Introduction
‘The Autism Education Trust (AET) believes that all children and young people with autism should receive an education which enables them to reach their individual potential to engage in society as active citizens. Individuals, families and professionals should be informed, supported and equipped to enable this to be achieved.’
Wittermeyer et al (2011)
Autism is a lifelong neurodevelopmental condition which affects one in a hundred people, with around 700,000 adults and children with the condition in the UK (NAS, 2021). It affects how individuals perceive, communicate and interact with the world and their environment. Batten et al (2006) in Wittermeyer et al (2011) state ‘Moreover, unless adequate help is provided, children with autism in mainstream schools might experience isolation, rejection and bullying. The risk of school exclusion in this group is particularly high relative to children with other types of SEN’ which is why it is so vital to ensure provision is robust and re-evaluated regularly within individual settings. A survey by the All Party Parliamentary Group for Autism (APPGA) identified that ‘60% of young autistic people said that having a teacher who understands autism is the main thing that would improve their experience of school’ (Guldberg et al, 2019) which is why there is more need for support and training for teachers in this area. Reading and developing my understanding in areas such as this has supported my own learning.
Assessment and Diagnosis: Individual Needs and strategies Based on Links to Research and Theories
As we know, autism has been identified in cases as far back as 1747 (Wolff, 2004). Much has been learnt around the condition with key theorists such as Asperger and Kanner leading the way in the development of the understanding of the condition. However, it was the work of Lorna Wing that made a significant contribution to the assessment and diagnosis of Autistic Spectrum Conditions (ASC) as we know it today, first using the term spectrum in 1979 (Happe and Frith, 2020).
The triad of impairments model was created by Wing and Gould in 1979 (Wing, 1993). This identified three key areas of difference; social communication, social interaction and social imagination. It was acknowledged that presentation in relation to these three areas can vary greatly from one individual to another, therefore a unique learning profile must be considered for each individual, with individuals needing a range of strategies which support their differences. Beardon (2019) also discusses and supports the use of the term spiky profiles and considers what this means for one individual on the spectrum could be very different for another.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) which is the assessment method and diagnostic tool most commonly used in the UK was first developed in 1952 (Blashfield, Keeley, Flanagan and Miles, 2014). We are currently on version V of the manual and this version has had sub-types such as Asperger syndrome removed. Assessment and diagnosis in the UK is also commonly through the assessment tool known as the Autism Diagnostic Observation Schedule (ADOS).
Assessment could take some time, up to two years before a formal diagnosis takes place. However, pupils showing behaviours associated with ASC could have strategies implemented within school to support progress without needing a formal diagnosis. Strategies and support in school should be based on individual needs and not a diagnosis.
There are several key areas I will examine in this section which have arisen from reflecting upon the many school visits I have made, and the positive practice I have observed.
Social Stories
Social stories were regularly used either for periods of change and preparation for this, or to reinforce or tackle an issue that had taken place. Staff had attended social story training and wrote their own stories adapted to the needs of the individual pupils. Gray (1994) developed the social story in 1991 and defined the criteria for writing a good social story. These criteria have been developed to include recent research in this area and strengthens the approach originally used. Timmins (2016) developed this approach and has written supporting material and resources to use in local schools, and to support her own son. She presents the use of social stories as support for children by giving the relevant clues about life, and to outline the context of a situation around people’s feelings and thoughts which are then linked to their reactions and expectations. The use of pre-made social stories and training for staff to develop personalised stories is beneficial, particularly in the context of Covid-19 and the changing situation in school and classrooms with often daily routines being changed at short notice.
Pre-teaching
Pre-teaching is a strategy commonly used in the specialist school and something I have seen being used within primary school regularly. Koegel et al (2003) was highlighted by Parsons (2011) as identifying the strengths of a pre-teaching approach in developing the knowledge and confidence in pupils with ASC when tackling new subjects and areas.
