conclusions will
now be discussed in terms of the five research objectives:
6.3.1 Training and experience of educators
The following conclusion was made from the first research objective, which investigated the
level of training and experience of educators of autism-specific classes in public schools
nationally:
6.3.1.1 Educators and school-based therapists require training and support in autism-
specific education:
Educators teaching learners with ASD within the South African context have variable
standards of qualifications and levels of specialisation (cf. 5.3.6.1). Autism-specific education
has been recently introduced in the South African context and there is a need for mentorship,
support and training from the Department of Education (cf. 5.3.6.2). School-based professional
working groups, autism support groups and educators themselves take responsibility to create
opportunities for professional development and training (cf. 5.3.6.3). Educators in ASD classes
reported a high demand for training in autism-specific education, but indicated limited training
opportunities and support from the Department of Education as a severe challenge. Since
educators do not always have access to training in research-based programmes, they often
use programmes that they are not optimally trained for.
Educators require more training and guidance in:
i) Sensory processing and praxis;
ii) Motor control;
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iii) Socio-emotional control and behaviour; and
iv) Activity level and focus (cf. 5.6.2, cf. 5.6.4.5).
School-based therapists play varying roles in the enablement of educators, but they also
require opportunities for continued professional development.
6.3.2 School-based operations
The following conclusions were made from the second research objective which was to
investigate school-based operations concerning admission criteria and procedures of learners
with ASD, extra-curricular services, therapeutic support and parent collaboration:
6.3.2.1 Barriers in the implementation of inclusive policy and operational procedures hamper
autism-specific education services:
Educators reported lack of management, leadership and support at district, provincial and
national level (cf. 5.7.2), and inadequate access to specialised resources and provisioning of
training from the Department of Education. The national strategy on Screening, Support,
Identification and Assessment is implemented with limited success due to insufficient training
and resources. The full spectrum of learners with ASD is currently not accommodated in
autism-specific, special and full-service schools. Autism-specific schools are filled beyond
capacity and these schools are limited to three provinces (cf. 5.2.4.3). ASD classes linked to
special schools (mainly schools for learners with intellectual disability) are the fastest growing
service model for learners with moderate to severe ASD (cf. 5.2.4.1). Mainstream and full-
service schools offer limited autism-specific support and the inclusion of learners with ASD is
challenging in mainstream settings (cf. 5.2.4.2). Full-service schools play a minor role in the
provision of autism-specific education to learners with mild to moderate autistic traits (cf.
5.2.4.1).
6.3.2.2 Schools providing autism-specific education develop their own service models and
operational models in accordance to the availability of resources:
Schools have similar admission criteria and procedures concerning autism-specific education
(cf. 5.4.6.2.) which include:
i) Continence and independence in toileting;
ii) Formal diagnosis of ASD by a medical specialist;
iii) Screening by a school panel;
iv) Age restrictions; and
v) Functional communication and language skills in full-service schools (cf. 5.4.1.4).
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The study results indicated that district-based support teams have different levels of efficiency
concerning admissions of learners to special schools, the provision of ASD training and
support strategies and development of educators.The extracurricular services offered depend
on the type of school, the availability of funding, school infrastructure and parent involvement
(cf. 5.4.6.3). Learners with ASD can be accommodated in hostels using specific strategies, but
access to hostel facilities are limited (cf. 5.5.6.4). Educators indicated that children with ASD
are in need of therapeutic services at schools that offer autism-specific education (cf. 5.4.6.5)
but there are differences in the availability and utilisation of therapeutic resources (5.4.6.6).
Hence, schools provide services in accordance to their resources and current operational
models.
6.3.2.3 Autism support groups play a key role in the expansion of autism-specific education in
South African public schools:
Autism support groups advocate the right of learners with ASD to education and create
awareness concerning the unique support needs of these learners (cf. 2.3.5.8). Pressure is
created through parent action groups and collaboration with the Department of Education to
develop and expand autism-specific education in public schools. Autism support groups
provide training for educators in autism-specific education (cf. 2.3.5.8, 5.3.6.3, 5.3.4).
Networking and regional support contributes to the development and emotional support of
educators and parents (cf. 2.4.2, cf. 5.3.5).
6.3.2.4 There is a need for collaboration between various stakeholders concerned with autism-
specific education:
Parent-educator collaboration is a critical success factor for ASD education, but parent
involvement and transfer of skills from the school to the home environment were indicated to
be serious challenges (cf. 5.4.6.7). Schools collaborate well with one another through
professional learning groups, but require support, guidance and training from the Department
of Education, universities and other authoritarians within the field of ASD. Results indicated
that autism-specific education is mainly provided for learners between the ages of 8-13 years,
which highlights the role of health practioners and social development in assisting with the
early identification in intervention of learners with ASD to ensure readiness for the admission
requirements of schools. Opportunities for vocational training in learners older than 13 years
are limited and require a collaborative multi-professional approach to increase the
employability and community integration of learners who need to exit school.
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6.3.3 Classroom management practices
The following conclusions were made from the third research objective which was to
investigate classroom management practices in terms of the curriculum, work schedules,
monitoring of learner progress as well as activity and environmental adjustments:
6.3.3.1 Schools use a variety of educational approaches and curriculum differentiation
strategies:
In keeping with global trends, schools used a variety of educational approaches in partial
inclusion and ASD classes to accommodate the needs of individual learners (5.5.8.4). There is
variability in the use of curriculums and curriculum differentiation strategies for learners with
ASD within the South African context. The challenges concerning monitoring and assessment
are similar to global challenges.
6.3.3.2 Visual and environmental structure is an important component of classroom practices
in ASD classes in the South African context:
The classroom structuring of ASD classes is in keeping with recommended practices: The
majority of educators indicated the use of unstructured supervision during break time. The
practices concerning individual support plans as well as daily- and weekly visual schedules
were similar to global practices. The visual strategies and structures used in PECS and
TEACCH were used by most educators.
6.3.4 Autism-specific support strategies
The following conclusions were made from the fourth research objective to investigate the use
of autism-specific support strategies with reference to research-based programmes, diagnostic
specific support strategies as well as assistive technology and alternative methods:
6.3.4.1 The efficiency in the use of research-based intervention strategies and South African
developed programmes require further investigation:
Training, development and implementation of South African developed programmes are
increasing but these programmes require more research (cf. 5.6.4.2). Educators indicated that
they were trained in- and used a wide range of programmes on a daily basis (cf. 5.6.4.3.) but
the efficiency of this eclectic approach requires further investigation.
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6.3.4.2 The availability of resources and training influenced the use of ASD specific support
strategies:
Educators reported high usage of low-tech visual aids on a daily basis, but limited usage of
high-tech assistive technology. The efficient use of ASD strategies, such as sensory
processing strategies, and devices is influenced by the knowledge and skills of educators.
6.3.5 Challenges and critical success factors
The following conclusions were made from the fifth research objective which was to investigate
the aspects that educators had regarded as challenges and critical success factors in
managing learners with ASD in public schools:
6.3.5.1 Educators agree with international views on critical success factors for autism-specific
education, but challenges in the South African education context hamper implementation:
The critical success factors identified in the study are similar to what is described by other
researchers and authoritarians in ASD education. Critical success factors were related to the
following five domains:
i) Educator-focused;
ii) Curriculum-focused;
iii) Operational processes and management; and
iv) Classroom management strategies (cf. 5.7.3).
The practical implementation of the critical success factors of autism-specific education is
hampered by challenges in the South African education system (cf. 5.7.3).
6.3.5.2 Educators employed in autism-specific education within South African public schools
are at risk for occupational burnout:
The educators who participated indicated that they experienced feelings of accomplishment in
educating learners with ASD (cf. 5.7.4.2). Recognition from management and parents,
operational support and opportunities for personal growth and professional development were
indicated as factors that contributed to their job satisfaction (cf. 5.7.4.1). These educators are
at high risk for occupational burnout (cf. 5.7.4.3) since critical success factors such as training
and access to ASD-specific resources are not met in all schools (cf. 5.7.4.5). Educators
reported the following challenges which are all related to barriers in the current education
system:
i) Limited training in autism-specific education;
ii) Inappropriate curriculums and limited access to research-based programmes;
240
iii) Increasing numbers of learners in classes;
iv) Limited chance to work with or limited support from therapists;
v) Limited parent involvement; and
vi) Lack of management, leadership and support at district, provincial and national
level (cf. 5.7.2).
6.4 RECOMMENDATIONS
The primary aim of the research study entailed an investigation of practices and challenges in
South African public schools that offer autism-specific education with the end goal of
contributing to the development of monitoring tools, strategies to support and develop
educators and to expand quality ASD education in the Motheo District. The study results
indicated practices and challenges on various levels within the education system. However, for
the purposes of the study, recommendations will focus on the scope of practise of district-
based occupational therapists within the limited availability of resources.
6.4.1 Training and experience of educators
6.4.1.1 Training and support for ASD educators and school-based therapists:
The training and support needs of educators have been discussed. In accordance with White
Paper 6, school-based therapists should play a key role in the enablement of educators
concerning learner support strategies. However, therapists also require strategies for
continued professional development and opportunities for specialist training, e.g. in sensory
integration. Although the study did not focus on the training needs of therapists, district-based
occupational therapists need to support school-based therapists through structured workshops
and professional learning committees.
