Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Supporting Inclusive Practice and Ensuring Opportunity is Equal for AllSupporting the inclusion of autistic children

Supporting Inclusive Practice and Ensuring Opportunity is Equal for All: Supporting the inclusion... Kent Academic Repository Martin, Nicola and Milton, Damian (2017) Supporting the inclusion of autistic children. In: Knowles, Gianna, ed. Supporting Inclusive Practice and Ensuring Opportunity Is Equal for All. Routledge, London, UK, pp. 111-124. ISBN 978-1-138-67438-7. Downloaded from https://kar.kent.ac.uk/62644/ The University of Kent's Academic Repository KAR The version of record is available from https://www.routledge.com/Supporting-Inclusive-Practice-and-Ensuring-Opportunity-is-Equal-for-All/Knowles/p/book/9781138674387 This document version Pre-print DOI for this version Licence for this version CC BY (Attribution) Additional information Versions of research works Versions of Record If this version is the version of record, it is the same as the published version available on the publisher's web site. Cite as the published version. Author Accepted Manuscripts If this document is identified as the Author Accepted Manuscript it is the version after peer review but before type setting, copy editing or publisher branding. Cite as Surname, Initial. (Year) 'Title of article'. To be published in Title of Journal , Volume and issue numbers [peer-reviewed accepted version]. Available at: DOI or URL (Accessed: date). Enquiries If you have questions about this document contact [email protected]. Please include the URL of the record in KAR. If you believe that your, or a third party's rights have been compromised through this document please see our Take Down policy (available from https://www.kent.ac.uk/guides/kar-the-kent-academic-repository#policies). Chapter 8 Supporting the inclusion of autistic children Nicki Mar tin and Damian Milton This chapter explores: 13 • What is the autism spectrum? 15 • How autism is about a different way of thinking 16 • Autism and sensory processing and stress and anxiety 17 • Autism, social interaction and the Theory of Mind 18 • Autism, communication and language 19 • Managing transitions for autistic children 20 • Strategies to support the inclusion of autistic children 21 This chapter aims to reflect that autism is a spectrum condition, that every individual is 23 different and that people change over time. Authentic views of people on the spectrum and 24 their families underpin discussion of autism theory and its relationship to practice. w hile the 25 focus is on education (at any age), good practice recommendations embedded in this chapter 26 apply in other contexts and could also help to foster inclusive practice for people without an 27 autism diagnosis. 28 Autism is usually identified by observational forms of diagnosis involving the child and the 29 family. Girls are often diagnosed later than boys and the spectrum is wide, encompassing 30 nonverbal people, with and without additional learning disabilities, as well as highly successful 31 employed graduates. As children grow into adults, characteristics associated with autism 32 may become less obvious and support requirements will change. Identification of autism in 33 adulthood is becoming more common, although the issue of who pays is contentious and post- 34 diagnostic support is usually minimal. Principles associated with good autism practice will be 35 relevant across the lifespan. 36 This chapter aims to foster an empathic understanding of what it might be like to be 37 autistic with a view to helping practitioners to create autism-friendly learning environments. 38 Autistic people and their families are increasingly present in all forms of media and this is a 39 bit of a mixed blessing. Scare stories about what might cause autism gained prominence 40 around the MMR vaccination debate and the consequences have been problematic (not least 41 because of the rise of measles, due to the decrease in vaccinations). Contrary to what the 42 papers say, there isn’t an autism epidemic. However, the number of people being identified 43 as being on the autism spectrum is increasing, primarily because of a changing recognition 44 of what autism is and what it means to be autistic. Once thought to be a rare condition, the 45 definition of autism was widened by the introduction of the notion of the ‘autism spectrum’ 46 (w ing and Gould 1979). Estimating the numbers of autistic people within society is thus not 47 112 Nicki Martin and Damian Milton 1 an easy task, yet a figure of more than one in a hundred is cited by the National Autistic 2 Society (UK’s leading autism charity). As public awareness is increasing and while access to diagnosis in adulthood is patchy at best, many older people have identified with what they have heard or seen, or googled informally, and have ‘self-diagnosed’. Historical under-identification of girls and women (who are thought often to present more subtly than males on the spectrum) appears to be being rectified to an extent. Family life often revolves around the requirements of the autistic child or children and families may need practical non-judgemental backup from a range of services. Practitioners are also reminded that parents are in it for the long haul, while teachers and other professionals are just passing through. The Children and Families Act (CFA) (2014) was conceived with the aim of joining up access to health, social care and education services for young people up to the age of 25 identified with Special Educational Needs and Disabilities (SEND). Only those with the most complex requirements access a full Educational Health and Care Plan (EHCP). Usually additional intellectual impairment as well as autism would be the trigger, but schools and colleges do have responsibility for pupils and students who do not reach the EHCP threshold and still need help. Transitions are notoriously problematic for people on the spectrum, so the extension to age 25 is good news. Although progress to further education and employment is specified, this rather implies that university has not been considered as a possible option, even though the number of students with autism in higher education is on the increase. Pupil and parental engagement are central to the principles which underpin the CFA. Practical means by which all autistic children and young people can make their views known need to be found, including those who communicate unconventionally for adults. The Autism Act 2009 and the Adult Autism Strategy (2010), similarly aim to take a more joined-up view of support. Access to w ork funding exists to help with employment and the d isabled Student Allowance is still in place in higher education. However, at the time of writing, all disability benefits are under threat, graduates with autism are frequently unemployed, and the Autism Act and Adult Autism Strategy have not necessarily had the impact that was anticipated. People on the spectrum are increasingly advocating for themselves and organising, often via the Internet. Research informed by the principle ‘nothing about us without us’ enables policy makers to flex their empathy muscles a little bit and see the world through the eyes of autistic people. w e also have the 2010 Equality Act – lest we forget. Traditionally, the education of autistic people has been dominated by behavioural and cognitive approaches, some of which have been criticised, particularly by autistic authors (Milton 2014). A recent increase is apparent in strategies based on relational or developmental concerns and focusing more on working with identifying requirements arising from autistic learning styles, rather than attempting to remediate perceived skills deficits. Some of these approaches are reviewed here. The authors emphasise an inclusive, person-centred ethos and urge readers to keep individuality in mind. If you have met one autistic person or child, you have met one autistic person, or child. A recent study in the preferred use of language by various stakeholders within the wider autism community found that autistic people generally had a preference for identity-first language, whilst parents and professionals tended to like being ‘on the spectrum’ (Kenny et al. 2015). Both terms are used here and the unpopular words (‘deficit’ and ‘disorder’) are avoided, unless directly quoted. 47 Supporting inclusion of autistic children 113 What is the autism spectrum? Autism is clinically defined as a neuro-developmental disorder, signified by deficits in social interaction and communication, coupled with the presence of repetitive behaviours and adherence to routines (WHO 1992; APA 2014). Some autistic people have significant learning disabilities. A ‘spiky profile’ is usual, with some showing significant areas of interest and ability and other areas of difficulty. Widening diagnostic criteria has led to an ever-growing number of verbally articulate people being diagnosed. In recent decades, a welcome rise of autistic writers, scholars and self-advocacy groups has led to informed critique of traditional notions of autism and what it means to be autistic. A different way of thinking Central to the majority of accounts of autism are descriptions of autistic cognition, in particular, explanations for the repetitive behaviours and routines which form part of the diagnostic criteria. A number of theoretical models have been devised in order to try and explain such observed patterns, the most significant being theories regarding executive functioning, a weak drive toward central coherence, and monotropism (Baron-Cohen 2008; Milton 2012b). The term ‘executive functioning’ is used by psychologists when referring to the employ- ment of planning or problem-solving abilities in order to attain a goal. Autistic people are often thought to have difficulties with executive function, as well as in switching attention between tasks. However, within areas of interest and strength, many are able to show skills associated with executive functioning, suggesting that differences exist in the way autistic executive processing operates. Happe (1994) theorised that executive functioning did not adequately explain areas of strength found within the autistic cognitive profile, such as an eye for detail, as evidenced by higher than average performance on tasks such the block design task (Shah and Frith 1993). Differences are not necessarily deficits and the use of the expression ‘executive function deficit’ as a catch-all has been criticised by autistic scholars who reject the deficit model. A weak drive toward central coherence was highlighted by Happe (1994) and associated with difficulties processing overall contextual meanings, whilst simultaneously having strengths in processing aspects or details within an overall context, something Vermeulen (2015) refers to as ‘context blindness’. However, many autistic people can demonstrate that they process gist meanings and conceptual abstractions, so the notion of ‘a weak drive to central coherence’ is not always applicable. Autistic scholars such as d inah Murray, Mike Lesser and w enn Lawson developed the term ‘monotropism’ to describe a different way of looking at autistic cognition and processing (Murray 1992; Lesser and Murray 1998; Murray et al. 2005; Lawson 2010). Monotropism is characterised by atypical distribution of attention and interest. Accordingly, the amount of attention available to a child or adult is limited and differing cognitive processes compete for this scarce resource. Murray and colleagues (2005) suggest that many autistic people prefer to concentrate attention on a small number of interests. Social interaction, language use and shifting attention are all tasks that require the broad use of attention and interest and challenge many people on the spec- trum: ‘We suggest that the uneven skills profile in autism depends on which interests have been fired into monotropic superdrive and which have been left unstimulated by any felt experience’ (Murray et al. 2005: 143). 