Pre-teaching prepares pupils for the lesson ahead, introduces some key terms and language and develops a grounding in the subject they are about to be taught so that they are more able to keep up with their peers within the main lesson.
General Environment
There were many elements to note here that could be considered in terms of how pupils with autism might be supported in a mainstream environment.
Rooms that are spacious and personalised for the pupils with plenty of room between desks is beneficial. This supports autistic pupils as some pupils can feel overwhelmed by physical contact or feeling crowded. Pupils staying in the main classroom for the majority of their teaching except for specialised lessons such as PE or D&T also supports pupils with autism as changes of routine can be problematic and unsettling.
Quiet, wide spaces in the corridors are beneficial, and corridor times that are managed by staff and timetabled for break and lunchtimes so that not all pupils come out of their rooms at the same times.
Sensory Rooms
Consider schools with sensory rooms in which pupils’ access with an adult. Scheduled sensory breaks for some pupils; timetabled into the day for specific individuals. Other rooms at times could be used reactively in relation to pupil need. Jones et al (2008) state that sensory processing differences are a core element of ASC, although it is not yet clear whether it is part of the condition or separate on co-occurring, and that hyposensitivity as well as hypersensitivity need consideration. Hyposensitivity could be the area being addressed for some pupils within the sensory rooms, such as awakening the senses through light and movement stimulation to ensure the pupil is ready for the next part of their learning.
There are other valuable interventions being used such as the Picture Exchange Communication System (PECS) (Frost and Bondy, 2011). However, this is not something commonly used in a mainstream school setting. More extensive therapies such as Applied Behavioural Analysis (ABA) for pupils with higher behavioural challenges might be considered. This should be delivered in conjunction with trained therapists with observation and understanding of the behaviour being sought to enable manipulation of pupil responses (Boucher, 2017). Some therapies I believe can be intrusive and Boucher (2017) discusses the view on the possibilities of prevention and cure, and treatment methods, Happe and Frith (2020) argue that this term is no longer acceptable, however it is still included within some theoretical perspectives. I found reading around this area and this viewpoint quite disturbing; the view that we can and should possibly consider trying to cure ASC for me was quite an odd perspective. Happe and Frith (2020) acknowledge that there are co-existing conditions with autism and these may need medical intervention. Harvey (2018) argues for recognising that ASC is a difference not a disorder, writing extensively on understanding the theory of autism as difference and how this is considered in practice. Milton (2014, 2019) explores neurodiversity and outlines that this is part of natural diversity, rather than a medical model of disability. From everything we know about neurodiversity, I cannot understand why the terminology of ‘treatment’ is being used and so recently. My own developing stance on this has led to my writing of the book ‘The Neurodiversity Handbook for Trainee Teachers’.
The Autism Education Trust
The Autism Education Trust devised eight key principles which are incorporated within four themes and link to the AET standards (Guldberg, 2019) which are:
• Understanding the individual
• Positive relationships
• Learning and development
• Enabling environments.
The principles highlight key elements of good autism practice:
1. Understanding the strengths, interests and challenges of the autistic child and young person
2. Enabling the voice of the autistic child and young person to contribute to and influence decisions
3. Collaboration with parents and carers of autistic children and young people
4. Workforce development to support autistic children and young people on the autism spectrum
5. Leadership and management that promotes and embeds good autism practice
6. An ethos and environment that fosters social inclusion for children and young people on the autism spectrum
7. Targeted support and measuring progress of children and young people on the autism spectrum
8. Adapting the curriculum, teaching and learning to promote well-being and success for autistic children and young people.
(Guldberg, 2019).
Guldberg (2019), Principle Four: Workforce development to support children and young people on the autism spectrum.
The Key points outline the expectations:
• All staff new to the workforce (including non-teaching staff and governors) receive autism training as part of their induction (e.g. new staff attend AET Making Sense of Autism training in their first year).