6.4.1.2 Collaboration with Universities
Study results indicated that universities are currently playing a minor role in the professional
development of educators teaching in autism-specific education. Collaboration with universities
is imperative to inform educators regarding the latest research in ASD and autism-specific
education. Educators, on the other hand, could also assist universities in developing
curriculums and support strategies that consider contextual realities within the South African
education system. Universities could also assist with proposed research projects.
241
6.4.2 School-based operations
6.4.2.1 Strengthen the role of district-based support teams in terms of ASD support:
District-based occupational therapists are in a position to enable district-based support teams
concerning admission criteria, the critical success factors of autism-specific education and
classroom strategies. The study highlighted that district-support teams are currently inefficient
in their role concerning the admissions of learners to special schools, advice concerning
classroom support strategies and the development of educators through structured training (cf.
6.3.5). The enablement of district-based support teams is vital to optimally assist schools in the
provisioning and expansion of quality autism-specific education.
6.4.2.2 Collaboration with stakeholders:
The results of this study indicated that there is a need for district-based occupational therapists
to collaborate with various stakeholders, which include the following:
Health care occupational therapists: Early identification and intervention were indicated as a
critical success factors for autism-specific education, since learners present with
developmental delays in various domains and struggle to master pre-academic skills (cf.
5.4.1.3). Since occupational therapists employed in the Department of Education work with
school-aged learners, it is essential to collaborate with therapists working with children with
ASD younger than five years, to ensure the inclusion of preparation for school admission (cf.
6.3.6) in intervention plans.
Social development: The study results indicated limited access to autism-specific education for
learners younger than five years, as well out-of-school learners who do not meet the criteria of
formal schooling. There is an urgent need to develop more learning and stimulation centres
within the public sector for the mentioned population.
Schools-based support teams: District-based support teams need to collaborate with school-
based support teams on a regular basis to ensure improved implementation of inclusive policy
and operational procedures, to optimise admission criteria and to enable educators with
classroom support strategies.
Autism support groups: Autism support groups are currently playing a key role in the training
and support of educators and advocate for the expansion of autism-specific education in the
public sector. Collaboration with provincial and district-based support teams is needed to
ensure training content and advocacies are aligned with inclusive practices and resources.
242
Autism support groups may also play a role in motivation of parents to be more involved in
school activities.
6.4.3 Classroom practices and autism-specific support strategies:
6.4.3.1 Development of service standards and monitoring tools to improve and expand quality
autism-specific education:
Study results indicated variability in the use of curriculums; curriculum differentiation strategies;
the utilisation of SIAS; and the implementation of critical success factors for autism-specific
education (cf. 6.3.1.2). The development of context-based service models and monitoring tools
are critical to ensure the development and expansion of quality autism-specific education. The
study provided adequate contextual information to guide the development of these mentioned
management tools.
6.4.3.2 Further research:
The following is recommended as possible research projects in terms of the study results:
i) An investigation concerning the efficiency of South African developed ASD training
and educational programmes;
ii) The efficiency of extra-curricular services for learners with ASD; and
iii) The efficiency of current classroom practices in autism-specific education within
South African public schools.
6.4.4 Critical success factors and challenges
6.4.2.1 Advocacy to policy makers concerning operational challenges:
Advocacy is required to continuously inform policy makers of challenges in the inclusive
system and the delivery of autism-specific education through monthly reports, review meetings
and provincial professional learning committees.
6.4.2.2 Support and recognition of best practises:
The implementation of best practices, such as the use of individual support plans, and critical
success factors of ASD education should be encouraged and supported by school
management and district-based support teams.
6.4.2.3 Training of senior management teams concerning factors that prevent occupational
burnout in the educators of ASD classes:
243
Senior management teams need to understand the factors that contribute to the job
satisfaction of educators of ASD classes. Adequate support, recognition and realistic service
targets would assist to prevent occupational burnout in educators of ASD classes.
6.5 TO CONCLUDE
The aim of the study was to identify the practices and challenges concerning autism-specific
education within South African public schools. The study had five research objects that
focussed on:
i) The training and experience of educators of ASD classes;
ii) School-based operations;
iii) Classroom practices;
iv) Autism-specific support strategies; and
v) Challenges and critical success factors of autism-specific education.
The study managed to produce valuable results concerning these five objectives that would
assist district-based occupational therapists in the development of tools to monitor quality
education (e.g. service standards and a self-audit tool to determine performance on key
objectives); strategies to support and develop educators (e.g. practical workshops on autism-
specific education and the management of challenging behaviours) and to expand quality ASD
education in the Motheo District.
The study not only supplied information for the development of context-based training models,
support strategies, and service standards, but provided valuable insights in the complexity of
autism-specific education within the South African inclusive education system. The need for
leadership and a shared vision, operational support, specialised resources and standards
management have been highlighted. Although, the systemic barriers in the education system
create concern, it also generates opportunities for school and district-based occupational
therapists to review their services, to develop context-based service models and to play a key
role in improving autism-specific education in South Africa.
244
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ADDENDUM A
LIST OF SCHOOLS THAT FIT THE INCLUSION CRITERIA
Addendum A: list of schools that fit the inclusion criteria
Public- Autism specific schools: filtered list to fit study criteria
Focus of school Province Number of ASDeducators Number of ASD learners Regional representative
1 Autism Specific Western CapeWoodstock 2 18 WC01
2 Autism Specific Western CapeRondebosch- East 11 111 WC01
3 Autism Specific GautengBraamfontein 4 24 G07
4 Autism Specific GautengPretoria East 10 102 G07
5 Autism Specific Eastern CapePort Elizabeth 9 60 EC06
36 315
Public -Special schools: filtered list to fit study criteria
Focus of School Province Number of ASDeducators Number of ASD learners Regional representative
1 Learning disability Western CapeRondebosch 2 12 WC01
2 Intellectually Impaired Western CapeBellville 5 20 WC02
3 Intellectually Impaired Western CapeGeorge 4 18 WC02
4 Intellectually Impaired Western CapePaarl 4 18 WC01
5 Intellectually Impaired Western CapeCape Town 2 12 WC01
1
Focus of School Province Number of ASDeducators Number of ASD learners Regional representative
6 School for the deaf Western CapeKhayaletsha 2 12 WC01
7 Intellectually Impaired Free StateKroonstad 2 12 FS03
8 Intellectually Impaired Free StateThaba Nchu 3 20 FS03
9 Intellectually Impaired Free StateBloemfotnein 4 16 FS03
10 Intellectually Impaired Free StateBloemfontein 5 20 FS03
11 Learning Disability Free StateBloem 1 6 FS03
12 Physical Disability and Northern Capeautism Kimberley 4 20 NC04
13 Intellectually Impaired Northern CapeKimberley 2 12 NC04
14 Intellectually Impaired Northern CapeKimberley 4 24 NC04
15 Physical Disability and KZNautism Pietermartisburg 7 28 KZN05
16 Intellectually Impaired KZNMadadeni 4 18 KZN05
17 Intellectually Impaired KZNPietermartisburg 5 20 KZN05
18 Intellectually Impaired KZNDurban 2 12 KZN05
19 Intellectually Impaired GautengRandberg 2 14 G07
20 Intellectually Impaired GautengVereeniging 2 12 G07
2
Focus of School Province Number of ASDeducators Number of ASD learners Regional representative
21 Intellectually Impaired and GautengAutism Parktown 3 14 G07
22 Intellectually Impaired Eastern CapeKing Williams Town 1 12 EC06
23 Intellectually Impaired Eastern CapeEast London 4 15 EC06
24 Intellectually Impaired North WestPotchefstroom 2 12 NW8
25 Intellectually Impaired North WestPotchefstroom 4 20 NW8
26 Intellectually Impaired Limpopo 1 8 L09
81 419
Public-Full service schools: filtered list to fit study criteria
Focus of school Province Number of ASDeducators Number of ASD learners Regional representative
1 Full Service School Free StateKroonstad 3 12 FS03
2 Full Service School Free StateThaba Nchu 3 16 FS03
3 Full Service LimpopoPolokwane 3 12 L09
9 40
3
ADDENDUM B
SUBMISSION OF MINOR PROTOCOL AMENDMENTS
Addendum B: Submission of minor protocol
amendments
The Chairperson: Ethics Committee
For Attention: Ms H Strauss
Block D, Dean’s Division, Room D115
Faculty of Health Sciences
PO Box 339 (Internal Post Box G40)
Nelson Mandela Drive
University of the Free State
BLOEMFONTEIN
9300
Tel: 051 405 2812
Fax: 051 444 4359
E-mail: StraussHS@ufs.ac.za
Reference: Ecufs 09/2013
Corina Botha – Occupational Therapist
Date: 27 May 2013
AMENDMENTS TO RESEARCH PROTOCOL – JC BOTHA
Thank you for taking the time to review the proposed amendments to my research protocol.
The main purpose of my study is to determine current practices and challenges regarding
autism-specific education in South African public schools. The study results would provide
valuable information in the expansion and monitoring of quality autism-specific education in the
Motheo District. The study would also be valuable in the identification of support strategies for
educators and learners with autism spectrum disorders.
