Exploring the Attitudes of Parents of Young Children With
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EXPLORING THE ATTITUDES OF PARENTS OF YOUNG CHILDREN WITH AUTISM TOWARDS THE TEACCH CONCEPTUAL MODEL: A NARRATIVE CASE STUDY by NATALIE LYNNE POWELL A Dissertation Submitted to the Faculty in the Curriculum and Instruction Program of Tift College of Education at Mercer University in Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY Macon, GA 2012 UMI Number: 3528454 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. UMI 3528454 Published by ProQuest LLC 2012. Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 © Natalie L. Powell 2012 All Rights Reserved DEDICATION For my husband, Andrew. Thank you for holding my hand on this journey. iv ACKNOWLEDGEMENTS To Dr. A1 Stramiello, my committee chair, for your support and honest advice over the years. Your encouragement and wisdom have had a profound on my life. To Dr. Sybil Keesbury and Dr. Theodora Berry, my committee members, for your feedback and suggestions. This dissertation would not have been possible without you. To Sheila and Jim Shields, Melissa and Gary Register, and Kay and Roy Powell, my parents and in-laws, for believing in me. It is only through your support and prayers that I have accomplished this task. To my siblings, family, and friends, for cheering me on through the years. To Dr. Catherine Bishop Gardner, my colleague, for your continuous pep talks. You made this ride a little bit less bumpy. Finally, to the parents of children with autism who participated in this study. Thank you for sharing your thoughts with me. v TABLE OF CONTENTS Page DEDICATION iv ACKNOWLEDGEMENTS v LIST OF TABLES ix LIST OF APPENDICES x ABSTRACT xi CHAPTER 1. INTRODUCTION TO THE STUDY 1 Conceptual Underpinning for the Study 3 The Culture of Autism 3 Disability Theory 5 Statement of the Problem 8 Purpose of the Study 11 Research Questions 12 Primary Research Question 12 Secondary Research Questions 12 Rationale 12 Significance 13 Methodology 14 Limitations, Assumptions, and Design Controls 16 Definition of Key Terms 17 Summary 20 2. REVIEW OF RELATED LITERATURE 21 Autism Spectrum Disorders 22 Treatment and Intervention 26 Applied Behavior Analysis 28 Parents with Children with Autism 37 Benefits of Parent Involvement in Intervention 45 vi Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) Philosophy 47 Parent Attitudes 49 Disability Theory and Parent Attitudes 59 Parent Views of Intervention Programs 61 Narrative Case Study 63 Conclusion 65 3. RESEARCH DESIGN AND METHODOLOGY 67 Problem and Purpose Overview 68 Research Questions 69 Primary Research Question 69 Secondary Research Questions 69 Population and Sample 69 Data Collection and Instrumentation 71 Materials 71 Procedures 72 Electronic Questionnaires 72 Data Analysis 74 Summary 76 4. RESULTS 77 Participants 78 Results of Data Analysis 79 Interview Questions 80 Phase 1: Making the Text Manageable 82 Research Problem and Theoretical Framework 82 Relevant Text 84 Phase 2: Hearing What Was Said 88 Repeating Ideas 88 General Themes 91 Phase 3: Developing Theory 93 Theoretical Constructs 93 Theoretical Narrative 94 Summary 101 5. SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS 103 Overview of Methodology 103 vii Findings for Research Questions 104 Limitations 113 Conclusions 114 Recommendations 117 Recommendations for Professionals 117 Recommendations for Parents of Young Children with Autism 118 Recommendations for Research 119 Closing Statement 119 APPENDICES A: INTERVIEW QUESTIONS 121 B: INSTITUTIONAL REVIEW BOARD APPROVAL LETTER 123 C: PARENT INFORMED CONSENT FORM 124 REFERENCES 126 viii LIST OF TABLES Table Page 1. Phase 1: Relevant Text for Participant A 85 2. Phase 1: Relevant Text for Participant B 86 3. Phase 1: Relevant Text for Participant C 87 4. Phase 2: Repeating Ideas 89 5. Phase 2: Themes 93 6. Phase 3: Theoretical Constructs 94 7. Theoretical Constructs, Themes, and Repeating Ideas Related to Addressing Research Question 1 105 8. Data Pertaining to the Primary Research Question 107 ix LIST OF APPENDICES Appendix Page A. Interview Questions 85 B. Institutional Review Board Approval Letter 86 C. Parent Informed Consent Form 87 x ABSTRACT NATALIE LYNNE POWELL EXPLORING THE ATTITUDES OF PARENTS OF YOUNG CHILDREN WITH AUTISM TOWARDS THE TEACCH CONCEPTUAL MODEL: A NARRATIVE CASE STUDY Under the direction of DR. ALBERT STRAMIELLO The purpose of this dissertation is to explore the attitudes of parents of young children with autism towards the Treatment and Education of Autistic and