47 114 Nicki Martin and Damian Milton 1 The ‘spiky profile’ is a term frequently associated with autistic people and reflects a 2 strikingly uneven pattern. Higher levels of ability and confidence are often associated with 3 areas of special interest which is hardly surprising because of the tendency to focus on these 4 in depth (Kenny et al. 2015), and autistic scholars caution against terms like ‘low’ or ‘high’ 5 functioning, as their use does not reflect the ‘spiky profile’. Such a label can result in the 6 needs of more verbal autistic people and the strengths of those who are less verbal going 7 unrecognised, highlighting again the need to communicate with autistic individuals on their 8 terms. w hilst specialist interests are very common across the spectrum, it is a myth to think 9 that ‘savant skills’ are common or only found amongst autistic people (Arnold 2012). Grandin 10 argues that autistic interests and ways of thinking can be utilised as the basis of employment 11 and meaningful occupation. Utilising a child’s interests within a learning environment can 12 also be highly motivating and calming as well as a source of joy. Scenario 1: Michael Michael is 9 years old and he loves everything about Lego. He likes building with it, sorting it, counting it, drawing it and even writing stories about his Lego people. He has a teacher who thinks he should be interested in things that are not Lego. His mum and dad and his little sister think Lego is just fine. They are impressed by Michael’s ability to create with Lego. Lego is Michael’s main interest. His teacher has a plan. If he completes the work she sets him, although he finds it tedious and unmotivating and for what feels to Michael like large amounts of time, then he can play with a Lego man for five minutes. However, she has decided he cannot take a Lego man into assembly because 28 if Michael did this, everyone else would want to. Michael does not like the teacher’s plan and his mum did not appreciate Lego being described as an ‘obsession’ in the Annual Review. Michael was very happy to get Lego from everyone in the family for his birthday. Working with a child’s interest From what we have already learnt about autism, it is clear from this scenario that Michael’s teacher is struggling to understand that she needs to communicate with Michael on his terms about his interest in Lego. A more supportive and inclusive approach for Michael would involve the teacher using Michael’s interest in Lego to motivate and support him in undertaking the learning and other school activities she has planned for him. Many children find going in to a large assembly hall with lots of other children and adults intimidating, noisy and overwhelming. Failing to understand what Michael, in particular, needs to support him through situations he finds challenging will cause Michael upset. It may also make the teacher feel frustrated that she is seen as being 47 Supporting inclusion of autistic children 115 unable to ‘manage’ the situation. By understanding that Michael’s behaviour is not an 2 act of defiance against the teacher, and perhaps through seeking advice, she will find 3 more appropriate ways of supporting Michael. As the National Autistic Society says, 4 what autistic children need is ‘effective supporters will be endowed with the personal 5 attributes of calmness, predictability and good humour, empathy and an analytical 6 disposition’ (NAS 2016). 7 Sensory processing Sensory sensitivities have been reported by autistic people for many years (Grandin 1986). However the inclusion of sensory processing differences into diagnostic criteria occurred for the first time in the most recent edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) (APA 2014) has been controversial, because sometimes non-autistic people have sensory issues too. Experiences of sensory processing can vary greatly between differing accounts by autistic people, with both ‘hyper’ and ‘hypo’ (or under) sensitivity to sensory stimuli. Sensory responses vary between individuals and may be context specific. Sensory fragmentation or a difficulty in integrating incoming sensory information, is commonly described by autistic people, with some reporting ‘synaesthesia’ and sensory information becoming entangled (Tammet 2006). The more obvious sensory modalities are sound, sight, smell, touch and taste, but things like perception of one’s own body position and balance and interpreting feelings of pain or temperature, difficulty with coordination and motor-planning may also pose challenges. There is a high incidence of dyspraxia amongst the autistic population. Struggling to process incoming sensory information can lead to overload, affecting levels of stress and potentially creating anxiety. A general low-arousal approach can be effective, as can sensory aides such as noise-cancelling headphones (Caldwell 2015). There is no credible evidence for the effectiveness of techniques looking to ‘desensitise’ autistic people. It is also worth remem- bering that heightened sensory experiences can be a source of fun for some. It is necessary to understand what is going on for the individual, a ‘one size fits all’ approach will not do. Scenario 2: Michael Michael’s teacher has taken his Lego away. He is now 10 years old and Lego is still his main interest. Michael is in the playground and everyone is running about. It is really hot and sunny, and the sunlight is reflecting off the shiny surface of the fence. Another boy is scraping a stick along the railings. Three children are swerving close to Michael playing aeroplanes. Nobody invites him to join in and he has his hands over his ears and his hood up, even though it is hot. He is not very happy and is just trying to keep out of the way. Michael puts his hand in his pocket and – oh joy! – Lego man is there. He sits on a bench in a quiet place and holds Lego man close to his face and wobbles him by his eye. That feels better. Michael’s Teaching Assistant comes up to him and takes Lego man away because he’s not supposed to have Lego in the playground. She says he can have him back at the end of the day if he ‘joins in nicely for the rest of playtime’. 47 116 Nicki Martin and Damian Milton 1 A number of sensory audit tools have been produced, some with input from autistic people 2 (Attfield et al. 2012). It’s worth looking at some of these resources. It would also be helpful 3 to try and empathise with the experience of someone who has sensory sensitivities when 4 trying to design learning environments. Learning environments and sensory stimulation Look around the setting in which you work. Is it: • Noisy, crowded, chaotic and extremely visually stimulating? • Are people racing about? • Is it unpredictable? • Would it be helpful to create some more tranquil ordered and predictable spaces? • Who might benefit? • Is this just an ‘autism thing’ or might it help others too? Research ways in which learning environments can be designed to support children 21 who can find them noisy and overwhelming places. Stress and anxiety ‘Everyday experiences’ can become highly stressful and anxiety-raising for some autistic people, whose senses become overwhelmed in their struggle to deal with an excess of information. Emotionally meaningful information may make overload more likely. The result can be a response often described as a ‘meltdown’, which presents as a sort of emotional outburst. An autistic child or adult may also react by ‘shutting down’ and being under- responsive while focusing attention on whatever is causing them stress, at the expense of being able to process more general information. Panic attacks are not uncommon. w hen an individual is in a state of ongoing chronic stress, it does not take much to ‘tip them over the edge’, and so autistic people are often already managing extremely well with high levels of stress and anxiety before additional demands on their attention are added. w hen meltdown, shutdowns and panic attacks appear to have no apparent environmental antecedent, it’s worth exploring whether the autistic child or adult has experienced a build-up of stressful events before the ‘presenting incident’. The term ‘challenging behaviour’ can be very unhelpful when applied to autistic people, especially when there may be a lack of understanding and respect for why an autistic child or adult may need to be acting in the way that they are. A low-arousal approach is often effective as a means of reducing potential stressors and overload. However, low arousal does not mean ‘no arousal’, as some sensory experiences can be fun and conducive to learning. A calm empathic approach is vital, both to reduce the 44 risk of meltdown or shutdown and when intervening. Identifying and reducing external 45 stressors is an appropriate response if a meltdown or shutdown has occurred and, ideally, to 46 avoid them happening in the first place. These factors will be particular to the individual and 47 may well involve the behaviour of other people. An attempt to engage with something Supporting inclusion of autistic children 117 predictable and comforting to the autistic child or adult can be helpful once calm has been 1 restored. Intervening without understanding in an authoritarian way when someone is already 2 agitated is unethical and likely to be ineffective. An opportunity to reflect on an incident may 3 be possible when the autistic child or adult is calm, but will not be helpful otherwise. 4 Social interaction The idea of Theory of Mind (ToM) attempts to theorise and explain the difficulties autistic 8 people experience around interacting socially with others. ToM is explained in terms of 9 the ability to empathise with other people and imagine what they might be thinking and 10 feeling, in order to comprehend and predict their actions. w ing (1996) suggested that autistic 11 people have impaired ‘social imagination’ (linked to aforementioned ‘context blindness’). 