I have completed my pilot study and I recommend the following minor chances to the data
collection process:
 Amendments to the schools suitable for the study: The list of schools indicated to
provide autism-specific schools has changed slightly (see Addendum 9) due to inaccurate
statistics on the Education Information Management System.  These changes would not have
any effect on the population size or study design. The following table has also changed:
Table 1: Summary of number of schools and educators for the different types of ASD
schools (p.20-21 in research protocol).
Type of public schools Number of Number of
Updated: Updated:
schools educators Number of Number ofSchools educators
Autism-specific schools 5 42 5 42
Special schools with autism-specific 26 48 27 54
classes
Full service schools 3 3 3 3
Total: 34 93 35 99
 The changes to the list of schools have also impacted the proposed division of regional
representatives who help to coordinate the data collection process. Schools in desolate areas
where there are no occupational therapists to serve as regional representatives would not be
excluded from the study due to the small population size. Documents would be e-
mailed/couriered to the schools directly.
Table 2: Changes to data collection to accommodate schools in desolate areas
Original Text: (p. 23: research protocol) Amended Text
The researcher identified 12 representatives The researcher identified representatives
nationally (occupational therapists) to (occupational therapists) nationally to
accommodate the 34 schools selected for the accommodate the schools selected for the study.
study. Gauteng will have three representatives and The occupational therapists selected as regional
the Western Cape two due to logistical challenges. representatives participate voluntarily and may be
The occupational therapists, selected as regional replaced with another regional representative,
representatives participate voluntary and may be should they be unable to honour the commitment.
replaced with another regional representative Schools in desolate areas where there are no
should they be unable to honour the commitment. occupational therapists to serve as regional
representatives would not be excluded from the
study due to the small population size. Documents
would be e-mailed/couriered to the schools
directly. Principals will then be asked to follow the
same data collection process recommended for
the regional representatives.
The following paragraph will also be added to the data collection guideline (Addendum 6).
Exceptions:
In cases were schools are not able to allocate a time slot for data collection, you may be
requested to provide all participants with a questionnaire and envelope. The educators will
complete the questionnaires during the day and place the completed questionnaire in an
envelope. You will be requested to collect the sealed envelopes at the end of the day.
 One school had indicated that it would be difficult for them to have all the educators
together for a session to collect data all at once. It is therefore suggested that educators would
have the opportunity to complete the questionnaires during the day and that it should then be
collected by the end of the day. However, educators will then be requested not to discuss the
questionnaire with one another to prevent the contamination of data. The researcher does not
want to exclude these schools from the study since the population is small.
2
Table 3: Description of roles in the data collection process (p.25 research protocol)
Original Text Suggested Amendment
6. The researcher will make telephonic contact The researcher will make telephonic contact with
with principals to schedule an appointment principals to schedule an appointment, during which
during which the regional representatives the regional representatives would collect data from
could collect data from the participating the participating educators. Principals will be
educators. Principals will be requested to requested to allocate a 60 minute timeslot and quiet
allocate a 60 minute timeslot and quiet venue for the data collection process. However, in
venue for the data collection process. schools where this could not be arranged, the
researcher will inform the regional representative to
hand out and brief the participants regarding the
questionnaire. The researcher and regional
representative will be telephonically available for
questions. The regional representatives will collect
the completed questionnaires, sealed in envelopes,
by the end of the day.
The following challenge would affect the time frame of the data collection process:
The researcher had struggled to establish contact with some of the principals and needed to
phone and e-mail several times to get them to complete the consent forms. The SADTU Go
Slow also influenced the levels of responsiveness at some schools. The process of obtaining
consent from schools is very time consuming and may have an impact on the proposed
timeframe of the study. The study is proposed to take three months longer (amendments p. 35
of research protocol).
Table 4: Timeline for research project (p. 25 research protocol)
Time allowed/anticipated for a quantitative Time
study: allocated Dates: Original
Dates:
in months Amendment
Choice of a research topic, scanning literature, 1 February to 31 1 February to 31
objective of research 2 March 2012 March 2012
Research proposal 3 30 June 2012 30 June 2012
Corrections and completion of final protocol 2 15 August 2012 15 August 2012
Review expert committee 1 27 September 27 September2012 2012
4 December 4 December
Review evaluation committee 1 2012 2012
Review ethics committee 1 31 January 2013 31 January 2013
Written consent from Directorate: Strategic
Planning, Policy and Research 1 28 February 2013 28 February 2013
Written consent from participating schools 1 28 February 2013 30 March 2013
Pilot study 1 30 March 2013 30 April 2013
Start empirical survey 0.5 20 April 2013 30 May 2013
 Preparing questionnaires to be sent out
 Inform schools and regional
representatives
3
Time allowed/anticipated for a quantitative Time
study: allocated Dates: Original
Dates:
in months Amendment
 Confirm dates and venues with principals
Data collection procedure: 1.5 10 May 2013 10 September
 Courier forms 2013
 Consent from participants
 Completion of questionnaires
 Collect forms
 Prepare for analyses
Analyse data 3 30 June 2013 30 December2013
Write research thesis 2 30 September2013 30 April 2014
Proofread and corrections 2 30 November2013 30 May 2014
Final submission 2 31 December2013 15 June 2014
Bind and submit 1 31 January 2014 1 July 2014
I have attached all the relevant documents requested by your office. Should you have any
queries or require more information, please do not hesitate to contact me.
I am looking forward to your feedback.
Kind Regards
Corina Botha
SES Occupational Therapist
Motheo Inclusive
Tel: 082 202 5952 / 051 404 8944
4
ADDENDUM C
RESEARCH QUESTIONNAIRES
ADDENDUM D
RATIONALE OF THE RESEARCH QUESTIONNAIRE
RATIONALE OF THE RESEARCH QUESTIONNAIRE
DESCRIPTION OF QUESTION TYPES:
Question types Level of data Comment:
Dichotomous questions Nominal The researcher used dichotomous questions extensively in the
 Highly structured closed questions. questionnaire since it saves time and fits well with the quantitative
 Require a yes / no response. approach.
Multiple choice questions Nominal Multiple choice questions have also been used extensively since it
 Choices are designed to capture the possible range of facilitates the accessibility and speed of completion.
responses given to statements.
Open-ended questions Word-based The researcher limited the use of open-ended questions since it
 Invite honest, personal comments from respondents. data requires more energy and effort from respondents. However, the
 Ownership and responsibility for data rests with the researcher used these questions in some case to get the views from
respondent. individuals.
Rank ordering Ordinal The researcher has not used this approach since it may be too
 Moves beyond multiple choice questions by asking complicated for respondents.
respondents to choose priorities.
Rating scales Ordinal Rating scales have been used in cases where the researcher wanted
 These scales build in a degree of sensitivity and to determine the frequency of use of programmes, challenges, etc.
differentiation of responses but still produce structured
quantitative data.
Constant sum questions: Ordinal Constant sum questions have not been utilised.
 Respondents are requested to distribute a given number of
marks between a range of items, e.g. distribute a total of 5
points among the sentences you think closely describe your
teaching style.
 The respondent needs to decide the relative weight of the
aspects provided before coming to a decision regarding the
balance of one aspect compared to another.
Ratio data questions Ratio Ratio data questions have been used in the demographical
 A fixed answer or category is not provided and the information.
respondent indicates an exact number. Ratio data questions
handles continuous variables where there may be a true zero
e.g. How many days have you been absent form school?
1
RATIONAL OF RESEARCH QUESTIONNAIRE
BIOGRAPHICAL QUESTIONS NOT COVERED IN OBJECTIVES:
No. Question Type of question Literature source Motivation
Demographical Date on which the Ratio data - -
1.1. questionnaire is completed questions
Ratio
Demographical What is your age? Ratio data To determine the average age of autism-specific
1.2. questions educators.
Ratio
Demographical What is your gender? Dichotomous - To determine the gender ratio of autism-specific
1.3. Nominal educators.
Demographical In which province are you Multiple choice - To determine the provinces that mainly participated
1.4. working? questions in the study.
Nominal
Objective 1: To determine the level of training and experience of educators of autism-specific classes in public schools nationally
No. Question Type of question Literature source Motivation
Demographical In which year did you Ratio data - To determine the time frames during which
1.10. complete your education questions educators completed their education qualification.
qualification?
Demographical Are you qualified for: Multiple choice - To determine the phases for which the majority of
1.11. questions educators are qualified.
Nominal
Demographical Was your basic education Multiple choice - To determine the basic training educators received.
1.12. qualification a:? questions
Nominal
Demographical Do you have any Dichotomous - To determine whether educators of autism-specific
1.13. qualification post your basic questions classes have post-basic qualifications.
qualification? (yes/no)
Demographical If you answered yes to Multiple choice - To determine the type of post-basic qualification
1.14. question 1.13, please questions educators of autism-specific classes have
indicate which post-basic Nominal completed.
qualification you completed.
Demographical Are you currently busy with Dichotomous - To determine whether educators of autism-specific
1.15. any post basic training? questions classes are busy with post-basic training.
(yes/no)
2
Demographical If you answered yes in Open-ended - To determine whether the postgraduate training
1.16. question 1.15, please Word-based involved autism-specific training or related training.
describe (e.g. B Ed Hons in
support).
Demographical How many years experience Open-ended To determine the average years of experience
1.17. do you have in the Word-based educators have regarding autism-specific
management of learners with education.
autism?
