Amber M. Chenoweth and Brittany L. Jackson (Hiram College)

Autism Spectrum Disorders (ASD) have a relatively recent history in terms of research attention. With the newly updated diagnostic criteria in the DSM-5 (American Psychiatric Association, 2013), even more attention has been made to this spectrum of developmental disorders as individual diagnoses may have changed (e.g., individuals with former diagnoses of Asperger’s syndrome are now diagnosed with ASD). Further, typical developing students are finding themselves in a variety of situations in which students with ASD are included, often without a full understanding of the experience of their peers with ASD. This lack of understanding can lead to a range of responses toward their peers with ASD, including simple confusion and frustration when attempting to interact with their peers with ASD, to the extreme of bullying those with ASD (Swaim & Morgan, 2001). As Harnum, Duffy, and Ferguson (2007) found, this is due to the perception that individuals with ASD are not the same as typical developing individuals, leading to less openness to interaction.

      Our institution is poised with a unique opportunity for our students to interact more fully with individuals with ASD, being situated nearby to a Living and Learning Community. This organization is a fully-functioning organic farm that provides the opportunity for adults with ASD to work and be provided with occupational therapy options. Several students from our institution have participated in internship opportunities at Living and Learning Community and found these experiences rewarding, both in a service aspect as well as in future career exploration. Moreover, this interaction with individuals with ASD serves to increase student understanding of the complexity of this spectrum of disorders. Because of this stimulated interest in ASD among students on our campus, several faculty members across disciplines offer courses on ASD. Given our institution’s emphasis on interdisciplinary learning, we found this to be a great opportunity to engage students in a course to explore the many facets of ASD.

      Why an interdisciplinary course? Much value can be gained from engaging students in exploring a complex topic through multiple and integrated lenses. By allowing students the opportunity to explore these topics within the course setting, we can push them to challenge their previously held beliefs and ideas while they explore that shared space between disciplines. Further, interdisciplinary courses, particularly those that are team-taught, can foster creative, critical, and divergent thinking, all skills that are sought by our students’ future employers (Putrienė, 2015).

Our Course

Our course integrates the disciplines of psychology and theatre. From the psychology perspective, students are exposed to material from the scientific literature on ASD, examining with depth the topics of diagnosis, hypothesized causes, treatments, as well as the concept of neurodiversity. The theatre perspective exposes students to two key areas: playwriting and acting. Students learn techniques for telling a story drawing from multiple sources – readings, interviews, discussions – and acquire how to portray what they learn in both abstract and concrete ways, while being made aware of issues of accuracy and sensitivity to a population different from themselves. The interdisciplinary nature of the course also integrates the disciplines to model for students how the two inform one another. For example, the psychology content serves as the context for which to explore these topics in a theatrical way; awareness of body, space, and wording informs students in best approaches to interviewing individuals with ASD and those that support those individuals.

The learning objectives of this course are for students to demonstrate understanding of the science of ASD and theatre methodology (playwriting, performing), and connect and listen to the other, testing empathy skills, and gain a truer sense of one’s own humanity. To meet these objectives, we designed the course to engage students in the following activities:

• ·       Class discussions focused on topics about the science of ASD (neurobiological etiology, symptoms, and therapeutic interventions), as well as theatrical portrayals and storytelling. The basis for these discussions are assigned readings, including both fiction and nonfiction sources, scientific articles, case studies, guest speakers, and current event topics.
• ·       Short writing assignments that scaffold students through the writing process by requiring students to submit specific creative writing pieces drawn from scientific literature. This begins with having students write a letter based on a scientific article, then a short story, and eventually multiple scenes of a play.
• ·       Interviews with either individuals with ASD or those that work with individuals with ASD, including caregivers and family members, teachers, doctors, intervention specialists, case workers, etc.
• ·       Field trips to various locations to explore aspects of ASD. Past field trips have included visiting the local Living and Learning Community that provides occupational therapy for adults with ASD and New York City to see the play The Curious Incident of the Dog in the Nighttime on Broadway.
• ·       Media portrayals that depict various aspects of ASD. Past feature films have included Rain Main, Temple Grandin, and Ben-X, as well as the documentary Autism is a World. We also have students view clips from TV shows that highlight characters either overtly diagnosed with ASD (e.g., Parenthood) and those that are exhibiting common characteristics associated with ASD (e.g., The Big Bang Theory). These portrayals are the basis for class discussions on accuracy of portrayals, the ethics of presenting characters with ASD in often stereotypical ways, how these portrayals either promote or hinder the idea of neurodiversity, as well as to inform students on how to connect with the characters they are developing in their final performance piece and present in both an accurate and sensitive way.
• ·       The final performance piece requires students to draw upon all the class activities to develop a brief (approximately 10 minute) play focused on a specific ASD topic. Students work in small groups (5 students per group, on average) to write and perform their piece.

