Over half a million people in the UK have Autism. Together with their families they make up over two million people whose lives are touched by Autism every single day. It is estimated that at least 1 in 100 children under 18 in the UK has an Autism Spectrum Disorder (ASD). More boys are diagnosed with an ASD than girls: a ratio of 4:1. A small percentage – perhaps 2% of people with an ASD, who are sometimes known as ‘savants’– may have a particularly special talent, for example, with numbers, in music or in art.
Consistency of approach across the whole school setting is an extremely important factor in supporting children with an ASD. Seek advice from your SENCO and ensure you have the student’s individual education plan and/or statements of special educational need. Teaching assistants and learning support assistants with an understanding of ASDs can also play a key role in the successful inclusion of children with an ASD in school life, as can lunchtime supervisors. Good two-way communication between school and parents can further help to ensure success.
The three main areas of difficulty (sometimes known as the ‘triad of impairments’) are:
1. Difficulty with social interaction
This includes recognising and understanding other people’s feelings and managing their own.
People with an ASD may:
- not understand the unwritten social rules which most of us pick up without thinking: they may stand too close to another person for example, or start an inappropriate subject of conversation
- appear to be insensitive because they have not recognised how someone else is feeling
- prefer to spend time alone rather than seeking out the company of other people
- not seek comfort from other people
- appear to behave ‘strangely’ or inappropriately, as it is not always easy for them to express feelings, emotions or needs.
Some may want to interact with other people and make friends, but may be unsure how to go about this. This range of difficulties can lead to problems in the classroom and the playground, with making friends and, in turn, bullying.
2. Difficulty with social communication
This includes using and understanding verbal and non-verbal language, such as gestures, facial expressions and tone of voice. Many people with an ASD have a very literal understanding of language, and think people always mean exactly what they say. They can find it difficult to use or understand:
- facial expressions or tone of voice
- jokes and sarcasm
- common phrases, sayings and metaphors; an example might be the phrase ‘It’s cool’, which people often say when they think that something is good, but strictly speaking, means that it’s a bit cold.
Some people with an ASD may not speak, or have fairly limited speech. They will usually understand what other people say to them, but may use alternative means of communication themselves, such as sign language or visual symbols. Others will have good language skills, but may still find it hard to understand the give-and-take nature of conversations, perhaps repeating what the other person has just said (this is known as echolalia) or talking at length about their own interests. It helps if other people speak in a clear, consistent way and give people with autism time to process what has been said to them.
3. Difficulty with social imagination
This includes the ability to understand and predict other people’s intentions and behaviour and to imagine situations outside their own routine. This can be accompanied by a narrow repetitive range of activities. People with an ASD find it hard to:
- understand and interpret other people’s thoughts, feelings and actions
- predict what will happen next, or what could happen next
- understand the concept of danger, for example that running on to a busy road poses a threat to them
- engage in imaginative play and activities: children with autism may enjoy some imaginative play but prefer to act out the same scenes each time
- prepare for change and plan for the future
- cope in new or unfamiliar situations.
Difficulties with social imagination should not be confused with a lack of imagination. People with autism can be very creative and may be, for example, accomplished artists, musicians or writers. Many have very particular special, all-absorbing interests about which they may be very knowledgeable.
Sensory issues and routines
People with an ASD may also experience over- or under-sensitivity to sounds, touch, tastes, smells, light or colours. Many, too, prefer to have a fixed daily routine so that they know what is going to happen every day and love to keep to fixed rules. Some enjoy repeating the same activity over and over again. The daily ‘hurlyburly’ of school life can be extremely stressful for pupils who display any or all of these particular characteristics.
The following guidelines on communicating with pupils who have an ASD may also prove helpful with a wider range of pupils. The level of language can be adjusted as appropriate to the pupils concerned. Visual aids may also need to be used, especially with children who have little or no speech, but these can also be useful with children whose speech may be more developed.
