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Fatty acid primary amides are potent, bioactive molecules. Oleamide induces physiological sleep1,2, potentiates the action of 5-hydroxytryptamine on rat brain 5-HT2A and 5-HT2C receptors3, and blocks gap junction communication in glial cells4. Erucamide stimulates angiogenesis5, arachidonamide is a tight-binding inhibitor of human synovial phospholipase A2 6, and valpromide (n-propylpentanamide) is used clinically as an antiepileptic7. These studies indicate that the fatty acid primary amides are an exciting new class of mammalian, bioactive lipid. The biosynthetic pathway leading to the formation of the fatty acid primary amides is not understood and is information critical to the understanding and control of diseases related to their production.

Several years ago at our University of North Carolina-Chapel Hill University Day observance, the keynote speaker, Dr. Robert Allen, described a Stanford University Business School study designed to identify shared elements of excellent and visionary companies. The authors of this study had assumed that the important variables would be factors such as exceptional leadership, strategic planning, mission statements, profit margins, or some combination of these. Instead, they found that what distinguished excellent companies was a shared core ideology: a set of values and sense of purpose beyond just making money. Moreover, those values were clearly articulated and well-understood among the workers of the companies. The core values were not the same from company to company, although they did have some important factors in common, but they all resulted in progressive growth and excellence.

The TEACCH Program as it exists at the time of this publication has served thousands of individuals and families involved with the challenges and problems of the autism spectrum It now employs hundreds of staff with multi-disciplinary training. The program’s mission, priorities, services, and practices are the product of the thoughtful, dedicated work and contributions of many faculty and staff. This chapter is intended to trace the motivating factors shaping the development and history of the program.

Structured Teaching, TEACCH’s intervention approach for people with autism spectrum disorders (ASD), shares principles and techniques with other psychoeducational interventions for this population. For example, during TEACCH’s earlier days in the 1970’s when behaviorism was the predominant educational intervention approach for students with developmental handicaps, most of the TEACCH intervention efforts emphasized reward and punishment contingencies. This approach is similar to many programs based on Applied Behavior Analysis (ABA) today. Structured Teaching continues to share with ABA a highly structured learning environment that facilitates development in people with ASD. Unlike many ABA approaches, however, TEACCH does not create structure by relying on repeated trials that begin with a prompt and are followed by material reinforcements, because of concerns that doing so would likely lead to strong attachment to this routine (sometimes called “prompt dependence”) and would compound already severe problems with generalization. Instead, structure is provided by the physical environment, organizational strategies, and the presentation of materials, which is also similar to the Montessori approach with typically-developing children. Materials are organized systematically in visual ways that are meaningful to individuals with ASD and are also tailored to individuals’ strengths and interests.

When parents understand their child’s developmental problems and special needs, they can obtain services, they can connect with other parents for support and mutual assistance, and they can form coalitions to advocate for more and better services and for research into treatment and prevention. However, initially learning about their child’s significant developmental problems is very distressing for most parents. First hearing the words “autism” and “mental retardation” is one of their worst nightmares come true, with fear, pain, grief, disbelief, rage, and heartache flooding them as the professional talks. Although professionals in psychology, education, medicine, etc. chose their careers in order to help people, not to cause them distress, the very nature of telling parents that their child has a developmental disability involves inflicting extraordinary pain. So the process of explaining developmental test results to parents can be difficult for professionals as well as for parents (Abrams & Goodman, 1998; Lipton & Svarstad, 1977; Nissenbaum, Tollefson, & Reese, 2002).

Culture refers to shared patterns of human behavior. Cultural norms affect the ways people think, eat, dress, work, spend leisure time, understand natural phenomena, and communicate, in addition to other fundamental aspects of human interactions. Cultures vary widely in these respects, so that people in one cultural group might at times find those from another group to be difficult to understand or unusual. They might also evaluate their differences negatively, seeing them only as deficits.