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United Nations Department of Economic and Social Affairs Sustainable Development

Inspire’s Structured Training and Education Programme (STEP)

    Description
    Intro

    In the early ‘90’s in Malta, there was an urgent need for autism-specific intervention. In view of a national drive towards inclusion, autism was a relatively ‘new’ challenge for schools. Due to the lack of knowledge/awareness regarding autism, the children were often misunderstood therefore, this was an enormous obstacle to their inclusion within the mainstream classroom. In response to this need, STEP was established in 1995. As the need to focus on the early years of development was recognized, it was decided that STEP Early Years would address early intervention, whilst other programmes were developed to address the other age groups.

    Objective of the practice

    The objective of the programme is to deliver specialised, highly individualised programmes built on evidence-based practice to our children, and to support the family and school staff. Our open-door policy encourages parents and school personnel to come to STEP and see exactly what, why and how it is possible to make an impact on the lives of their children. Ultimately, we embrace and promote Inspire’s commitment to inclusion for all, while providing support for those children for whom inclusion is not a straightforwardly achievable objective. Due to the challenges faced by autistic children during their early years of development, their inclusion in the pre-school setting may be problematic. Once a child joins STEP, an initial meeting with the multi-disciplinary team is held with the parents to begin gathering information about the child. Team members include the psychologist, speech-language pathologist, occupational therapist, physiotherapist, parent relations manager, autism consultant and the specialised tutor. The premises are specially designed and great attention is given to possible environmental stressors and sensory issues. Structure is an essential part of the physical environment while emphasis is placed on the environmental organisation that enables children with autism to communicate more effectively and accounts for their cognitive difficulties. The consistent use of visual structure, low arousal approaches, high levels of predictability and individualised practice are implemented throughout the service. The benefits of consistency in our approach with the children may be seen across different settings such as the summer programme that is held in our therapeutic premises which is situated on another site. Individual/group sessions are organised to offer choice, variety and opportunities in coping with change and problem-solving. STEP welcomes teachers and learning support educators (LSEs) to attend meetings where the child’s programme is discussed and planned. The LSEs attend STEP sessions to observe, thus specialised teaching and instructional techniques can be carried over and implemented within the mainstream classroom. STEP tutors actively participate in mainstream schools’ IEPs (Individual Education Planning) and MAP (Making Action Plans) meetings. The STEP tutors carry out school visits to observe the child while in a classroom amongst peers. This is an opportunity for the tutor and LSE to discuss any issues regarding the child’s intervention and how specialised approaches are being transferred/generalized. Parents participate within the programme and can observe their child while at STEP. As a result, the parents are empowered with the strategies that will enable them to take an active role in enhancing their child’s development while at home and within the community. Parents are supported by the Parent Relations department through therapeutic group sessions as well as individual sessions if required.

    Partners
    Beneficiaries include the children identified as having difficulties found on the autism spectrum up to the age of 5; their parents/guardians, siblings, extended family; school staff such as teachers, LSEs, INCO (Inclusion Coordinators); internal and external therapists; community service providers (training given to staff at the Malta International Airport in their campaign to make the airport ‘autism friendly’); pre and post grad university students doing research projects.
    Implementation of the Project/Activity