- Be as clear in your communication as possible and say exactly what you mean. Anything merely implied will probably not be understood. For example, asking, ‘Would you like to get your work out now?’ may get the very honest (But unintentionally rude) answer, ‘No!’ Similarly, you may ask, ‘Can you just sit over there?’ or ‘Can you pick up that piece of paper and put it in the bin?’ and get the answer ‘Yes’, followed by no action: the answer has been truthful, but the pupil may well not have understood that you were actually asking them to carry out the action
- Keep your language direct, avoiding the use of double meanings, sarcasm, teasing, complex open questions or subtle jokes, unless you are really sure the pupil understands. Make sure that you have their attention before communicating. Use their name, but don’t necessarily expect to gain full eye contact – this can be difficult for pupils with an ASD
- You will probably need to slow down your communication – allow several seconds for the pupil to process new information and to respond before you give more information, or repeat your request
- Check that they understand what they have to do in class or for homework. They may not necessarily understand just because they can repeat back the instruction you have just given. Processing verbal information tends to be harder for pupils with an ASD. Visual aids can help
- Make sure that the pupil knows what is expected of them in school, for example, where they should be in the classroom or for each lesson; how to negotiate around the school site; what homework is expected; where they are able to go at break and lunchtime, if being in the playground causes too much stress, or what time the day trip will return to school. Most difficulties occur as a result of insufficient information about what to do in different social situations
- Be patient. A few pupils will seem to be intentionally aloof (Avoiding eye contact), rude or disinterested. This is rarely the case. Pupils with an ASD usually do not have the basic social understanding to realise how they appear to others. Occasionally they may say or do things that seem to threaten your authority in school. Try not to take this personally, but deal with it in a calm way
- Ensure that there is a planned exit strategy available if a pupil has difficulty regulating their behaviour in class, for example, a quiet room they can go to when stress levels get too high, or a particular quiet area
- Avoid confronting an angry/upset pupil by arguing or raising your voice. Many people with an ASD are very sensitive to noise, some finding loud noise physically painful. A raised voice will not help them understand what is wanted. Use a calm, neutral tone of voice – do not shout, or expect them to be able to read facial expression and gesture. Instead try to divert and defuse the situation. For example, allow the pupil to ‘exit’, giving a clear alternative choice, a compromise if possible. Sometimes a visual support, such as a card with a photo of the quiet room, will help him to understand what you want them to do next. If there is no room for compromise, make the request a couple of times, allowing plenty of time for them to process this information, then calmly, with few words, follow through the consequences of non-compliance if necessary (Which should already have been explained very simply and clearly)
- Home/school diaries and/or school planners can help reinforce what is being communicated and keep parents informed.
A range of support strategies
Choosing the right kinds of support for the individual child is important. The following list offers a wide variety of approaches which can be used according to the child’s needs.
Using visual aids
Children with an ASD often find it easier to understand the world about them through visual aids. Teachers can use a visual timetable showing times and simple drawings of the activities, so that the pupil knows exactly what they will be doing and when. This approach can be applied to all kinds of sequential processes. For a child at Primary school who is particularly anxious about getting changed for PE, for example, a sequence of photos or illustrations of each stage of the process can be invaluable.
The- visual aids can be laminated to make sure that they are robust and displayed where appropriate. Many schools use computer software packages to write out stories, descriptions and instructions in both words and symbols simultaneously. Other visual supports include written lists, objects and calendars which can help children understand sequence and predict what is to happen.
Parents, too, may well value copies of the timetables so that they can help their children to be organised for the school day. For older pupils who wish to keep their visual supports discreetly, pasting their visual timetables into a school planner can be helpful, as can keep pictorial reminders on a key ring in a pocket. Clocks or sand timers can be a useful aid, too, for those who find it difficult managing their time.
The Picture Communication Exchange System (PECS)
PECS is a commonly used approach to teach children who have limited language. Teachers use pictures as symbols to teach children the names of different objects. Gradually a child is taught to exchange a picture for the object he or she wants, to construct simple sentences using the pictures, and indicate choices between various objects.
Comic strip conversations
Comic strip conversations assist children with autism to develop greater social understanding, by providing visual representations of the different levels of communication that take place in a conversation, using symbols, stick figure drawings and colour. By seeing the different elements of a conversation visually presented, some of the abstract aspects of social communication (such as recognising the feelings and intentions of others) are made more concrete and are therefore easier for the child to understand.
