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Perspectives of Service Providers on Supports for Students with Autism Spectrum Disorders in Iran
Abstract
In this study, we contribute to the limited database on the perspectives of service providers including teachers, speech therapists, occupational therapists, and psychologists working with students with ASD in Iran. Specifically, we examined the types of supports received, challenges faced, the collaboration between providers and families, and overall job satisfaction. Data in this qualitative study were gathered through the use of semi-structured, open-ended individual interviews conducted remotely and were analyzed using thematic analysis to identify patterns of meaning. Overall, findings indicated that most participants felt unsupported in their role as service provider and identified a number of challenges to effectively perform their jobs. These challenges included lack of appropriate space and/or equipment, training, financial compensation, and support for families. Positive aspects of the job include collaborating effectively with other professionals and overall job satisfaction. Implications for educational and governmental agencies are provided, along with limitations of the study and suggestions for future research.
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Although inclusive classrooms provide unique opportunities for students with autism spectrum disorder (ASD), these students face barriers during the initial transition from self-contained classrooms (Sanahuja-Gavaldà, Olmos-Rueda, & Morón-Velasco, 2016). The purpose of this qualitative, generic study was to identify how home and school collaboration impacted the transition and adjustment of students with ASD to an inclusive setting. Using a generic qualitative methodology, we collected data from 16 teachers who responded to a series of open-ended questions about their experiences with parental engagement during the transition to inclusion for students with ASD. Three themes emerged; teachers indicated that when parents and educators collaborated, (a) the students demonstrated improved academic performance, (b) the transition phase progressed more smoothly, and (c) the students achieved better social adjustment. Further, home-school collaboration resulted in teachers’ ability to adjust the curricula to meet the needs of the students, students’ increased motivation to complete tasks, and parents’ willingness to reinforce skills at home.
In an effort to provide clarity about the unique contributions of several professions within the context of multidisciplinary treatment, we reviewed the definitions, philosophical underpinnings, and national requirements pertaining to both scopes of practice (i.e., model licensing acts, legislation, and regulatory boards) and training (i.e., task lists, accreditation standards and course requirements, and exam blueprints) of 4 behavioral health professions. The professions we selected (behavior analysis, psychology, speech-language pathology, and occupational therapy) are likely to provide treatment alongside one another and often to the same clients. In a review of documents pertaining to scopes of practice and training for each profession, we found overlapping content. However, the similarities between professions diminished when we reviewed more specific guidelines such as learning objectives, educational requirements (i.e., coursework), supervised clinical experience (e.g., internships), and national examinations. This was especially true when considering each profession’s underlying approach to treatment (i.e., philosophical underpinnings) and, hence, service activities. We discuss our findings in light of service overlap and make a call for greater collaboration between professions, as related to the separate content knowledge and expertise of professionals in each field and the impact on client outcomes. Link to full-text: https://rdcu.be/cOcaS
There is considerable need for adoptable evidence-based interventions for implementation in public classrooms serving children with autism spectrum disorders (ASD) during the preschool years, an important period in neurodevelopment. Barriers to implementation, including gaps in teacher education, contribute to the research-to-practice gap, and may compromise child outcomes. This qualitative study collected ongoing verbal and written feedback from educators (n = 8) and administrators (n = 3) during their participation in the iterative development phase of a larger project to translate and preliminarily trial an evidence-based intervention, Early Achievements, in public preschool classrooms. Using a grounded theory-based approach, barriers were identified in areas of educator preparedness, engagement, and cohesion, complexity of instructing students with ASD, limited time/resources, and administrator support. Educators and administrators differed in their perspectives. Innovative strategies are presented for enhancing transportability, along with discussion of implications for teacher education practices and related policy.
Background: Autism Spectrum Disorders (ASD) do not cause premature death and there is no definitive treatment. Thus, the life time cost of ASD is extremely heavy and overwhelming. Identifying factors contributing to the cost of this debases has a key role in its cost containment. Hence, the purpose of this study was to examine social factors affecting ASD costs.
