Children with Autism and Fire Alarm Sound Desnsitization ...nfa.usfa.fema.gov/pdf/efop/efo48715.pdf · Autism and FASDT: Retain or Retrain 7 The Autism and Developmental Disabilities

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


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: ______________________________________


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.


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


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). Dern and

Pittman (2012) are the authors of the fire alarm sound desensitization program, Fearless

Fire Drills: Teaching Life Skills for Success.

The problem is the hypothesis that a child with an Autism Spectrum Disorder (ASD),

one year after receiving fire alarm sound desensitization 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


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).


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


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


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


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).


Literature Review

A literature review was performed to identify available research relating to children

with autism and fire alarms and to establish the groundwork for this research project. Only

one peer-review journal article was identified relating specifically to autism and fire drills

or fire alarms, however, that article was published in 1993.

Autism is a “developmental disability that typically involves delays and impairments

in social skills, language, and behavior” (Adams, Edelson, Grandin & Rimland, 2008, ¶ 4).

Autism is a complex disability in which there is no cure. However, early intervention and

treatment may greatly enhance the quality of life for those suffering from autism (Autism

Society of America (ASA), n.d., ¶ 1). Autism is a spectrum disorder, meaning that there is a

wide range of deficits and intensities of deficits, and no two people are affected in the same

manner (Adams, et al., 2008; Mintz, 2009).

According to the CDC, there is no medical test to diagnose or screen for autism.

Diagnosis is based solely on the child’s behavior and development. Screening for autism

should begin at 9 months and continue to 24 to 30 months or longer if there is a high risk

for ASD or other developmental disability (2014). Diagnosis is based on persistent deficits

in social communication and interaction in various situations and environments (American

Psychiatric Association (APA), 2013).

Hyperacusis is a condition affecting many children with autism (Adams, et al., 2008;

ASHA, 2011; Dawson & Watling, 2000; Johnson & Myers, 2007), and is a “phenomenon that

is rare among children and adolescents who do not have autism” (Rosenhall, Nordin,

Sandstrom, Ahlsen & Gillberg, 1999, p. 356). Hyperacusis is an abnormal or unusual

intolerance to normal environmental sounds (Vernon, 1987), with no evidence of


physiological abnormalities (ASHA, 2011; Dancer & Mulcahy, 2012; Gravel, Dunn, Lee &

Ellis, 2006; Steigler & Davis, 2010). In many cases, the same individual with autism may

exhibit both hyper-, as well as hypo-responses, to normal sounds (Baranek, 2002; Dawson

& Watling, 2000; Johnson & Myers, 2007).

Children with autism who have difficulties with loud noises will respond in an

inappropriate manner. Many will scream out or attempt to flee from the offending sound

while others may lash out violently (Personal communication, D. Finn, November 14, 2013;

A. Dern, October 10, 2013 L. Pittman, October 10, 2013). Cohen (2012) reported a variety

of responses to loud noises including covering ears, pulling hair, panicking or no reaction at

all.

Children with autism have difficulties with fire drills or fire alarms. Cohen surveyed

parents of children with autism, teachers and fire marshals regarding how children with

autism respond to fire alarms and fire drills, and found that the majority of children were

most afraid of the fire alarm sound (2012). Cohen identified the most common reactions to

fire drills were agitation, anxious, panic or meltdown. Many times these reactions carried

over after the fire drill, causing difficulties for the student for the remainder of the day

(2012).

In a study of children with autism and fire drills, Finn, Gerhardt, Wooley, Cohen,

Pittman, and Dern (2013) reported severe behaviors of three children. The first began the

fire drill withdrawn from his surroundings but then became uncooperative once outside

the building. The second exited normally but became combative upon re-entering the

building. The third was intolerant and out of control during the entire drill, and was unable

to participate in any class activities after the fire drill. According to McGowan, getting a


child with autism through a fire drill may be impossible, particularly if they are sensitive to

sound (2009).

Hearing protection for those who suffer from hyperacusis during fire drills is

contraindicated, except for rare instances (ASHA, 2011; Baguley, 2003; McGowan, 2009).

Advance warning or removing children with autism prior to the fire drill is also not

recommended since fire alarm activations for actual fires do not have advance warning

(Cohen, 2012; McGowan, 2009; Reeve, 2013). Desensitization, along with preparation, is

the preferred method of overcoming issues with hyperacusis and fire alarms (Baguley,

2003; Collins, 2011; Grandin, 2002; Koegel, Openden, & Koegel, 2004; Steigler & Davis,

2010). Grandin (2002), who was diagnosed with autism, recommends allowing a child to

play with a recording of the fire alarm sound, allowing the child to initiate the sound and

gradually increase the volume. The child must be in control of the playback of the sound

(Grandin, 2002).

Teaching life skills or skills for daily living are part of a child’s Individualized

Education Program (IEP) (Personal Communication, D. Finn, November 14, 2013). Every

child in public school that receives special education services or other related services

must have an IEP that establishes a plan to allow the student to succeed in school. The IEP

also includes transition planning that will prepare the student for adult life, including post-

secondary education and career planning (U.S. Department of Education, 2000).