    Once a child joins STEP, close attention is given to the assessment of their individual needs. The assessment period lasts between 8 and 12 weeks to ensure that a true picture of the child is seen. A case conference is held and together with the parents, an individualised programme is designed. SMART (Specific, Measurable, Achievable, Realistic and Timely) goals are set to ensure that the holistic development of the child is being addressed. The premises are specially designed and great attention is given to possible environmental stressors and sensory issues. This is to ensure that a low arousal environment is provided and maintained. Structure is an essential part of the physical environment; therefore, emphasis is placed on the environmental organisation that enables children with autism to communicate more effectively and accounts for their cognitive difficulties. The consistent use of visual structure, low arousal approaches, strong sequencing, high levels of predictability and individualised practice are implemented throughout the services offered by STEP. Individual and group sessions are organised to offer choice, variety and opportunities in coping with change and problem-solving. Strategies used may vary from one individual to another since each person with autism is unique and has individual needs. STEP welcomes teachers and learning support educators (LSEs), who assist the child while in the mainstream classroom, to attend meetings where the child’s programme is discussed and planned. The LSEs come to STEP to observe and participate in activities, thus specialised teaching and instructional techniques can be adapted and carried over to the regular classroom. On the other hand, STEP tutors actively participate in mainstream schools’ IEPs (Individual Education Planning) and MAP (Making Action Plans) meeting. In addition, the STEP tutors carry out school visits so that the child may be observed while in a classroom environment amongst peers. This also is an opportunity for the tutor and LSE to discuss any issues regarding the child’s individualised programme and how specialised approaches are being transferred applied in the mainstream setting. Parents are invited to participate within the programme and can observe their child while at STEP. Following the observation session, a discussion is held with their child’s tutor regarding the aims of the activities presented, the child’s performance and any other issue regarding their child’s development and programme. As a result, the parents are empowered with the strategies that will enable them to take an active role in enhancing their child’s development and learning experiences while at home and within the community. Communication, occupational and physiotherapy are part of the holistic programme delivered at STEP. The STEP psychologist provides regular sessions in collaboration with parents and tutors. Additional services available at our Therapeutic and Leisure Centre include hydrotherapeutic swimming, therapeutic horseback riding, therapeutic and creative arts and the use of a state-of-the-art multi-sensory room. STEP is monitored by the National Autistic Society, UK. A formal evaluation occurs every 3 years and the programme is monitored yearly through an interim development assessment/visit.

    Results/Outputs/Impacts
    STEP Early Years was accredited by the NAS Accreditation Programme, UK in 2002 and was the first service outside of the UK to have achieved accreditation status. STEP in fact is the only accredited service on the island. Ever since STEP has successfully maintained accreditation status. The Inspire Foundation has been awarded ISO 9001:2008 Accreditation status. This is a testament to the quality standards to which we work and the drive towards continuous improvement as an organization.
    Unanticipated spill overs - positive and negative, including how negative impacts were alleviated or mitigated.
    Due to a limit of available spaces within the programme, and more often than not, demand is higher that the spaces available, children may not be accepted to join. Another limitation is that our centre is located in the south of the island, therefore, this may be an obstacle for those living in the north and who do not have their own means of transport.
    Longer term results to which practice contributes.
    The aim of the programme is to identify the individual needs of each child, focusing on developmental milestones and communication. Independent skills such as feeding, and toileting are also addressed as although very basic, many times, these are major obstacles to the child’s inclusion in a mainstream setting. Intervention is held in a specialized environment to enhance the learning experience. Hence, long term result include:
    Coping within the mainstream educational setting
    Independent self-help skills
    Social competence
    Acquiring a means to communicate
    The development of cognitive skills
    Play skill development
    The reduction of challenging behaviour by providing alternative appropriate means of expression
    Empowering parents to be able to understand and guide their child on the path to further development
    Focus is enhancing development in all areas, addressing transfer and generalisation of skills across different settings – using autism-specific techniques.
    Impacts across genders/population groups if any:
    The STEP Early Years programme is replicated at Inspire’s premises on our sister island, Gozo. The programme is closely monitored and supported by the base in Malta.
    Enabling factors and constraints
    Through dedicated staff and volunteers, we provide a range of free services and activities that help our children and their families to live a quality life, experience growth and a sense of achievement and to integrate into society. A major constraint for the further development of the programme and the ability for all children to attend was the financial implications that come along when offering a quality programme and a variety of services. However, this is no longer an issue as the financing of the programme has been secured from the Ministry of Education and Employment.