12 For Hobson (2002), ToM forms the basis of symbolic thought and the development of 13 imagination. 14 Milton (2012a) poses an alternative argument which suggests that rather than seeing the 15 breakdown in interaction between autistic and non-autistic people as solely located in 16 the mind of the autistic child or adult, a ‘double empathy problem’ exists between the two 17 parties, largely due to the differing perspectives of those attempting to interact with one 18 another. Drawing upon the sociological theories of Erving Goffman and Harold Garfinkel, 19 Milton (2012a) suggests that the social subtext of a social situation is never a given, but 20 negotiated in practice in the interactions between people. w hen people of widely differing 21 dispositions (both biologically and culturally) interact, both will have a difficulty in under- 22 standing the other. This theory is particularly pertinent when considering the teaching 23 of social skills and social rules in explicit ways. As much social life is understood tacitly, 24 mutual understanding and rapport needs to be built, rather than simply imposing a normative 25 interpretation of social contexts and interactions onto autistic people (Milton 2014). 26 As w illiams has written: 27 I had virtually no socially shared nor consciously, intentionally expressed, personhood 29 beyond this performance of a non-autistic ‘normality’ with which I had neither compre- 30 hension, connection, nor identification. This disconnected constructed facade was 31 accepted by the world around me when my true and connected self was not. Each 32 spoonful of its acceptance was a shovel full of dirt on the coffin in which my real self 33 was being buried alive . . . . 34 (w illiams 1996, p.243) 35 Given differences in ways of processing information, various social contexts can become 37 very tricky to navigate, even without additional communication difficulties or learning 38 disabilities. Gaining mutual rapport and a flow within social interaction is not the sole 39 responsibility of one child or adult. Empathy is a two-way street and it would be very helpful 40 if people tried to see things from the perspective of the autistic child or adult. Rather than 41 interpreting autistic people as being overly ‘rigid’ in their manner and pursuit of interests, 42 such tendencies could be understood as providing predictability and stability in an otherwise 43 chaotic and fragmented experience. w hen considering the need for predictability, unfor- 44 tunately other children and adults can be very unpredictable and can increase stress and 45 anxiety. Gentle and structured play may help build interactions between autistic pupils 46 and their peers. Rather than assuming that the autism creates a number of problems in need 47 118 Nicki Martin and Damian Milton 1 of fixing, a child-centred pedagogy could be focused on helping the autistic child to gain 2 recognition of themselves and their own capacities. At any age, working with the autistic child or adult and not against their autism, is more likely to be productive and is undoubtedly more humane. Communication and language Building communication is a two-way process, involving shifting relationships, tacit under- standing, and changing social environments. Given different ways of thinking and processing sensory information, it is little wonder that many autistic people struggle with aspects of communication, including the assumed need for making eye contact, or conversational turn- taking. Jordan and Powell (1990) argue that superficially ‘good’ language skills can mask more subtle difficulties in communication. Visual communication aides can help some individuals but not every autistic child or adult learns well from visual materials, particularly those which are symbolic and abstract in nature. In an educational context, it is easy to become overly reliant on one system of communication which may not suit everybody. The Picture Exchange Communication System (PECS) could help some learners in the educational setting while others do not relate to it well. Pupils can grow out of PECS and settings may well be slow to phase the approach out once it has become redundant. It is possible to overload an autistic child or adult by trying out too many communication systems at one time. Conversely, visual reference points may also provide aids to comprehension for learners who are not on the autism spectrum, so their use in an educational setting may be appropriate within a broader framework of universal design for learning. w hen PECS goes wrong. it is usually because the setting is slow to adapt and insists on continuing with the symbols after they have ceased to be useful to the individual. For example, in the case where a teacher stated: ‘Gerry dragged me by the hand to the fridge, opened it and pointed at the juice. I insisted that he go back to the board and fetch his PECS symbol, and then I gave him the drink as a reward’, it is clear that the teacher was missing the fact that the child had moved on, and no longer needed the PECS symbol to make his wishes known. Transitions large and small Transitions between activities can be stressful, especially if they are poorly managed. Big transitions, such as moving from one phase of education to another, or navigating a parental divorce, can be extremely anxiety provoking. Sharing information between educa- tional establishments requires co-operation and ensuring that an approach which is suitable for the individual is employed. Visual references may be included in a transition passport document, for example, which may record interests and favoured activities, likes and dis- likes, strengths and difficulties. Leaving school may be a time when a young person decides to leave their autism diagnosis behind them and confidentiality must be respected if this is the decision that has been made. 47 Supporting inclusion of autistic children 119 Scenario 3: Michael Michael is now 16 and is going to an open day at the local sixth form college where he hopes to take A levels. There is an ‘ice-breaking exercise’ in a large hall with over a hundred other students and five members of staff. For about the first five minutes, everyone has to stand in a circle and throw a ball to someone and say 7 their own name – this seems like half an hour to Michael. After that, they have to throw the same ball and say the name of the person they are throwing the ball to (except if this is the third throw or the last person had a ‘b’ in their name or a ponytail). If any of these conditions apply, they have to stand on one leg, but it’s not clear why or how the ball starts being thrown about again. It’s quite a heavy, fast- moving ball which some people throw quite hard, but it is required that everyone joins in even if it is a very unpleasant experience. Some people are laughing and that’s a bit confusing. This does not seem to have anything to do with A-level choices and it is not clear how long the activity will last. Michael hopes he will never have to do this again. He has prepared a list of questions to ask a member of staff, but doesn’t know who to ask or indeed which people are staff. It’s very hot. Suddenly, the game is stopped 20 by someone who blows a whistle really loud and says ‘Right, take twenty minutes, and then make your way to the other building to meet and greet the staff and iron out any outstanding issues.’ Michael walks out and realises he did not know what time he was supposed to go to the other building, or where it was, or what he was supposed to do. He thought there were at least three other buildings. Michael went into the toilet and locked himself in a cubicle to think. Removing barriers to participation In any social situation there will be autistic children and adults. The college did not need to be told that Michael, who is autistic, would be visiting them on their open day to consider how they might organise the day to meet a range of young peoples’ needs. For all the young people who attended the open day and enjoyed the activities they participated in, there will have been a significant number, autistic or not, who would have found the ice-breaker activity challenging. Society is becoming increasingly aware that children and adults respond to social situations in a range of ways and therefore must be provided with a range of ways which allow access to and participation in social situations. In order to support Michael and other attendees at the open day the college might have: • Provided ‘ambassadors’ to meet attendees and explain the different events scheduled for the day 47 120 Nicki Martin and Damian Milton 2 • The information could have been more explicit, with a timetable of activities and 3 information about where to go for advice on the different courses the college 4 offers 5 • Quiet places to go to, and 6 • Specific people to contact who can answer particular enquiries Universal Design for Inclusive Learning Intervening with understanding has been emphasised within this chapter. Inclusive practice is about including everyone and fostering a sense of belonging and community. It is not about treating all learners the same, but it is about equality of opportunity. Some autism-focused interventions will be discussed briefly here, but these also have the potential to reduce barriers for other learners within a framework of Universal d esign for Learning (Ud L) (Milton et al. 2016) Autism-focused examples of UDL A useful distinction can be made between interventions and overarching frameworks. Rigid adherence to a specific intervention may not meet the diverse requirements of all the learners in a given setting and, in practice; a fairly eclectic approach is common. Ud L is a framework, as are approaches such as SPELL and REAL, which seek to provide a set of principles rather than a box of tools. REAL principles (Reliability, Empathy, Anticipation and Logic) can help things to run smoothly for everyone (Hastwell et al. 2013). No one thrives in chaos, and reliability fosters a sense of security. Seeing the world through the eyes of the learners will enable practitioners to anticipate what is likely to work well and situations which should be avoided, such as unpredictable changes. Logical communication increases understanding and feelings of safety. Techniques, such as the use of visual timetables could enhance clarity. REAL owes much to Maslow’s hierarchy of needs (1954), and is based on the same assumption that learning is only possible if learners feel a sense of safety and belonging. The National Autistic Society describes the SPELL approach, which is similar to REAL. SPELL stands for Structure, Positive (approaches and expectations), Empathy, Low arousal, and Links. Knowing the usual order of events in a day increases predictability and makes it easier to be more flexible within a framework. Positive expectations are based on an empathic understanding of the learner and building on natural strengths and interests enhances motivation. Utilizing in-depth interests within the curriculum, rather than as add-on motivators, contributes to the creation of a positive atmosphere. Understanding is checked constantly within SPELL and links between learning experiences are made explicit rather than implied. Calm and order are essential components of an anxiety-reducing situation and attention should be paid to the potential for sensory overload. Noise, busy colourful displays, bright lights, strong smells and general clutter can be distracting and aversive. The SPELL framework is complementary to other approaches, including REAL and TEACCH (Treatment and Education of Autistic and related Communication Handicapped Children.). A TEACCH classroom would include visual approaches to routine, as well as areas for quiet focus, rather than having every wall covered in bright displays. The Picture 47 Supporting inclusion of autistic children 121 Exchange Communication System (PECS) can be usefully incorporated into a TEACCH 1 classroom. Visual timetables to make routines predictable, and other visual prompts, can help 2 autistic pupils and, for example, some for whom English is an additional language. 