Teachers are including safety goals into the IEP for those receiving transition

planning, focusing on teaching skills to increase awareness of safe and unsafe practices, and

how to respond to dangerous situations (Mechling, 2008). However, even if those skills are


taught, there is no mechanism in place to assess the maintenance or retention of these

skills (Mechling, 2008; White, Koenig, & Scahill, 2007).

Mechling reviewed literature from 1976 to 2006 relating to teaching personal safety

skills to individuals with intellectual disabilities. Of the 36 studies reviewed, only one of the

studies assessed maintenance of skills at 5 to 8 months, one at 6 months, one at 7 months

and one at 66 weeks. In the remaining studies, skill assessment was less than 3 months or

was not reported (2008). Reichow and Volkmar reviewed 66 peer-reviewed studies

published between 2001 and 2008 to evaluate teaching methodologies related to social

skills. None of the studies included any discussion of assessments to determine long-term

retention or maintenance of safety skills (2010). Dixon, Bergstrom, Smith, and Tarbox also

reviewed literature for training emergency skills to persons with developmental

disabilities. None of the reviewed literature had any provisions for assessing long-term

retention or maintenance of those skills (2010).

There is very little research relating to fire drills and fire alarms and the effects

these have on children with autism. There is little research on hyperacusis and fire alarms.

However, several studies have shown the effectiveness of desensitization to offensive

sounds including fire alarms. Many studies have shown the methodologies of teaching

safety skills and measured the effectiveness of those methodologies, but there is very little

research on the assessment of long-term retention or maintenance of safety skills that are

used infrequently. Mechling wrote “Given the critical nature of the skills being taught and

the ability to use them over an extended period of time, the importance of maintenance

measures in apparent. A difficulty addressed in the literature is how to maintain skills that

are seldom needed or practiced” (2008, p. 321).


Procedures

Research began in the Learning Resource Center (LRC) at the National Fire Academy

with a review of available references relating to Autism, fire drills and fire alarms. Previous

Applied Research Projects (ARP) identified seven projects relating to Autism. Mims (2008)

developed a strategy to train firefighters about the characteristics of Autism Spectrum Disorder

(ASD), as well as various medical conditions and emergency rescue scenarios involving those

with an ASD. Russell (2009) created a fire prevention education program consisting of visual

aids and handout materials for families with children with autism. Cohen (2012) identified

various responses that are displayed by children with autism during fire alarms and fire drills,

along with interventions used to teach children with an ASD how to appropriately respond

during fire drills. Kupietz (2012) identified best practices for responding to individuals with

autism during emergencies. Firth (2012) identified the basic knowledge necessary for emergency

evacuation shelter personnel to properly care for the needs of individuals with autism. Cohen

(2012) conducted behavioral assessments to determine the effectiveness of a fire alarm

desensitization program for children with autism. A home safety inspection checklist was

developed for pre-K children with autism (Agenbroad, 2013). A search was also performed in

the First Responder Dissertations and Thesis collection using autism, autistic, ASD, fire drills or

fire alarms as keywords with no records found.

A literature review was performed in the Learning Resource Center at the National Fire

Academy in July 2013 for fire and emergency medical service journals and other publications. A

literature review was also periodically conducted in the library at Samford University, the

Mervyn H. Sterne Library and Lister Hill Library of Health Sciences on the campus of the

University of Alabama at Birmingham.


An Internet search was performed on Google and Bing using keywords such as Autism,

Autism Spectrum Disorder, Asperger, ASD, fire alarm or fire drill. Internet searches were also

performed on various academic search engines using additional keywords such as hyperacusis,

daily living skills, learning outcomes, safety skills, proficiency and others. Appendix A contains

a full list of keywords and academic search engines used. The literature review was initially

conducted to identify questions relating to children with autism and long-term retention of

learned skills as well as methodologies used to assess long-term life skills. The literature review

and Internet searches continued for the duration of the research project.

Several interviews were conducted with Sandy Naramore, Executive Director at

Mitchell’s Place, an autism-learning center, to solicit participation in the research. Mitchell’s

Place was one of the test sites used in previous research on fire alarm sound desensitization

(Cohen, 2012) and was chosen for this research because it contained children who had

previously participated in the desensitization training as well as new children who had not been

exposed to fire drills.

Amy Dern, Occupational Therapist and Libby Pittman, Speech Language Pathologist at

Crestline Elementary School were interviewed to discuss their experiences with children who

had participated in the FASDT program. Dern and Pittman also discussed their expectations for

long-term outcomes for all children who undergo the FASDT program.

Interviews were conducted with Dr. David Finn, Professor, Director of Special

Education, Orlean Bullard Beeson School of Education and Professional Studies, Samford

University, to identify procedures and other requirements necessary for Institutional Review

Board (IRB) approval. Further interviews involved questions about research methodologies as


well as his experience with hyperacusis and behavioral issues. Other questions related to follow-

up assessment and evaluation of long-term instructional outcomes.

Dr. Thomas Wooley, Professor of Statistics, Brock School of Business, Samford

University, was interviewed to review data collection methodologies for student behavioral

assessments as well as survey instrument formats. Further interviews were conducted to evaluate

the results of the statistical analysis of data collected.

