Understanding autism

As World Autism Awareness Week commences (2-8 April), a study at Great Ormond Street Hospital encourages an autism-friendly environment at a crucial transition stage for children: secondary school…

Awareness and support

“In simple terms, our world is unnecessarily complicated when it comes to children with autism. But with increased awareness, our world could be a lot more autism friendly.”

Marianna Murin is a clinical psychologist who has been working on an autism project for the past three years, funded by Great Ormond Street Children’s Charity. Together with project lead, Professor David Skuse, Marianna’s work focusses on better support for young people with autism.

“There is an increasing interest in theories suggesting that the autism spectrum conditions are naturally occurring cognitive variations,” says Marianna. “People with Autism Spectrum Disorders (ASD) have contributed significantly to advances in science, technology or art throughout history due to their unique thinking styles, so ensuring that children with ASD are well understood and supported is therefore paramount for enabling their potential to develop fully.

“There’s been much research into the causes and the possibility of curing autism, but if you look at what the parents and people with ASD actually are looking for and need is more research into how we can lead more fulfilling lives and with autism.” 

When it comes to support and advice on the subject, it’s a bit of a minefield. Indeed, if you Google ‘autism advice’, you’ll bring up literally millions of pages on the subject and for a parent, teacher or a child with autism, this can be disorientating, intimidating and frustrating. 

The idea behind the study is to bring everything together and provide clear guidance.

Support when children need it most

“The main focus of our work has been supporting children with ASD in mainstream education, especially during the transition from primary to a secondary school,” says Marianna. 

“Children with ASD are eight times more likely to be permanently excluded from school than neuro-typical pupils. As a clinician of more than 15 years I consistently had referrals from children who were coming to the age of ten and the parents were consistently saying how anxious they were of their children coping in the environment of a secondary school.” 

While the transition to secondary school can be a major step for all children, for pupils with ASD it poses even more of a challenge.

“Children with ASD may have difficulties with predicting and adapting to new situations,” says Marianna. “Although a child may appear to be coping well initially, it is important to be aware that accumulated frustration can often lead to significant problems, such as behavioral difficulties, school avoidance, social isolation or academic underachievement.

“We studied children prior to transition, after transition and one term after that and we monitored the overall difficulties in different areas including difficulties with adjusting, social interaction, communication, organisation, bullying, anxiety or behaviour. Based on the findings from the first part of the study, we developed a ‘manualised intervention package’, which is designed to be individualised for each pupil based on their unique sets of difficulties and strengths.”

Marianna continues: “The key idea of this intervention package – this manual – is based on enabling teachers to deliver specifically tailored support for each pupil, rather than a ‘one size fits all’ approach, which doesn’t work so well for children with ASD. 

“The results have been very positive, with pupils who were involved in the intervention sample doing significantly better; their overall degree of difficulties was rated as significantly lower by teachers. 

Practical help

Due to the success of this study, Autism Spectrum Disorder and the Transition into Secondary School is now available for school professionals and parents and it also includes a workbook for children. 

“It’s very comprehensive and covers a wide range of difficulties commonly associated with ASD. However, for each child, only specific sections will apply, based on their support needs. The purpose of the manual is to be as user friendly as possible for busy school professionals, who in our experience, often have to go out of their way and with minimal specialist training in ASD, prepare their own support strategies, often in their own personal time.”

The intervention package pulls together best evidence-based strategies and it’s full of practical advice to help young people in the potentially high-stress environment of secondary school.

“When you have autism, something seemingly small like changing classrooms for different lessons can be very stressful,” says Marianna. 

“In terms of support, small things like allowing a child to leave the lesson slightly earlier than the rest can reduce anxiety levels throughout the day – this is a very simple intervention but can make a whole world of difference to young person’s ability to concentrate on learning instead of managing their distress.” 

For other children it can be a sensory overload that causes distress and frustration. 

“Allowing the child to have a safe haven in school can help – just a quiet place where young people can go to relax and reduce their stress levels when there is a sensory overload like at lunchtime in a busy canteen.”

Fulfilling potential

“Children with autism can often have very good individual skills, like mathematical reasoning, exceptional vocabulary or fantastic drawings but what they often struggle with is executive functioning, which is planning, organisation and problem solving skills. You need to co-ordinate these types of skills in the right order and sequence and that’s what children with autism struggle with,” says Marianna.

“So a lot of the support in the manual is how to best support executive functioning – like helping children structure a task, how to initiate a task and to know when you’ve done enough and can move on. It’s not only about learning new information but about using this information in day-to-day problem solving – that’s often the key for children with autism.” 

For Marianna, the research into autism could potentially help establish a truly diverse and inclusive environment within secondary schools and thereafter. 

“When it comes to autism, it’s about understanding the concept of inclusion and making small adjustments to achieve this, naturally increasing our awareness and understanding of autism. It doesn’t take that much to make adjustments to be truly inclusive and making sure a young person with ASD can reach their full potential because we know that children with ASD can achieve anything – they can go on to achieve amazing things with the right help.”

Find out more

Autism Spectrum Disorder and the Transition into Secondary School: A Handbook for Implementing Strategies in the Mainstream School Setting is available now.

Check out the Autism Matters podcast about the subject.

Read more about some of the amazing things happening at GOSH.