Methods: This descriptive and cross-sectional study was conducted using a valid and reliable questionnaire in Tehran, Iran, in 2017. ASD’s direct medical costs, direct non-medical costs, indirect costs, and social and economic factors contributing to ASD costs were examined in this study. A sample of 290 ASD patients in Tehran, were recruited for the aim of this study. Data was analyzed using SPSS software, 21st version. Appropriate statistical test (Spearman and Pearson tests, independent T-test and ANOVA test) were applied.
Results: The average ASD total cost was 223,561,841 Rials (6,883 $US) per patient. About 32%, 52% and 16% of the total costs were related to direct medical costs, direct non-medical costs, and indirect costs. There were significant statistically association between ASD costs and patient age, gender and type of school, parents’ education and job, family income and health insurance.
Conclusion: Autism imposes heavy costs on patients and their families. AS social and economic factors such as age, gender, education, health insurance and income affect the cost of ASD, health policy makers and managers must take the most effective measures to reduce the cost of the disease for patients and their families and subsequently, reduce its psychosocial burden.
Keywords: Autism, Economic burden, Social determinants, Tehran
Ref: Mosadeghrad A M, Pour-reza A, Akbarpour N. Social determinant of economic burden of Autism in Iran. SJKU. 2019; 23 (6) :101-114.
Objective: The present study is a part of a larger study that aimed at developing a comprehensive model of service delivery for individuals with autism in Iran based on the local needs and characteristics. In this study, the status of the services provided to those with autism in Iran was investigated based on the perspectives of parents of children with autism.
Method: A semi-structured interview was used to qualitatively investigate the status of the services with regards to autism in Iran based on the perspectives of parents of children with autism.
Results: This study revealed several barriers, including shortness of eligible professionals, difficulty in access to care for families, high costs, and lack of formal and informal supports, in providing services to those with autism in Iran. Early detection and diagnosis are of prime importance. We also need to train our specialists to diagnose autism based on the standard protocols and tests.
Conclusion: In sum, we need a comprehensive program that involves different sectors in charge of health and education in Iran.
Teachers' knowledge and perceptions about autism spectrum disorder (ASD) is found to be a critical component for the identification and education of children with ASD. This study examined Turkish general education teachers' knowledge and perceptions about ASD. A total of 478 general education teachers across four school types participated in the study. Data were collected using an online survey package. Results showed Turkish general education teachers across all school types and grade levels had limited knowledge and perceptions of autism. Findings show that there is an urgent need to develop professional development or certification programs to train teachers to work with children with ASD. Implications for future research and practice are discussed. Öğretmenlerin otizm spektrum bozukluğu hakkında bilgileri: Türkiye örneği ÖZ Öğretmenlerin otizm spektrum bozukluğu (OSB) hakkındaki bilgi ve algıları bu çocukların tanılanmaları ve eğitimleri için kritik öneme sahiptir. Bu çalışmada, anaokulu, ilkokul, ortaokul ve lise kademelerinde görev yapan öğretmenlerin OSB hakkındaki bilgi ve algıları incelenmiştir. Çalışmaya bu dört eğitim kademesinde görev yapan 478 genel eğitim öğretmeni katılmıştır. Çalışmanın sonuçları farklı eğitim düzeyinde görev yapan öğretmenlerin OSB hakkında sınırlı bilgiye sahip olduklarını ve öğretmenlerin bilgi düzeylerinin çalıştıkları eğitim kademelerine göre farklılık gösterdiğini ortaya koymuştur. Bulgular, OSBli çocuklara çalışan ve çalışma olasılığı olan öğretmenler için acil bir şekilde mesleki gelişim programlarının geliştirilmesi ve uygulanması gerektiğini göstermektedir. Makalenin sonunda gelecekte yapılacak araştırma ve uygulamalar için öneriler sunulmuştur.
Family members are often the primary caregiver for autistic adults and this responsibility may impact on the carer’s wellbeing and quality of life. 109 family members of autistic adults completed an online survey assessing their wellbeing relating to their caring role for their autistic relative. Family members who were supporting an autistic relative with co-occurring mental health difficulties and who they reported as unprepared for the future, self-reported higher levels of worry, depression, anxiety and stress, and poorer quality of life. These findings emphasise the importance of support for family members of autistic adults, whether through external services to support their relative or individual mental health support for the carer.
