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J Autism Dev Disord (2012) 42:755–768 DOI 10.1007/s10803-011-1309-7

ORIGINAL PAPER

ORIGINAL PAPER

Teachers’ Perceptions Regarding the Management of Children with Autism Spectrum Disorders

Christine K. Syriopoulou-Delli Dimitrios C. Cassimos Grigorios I. Tripsianis Stavroula A. Polychronopoulou

Published online: 23 June 2011 Springer Science+Business Media, LLC 2011

Abstract This study examines Greek teachers’ percep- tions related to the nature and management of autistic children. To investigate these issues, a statistically reliable number of questionnaires (n = 228) was distributed to a diversified teacher population. The questionnaire responses were analyzed statistically to identify the explanatory power of critical independent variables. The research findings support that teachers’ specialized training and working experience are critical inputs to improve teachers’ perceptions and efficient serving of autistic children. A cumulative joint effect of teachers’ previous specialized education and working experience working with autistic children was also indicated. This could be supportive of teachers upgrading their active leading role in team working with specialized scientific staff, parents and institutions on autistic children.

C. K. Syriopoulou-Delli ( & )

Department of Educational and Social Policy, University of Macedonia, 49, Bouziki Str., Nea Philothei, 11524 Athens, Greece e-mail: dellis@mfa.gr

D. C. Cassimos

Pediatric Department, Democritus University of Thrace,

Alexandroupolis, Greece

G. I. Tripsianis

Department of Statistics, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece

S. A. Polychronopoulou

Department of Primary Education, National and Kapodistrian University of Athens, Athens, Greece

Keywords

Teachers’ experience Teachers’ leading role

Autistic students

Autism Education Teachers’ education

Introduction

Over the last decade, the number of children diagnosed to suffer from autism spectrum disorders (ASD) is seen to have increased dramatically (Arick et al. 2005; Finke et al. 2009; Harris et al. 2005; Powell and Jordan 1992). As a consequence, more children with ASD participate in gen- eral education (ASD Centers for Disease Control and Prevention 2007). A prevailing tendency in the education community lately indicates that children with disabilities, particularly pervasive developmental disorders, join gen- eral (mainstream) education classrooms (McDonnell 1998). Teachers’ specialized training is argued to be a critical component with profound implications for the education of ASD children (Mesibov et al. 2006). In Greece, the idea of ‘one school for all’ was intro- duced during the last decade (Greek Government Gazette 2000). Before the application of this legislation, ASD children had access only to special schools for the mentally retarded. As a result, in some of these latter cases, parents would prefer to keep their children at home, or asylums, or youth institutions. Hence, these children were deprived of mainstream education (Anastasiou and Polychronopoulou 2009). The Greek government has, recently, recognized the right of ASD children to participate in the educational process (Greek Government Gazette 2008). Since 2008, Greek students with ASD can explore two options. They can either attend a mainstream school class, receiving additional support from the classroom, or special educa- tion, teacher; or, they can attend a special integration class

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within mainstream or vocational schools. ASD students, and especially those with limited functional capabilities, exhibit a range of unique characteristics that pose high challenges for teachers serving them. To be specific, ASD students frequently display deficits in cognition, commu- nication, and socialization. Basic functional and learning

1991).

feedback mechanism would assimilate practical evidence gained at school level. On the one hand, an adjusted edu- cational programme tailor-made to the ASD cases could be useful to remediate the multidimensional deficits of ASD students. On the other hand, and complementary to that, an integrated, multidisciplinary approach could be conve-

skills are often reduced or are even absent. A major con- cern remains, however, the fact that the exact characteris- tics of autistic disorders are not fully understood in a consistent and integrated framework but remain largely vague as yet. The prerequisite formal qualifications for a Greek tea- cher to work in the field of special education include a Ph.D. or a postgraduate degree in the field of special education or educational psychology, or a degree from either the Pedagogical Department of Primary/Special Education or the Department of Educational and Social Policy. Nevertheless, due to inadequate past practices and institutional constraints, the working experience of Greek teachers with ASD children has remained limited. How- ever, there appear to be mounting concerns regarding

niently designed to further support teachers and children in the ASD front. Following the limited past research, it appears useful, interesting and timely to investigate these issues further (especially education and experience of teachers serving ASD children). A study on Greek teachers revealed that even special education teachers are somewhat confused regarding the basic characteristics and causes of ASD (Mavropoulou and Padeliadu 2000). The upgrading of teachers’ education on ASD contributes to the improvement of ASD children’s behavior, language, social capabilities and play skills. Children’s behavioral problems may potentially induce educational concerns and stress to teachers. This, in turn, can ultimately hinder teachers’ ability to cope with everyday problems of ASD children (Probst and Leppert

teachers’ appropriate qualifications and education, shortage

2008).

of specialized staff, and the subsequent impact on the

Based on past literature review, the prevailing policies

quality of education provided to ASD students. In addition, it is argued that research should also investigate everyday problems teachers face in relation to the education of ASD students (Scheuermann et al. 2003; Simpson 2003). The learning objectives of teachers on ASD are not specified in details, while there is a wide range of required knowledge and skills (Maurice et al. 1996; National Research Council 2001; Scott et al. 2000). It is well recognized that under- graduate training is limited and insufficient not only in the

educational preparedness of educators from across the globe in serving children with ASD appear to be con- strained with a number of limitations. The educational curriculum on ASD, for instance, is seen to focus pre- dominantly on particular areas of ASD children’s special needs (such as on social or communication skills or lan- guage deficits). Furthermore, specific teaching tech- niques—rather than an integrated approach on ASD children—are promoted. This results to teachers not being

on

case of Greek education but also on an international scale,

in

a position to formulate spherical and clear-cut views on

as recent relevant research indicates (McConkey and

their own role and service of potential ASD children cases.