This study uses a simple ex post facto design to evaluate the long-term effect of the

FASDT program on student response to a fire drill. In this design, the test group underwent a

treatment or had an experience that the control group did not have (Gay, Mills & Airasian,

2009). The treatment or experience being evaluated, in this instance the FASDT program,

occurred before the current study began (Leedy & Ormrod, 2010).

Because human subjects will be involved in the study, approval from an Institutional

Review Board (IRB) is required (Protection of Human Subjects, 2009). An application was

submitted to the IRB at Samford University, whose role is to review and approve research to

ensure that the research complies with federal regulations and that those participating in the

research are protected from harm (Samford University, 2011). The IRB application was

submitted on August 30, 2013 and expedited approval EXPD-E-13-F-5 was received on

November 19, 2013 (Appendix B).

The IRB application (Appendix C) details the protocol and procedures used in conducting

the research. All researchers participating in the project must complete the National Institute of

Health web-based training course titled “Protecting Human Research Participants,” and include

their certificate number on the IRB application. The application also includes the purpose of the

research, anticipated number of participants and their age and gender, and whether any


participants are members of a vulnerable population such as minors under 19 years of age,

decisionally impaired or mentally incompetent. The application also requires a full description of

the study, including methods and procedures used as well as copies of all data collection

instruments.

Confidentiality is a significant concern of the IRB. Procedures must be developed to

minimize the risk of a breach of confidentiality or invasion of privacy. Individual identities of

teachers, parents and children participating in the research are confidential. All children and

teachers are issued a unique alphanumeric identification. Those who participated in the previous

FASDT research (Cohen, 2012) will continue to use the same identifier they received in order to

correlate previous data with the data collected in this research project. Informed consent forms,

once completed and signed will be stored in a locked file cabinet in the researcher’s office,

separate from all other research documentation. Informed consent forms do not contain the

alphanumeric identifier. Data collection devices including survey instruments as well as

behavioral assessments do not contain participant names. Fire drills are video recorded to ensure

consistent and accurate data collection. All video recordings are stored on two external hard

drives that are kept in a locked file cabinet. Video recordings are encrypted and a password is

required to gain access. In no instance will individual identities be revealed. Individuals

exhibiting unique behaviors may be chosen to emphasize those behaviors but will have their

identity protected by altering demographic and case details as well as using a pseudonym.

This study presents minimal risk to the participants. All children are required to

participate in fire drills (International Fire Code, 2012). However, children may become anxious

or exhibit inappropriate behaviors due to the fire drill (Cohen, 2012). The risk of injury to

children and teachers is minimal and includes tripping, falling or bumping into other people or


objects or other injuries associated with exiting the building during the fire drill. All children will

be under direct supervision of a Special Education teacher and at least one teacher aide as well as

by a Speech Language Pathologist or Occupational Therapist.

Benefits to society can be significant. Children with autism have been excluded from

participation in fire drills because of behavioral issues during and after fire drills. (Cohen, 2012).

Validation of the fire alarm sound desensitization program will allow the program to be

introduced as a viable treatment option to teach children with autism how to respond

appropriately to fire alarm activations (D. Finn, Personal Communication, November 14, 2013).

The potential benefits of this project for children with autism and their response to fire alarm

activations outweighs the potential risks involved in this study.

Parents of children attending Mitchell’s Place will be notified of the study during pre-

school orientation programs. A letter of introduction (Appendix D) will be given to the parents

along with an Informed Consent form (Appendix E) approved by the IRB. The Informed

Consent form outlines the study including procedures used, confidentiality and risks associated

with the study along with the potential benefits. Parents will receive a card with their child’s

randomly assigned alphanumeric identifier, which will be used on the Pre-Participation survey

and Post-Drill survey. Participation in the study is voluntary and the parent may remove their

child from the program at any time without consequences. In addition, the teacher, Occupational

Therapist, or Speech Language Pathologist may remove a child if they determine it is in the best

interest of the child. The Informed Consent forms must be completed, signed and collected prior

to surveys being distributed, fire drill performed and video recorded.

Participants in the research project consist of five classes, and one individual from an

autism learning center, composed of typical children (n=21) and children with autism (n=31)


ranging in age from 2 to 7. The children were divided into control and test groups. Those in the

control group (n=41) have not participated in a FASDT program prior to participating in this

research project. The test group (n=12) last participated in the FASDT program in September

2012. The children will take part in one unannounced fire drill. Each class is to be video

recorded during the fire drill in accordance with procedures outlined in the Video Recording

Guidelines (Appendix F), which were used in previous research (Cohen, 2012, p. 81).

The four research questions, along with interviews and literature review provided the

basis for the survey questions. Consultations with Finn, Pittman, Dern and Naramore provided

further refining for the survey questions, and reviewed the final survey questions prior to

submitting for IRB approval. Three surveys were compiled for teachers and parents. These

surveys were used to collect responses regarding the behavior of children during and after fire

drills. Teachers were asked to deliver paper copies of the surveys to parents at designated times,

and collect completed surveys. Parents were asked to place their student’s alphanumeric ID

number on the survey. Surveys contained no questions by which children could be identified.

