What I Consider Most Important in Support Through Structuring
Hello everyone. This is Sasaki from the Yokohama Developmental Consultation Office. Previously, when I wrote about SPELL, I explained "Structure." This concept of Structure is also positioned as a very important form of support for individuals with autism at the TEACCH Autism Program at the University of North Carolina, which continues to lead the way in autism support. I often explain Structure (structuring) at seminars held at our office, and while I plan to discuss it in detail again at our spring seminar from Friday, May 29, to Sunday, May 31, 2020, I would like to share what I consider to be the most important aspect of it here.
Is Structuring = A Fixed Method?
Recently, it seems that more people have heard the term "structuring" wherever I speak. This is very gratifying in the sense that the importance of support for individuals with autism is becoming recognized. When I ask about structuring on such occasions, I am almost always told about specific initiatives being practiced in individual settings, such as "I use picture cards as visual support," "I use schedules," "I physically separate each activity and location," or "I use partitions." When I hear these things, while I think "I see," the question I always ask is, "Why are you doing that?" and "What is the meaning behind doing that?" This is because I believe that all support should be based on evidence (assessment), and support where the provider does not understand its meaning is far too irresponsible. I feel that such support is similar to, for example, "going to the hospital for a headache and being given painkillers without a medical examination" (this would not happen in reality, but if I were treated this way, my anxiety and distrust would increase). Therefore, when I receive answers like "because my predecessor did it," "because I heard it's good to do for people with autism," or "actually, I don't really understand," when I ask the questions mentioned above, I ask them to review their approach to support.
The most important thing in structuring is not the method, but the "way of thinking"
There are various opinions and thoughts, but I believe that the most important thing about structuring is not the specific methods or rules, but the "way of thinking." If we do not grasp this way of thinking, things like "the approach is completely different depending on the person in charge," "structuring is only effective for those with intellectual disabilities," or "continuing to use structuring that has stopped working" will occur.
Understanding the way of thinking about structuring -> Assessment -> Specific ideas
Even when implementing structuring, the way of thinking is the same as the principles of support for individuals with autism. The start is not "because they have autism," but understanding the individual, grasping what points they are having trouble with, and what needs they have. On that basis, it is necessary to start from where it seems helpful for each person. Therefore, rather than "a schedule because they have autism," isn't it important to think, "they seem to have anxiety because they lack a sense of perspective, so let's use a schedule so they can have a sense of perspective and feel at ease," or "they don't really care about their daily schedule, but they want to know about their leisure schedule (= they have a sense of perspective for leisure), so let's first properly convey the schedule for leisure activities"?
Structuring is effective but not a panacea
Finally, to share one more thing I consider important, "structuring is effective but not a panacea. Support for individuals with autism does not mean that just doing structuring is enough. For example, what I often experience in the field is that structuring is done, but the way to use it or its meaning is not taught. When we support individuals with autism, I think the idea of "teaching and conveying" is important (of course, there are also tips on "how to teach" and "how to interact," but I think I will leave that for another occasion).
Well, I have shared my thoughts on "structuring" up to this point. More detailed explanations of these are provided at seminars and the like, and at the seminars, I introduce specific ideas based on the way of thinking I have conveyed so far, as time permits. For reference, I have made a part of the web seminar public, so please take a look if you are interested.
Structuring for those with intellectual disabilities -> https://www.kokuchpro.com/event/ad1119a6b0c731034536c15273fd37f4/
Various structuring from those with intellectual disabilities to those without -> https://www.kokuchpro.com/event/71ece9fc9b2be8cb66e4e52e22f94bee/
Yokohama Developmental Consultation Office Yasuei Sasaki