Bhlirgri 2003; inter alia). However, a growing interest in

A

major constraint to handle these issues relates to the

special education training is formed in Greece lately (Mavropoulou and Padeliadu 2000; Syriopoulou 2003). Probst and Leppert (2008) state that information about

diversified nature and characteristics of ASD children as well as to the fact that these characteristics alter as the child grows. Hence, in several countries, the prevailing policies

the particular characteristics of children with ASD as well

on

educational preparedness of educators in serving ASD

as interventional methods should be strongly integrated into the curricula of teacher-training programs. Other

children appear to be a subject of ongoing concern, eval- uation, reappraisal, and reformation to dynamically adjust

studies demonstrate that teachers and other professionals

to

the changing perception of the autististic disorders (Lian

who work with ASD students need to be well trained and

et

al. 2008, Singapore; Mavropoulou and Padeliadu 2000,

supported in order to provide coordinated services that are beyond the scope of the efforts of individual teachers (Cotugno 2009; Dib and Sturmey 2007; Grey et al. 2005; Lerman et al. 2008; O’Neil et al. 1993; Schuster et al.

Greece; Probst and Leppert 2008, Germany, UK, US; Scheuermann et al. 2003, US; Simpson 2003, US; inter alia). Broad policy measures to promote and further sup- port special education could potentially include a variety of flexible and focused undergraduate, postgraduate and in-

Special education and past relevant experience of teachers serving ASD children can exert a critical impact on teachers’ capability to develop a focused and interdis- ciplinary educational curriculum. This could be efficiently supported particularly in case a flexible educational

service training programmes and courses, enriched with teaching approaches tailor-made to ASD cases. The purpose of this study is to investigate teachers’ perceptions focusing on the nature and management of children with ASD. More specifically, this research

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757

examines the following core topics: evaluation of the

Table 1 Teachers’ demographic and working characteristics

 

implications of teachers’ previous training and working experience and the assessment of the influence and impact on teachers’ perceptions and attitudes in key issues for serving and managing ASD children.

 

n

%

Gender

Female

166

72.8

 

Male

62

27.2

Age (years)

 

Method

B30

53

23.2

 

31–40

83

36.4

Participants

41–50

81

35.5

[50

8

3.5

Greek Teachers’ Sample Identity

No response Place of work Urban areas Semi-urban areas Rural areas No response Years of service

3

1.3

This applied study has been based on the construction, evaluation and statistical analysis of a conveniently con-

174

76.3

32

14.0

structed questionnaire to investigate the core objectives of teachers’ attitudes on issues relevant to managing autistic children. The questionnaire was organized on the basis of

7

3.1

15

6.6

33

major questions and was subdivided in two major parts.

B5

73

32.0

The first part of the questionnaire focused on the educa- tional and professional experience of the teachers’ sample population (8 questions). The second part addressed critical questions relevant to the following core pillars: (a) nature and characteristics of autism (7 questions); (b) assessment of children with autism (5 questions); (c) management of children with autism (8 questions); and (d) the teachers’

role in the education of autistic children (5 questions) (a questionnaire sample is included in ‘‘ Appendix ’’). The study cohort consists of 228 teachers [166 females (72.8%) and 62 males (27.2%)] who met the criterion of being a teacher currently working in the formal educational system of Greece. As to the teacher demographic and service characteristics, including age, work experience (years of service) (Table 1), the sample majority, namely

teachers (36.56%) are in the 31–40 years age range and

80 teachers (35.24%) in the 41–50 years age range (Table 1). As regards teachers’ years of service, the sample majority, namely 74 teachers (32.46%) have up to 5 years of service, 49 ones (21.49%) 6–10 years, 38 ones (16.67%) 11–15 years, and 57 ones (25.00%) more than 15 years (Table 1). Furthermore, the majority of teachers’ sample popula- tion, namely 175 teachers (76.75%), serves in urban areas, and 31 ones (13.60%) in semi-urban areas (Table 1). The sample majority, namely 118 teachers (51.75%), serves primary education, and 67 ones (29.39%) serve secondary education (Table 1). The sample majority, namely 144 teachers (63.16%), serves in mainstream schools, 35 ones (15.35%) in special schools, and the rest evenly divided between special schools, integration classes, Technical Secondary Education in Special Vocational Training Sec-

84

ondary Education (EEEEJ), and multicultural schools (Table 1).