Demographical Have you ever worked Dichotomous - To determine how many educators have worked
1.18. abroad with learners on the questions abroad. Educators who have worked abroad had an
autism spectrum? (yes/no) example of how autism-specific education is
performed efficiently within an inclusive education
setting. Educators who gained experience and
received mentorship within well recognised autism-
specific education facilities have an example and
role model of the resources, skills, programmes and
interventions required to perform efficient autism-
specific education.
Autism-specific Do you have any formal Multiple choice Carr & Felce 2006:780-787, To determine whether South African educators are
Training: 2.1. training in any of the questions Gray 2012:online,  Hume & trained in the internationally recognised research
following autism-specific Nominal Odom 2007:1166-1180, Lund programmes. The research-based programmes
programmes?: and Thorba  2008: 719-730, indicated in the question are developed to assist
Ryan, Hughes, Katsiyannis, educators and therapists to optimise learning and to
McDaniel, and Sprinkle optimally manage challenging behaviour. These
2011:56-64, (Pheiffer, Koenig, programmes are costly and involve training to
Moya, Sheppard and ensure efficient use. These programmes are
Henderson  2011: 2011:76, frequently used and recognised internationally.
Sheehy & Duffy 2009:11,
Simpson 2005:140-149, Smith
Myles 2005:80-81
3
Autism-specific Please name any other Open-ended Carr & Felce 2006:780-787, To determine whether there are any other research-
Training: 2.2. autism-specific programme Word based Gray 2012:online,  Hume & based programmes for which South African autism-
that you are trained in which Odom 2007:1166-1180, Lund specific educators are trained.
is not mentioned in the and Thorba  2008: 719-730,
previous section. Ryan, Hughes, Katsiyannis,
McDaniel, and Sprinkle
2011:56-64, (Pheiffer, Koenig,
Moya, Sheppard and
Henderson  2011: 2011:76,
Sheehy & Duffy 2009:11,
Simpson 2005:140-149, Smith
Myles 2005:80-81
Autism-specific Who trained educators of Multiple choice Dalton, Mckenzie & Kahonde To know whether information is merely cascaded
Training: 2.3. autism-specific classes? questions 2013:online,  Geldenhuys & down, or whether educators receive training from
Nominal Wevers  2013:7, Ladbrook recognised, accredited trainers. The researcher is
2009:46,116-117, National also interested to determine who is mainly
Department of Education: responsible for autism-specific Training in South
Directorate Inclusive Africa.
Education, 2001:29, Wagner
2011:27-29,
Autism-specific Does your school offer Dichotomous National Department of To determine whether schools with autism-specific
Training:  2.4. training on autism-specific questions Education: Directorate classes offer training to other schools.
education to other schools? (yes/no) Inclusive Education 2001 In accordance to White Paper 6, special schools
and autism-specific schools should serve as
resource centres to neighbouring schools. These
schools therefore have a responsibility to empower
colleagues with evidenced-based strategies and
skills.
Autism-specific If you answered yes to 2.4, Open-ended - To determine the type of training schools with
training: 2.4.1. please describe the type of Word-based autism-specific schools provide.
training you provide.
Autism-specific How do you keep updated Open-ended Wagner 2011:27-29 Educators need to take responsibility for their own
Training: 2.5. with the latest developments Word-based development and training. The researcher wants to
in autism-specific education? determine how and if autism-specific educators
achieve this.
4
Objective 2: To determine school-based operations concerning admissions criteria and procedures of learners with ASD, extra-curricular
services, therapeutic support and parent collaboration
No. Question Type of Literature source Motivation
question
Demographical: Type of school where you are Multiple choice - To determine the type of school the educators is
1.6. employed. questions employed at.
Nominal The operational models and operational procedures
differ in autism-specific schools, special schools
and full service schools.
Admissions Does the school make use of Dichotomous American Academy of To determine the assessment tools used in schools
criteria and any of the following questions Pediatrics, 2006:410-413, that provide autism-specific education. There a
extracurricular assessment tools? (yes/no) Falkmer, Anderson, Falkmer range of research-based screening and diagnostic
support: 3.1. and Horlin 2013:329, Texas tools available that could assist schools in
Statewide Leadership for determining the support needs of learners.
Autism Training 2009:1-51,
Admissions Do you make use of the Dichotomous National Department of The Screening Identification Assessment and
criteria and Screening Identification questions Education: Directorate Inclusive Support (SIAS) guideline is a national document
extracurricular Assessment and Support (yes/no) Education 2008: that has been designed to standardise operational
support: 3.2. (SIAS) guidelines? procedures in the design of support strategies. The
researcher is interested whether this tool is used in
the design of support strategies for learners with
ASD.
Admissions For which age ranges do Ratio data Matson, Wilkins & Gonzalez Ideally, schools should offer autism-specific support
criteria and your school provide autism- questions 2008:71-76 for the age group 3-18 years. Special schools and
extracurricular specific education? Ratio full service schools cannot accommodate the full
support: 3.3. age range and usually only have one or two classes
that accommodate learners within a specific age
range. The researcher wants to determine which
age groups are mostly targeted and where the
biggest gaps are in terms of service delivery.
Admissions Please indicate which of the Multiple choice National Department of All schools have admissions criteria by which they
criteria and following aspects  are questions Education: Directorate Inclusive select the learners who would optimally benefit from
extracurricular prerequisites for admission to Nominal Education 2007:7-8, American their programmes. The criteria are rigorously
support: 3.4. your school: Psychiatric Association 2013:5- applied in some settings while others are much
51 more lenient in the selection process. The
researcher is interested to identify these
prerequisites since it assists in the optimal
5
preparation of learners for admissions.
Admissions Does the school offer hostel Dichotomous National Department of Learners in rural areas struggle more to access
criteria and accommodation? questions Education: Directorate Inclusive autism-specific education since specialised services
extracurricular (yes/no) Education 2007:9-16 are mostly offered in urban areas. Hostel
support: 3.5. accommodation is therefore a vital consideration in
finding a suitable educational facility.
Admissions If you answered yes to Open-ended - Since autism is a spectrum disorder, it implies
criteria and question 3.5, please describe questions variability in functional, academic and clinical
extracurricular how do you accommodate (word-based- profiles where symptoms may differ in nature,
support: 3.6. the individual needs of data) intensity and severity. Learners have individualised
learners concerning the needs and are often resistant to change which
hostel routine. creates concern when they need to adjust within a
new routine. The researcher is interested to
determine how schools accommodate the
individuality of learners.
Admissions Does the school offer any of Multiple choice Bass, Duchowny & Llabre To determine which extracurricular activities are
criteria and the following extracurricular questions 2009:1261,  Lang, Koegel, offered for learners with ASD.
extracurricular activities for learners with Nominal Ashbaugh, Regester, Ence Learners with ASD require an all-encompassing
support: 3.7. ASD?: and Smith 2010:576, National programme to optimise all aspects of their
Department of Education: development. Many schools provide additional
Directorate Inclusive Education activities to optimise the development of their
2007:9-16,  Pan 2010:9 learners.
Admissions If you answered yes to Open-ended - To determine the extracurricular activities educators
criteria and question 3.7, which of these questions view as most beneficial.
extracurricular activities do you think are (word-based-
support: 3.7.1. most beneficial to learners data)
with autism?
Admissions Who is responsible for the Multiple choice National Department of To determine whether schools or parents pay for
criteria and costs of the activities named questions Education: Directorate Inclusive extracurricular activities offered at schools.
extracurricular in 3.7.? Nominal Education 2007:9-16,
support: 3.8. Geldenhuys and Wevers
2013:11, Ladbrook 2009:88-89
Therapeutic Do you think it is necessary Dichotomous Brown & Dunn 2010:475, Learners with ASD benefit from a multi-
services and to have therapists at schools questions National Department of professional, all encompassing approach. The
parent that offer autism-specific (yes/no) Education: Directorate Inclusive researcher wants to determine how schools
collaboration: education? Education 2007:13-17, experience therapeutic involvement.
4.1. Ladbrook 2009:90-92
6
Therapeutic Please motivate your answer Open-ended - To determine the reasons why educators feel they
services and in 4.1.: questions do or do not benefit from therapeutic inputs at
parent (word-based- schools.
collaboration: data)
4.2.
Therapeutic Which of the following Multiple choice Bazyk & Case-Smith 2010:713- To determine which therapeutic services are offered
services and therapeutic services are questions 743 at schools.
parent offered at your school? Nominal
collaboration:
4.3.
Therapeutic Do you receive support from Dichotomous Brown & Dunn 2010:475, To determine whether therapists provide hands-on
services and therapists to assist you with questions National Department of support and advice to educators in order to optimise
parent the handling of learners? (yes/no) Education: Directorate Inclusive the management and learning of individual learners.
collaboration: Education 2007:13-17,
4.4. Ladbrook 2009:90-92,  Sonday
2012:5-6
Therapeutic If yes, please indicate the Multiple choice Sonday 2012:5-6, Wagner The researcher wants to determine the type of
services and type of support they provide. questions 2011:27-29 support services therapists offer at schools.
parent Nominal
collaboration:
4.4.1.
Therapeutic Do parents participate in the Dichotomous Wagner 2011:27-29 To determine the participation of parents in
services and educational programme at questions educational programmes offered at the school.
parent your school? (yes/no) Parents are also considered key stakeholders in the
collaboration: management of learners with ASD.
4.5.