The Teacher and Parent surveys consisted of two types of questions to gather qualitative

data. Checklist type questions were used to gather structured items, which require the respondent

to select from a list of options. Several questions also allowed the respondent to provide more

information than what was asked for in the structured questions. Unstructured items gave the

respondents the opportunity to include whatever information they felt was pertinent (Gay, Mills,

Airasian, 2009).

The Parent Pre-Participation Survey (Appendix G) is given to the parents prior to the fire

drill. This survey is composed of ten questions and is divided into three sections: demographic,

sensory and additional information. The demographic data includes the child’s age, diagnosis of


ASD or other developmental disability and whether the child has participated in the FASDT

program. The sensory questions identify any issues the child may have regarding fire drills or

fire alarms and what aspect of the drill or alarm frightens the child. The respondent could add

additional comments to the back of the survey.

The Parent Post-Drill Survey (Appendix H) was given to the parents on the afternoon of

the day the fire drill occurred. This survey was composed of seven questions and asked for

responses regarding the child’s response to the fire drill including any unusual behaviors, and

how long those behaviors lasted. The survey also asked if the child had previously participated in

the FASDT program, and if so, was there a change in behavior after participation. Lastly, the

parent was given the opportunity to include any additional comments on the back of the page.

The last survey was the Teacher Post-Drill Survey (Appendix I). This survey was

composed of six questions and was completed by the teacher after the fire drill. The survey asked

about any child exhibiting unusual behaviors because of the fire drill along with the behavior that

was displayed and how long the behavior lasted. The teacher was asked to identify the student by

alphanumeric identification. The teacher also had the opportunity to add any additional

comments.

Student behavior before, during and after the fire drill was observed and evaluated via

video recordings made during the fire drills. Teacher aides recorded behaviors on iPads® using

the same Video Recording Guidelines (Appendix F) used in previous research (Cohen, 2012).

Video recordings began one minute prior to fire alarm activation, continued throughout the drill

and finished one minute after children returned to the classroom, with a particular focus on any

children exhibiting any difficulties relating to the fire drill. In order to maintain student

confidentiality, the video recordings were downloaded to the researcher’s laptop, identified only


by class and date, and then deleted from the iPad®. All video recordings were encrypted and

saved to two external hard drives, and then deleted from the researcher’s computer.

Cohen (2012, p. 81) utilized an assessment spreadsheet to separate each fire drill video

into seven divisions. Each of the divisions is further divided into 30-second subdivisions as

shown on the assessment spreadsheet in Appendix J, using the time stamp on the video

recording. The Pre-Fire Drill and Post-Fire Drill divisions are one minute each. The Alarm to

Exiting, Exiting to Staging, Waiting in Staging, Staging to Building and Building to Classroom

divisions vary in length for each class. This same spreadsheet format was utilized during this

research.

Cohen developed a “behavioral assessment rubric” (Appendix K) and a “narrative

assessment” (Appendix L) that was used to perform behavioral assessments (p. 82-83). The

researcher and an independent evaluator, using the narrative assessment, evaluated each fire drill

video recording. Data was gathered on all children exhibiting atypical behavior including a

physical description of the student, the behavior exhibited, time stamp of the start and end of the

behavior, and the rubric number relating to the behavior. This information was then inserted into

the proper time segment on the assessment spreadsheet. The assessment spreadsheets from the

researcher and the independent evaluator were compiled into a single spreadsheet per class

(Appendix M). Teachers identified children and provided the student ID based on the physical

description and behavior to connect previous research data and Parent surveys to that particular

student, where applicable.

Dr. Constance Lawrence provided the independent evaluations for the fire drills to ensure

reliability in the assessment process. Dr. Lawrence received a PhD in Early Childhood Education

from the University of Alabama at Birmingham. According to Leedy and Ormrod (2010), inter-


rater reliability is the “extent to which two or more individuals evaluating the same product or

performance give identical judgments” (p. 93). Leedy and Ormrod (2010) identify three methods

to enhance reliability: consistent administration of the instrument; specific criteria established to

dictate the kinds of judgments made; and, those performing the assessments should be well

trained. The same evaluators performed the assessment in this research as well as in the previous

research, the behavioral assessment rubric provides the specific judgment criteria, and the

evaluators were both well trained in the assessment process.

The six fire drill video recordings were independently assessed and scored by each

evaluator. The resulting assessments were compiled into a single assessment spreadsheet and

compared to calculate the percentage of agreement. Inter-rater reliability was calculated by

dividing the number of agreements (n=485) by the total number of assessment points (n=558)

and multiplying by 100. The inter-rater reliability or percentage of agreement, for this research

project was 86.9%.

Minitab® release 16.2.4, a statistical analysis software package, was used to

perform statistical analysis of the collected data. Data was compiled and sorted from the

assessment spreadsheets into Fire Drill Comparison data set (Appendix N) to determine

the effectiveness of the FASDT program one year after participation in the program.