    The introduction of the use of visuals and structured teaching over 20 years ago has brought forward a significant improvement in the inclusion of children on the spectrum within the mainstream school setting.
    Sustainability and replicability
    The securing of government funding has made a significant impact on the stability of the programme and the taking on of more clients who may have previously encountered financial difficulty. During the child’s time at the programme, every minute is a learning experience, therefore, no time is wasted. Throughout the day, there are opportunities to learn and acquire self-help and independent skills within natural settings. This also allows for specific therapists to focus on their area and also support the tutors by providing an element of role release. As the location of our premises sometimes presents as a challenge to those families from the north of the island, the possibility of extending our service to the north is being explored.
    Conclusions

    Although currently there is no cure for autism, research has confirmed the positive impact that appropriate intervention may have on the further development and enhancement of skills. Specialized programmes such as STEP Early Years, have often been the key for enabling and empowering children on the autism spectrum to access learning and social opportunities as well as supporting their parents and other relevant stakeholders. <br />
    Awareness is key! Sadly, parents raising a child with autism may not only be dealing with the challenges that this condition may bring, however, must also face the battle of being unfairly judged by society. People are quick to judge and assume that the parent is failing, or the child is simply out of control. The last thing a parent needs is to be told to ‘discipline’ their child who may be having a meltdown due to a possible sensory overload. These parents need help, not judgement. Hence our commitment is not only to support the child, however, to empower their parents! <br />
    School staff must be supported and empowered with information/training as this enhances their understanding of autism. Inclusion is not just physically having the autistic child in the classroom, it’s about ensuring that the student participates in the class’ activities and benefits from being in a mainstream classroom. Schools must be aware that autistic children need more specialized intervention such as specialized resources, including specially trained staff, communication aids, sensory equipment and environmental considerations which cater specifically to this condition. <br />
    Inspire has a wealth of experience directly supporting and advising staff involved in teaching children on the autism spectrum such as learning support educators (LSE) and teachers. Specialised tutors visit the children while at school in order to observe the child in the mainstream setting along with their peers. This is followed by a discussion with the LSE, where recommendations regarding communication strategies, behaviour management techniques and possible environmental considerations are outlined and adapted for the classroom environment. <br />
    External training events are tailor-made and specifically designed to provide basic information regarding autism to promote awareness and broaden the participants’ knowledge of the condition, leading to more understanding. Specialised techniques are discussed in an interactive manner, providing the participants with the opportunity to take away practical strategies and apply them within their context. An example of a very popular training event is that of the Inclusion/Exclusion training. The content of this training event focuses on educating people on the importance of embracing diversity and pointing out that we are all different from each other in many ways. <br />
    An important component of delivering a fully comprehensive service is providing support to children during extracurricular activities. During the summer months, STEP Early Years children make use of the therapeutic services at our Marsascala branch. Using facilities such as the indoor hydrotherapeutic pool, the state-of-the-art multi-sensory theatre and therapeutic horseback riding provide the children with an opportunity to generalise acquired skills in a variety of environments – and have fun at the same time! The feedback received from the parents is overwhelmingly positive and continues to fuel our enthusiasm to continue our work.

    Other sources of information
    www.inspire.org.mt
    www.know-ur-rights.com
    Dissertation for MEd Autism (Birm): A Study about the Role of a Structured Teaching Programme in the Transfer of Specialised Teaching Strategies to the Home and Mainstream School Settings (written by Doreen Mercieca)
    NAS Accreditation Reports
    N/A
    Resources
    Staff / Technical expertise
    Autism consultant, speech language pathologists, occupational therapists, physiotherapists, psychologists, tutors
    No progress reports have been submitted. Please sign in and click here to submit one.
    False
    Name Description
    Action Network
    SDG Good Practices First Call
    This initiative does not yet fulfil the SMART criteria.
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    Timeline
    01 September 1995 (start date)
    01 January 0001 (date of completion)
    Entity
    Inspire (The Eden and Razzett Foundation) VO/0199
    SDGs
    Region
    1. Europe
    Geographical coverage
    The STEP programme is offered to all eligible children across Malta and Gozo.
    Website/More information
    N/A
    Countries
    Malta
    Malta
    Contact Information

    Doreen Mercieca, Ms