Children with Autism and Fire Alarm Sound Desnsitization

72 Pages·2014·6.55 MB·English

by  David A. Cohen

Autism and FASDT: Retain or Retrain 1
Running Head: AUTISM AND FASDT: RETAIN OR RETRAIN

Children with Autism and Fire Alarm Sound Desensitization: Retain or Retrain
David A. Cohen
Mountain Brook Fire Department, Mountain Brook, Alabama
Autism and FASDT: Retain or Retrain 2
CERTIFICATION STATEMENT

I hereby certify that this paper constitutes my own product, that where the language of others is
set forth, quotation marks so indicate, and that appropriate credit is given where I have used the
language, ideas, expressions, or writings of another.

Signed: ______________________________________
Autism and FASDT: Retain or Retrain 3
Abstract
Research indicates children with autism do not respond in the same manner as typical
children to fire alarms. The purpose of the causal-comparative applied research project is to test
the hypothesis that, one year after receiving Fire Alarm Sound Desensitization Training
(FASDT), children with autism will respond in a manner similar to typical children during a fire
alarm activation.
Parents of children with autism were surveyed concerning how children with autism
respond to fire alarms. One fire drill was performed at an autism-learning center where the FAST
program had been taught fourteen months previous. The fire drill was video recorded and a
behavioral assessment was performed to identify atypical behaviors resulting from the fire drill.
Children were divided into the Test Group, consisting of those children who had participated in
the FASDT program, and the Control Group consisting of all other children. Data was collected
from previous research for the Test Group and compared to data collected from this research.

Based on the statistical analysis and the qualitative data, there was not enough
evidence to support the hypothesis that a child with an ASD, one year after receiving fire
alarm sound desensitization training, will respond in the same manner as a typical child
during a fire alarm activation. Likewise, there was not enough evidence to support the null
hypothesis that one year after receiving FASDT, there will be no difference in the response
of a child with an ASD to the sound of a fire alarm and those who have not received the
FASDT program.
The Mountain Brook Fire Department will encourage the use of a FASDT program in
the preschool and kindergarten classes to improve behaviors of children with autism as
well as typical children during fire drills.
Autism and FASDT: Retain or Retrain 4
Table of Contents

CERTIFICATION STATEMENT ............................................................................................................ 2
Abstract ..................................................................................................................................................... 3

Table of Contents .................................................................................................................................... 4

Introduction .............................................................................................................................................. 5

Background and Significance ............................................................................................................... 6

Literature Review.................................................................................................................................. 11

Procedures .............................................................................................................................................. 15

Results ...................................................................................................................................................... 26

Discussion ................................................................................................................................................ 35

Recommendations ................................................................................................................................. 38

References ............................................................................................................................................... 40

Appendix A ............................................................................................................................................. 46

Appendix B ............................................................................................................................................. 47

Appendix C ............................................................................................................................................. 48

Appendix D ............................................................................................................................................. 58

Appendix E ............................................................................................................................................. 59

Appendix F .............................................................................................................................................. 62

Appendix G ............................................................................................................................................. 63

Appendix H ............................................................................................................................................. 64

Appendix I............................................................................................................................................... 65

Appendix J .............................................................................................................................................. 66

Appendix K ............................................................................................................................................. 67

Appendix L ............................................................................................................................................. 68

Appendix M ............................................................................................................................................ 70

