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Autism and Addiction: Exploring Substance Misuse Article

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Autism and Addiction: Exploring Substance Misuse Article

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Autism and Addiction: Exploring Substance Misuse in Autistic Folks

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Studies show that autistic folks may be at higher risk of substance misuse, but that’s not the whole story. Let’s look deeper.

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The Autistica Tips Hub is a free app to help you find reliable autism tips and evidence-based resources. Created by and for the autistic community, it offers practical autism tips and high-quality resources to make everyday life easier.

Autism tips to make life easier

Whether you're looking for tips on daily routines, mental health, or professional guidance, the Autistica Tips Hub has you covered. It's a place to share what has helped you, learn from others and connect with the autistic community.

Our goal is to provide high-quality information that meets the real needs of autistic people and their families. We continuously update the Tips Hub based on user feedback to ensure it remains relevant and helpful.

Join us in making the Autistica Tips Hub a trusted source of information and a supportive community for autistic people, their families, and professionals working with autistic people.

Download the Autistica Tips Hub today, for autism tips and evidence-based resources.

If you're diagnosed later in life and you're trying to search information for information about autism, it can be really overwhelming. There is so much information that is scattered everywhere. There's a lot of contradictory advice on forums or from comments from people, which can be really tricky to navigate. So it's good to have one place that provides reliable information."

Finty, Insight Group member

What the Autistica Tips Hub includes

There are three distinct types of information included:

1. Everyday tips. Find tips that are accessible and relevant for autistic people, their families and loved ones. This content aligns with our 2030 Goal to provide every autistic person with support from day one

2. Mental health and wellbeing tips. Access tips and resources to understand anxiety and manage mental health. Mental health is an urgent priority for the autistic community. Read more about our 2030 Goal of proven treatments for anxiety.

3. Professional tips. Tips supporting professionals working with autistic people. This supports our 2030 Goals to make public spaces more accessible to neurodivergent people, and the employment rate for autistic people will double.

Thank you to the Aviva Foundation for generously supporting the financial resilience workstream of the Tips Hub. Thank you to Jingle Jam for generously supporting autistic children and young people's mental health through the Tips Hub.

What we can't offer

The information provided by Autistica Tips Hub is designed to empower autistic individuals but is not a substitute for professional medical advice. Always consult a qualified healthcare professional before making medical decisions or acting on tips provided by this app. Although we do not offer direct support, we have created a list of organisations that may be able to assist you.

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Autistica Tips Hub | Autism tips and resources to make everyday life easier | Autistica

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The Autistica Tips Hub app helps you find reliable autism tips and evidence-based resources to make everyday life easier for autistic people and their families.

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Podcast on Parenting Neurodivergent Siblings

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Podcast on Parenting Neurodivergent Siblings

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Tools to Support EAL Learners in Assessments with Eowyn Crisfield

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Tools to Support EAL Learners in Assessments with Eowyn Crisfield

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Tools to Support EAL Learners in Assessments with Eowyn Crisfield - Live TeachMeet Recording

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Developing Speech and Language across the Curriculum with DSUK

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Developing Speech and Language across the Curriculum with DSUK

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Developing Speech and Language across the Curriculum with DSUK - Live TeachMeet Recording.

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Our review of the area SEND inspection framework

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Our review of the area SEND inspection framework

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Through the Big Listen, children, parents, carers and professionals told us that the special educational needs and disabilities (SEND) system is 'broken'. Families shared heartbreaking stories of their fight to get the right support. Frustrated professionals told us that they are striving to do their best for children and young people with SEND, but are hamstrung by a lack of resources.

In response to what we heard, we committed to a range of actions to increase our focus on how providers are meeting the needs of children and young people with SEND. These include:

consulting on new inspection criteria for inclusion across education settings

establishing the Ofsted Academy to improve SEND training and to recruit SEND specialists

enhancing our inspections of area SEND provision.

Joint area SEND inspections with the Care Quality Commission (CQC) have been in operation for nearly 2 years. We've learned a lot about what works well, and where improvements can be made. This, along with the feedback we received as part of the Big Listen, will form the basis for our joint review of the inspection framework that we started last month.
What will be included in our review
The review, and any actions that Ofsted and CQC take as a result, will not reduce accountability for children and young people with SEND. We will focus on how we can enhance the existing framework, so that it supports quicker but sustained improvement. We will not be making any fundamental changes such as changes to the inspection cycle or the evaluation criteria.

