Bringing Evidence-Based Autism Education to Bosnia: A Model of Success

This was the Proposal Summary given at the American Speech Language Hearing Association (ASHA) Convention in San Diego, CA in November 2011.

“In the summers of 2009 and 2010, volunteer teams of SLPs, medical practitioners, and special needs teachers from the San Francisco Bay Area, along with Behavior Analysts from California State University-Fresno, went to Bosnia to train parents, professionals, and university students about autism diagnosis and treatment. The two-week practical training seminars, held in Sarajevo in 2009 and repeated in Tuzla in 2010, incorporated theoretical training and hands-on work with community children who had been identified as having autism.

Using the National Standards Project, published by the National Autism Center, as a guide in choosing which evidence-based strategies to train in Bosnia, the teams developed five days of lectures comprised of the basics in autism diagnosis and treatments.  The lectures were open for families of children with autism, the medical community, teachers, psychologists and speech-language pathologists to attend. Each year there were over 300 people from Bosnia and neighboring countries in attendance.

For the second phase of training, a small group of professionals were chosen to take part in a classroom-based, real-life training experience in which they could learn to apply some of the treatments discussed as part of the theoretical training. The Bosnians were ultimately identified because they had: 1) attended the previous five-days of lectures, and 2) either had already been serving the autism population in their local communities or were hoping to serve autism in the future. In the two years the seminar was held, 34 professionals were trained.

The classroom spaces themselves were donated by the local governments of Bosnia, and all materials, educational items and furniture were either donated through a non-profit organization in the U.S. and brought to Bosnia by the American professionals in suitcases, or purchased while in Bosnia. The classrooms where training occurred were designed using the TEACCH model, and were the first of their kind in the country.

Children between the ages of 2-6 years old were identified by local autism parent associations, and invited to participate in the classroom experience. In 2009 there were 8 children identified who met the age criteria and participated in the classroom training, and in 2010 there were 9 children who participated. It was believed that hundreds more children with autism may exist in those large communities, but because of cultural and socio-economic factors, many children with autism were reported to be either hidden in the homes or abandoned in institutions. The majority of the children who participated in the classroom training had no previous school or classroom experience.

For educational consistency, each child was paired with two Bosnian professionals for duration of the 5 days of classroom experience. However, using a center-based, rotating classroom schedule, each child and pair of Bosnian “teachers” was able to work with all of the American professionals in their varied areas of expertise. As the practical training experience progressed across the five days, the American trainers faded their assistance until the final day, when ultimately the Bosnian professionals were running the classroom independently.

In just five days, the Bosnian professionals, with the American trainer’s assistance, had the classrooms running smoothly and children were making progress on a number of goals.

Progress for children was measured by a simple system of data collection in areas such as inappropriate behaviors, language/ communication, and social interaction. To monitor the progress and learning of the Bosnian professionals, a self-reporting interview system was used.

In summary, a two-week training offered in Sarajevo, and then in Tuzla the following year to different children and professionals, resulted in a total of 34 professionals, university students and professors being trained in the basics of autism intervention. Additionally, seventeen children and families from those two citied participated in the experience. Inappropriate behaviors decreased to near zero levels, preliminary communication and language goals had been established and behavioral intervention goals were developed. Incredibly, each of the 8 children who participated in 2009, and the 9 children who participated in the 2010 week-long program made measurable, albeit preliminary progress across a number of areas. 

In as little as three years since the first seminar was conducted in Sarajevo, Bosnia has undertaken sweeping changes for autism education and treatment across the country.  There are now two official “schools” established in Bosnia’s larger cities to treat autism, with some satellite centers developing in smaller towns and villages. The professionals who were trained continue to report their successes in their current places of employment, as well as with individual children. Families are organizing into support networks and providing resources to the general population to educate and increase awareness of autism.

This presentation will discuss in detail how a collaborative model for treatment can be implemented with highly structured yet minimal staff training. Participants will understand the content of the two-week trainings and the model for the classroom which relied heavily on applied behavior analysis and speech-language interventions.”

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