Assessing Our Course

During the fall 2015 offering of Exploring Ability and Disability: ASD, we administered a voluntary pre- and post-test survey to students enrolled in the course to assess changes in knowledge of ASD, as well as to inform us on the students perceived effectiveness of the course activities described above. A total of 25 of our 31 enrolled students completed both the pre- and the post-test set of questionnaires.

At pre-test, we administered a prior experience survey which revealed participants had, on average, approximately five years of experience interacting with an individual with ASD, typically a classmate, friend, co-worker, or relative.

At both the pre- and the post-test we administered the Autism Knowledge Survey-Revised (AKS-R) developed by Stuart, Swiezy, and Ashby (2008). This questionnaire of 20 statements about ASD provided a measure of baseline and change in knowledge of ASD, as participants indicated on a 6-point Likert-type scale how much they agreed or disagreed with each statement. We found that overall students did increase in their knowledge of ASD compared to pre-course baseline. However, there were a couple items that did not show the same increase in knowledge, highlighting our need to address those topics more clearly in future offerings of the course. One example included the item “Children with autism do not show attachments, even to parents/caregivers,” to which the correct response should be “Fully Disagree.” Upon reflection, we identified areas where we could emphasize the fuller range of emotion and attachments that children with ASD do express.

We also administered the Openness Scale, adapted from Harnum et al. (2007), at both pre- and post-test. This scale first presented a vignette depicting characteristic behaviors of an individual that may be diagnosed with ASD, and then presented a series of statements regarding reactions to and the willingness to interact with that individual, to which respondents rated on a 5-point Likert-type scale how much they agreed or disagreed with each statement. With this measure, we found that participants remained at their initial high openness to interact levels pre-to-post, indicating that there may have been potential bias. This bias may be from demand characteristics – who would want to admit that they would not want to interact with an individual who clearly displays behaviors of the disorder for which this course is based upon? – or from the self-selecting nature of taking a course on ASD, or both.

Lastly, we surveyed participants on their class experience with a series of open-ended questions. They all took the form of “Reflect on how the [assignment/activity] affected your understanding of individuals with Autism Spectrum Disorder.” Representative responses are below.

Final performance pieces.

• ·       “It helped me understanding people with autism because it allowed me to imagine what it would be like to actually be involved in a family with children with autism.”
• ·       “There were many different views of autism portrayed. It reminded me that everyone experiences the disorder differently.”
• ·       “I think it helped show how people took their own version of what they saw autism as and turned it into a play. Each play had different aspects to it which showed all the things we've learned.”

Short writing assignments.

• ·       “They allowed me to express what I have learned in different ways from monologues to poems. Sometimes things are hard to express so this gave me the chance to try different ways.”
• ·       “The SWA's were the most influential piece for my learning in this course. I learned a ton through the articles and reflecting in a creative way.”
• ·       “I never thought I could be creative when talking about autism.”

Class discussions.

• ·       “It allowed me to see and compare my thoughts with my peers and fellow classmates. I got to see and hear that I wasn't the only person with confusions and thoughts about people with autism.”
• ·       “They allowed me to see many different opinions from everyone in class. Not everyone has the same type and amount of experiences so this class gave me the chance to see what others see and think.”

Interviews.

