Bill Moss, Executive Director
Noted as “The Linwood Method” for many years, the fundamentals as practiced everyday in Linwood’s programs have intrigued parents and professionals for many years. These practices have been studied, lauded and sometimes criticized. As we take a brief look at Linwood’s approach to working with individuals living with autism, we will examine just how the staff implements its practices, we will also look at how Linwood came to be and what Linwood has done for the children and adults who have passed through its doors.
To understand Linwood’s practices, one must accept a fundamental tenet which is at the heart of our approach: The only lasting change is that which occurs as an integral part of the child’s overall development. Different than the often used practice of changing behavior as a mechanical response to repeated drill and training, the Linwood Method is more likely to produce lasting outcomes by implementing practices that motivate the child to learn. Applied Behavior Analysis (ABA) teaches us that, in order to bring about positive behavior change, one must be able to identify the pivotal elements in the child’s environment that influence behavior. Like Koegel and Koegel’s Pivotal Response Treatments (Koegel & Koegel, 2006), Linwood relies on the fundamental aspects of observation, establishing relationships, and changing behaviors in the child’s natural settings.
Learning occurs in the classroom, on the playground, in the lunchroom, in the child’s own living room, and in the community. Rather than isolate the child in a therapy room to address a specific behavior, Linwood staff engages the child in learning events within activities identified as strong motivators for the child. Because each child has highly individualized needs, interests and tolerance thresholds, he may not, for example, be required to sit at a desk in a classroom for prolonged periods of time. While one child can sit at a desk for 20 or 30 minutes, another child may only be able to sit for three or four minutes. Requiring that child to conform to “classroom rules” more often than not leads to a power struggle between the child and the adult. The more effective process is for the adult to devise a learning activity in which the child can successfully participate within the timeframe his threshold will permit. Once the child accomplishes the prescribed task(s), staff will reward him with his favorite item or activity. Basic principles of learning theory such as reinforcing successive approximations of the targeted response come into play here. The thoughtful staff member will ensure that the learning activity is laced with an abundance of positive social interplay, reinforcement and needed breaks. The adult will adjust expectations accordingly by following the child’s lead.
Determining the dynamics in the child’s environment that influence behavior and motivate participation and cooperation are critical components of the Linwood Method. Determining these dynamics can only be accomplished through decisive and deliberate observation. In the above scenario, staff will have determined the child’s threshold for sitting at his desk and actively engaging in a learning activity. The staff member, through observation, will have also determined those dynamics that motivate the child. The threshold may change from day to day, activity to activity and staff member to staff member. As the child demonstrates a readiness to accept increasing demands, this threshold will be carefully “stretched” and then stretched again when it can be tolerated. At Linwood, the relationship (the social dynamics) between the child and the adult is essential and will dictate the effectiveness of any given learning activity
Let’s examine another scenario. The child’s program plan calls for the child to learn to use a ruler. The child has few interests and many interfering behaviors. Observation reveals that one of his interests is to play with colorful yarn. As it becomes time to engage in the math lesson, rather than ask the child to put down his yarn, the teacher, through that very important positive relationship she has previously established with the child, will engage the child in a brief counting activity using his yarn. They will then compare the lengths of his yarn, identify the colors of his yarn, and then measure his yarn using a ruler. They will write the word, “yarn,” they will incorporate the words and pictures into the child’s picture exchange communication system, they will create silly stories with the yarn, and so forth. The point is that the adult will use whatever motivates the child in order to facilitate learning, develop communication skills and build social relationships.
In 1955, long before “autism” was commonly known, and long before the advent of Applied Behavior Analysis, the Dutch therapist, Jeanne Simons, opened Linwood’s doors to children who were destined at that time to be institutionalized. Simons created a school and residential haven for these children, the first and only program of its kind, to provide relief for the parents. Linwood’s unique place in the short history of autism is defined by its very early connection to the first researchers in the field. Dr. Leo Kanner, who, in the 1940s, developed the nation’s first child psychiatry program in a pediatric hospital, conducted his early autism research at Linwood. Kanner developed this program at Johns Hopkins Hospital in Baltimore, where he coined the term, “Early Infantile Autism.” In 1965, Dr. Charles Ferster, an American University professor and researcher, obtained a federal grant to conduct research on behavior modification with autistic children. He developed the “Linwood Project,” where he analyzed Simons’ therapy, breaking the methods down to objective behavioral language and defining “The Linwood Method.”
Fundamental rights, courtesy, respect, dignity, individuality, and self determination are the concepts common to the language we use today in the developmental disabilities community. These words were not so commonly used in the early years when little was understood about the condition just being defined as “autism.” However, Jeanne Simons understood these concepts; she practiced them and handed them down to her staff where they are now woven into the fabric of Linwood and the approach as it is practiced today. Displayed on the walls at Linwood are the following words that Simons wrote, circa 1960:
“And that’s why we walk behind the child. He feels your protection when you walk behind. If you give him a chance to go any direction, he may be wrong when he goes this way or that. Just follow him. If it’s a dead end, pick him up gently and bring him to the main route. But never think that you know the answer, because you are dealing with an individual who may want to go very different routes, which for him may be better. That’s why I feel more comfortable behind the children so I can see where they are going.”
Linwood is a small program with roots emanating from its inception in historic Ellicott City, Maryland, halfway between Baltimore and Washington D.C. As the prevalence of autism increased and captured the attention of the public at large, a wide array of therapies and programs sprung up throughout the world. Linwood persisted in quietly, modestly and successfully providing programs and services to children and adults living with autism. Addressing the ever-increasing need for services throughout the lifespan for individuals on the autism spectrum, Linwood has developed what is widely considered some of the best and most innovative services in the region. In addition to basic educational and vocational education for students, Linwood provides community-based residential services for both children and adults on the spectrum, as well as vocational training and employment services for these individuals.
Jimmy’s story perhaps best illustrates Linwood’s impact on the autism community. At age seven, Jimmy could read, write, and do math. However, his days were characterized by screaming, flapping his hands, and spinning in panic. He was a danger to himself and destructive to his environment. Doctors were sympathetic, but could not help. At age 11, after being turned down by 23 different programs, Jimmy’s parents found Linwood. After 10 years in Linwood’s school and residential program, he gently transitioned into adulthood where he now receives both residential and employment support. Jim is a semi-independent adult. He lives in a beautiful home in a quiet suburban neighborhood and works full-time at Wal-Mart as the head “cart man” – nine years and counting. The negative and frightening “autistic behaviors” are gone. Jim has a delightful personality and is well-loved by family, staff and co-workers.
References
Koegel, R. L., & Koegel, L. K. (2006). Pivotal Response Treatments for Autism. Baltimore:
Brooks Publishing Company.