3 What does Universal Design in a mainstream classroom look like? The setting is a mainstream classroom which includes many neurodiverse learners as well as refugee children and those for whom English is an additional language. Some of the pupils’ parents do not speak or read English. Classroom displays are designed for sharing information with as many pupils and parents as possible; therefore the written word is used minimally and images are used extensively in a structured and predictable way to help everyone to understand what is going on. d isplays include visual timetables which are changed each day. TEACCH principles underpin the approach and it is not just useful to disabled pupils. An emphasis on order and structure and multiple approaches to supporting and developing communication are also evident here. A circle of friends and buddy systems in which peers provide a support network can benefit learners who are socially isolated and create a co-operative atmosphere in class. It is important to be careful not to coerce people into false friendships. Remember too that peers may still be together at age 11 or 15, so the way the intervention is introduced might create difficulties further down the line. d o not say ‘Be very nice to Andrea. She is special because she is autistic and she has got no friends.’ Social stories (Gray 1994) were developed to help people understand their own feelings and those of others via personalised comic strip conversations. These could be utilised to help explore social situations and conventions from different perspectives. On a cautionary note, Reynhout and Carter (2006) questioned the extent to which skills learnt via social stories are maintained, as navigating social life is not achieved via acquiring a set of measurable competencies. An eclectic approach which is built on an understanding of the requirements of the individuals operating within an educational setting is likely to be more inclusive than the adoption of a set of techniques which may well not be right for everyone. A framework such as SPELL or REAL and the principles of Ud L act as a reminder to consider carefully everything we do as practitioners and to intervene with understanding and with a view to creating a learning environment in which everyone thrives and everyone belongs. Working with autistic children In working with autistic children, the key points to remember from this chapter are: • Good autism practice is good inclusive practice and an autism-friendly classroom can benefit everyone. Universal Design for Learning is a positive approach which 45 involves planning for inclusion from the beginning. 46 47 122 Nicki Martin and Damian Milton 2 • Interventions are often utilised in an eclectic manner and it is important to 3 intervene only with understanding and within a framework that fosters belonging 4 and well-being for all learners. 5 • Insights from people who are themselves on the autism spectrum are an essential 6 aid to understanding autism. 7 • Remember to respect the learning style of the individual – work with the autistic 8 child and not against their autism. 9 • Be mindful of individuality and that people change over time. (Families are 10 individual too.) 11 • Diagnosis is not necessarily a goal in itself, as it will not automatically lead to 12 services. 13 • Work out how the autistic person is processing information rather than making 14 assumptions. 15 • Stress can be very disabling – reduce input when people are over-stressed. 16 • Collaborate for consistency of approach. 17 • Utilise interests as an intrinsic part of the learning process. 18 • Avoid the deficit model of autism – think about what the child can do and how to 19 enable that to happen. References 24 APA (American Psychiatric Association) (2014) Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V). w ashington, d C: APA. Arnold, L. (2010) The medium is the message. Accessed at: www.ucl.ac.uk/cpjh/Arnold (22 November 2010). Attfield, I., Fowler, A. and Jones, V. (2012) Sensory Audit for School and Classroom. Autism Education Trust. Accessed at: www.aettraininghubs.org.uk/wp-content/uploads/2012/05/37.1-Sensory-audit- tool-for-environments.pdf (17 March 2017). Baron-Cohen, S. (2008) Autism and Asperger Syndrome: the facts. Oxford: Oxford University Press. Caldwell, P. (2014) The Anger Box: sensory turmoil and pain in autism. Hove: Pavilion Press. Grandin, T., 1986. Emergence, Labeled Autistic. Novato, CA: Academic Therapy Publications. Grandin, T. (1995) Thinking in Pictures. New y ork: Vintage. Gray, C., 1994. Comic Strip Conversations: illustrated interactions that teach conversation skills to students with autism and related disorders. Arlington, TX: Future Horizons. 37 Happe, F. (1994) Autism: an introduction to psychological theory. London: UCL Press. 38 Hastwell, J., Harding, J., Martin, N. and Baron-Cohen, S. (2013) Asperger Syndrome Student Project. 2009–12. Final Report, June. University of Cambridge d isability Resource Centre. Hobson, P. (2002). The Cradle of Thought: exploring the origins of thinking. London: Macmillan. Jordan, R. and Powell, S. (1990) Teaching autistic children to think more effectively. Communication, 24, pp. 20–23. Kenny, L., Hattersley, C., Molins, B., Buckley, C., Povey, C. and Pellicano, E. (2016) w hich terms should be used to describe autism? Perspectives from the UK autism community. Autism, 20(4), pp. 442–462. Lawson, w . (2010) The Passionate Mind: how people with autism learn. London: Jessica Kingsley. Maslow, A. (1954) Motivation and Personality. New y ork: Harper Collins. 47 Supporting inclusion of autistic children 123 Milton, d . (2012a) On the ontological status of autism: the ‘double empathy problem’. Disability and Society, Vol. 27(6), pp. 883–887. Milton, d . (2012b) So What Exactly is Autism? [resource linked to competency framework]. Autism Education Trust. Accessed at: http://www.aettraininghubs.org.uk/wp-content/uploads/2012/08/1_ So-what-exactly-is-autism.pdf (14 March 2017). Milton, D. (2014) So what exactly are autism interventions intervening with? Good Autism Practice, Vol. 15(2), pp. 6–14. Milton, d ., Martin, M. and Melham, P. (2016) Beyond reasonable adjustment: autistic-friendly spaces and Universal d esign. In d . Milton and N. Martin (eds), Autism and Intellectual Disabilities in Adults, Vol. 1. Hove: Pavilion, pp. 81–86. Murray, d . (1992) Attention tunnelling and autism. In P. Shattock and G. Linfoot (eds), Living with Autism: the individual, the family and the professional. d urham conference proceedings, pp. 183–193; 11 obtainable from Autism Research Unit, School of Health Sciences, The University of Sunderland, Sunderland SR2 7EE or the National Autistic Society. Murray, d ., Lesser, M. and Lawson, w . (2005) Attention, monotropism and the diagnostic criteria for autism. Autism, Vol. 9(2), pp. 136–156. National Autism Society (2016) About autism: strategies and approaches. Accessed at: www.autism. org.uk/about/strategies.aspx (17 March 2017). Reynhout, G. and Carter, M. (2006) Social Stories™ for children with disabilities. Journal of Autism and Developmental Disorders, Vol. 36(4), pp.445–469. Shah, A. and Frith, U. (1993) w hy do autistic individuals show superior performance on the block design task? Journal of Child Psychology and Psychiatry, Vol. 34(8), pp. 1351–1364. Tammet, d . (2006) Born on a Blue Day: Inside the mind of an autistic savant. New y ork: Free. Vermeulen, P., 2015. Context blindness in autism spectrum disorder: not using the forest to see the 22 trees as trees. Focus on Autism and Other Developmental Disabilities, Vol. 30(3), pp.182–192. w illiams, d . (1996) Autism: An inside-out approach. London: Jessica Kingsley. w ing, L., 1996. Autistic spectrum disorders. British Medical Journal, Vol. 312(7027), p. 327. w ing, L. and Gould, J. (1979) Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. Journal of Autism and Childhood Schizophrenia, Vol. 9, pp. 11–29. WHO (World Health Organization) (1992) The International Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines, 10th edition (ICD-10). Geneva: w HO. Children and Families Act 2014 https://councilfordisabledchildren.org.uk/sites/default/files/uploads/documents/import/Children AndFamiliesActBrief.pdf (accessed 17 March 2017). Equality Act 2010 https://www.gov.uk/guidance/equality-act-2010-guidance (accessed 14 March 2017). 38 Martin, N. (2008): REAL services to assist university students who have Asperger syndrome. NADP Technical Briefing 10/08. SEN Code of Practice (2015) https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/428744/SFR14-2015_ Main_Text.pdf (accessed 17 March 2017). http://integratedtreatmentservices.co.uk/our-approaches/speech-therapy-approaches/spell-framework/ (accessed 14 March 2017). 47 124 Nicki Martin and Damian Milton https://www.teacch.com/ (accessed 17 March 2017). www.pecs-unitedkingdom.com/ (accessed 17 March 2017). Tomlinson, J. (1996) Inclusive Learning: the Report of the Committee of Enquiry into the postschool education of those with learning difficulties and/or disabilities, in England. Accessed at: www.csie. org.uk/resources/tomlinson-96.pdf (14 March 2017). http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Supporting Inclusive Practice and Ensuring Opportunity is Equal for All Unpaywall

Supporting Inclusive Practice and Ensuring Opportunity is Equal for AllSupporting the inclusion of autistic children

Martin, Nicola; Milton, Damian
Unpaywall — Jul 6, 2017
Download PDF
15 pages

Loading next page...