Working with CQC, we will look at what we have learned from the first 2 years of inspections. And we will listen to the feedback we received from local areas inspected, as well as parents and carers. We will publish a summary report on the national issues local area partnerships face, as well as examples of good practice. We will also consider how we can best support improvement through our monitoring inspections and engagement meetings.

We know that many leaders are frustrated at being held to account for national and systemic challenges. Some want us to stop inspecting until there is national reform of the SEND system. But we think it's important that area SEND inspections continue. They provide an important voice for children with SEND and their families. And they hold local leaders to account for their vital role in providing high-quality services.

We do recognise the challenging context that leaders are working in. We know that they feel as though they are held responsible for issues that they do not have the levers to change. This includes:

national decision-making that reduces the availability locally of children's health assessments and services

at a local level, the participation of some multi-academy trusts in fair access and inclusive pathways for children with SEND.

Where improvements are needed, we want our inspection reporting to be clear about who needs to act. This will be true whether it is the local authority, the integrated care board, local health providers, education providers, or multi-academy trusts (or a combination of these partners working together).

We'll also look at where we can reduce the inspection-related workload for local areas. For example, we will consider what information we ask for, and how we best train our workforce to lead these complex inspections.

We have paused the introduction of our monitoring inspections under the new framework. Before we do introduce them, we will use the review to ensure that they are well designed. They should foster a constructive, professional dialogue that supports improvement and helps a local area to understand its progress against its areas for priority action.

We will also explore how we can use engagement meetings to their best effect. We must keep the spotlight on SEND and on supporting areas to improve between inspections, but we will take care not to distract areas from the vital work they are doing as part of their improvement journey.
What's next
Over the next few months, we will be talking to children and young people with SEND, their families, SEND professionals and local area leaders. This will inform any changes that Ofsted and CQC will make. We want to hear from local area leaders to understand how our inspection activity can be as supportive as possible, while continuing to hold local area partnerships to account.

We will shortly be consulting on proposed wider changes across Ofsted to support children and young people with SEND. These will include proposals to increase our focus on inclusion in schools and other education providers through our updated education inspection framework. This will help us to hold schools to account for the important role they play in their local area partnership.

We are also replacing single-word overall effectiveness judgements with inspection 'report cards' in all areas that Ofsted inspects. This will provide a more nuanced and detailed assessment of providers' work.

Finally, we'll complement these changes with a continued emphasis on working with relevant government bodies to understand and influence their plans for SEND system reform.

We plan to finish our review in spring 2025. Until then, our full inspections and thematic visits will continue, but we will keep monitoring inspections on pause. We will publish our review findings and updated guidance for monitoring inspections before they restart in the summer term. There are only a very small number of local areas affected by the pause and we will be prioritising their monitoring inspections when they restart.

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Yvette Stanley, National Director, Social Care and Regulation

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Our review of the area SEND inspection framework

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Through the Big Listen, children, parents, carers and professionals told us that the special educational needs and disabilities (SEND) system is 'broken'. Families shared heartbreaking stories of their fight to get the right support. Frustrated professionals told us that they ...

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The 2025 Award for SEND and Inclusive Practice - The Pearson National Teaching Awards

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Celebrating Transformational Teaching Across the UK

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This channel provides short online SEN Support training for school SENCOs, Neurodiversity Champions and Mental Health & Wellbeing Leads.

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Introduction to ADHD 2 - Identifying needs

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Introduction to ADHD 2 - Identifying needs

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Introduction to ADHD 2 - Identifying needs

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Video clips and promotion all about the Learn and Thrive project ‘Learning for Life’ all about Relationship and Sexual Education and Health. Learning for Lif…

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How can schools support EAL learners arriving from Yr 9 and beyond? Webinar

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How can schools support EAL learners arriving from Yr 9 and beyond? Webinar

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This is the second in a series of webinars drawing on research commissioned by The Bell Foundation into the experiences of learners who arrive late to the UK education system. In September's webinar, "Why Are So Many Refugees In The UK Missing Out On Education?" a panel group explored the findings of REUK's research "Education for late arrivals " on the barriers to young refugees accessing education, and considered what needs to change at a policy level.