6–10

49

21.5

11–15

38

16.7

[15

58

25.4

No response

10

4.4

Type of educational unit in which teachers serve Special school Mainstream school Inclusive class Technical school Special education vocational center Multicultural school No response Previous significant studies on autism Yes No Number of children with autism in the classroom

36

144

8

8

5

3

24

83

145

15.8

63.2

3.5

3.5

2.2

1.3

10.5

36.4

63.5

None

176

77.2

1–3

27

11.8

4 or 5 More than 5 No response Previous experience with autistic children Yes No

13

5.7

4

1.8

8

3.5

64

28.1

164

71.9

Of the teacher’s sample population, 83 teachers (36.4%) had previously been trained or had attended authorized postgraduate seminars, specialized on autism, at least in one accredited undergraduate or postgraduate course on autism, under the auspice of the Ministry of Education. Those teachers who had participated in unauthorized seminars or attended only conferences (n = 7) were not

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included in the category ‘significantly trained’. The term ‘authorized’ training refers to certified training education provided by the Ministry of Education that qualifies teachers to work in special education units. The ‘unau- thorized’ training refers to voluntarily and privately gained training, including special seminars, conferences, venues, workshops, and other relevant activities on special educa- tion. Experience in teaching and managing children with autism in inclusive classes, mainstream schools, or special schools was held by 64 teachers (28.1%). Teachers with less than 2 years of experience with autistic children or experience as a parent-relative or friend were not included in the significantly experienced.

Measures

The teachers’ opinions were evaluated using a structured questionnaire. An initial pilot study was conducted with 20 teachers from the area of Athens, in order to test teachers’ comprehension and objectivity in answering this ques- tionnaire. The responses, feedback and final structure of the questionnaire were evaluated by the research team and were also based upon and compared with relevant input from most recent international literature on the subject (Conroy et al. 2007; Grey et al. 2005; Probst and Leppert 2008; Roth et al. 2010). The questionnaire comprised of four sets of questions regarding the nature and character- istics of autism, assessment of children with autism, man- agement of ASD children, and the teacher’s role in the education of autistic children. Each question included in the questionnaire was considered a dependent variable that described teachers’ perceptions and attitudes. The respon- ses ‘in line with prevailing educational norms’ and ‘not in line with prevailing educational norms’ were discriminated by the researchers (C.S., S.P.) based on the literature (Conroy et al. 2007; Grey et al. 2005; Probst and Leppert 2008; Roth et al. 2010). Responses such as ‘I do not know’ and ‘I do not answer’ were defined as responses ‘not in line with prevailing educational norms’ for the purpose of sta- tistical analysis. Teachers’ training and education on aut- ism, and experience in managing autistic children were the selected independent variables. The dependent variables were investigated and assessed under the influence of these independent variables.

Materials and Procedures

The questionnaires of the study were distributed to teachers in different towns around the country during lectures delivered by one of the researchers (S.P.). Twelve lectures took place in seven towns/cities in mainland Greece between November 2008 and May 2009. The core objec- tives of these lectures were to inform voluntarily

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participating teachers about critical issues of ASD. The lecture participants were interested in seeking out spe- cialized information on ASD, were working in different types of schools and level of education (mainstream/spe- cial; primary/secondary; vocational/multicultural etc.) and had different educational background and experience with ASD children. Random sampling was applied to one in three attendees to whom the questionnaire was distributed. The questionnaire responses were anonymous. A written consent was obtained by each responder. In total, 300 questionnaires were distributed to 900 attendees of the aforementioned lectures, and 228 were returned. The characteristics of this teachers’ cohort are presented in Table 1.

Statistical Analysis and Multivariate Logistic Regression

Statistical analysis of the data was performed using the Statistical Package for the Social Sciences (SPSS, version 16.0, Chicago, IL, USA). All variables were categorized and were expressed as frequencies and percentages. The chi-square test was used to evaluate any potential associ- ation between teachers’ perceptions and selected indepen- dent variables, such as teachers’ education and experience regarding the management of autistic children. To assess the independent impact of teachers’ education and expe- rience on their perceptions and knowledge of autism, a multivariate stepwise logistic regression analysis was also performed; teachers’ gender, age, place of work and years of service were considered as possible confounders. Adjusted odds ratios (aOR) with their 95% confidence intervals (CI) were estimated as the measure of association of teachers’ education and experience in autism with their perception and knowledge of autism. All tests were two tailed, and the level of statistical significance was set at p \ 0.05.

Results

Statistical Analysis of Questionnaires on Teachers’ Perceptions and Knowledge of ASD

The findings regarding teachers’ perceptions of ASD children are summarized in Table 2.

Overview of Key Findings

The majority of the Greek teachers’ cohort (55.3%) was seen to believe that autism is the most serious mental- health disorder among children. Less than half of the subjects were aware of children with autism having serious speech disorders. Nearly half of teachers’ sample (45.2%;

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Table 2 Teachers’ perceptions and knowledge of ASD

 

Agree

Disagree

Do not

No

 

know

response

 

