In my classroom experience with kids who had those awful labels (CDS, moderate/severe/profound MR, multiply handicapped, or whatever) there were always difficult choices to be made about how to spend our days. It goes without saying that these kids had many deficits - by definition that is why they were placed in that particular classroom. Most were served by a variety of other professionals within the school setting, and often another whole set of professionals outside that setting. Services such as physical therapy (PT), occupational therapy (OT), speech and language therapy (SLT) were common in school, and various medical or behavioral specialists would be working with the family when school was not in session. All such services were much needed and much appreciated. But all took up valuable time and energy. Everything these kids did was hard work for them, and of course keeping them healthy, strong and alert was a prime concern for all of us. We wanted to help in every way we could, and we wanted to make the best possible use of the time we had available.
Thank goodness for the IEP process. Sitting down with the parents - and all those wonderful professionals who worked with us - we could review progress at least annually and hash out our priorities for the coming year. I always encouraged the parents to be open and honest about what they wanted most from the school, and to give us any suggestions they might have about what we could/should be attempting to teach. This was before the age of standardized testing, and as long as the parents agreed with me that there was no need for formal testing or assigning grades, we could move forward in agreement with a highly individualized plan in place.
Without a doubt, the primary decision was how much emphasis to place on functional life skills, and how much to place on academic learning. Thinking back to one of my earliest classrooms, we had a variety of adaptive equipment so that kids with physical disabilities could be comfortably positioned in a variety of ways (with therapeutic value of one sort or another) throughout the school day. Rotating each one through the various equipment (not unlike a visit to Curves these days!) along with frequent bathroom visits and time for feeding and rest, there really wasn't a lot of time for other activities. We also had open access to a classroom that had been converted into a mock apartment, with laundry facilities, kitchen appliances, a bed we could practice making, even a sofa with a TV to watch.
Have I mentioned that I was part of a very hard-working committee that spent many long hours developing what we thought was a state-of-the-art curriculum for teaching life skills? We took this very seriously! In addition to skills that might help around the home, we taught community-related skills, social skills, pre-vocational skills and the like.
It wasn't "bad," but in retrospect I am quite sure we were not giving the kids quite enough credit. For example, we commonly worked on such tasks as sorting silverware or folding towels. With so many students having serious motor impairments, this could be quite a challenge. If we were hoping that some day they might live on their own (not likely for most) or maybe work in a restaurant or hotel where these skills might be useful, was the idea that ten or more years of "practice" might make them able to do this satisfactorily? Is it not possible that these skills might not even be needed in the next decade when they would be ready to go out into the world? What about the possibility that we were insulting their intelligence and/or missing valuable time when they could be learning something more important?
The parents I worked with covered a wide spectrum in their expectations. Most were very happy that the school was there to work with their child and gave us a wide berth in the choices we made, trusting our training and experience, our "expertise!" (SCARY!) Some were very specific in what they wanted us to work on in the time we spent with their child, but even they were usually realistic in their expectations and appreciative of our efforts.
And yet, by the time these students left the school system, I think all of us - teachers, therapists, and parents - would agree we hadn't really taught them much, and certainly not enough to be really ready to tackle the world with all its complexities.
When it came to those students on the autism spectrum, things were even more complex and confusing. I worked mostly with those who struggled with communication, so that was always a top priority for me. In the early days, however, my students would often be denied access to the various therapies because they (1) didn't talk (most speech/language therapists were used to working with articulation at the time) or (2) didn't cooperate. They didn't manifest the same type of motor problems as those with physical impairments, so physical therapy was seldom even considered. Always there was a strong emphasis on behavior - lots of time was spent analyzing various behavior patterns that were deemed unacceptable and in need of modification. Once we settled on a specific target behavior the task shifted to finding ways to encourage the child to change, using a combination of rewards and consequences (and yes, in those days, sometimes even punishment). Trouble was, the smartest among them could outsmart the professionals at every turn and a lot of time was spent trying to stay ahead of the game.
What I would change for sure in every single situation - and did, once we started learning more about the true cognitive level of so many of our students - is the level of interaction and instruction. Rather than a room decorated with characters from Sesame Street or Disney movies (even though so many of the kids really did love these characters!) we switched to world maps, pictures of the Presidents, and covers from current news magazines. We had always read to the students regularly, but switched to age-appropriate fiction and non-fiction spanning a wide array of topics that might be both interesting and educational.
For those with autism, it began to seem more important - and respectful - to help the kids learn ways to recognize when they might need a break and how to best do that in the school setting. Learning to occupy themselves during free time, playing alone or with others, expanding their interests -- all seem valuable areas for teaching/learning. As we learned more about the difficulties these kids had dealing with sensory systems that were out of whack most of the time, we realized that helping them find ways to self-regulate was a much more critical life skill than any of the behavior management techniques we had been using.
In general, we were operating from a deficit model. We identified areas where a particular student was unable to perform some task that sooner or later would be needed to get by in life. But the reality is that many of these individuals would never be able to do many of the things we considered essential; they would always need some level of support. Sadly, our focus was so intense that we missed the opportunity to identify and encourage interests and celebrate abilities.
By the time I retired, I had come a long way in my understanding - but not nearly far enough. I won't have another chance to do it differently, but maybe I can help other teachers (or parents) find a way to make better choices.