In this webinar, a panel of speakers will consider the findings and recommendations in the research from a more practical perspective and will share personal insights into some of the experiences of late arrivals. Additionally, the panel will offer practical ideas around how schools might support learners, including in the transition to post 16 education.

Panel:

Sarah Moodie - Trainer, The Bell Foundation.

Alice Robinson- Research Manager, Refugee Education UK (REUK)

A Youth Ambassador from Kent Refugee Action Network (KRAN)

Ahead of the webinar:

To make the most of this webinar, you may wish to familiarise yourself with REUK's research "Education for late arrivals" and you may be interested in watching the recording of the first webinar: "Why Are So Many Refugees In The UK Missing Out On Education?"

Who should register for the webinar:

Staff with responsibility for EAL in secondary schools;

Staff with responsibility for induction.

One-hour intensive session with Q&A

Access to session recording;

First to hear about future webinars and how to sign up.

Why you should register for this webinar:

If you have any questions that specifically relate to the webinar topic, which you would like answered during the live session, please send them to: webinar@bell-foundation.org.uk.

If the webinar is full, please complete the wait list form and you will be contacted if a place becomes available. Everyone on the wait list will be sent a copy of the webinar recording.

Ticket sales close 13 February, 12:00 UK time.

If you are viewing this event after ticket sales have closed, please click here to register for our newsletter and receive updates on future webinars or online courses.

The webinar URL will be issued 90 minutes before the session. When you receive the webinar URL, please check that it takes you to the event room, and if not, please email: info@bell-foundation.org.uk. Please note that you will not be able to log in to the webinar event room in advance. Please check your "junk" folder if you have not received this information one hour before the event.

Important notice: there are only two websites authorised to promote and take bookings for this event run by The Bell Foundation. These are: The Bell Foundation's website and Eventbrite. Please do not book, or express interest in, this event through any other website or platform.

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how can schools support eal learners arriving from yr 9 and beyond? webinar

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how can schools support eal learners arriving from yr 9 and beyond? webinar tickets

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How can schools support EAL learners arriving from Yr 9 and beyond? Webinar

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Eventbrite - The Bell Foundation presents How can schools support EAL learners arriving from Yr 9 and beyond? Webinar - Thursday, 13 February 2025 - Find event and ticket information.

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Adaptive Teaching: Scaffolds, Scale, Structure and Style

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Adaptive Teaching: Scaffolds, Scale, Structure and Style

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Adaptive teaching may be tricky to define, but we must define it well, and exemplify it, otherwise it will prove an empty buzzword.

I've tried to characterise it into broadly two types of adaptations:

Microadaptations (Corno, 2008). Sensitive, moment-to-moment adaptations responding to pupils' learning e.g. deploying flexible grouping in a history lesson to quickly reexplain how they might more effectively plan their essay on Scrooge.

Significant adaptations. Pupils with a learning difficulty or disability may require significant adaptations and schools are required to ensure reasonable adjustments are made e.g., offering additional Teaching Assistant support with complex tasks. (these can be concurrently described as 'reasonable adjustments' when supporting pupils with SEND).

It is helpful to have examples of adaptive teaching, but also to present 'non-examples' of what it isn't too. This is where 'differentiation' comes in: the forerunner to the more recently popular adaptive teaching. In training I do on adaptive teaching, I call for more of it and less differentiation (or at least the dubious practices spread in its name):

In a brilliant recent blog, entitled 'Adaptive teaching: The Four Verbs Approach', Clare Sealy has done an excellent job in breaking down and exemplifying approaches that can be characterised as adaptive teaching. It is so useful because she defines some of the variables that teachers must consider when setting tasks that challenge all pupils. Sealy describes the following four principles for adaptive teaching by design:

1. Having to think about more things

2. The intrinsic demands of the content

3. How much external support for memory demands is provided

4. How much the learner knows.

Differentiation by task is one of the challenging areas that we need to leave behind. If we are setting simple tasks for struggling pupils, but complex tasks for high prior attainers, how are they ever meant to catch up. As Sealy describes, "being given different work [should] become rare rather than routine". Instead, we can approach planning lesson tasks with the above principles and high expectations that every pupil can navigate the challenge with support.