n

%

n

%

n

%

n

%

Nature and characteristics of autism

Autism is the most serious mental-health disorder

126

55.3

57

25.0

38

16.7

7

3.1

Most individuals with autism acquire good language skills at a later stage

57

25.0

103

45.2

65

28.5

3

1.3

Autism exists alongside mental retardation

89

39.0

87

38.2

42

18.4

10

4.4

Autism is a hereditary disorder

24

10.5

108

47.4

85

37.3

11

4.8

Autism is a form of schizophrenia

26

11.4

159

69.7

38

16.7

5

2.2

Autistic children have intelligent parents

46

20.2

85

37.3

93

40.8

4

1.8

Autistic children are always hyperactive

100

43.9

74

32.5

49

21.5

5

2.2

Assessment of children with autism

Autism can be diagnosed in infancy

73

32.0

79

34.6

72

31.6

4

1.8

Disorders can be overcome to a large extent with the appropriate education

34

14.9

104

45.6

86

37.7

4

1.8

Autistic children can acquire exceptional skills in a particular field

146

64.0

5

2.2

31

13.6

46

20.2

Almost every teacher can recognize autistic characteristics in a child

116

50.9

73

32.0

30

13.2

9

3.9

Children with autism succeed in tests that involve rote learning

82

36.0

42

18.4

99

43.4

5

2.2

Management of children with autism

Psychoanalytic programs are the most beneficial for autistic children

51

22.4

59

25.9

115

50.4

3

1.3

Autistic children should be educated in a special school

167

73.2

47

20.6

11

4.8

3

1.3

Autistic children are suppressed and their condition worsens in a strictly structured environment

66

28.9

95

41.7

50

21.9

17

7.5

The treatment of most autistic children should include drugs

44

19.7

77

33.8

98

43.0

8

3.5

Autistic children are better off if their education is focused on social skills rather than on academic subjects

126

55.3

55

24.1

40

17.5

7

3.0

Auditory teaching methods are superior to visual methods

28

12.3

91

39.9

100

43.9

9

3.9

Behaviorism is an obsolete method

34

14.9

70

30.7

115

50.4

9

3.9

It is preferable for autistic children to attend special vocational schools rather than mainstream secondary schools

117

51.3

45

19.7

53

23.2

13

5.7

The role of the teacher in the education of children with autism

Teachers should cooperate with specialists

216

94.7

4

1.8

5

2.2

3

1.3

Autistic children constitute the most difficult group of students

130

57.0

57

25.0

38

16.7

3

1.3

Teachers rather than medical doctors should play the leading role in the educational- therapeutic treatment of autistic students

114

50.0

56

24.6

53

23.2

5

2.2

With appropriate training, teachers can deal effectively with an autistic child

180

78.9

25

11.0

19

8.3

4

1.8

Even with the appropriate training, teachers cannot raise the question about autism

121

53.1

65

28.5

35

15.4

7

3.1

n = 103) did not perceive that these children would be able to acquire good language skills at a later stage. The teachers’ cohort was found to split evenly as to whether autism exists alongside mental deficiency (39.0% agreed and 38.2% disagreed). Most teachers disagreed whether autism is a hereditary disorder (47.4%; n = 108). Most of the sample teachers (69.7%; n = 159) disagreed about autism being a form of schizophrenia. The largest pro- portion of the study group (40.8%) did not know whether autistic children have intelligent parents. The number of responses regarding the plausibility of diagnosing autism in infancy was evenly split: 73 teachers (32.0%) believed that this is plausible indeed, 79 teachers (34.6%) disagreed, and

72 teachers (31.6%) did not know. Only 34 teachers (14.9%) did they believe that appropriate education can contribute to overcome the disorder, while 146 teachers (64.0%) believed that autistic children can acquire excep- tional skills in a particular field. Half of the teachers’ cohort (50.9%; n = 116) declared capable of pinpointing autistic characteristics. As regards teachers’ perceptions with respect to the management of ASD children, 115 teachers (50.4%) did not know whether the best programs for autistic children are those of the psychoanalytic type. Approximately three- quarters (73.2%) of the study cohort were seen to believe that ASD children should attend a special school; and, 95

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teachers (41.7%) considered that autistic children are not suppressed in a strictly structured environment. Over half of the cohort (55.3%; n = 126) agreed that children with autism are better off receiving education on social skills rather than academic education, and 43.9% (n = 100) did not know whether auditory teaching methods are superior to visual ones. Half of the study group (50.4%; n = 115) did not consider behaviorism to be an obsolete interven- tional method; and, half of the study group (51.3%; n = 117) considered autistic children to be better off receiving education at vocational schools of special edu- cation rather than at mainstream schools. The approach proceeded to also evaluate the teachers’ views about their role in the education of children with autism. The vast majority of teachers (94.7%; n = 216) maintained that teachers should cooperate with specialists as regards the treatment of autistic children. More than half of the cohort (57.0%; n = 130) was seen to believe that ASD children constitute the most difficult group of stu- dents. Furthermore, half of the study group (50.0%; n = 114) claimed that teachers rather than medical doctors should have the first word on the educational-therapeutic treatment of an autistic student. A particularly large sample proportion (78.9%; n = 180) was seen to support the idea that a teacher with the appropriate training can effectively deal with an autistic child. More than half of sample teachers (53.1%; n = 121) were found to believe that a teacher, despite the appropriate training, is unable to pin- point autistic characteristics in a child, in order to raise the question about autism and refer the child to specialists.

Teachers’ Perceptions of ASD Children Relative to Their Education and Experience

The research approach was backed up with statistical analysis focusing on selected critical independent vari- ables. The relevant responses of the teachers’ cohort were examined in relation to teachers’ previous education and working experience and their efficiency in serving and managing ASD children. Tables 3 and 4 present the research findings of the statistical analysis on these inde- pendent variables.