We conducted a meta-analysis to investigate the effectiveness of interventions aimed at reducing teacher burnout. Online and reference lists searches yielded 513 unique results, and the final sample contains 23 controlled trials (19 journal articles and 4 unpublished dissertations). More than two-thirds of the studies had optimal quality, and the risk of bias was not related to the overall effectiveness of the interventions. The overall effects were small, but statistically significant (d = .18, SE = .05, Z = 3.26, p < .001, k = 23). Separate analyses on each burnout component showed similar intervention effects on emotional exhaustion and personal accomplishment, but almost null effects on depersonalization (d = .03, SE = .06, Z = 0.53, p > .05, k = 11). Additional moderator analyses suggested that mindfulness interventions had significant effects on exhaustion and personal accomplishment. Interventions on primary and middle-school teachers reported effect sizes below the average effect. Similar to previous findings, interventions that lasted less than one month had the smallest levels of efficacy.
This study aimed at measuring the level of the psychological burnout in the teachers of students that have autism symptoms in Al-Riyadh area—kingdom of Saudi Arabia. In light of variables. These variables are the gender, the teaching place, the academic qualification of the teachers, the experience of the teachers, the age of the teachers, and the grades that the teachers teach. The methodology adopted in this study was the descriptive surveying method using the “Maslach Burnout Inventory” (MBI) of the psychological burnout. This measure consists of three dimensions as follows: The emotional fatigue, Sagging Feeling, Lack of feeling of personal Achievement. The sample of study included 94 teachers. All of the teachers in the Autism discover symptoms. The result obtained in this study has shown that there is an average level of burnout signs shown by the sample members at all of the three dimensions together. However, the study also showed that the awareness level varied against each dimensions as follows: the lack of feeling the personal achievement—dimension came first with a high average 27.56. In the second, place the (Emotional fatigue) dimension with an average of 23.06. Finally, in the third place came the (sagging feelings) dimension with an average of 3.16. In addition, the results showed significant differences at a level of α=0.05 due to the effect of the variables, affecting the burnout level, namely the teachers’ gender, the teachers’ age, and the teacher’s experience. On the other hand, the results showed insignificant differences at the effect of the other variables, which are the teaching place, the teachers’ academic qualification, and the age of students with autism disorder.
Preparing teachers to implement evidence-based practices for students with autism spectrum disorder (ASD) is a pressing need. We surveyed 456 teachers and administrators in a southern state about professional development related to educating students with ASD. Specifically, we were interested in confidence in implementation of evidence-based practices, interest in accessing training on these topics, perceived benefit of different avenues of professional development, and interest in accessing these avenues. Overall, teachers were not very confident in their ability to implement evidence-based practices and address important issues for students with ASD. Surprisingly, lower confidence was not related to increased interest in training. In addition, teachers and administrators perceived workshops to be a more beneficial and attractive avenue of professional development compared with coaching, despite empirical evidence to the contrary. We offer possible explanations for these findings and share implications for administrators, technical assistance providers, and policy makers who make decisions about professional development opportunities.
Objective:
Teachers often experience burnout and challenges during their active career. Different studies have shown that those directly involved with teaching children with special needs are more subject to burnout. Due to advance screening tools, more children with autism are now diagnosed and involved in special education. The aim of the present study was to investigate the professional burnout in teachers of children with autism compared to teachers of other children with special needs.
Methods:
Casual Comparative study design was used for this research. Three self-reported measures (Maslach Burnout Inventory, Job Descriptive Index, and General Health Questionnaire) were distributed; clustered sampling selection was conducted to select participants. Ninety three female teachers (32 teachers of children with autism, 30 teachers in schools for deaf and 31 for teachers of children with mental retardation) from 12 schools located in 4 districts of Tehran were selected. Pearson's and Spearman's correlation statistical tests, analysis of variances and regression were used to analyze the results.