Scaffolds, Scale, Structure and Style

It is important, if we are trying to help teachers move on from differentiation, to be clear how tasks can be adapted whilst retaining the same challenging goal. The 4 Ss of ' scaffolds, scale, and style ' could helpfully define adaptations of a core classroom task every pupil undertakes.

Let's take the common task of the self-portrait in art. Both in primary school, and particularly in many year 7 classes, working on a self-portrait is a common way to learn art. Of course, lots of pupils have varying starting points. Difficulty is relative. Some pupils who may struggle can begin with the scaffold of a tracing outline, or a basic template to start ( scaffolds). Additionally, some pupils may increase the degree of challenge by increasing the scale of the portrait ( scale). Equally, some pupils could take a more challenging style, such as using the medium of watercolour paint for their self-portrait ( style).

The above task alterations ensures that every pupil accesses the same challenging task. It also addresses Sealy's verbs, or principles. Templates adjusts ' external support for memory demands', whereas a larger scale can increase the ' intrinsic demand ' of the task.

In English, narrative writing tasks can be adjusted to encompass 'Scaffolds, scale, and style'. Pupils can be supported with planning frame, sentence starters, phrase banks, style prompts, and much more ( scaffolds). The task can vary in length ( scale), although pupils can naively mistake the notion that 'shorter is easier'. Pupils can be given a specific narrative structure to follow, or be expected to make unique choices independent of any style models ( structure). To adjust the degree of challenge, pupils may be prompted to imitate an author, reverse a style, or similar ( style).

Writing an evaluative essay in religious studies on attitudes to artificial contraception can equally be adapted with 'scaffolds, scale, and style' in mind. Pupils can be given an essay structure prompt ( scaffolds) or choose to write with more independent planning. We can pose additional sentence signposts for them to use ( scaffolds and structure), and so on.

If we explicit with pupils, they can begin to make independent choices about adapting tasks. We can offer scaffolds and scale and style choices, making explicit to them the varying complexities of a given task. By using the 4 Ss explicitly it could encourage self-regulation and even a greater understand of curriculum tasks. Instead of the 'Chilli challenge' type approach, or 'All/Most/Some' some tasks, there is no race to the bottom of picking the easiest task. Instead, pupils choose the supports to scaffold them to the top.

The 4 Ss model is unlikely to perfectly match every task in the school curriculum, but it may be a helpful heuristic so that teachers can move away from planning different tasks to instead adapt with greater confidence.

...

Related Training: I am doing an ' Adaptive Teaching Masterclass ' for Teachology in Manchester, live and online, on Fri 24th May. Find out more .

[Image via Creative Commons licence - Preply.com Images: https://www.flickr.com/photos/194356589@N04/51701952903]

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Adaptive Teaching: Scaffolds, Scale, Structure and Style

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Adaptive teaching may be tricky to define, but we must define it well, and exemplify it, otherwise it will prove an empty buzzword. I've tried to characterise it into broadly two types of adaptations: * Microadaptations (Corno, 2008). Sensitive, moment-to-moment adaptations responding to pupils' learning e.g. deploying flexible grouping

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Assumptions Around Physical Disabilities with Chloe Plummer

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Assumptions Around Physical Disabilities with Chloe Plummer

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Assumptions Around Physical Disabilities with Chloe Plummer

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Podcast Episode · The SENDcast · 05/12/2024 · 59m

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A network for those supporting learners with a physical disability

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A network for those supporting learners with a physical disability

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pdnet – a network for those supporting learners with physical disability

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pdnet is a free to join, national network that provides professionals in education with support in promoting positive outcomes for children and young people with physical disability.

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Specialist Spotlight: An introduction to teaching learners with physical needs (Secondary / FE)

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Specialist Spotlight: An introduction to teaching learners with physical needs (Secondary / FE)

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Specialist Spotlight: An introduction to teaching learners with physical needs (Secondary / FE)

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Join us for a FREE discussion exploring an introduction to teaching learners with physical needs in primary settings.

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Specialist Spotlight: An introduction to teaching learners with physical needs (Primary)

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Specialist Spotlight: An introduction to teaching learners with physical needs (Primary)

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Specialist Spotlight: An introduction to teaching learners with physical needs (Primary)

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Join us for a FREE discussion exploring an introduction to teaching learners with physical needs in primary settings.