related Communication Handicapped Children Program's (TEACCH) conceptual model, known as the Culture of Autism. One primary research question guided the study: What are the attitudes of parents of young children with autism towards the TEACCH conceptual model, the Culture of Autism? Three additional secondary research questions were also considered: How do parents of young children with autism interpret the meaning of the Culture of Autism? To what extent do parents of young children with autism agree or disagree with the TEACCH conceptual model, known as the Culture of Autism? What experiences have the parents had with the TEACCH program that has affected their attitudes regarding the TEACCH conceptual model, known as the Culture of Autism? This qualitative study utilized a narrative case study approach in order to explore the parent attitudes. An electronic questionnaire was given to three parents of children with autism between the ages of 3 and 7. The data was analyzed using Auerbach and Silverstein's (2003) coding method, which included (1) filtering the text by revisiting the xi research problem and theoretical framework, (2) identifying relevant text, (3) organizing relevant text into repeating ideas, (4) forming themes, (5) grouping themes into theoretical constructs, and (6) create the theoretical narrative. The four themes that emerged were: acceptance, perspective, hope, and fear. It was concluded that all three parents questioned had positive attitudes towards the TEACCH conceptual model. xii CHAPTER 1 INTRODUCTION TO THE STUDY The researcher's deep interest with autism spectrum disorders began as she watched an informational video while a sophomore undergraduate student. Her interest in the field grew as she began a fieldwork experience that same year in a preschool classroom of students with autism. The months that she spent working with those young children with autism led her to the decision that she wanted to pursue a teaching position in a similar classroom after graduating. Ironically, she was given the opportunity to teach that actual class upon graduation from college. As an educator of low-functioning students with autism for the next 4 years, she continued to learn about the characteristics of autism and various intervention techniques to be used with people with autism. She was especially interested in one program in particular, the Treatment and Education of Autistic and related Communication Handicapped Children (TEACCH)1 program. The TEACCH program was developed by Division TEACCH at the University of North Carolina in Chapel Hill. Division TEACCH is a statewide program for people with autism or other similar developmental disorders and their families. The program provides diagnostic, evaluation, early intervention, treatment, and assists in residential and work 'Regarding acronyms, this researcher has chosen to use the full expression of an acronym if found necessary. 1 2 placements. TEACCH was founded in 1966 by Eric Schopler and Robert Reichler, along with the help of several parents of children with autism (Watson, 1985). At that time, parents petitioned the state legislature to make this program a part of the state educational structure. TEACCH is operated by five regional centers and over 50 classrooms, serving over 250 children throughout the state. TEACCH is known around the world for its use of structured teaching, visual structure, and individual work tasks, often referred to as "shoebox tasks" (Watson, 1985). Another important factor of the TEACCH program was the collaboration between educators and families (Mesibov, Shea, & Schopler, 2004). In the 1960s, most theorists blamed parents for their child being autistic. It was thought that a child became autistic because they were not given enough attention or physical comforting. TEACCH was partially developed in reaction to this idea, and placed an emphasis on parents taking a role as "co-therapists" (Mesibov et al., 2004). TEACCH also differed from many other treatment programs in that it did not include the goal of curing the individual with autism, but instead involved a respect for the individual's differences and a search to assist the individual in being as successful as possible in society (Mesibov & Shea, 1998). Educators who are trained to use TEACCH are taught to focus on unobservable variables, including the students' cognition or how they understand their environments, in addition to their behavior (Jennett, Harris, & Mesibov, 2003). The TEACCH program is centered on five core values, which form its conceptual