Results:
Results of the current study revealed a significant difference in criterion validity between the three groups of teachers The three groups were different in terms of general health (p=0.010), emotional exhaustion (p=0.005) and depersonalization (p<0.001); however considering other variables no significant differences were observed. Comparison between groups showed that the average scores of teachers of children with autism were significantly higher than teachers of deaf and hard of hearing and mentally retarded children in general health, fatigue, and depersonalization variables. No significant differences were observed in average scores of teachers for mentally retarded and deaf children.
Conclusions:
Female teachers' of children with autism are experiencing significantly higher levels of burnout and general mental health problems compared to teachers of children with other disabilities requiring special education.
Most research into Autism Spectrum Disorders has been conducted in affluent English-speaking countries which have extensive professional support services. This paper describes a series of investigations that was undertaken in Iran, and these findings, together with reviews of research in other low-income countries, are used to identify key lessons in three areas of service provision of particular relevance to developing countries with scarce professional resources: first, the issues to be considered in establishing the prevalence of the condition nationally; second, identification of parental understanding of ASD and the impact it has on them as carers; third, the education and training that could be provided to families when professional supports are sparse. It is concluded that culturally sensitive, parental support strategies must be central to the planning and development of services. Moreover, future research should further elucidate the needs of families and evaluate the impact of culturally tailored interventions designed to promote the children's development and overall family quality of life.
This study is aimed at assessing special education teachers' attitudes toward teaching pupils with autism spectrum disorders (ASDs) and at determining the role of variables associated with a positive attitude towards the children and their education. Sixty-nine special education teachers were interviewed. The interview included two multiple-choice Likert-type questionnaires, one about teachers' attitude, and another about teachers' perceived needs in relation to the specific education of the pupil with ASD. The study shows a positive view of teachers' expectations regarding the education of pupils with ASD. A direct logistic regression analysis was performed testing for experience with the child, school relationship with an ASD network and type of school (mainstream or special) as potential predictors. Although all three variables are useful in predicting special education teachers' attitudes, the most relevant was the relationship with an ASD network. Need for information and social support are the relatively highest needs expressed by teachers.
In Iran, more than 1.3 million five-year olds have been screened for autism over three academic years, with the Social Communication Questionnaire (SCQ). The Autism Diagnostic Interview-Revised (ADI-R) is used to confirm a diagnosis of typical autism. The resulting prevalence of 6.26 per 10,000 for typical autism is in line with rates for certain countries but is lower than those reported recently for some Western nations. This may be due to the younger age range assessed but the suitability of the tools and aspects of Iranian culture could be other reasons for the lower prevalence. International comparisons of prevalence rates is fraught with difficulties, but it is a valuable endeavour as it can identify issues around cultural and societal perceptions of children's development.
Training courses on autism spectrum disorders (ASD) are required to meet the needs of the increasing numbers of children attending schools and care centers with a diagnosis of this condition internationally. A 14-day active learning course was developed based on three self-contained workshops which took place nationally in Iran over a 6 month period. In all, 162 personnel attended the training course. Participants were more disposed to including children with ASD in centers and their knowledge had significantly improved at the 3-month follow-up. The course was fairly effective in meeting its aims, although greater emphasis needs to be placed on supporting staff ‘on-the-job’ to implement their learning; a role that local tutors could undertake when they present the course.Abbreviations: ASD (Autism Spectrum Disorders) TEACCH (Treatment and Education of Autistic and related Communication Handicapped Children) ISEO (Iranian Special Education Organization) ISWO (Iranian State Welfare Organization)
A recent special education legislation reform in Greece puts emphasis on the inclusion of pupils with special educational needs into mainstream schools. The purpose of the present study was to investigate knowledge of ASD among 67 mainstream nursery and primary classroom teachers, and evaluate the effectiveness of a half-day ASD awareness seminar in increasing their knowledge of the disorder. A self-report ASD Knowledge Questionnaire (ASD-KQ), developed for the purpose of this study, was used before and after the ASD awareness seminar. The results indicated a significant shift from low to moderate/high level of ASD knowledge among teachers with no previous training in special education and/or autism (58.7%), whereas this shift did not reach significance level in the teacher’s group with previous training (16.7%) after the seminar. The present findings have important implications for the development of training programmes of practising teachers.