Therapeutic How do you ensure the Open-ended National Association of To determine how skills learned at school are
services and transfer of skills to the home questions Elementary School Principals. transferred to the home environment. In order to
parent environment? (word-based- Retrieved February 9, 2012, ensure transfer of learning and consistency in the
collaboration: data) from www.NAESP.org: handling of challenging behaviour; learning
4.6. http://www.NAESP.org strategies should be communicated to parents.
Therapeutic How frequently do you have Multiple choice - To determine the frequency of communication with
services and parent feedback and questions parents.
parent information sessions? Nominal
collaboration:
4.7.
7
Therapeutic Do parents pay extra for the Dichotomous - To determine whether specialised support is proved
services and intensive, specialised questions at additional cost. Parents from disadvantaged
parent education and services they (yes/no) communities often struggle to access specialised
collaboration: receive? services.
4.8.
Therapeutic Does your school offer Dichotomous Autism South Africa: Training and empowerment of parents is vital to
services and specialised training and questions Management Team ensure transfer for learning and a consistent, all
parent educational programmes for (yes/no) 2012:online encompassing educational approach. The
collaboration: parents? researcher wants to determine whether schools
4.9. offer additional training and support to parents.
Therapeutic Is your school affiliated with Dichotomous Autism South Africa To determine whether schools are affiliated with
services and Autism SA? questions 2012:online Autism South Africa. Autism South Africa plays an
parent (yes/no) important role in advocating for the rights of
collaboration: learners with autism, including the right to
4.10. education. Individuals and schools affiliated with
Autism South Africa become part of a network of
individuals who represent ASD issues.
Therapeutic Please name any other Open-ended Autism South Africa To determine whether educators and school are
services and support group you are a questions 2012:online affiliated with other support groups.
parent member of: (word-based-
collaboration: data)
4.11.
8
 Objective 3: To determine classroom management practices in terms of the curriculum, work schedules, monitoring of learner progress as
well as activity and environmental adjustments.
No. Question Type of question Literature source Motivation
Demographical What is your language of Multiple choice - To determine the languages of teaching in autism-
1.5. teaching? questions specific classes.
Nominal
Demographical What is the age range of the Ratio data Matson, Wilkins, Gonzalez To determine the age ranges of learners. The age
1.7. learners in your class, e.g. 6- questions 2008: 75-84 range of learners will influence the programmes,
9 years? Ratio classroom strategies and learning objectives the
educators will implement.
Demographical How many learners do you Ratio data National Department of To determine how many learners are on average in
1.8. have in your class? questions Education: Directorate autism-specific classes in South Africa. Since
Ratio Inclusive Education 2001 learners with autism have individualised needs,
classes should ideally have 10 or less learners per
class. Class size would directly influence classroom
practices, administrative loads and effort the
educator need to employ to efficiently manage the
group of learners.
Demographical How many boys do you have Ratio data Fombonne 2003: 365-382. To determine the gender ratio of learners in autism-
1.9. in your class? questions Centres for Disease Control specific classes.
Ratio and Prevention 2013:online Boys are five times more likely to be affected by
autism. These ratios are important since it impact
on the planning of class room activities.
Demographical Do you have a class Dichotomous Van Rijswijk 2012:online To determine how many autism-specific educators
1.20. assistant? questions have class assistants. The availability of class
(yes/no) assistants impacts on the educators’ planning,
grading of activities and capacity to provide
individualised attention.
9
Curriculum, Please indicate which of the Multiple choice American Psychiatric To determine the severity of autism educators deal
additional following options best questions Association 2013:50-51, within classes. The severity of autism-specific
support and describes the learners with Nominal Kaufmann 2012:online symptoms may influence the choice of curriculum,
classroom autism spectrum disorders in teaching methods, the use of assistive technology
compilation: 5.1. your class? and classroom adaptations.
Curriculum, Does your school offer Dichotomous - To determine whether schools offer vocational
additional vocational training questions training programmes for learners with autism. A
support and programmes for older (yes/no) primary purpose of schools is to equip learners to
classroom learners? become positive contributors to society. Vocational
compilation: 5.2. rehabilitation programmes would therefore be a
primary focus to ensure extended opportunities
after school.
Curriculum, Are learners with autism Dichotomous National Department of The inclusive education system promotes that
additional spectrum disorders included questions Education: Directorate learners, irrespective of diagnoses, disability, race,
support and with others who do not have (yes/no) Inclusive Education 2001 gender, and other differences, should be
classroom the condition? accommodated in the same classroom. This does,
compilation: 5.3. however, pose some practical challenges and the
researcher is interested to see whether schools
implement inclusive strategies.
Curriculum, Do you have classes that Dichotomous - To determine whether learners with autism are
additional exclusively accommodate questions accommodated exclusively in autism-specific
support and learners with autism (yes/no) classes. Since learners with ASD have high-level
classroom spectrum disorders? support needs and atypical learning styles, many
compilation: 5.4. schools group their learners with ASD together
since they benefit from diagnostic specific support.
Curriculum, Which of the following Multiple choice - To determine which curriculums are used in schools
additional curriculums do you offer for questions that offer autism-specific education.
support and learners with autism Nominal
classroom spectrum disorders?:
compilation: 5.5.
Curriculum, Please indicate which of the Multiple choice Bazyk, S., Case-Smith, J. Children with autism benefit mostly from holistic
additional following aspects are questions 2010. School-Based intervention in an all encompassing educational
support and targeted in your curriculum: Nominal Occupational Therapy. In programme that focuses on all aspects of their
classroom Case-Smith J. O'Brien J. development. The researcher wants to determine
compilation: 5.6. Occupational Therapy for whether this aspect is accommodated in public
Children. 6th Ed. Missouri: schools.
10
Mosby Elsevier: 713-743.
Bellini, Peters, Benner and
Hopf 2007:153-162.
Brown and Dunn 2010: 474-
481.
Work schedules How do you adjust your Open-ended National Department of To determine how educators plan their daily
and monitoring lesson plan to accommodate questions Education: Directorate lessons to accommodate complex and
of progress: 6.1. the learning pace of all the Word-based Inclusive Education 2008 individualised learning needs.
learners in your class?
Work schedules Do you make use of Dichotomous National Department of To determine whether individual support plans are
and monitoring individual support plans? questions Education: Directorate used in public schools that offer autism-specific
of progress: 6.2. (yes/no) Inclusive Education 2008 education.
Bazyk, S., Case-Smith, J. An individual support plan is the centrepiece of a
2010. School-Based specialised education programme and describes
Occupational Therapy. In the support targets critical in meeting the learners’
Case-Smith J. O'Brien J. unique needs.
Occupational Therapy for
Children. 6th Ed. Missouri:
Mosby Elsevier: 713-743.
Work schedules Do the individual support Dichotomous National Department of To determine whether a collaborative, multi-
and monitoring plans involve the input of questions Education: Directorate professional approach is used to design and
of progress: 6.3. other stakeholders, e.g. (yes/no) Inclusive Education 2008 provide intervention strategies focussed at
therapists, parents, etc? Bazyk, S., Case-Smith, J. individualised support needs.
2010. School-Based
Occupational Therapy. In
Case-Smith J. O'Brien J.
Occupational Therapy for
Children. 6th Ed. Missouri:
Mosby Elsevier: 713-743.
Work schedules Do you make use of daily Dichotomous National Department of To determine whether educators of autism support
and monitoring schedules for individual questions Education: Directorate classes make use of daily schedules. A daily
of progress: 6.4. learners? (yes/no) Inclusive Education 2008 schedule helps the teacher to achieve the goals in
the individual support plan since it assist in daily
goal setting and monitoring of a learners progress.
11
Work schedules Do you make use of weekly Dichotomous National Department of To determine whether educators of autism support
and monitoring schedules for individual questions Education: Directorate classes make use of weekly schedules. A weekly
of progress: 6.5. learners?: (yes/no) Inclusive Education 2008 schedule helps the teacher to achieve the goals in
the individual support plan since it ensures that
individual schedules are monitored over a week.
Work schedules Please describe how you Open-ended National Department of To determine how the performance of learners with
and monitoring assess and monitor the questions Education: Directorate ASD is measured, since they do not always benefit
of progress: 6.6. progress of learners. (word-based- Inclusive Education 2008 from traditional approaches.
data)
Class and Which of the following class Multiple choice Hanbury 2005. The researcher observed different classroom
playground room structures do you use questions structures at schools and is interested to see what
environment: to optimise the performance Nominal is commonly used.
7.1. of learners in your class?:
Class and Which of the following Multiple choice - Due to the attention deficits (hyper-focus and
playground describes your class room questions under-responsiveness) some learners appear to
environment: best?: Nominal benefit from stimulus-free settings; however, there
7.2. are educators who suggest that busy classroom
settings have the benefit of repetition of concepts
and provide structured visual stimuli.
Class and How do you ensure the Open-ended - To determine how the safety of learners is ensured,
playground safety of learners during questions especially during break times when there is usually
environment: break times? (word-based) less structure and control. Learners with autism do
7.3. not always have insight in safety guidelines and
may even present with self-injurious behaviour.
Objective 4: To determine the use of autism-specific support strategies with reference to research-based programmes, diagnostic specific
support strategies as well as assistive technology and alternative methods.