Appendix N ............................................................................................................................................. 71
Autism and FASDT: Retain or Retrain 5
Introduction
“For most children, the first day of school is an adventure. It is
a day of anticipation and excitement. However, Johnny was not
like most children. His first day of school was a disaster. He had
to be pulled and dragged, screaming into the building because
he was absolutely terrified of having a fire drill… For Johnny,
fire drills are a painful and stressful event, and a break from his
cherished routine. After a fire drill, Johnny will probably not be
able to return to normal classroom activities. Johnny has
autism (E. Pittman, personal communication, September 7,
2011).” (Cohen, 2012, p. 5).
Today, Johnny (pseudonym) has completed seventh grade and plays trumpet in the
Junior High Band. According to Johnny, fire drills no longer scare him. He even
demonstrates, with a smile, how the fire alarm sounds. Loud, unexpected noises used to
terrify Johnny but he said that fire drills and loud sounds no longer scare him because of
Mrs. Pittman’s fire drill class (Johnny, Personal Communication, June 24, 2014). DFeeranr l easnsd
FPiirttem Darnil l(20T1e2a)c hairneg t Lhief ea Sukthilolsr fso orf S tuhcec efisrse alarm sound desensitization program,
s: . with an Autism Spectrum Disorder (ASD),
one yeaTr hafet eprr roebcleeimvin igs tfhiree haylaprmot hsoeusinsd t hdeast ean csihtiizlda tion training (FASDT), will respond in the
same manner as a typical child during a fire alarm activation has not been tested. The purpose of
this causal-comparative applied research project is to test the hypothesis that, one year after
Autism and FASDT: Retain or Retrain 6
receiving FASDT, children with autism will respond in a manner similar to typical children
during a fire alarm activation.
The hypothesis of this research is that a child with an ASD, one year after receiving
FASDT, will respond in the same manner as a typical child during a fire alarm activation. The
null hypothesis is that one year after receiving FASDT, there will be no difference in the
response of a child with an ASD to the sound of a fire alarm and those who have not received the
FASDT program.
The evaluative research method will be used to answer the following research questions:
(1) How do typical children respond to fire alarms in school; (2) How do children with an ASD
respond to fire alarms in school; (3) How do typical children respond to fire alarms one year
after receiving FASDT; and, (4) How do children with an ASD respond to fire alarms one year
after receiving FASDT?
The methodology used to collect data for statistical analysis will be the causal-
comparative design and behavioral assessments from fire drill video recordings. Surveys and
interviews will also be conducted to collect anecdotal and qualitative data.