• Every setting has access to an autism champion/lead practitioner who coordinates support and information between CYP, staff, parents and other services.
• Settings regularly audit staff confidence levels, understanding and knowledge of autism and link this to Continuing Professional Development (CPD) and the Performance Management system (e.g. settings use the AET autism competency framework to audit staff skills and identify areas for staff development).
• Leadership and management have a commitment to an ongoing programme of CPD in autism to update the knowledge, skills and practice of their workforce.
Guldberg (2019) outlines further research, and reports that staff development is critical for pupils with ASC. It is argued that there is a need for regular CPD directly around autism for all staff (not just new staff) to update knowledge, skills and practice. It is acknowledged that this would require commitment from the leadership and management team, and this is an area that I feel needs addressing directly in the setting to develop a ‘well-informed and effective workforce to enhance practice’ (Guldberg, 2019).
To conclude, and reiterate, as Guldberg (2019) states;
‘As autism is a complex condition that impacts daily functioning, autistic CYP require distinctive support and assistance to be successful. Educational practitioners need knowledge of the likely challenges facing autistic CYP in educational settings and effective educational practices to address these. When settings understand autism and make adjustments to the physical, sensory and social environment and to the curriculum, autistic CYP are able to learn and succeed.’
References
Beardon. L. (2019). Autism and Asperger Syndrome in Children. Sheldon Press. London.
Blashfield, R. Keeley, J. Flanagan, E. and Miles, S. (2014). The Cycle of Classification
DSM-I through DSM-V. The Annual Review of Clinical Psychology. 10:25-51.
Boucher, J. (2017). Autism Spectrum Disorder; Characteristics, Causes and Practical Issues. SAGE. London.
Frost, L. and Bondy, A. (2011). A Clear Picture: The Use and Benefits of PECS. Pyramid Education Consultants. Brighton.
Gray, C. (1994). Comic Strip Conversations. Arlington. Future Horizons.
Guldberg, K., Bradley, R & Wittemeyer, K. (2019) Good Autism Practice. London: Autism Education Trust.
Happe, F. and Frith, U. (2020). Annual Research Review: Looking Back to Look Forward – Changes in the Concept of Autism and Implications for Future Research. Journal of Psychology and Psychiatry. 61:3, 218-232.
Harvey, C. (2018). Difference Not Disorder; Understanding Autism Theory in Practice. Jessica Kingsley Publishers. London.
Jones G, English A, Guldberg K, Jordan R, Richardson P, Waltz M. (2008). Educational Provision for Children and Young People on the Autism Spectrum Living in England: A Review of Current Practice, Issues and Challenges. London: Autism Education Trust.
Milton, D. (2012). So What Exactly is Autism? Autism Education Trust. DfE.
Milton, D. (2014). So What Exactly are Autism Interventions Intervening With? GAP. 15.2.2014
Milton, D. (2019). Disagreeing over Neurodiversity. Psychologist, 32 . p. 8. ISSN 0952-8229.
National Autistic Society (2021). What is Autism? What is autism [Date accessed 22/03/2021].
Parsons, S, Guldberg, K. Macleod, A. Jones, G. Prunty, A. and Balfe, T. (2011). International review of the evidence on best practice in educational provision for children on the autism spectrum. European Journal of Special Needs Education, 26, (1), 47-63.
Timmins, S. (2016). Successful Social Stories; Growing Up with Social Stories. Jessica Kingsley Publishers. London.
Wing, L. (1993). The Definition and Prevalence of Autism: A Review. European and Child Adolescent Psychiatry. 2:2 61-74.
Wittemeyer, K. Charman, T. Guldberg, K. Hastings, R. Howlin, P. Macnab, N. Parsons, S. Pellicano, L. Slonims, V. (2011). Educational provision and outcomes for people on the autism spectrum. London: Autism Education Trust.
Wolff, S. (2004). The History of Autism, European Child Adolescence Psychiatry, 13:201-208.
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