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OCTOBER 2006

Special Education Perspectives 2007
McCarton School Educates Children with Autism
By Emily Sherwood, Ph.D.

The statistics are daunting. More than 1.5 million people in the United States are affected by autism, the mysterious brain disorder leading to impaired social skills, communication, and impulse control. One in every 166 American children suffers from autism, and the numbers are growing at a rate that is baffling scientists and confounding practitioners.

One person who decided to meet this challenge head-on is Dr. Cecilia McCarton, Professor of Pediatrics at the Albert Einstein College of Medicine, who in 1998 founded the McCarton Center for Developmental Pediatrics. “The numbers of autistic children we began to see in our Center suddenly became an avalanche. We would be giving therapy to these children and there would be no schools for them, no places for them to go to after age five. Autism overtook us,” explains McCarton. So in 2002, McCarton—who is widely regarded as one of the nation’s leading experts in diagnosing and treating children with developmental disorders—rallied a core of committed parents who provided the necessary support and endowment funding to open The McCarton School for children aged 3-12 who have autistic spectrum disorders (ASD).

McCarton’s East 82nd Street school in New York City is an impressive two-story space. Intimate classrooms on the second floor offer one-way mirrors for parents to observe their children’s education, helping them to provide consistent reinforcement in the home. Within each classroom, teachers who are all trained in Applied Behavioral Analysis (ABA) as well as a speech and language therapist work one-to-one with a small group of five students. Explains Educational Director Dr. Ivy Feldman, “We are working to break each desired task into small, incremental components. Ultimately, we look to create replacement behaviors for behaviors that are not so adaptive.” For the child who might be screaming, “We assess the function of that behavior. A child who is having a tantrum might want to gain access to candy or a toy. Or he might want to escape working. Or he might want to gain sensory stimulation. Once we find out the function, we know how to treat it. ABA gives us the tools to look at things scientifically,” concludes Feldman. While ABA has sometimes been given “a bad rap” for being too Pavlovian, it has “a very fluid methodology when done well,” according to McCarton. To wit, a child in one classroom is sorting and classifying objects by category. “Good job,” exclaims his teacher enthusiastically when he accomplishes his task. “What did you earn?” The youngster selects play-doh as his reward (positive reinforcement is a key component of ABA.)

In addition to one-on-one instruction, the McCarton School offers its young charges one hour of intensive speech therapy and one hour of occupational therapy each day, five days a week. Within amply padded gymnasiums that are equipped with hammocks, swings, balls, and even a small—scale rock wall, “children are helped with sensory integration. A child who is lethargic may jump on a trampoline, or get bounced around on a hammock. A hyperactive child may be calmed by a swing that rocks him back and forth,” explains Feldman, who holds a Ph.D. in psychology. But not all the instruction takes place within the four walls of the McCarton School. “We provide lots of outings. As part of our adaptive model, we teach the children to function in their community and in their homes—in the places they actually live. We work a lot on play and proper requesting during these outings,” Feldman adds.

The McCarton School is not cheap—tuition is $80,000 a year, although some parents who have elected to go to an impartial hearing with the Board of Education have been fully reimbursed for its tuition. By the end of 2007, five of the 23 children in the school will be mainstreamed back into their districts, probably with aides to assist them in their classrooms. But McCarton worries about “the majority of children who cannot transition back to mainstream. Some will always need one-to-one help. That’s the nature of this disorder.” McCarton is hoping to find more space so that she can expand her school for children up to the age of 18 while providing more slots to meet existing demand for her program. But until then, there are simply too few resources out there, she concludes regretfully.

Though one might have thought McCarton had her hands full right now, she looks ahead to opening a training institute for ABA, speech/ language and occupational therapy professionals. “I want people to understand what good therapy is for children with autism. Then we’re insuring that the quality of people who teach these children will be the gold standard. Ultimately they will start their own schools or be recruited as directors. I want to train the next generation,” she sums up.

McCarton knows she’s pioneering new territory, but, in her words, “There are just so many kids out there who need our help.”#

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