Background and Significance
The prevalence of Autism and Autism Spectrum Disorders (ASD) is increasing at an
alarming rate. According to the Centers for Disease Control and Prevention (CDC), in findings
released in March 2014, 1 in 68 children were identified with an ASD in 2010 (2014). Previous
findings indicated 1 in 88 in 2008 (CDC, 2012), 1 in 110 in 2006 (CDC, 2009), and 1 in 150 in
2002 (CDC, 2007).
Autism and FASDT: Retain or Retrain 7
The Autism and Developmental Disabilities Monitoring Network (ADDM), funded by
the CDC, estimates the incidence of ASD’s among children 8 years of age, in 11 monitoring
networks around the United States (CDC, 2014). The University of Alabama at Birmingham
(UAB) is one of eleven sites participating in ADDM. According to data collected at UAB, the
overall prevalence of ASD’s in Alabama (5.7 per 1,000) is much lower than the other ADDM
sites (CDC, 2014). However, that number is still higher than the 4.8 per 1,000 identified in
Alabama in 2008 (CDC, 2012). The Alabama State Department of Education (ALSDE) reported
in the annual report for the 2013-2014 school year, 0.79% (n=5,917) of the 746,204 students in
Alabama had an Autism diagnosis (ALSDE, 2014).
On a local level, Jefferson County schools reported 244 (0.67%) out of 36,203 students
enrolled in the Jefferson County School System had an Autism diagnosis (ALSDE, 2014). The
Mountain Brook Board of Education reported that of the 4,477 students enrolled in the Mountain
Brook Schools, 1.07% (n=48) had been diagnosed with an ASD (ALSDE, 2014).
According to the National Institute of Neurological Disorders and Stroke (NINDS),
Autism is a “range of complex, neurodevelopment disorders, characterized by social
impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of
behavior” (2014, ¶ 1). Several previously separate conditions, such as Asperger syndrome,
Autism or Autistic disorder, and pervasive developmental disorder not otherwise specified
(PDD-NOS) are now grouped together under a common umbrella called autism spectrum
disorder (ASD) (CDC, n.d.).
Symptoms of ASD are as varied in character and severity as the number of people
diagnosed and affects each person differently. Autism is called a “spectrum” disorder for that
reason (Adams, Edelson, Grandin, and Rimland, 2008). The most dominant feature of ASD is
Autism and FASDT: Retain or Retrain 8
impaired social interaction while other categories of symptoms include repetitive movements,
abnormal language development and atypical sensory and motor processing (NINDS, 2014,
Sears, 2010).
One condition that can occur simultaneously with ASD is sensory sensitivity. Children
with autism may have unusual sensitivities to touch, taste, smell, sights or sounds (Adams, et al.
2008). Hyperacusis, according to the American Speech-Language-Hearing Association (ASHA),
is a “hearing disorder that causes sound, which would otherwise seem normal to most people, to
sound unbearably loud. People who suffer from hyperacusis may even find normal
environmental sounds to be too loud” (2011, ¶ 1). Greenspan and Weider (1997) reported 100%
of the participants in their study with ASD (n=200), showed atypical responses to auditory
stimulation. Dawson and Watling (2000) indicated that 30 to 100% of individuals with autism
may have abnormal responses to sensory stimuli while ASHA estimates that as much as 40% of
children with autism suffer from hyperacusis (2011, ¶ 7).
Exiting the building during fire alarm activations is critical for life safety. Children with
autism do not typically respond in a safe manner to fire drills in school (Cohen, 2012). Many
have difficulties with fire drills “for a variety of reasons – the noise, the lights, the change in
schedule, the crowded halls…and the list goes on” (Reeve, 2013, ¶ 1). Children with autism may
endanger themselves or those around them (Autism Society of America, n.d.). Behaviors
exhibited by children with autism during fire drills include screaming, aggressive or disruptive
behavior, agitation, or even no response (Cohen, 2012).
For many people who suffer from hyperacusis, their first response to loud noises is to
cover their ears, use earplugs or earmuffs (Baguley, 2003). Studies have indicated that protecting
the ears from the offensive, yet relatively soft sounds, may be causing more damage than the
Autism and FASDT: Retain or Retrain 9
sound itself (ASLHA, 2011; Baguley, 2003). The recommended treatment for hyperacusis is
desensitization (Baguley, 2003; Grandin, 2010; Koegel, Openden & Koegel, 2004).
Research indicates children with autism frequently receive advance warning about fire drills,
have been allowed to use hearing protection, or have even been removed from the building
before the fire alarm activates (Cohen, 2012). In the case of an unscheduled fire alarm activation
or true fire emergency, “a student with autism could suffer injury or death due to an elopement or
tantrums in the middle of a true fire evacuation (Collins, 2011).
This research is significant to those children who desire to live independently. Some
children with autism will graduate from high school and live independently, going into the
workforce or to college (Personal Communication, D. Finn, November 14, 2013). According to
Nevill and White, in the absence of other intellectual disabilities, individuals with autism may be
able to have a positive experience in college (2011). Fire alarm activations are unpredictable, and
can occur nearly anywhere. This research can ensure that children with autism have the
necessary life skills needed to be able to respond immediately and appropriately during fire
alarm activations.
This research is significant to the fire service because the fire service has an obligation to
those we serve to reduce the risk of injury and death due to fire. The autism population is
increasing and therefore the risk of fire injuries and fatalities is increasing. In addition, the
Insurance Services Office (ISO) has set forth procedures to evaluate a department’s Community
Risk Reduction programs (2012). Included is Public Fire Safety Education Programs, which
requires that schools conduct fire drills in accordance with NFPA 101, Life Safety Code or the
ICC International Fire Code each month, as well as “present developmentally appropriate
Autism and FASDT: Retain or Retrain 10
classroom instruction on fire safety” for children in early childhood education (Insurance
Services Office, 2012, p. 60).
This research is significant to the Mountain Brook Fire Department because its mission
statement requires it to provide “a range of quality public services for the health, safety and
welfare of the Mountain Brook Community” (Mountain Brook Fire Department, 2012, p.
101.01). This responsibility applies to all who comprise the Mountain Brook Community,
including, and in particular, those who have special needs.
This research is related to the United States Fire Administration (USFA) Goal 1 to
“Reduce risk at the local level through prevention and mitigation” (2009, pg. 14). This
research is also related to the Fire Prevention and Life Safety Strategic Initiative Objective
to “Encourage the State, local and tribal adoption of risk reduction, prevention, mitigation,
and safety strategies” (USFA, 2009, p. 18). This research particularly relates to the
Operational Initiative to “Expand initiatives in public fire and safety education through
various avenues to reach all segments of the population, particularly high risk groups”
(USFA, 2009, p. 18).
This research relates to the EFO Executive Leadership class (R0125) course goal to
“develop the ability to conceptualize and employ the key processes and interpersonal skills
used by effective executive-level managers” (USFA, 2012, p. SM 1-7).” This research relates
to Unit 3, Thinking Systematically, by collecting data from surveys and video recordings of
fire drills and relating that data to the effectiveness of fire drills. This research relates to
Unit 11, Exercising Leadership Practicum, by influencing others to participate in the
research. This research also relates to Unit 13, Taking Risks, by explaining the risks,
benefits and rewards resulting from the experimental process (USFA, 2012).