 
/lp/unpaywall/supporting-inclusive-practice-and-ensuring-opportunity-is-equal-for-5Ckqf01Gmw

References

References for this paper are not available at this time. We will be adding them shortly, thank you for your patience.

DOI
10.4324/9781315561325-9
Publisher site
See Chapter on Publisher Site

Abstract

Kent Academic Repository Martin, Nicola and Milton, Damian (2017) Supporting the inclusion of autistic children. In: Knowles, Gianna, ed. Supporting Inclusive Practice and Ensuring Opportunity Is Equal for All. Routledge, London, UK, pp. 111-124. ISBN 978-1-138-67438-7. Downloaded from https://kar.kent.ac.uk/62644/ The University of Kent's Academic Repository KAR The version of record is available from https://www.routledge.com/Supporting-Inclusive-Practice-and-Ensuring-Opportunity-is-Equal-for-All/Knowles/p/book/9781138674387 This document version Pre-print DOI for this version Licence for this version CC BY (Attribution) Additional information Versions of research works Versions of Record If this version is the version of record, it is the same as the published version available on the publisher's web site. Cite as the published version. Author Accepted Manuscripts If this document is identified as the Author Accepted Manuscript it is the version after peer review but before type setting, copy editing or publisher branding. Cite as Surname, Initial. (Year) 'Title of article'. To be published in Title of Journal , Volume and issue numbers [peer-reviewed accepted version]. Available at: DOI or URL (Accessed: date). Enquiries If you have questions about this document contact [email protected]. Please include the URL of the record in KAR. If you believe that your, or a third party's rights have been compromised through this document please see our Take Down policy (available from https://www.kent.ac.uk/guides/kar-the-kent-academic-repository#policies). Chapter 8 Supporting the inclusion of autistic children Nicki Mar tin and Damian Milton This chapter explores: 13 • What is the autism spectrum? 15 • How autism is about a different way of thinking 16 • Autism and sensory processing and stress and anxiety 17 • Autism, social interaction and the Theory of Mind 18 • Autism, communication and language 19 • Managing transitions for autistic children 20 • Strategies to support the inclusion of autistic children 21 This chapter aims to reflect that autism is a spectrum condition, that every individual is 23 different and that people change over time. Authentic views of people on the spectrum and 24 their families underpin discussion of autism theory and its relationship to practice. w hile the 25 focus is on education (at any age), good practice recommendations embedded in this chapter 26 apply in other contexts and could also help to foster inclusive practice for people without an 27 autism diagnosis. 28 Autism is usually identified by observational forms of diagnosis involving the child and the 29 family. Girls are often diagnosed later than boys and the spectrum is wide, encompassing 30 nonverbal people, with and without additional learning disabilities, as well as highly successful 31 employed graduates. As children grow into adults, characteristics associated with autism 32 may become less obvious and support requirements will change. Identification of autism in 33 adulthood is becoming more common, although the issue of who pays is contentious and post- 34 diagnostic support is usually minimal. Principles associated with good autism practice will be 35 relevant across the lifespan. 36 This chapter aims to foster an empathic understanding of what it might be like to be 37 autistic with a view to helping practitioners to create autism-friendly learning environments. 38 Autistic people and their families are increasingly present in all forms of media and this is a 39 bit of a mixed blessing. Scare stories about what might cause autism gained prominence 40 around the MMR vaccination debate and the consequences have been problematic (not least 41 because of the rise of measles, due to the decrease in vaccinations). Contrary to what the 42 papers say, there isn’t an autism epidemic. However, the number of people being identified 43 as being on the autism spectrum is increasing, primarily because of a changing recognition 44 of what autism is and what it means to be autistic. Once thought to be a rare condition, the 45 definition of autism was widened by the introduction of the notion of the ‘autism spectrum’ 46 (w ing and Gould 1979). Estimating the numbers of autistic people within society is thus not 47 112 Nicki Martin and Damian Milton 1 an easy task, yet a figure of more than one in a hundred is cited by the National Autistic 2 Society (UK’s leading autism charity). As public awareness is increasing and while access to diagnosis in adulthood is patchy at best, many older people have identified with what they have heard or seen, or googled informally, and have ‘self-diagnosed’. Historical under-identification of girls and women (who are thought often to present more subtly than males on the spectrum) appears to be being rectified to an extent. Family life often revolves around the requirements of the autistic child or children and families may need practical non-judgemental backup from a range of services. Practitioners are also reminded that parents are in it for the long haul, while teachers and other professionals are just passing through. The Children and Families Act (CFA) (2014) was conceived with the aim of joining up access to health, social care and education services for young people up to the age of 25 identified with Special Educational Needs and Disabilities (SEND). Only those with the most complex requirements access a full Educational Health and Care Plan (EHCP). Usually additional intellectual impairment as well as autism would be the trigger, but schools and colleges do have responsibility for pupils and students who do not reach the EHCP threshold and still need help. Transitions are notoriously problematic for people on the spectrum, so the extension to age 25 is good news. Although progress to further education and employment is specified, this rather implies that university has not been considered as a possible option, even though the number of students with autism in higher education is on the increase. Pupil and parental engagement are central to the principles which underpin the CFA. Practical means by which all autistic children and young people can make their views known need to be found, including those who communicate unconventionally for adults. The Autism Act 2009 and the Adult Autism Strategy (2010), similarly aim to take a more joined-up view of support. Access to w ork funding exists to help with employment and the d isabled Student Allowance is still in place in higher education. However, at the time of writing, all disability benefits are under threat, graduates with autism are frequently unemployed, and the Autism Act and Adult Autism Strategy have not necessarily had the impact that was anticipated. People on the spectrum are increasingly advocating for themselves and organising, often via the Internet. Research informed by the principle ‘nothing about us without us’ enables policy makers to flex their empathy muscles a little bit and see the world through the eyes of autistic people. w e also have the 2010 Equality Act – lest we forget. Traditionally, the education of autistic people has been dominated by behavioural and cognitive approaches, some of which have been criticised, particularly by autistic authors (Milton 2014). A recent increase is apparent in strategies based on relational or developmental concerns and focusing more on working with identifying requirements arising from autistic learning styles, rather than attempting to remediate perceived skills deficits. Some of these approaches are reviewed here. The authors emphasise an inclusive, person-centred ethos and urge readers to keep individuality in mind. If you have met one autistic person or child, you have met one autistic person, or child. A recent study in the preferred use of language by various stakeholders within the wider autism community found that autistic people generally had a preference for identity-first language, whilst parents and professionals tended to like being ‘on the spectrum’ (Kenny et al. 2015). Both terms are used here and the unpopular words (‘deficit’ and ‘disorder’) are avoided, unless directly quoted. 47 Supporting inclusion of autistic children 113 What is the autism spectrum? Autism is clinically defined as a neuro-developmental disorder, signified by deficits in social interaction and communication, coupled with the presence of repetitive behaviours and adherence to routines (WHO 1992; APA 2014). Some autistic people have significant learning disabilities. A ‘spiky profile’ is usual, with some showing significant areas of interest and ability and other areas of difficulty. Widening diagnostic criteria has led to an ever-growing number of verbally articulate people being diagnosed. In recent decades, a welcome rise of autistic writers, scholars and self-advocacy groups has led to informed critique of traditional notions of autism and what it means to be autistic. A different way of thinking Central to the majority of accounts of autism are descriptions of autistic cognition, in particular, explanations for the repetitive behaviours and routines which form part of the diagnostic criteria. A number of theoretical models have been devised in order to try and explain such observed patterns, the most significant being theories regarding executive functioning, a weak drive toward central coherence, and monotropism (Baron-Cohen 2008; Milton 2012b). The term ‘executive functioning’ is used by psychologists when referring to the employ- ment of planning or problem-solving abilities in order to attain a goal. Autistic people are often thought to have difficulties with executive function, as well as in switching attention between tasks. However, within areas of interest and strength, many are able to show skills associated with executive functioning, suggesting that differences exist in the way autistic executive processing operates. Happe (1994) theorised that executive functioning did not adequately explain areas of strength found within the autistic cognitive profile, such as an eye for detail, as evidenced by higher than average performance on tasks such the block design task (Shah and Frith 1993). Differences are not necessarily deficits and the use of the expression ‘executive function deficit’ as a catch-all has been criticised by autistic scholars who reject the deficit model. A weak drive toward central coherence was highlighted by Happe (1994) and associated with difficulties processing overall contextual meanings, whilst simultaneously having strengths in processing aspects or details within an overall context, something Vermeulen (2015) refers to as ‘context blindness’. However, many autistic people can demonstrate that they process gist meanings and conceptual abstractions, so the notion of ‘a weak drive to central coherence’ is not always applicable. Autistic scholars such as d inah Murray, Mike Lesser and w enn Lawson developed the term ‘monotropism’ to describe a different way of looking at autistic cognition and processing (Murray 1992; Lesser and Murray 1998; Murray et al. 2005; Lawson 2010). Monotropism is characterised by atypical distribution of attention and interest. Accordingly, the amount of attention available to a child or adult is limited and differing cognitive processes compete for this scarce resource. Murray and colleagues (2005) suggest that many autistic people prefer to concentrate attention on a small number of interests. Social interaction, language use and shifting attention are all tasks that require the broad use of attention and interest and challenge many people on the spec- trum: ‘We suggest that the uneven skills profile in autism depends on which interests have been fired into monotropic superdrive and which have been left unstimulated by any felt experience’ (Murray et al. 2005: 143). 