Statistical analysis included One-way Analysis of Variance (ANOVA) to determine whether

the behavior of the Test group was significantly different from the behavior of the Control

group (Gay, Mills & Airasian, 2009). The Two-Sample t-Test was performed to compare the

actual difference to determine whether the Test and Control groups were significantly

different (Gay, Mills & Airasian, 2009).


Research Question 1 examined, “How do typical children respond to fire alarms in

school?” Typical, also referred to as neurotypical is, according to Rudy (2010), “best

understood in the negative: not autistic or otherwise diagnosed with an intellectual or

developmental difference” (¶ 1). Those who are “typical” do not have autism, intellectual or

developmental difference. The purpose of this question is to provide a baseline of behavior

for children without disabilities during fire drills. Previous research and interviews along

with fire drill video assessments were used to answer this research question. Parent Pre-

Participation Survey question 4, Parent Post-Drill Survey questions 3 and 4, and Teacher

Post-Drill Survey questions 1, 2, 3 and 4 were also used to answer this research question.

Research Question 2 asked, “How do children with an ASD respond to fire alarms in

school?” This question was answered using previous research, fire drill video assessments,

interviews, and survey responses. Parent Pre-Participation Survey question 4, Parent Post-

Drill Survey questions 3 and 4, and Teacher Post-Drill Survey questions 1, 2, 3 and 4 were

also used to answer this research question.

Research Question 3 looked for changes in behavior by asking “How do typical children

respond to fire alarms one year after receiving FASDT?” Behavioral assessments will be

performed on those typical children who participated in the FASDT program one year ago, and

that data will be compared to behavioral assessments (Cohen, 2012) immediately following the

FASDT program. Parent Pre-Participation Survey question 8 and 9, Parent Post-Drill Survey

questions 3 through 6, and Teacher Post-Drill Survey questions 1, 2, 3, 4 and will also be

used to answer this research question.

Research Question 4 was the primary focus of this research and asked, “How do children

with an ASD respond to fire alarms one year after receiving FASDT?” Children with an ASD


who previously participated in the FASDT will be evaluated during the fire drill video

assessment and that data compared to results of the previous research to determine if

desensitization persists. Parent Pre-Participation Survey question 8 and 9, Parent Post-Drill

Survey questions 3 through 6, and Teacher Post-Drill Survey questions 1, 2, 3, 4 and 5 were

also used to answer this research question.

Limitations, according to Gay, Mills and Airasian, are any part of a study that may

adversely impact the results of a study of which the researcher has no control (2009). The largest

and most significant limitation of this research is the extremely small number of participants. Of

the 54 total participants in the research, only eight children with autism and four typical

children comprised the control group.

The rate of return for the Parent Post-Drill survey was a limitation. According to Gay,

Mills and Airasian, the survey return rate may be as low as 60% , and still be acceptable (2009).

The Parent Pre-Participation Survey had a return rate of 88.9% (n=48). The Parent Post-Drill

Survey had a return rate of 48.1% (n=26). The Teacher Post-Drill Survey return rate was 100%.

Another limitation identified was the lack of control over video recordings. Those teacher

aides that were video recording the fire drills were given Video Recording Guidelines (Appendix

F). However, due to crowded hallways during exiting the building, the close proximity of the

various classrooms, and the intermingling of children among classes, it was difficult to obtain a

complete recording of all the student behaviors.

Lastly, respondent bias and emotion create problems in survey reliability. According to

Leedy and Ormrod (2010), respondents may “intentionally misrepresent the facts (or at least, the

“facts” as they know them) in order to present a favorable impression to the researcher” (p. 188).


Results

The purpose of this causal-comparative applied research project was to test the

hypothesis that, one year after receiving fire alarm sound desensitization training (FASDT),

children with autism 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. Data collection consisted of interviews, two parent

survey instruments, one teacher survey instrument and a simple ex post facto design method to

answer the research questions.

Of the 53 children enrolled in Mitchell’s Place, 48 parents (90.6%) returned the first

parent survey. Preliminary demographic data was gathered from the parents using the Parent Pre-

Participation survey. Question 1 asked about the child’s age. Table 1 shows the breakdown of

children in the Test Group and Control Group, by age.

Table 1. Age. How old is your child?

Age Test Group Control Group 2 0 7 3 2 15 4 3 5 5 4 7 6 1 3 7 1 0

Examination of the Test Group indicated one student each for ages four, six and seven were on

the spectrum, while three five-year olds were also on the spectrum. There were no two- or three-

year olds on the spectrum. The control group had nine three-year olds on the spectrum and three


each for two-, four-, five- and six-year olds. There were no seven-year olds on the spectrum in

the control group.

Parent Pre-Participation Survey question two determined the diagnosis of the

participants. Twenty-four children (50.0%) were diagnosed with autism, two with PDD-NOS,

and one with other developmental delay. Twenty-one children did not have a diagnosis. Table 2

breaks down the diagnosis by Test Group and Control Group.

Table 2. Diagnosis. What is your child’s diagnosis? Diagnosis Test Group Control Group None 5 16 Autism 5 19 Asperger 0 0 PDD NOS 1 1 Other DD 0 1

Questions 3 to 6 of the Parent Pre-Participation survey ask about sensory issues relating

to fire drills and fire alarms. Question 3 asked if the children had previously experienced a fire

drill. Note that all the children in the Test Group previously experienced three fire drills as part

of the FASDT program. The breakdown of parent responses is shown in Table 3.