https://www.tandfonline.com/eprint/DZmmeSFm2gUPQYXfgMMJ/full
Many teachers are prepared for professional practice by attending Initial Teacher Education (ITE) courses in universities across the world. Under UK legislation, this preparation must equip teachers to address the needs of all children in mainstream classrooms, including learners on the autism spectrum – but does it? In this paper, I will critically explore this question by examining the findings of a research study focusing on a four-year ITE programme in a UK university. The research was designed using qualitative methods (online open-ended questionnaires and focus groups). The key findings were that the majority of students and tutors had some basic autism awareness, but little or no knowledge and understanding of autism teaching strategies. There was a consensus that teachers require both of these to ensure the inclusion of learners with autism in mainstream classrooms. Participants agreed there were currently insufficient inputs on autism on the ITE programme. This was related to a lack of tutor expertise, concerns about medical labelling and questions about ITE curriculum overload and priorities. Participants identified a range of ideas for improving autism education across the ITE programme which will be explored in the second phase of the study.
Inclusion in schools of students with autism spectrum disorder (ASD) is a source of stress for teachers and requires a certain amount of adaptation to deal with it. The effects of perceived self-efficacy on burnout in professionals have been substantiated but the indirect effects, mediated by transactional processes of stress and coping, have never been explored in this specific context. This study aims to test the mediating effect of perceived stress and coping strategies on the relationship between perceived self-efficacy and burnout.
As the rates of diagnosis of autism spectrum disorder (ASD) increase and more students with ASD are enrolled in mainstream schools, educators face many challenges in teaching and managing social and behavioural development while ensuring academic success for all students. This descriptive, qualitative study, embedded within an inclusive pedagogical approach, draws on a purposive sample of 13 elementary school teachers who have experience in teaching children with ASD within two cities in Ontario, Canada. Through in-depth interviews we asked about teachers' strategies for creating an inclusive environment within their classroom. Teachers had several recommendations for successfully including children with ASD in mainstream classrooms including: (1) advocating for resources and essential training; (2) tailored teaching methods; (3) teamwork within the school; (4) building a rapport with parents and students; and (5) building a climate of acceptance within the classroom through disability awareness, education and sensitivity training. In conclusion, teachers need to use several strategies and have appropriate training and resources to optimise the successful inclusion of children with ASD.
Background:
To date, most research with families who have a child with autism spectrum disorder (ASD) has been undertaken in English-speaking countries. Increased levels of stress allied with poorer health have been commonly reported for mothers, with less attention paid to fathers. This study aimed to document the personal impact on Iranian mothers and fathers and identify the correlates of increased stress and poorer emotional well-being.
Method:
In all, 103 parents (58 mothers and 45 fathers) from 74 families who had a child with ASD volunteered to take part in the study. Each participant completed through interview, standardised rating scales of parenting stress, emotional well-being and family functioning as well as rating their child's autistic symptoms, including stereotyped behaviours.
Results:
Mothers had significantly higher scores than fathers on measures of stress and emotional well-being. Although these variables were highly correlated, binary logistic regression identified that the poorer health was also associated with lower educational levels of the parents, more behavioural problems with the child and fewer autistic symptoms overall. A similar regression analysis of stress scores identified no gender differences but found that lower stress was associated with mothers and fathers who were joint caregivers and when the family lived with relatives.
Conclusions:
Iranian parents experience broadly similar responses to parents in other countries, which suggests that the impact of ASD outweighs any cultural differences that might otherwise be present in parental responses to caring for children. In common with families internationally, these parents are likely to benefit from opportunities to become better informed about ASD and the management of their child at home allied with increased support from families and friends.
Children with autism are neglected in Iran, health official says
- Azizi
“Just like other kids.” Lack of access to inclusive quality education for children with disabilities in Iran
- Human Rights Watch
Annual report 2020 of NCRI Women’s Committee
- National Council of Resistance of Iran
Autism spectrum disorders
- World Health Organization