• ·       “It made me face something about my friend. And myself.”
• ·       “I learned SO much about my interviewee and ASD in general. I had known the person for years, yet never thought to ask these questions or care to listen for the answers. This was a crucial part of the course.”

Field trips and media portrayals.

• ·       “It definitely drew my attention to the fact that many types of the disorder are not reflected in the media at all.”
• ·       “I loved them all, all of them provided me with a learning experience that helped me gain an understanding of ASD. It also reminded me that this is something I want to do for the rest of my life.”
• ·       “This was a great idea as it allowed us to gain realistic perspectives of people with ASD. Experiencing something in real life is much different than in a classroom or through a book.”

As with any course assessment, however, not all our responses were quite so positive. A few respondents indicated they thought the short writing assignments and class discussions were repetitive, and that the final performance pieces showed more stereotypical representations of ASD. Overall, though, students generally rated each of the activities as valuable at some level, and attributed the activities and assignments to enhancing their knowledge of ASD.

Lessons Learned

From the open-ended responses, both indicating “success” as well as negative aspects to consider for future modifications to the course, we have identified key lessons learned when teaching a course on a complex and sensitive topic, particularly when you are expecting them to demonstrate their understanding through creative methods.

First, it is crucial to provide your students lots of examples. Luckily, we have taught this course a handful of times now and have built up a repository of good examples (with those students’ permission, of course) to share with our students, particularly for the short writing assignments. One area we identified could use more examples is with plays and performances in different formats. By having students practice what we are expecting to have them complete by the end of the course – i.e., a full performance piece – we greatly enhance the success of achieving that learning goal.

Second, whenever possible incorporate experiential learning opportunities. As evidenced by the responses we received about the field trips and interviews, students learn so much by doing rather than just through merely reading or being lectured to. We are fortunate to have the Living and Learning Community for adults with ASD within walking distance of our campus, but there are other ways to incorporate these experiences into any course. For example, reach out to the local community for guest speakers, such as special education instructors, the director of the local disability services office, and parents of children with ASD. In our experience, many of the individuals in these positions are wanting to share their experiences to promote greater understanding. We also found value from engaging our students in simulation exercises, such as simulating sensory overload. However, such exercises need to be placed in the correct context and introduced and discussed in a way to not promote feelings of pity in the students, but rather to promote understanding (Nario-Redmond, Gospodinov, & Cobb, 2017).

Third, and we would argue most important, be encouraging! For some students, this is their first creative experience and they are anxious. In our course, many of our students did not come having had acting experience, or even creative writing experience. It was important for us to emphasize that the class space was a safe space to explore both the theme and content of the course, as well as how to express themselves in a creative way. This led to our favorite response provided above: “I never thought I could be creative when talking about autism.”

References

American Psychiatric Association. (2013). Autism Spectrum Disorder. In Diagnostic and statistical manual of mental disorders (5^th ed.), 50–59.

Harnum, M., Duffy, J., & Ferguson, D. A. (2007). Adults’ versus children’s perceptions of a child with autism or attention deficit hyperactivity disorder. Journal of Autism and Developmental Disorders, 37, 1337-1343.

Nario-Redmond, M. R., Gospodinov, D., & Cobb, A. (2017, March 13). Crip for a day: The unintended negative consequences of disability simulations. Rehabilitation Psychology. Advance online publication. http://dx.doi.org/10.1037/rep0000127

Putrienė, N. (2015). The links between competences acquired through interdisciplinary studies and the needs of the labour market. Social Sciences (1392-0758), 88(2), 54-64. doi:10.5755/j01.ss.88.2.12741

Swaim, K. F., & Morgan, S. B. (2001). Children’s attitudes and behavioral intentions toward a peer with autistic behaviors: Does a brief educational intervention have an effect? Journal of Autism and Developmental Disorders, 31, 195-205

Stuart, M., Swiezy, N., & Ashby, I. (February 2008). Autism Knowledge Survey:  Understanding Trends in Autism Spectrum Disorders. Poster presented at the 2^nd annual ABA Autism Conference, Atlanta, GA.