Nature and Characteristics of Autism The views and perceptions of autism were found to differ substantially between teachers with and without previous specific edu- cation in the field of autism (Table 3). The most striking, and statistically significant differences between these two teacher groups were seen to be the following: (a) autism is perceived as the most serious mental-health disorder (66.3 and 49.0% for those with and without previous education on autism, respectively; p = 0.011); (b) autism exists alongside mental retardation (55.4 and 29.7%, respectively;

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p \ 0.001); and (c) autism has no genetic predisposition (56.6 and 42.1%, respectively; p = 0.034). Teachers with previous education did not perceive autism as a form of schizophrenia (80.7%, compared to 63.4% of teachers without previous education; p = 0.006). Furthermore, the former did not recognize hyperactivity as a common fea- ture of children with ASD (26.9%, compared to 42.2%, respectively; p = 0.018). In addition, the teachers’ per- ception of the nature and characteristics of autism differed between teachers with and without previous experience in this subject (Table 4). Most of the teachers with previous experience in autism, contrary to teachers with no previous experience, were seen to believe that ASD constitutes the most serious mental- health disorder (71.9 and 48.8%, respectively; p = 0.002). Furthermore, most of ASD children were seen to not acquire good language skills later in life (64.1 and 37.8%, respectively; p \ 0.001). Experienced teachers on autism had more often the perception that autism exists alongside mental retardation (57.8 and 31.7%, respectively; p \ 0.001). In addition, autism was not perceived as a form of schizophrenia (85.9 and 63.4%, respectively; p = 0.001). Finally, autistic children were not perceived to behave always hyperactively (45.3 and 27.4%, respec- tively; p = 0.010). The gender (male/female teacher) was also tested as an independent factor for teachers’ percep- tions on ASD but was not found to exert a statistically significant impact.

Assessment of Children with Autism The teachers’ per- ception of how to assess ASD children differed statistically significantly between the teachers’ group with previous education on ASD against the teachers’ group with no previous ASD education (Table 3). Teachers with previous ASD education were more often seen to believe that autism can be diagnosed in infancy (48.2 and 26.9%, respectively; p = 0.001). Furthermore, these teachers perceived that ASD children can achieve exceptional skills in a particular field (80.7 and 54.5%, respectively; p \ 0.001). In addi- tion, ASD children can succeed in tests that involve rote learning (48.2 and 29.0%, respectively; p = 0.004). Nev- ertheless, educated teachers on ASD had the opinion that autism cannot be overcome to a large extent (66.3 and 33.8%, respectively; p \ 0.001). There was no statistically significant difference between the two teachers’ groups as regards the impression that almost every teacher could recognize autistic characteristics in a child. These critical issues put forward earlier were also examined in two groups of teachers stratified according to teachers’ previous working experience with ASD children. A broad research conclusion indicates similar pattern of responses as earlier obtained by these two teachers’ groups (Table 4). Previous working experience of teachers with

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Table 3 Teachers’ perceptions and knowledge of ASD in relation to their previous relevant education

 

Education on autism

p

No

Yes

n

%

n

%

Nature and characteristics of autism

Autism is the most serious mental-health disorder

71

49.0

55

66.3

0.011

Most individuals with autism do not acquire good language skills later in life

49

33.8

54

65.1

\0.001

Autism exists alongside mental retardation

43

29.7

46

55.4

\0.001

Autism is not a hereditary disorder

61

42.1

47

56.6

0.034

Autism is not a form of schizophrenia

92

63.4

67

80.7

0.006

Autistic children have intelligent parents

30

20.7

16

19.3

0.798

Autistic children are not always hyperactive

39

26.9

35

42.2

0.018

Assessment of children with autism

Autism can be diagnosed in infancy

39

26.9

40

48.2

0.001

Disorders cannot be overcome to a large extent even with the appropriate education

49

33.8

55

66.3

\0.001

Autistic children can acquire exceptional skills in a particular field

79

54.5

67

80.7

\0.001

Almost every teacher can recognize autistic characteristics in a child

76

52.4

40

48.2

0.540

Children with autism succeed in tests that involve rote learning

42

29.0

40

48.2

0.004

Management of children with autism

The most beneficial programs for autistic children are not psychoanalytic

19

13.1

40

48.2

\0.001

Autistic children should not be educated in a special school

28

19.3

19

22.9

0.520

Autistic children are not suppressed and their condition improves in a strictly structured environment

43

29.7

52

62.7

\0.001

The treatment of most autistic children should not include drugs

38

26.2

39

47.0

0.001

Autistic children are better off if their education is focused on social skills rather than on academic subjects

68

46.9

58

69.9

0.001

Auditory teaching methods are not superior to visual methods

34

23.4

57

68.7

\0.001

Behaviorism is not an obsolete method

24

16.6

46

55.4

\0.001

It is preferable for autistic children to attend special vocational schools rather than mainstream secondary schools

26

19.9

19

22.9

0.365

The role of the teacher in the education of children with autism

Teachers should cooperate with specialists

137

94.5

79

95.2

0.820

Autistic children constitute the most difficult group of students

73

50.3

57

68.7

0.007

Teachers rather than medical doctors should play the leading role in the educational-therapeutic treatment of autistic students

60

41.4

54

65.1

0.001

With the appropriate training, teachers can effectively deal with an autistic child

108

74.5

72

86.7

0.029

Even with the appropriate training, teachers cannot raise the question about autism

31

21.4

34

41.0

0.002

ASD children did not affect significantly teachers’ per- ception of diagnosing autism in infancy or the ability of the teacher to recognize autistic characteristics in a child. The teachers’ gender did not modify, in general, their percep- tions and attitudes in autism. However, the belief that autistic children can gain exceptional skills in a particular field was significantly more common among female than male teachers (70.5 and 46.8%, respectively; p = 0.001).