Table 3. Fire Alarm Experience. Has your child experienced a fire alarm?

Test Group Control Group ASD Typical ASD Typical

No 0 0 8 4 Yes 6 5 7 9 Don’t Know 0 0 6 3


The responses to the Parent Pre-Participation survey Question 4 identified how the

children who had experienced a fire alarm responded to that alarm. Table 4 indicates the various

responses the children had to the fire alarm.

Table 4. Response to fire alarm. How did your child respond to a fire alarm?


No problem 1 3 1 4 Not like it 1 1 0 0 Unsure 2 0 0 0 Anxious, fearful, scared

0 1 2 2

Screamed, startled, cried 0 0 1 1 Covered ears 1 0 0 2 Sometimes good or bad 1 0 0 0 Don’t Know 0 0 30 3

Parent Pre-Participation survey Question 5 asks parents if their children are scared by fire

alarms. Of those parents who responded to the survey, over 54% (n=25) do not know if fire

alarms scare their child. Table 5 shows the breakdown of parent responses.

Table 5. Scared by fire alarms. Do fire alarms scare your child?


No 1 3 1 4 Yes 2 1 6 4 Don’t Know 3 1 15 6

Parent Pre-Participation survey Questions 7 to 9 focus on those children who previously

participated in the FASDT program. Of the fifty-three parent responses to Parent Pre-

Participation survey Question 7, 20.8% (n=11) of the children had participated in the FASDT


program. Thirty-one of the children were diagnosed with an ASD or other learning disability.

Table 6 shows the breakdown by Test and Control group.

Table 6. FASDT Participation. Did your child participate in the FASDT program?


No 0 0 19 12 Yes 6 5 0 0 Don’t Know 0 0 6 5

Table 7 shows the breakdown of Test Group parent responses to Parent Pre-Participation

survey Question 8 about a change in behavior that was noted after the student had participated in

the FASDT program. Control Group parent responses were not tabulated for this question. Three

of the eleven (27.3%) parents responded that there was a change in behavior. Six other parents

(27.3%) responded that they didn’t know if there was a change. Two responded that there was

not a change. Three parents did not answer this question.

Table 7. FASDT Behavior change. Did your child’s reaction to loud sounds change?

ASD Typical No 0 2 Yes 3 0 Don’t Know 3 0

The three parents who said there was a change said (1) their child was less scared of loud noises,

(2) sometimes there was no problem and (3) sudden loud noises do not surprise him.

Question 10 of the Parent Pre-Participation Survey gave parents the opportunity to add

any additional comments. Table 8 lists those comments. Interestingly, one typical student in the


Test Group had a previous incident with a fire alarm at Wal-Mart and has since been afraid of

red fire exit doors.

Table 8. Parent Comments. Additional comments.


Loud noises scare child 0 0 1 2 Red fire exit door at Wal-Mart

0 1 0 0

Not usually react to loud noises 0 0 1 0 Better after participating in

1 0 0 0

Previous research along with current data indicated typical children respond in a variety

of manners during fire alarm activations. The Test Group data of the twelve children who

participated in the FASDT program was gathered from previous research (Cohen, 2012) to

determine how those children responded to the fire alarm prior to participating in the FASDT

program. Seventeen typical children from the Control Group were evaluated during the fire drill

video. Four typical children from the previous Test Group assessment were also included. Of the

21 typical children, 52.4% (n=11) exhibited atypical behaviors ranging from covering ears

(Rubric 2) to agitated and crying out (Rubric 4). Table 9 shows the breakdown of typical

children in both the Test Group and Control Group.

Table 9. Pre-FASDT Typical Child Fire Drill Response. Rubric Scale Test Group Control Group

1 3 7 2 1 3 3 0 6 4 0 1 5 0 0 0 0 0


Current behavioral assessment data along with previous research indicated children with

autism respond in a variety of manners, very similar to those of typical children, during fire

alarm activations. The Test Group data of the eight children on the spectrum who participated in

the FASDT program was gathered from previous research (Cohen, 2012) to determine how those

children responded to the fire alarm prior to participating in the FASDT program. Twenty-one

children from the Control Group who have been diagnosed with an ASD were evaluated during

the fire drill which had been video recorded. Of the 29 children with an ASD, 44.8% (n=13)

exhibited atypical behaviors ranging from covering ears (Rubric 2) to agitated and whining,

scared or forcefully covering ears (Rubric 3). Table 10 shows the breakdown of children with an

ASD in both the Test Group and Control Group.

Table 10. Pre-FASDT ASD Child Fire Drill Response. Rubric Scale Test Group Control Group

1 3 13 2 4 1 3 1 7 4 0 0 5 0 0 0 0 0

Behavioral assessments were performed on all typical children who last participated in

the FASDT program in October 2012 to determine how those children responded to the fire

alarm, approximately fourteen months later. Table 11 shows the results of the behavioral

assessment.