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Preparing for Adulthood pathways - London Borough of Bromley

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London Borough of Bromley - Bromley Council website homepage www.bromley.gov.uk.

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Self-injury in children with intellectual disability - Cerebra

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We are delighted to publish our new comprehensive guide for parents on ‘Self-injury in children with intellectual disability’ in partnership with the Cerebra Network for Neurodevelopmental Disorders. For children with intellectual disabilities and their parents and carers, self-injury is a really important issue. Cerebra Network Director Professor Caroline Richards, one…

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Where Do I Start If My Child Shows Self-Injury? - Cerebra

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Self-injury, or challenging behaviour, is a really important issue for children with intellectual disabilities and their parents and carers. Produced in partnership with the Cerebra Network, our new resources on ‘self-injury in children with an intellectual disability’ can help you to understand what self-injury is, what can cause self-injury and…

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22 Ways to Support Autistic Girls* at School

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22 Ways to Support Autistic Girls* at School

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In a previous blog, we discussed how to recognise an autistic girl in the classroom because she is often not discovered until after mental health concerns have begun. Once recognised and understood, there are many ways in which teachers can support their autistic female students in the classroom across social, emotiona

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attention autism "gina davies" activity education

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Share your videos with friends, family, and the world

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What actually is autism? - Autism Understood

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Are you confused about what autism actually means? Well here are some real life accounts which will help you understand better.

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Being an Autistic parent can raise unique challenges that historically have been poorly supported. Autistic Parents UK is an Autistic-led Charity (CIO) and is committed to supporting Autistic parents in a number of ways including through peer support, education and advocacy.

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Are you an adult who has an autistic brother or sister? Would you like to meet others, share experiences and feel more confident as a sibling? Find out more about our exciting new programme here!

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Asperger Experts - Keynotes and Workshops

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Asperger Experts - Keynotes and Workshops

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Professional Autism Speakers For Your Next Event - Asperger Experts

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Get the insiders perspective from someone who has lived it with a professional presentation geared toward helping you understand the experience of someone on the Autism spectrum.

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We work with young people, parents and carers, schools, colleges, universities and employers.

All our work is based on sound evidence. It gives people the confidence and skills to look after their mental health.

Charlie sits at the heart of our story, our vision and our purpose.

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Charlie Waller Trust, mental health charity

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We understand mental health. Our aim is to educate young people, & those with responsibility for them, about their mental health & wellbeing. The Charlie Waller Trust was created by the Waller family in 1997 in response to the loss of their son and brother Charlie to suicide having suffered from depression.

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Headscape has been developed by Oxleas NHS Foundation Trust for young people who live in Bexley. If you live outside Bexley, you may still use the website, but certain features will not be available to you. For more information, please read our privacy policy

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This site uses cookies to improve your user experience. By using this site you agree to these cookies being set. See our cookies policy for more information or to change your cookie preferences at any time.

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We give hope and help to thousands of children and families each year and work in communities throughout England and Wales to help keep children safe. Our vision is for all children to grow up in supportive communities safe from bullying and harm.​ Our mission is to provide practical support, training, and advice to challenge bullying and protect young lives.

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Kooth is your online mental wellbeing community. Access free, safe and anonymous

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There are lots of way to feel calmer. Try our breathing exercises, activities and games or watch a video to help let go of stress.

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Read advice about loads of different topics, from what happens during puberty to bullying and abuse.

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The Mix – Essential support for under 25s

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The Mix – Essential support for under 25s

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Essential support for under 25s

The Mix is the UK's leading support service for young people. We are here to help you take on any challenge you're facing - from mental health to money, from homelessness to finding a job, from break-ups to drugs. Talk to us via our online community, on social, through our free, confidential helpline or our counselling service.

Featured

The Mix. Registered charity number: 1048995

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Welcome to The Mix, offering essential support for under 25s.

Log in to submit your own content on our platform Your Voices.

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Welcome to The Mix, the online guide to life for young people in the UK.

Your Voices is a community-focused section of The Mix where you can share stories about your experiences on a specific issue. Upload your own videos, images, blog posts, and playlists to Your Voices and share them with your friends.

Don't have a Your Voices account? Sign up here to submit your own content.