47 114 Nicki Martin and Damian Milton 1 The ‘spiky profile’ is a term frequently associated with autistic people and reflects a 2 strikingly uneven pattern. Higher levels of ability and confidence are often associated with 3 areas of special interest which is hardly surprising because of the tendency to focus on these 4 in depth (Kenny et al. 2015), and autistic scholars caution against terms like ‘low’ or ‘high’ 5 functioning, as their use does not reflect the ‘spiky profile’. Such a label can result in the 6 needs of more verbal autistic people and the strengths of those who are less verbal going 7 unrecognised, highlighting again the need to communicate with autistic individuals on their 8 terms. w hilst specialist interests are very common across the spectrum, it is a myth to think 9 that ‘savant skills’ are common or only found amongst autistic people (Arnold 2012). Grandin 10 argues that autistic interests and ways of thinking can be utilised as the basis of employment 11 and meaningful occupation. Utilising a child’s interests within a learning environment can 12 also be highly motivating and calming as well as a source of joy. Scenario 1: Michael Michael is 9 years old and he loves everything about Lego. He likes building with it, sorting it, counting it, drawing it and even writing stories about his Lego people. He has a teacher who thinks he should be interested in things that are not Lego. His mum and dad and his little sister think Lego is just fine. They are impressed by Michael’s ability to create with Lego. Lego is Michael’s main interest. His teacher has a plan. If he completes the work she sets him, although he finds it tedious and unmotivating and for what feels to Michael like large amounts of time, then he can play with a Lego man for five minutes. However, she has decided he cannot take a Lego man into assembly because 28 if Michael did this, everyone else would want to. Michael does not like the teacher’s plan and his mum did not appreciate Lego being described as an ‘obsession’ in the Annual Review. Michael was very happy to get Lego from everyone in the family for his birthday. Working with a child’s interest From what we have already learnt about autism, it is clear from this scenario that Michael’s teacher is struggling to understand that she needs to communicate with Michael on his terms about his interest in Lego. A more supportive and inclusive approach for Michael would involve the teacher using Michael’s interest in Lego to motivate and support him in undertaking the learning and other school activities she has planned for him. Many children find going in to a large assembly hall with lots of other children and adults intimidating, noisy and overwhelming. Failing to understand what Michael, in particular, needs to support him through situations he finds challenging will cause Michael upset. It may also make the teacher feel frustrated that she is seen as being 47 Supporting inclusion of autistic children 115 unable to ‘manage’ the situation. By understanding that Michael’s behaviour is not an 2 act of defiance against the teacher, and perhaps through seeking advice, she will find 3 more appropriate ways of supporting Michael. As the National Autistic Society says, 4 what autistic children need is ‘effective supporters will be endowed with the personal 5 attributes of calmness, predictability and good humour, empathy and an analytical 6 disposition’ (NAS 2016). 7 Sensory processing Sensory sensitivities have been reported by autistic people for many years (Grandin 1986). However the inclusion of sensory processing differences into diagnostic criteria occurred for the first time in the most recent edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) (APA 2014) has been controversial, because sometimes non-autistic people have sensory issues too. Experiences of sensory processing can vary greatly between differing accounts by autistic people, with both ‘hyper’ and ‘hypo’ (or under) sensitivity to sensory stimuli. Sensory responses vary between individuals and may be context specific. Sensory fragmentation or a difficulty in integrating incoming sensory information, is commonly described by autistic people, with some reporting ‘synaesthesia’ and sensory information becoming entangled (Tammet 2006). The more obvious sensory modalities are sound, sight, smell, touch and taste, but things like perception of one’s own body position and balance and interpreting feelings of pain or temperature, difficulty with coordination and motor-planning may also pose challenges. There is a high incidence of dyspraxia amongst the autistic population. Struggling to process incoming sensory information can lead to overload, affecting levels of stress and potentially creating anxiety. A general low-arousal approach can be effective, as can sensory aides such as noise-cancelling headphones (Caldwell 2015). There is no credible evidence for the effectiveness of techniques looking to ‘desensitise’ autistic people. It is also worth remem- bering that heightened sensory experiences can be a source of fun for some. It is necessary to understand what is going on for the individual, a ‘one size fits all’ approach will not do. Scenario 2: Michael Michael’s teacher has taken his Lego away. He is now 10 years old and Lego is still his main interest. Michael is in the playground and everyone is running about. It is really hot and sunny, and the sunlight is reflecting off the shiny surface of the fence. Another boy is scraping a stick along the railings. Three children are swerving close to Michael playing aeroplanes. Nobody invites him to join in and he has his hands over his ears and his hood up, even though it is hot. He is not very happy and is just trying to keep out of the way. Michael puts his hand in his pocket and – oh joy! – Lego man is there. He sits on a bench in a quiet place and holds Lego man close to his face and wobbles him by his eye. That feels better. Michael’s Teaching Assistant comes up to him and takes Lego man away because he’s not supposed to have Lego in the playground. She says he can have him back at the end of the day if he ‘joins in nicely for the rest of playtime’. 47 116 Nicki Martin and Damian Milton 1 A number of sensory audit tools have been produced, some with input from autistic people 2 (Attfield et al. 2012). It’s worth looking at some of these resources. It would also be helpful 3 to try and empathise with the experience of someone who has sensory sensitivities when 4 trying to design learning environments. Learning environments and sensory stimulation Look around the setting in which you work. Is it: • Noisy, crowded, chaotic and extremely visually stimulating? • Are people racing about? • Is it unpredictable? • Would it be helpful to create some more tranquil ordered and predictable spaces? • Who might benefit? • Is this just an ‘autism thing’ or might it help others too? Research ways in which learning environments can be designed to support children 21 who can find them noisy and overwhelming places. Stress and anxiety ‘Everyday experiences’ can become highly stressful and anxiety-raising for some autistic people, whose senses become overwhelmed in their struggle to deal with an excess of information. Emotionally meaningful information may make overload more likely. The result can be a response often described as a ‘meltdown’, which presents as a sort of emotional outburst. An autistic child or adult may also react by ‘shutting down’ and being under- responsive while focusing attention on whatever is causing them stress, at the expense of being able to process more general information. Panic attacks are not uncommon. w hen an individual is in a state of ongoing chronic stress, it does not take much to ‘tip them over the edge’, and so autistic people are often already managing extremely well with high levels of stress and anxiety before additional demands on their attention are added. w hen meltdown, shutdowns and panic attacks appear to have no apparent environmental antecedent, it’s worth exploring whether the autistic child or adult has experienced a build-up of stressful events before the ‘presenting incident’. The term ‘challenging behaviour’ can be very unhelpful when applied to autistic people, especially when there may be a lack of understanding and respect for why an autistic child or adult may need to be acting in the way that they are. A low-arousal approach is often effective as a means of reducing potential stressors and overload. However, low arousal does not mean ‘no arousal’, as some sensory experiences can be fun and conducive to learning. A calm empathic approach is vital, both to reduce the 44 risk of meltdown or shutdown and when intervening. Identifying and reducing external 45 stressors is an appropriate response if a meltdown or shutdown has occurred and, ideally, to 46 avoid them happening in the first place. These factors will be particular to the individual and 47 may well involve the behaviour of other people. An attempt to engage with something Supporting inclusion of autistic children 117 predictable and comforting to the autistic child or adult can be helpful once calm has been 1 restored. Intervening without understanding in an authoritarian way when someone is already 2 agitated is unethical and likely to be ineffective. An opportunity to reflect on an incident may 3 be possible when the autistic child or adult is calm, but will not be helpful otherwise. 