No. Question Type of question Literature source Motivation
Utilisation of How much do you use the Rating scale Ryan, Hughes, Katsiyanis, To determine the frequency of use of research-
research-based following programmes?: Ordinal McDaniel and  Sprinkle 2011 based ASD programmes in public schools.
programmes: 56-64.
8.1.
Utilisation of Which four programmes do Open-ended - To determine which programmes educators benefit
research-based you find most beneficial in questions mostly from.
programmes: the management of learners (word-based-
8.2. with autism? data)
Autism-specific How do you rate your skill Rating scale Hanbury 2005 The symptoms and behaviours of ASD are
handling skills: level in handling the following Ordinal challenging and specialised skills are required to
9.1. aspects in learners with handle individual learners. The researcher wants to
12
autism spectrum disorders? determine which aspect of ASD is most challenging
to handle. This would also provide a guideline to
indicate priorities for training and the development
of management tools.
Assistive How frequently do you make Rating scale Hanbury 2005 To determine which assistive devices are
technology and use of the following in your Ordinal commonly used in class.
alternative class?:
methods: 10.1.
Assistive Which of the above- Open-ended American Occupational To determine which assistive technologies and
technology and mentioned assistive questions Therapy Association, 2008 assistive devices are viewed by educators as
alternative technology and assistive (word-based) successful.
methods: 10.2. devices do you find most
beneficial?
Assistive What other useful strategies Open-ended New Brunswick Department of Educators may use efficient strategies that other
technology and and alternative teaching questions Education 2005: 1-58, educators may benefit from. The researcher wants
alternative methods do you use with (word-based) to indentify these.
methods: 10.3. efficiency in the management
of the learners with autism in
your class?
Assistive Are learners allowed to bring Dichotomous Van Rijswijk 2012:online To determine the utilisation of caregivers in
technology and their own caregivers to questions classrooms. Since learners with autism have high
alternative class? (yes/no) level support needs, caregivers may assist to
methods: 10.4. optimise an individual approach. The researcher
wants to know whether this is allowed. There are
educators that are of opinion that learners become
too dependent of caregivers and therefore prefer
that learners should cope independently..
13
Object 5: To determine the aspects educators regard as challenges and critical success factors in managing learners with ASD in public
schools.
No. Question Type of question Literature source Motivation
Demographic Please indicate why you Open-ended Hanbury 2005:24, Koegel, To determine whether educators have a passion for
1.19. have decided to work with questions Matos-Fredeen, Lang  and learners with ASD or whether they were placed in this
learners with autism (word-based- Koegel 2011:online, Wagner position due to operational demands.
spectrum disorders. data) 2011:29,
Challenges and How do you rate the Rating scale Geldenhuys and Wevers To determine how resources, logistics and
critical success following aspects of autism- Ordinal 2013:1-12,  Ladbrook operational systems impact on the challenges
factors: 11.1. specific education? 2009:171 educators experience.
Challenges and Do you experience a feeling Dichotomous Rodríguez, Saldaña, and To determine whether educators experience any job
critical success of accomplishment in questions Moreno 2011:online, satisfaction in dealing with a challenging population.
factors: 11.2. working with learners with (yes/no) (Skaalvik  and Skaalvik
autism spectrum disorders? 2009:1068-1069 Zarafshan,
Mohammadi, Ahmadi and
Arsalani 2013:20-27
Challenges and Please motivate your answer Open-ended Rodríguez, Saldaña, and To determine why autism-specific educators do or do
critical success in 11.2. questions Moreno 2011:online, not experience job satisfaction.
factors: 11.2.1. (word-based- (Skaalvik  and Skaalvik
data) 2009:1068-1069 Zarafshan,
Mohammadi, Ahmadi and
Arsalani 2013:20-27
Challenges and What, in your opinion, are Open-ended Boutot 2013:online, Daily The identification of critical success factors gives an
critical success critical factors for success in questions 2012:online,  Iovannone, indication of what educators view as essential
factors: 11.3. working with learners with (word-based- Dunlap, Huber and Kinkaid components of autism-specific programmes.
autism spectrum disorders? data) 2003: online, Jones and
Frederickson  2010:1094,
Wagner 2011:27-28,
14
ADDENDUM E
DATA COLLECTION GUIDELINE
Addendum E: Data Collection Guideline
Date _______________________
Dear __________________________
DATA COLLECTION GUIDELINE:
Autism-Specific Education in South African Public Schools: Practices and Challenges
Thank you for taking time to participate in this research project in spite of your busy schedule.
Your contribution to this project is invaluable and I cannot thank you enough for your efforts
and sacrifices.
I have compiled a data collection procedure to ensure a standard data collection process
across schools. It will be appreciated it if you could review the document and watch the short
PowerPoint presentation to ensure that you are well informed regarding the procedure.
Please do not hesitate to contact me should you have questions or concerns. I will be available
telephonically during the data collection process to provide support and to assist with queries.
Regards
Corina Botha
SES: Occupational Therapist
Tel: 051-4048944/ 0822025952
1
DATA COLLECTION PROCEDURE:
Autism-Specific Education in South African Public Schools: Practices and Challenges
APPOINTMENT FOR DATA COLLECTION:
School: Date: Time: Number of educators:
School contact details:
Principal: Address: Telephone number:
VENUE:
The schools have been requested to provide you with a quiet, comfortable venue (e.g. the staff
room) for the completion of the questionnaire.
PROCEDURE:
 Thank all educators for their participation and invaluable contribution in the project.
 Shortly review the information document and reassure them of the confidentiality of their
participation.
 Ensure that all the participants are comfortable. (Participants are allowed to have coffee
while completing the questionnaire, should that assist in putting them at ease.)
 Hand out the questionnaires and envelopes. Ask educators to wait for your introduction
prior to completion of the questionnaire.
 Introduce the research questionnaire and please highlight the following:
o The questionnaire appears to be very long, but does not require extensive writing.
o Motivate honest and comprehensive responses.
o Restrict communication amongst educators during the completion of the
questionnaires to avoid contamination of data.
o Educators are invited to ask for clarity should they be uncertain regarding the
meaning or interpretation of questions. (The data collector is welcome to contact
the researcher telephonically should she require assistance.)
o Educators are requested to check whether they have completed all sections of the
questionnaire to optimise the usability of data.
o The privacy of educators is respected at all times. The questionnaires are
completed confidentially and only the province and regional representative will be
coded for the purposes of data analysis. Questionnaires will be sealed individually
in the envelopes provided with each questionnaire.
2
 Thank all participants as well as the school for their participation. After completion of the
questionnaires, each participant can take an Autism South African ribbon and pen as a
token of appreciation for their participation.
 Compile all the questionnaires and put it into the self-addressed envelope for return to the
researcher. Please do not remove the questionnaires from their individually sealed
envelopes, to increase the confidentially of the questionnaires.
 Complete the transport claim and e-mail it to the researcher for payment.
 The researcher will phone the regional representative to ask about possible variables that
could have affected the data collection process.
Exceptions:
 In cases were schools are not able to allocate a time slot for data collection, you may be
requested to provide all participants with a questionnaire and envelope. The educators will
complete the questionnaires during the day and put the completed questionnaire in an
envelope. You will be requested to collect the sealed envelopes at the end of the day.
CONTACT DETAILS OF THE PROJECT MEMBERS:
The researcher will be available to answer any questions you have concerning the study, the
procedure and any risks or benefits that may arise from the study. Alternatively, the study
leader can be contacted. Contact details are as follows.
Researcher:
Corina Botha
Tel (work): 051 404 8944
Cel: 082 202 5952
E-mail: corina.botha@gmail.com
Study leader:
Dr R van Heerden
Postgraduate Coordinator: Occupational Therapy
University of the Free State
Tel (work): 051 401 2829
082 461 1511
E-mail: rita@waldie.co.za
3
CLAIM FORM: RESEARCH REPRESENTATIVE:
Name:
HPCSA number:
Telephone number:
Address:
Fax number:
E-mail address:
BANKING DETAILS:
Name of account:
Banking institution:
Branch name:
Branch code:
Type of account:
Account number:
Date:
TRAVELLING CLAIM:
Destination Distance travelled UnitCost Total
OTHER EXPENSES:
4
ADDENDUM F
POWER POINT REGIONAL REPRESENTATIVE
ADDENDUM G
Regional representative confirmation letter
Addendum G: Confirmation of participation-
Regional Representative
Date:_________________________________
Dear Colleagues
CONFIRMATION OF PARTICIPATION: REGIONAL REPRESENTATIVE
Thank you very much for your willingness to assist me with the data collection for my research
project. Since the research project is performed nationally, it would not be possible for me to
collect the data personally and I am appreciative of your willingness to represent me in your
region. I realise the enormous sacrifices you are making to assist me in the research project
and can never repay you for your significant contribution to this project.
We have only discussed your involvement telephonically and I kindly request your confirmation
to participate in the project. I shall provide you with an electronic copy of the protocol, an
information sheet, PowerPoint presentation (with voice recording) and data collection guide to
ensure that you are fully informed before you participate. Should you require more information,
please do not hesitate to contact me.
I trust that this application will be given your kind consideration and time. Should you
favourably consider the request to participate; please forward the attached confirmation slip to
email: corina.botha@gmail.com or fax: 086 729 1476 by _____________________________.
Should you agree to assist me; I shall appreciate it if you can provide me with your postal
address to facilitate the distribution of the research questionnaires.