Management of Children with Autism The opinions and attitudes on certain topics of serving and managing ASD children were found to differ considerably between teachers with previous specific education or previous

working experience and teachers without previous educa- tion or experience on autism, respectively. More specifi- cally, the majority of sample teachers with education and/ or experience attributed low credit to psychoanalytic pro- grams, as it was accepted that the most beneficial programs for ASD children are not psychoanalytic ones (teachers with education on autism: 48.2% compared to 13.1%; p \ 0.001; previous working experience: 40.6% compared to 20.1%; p = 0.001). The majority of educated and experienced teachers were seen to believe that the treat- ment of most ASD children should not be based on drugs but emphasize on special education (educated teachers:

47.0% compared to 26.2%; p = 0.001; experienced

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Table 4 Teachers’ perceptions and knowledge of autism in relation to their previous relevant experience

 

Experience with

 

p

autism

No

Yes

n

%

n

%

Nature and characteristics of autism

Autism is the most serious mental-health disorder

80

48.8

46

71.9

0.002

Most individuals with autism do not acquire good language skills later in life

62

37.8

41

64.1

\0.001

Autism exists alongside mental retardation

52

31.7

37

57.8

\0.001

Autism is not a hereditary disorder

74

45.1

34

53.1

0.277

Autism is not a form of schizophrenia

104

63.4

55

85.9

0.001

Autistic children have intelligent parents

35

21.3

11

17.2

0.482

Autistic children are not always hyperactive

45

27.4

29

45.3

0.010

Assessment of children with autism

Autism can be diagnosed in infancy

51

31.1

28

43.8

0.071

Disorders cannot be overcome to a large extent even with the appropriate education

62

37.8

42

65.6

\0.001

Autistic children can have exceptional skills in a particular field

92

56.1

54

84.4

\0.001

Almost every teacher can recognize autistic characteristics in a child

83

50.6

33

51.6

0.897

Children with autism succeed in tests that involve rote learning

45

27.4

37

57.8

\0.001

Management of children with autism

The most beneficial programs for autistic children are not psychoanalytic

33

20.1

26

40.6

0.001

Autistic children should not be educated in a special school

29

17.7

18

28.1

0.080

Autistic children are not suppressed and their condition improves in a strictly structured environment

54

32.9

41

64.1

\0.001

The treatment of most autistic children should not include drugs

44

26.8

33

51.6

\0.001

Autistic children are better off if their education is focused on social skills rather than on academic subjects

79

48.2

47

73.4

0.001

Auditory teaching methods are not superior to visual methods

42

25.6

49

76.6

\0.001

Behaviorism is not an obsolete method

35

21.3

35

54.7

\0.001

It is preferable for autistic children to attend special vocational schools rather than mainstream secondary schools

30

18.3

15

23.4

0.380

The role of the teacher in the education of children with autism

Teachers should cooperate with specialists

153

93.3

63

98.4

0.118

Autistic children constitute the most difficult group of students

85

51.8

45

70.3

0.011

Teachers rather than medical doctors should play the leading role in the educational-therapeutic treatment of autistic students

69

42.1

45

70.3

\0.001

With the appropriate training, teachers can effectively deal with an autistic child

124

75.6

56

87.5

0.048

Even with the appropriate training, teachers cannot raise the question about autism

41

25.0

24

37.5

0.060

teachers: 51.6% compared to 26.8%; p = 0.001). The research findings also indicated that behaviorism is not an obsolete intervention for ASD children (educated teachers:

55.4% compared to 16.6%; p \ 0.001; experienced teachers: 54.7% compared to 21.3%; p \ 0.001). Further- more, based on the findings, in a strictly structured envi- ronment, ASD children do not feel suppressed but tend to improve (educated teachers: 62.7% compared to 29.7%; p \ 0.001; experienced teachers: 64.1% compared to 32.9%; p \ 0.001). Autistic children were also believed to be better off in case their education is focused on social skills rather than on academic subjects (educated teachers:

123

69.9% compared to 46.9%; p = 0.001; experienced teachers: 73.4% compared to 48.2%; p = 0.001). The

findings also postulated that there is no particular advan- tage of auditory over visual teaching methods (educated

teachers: 68.7% compared to 23.4%;

enced teachers: 76.6% compared to 25.6%; p \ 0.001). Teachers with previous special education and/or previous working experience indicated a rather balanced view as to whether it is preferable for ASD children to attend a spe- cial vocational rather than a mainstream school, although there appears to be a slight preference for the former type of school (Tables 3, 4).

p \ 0.001; experi-

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763

Table 5 Cumulative effect of past specialized education and working experience on teachers’ perceptions of autism

 

a (%)

b (%)

c (%)

p

1. Most individuals with autism do not acquire good language skills later in life

31.7

54.4

71.7

\0.001

2. Autism exists alongside mental retardation

28.6

40.4

66.7

\0.001

3. Autistic children are not always hyperactive

26.2

31.6

51.1

0.004

4. Autism can be diagnosed in infancy

27.0

38.6

51.1

0.003

5. The disorders associated with autism cannot be overcome to a large extent even with the provision of appropriate education