4 Social interaction The idea of Theory of Mind (ToM) attempts to theorise and explain the difficulties autistic 8 people experience around interacting socially with others. ToM is explained in terms of 9 the ability to empathise with other people and imagine what they might be thinking and 10 feeling, in order to comprehend and predict their actions. w ing (1996) suggested that autistic 11 people have impaired ‘social imagination’ (linked to aforementioned ‘context blindness’). 12 For Hobson (2002), ToM forms the basis of symbolic thought and the development of 13 imagination. 14 Milton (2012a) poses an alternative argument which suggests that rather than seeing the 15 breakdown in interaction between autistic and non-autistic people as solely located in 16 the mind of the autistic child or adult, a ‘double empathy problem’ exists between the two 17 parties, largely due to the differing perspectives of those attempting to interact with one 18 another. Drawing upon the sociological theories of Erving Goffman and Harold Garfinkel, 19 Milton (2012a) suggests that the social subtext of a social situation is never a given, but 20 negotiated in practice in the interactions between people. w hen people of widely differing 21 dispositions (both biologically and culturally) interact, both will have a difficulty in under- 22 standing the other. This theory is particularly pertinent when considering the teaching 23 of social skills and social rules in explicit ways. As much social life is understood tacitly, 24 mutual understanding and rapport needs to be built, rather than simply imposing a normative 25 interpretation of social contexts and interactions onto autistic people (Milton 2014). 26 As w illiams has written: 27 I had virtually no socially shared nor consciously, intentionally expressed, personhood 29 beyond this performance of a non-autistic ‘normality’ with which I had neither compre- 30 hension, connection, nor identification. This disconnected constructed facade was 31 accepted by the world around me when my true and connected self was not. Each 32 spoonful of its acceptance was a shovel full of dirt on the coffin in which my real self 33 was being buried alive . . . . 34 (w illiams 1996, p.243) 35 Given differences in ways of processing information, various social contexts can become 37 very tricky to navigate, even without additional communication difficulties or learning 38 disabilities. Gaining mutual rapport and a flow within social interaction is not the sole 39 responsibility of one child or adult. Empathy is a two-way street and it would be very helpful 40 if people tried to see things from the perspective of the autistic child or adult. Rather than 41 interpreting autistic people as being overly ‘rigid’ in their manner and pursuit of interests, 42 such tendencies could be understood as providing predictability and stability in an otherwise 43 chaotic and fragmented experience. w hen considering the need for predictability, unfor- 44 tunately other children and adults can be very unpredictable and can increase stress and 45 anxiety. Gentle and structured play may help build interactions between autistic pupils 46 and their peers. Rather than assuming that the autism creates a number of problems in need 47 118 Nicki Martin and Damian Milton 1 of fixing, a child-centred pedagogy could be focused on helping the autistic child to gain 2 recognition of themselves and their own capacities. At any age, working with the autistic child or adult and not against their autism, is more likely to be productive and is undoubtedly more humane. Communication and language Building communication is a two-way process, involving shifting relationships, tacit under- standing, and changing social environments. Given different ways of thinking and processing sensory information, it is little wonder that many autistic people struggle with aspects of communication, including the assumed need for making eye contact, or conversational turn- taking. Jordan and Powell (1990) argue that superficially ‘good’ language skills can mask more subtle difficulties in communication. Visual communication aides can help some individuals but not every autistic child or adult learns well from visual materials, particularly those which are symbolic and abstract in nature. In an educational context, it is easy to become overly reliant on one system of communication which may not suit everybody. The Picture Exchange Communication System (PECS) could help some learners in the educational setting while others do not relate to it well. Pupils can grow out of PECS and settings may well be slow to phase the approach out once it has become redundant. It is possible to overload an autistic child or adult by trying out too many communication systems at one time. Conversely, visual reference points may also provide aids to comprehension for learners who are not on the autism spectrum, so their use in an educational setting may be appropriate within a broader framework of universal design for learning. w hen PECS goes wrong. it is usually because the setting is slow to adapt and insists on continuing with the symbols after they have ceased to be useful to the individual. For example, in the case where a teacher stated: ‘Gerry dragged me by the hand to the fridge, opened it and pointed at the juice. I insisted that he go back to the board and fetch his PECS symbol, and then I gave him the drink as a reward’, it is clear that the teacher was missing the fact that the child had moved on, and no longer needed the PECS symbol to make his wishes known. Transitions large and small Transitions between activities can be stressful, especially if they are poorly managed. Big transitions, such as moving from one phase of education to another, or navigating a parental divorce, can be extremely anxiety provoking. Sharing information between educa- tional establishments requires co-operation and ensuring that an approach which is suitable for the individual is employed. Visual references may be included in a transition passport document, for example, which may record interests and favoured activities, likes and dis- likes, strengths and difficulties. Leaving school may be a time when a young person decides to leave their autism diagnosis behind them and confidentiality must be respected if this is the decision that has been made. 47 Supporting inclusion of autistic children 119 Scenario 3: Michael Michael is now 16 and is going to an open day at the local sixth form college where he hopes to take A levels. There is an ‘ice-breaking exercise’ in a large hall with over a hundred other students and five members of staff. For about the first five minutes, everyone has to stand in a circle and throw a ball to someone and say 7 their own name – this seems like half an hour to Michael. After that, they have to throw the same ball and say the name of the person they are throwing the ball to (except if this is the third throw or the last person had a ‘b’ in their name or a ponytail). If any of these conditions apply, they have to stand on one leg, but it’s not clear why or how the ball starts being thrown about again. It’s quite a heavy, fast- moving ball which some people throw quite hard, but it is required that everyone joins in even if it is a very unpleasant experience. Some people are laughing and that’s a bit confusing. This does not seem to have anything to do with A-level choices and it is not clear how long the activity will last. Michael hopes he will never have to do this again. He has prepared a list of questions to ask a member of staff, but doesn’t know who to ask or indeed which people are staff. It’s very hot. Suddenly, the game is stopped 20 by someone who blows a whistle really loud and says ‘Right, take twenty minutes, and then make your way to the other building to meet and greet the staff and iron out any outstanding issues.’ Michael walks out and realises he did not know what time he was supposed to go to the other building, or where it was, or what he was supposed to do. He thought there were at least three other buildings. Michael went into the toilet and locked himself in a cubicle to think. Removing barriers to participation In any social situation there will be autistic children and adults. The college did not need to be told that Michael, who is autistic, would be visiting them on their open day to consider how they might organise the day to meet a range of young peoples’ needs. For all the young people who attended the open day and enjoyed the activities they participated in, there will have been a significant number, autistic or not, who would have found the ice-breaker activity challenging. Society is becoming increasingly aware that children and adults respond to social situations in a range of ways and therefore must be provided with a range of ways which allow access to and participation in social situations. In order to support Michael and other attendees at the open day the college might have: • Provided ‘ambassadors’ to meet attendees and explain the different events scheduled for the day 47 120 Nicki Martin and Damian Milton 2 • The information could have been more explicit, with a timetable of activities and 3 information about where to go for advice on the different courses the college 4 offers 5 • Quiet places to go to, and 6 • Specific people to contact who can answer particular enquiries Universal Design for Inclusive Learning Intervening with understanding has been emphasised within this chapter. Inclusive practice is about including everyone and fostering a sense of belonging and community. It is not about treating all learners the same, but it is about equality of opportunity. Some autism-focused interventions will be discussed briefly here, but these also have the potential to reduce barriers for other learners within a framework of Universal d esign for Learning (Ud L) (Milton et al. 2016) Autism-focused examples of UDL A useful distinction can be made between interventions and overarching frameworks. Rigid adherence to a specific intervention may not meet the diverse requirements of all the learners in a given setting and, in practice; a fairly eclectic approach is common. Ud L is a framework, as are approaches such as SPELL and REAL, which seek to provide a set of principles rather than a box of tools. REAL principles (Reliability, Empathy, Anticipation and Logic) can help things to run smoothly for everyone (Hastwell et al. 2013). No one thrives in chaos, and reliability fosters a sense of security. Seeing the world through the eyes of the learners will enable practitioners to anticipate what is likely to work well and situations which should be avoided, such as unpredictable changes. Logical communication increases understanding and feelings of safety. Techniques, such as the use of visual timetables could enhance clarity. REAL owes much to Maslow’s hierarchy of needs (1954), and is based on the same assumption that learning is only possible if learners feel a sense of safety