I am looking forward on working with you and I am grateful for your support!
Regards
Corina Botha
SES: Occupational Therapist
Tel: 051 404 8944 / 082 202 5952
1
Participation as Regional Representative
Autism-Specific Education in South African Public Schools: Practices and
Challenges
Researcher: JC (Corina) Botha (Bachelors in Occupational Therapy, UFS)
Student number: 1990110569
Academic Facility: University of the Free State
Department: Occupational Therapy
INVITATION TO PARTICIPATE:
You are requested to assist me with the data collection process at the following
____________________________________ school/ schools.
YOUR EXPECTED ROLE:
I. I will forward you a copy of the research protocol to develop some understanding of the
purpose and process of the research study.
II. Three weeks prior to the data collection date, I will forward you the research
questionnaires. It would be appreciated it if you could familiarise yourself with the
questionnaire to ensure that you have a clear understanding of the content and
procedure.
III. A time and date for data collection will be negotiated with you and the school. I will take
responsibility for organising the appointments. We will try to agree on a timeframe that
is most convenient for you and schools.
IV. Data will be collected on the scheduled date and time according to the attached
procedure (Addendum 7).
V. The data collection process should not take longer than an hour (excluding travelling
time to and from the school). This is only a once-off data collection process and
repeated trips to schools are not expected.
VI. After the data collection, you will be requested to mail the consent forms and
questionnaires to the researcher. Self-addressed envelopes will be provided to avoid
any mailing cost on your side.
VII. Please complete the transport claim once you have completed the data collection
process.
VIII. The researcher will phone you after the data collection process to ask about possible
factors that could have influenced the data collection process.
DISCOMFORT OR RISKS:
There are no known risks and/or discomforts from this project. The results of this project will be
used to expand and improve the quality of autism-specific education in the Motheo District.
BENEFITS:
Although you would not benefit directly from the project, your participation will contribute to
research in the profession and the body of knowledge regarding autism-specific education.
The results of the project would provide valuable contextual information in the expansion of
2
quality autism-specific programmes. The project would assist in the development of evidenced
based training programmes and operational systems.
VOLUNTARY PARTICIPATION:
Participation is voluntary. You are free to withdraw from this project at any time without penalty
or prejudice. However, I would really appreciate your commitment and support.
CONFIDENTIALITY:
The researcher will at all times respect the privacy of all participants. The identity or potentially
identifying information regarding schools or individuals will not be revealed during the
publication of results. Every effort will be made by the part of the researcher to ensure
participants confidentiality.
REIMBURSEMENT AND FINANCIAL IMPLICATION:
Compensation for participation:
You will be compensated at R3 per kilometre for travelling costs. Telephone costs related to
the project will also be reimbursed. The researcher will cover all postage fees. You will also
receive a gift voucher of R100 as a token of appreciation.
Cost:
Unfortunately, I will not be able to compensate you for loss of clinical time and income. The
data collection appointments will be scheduled at a time that is convenient for both you and
schools to minimise loss of learner contact and clinical time.
Results:
The researcher will publish the results in relevant journals. The researcher will continuously
consider the privacy and confidentiality of all participants.
QUALIFICATIONS AND CREDENTIALS OF RESEARCHER:
Researcher:
 Corina Botha (B. Occupational Therapy, UFS).
 18 years’ experience in the field of adult and paediatric neurology.
 The researcher worked predominantly in healthcare, but has been employed at the
Department of Education since 1 February 2011.
 Postgraduate qualifications in Adult NDT and Sensory Integration.
Study leader:
 Dr R van Heerden (PHD. Occupational Therapy, UFS)
3
CONTACT DETAILS OF THE PROJECT MEMBERS:
The researcher will be available to answer any questions you have concerning the study, the
procedure and any risks or benefits that may arise from the study. Alternatively, the study
leader can be contacted. Contact details are as follows:
Researcher:
Corina Botha
Tel (work): 051 404 8944
Cell: 082 202 5952
E-mail: corina.botha@gmail.com
Study leader:
Dr R van Heerden
Postgraduate Coordinator: Occupational Therapy
University of the Free State
Tel (work): 051 401 2829
082 461 1511
E-mail: rita@waldie.co.za
CONFIRMATION OF PARTICIPATION:
REGIONAL REPRESENTATIVE
I declare that I have read this document and understand all the risks and benefits of
participating in this project.
I, ____________________________________________, hereby confirm my participation in
the data collection of a survey conducted by the researcher for the purpose of the project.
Therapist Date:
My postal address is:
Name:
Postal address
Code:
Telephone number:
4
ADDENDUM H
ETHICS APPROVAL UNIVERSITY OF THE FREE STATE
ADDENDUM I
APPROVAL LETTER FROM PROVINCIAL
DIRECTORATE:
FREE STATE
ADDENDUM J
INLIGTINGS DOKUMENT
INFORMATION DOCUMENT
Addendum J Inligtings Dokument
INLIGTINGSDOKUMENT:
Outisme-Spesifieke Onderwys in Suid Afrikaanse Openbare Skole:
Praktyke en Uitdagings
Navorser: JC (Corina) Botha
(Baccalaureus in Arbeidsterapie)
Akademiese Instelling: Universiteit van die Vrystaat
Fakulteit: Gesondheidswetenskappe
Departement: Arbeidsterapie
UITNODIGING OM DEEL TE NEEM:
Onderwysers van leerders met outismespektrumversteurings (werksaam in outisme-spesifieke
klasse in die openbare sektor) word uitgenooi om deel te neem aan bogenoemde studie.
AGTERGROND TOT DIE STUDIE:
Die arbeidsterapeute in diens van die distrik-gebaseerde ondersteuningspan: Motheo Inklusief
is onder andere verantwoordelik is vir die ondersteuning van leerders wat nie toegang tot ʼn
skool het nie, vanweë hul gestremdheid of sosiale omstandighede. ʼn Totaal van 40% van die
buiteskoolleerders wat deur die arbeidsterapeute geassesseer is; is gediagnoseer met
outismespektrumversteurings of blyk eienskappe van die toestand te hê. Leerders met ligter
vorme van outismespektrumversteurings word in hoofstroomskole geakkommodeer indien
hulle die kurrikulum en sosiale eise kan hanteer. Leerders met matige tot ernstige vorme van
outisme het egter intensiewe ondersteuning nodig a.g.v. die kompleksiteit van hul simptome,
atipiese leerstyle en moeilike gedrag. As ʼn korttermyndoelwit om toegang tot toepaslike
outisme-onderrig in die Motheo-distrik te verhoog, is outismespesifieke klasse in 2010 begin by
drie spesiale skole en een voldiensskool. Ongelukkig akkommodeer hierdie outismespesifieke
klasse slegs ʼn beperkte aantal leerders (ongeveer 60). Die skole het ook waglyste en die
kwaliteit van dienslewering wissel. Arbeidsterapeute werksaam by Motheo Inklusiewe
Onderwys fokus op beide die effektiwiteit en die uitbreiding van ʼn outismespesifieke
onderwysmodel wat geskik en volhoubaar is binne die Suid Afrikaanse konteks.
Die navorser se doelwit is om die praktyke van outisme-onderwys in openbare skole in Suid-
Afrika te identifiseer. Aangesien outismespesifieke onderwys ʼn nuwe spesialiteitsveld in die
Motheo-distrik is, kan die resultate van die studie waardevol wees in die ontwikkeling en
verbetering van outismespesifieke onderwys in die area.
1
DOEL VAN DIE STUDIE:
Die hoofdoel van die studie is om nasionale praktyke en uitdagings ten opsigte van
outismespesifieke onderwys in openbare skole te bepaal. Die studieresultate sal waardevolle
inligting voorsien in die uitbreiding en monitering van gehalte-outismespesifieke onderwys in
die Motheo-distrik. Die studie sal ook van waarde wees in die identifisering van
ondersteuningstrategieë vir onderwysers en leerders met outismespektrumversteurings. Die
studieresultate sal ook gebruik word om voorspraak te maak vir die opvoedkundige regte van
leerders met outismespektrumversteurings.
WAT BEHELS DEELNAME AAN DIE STUDIE:
Deelnemers sal versoek word om ʼn vraelys te voltooi. Indien u die vraelys voltooi, gee u
vrywillige toestemming tot deelname aan die studie. Die voltooiing van die vraelys sal
ongeveer 45 minute neem en is ʼn eenmalige proses. Die projek sal uitgevoer word by die
skool in ʼn geskikte tydgleuf wat deur die skool aangedui word. Aangesien die projek nasionaal
uitgevoer word, het die navorser plaaslike verteenwoordigers (arbeidsterapeute) geïdentifiseer
wat verantwoordelik sal wees vir die proses van data-insameling by skole. Die plaaslike
verteenwoordigers sal vrae hanteer tydens die voltooiing van die vraelyste. U word versoek om
die vraelys so eerlik moontlik te beantwoord. Nadat u die vraelys voltooi het, kan u die vraelys
individueel verseël in ʼn koevert wat saam met die vraelys uitgedeel word. Aangesien die studie
vertroulik uitgevoer word, hoef u nêrens enige identifiseerbare inligting (bv. u naam of die skool
se naam) aan te dui nie.
ONGEMAK EN/OF RISIKO’S:
Daar is geen risiko’s en / of ongemak wat voorsien word tydens deelname aan die projek nie.