Table 11. Post-FASDT Typical Child Response. Rubric Scale Test Group

1 0 2 2 3 2 4 0 5 0 0 0

Behavioral assessments were performed on all children diagnosed with an ASD who last

participated in the FASDT program in October 2012 to determine how they responded to the fire

alarm, approximately fourteen months later. Table 12 shows the results of the behavioral

assessment.

Table 12. Post-FASDT ASD Child Response. Rubric Scale Test Group

1 6 2 0 3 1 4 1 5 0 0 0

A spreadsheet was compiled utilizing the video fire drill behavioral assessments collected

from previous research (Cohen, 2012) for the Test Group, for fire drills 1, 2 and 3. Data was also

included for fire drill 4 for both the Test Group and Control Group, for statistical analysis

(Appendix N).

The mean and standard deviation was calculated for the Test Group using all four fire

drills and the single Control Group fire drill. Table 13 shows no statistically significant

difference between the Test Group and Control Group assessments.


Table 13. Mean and Standard Deviation of Fire Drills Level N Mean StDev TrmtDrill1 12 1.5833 0.6686 TrmtDrill2 12 1.8333 0.7177 TrmtDrill3 12 1.6667 0.9847 TrmtDrill4 12 1.9167 1.0836 ControlDrill4 39 1.8462 0.9878 Pooled StDev = 0.9321

A One-way ANOVA, shown in Table 14 indicates that there is no difference in mean rating

among all group comparisons.

Table 14. One-way ANOVA Source DF SS MS F P Factor 4 1.032 0.258 0.30 0.879 Error 82 71.244 0.869 Total 86 72.276 S = 0.9321 R-Sq = 1.43% R-SQ (adj) = 0.00%

Parents were surveyed after the fire drill to determine what the child said about

the fire drill and any atypical behaviors that may have resulted from the fire drill. Of the 26

surveys returned, 76.9% (n=20) said their child did not mention the fire drill. Table 15 shows the

comments the student made to the parent after the fire drill.

Table 14. Child’s comments about drill. Child’s comments about drill.


Heard noise, went outside 0 0 0 1 Loud, Teacher held hand 0 0 0 2 Scared, fell down, covered ears 0 0 0 1 Just mentioned drill 1 0 0 0


When asked about unusual behaviors, 92% (n=23) of the parents said there was none

when the child got home from school. Table 16 shows the unusual behaviors and how long they

lasted.

Table 16. Behavior at home and duration Atypical behavior exhibited and how long? Test Group Control Group ASD Typical ASD Typical How Long None 5 2 7 9 NA Seemed Down 0 0 1 0 All evening Anxious 0 0 1 0 1-2 hours

Two parents responded to the question about behavior changes after participating in

FASDT. The parent of a typical child said their child is not scared of fire drills anymore and

follows directions. The parent of a child with ASD said their child doesn’t scream at loud noises

the way they used to.

Teachers were surveyed concerning specific behavioral issues exhibited by any children

during and after the fire drill in Teacher Post Drill Survey (Appendix I). Seven teachers returned

surveys. Six children were reported to have exhibited atypical behaviors. Of those six, three had

a diagnosis of ASD. Table 17 shows the breakdown of those children with atypical behaviors.

Table 17. Teacher Observations Atypical Behavior Exhibited? Test Group Control Group ID ASD Typical ASD Typical Unknown Behavior ODI3 X Overstimulation 23ME X Frightened USI3 X Frightened Unknown X Anxious Unknown X Anxious Unknown X Covered ears


Teachers reported the behaviors lasted for less than one hour with one teacher reporting the

behavior only lasted until the student was outside the building.

Student, ID CA0L, received a behavioral assessment of 2 (cover ears) for both the pre-

FASDT fire drill and fire drill one year after receiving the FASDT training, indicating no change

in behavior. Student, ID QW2Y, received a behavioral assessment of 1 (no atypical behavior) on

the first drill (pre-FASDT) and a 2 (cover ears) for the last fire drill. Two children, 883X and

H0BK went from a 1 on the first fire drill to a 3 (cover and hold ears) on the last drill. Student,

ID USI3, received a behavioral assessment of 2 (cover ears) on the first drill (pre-FASDT) and a

3 (cover and hold ears) for the last fire drill. Student, ID MCA7, went from a 2 on the first fire

drill (pre-FASDT) to a 4 (extremely agitated) on the last drill.

One child, student ID FLZB, was recognized by the school Occupational Therapist (OT)

as having significant issues with loud noises. She began working with the child at the beginning

of the school year to help her become desensitized to the fire alarm, and had used the FASDT

program with the student. The student was allowed to stand outside before the fire drill and then

allowed to open the door at the time of her choosing. The child reported, according to the parent,

that it was not as scary as she thought it would be. The parent reported no atypical behaviors

because of the fire drill.

Discussion

This applied research project was performed to determine the long-term

effectiveness of a fire alarm sound desensitization program to help children with autism

respond to fire drills and fire alarms. Statistical analysis of the data collected showed there

was no change, either positive or negative, from the first fire drill (pre-FASDT) and the


fourth fire drill one year later. However, qualitatively, parents and teachers reported interesting

positive effects for several children.

This research indicates typical children respond to fire alarms in a variety of ways.