and belonging. The National Autistic Society describes the SPELL approach, which is similar to REAL. SPELL stands for Structure, Positive (approaches and expectations), Empathy, Low arousal, and Links. Knowing the usual order of events in a day increases predictability and makes it easier to be more flexible within a framework. Positive expectations are based on an empathic understanding of the learner and building on natural strengths and interests enhances motivation. Utilizing in-depth interests within the curriculum, rather than as add-on motivators, contributes to the creation of a positive atmosphere. Understanding is checked constantly within SPELL and links between learning experiences are made explicit rather than implied. Calm and order are essential components of an anxiety-reducing situation and attention should be paid to the potential for sensory overload. Noise, busy colourful displays, bright lights, strong smells and general clutter can be distracting and aversive. The SPELL framework is complementary to other approaches, including REAL and TEACCH (Treatment and Education of Autistic and related Communication Handicapped Children.). A TEACCH classroom would include visual approaches to routine, as well as areas for quiet focus, rather than having every wall covered in bright displays. The Picture 47 Supporting inclusion of autistic children 121 Exchange Communication System (PECS) can be usefully incorporated into a TEACCH 1 classroom. Visual timetables to make routines predictable, and other visual prompts, can help 2 autistic pupils and, for example, some for whom English is an additional language. 3 What does Universal Design in a mainstream classroom look like? The setting is a mainstream classroom which includes many neurodiverse learners as well as refugee children and those for whom English is an additional language. Some of the pupils’ parents do not speak or read English. Classroom displays are designed for sharing information with as many pupils and parents as possible; therefore the written word is used minimally and images are used extensively in a structured and predictable way to help everyone to understand what is going on. d isplays include visual timetables which are changed each day. TEACCH principles underpin the approach and it is not just useful to disabled pupils. An emphasis on order and structure and multiple approaches to supporting and developing communication are also evident here. A circle of friends and buddy systems in which peers provide a support network can benefit learners who are socially isolated and create a co-operative atmosphere in class. It is important to be careful not to coerce people into false friendships. Remember too that peers may still be together at age 11 or 15, so the way the intervention is introduced might create difficulties further down the line. d o not say ‘Be very nice to Andrea. She is special because she is autistic and she has got no friends.’ Social stories (Gray 1994) were developed to help people understand their own feelings and those of others via personalised comic strip conversations. These could be utilised to help explore social situations and conventions from different perspectives. On a cautionary note, Reynhout and Carter (2006) questioned the extent to which skills learnt via social stories are maintained, as navigating social life is not achieved via acquiring a set of measurable competencies. An eclectic approach which is built on an understanding of the requirements of the individuals operating within an educational setting is likely to be more inclusive than the adoption of a set of techniques which may well not be right for everyone. A framework such as SPELL or REAL and the principles of Ud L act as a reminder to consider carefully everything we do as practitioners and to intervene with understanding and with a view to creating a learning environment in which everyone thrives and everyone belongs. Working with autistic children In working with autistic children, the key points to remember from this chapter are: • Good autism practice is good inclusive practice and an autism-friendly classroom can benefit everyone. Universal Design for Learning is a positive approach which 45 involves planning for inclusion from the beginning. 46 47 122 Nicki Martin and Damian Milton 2 • Interventions are often utilised in an eclectic manner and it is important to 3 intervene only with understanding and within a framework that fosters belonging 4 and well-being for all learners. 5 • Insights from people who are themselves on the autism spectrum are an essential 6 aid to understanding autism. 7 • Remember to respect the learning style of the individual – work with the autistic 8 child and not against their autism. 9 • Be mindful of individuality and that people change over time. (Families are 10 individual too.) 11 • Diagnosis is not necessarily a goal in itself, as it will not automatically lead to 12 services. 13 • Work out how the autistic person is processing information rather than making 14 assumptions. 15 • Stress can be very disabling – reduce input when people are over-stressed. 16 • Collaborate for consistency of approach. 17 • Utilise interests as an intrinsic part of the learning process. 18 • Avoid the deficit model of autism – think about what the child can do and how to 19 enable that to happen. References 24 APA (American Psychiatric Association) (2014) Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V). w ashington, d C: APA. Arnold, L. (2010) The medium is the message. Accessed at: www.ucl.ac.uk/cpjh/Arnold (22 November 2010). Attfield, I., Fowler, A. and Jones, V. (2012) Sensory Audit for School and Classroom. Autism Education Trust. Accessed at: www.aettraininghubs.org.uk/wp-content/uploads/2012/05/37.1-Sensory-audit- tool-for-environments.pdf (17 March 2017). Baron-Cohen, S. (2008) Autism and Asperger Syndrome: the facts. Oxford: Oxford University Press. Caldwell, P. (2014) The Anger Box: sensory turmoil and pain in autism. Hove: Pavilion Press. Grandin, T., 1986. Emergence, Labeled Autistic. Novato, CA: Academic Therapy Publications. Grandin, T. (1995) Thinking in Pictures. New y ork: Vintage. Gray, C., 1994. Comic Strip Conversations: illustrated interactions that teach conversation skills to students with autism and related disorders. Arlington, TX: Future Horizons. 37 Happe, F. (1994) Autism: an introduction to psychological theory. London: UCL Press. 38 Hastwell, J., Harding, J., Martin, N. and Baron-Cohen, S. (2013) Asperger Syndrome Student Project. 2009–12. Final Report, June. University of Cambridge d isability Resource Centre. Hobson, P. (2002). The Cradle of Thought: exploring the origins of thinking. London: Macmillan. Jordan, R. and Powell, S. (1990) Teaching autistic children to think more effectively. Communication, 24, pp. 20–23. Kenny, L., Hattersley, C., Molins, B., Buckley, C., Povey, C. and Pellicano, E. (2016) w hich terms should be used to describe autism? Perspectives from the UK autism community. Autism, 20(4), pp. 442–462. Lawson, w . (2010) The Passionate Mind: how people with autism learn. London: Jessica Kingsley. Maslow, A. (1954) Motivation and Personality. New y ork: Harper Collins. 47 Supporting inclusion of autistic children 123 Milton, d . (2012a) On the ontological status of autism: the ‘double empathy problem’. Disability and Society, Vol. 27(6), pp. 883–887. Milton, d . (2012b) So What Exactly is Autism? [resource linked to competency framework]. Autism Education Trust. Accessed at: http://www.aettraininghubs.org.uk/wp-content/uploads/2012/08/1_ So-what-exactly-is-autism.pdf (14 March 2017). Milton, D. (2014) So what exactly are autism interventions intervening with? Good Autism Practice, Vol. 15(2), pp. 6–14. Milton, d ., Martin, M. and Melham, P. (2016) Beyond reasonable adjustment: autistic-friendly spaces and Universal d esign. In d . Milton and N. Martin (eds), Autism and Intellectual Disabilities in Adults, Vol. 1. Hove: Pavilion, pp. 81–86. Murray, d . (1992) Attention tunnelling and autism. In P. Shattock and G. Linfoot (eds), Living with Autism: the individual, the family and the professional. d urham conference proceedings, pp. 183–193; 11 obtainable from Autism Research Unit, School of Health Sciences, The University of Sunderland, Sunderland SR2 7EE or the National Autistic Society. Murray, d ., Lesser, M. and Lawson, w . (2005) Attention, monotropism and the diagnostic criteria for autism. Autism, Vol. 9(2), pp. 136–156. National Autism Society (2016) About autism: strategies and approaches. Accessed at: www.autism. org.uk/about/strategies.aspx (17 March 2017). Reynhout, G. and Carter, M. (2006) Social Stories™ for children with disabilities. Journal of Autism and Developmental Disorders, Vol. 36(4), pp.445–469. Shah, A. and Frith, U. (1993) w hy do autistic individuals show superior performance on the block design task? Journal of Child Psychology and Psychiatry, Vol. 34(8), pp. 1351–1364. Tammet, d . (2006) Born on a Blue Day: Inside the mind of an autistic savant. New y ork: Free. Vermeulen, P., 2015. Context blindness in autism spectrum disorder: not using the forest to see the 22 trees as trees. Focus on Autism and Other Developmental Disabilities, Vol. 30(3), pp.182–192. w illiams, d . (1996) Autism: An inside-out approach. London: Jessica Kingsley. w ing, L., 1996. Autistic spectrum disorders. British Medical Journal, Vol. 312(7027), p. 327. w ing, L. and Gould, J. (1979) Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. Journal of Autism and Childhood Schizophrenia, Vol. 9, pp. 11–29. WHO (World Health Organization) (1992) The International Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines, 10th edition (ICD-10). Geneva: w HO. Children and Families Act 2014 https://councilfordisabledchildren.org.uk/sites/default/files/uploads/documents/import/Children AndFamiliesActBrief.pdf (accessed 17 March 2017). Equality Act 2010 https://www.gov.uk/guidance/equality-act-2010-guidance (accessed 14 March 2017). 38 Martin, N. (2008): REAL services to assist university students who have Asperger syndrome. NADP Technical Briefing 10/08. SEN Code of Practice (2015) https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/428744/SFR14-2015_ Main_Text.pdf (accessed 17 March 2017). http://integratedtreatmentservices.co.uk/our-approaches/speech-therapy-approaches/spell-framework/ (accessed 14 March 2017). 47 124 Nicki Martin and Damian Milton https://www.teacch.com/ (accessed 17 March 2017). www.pecs-unitedkingdom.com/ (accessed 17 March 2017). Tomlinson, J. (1996) Inclusive Learning: the Report of the Committee of Enquiry into the postschool education of those with learning difficulties and/or disabilities, in England. Accessed at: www.csie. org.uk/resources/tomlinson-96.pdf (14 March 2017).

Published: Jul 6, 2017

There are no references for this article.