VOORDELE:
Alhoewel die deelnemers nie direkte voordeel trek uit die projek nie, sal die resultate van die
projek waardevolle kontekstuele inligting verskaf in die uitbreiding van gehalte-
outismespesifieke onderwys. Die projek sal bydra tot die ontwikkeling van
navorsingsgebaseerde opleidingsprogramme en bedryfstelsels vir outismespesifieke
onderwys.
VRYWILLIGE DEELNAME:
Deelname is vrywillig. Dit staan deelnemers vry om hul te enige tyd te onttrek uit die studie
sonder vooroordeel of benadeling.
VERTROULIKHEID:
Enige informasie wat verband hou met die identifisering van deelnemende skole of individue
sal vertroulik hanteer word. Slegs die provinsie en plaaslike verteenwoordiger
(arbeidsterapeut) sal aangedui word in die kodering van vraelyste. Geen ander potensieel
identifiseerbare inligting sal aangedui word nie.
2
VERGOEDING EN DIE FINANSIËLE IMPLIKASIE:
Vergoeding vir deelname:
Nog die opvoeders nog die skole sal enige finansiële vergoeding ontvang vir deelname aan die
projek.
Koste:
Daar is geen kostes verbonde m.b.t. deelname aan die studie nie.
UITSLAE:
Die navorser sal die resultate slegs na oorleg met die Departement van Onderwys publiseer in
ʼn geakkrediteerde joernaal. Die resultate sal ook in die vorm van ʼn dissertasie as deel van die
kwalifikasie Magister in Arbeidsterapie beskikbaar wees. Die navorser sal te alle tye die
privaatheid en vertroulikheid van die skole en deelnemers respekteer en beskerm. Die
navorser sal met graagte die resultate beskikbaar stel aan belangstellende skole of individue.
KONTAKBESONDERHEDE VAN DIE PROJEKLEDE:
Die navorser sal beskikbaar wees om enige vrae te beantwoord m.b.t. die studie, die
prosedure en enige risiko’s of voordele wat mag voortspruit uit die studie. Alternatiewelik kan
die studieleiers gekontak word. Kontak besonderhede is soos volg:
Navorser:
Corina Botha
Tel (werk): 051 404 8944
Sel: 082 202 5952
E-pos: corina.botha@gmail.com
Studieleier:
Dr R van Heerden
Nagraadse Koördineerder: Arbeidsterapie
Universiteit van die Vrystaat
Tel (werk): 051 401 2829
Sel: 082 461 1511
E-pos: rita@waldie.co.za
Medestudieleier:
A van Jaarsveld
Tel (werk): 051 404 2829
3
Addendum J: Information Document
INFORMATION DOCUMENT:
Autism-Specific Education in South African Public Schools:
Practices and Challenges
Researcher: JC (Corina) Botha
(Bachelors in Occupational Therapy, UFS)
Academic Facility: University of the Free State
Faculty: Health Sciences
Department: Occupational Therapy
INVITATION TO PARTICIPATE:
Educators of learners with autism spectrum disorders (employed in autism-specific classes in
the public sector) are invited to participate in the study.
BACKGROUND TO THE STUDY:
The occupational therapists employed at the district-based support team at Motheo Inclusive
are amongst other duties responsible for the support of learners who do not have access to a
school due to their disability or social circumstances. A total of 40% of out-of-school learners
assessed by the occupational therapists are diagnosed with autism spectrum disorders or
seem to have traits of the condition. These learners experience difficulty in accessing
appropriate education. Learners with milder forms of autism spectrum disorders are
accommodated in ordinary schools if they can cope with the curriculum and social demands.
However, learners with moderate to severe forms of autism have intensive support needs due
to the variability and complexity of autism-specific symptoms, their atypical learning styles and
specialised educational support needs. As a short-term goal, to increase access to appropriate
educational support, autism-specific classes were started in 2010 at three special schools and
one full-service school in the Motheo District. Unfortunately, these autism-specific classes
accommodate only a limited number of learners (approximately 60). They also have waiting
lists have variability in service delivery. Occupational therapists working at Motheo Inclusive
are focused on both the efficiency and expansion of an education model that is appropriate,
applicable and sustainable within the South African context.
It is the researcher’s aim to identify the practices of autism education in public schools in South
Africa. Since autism-specific education is new in the Motheo District; the results could be
valuable in the development and improvement of autism-specific education in the area.
4
PURPOSE OF THE STUDY:
The main purpose of the study is to determine national practices and challenges regarding
autism-specific education in public schools. The study results will provide valuable information
in the expansion and monitoring of quality autism-specific education in the Motheo District. The
study will also be valuable in the identification of support strategies for educators and learners
with autism spectrum disorders. The study will also assist in advocating the educational rights
of learners with autism spectrum disorders.
WHAT THE STUDY INVOLVES:
Participants will be asked to complete a questionnaire. Completion of the questionnaire will be
considered as voluntary consent to participate in the study. The completion of the
questionnaire will take no longer than 45 minutes and is a once-off process. The project will be
performed at the school in a suitable time slot (indicated by the school). Since the project is
nationally executed, the researcher has identified local representatives (occupational
therapists) who will be responsible for the data collection process at schools. The local
representatives will handle questions during the completion of the questionnaires. You are
requested to answer the questionnaire as honestly as possible. After you have completed the
questionnaire, please seal the questionnaire in the envelope, which will be handed to you with
the questionnaire. Since the study is conducted confidentially, no potential identifiable
information (e.g. your name or school name) will be indicated on the questionnaire.
DISCOMFORT OR RISKS:
There are no known risks and/or discomforts from this project. The results of this project will be
used to expand and improve the quality of autism-specific education in the Motheo District.
BENEFITS:
Although participants will not benefit directly from the project, the results of the project will
provide valuable contextual information in the expansion of quality autism-specific education.
The project will assist in the development of evidence-based training programmes and
operational systems for autism-specific education.
VOLUNTARY PARTICIPATION:
Participation is voluntary. Participants are free to withdraw from the study at any time without
penalty or prejudice.
CONFIDENTIALITY:
Any information related to the identification of participating schools or individuals will be treated
confidentially. Only the province and local representative (occupational therapist) will be
indicated in the coding of questionnaires. No other potentially identifiable information will be
indicated.
5
REIMBURSEMENT AND FINANCIAL IMPLICATION:
Compensation for participation:
Neither the educators nor schools will receive any financial remuneration for participation in the
project.
Cost:
There will be no costs incurred on your part for participation in this project.
RESULTS:
The research results will be published in an accredited journal only after consultation with the
Department of Education. The results will also be available in the form of a dissertation as part
of the qualification Magister in Occupational Therapy. The researcher will respect and protect
the privacy and confidentiality of the schools and participants at all times. The researcher will
gladly make the results available to interested schools or individuals.
CONTACT DETAILS OF THE PROJECT MEMBERS:
The researcher will be available to answer any questions you have concerning the study, the
procedure and any risks or benefits that may arise from the study. Alternatively, the study
leaders can be contacted. Contact details are as follows:
Researcher:
Corina Botha
Tel (work): 051 404 8944
Cell: 082 202 5952
E-mail: corina.botha@gmail.com
Study leader:
Dr R van Heerden
Postgraduate Coordinator: Occupational Therapy
University of the Free State
Tel (work): 051 401 2829
082 461 1511
E-mail: rita@waldie.co.za
Co-study leader:
A van Jaarsveld
Tel (work): 051 404 2829
6
ADDENDUM K
SCHOOL PERMISSION TO PARTICIPATE
Addendum K: Permission for research: Schools
Date:___________________________
Dear Principal / School Governing Body
PERMISSION TO PERFORM RESEARCH AT SCHOOL
Thank you for making time to review my research application in spite of your busy schedules. I
am a qualified Occupational Therapist, busy with my Magister in Occupational Therapy at the
University of the Free State. I am employed as a Senior Education Specialist: Occupational
Therapist at the Department of Education: Motheo Inclusive.
The main purpose of my study is to determine current practices and challenges regarding
Autism Specific Education in South African public schools. The study results would provide
valuable information in the expansion and monitoring of quality Autism Specific Education in
Motheo District. The study would also be valuable in the identification of support strategies for
educators and learners with Autism Spectrum Disorders.
Ethical clearance, as well approval from the Department of Education Directorate: Strategic
Planning, Policy & Research has been obtained. Your school is hereby invited to participate in
the research study and consequently I request permission to involve educators from your
school in the research study. Your participation and support of this research project would be
appreciated since there are only a limited number of schools that provide Autism Specific
Education in the public sector.
An information document regarding this project is attached to ensure that you are fully
informed before you participate. Should you require more information, please do not hesitate to
contact me or my study leaders at the contact details provided.
I trust that this application will be given your kind consideration and time. Should you consider
the request to participate favourably, please forward the attached consent to e-mail:
corina.botha@gmail.com or fax:0867291476 by __________________________
Kind regards
Corina Botha
SES: Occupational Therapist
Tel: 051-4048942
1
CONSENT TO PARTICIPATE: SCHOOLS
Hereby I, (full name)__________________________ of____________________________
(name of School) give permission for the research project to be performed at this school. I
realize that participants must still give informed consent and that the school and educators
may at any time discontinue their participation to no detrimental effects.
Principal Date:
Witness Date:
2