Children with an ASD can benefit from working in a distraction-free environment. It may be possible for Primary teachers, for example, to allocate an area of their classroom which can be kept as free from anything which may distract the pupil from their tasks, but where they may see their visual timetable. Subject teachers at Secondary schools may like to find the best seating position in their classroom for a pupil with autism. In large schools, a quiet area available to pupils who have additional learning needs can be very beneficial.
Some children with an ASD respond well to drama and role-play activities to help them learn social skills such as greetings, turn taking in conversation and watching for cues in social skills groups. A ‘circle of friends’ or buddy system can also help a child with autism understand the social world of the classroom and the playground
Circle of friends
A circle of friends encourages the development of a support network for a child in a structured setting, which can also extend to outside this setting. Six to eight willing and sensible children are recruited as volunteers to form the circle of friends. Meeting regularly, they can help the child to express his feelings and decrease anxiety levels. This can lead to improved social integration and higher levels of peer contact.
It is not an approach to provide instant friendship, but over a period of time, the child may be able to build closer and better relationships with other children. The group will need awareness and training on how to communicate and make the person feel more included. The form of support will depend on the pupil’s needs, for example – helping the person join in lunchtime games, walking the pupil home after school to prevent bullying, reminding the pupil about homework or getting them to the next class on time. The group usually meets one lunch-time every few weeks to review the support methods and progress, with close monitoring and support by staff.
Finding a buddy for a child with autism – possibly in the same year group or older - can help increase their confidence. They will have someone to turn to if they have difficulties understanding what is going on around them socially, or a problem understanding jokes, or problems with other children.
Older children may well benefit from having a mentor who could be an older pupil, a teacher or a member of the school support staff. Regular mentoring sessions offer the possibility of dealing with any problems which have occurred in the previous week, or looking at the coming week and planning how to deal with things which may cause anxiety. Buddies and mentors should also have a good basic awareness of ASDs and how they affect an individual.
The behaviour of some children with autism is not always easy to deal with. It may not always be immediately obvious why a child is behaving in a particular way, and it can be hard to control the situation without knowing more about what lies behind it and what kinds of strategies to use.
With limited verbal communication, a child with autism may, for example, not be able to express their feelings of anxiety, discomfort, or frustration except in an outburst of unwanted behaviour. They may have learnt from experience that sometimes such behaviour achieved a desired object.
Children with Asperger syndrome whose verbal communication is not severely impaired may, however, also not be able to communicate their anxieties clearly and may react in what may seem to be an extreme way. Therefore staff need to analyse what was happening before the outburst that might have upset the child, and teach him some other way of communicating what they want or what the problem is.
Monitoring cards/Time out cards/Exit passes
It may be useful for some pupils to use special coloured cards to indicate their extreme anxiety to the class teacher or to a teaching assistant rather than have to try and explain in detail what is wrong and interrupt the flow of the lesson under the gaze of all the rest of the class. The card could simply note that they will need some extra monitoring in class, or offer an exit strategy which has been agreed by staff at school, saying something like ‘Urgent: please be aware that Paul sometimes has difficulty coping with social situations. If he puts this card on your table he is feeling very stressed and needs to go to the learning support department
Coping with transition times
For some children with an ASD lesson changeover times, breaktimes and lunchtimes pose particular difficulties as they become particularly anxious in the unpredictable and noisy hustle and bustle. It is helpful to have strategies in place which can help overcome these problems. It may be appropriate for the pupil to be allowed to leave the classroom a little early just before all the others so that they can get to the new classroom without encountering large crowds. Alternatively, a buddy or mentor may be able to help at these times. Break times and lunchtimes could also be made less tense if buddies or a circle of friends could help – or if there were a calm place to go to when necessary
Safe place/calm refuge
It is extremely helpful to have a planned place of refuge for children with an ASD where they can go when their anxieties become so great that they cannot manage in either the classroom activity or break or lunchtimes, especially if their circle of friends, buddy or mentor is not available for some reason. In Secondary schools, for example, this could be the learning support department or a specifically designated pastoral room which is supervised. In Primary schools, depending on the situation, it may be possible to go to the library or other calmer area of the school perhaps with a learning support assistant and become involved in a quiet task.
There are plenty that teachers, support staff and other pupils can do to help students with ASD