31.7

54.4

73.3

0.004

6. Most therapeutic programs for autistic children are not psychoanalytic

14.3

28.1

55.6

\0.004

7. Autistic children do not feel suppressed in a strictly structured environment, and their condition improves

27.8

47.4

73.3

\0.001

8. The treatment of most autistic children should not be based on drug therapy, but rather on special education

24.6

35.1

57.8

\0.001

9. Autistic children are better off receiving education on social skills rather than an academic education

45.2

57.9

80.0

\0.001

10. Auditory teaching methods are not superior to visual methods

19.8

45.6

88.9

\0.001

The table records only the items with statistically significant difference

a: Without education or experience; b: with either education or experience; c: with both

The Teacher’s Role in the Education of Children with Autism Based on the research findings, the teachers’ role in educating ASD children was shaped more clearly among the group of teachers with previous special education on autism than among teachers with lack of such background. The former group of teachers was seen to more often believe that autistic children comprise the most difficult group of students to handle (68.7 and 50.3%, respectively; p = 0.007). However, it was perceived that, subsequent to ASD students receiving appropriate training, any teacher can deal effectively with autistic students (86.7 and 74.5%, respectively; p = 0.029; Table 3). In addition, educated teachers on autism, more frequently, held the view that teachers rather than medical doctors should play the lead- ing role in the management of autistic students (65.1 and 41.4%, respectively; p = 0.001). In any case, the group of teachers with previous education on autism more fre- quently supported the view that, even with appropriate training, teachers are not in a position to raise the question about autism (41.0 and 21.4%, respectively; p = 0.002). The findings based on teachers with past working experience on autism also supported further the earlier findings, as they were seen raising similar views (Table 4). The perception related to the necessity of cooperation between teachers and specialists, in order to treat ASD children effectively, did not differ significantly between teachers with and without education or experience (Tables 3, 4). Moreover, more female than male teachers were found to believe that autistic children comprise the most difficult group of students, and, in addition, that teachers should cooperate with specialists in order to manage autistic children. (As these findings on gender were not statistically robust they should be treated with caution). The cumulative effects of past specialized education and working experience on teachers’ perceptions of autism

were also examined. The frequencies of responses termed ‘in line with prevailing educational norms’ were higher in the group of teachers who had both education and experi- ence (19.7%; n = 45) than in the group of teachers without education or experience (55.3%; n = 126) as well as than in the group of teachers with either education or experience only (25.0%; n = 57). The aspects of autism investigated under the cumulative effects of teachers’ past education and experience are summarized in Table 5. The findings produced by the multivariate logistic regression analysis revealed that specialized education as well as working experience remain critical and robust independent predictors of teachers’ perception and knowledge of autism. The adjusted odds ratios (aOR) were found to range from 1.9 to 4.7 for teachers’ previous spe- cialized education and from 2.1 to 5.8 for teachers’ pre- vious working experience, at the 95% confidence interval (Table 6).

Discussion

Past studies have postulated that teachers’ perceptions and knowledge play a crucial role on the service and manage- ment of autistic children. However, despite its importance, research remains surprisingly thin in this field. A core objective of this study has been to partially mitigate this gap, focusing in particular on the Greek educational sys- tem. More specifically, revealing Greek teachers’ percep- tions and knowledge of the nature and management of ASD children has been, thus, a principal purpose of this paper. The findings are indicative of the prevailing con- tradictions, ambiguity and confusion about autism among teachers, especially as regards the nature of autistic disor- der, the most efficient approaches to manage ASD students

123

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Table 6 Association of teachers’ education and experience in autism with their perception and knowledge of autism, expressed as adjusted odds ratios (aOR) with their 95% confidence intervals (CI)

 

Education

Experience

aOR (95%

p Value

aOR (95%

p Value

CI)

CI)

Nature and characteristics of autism

Autism is the most serious mental health disorder

2.2 (1.1–4.5)

0.029

Most individuals with autism do not acquire good language skills later in life

2.7 (1.4–5.2)

0.002

2.1 (1.0–4.1)

0.043

Autism exists alongside mental retardation

2.1 (1.1–4.0)

0.019

2.3 (1.2–4.5)

0.017

Autism is not a hereditary disorder

Autism is not a form of schizophrenia

2.7 (1.1–6.3)

0.023

Autistic children have intelligent parents

Autistic children are not often hyperactive

Assessment of children with autism

Autism can be diagnosed in infancy

2.4 (1.2–4.5)

0.009

Disorders cannot be overcome to a large extent even with the appropriate education

2.9 (1.6–5.5)

\0.001

2.2 (1.1–4.4)

0.025

Autistic children can have exceptional skills in a particular field

2.4 (1.2–5.0)

0.016

3.1 (1.4–7.3)

0.008

Almost every teacher can recognize autistic characteristics in a child

Children with autism succeed in tests that involve rote learning

3.3 (1.6–6.4)

\0.001

Education of children with autism

The most beneficial programs for autistic children are not psychoanalytic

5.6 (2.7–11.4)

\0.001

Autistic children should not be educated in a special school

Autistic children are not suppressed and their condition improves in a strictly structured environment

2.9 (1.6–5.5)

\0.001

2.3 (1.2–4.6)