Of the 21 typical children evaluated, including data collected from the first fire drill, 47.6%

(n=10) had no behavioral difficulties with the fire drills. Cohen (2012) reported that 51.5%

(n=69) of the 134 typical children evaluated had no behavioral difficulties with the fire

drill. Eleven typical children (52.4%) exhibited atypical behaviors ranging from covering

ears (Rubric 2) to crying out (Rubric 4). Cohen (2012) reported 48.5% (n=65) children’s

exhibiting atypical behaviors ranging from covering ears (Rubric 2) to covering and

holding ears (Rubric 3). This research appears to be consistent with previous research.

Previous research indicates children with autism respond in a variety of ways to fire

alarms and fire drills. This research confirms previous research. Of the 29 children with an

ASD, including data collected from the first fire drill, 16 (55.2%) had no behavioral

difficulties with the fire drill. Cohen (2012) reported 22.2% (n=6) had no behavioral

difficulties resulting from the fire drill. Thirteen children (44.8%) exhibited atypical

behaviors ranging from covering ears (Rubric 2) to covering and holding ears (Rubric 3).

Previous research of children with ASD indicated 18 children (66.7%) exhibited atypical

behaviors from the fire drill ranging from covering ears (Rubric 2) to covering and holding

ears (Rubric 3) while 3 children (11.1%) behaviors ranged from severe agitation (Rubric 4)

to completely intolerant (Rubric 5) (Cohen, 2012). This research is consistent with

previous research regarding children with autism and their response to fire drills.

Four typical children had previously participated in the FASDT program. All four

exhibited atypical behaviors resulting from the fire alarm. Two children covered and


uncovered their ears, while two others held their hands over their ears. All four behaviors

resolved upon exiting the building.

The research question “How do children with an ASD respond to fire alarms one year

after receiving FASDT?” was answered comparing data collected from previous research

(Cohen, 2012) and the current fire drill video assessments collected approximately 14

months after the FASDT program was completed. Eight children with autism participated

in the FASDT program fourteen months ago. Four children had no change between the

third and last fire drill, scoring a 1 on the rubric (Appendix K) for both drills. Two children

showed an improvement in behavior, one improving from a 2 to a 1 while the other

improved from a 3 to a 1. One child stayed the same between the third and fourth fire drill,

scoring a 4 for extreme agitation on both fire drills. One child regressed from a 1 on the

third fire drill to a 3 on the fourth fire drill.

Children with autism exhibit a variety of behaviors when exposed to fire alarms, as

seen in this study. Although the statistical analysis of the data collected does not indicate a

statistically significant improvement in behavior, 50% of the children, fourteen months

later, maintained a rubric score of 1. Two children showed improvements in behavior,

which may be due to maturation or other factors unrelated to the FASDT program. One

child regressed, which may be a result of having a bad day, regression, or other unrelated

factors. It is important to note, there were no negative or deleterious effects observed

during the fire drill.

Based on the statistical analysis and the qualitative data, it appears there is 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 is 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.

Recommendations

The purpose of this applied research project was to determine whether a child with

autism would retain the necessary skills to evacuate safely in the event of a fire alarm

activation.

Much of the research relating to safety skills did not assess the long-term retention

or maintenance of those skills. Many of the researchers recommended conducting research

of the long-term maintenance of the safety skills that are practiced or used infrequently.

Due to the very small sample size, this study should be replicated to confirm the

effects of desensitization to fire alarms using a larger sample group. This research should

be expanded to test the effectiveness of a FASDT program with a secondary school

population as well as those who receive services in a more restrictive setting (i.e.,

residential or institutional). Further research should also be conducted to determine if the

skills learned using the sound of the fire alarm could be generalized to other alarm types,

i.e., smoke alarms or alarm clocks. Other questions to ask include: Does the desensitization

to loud noises carry over into other venues; Do other developmental disabilities have

similar issues with fire alarms, and if so, does desensitization work for them?

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. The Mountain Brook Fire Department will also


work with the Mountain Brook School System to ensure that all students learn the

appropriate responses to fire alarms and fire drills.

Shabha wrote, “Children on the autistic spectrum are amongst the most vulnerable

group in our society. This largely stems from the overwhelming disabling effects of a

sensory handicapping built environment within which they live” (2006, p. 32). The fire

service has an obligation to help these children overcome these handicaps whenever

possible. The use of a desensitization program can be the first step in aiding children with

autism to respond quickly and safely when a fire alarm activates.


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Appendix A


Appendix B


Appendix C











Appendix D


Appendix E




Appendix F

(Cohen, 2012, pg. 81)


Appendix G


Appendix H


Appendix I


Appendix J

(Cohen, 2012, p. 82)


Appendix K

(Cohen, 2012, p. 83)


Appendix L


Form adapted from Cohen (2012, p. 84).


Appendix M

Form adapted from Cohen (2012, p. 85).


Appendix N


Documents

Children with Autism and Fire Alarm Sound Desnsitization ...nfa.usfa.fema.gov/pdf/efop/efo48715.pdf · Autism and FASDT: Retain or Retrain 7 The Autism and Developmental Disabilities