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June 2, 1997 -- No. 387

Autistic adult residential center expands; studies confirm benefits

By CAROL HENDERSON
UNC-CH News Services

CHAPEL HILL -- This month, the Carolina Living and Learning Center -- a residential and vocational training program for adults with autism -- will triple in size. The expanded center will house 15 residents, up from five, and increase from three to five the number of day students.

Located on a farm in rural Pittsboro, the center was founded in 1990 and developed by Division TEACCH, a branch of the psychiatry department at the University of North Carolina in Chapel Hill School of Medicine. Residents receive vocational training in farming and landscaping.

“The beauty of this approach is that it is meaningful,” said Dr. Mary Van Bourgondien, clinical director of the center. “Even a person with a communication handicap has a concept of growing and preparing food. Tasks are individualized to meet each person's level of skills. We've also found that the daily exercise involved in working on the farm not only promotes fitness but also reduces behavioral problems.”

Residents learn skills they can take into the community, Van Bourgondien said. They grow and sell organic vegetables, bake bread to sell, clear woods trails and do landscaping jobs. They are paid for their work.

“There isn't anything like the CLLC anywhere else in the world,” she said. “This is a model program.” The curriculum is designed to promote independence and quality of life, Van Bourgondien added. “Even though most of our residents can't read or write, they are good, steady workers.”

The center follows an educational curriculum based on the TEACCH model. Started at UNC-CH in the 1960's, TEACCH (Treatment in Education of Autistic and related Communication-handicapped Children) now includes programs for adults with autism and their families.

Autism is a developmental disability people are born with that involves three major difficulties: communication (both verbal and non-verbal), social relationships and coping with change. Other characteristics include ritualistic behaviors and a pronounced tendency to become anxious and easily upset.

“We need to think about autism as another culture,” said Dr. Gary Mesibov, director of Division TEACCH and professor of psychiatry at UNC-CH. “To be successful in working with people with autism we have to understand their culture and be their tour guide to our culture.”

“We emphasize building on the strengths of autism to compensate for the weaknesses,” Van Bourgondien said. “For example, people with autism tend to have great visual skills, so we use visual systems -- pictures and objects -- to communicate daily schedules and activities at the center.”

The TEACCH model emphasizes development of social and leisure skills, instruction in communication and an active approach to behavior management, Mesibov said.

The center staff consists of two psycho-educational consultants: Tom Wiebe, day program coordinator, and Gina Chapman, residential coordinator. Dr. Nancy Reichle is assistant director and research coordinator.

“What we learn from research we can apply immediately to our clinical setting,” Van Bourgondien said. “We also offer extensive training programs for people working in autism.”

The CLLC receives more than 300 visitors each year. TEACCH methods are used in classrooms and residential programs around the world, Mesibov said. “We've placed over 100 people with autism in regular jobs where they earn minimum wage or above.”

Researchers at the center have recently completed two studies.

The first, a six-year project funded by the National Institute of Mental Health, compared the developmental progress of the original CLLC residents with a control group who were placed in other settings around the state.

“In all areas, the highly structured treatment program used at the CLLC related to better behavior and better social adaptability,” Van Bourgondien said. Families of CLLC residents were also considerably happier with this program than were families in other settings.

“We found that our program had more structure than other programs and that we could quantitatively measure that structure,” Mesibov said.

The second study, also funded by the National Institute of Mental Health, tracked 25 North Carolina adults with autism as they moved into new group homes. For the majority of subjects, the move created extreme stress and a consequent increase in behavioral problems and loss of some skills. However, those exposed to TEACCH methods were better able to maintain skills and experienced fewer behavioral setbacks, Van Bourgondien said. “The specialized approach for autism actually served as a buffer to the negative effects of change,” she said.

Eventually, the CLLC will house 30 adults with autism, in four homes. Applicants must be 18 years old and N.C. residents. For the current expansion, there were 65 applicants for 10 openings.

“These days there is a move away from large institutions towards smaller, combined residential/vocational models like ours,” Mesibov said. “We try to make our environment very predictable and our programs very clear. All the original residents at the CLLC had experienced major difficulties adapting to other programs. Here, they're doing very well.”

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Note: Van Bourgondien can be reached at (919) 966-8199.

Contact: David Williamson