0.014

The treatment of most autistic children should not include drugs

2.2 (1.1–4.2)

0.024

Autistic children are better off if their education is focused on social skills rather than on academic subjects

1.9 (1.0–3.6)

0.044

2.2 (1.1–4.5)

0.025

Auditory teaching methods are not superior to visual methods

4.3 (2.2–8.4)

\0.001

5.8 (2.8–12.1)

\0.001

Behaviorism is not an obsolete method

4.7 (2.3–9.4)

\0.001

2.8 (1.4–5.8)

0.006

It is preferable for autistic children to attend special vocational schools rather than mainstream secondary schools

The role in the education of children with autism

Teachers should cooperate with specialists

Autistic children constitute the most difficult group of students

Teachers rather than medical doctors should play the leading role in the educational- therapeutic treatment of autistic students

2.6 (1.3–5.2)

0.007

With the appropriate training, teachers can effectively deal with an autistic child

Even with the appropriate training, teachers cannot raise the question about autism

2.3 (1.2–4.5)

0.015

Results of multivariate logistic regression analysis, adjusting for teachers’ gender, age, place of work and years of service

and the relevant potential outcomes. The high percentages seen in the ‘do not know’ answers may reflect the obscurity and vagueness of the concept of autism, combined with teachers’ limited knowledge and practical experience on autism. As anticipated, the teachers’ population holding previ- ous specialized education and/or experience on autism holds clearer views and opinions on the issues put forward by the survey. More specifically, teachers with relevant educational background and/or working experience have

123

the opinion that ASD can be diagnosed in infancy. Fur- thermore, past specialized education can contribute to the acquisition of skills in particular fields of autism. A sig- nificant divergence between the two sample teacher sub- groups (with or without past education and/or experience on autism) was seen in the case of management of autistic children. This view was related to the substantial improvement of ASD students whenever they were taught in a strictly structured environment, where they could upgrade their social skills. Based on the research evidence,

J Autism Dev Disord (2012) 42:755–768

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teachers with relevant educational background and/or experience on autism appear to marginally favor special vocational rather than mainstream schools as more appro- priate for ASD students. This is an interesting finding which can imply that educational policies on autism may have not been fully organized and developed as yet in both mainstream and special vocational schools. If this is the case, it raises concerns regarding the current flexibility and adaptability of the educational curriculum in mainstream and vocational schools, sufficient training and specializa- tion of teachers as well as adequacy of premises infra- structure. Since these are critical policy issues, further research on these issues should be useful. Finally, previous education and/or experience on autism were found to be fundamental in supporting teachers dealing more efficiently with ASD students. This can potentially imply that teachers’ training in diverse educa- tional environments has a critical impact to raise teachers’ motivation and initiative contributing in special education. The educated or experienced teachers’ group more often than the noneducated or nonexperienced teachers’ group was seen to believe that ASD is the most serious mental- health disorder in children, often coinciding with mental retardation; and, ASD students comprise the most difficult group of students to manage. These findings were further validated and supported by the multivariate logistic regression analysis. This latter approach also underlined the independent impact of specialized education and working experience on teachers’ perception and knowledge of autism, with a twofold to threefold increase in the fre- quency of the ‘more in line with prevailing educational norms’ response. A broad conclusion put forward by this survey is the need for an interdisciplinary educational background with solid training on ASD teaching approa- ches. This would critically support teachers in undertaking a leading role whenever working within a team together with specialized scientific staff, parents and institutions. In any case, teachers’ special education and past working experience provide a solid fundamental backup in knowing how to serve and manage ASD students. A number of constraints in this study should be also mentioned. For a start, previous research has been thin on the issue of teachers’ perceptions on the management of ASD children. In addition, the sample size was cut down in

order to keep the teachers’ cohort at a manageable level. Moreover, further evaluation of the structured question- naire and the distribution process should be ideally con- ducted. However, despite these limitations, the results have been encouraging, and emphasized on the significant implications of teachers’ previous specialized education and working experience on autism for the efficient educa- tional process of autistic children. In conclusion, ASD students possess a variety of char- acteristics that impose constraints on their smooth educa- tional process but, on the other hand, induce material challenge for the educational community. The findings of this study have also revealed ambiguities and contradic- tions with view to the basic ASD characteristics and the resulting tremendous difficulties in managing autistic children. Nevertheless, the research results were seen to improve significantly when a number of critical issues on autism were examined in relation to teachers’ previous special education and/or working experience. These latter key factors (education—experience) were found to empower teachers with knowledge and confidence, enabling them to build upon existing knowledge of the nature and problems of autism, without ignoring the con- straints and unfavorable educational outcomes of ASD children. The positive impact of teachers’ previous specialized education appears to be reinforced when seen jointly with working experience on ASD children. Autistic children are considered to be highly ‘needy’ as regards their educational achievements. In order to fulfill ASD children’s demands, it is crucial for teaching personnel to have been appropri- ately trained. The present study and the limited past research support the plausible view that teachers with rel- evant specialized education have a broader view of autistic disorders and are, therefore, in a better position to select and structure their educational goals. The additional experience gained working with and managing of autistic children strengthens teachers’ self-esteem and upgrades their position in the class, enabling them to have an active leading role within working teams on autism, including specialized scientific staff, parents and institutions.

Appendix

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