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The Mix - Essential support for under 25s

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The Mix: 0808 808 4994 - Free information and support for under 25s in the UK. Get advice about sex, relationships, drugs, mental health, money & jobs.

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Self-care is about the things we can do to look after our own mental health. Young people told us that when they are struggling they are usually told to see a professional. They don't often get much advice about how they could help themselves.

We spoke to professionals and looked at academic research. Then we drew up a list of strategies young people use (you can see the process in this self-care infographic). We also published a report following a consultation with young people and their families online.

We're sharing these strategies with you to help you to manage your wellbeing. It's up to you to decide what helps. If it works, keep doing it. If it doesn't, stop and try something else. And you can help us build an evidence-base for these activities by letting us know what works by clicking on the 'Did this activity help your mental wellbeing' button on each page. This will help us decide which ones to research further. We've also created a booklet to help you create your own self-care plan as part of our and another booklet with advice for young parents and carers on looking after their wellbeing.

These activities are not a substitute for seeing a mental health professional. Sometimes we need outside help and advice. Getting help is good. No-one should feel bad about it. That's what this site is about.

This self-care section was developed by Common Room and young people from mental health support group Hearts & Minds.

These strategies were identified by young people aged 11-25 though some strategies might not be appropriate for all ages without support or guidance of a trusted adult.

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Resources to enable the prioritisation of mental health and wellbeing

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Mental Health Resources For Children and Young People

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Free mental health resources, posters, lesson plans and activity sheets for primary and secondary school staff, and mental health professionals working with children and young people.

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Adaptive Clothing for Kids | Assisted Dressing | M&S

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Discover adaptive clothing for kids in our easy dressing range. You'll find carefully crafted garments and soft cotton materials in the range at M&S

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All about us lesson plans manual - Family Planning Association

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Designed to accompany the award-winning All About Us DVD-ROM, this manual contains lesson plans covering growing up and personal and sexual relationships.

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Libby Scott: 'My autism diagnosis stopped me hating myself'

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Libby Scott: 'My autism diagnosis stopped me hating myself'

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Libby Scott: ‘My autism diagnosis stopped me hating myself’

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An autism diagnosis allowed Libby Scott to finally understand herself. Since then she’s written three books to share her experiences.

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In Bromley we want all our children to grow up, thrive and have the best life chances in families who flourish and are happy to call Bromley home.

This is our ambition and what we strive to achieve every single day.

For our children to thrive and live healthy, safe and secure lives, they need to experience family relationships that are healthy and stable. All relationships have tricky moments - it's how they are experienced and resolved that matters. Many research studies have proven that positive relationships have a significant impact on the children in those families.

And the opposite is true - parental conflict has a significant and direct negative impact on the children in those families.

The Bromley Parenting Hub pulls together information for all parents in the borough, whether together, separated or considering separation, who want to find ways to improve their relationship and get on better.

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Welcome to the Bromley Parenting Hub - Bromley Parenting Hub

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In Bromley we want all our children to grow up, thrive and have the best life chances in families who flourish and are happy to call Bromley home. This is our ambition and what we strive to achieve every single day.

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Self Injury

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Self-injury in children with intellectual disability - Cerebra

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We are delighted to publish our new comprehensive guide for parents on ‘Self-injury in children with intellectual disability’ in partnership with the Cerebra Network for Neurodevelopmental Disorders. For children with intellectual disabilities and their parents and carers, self-injury is a really important issue. Cerebra Network Director Professor Caroline Richards, one…

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Adaptations to Autism
This is chapter 1 in Autism and Girls by Tony Attwood and Michelle Garnett, published by Future Horizons.
Until recently, the gender ratio for autism was estimated as four boys for each girl. However, clinicians are increasingly receiving referrals for diagnostic assessments of girls and women, and a recent research study has established a ratio of two to one (Rutherford, McKenzie and Johnston 2016). Why have we not previously diagnosed the true prevalence of autism in girls and women? The answer is that girls and women have so often successfully camouflaged their autism.

One of the central characteristics of autism is a deficit in social communication and social interaction (American Psychiatric Association 2013). The social and interpersonal aspects of life are a challenge, so how does the person who has autism adapt to these challenges? Clinical experience suggests there are three potential adaptations: the introvert, the "intensive" extrovert, and the "camouflaging" extrovert.

The Introvert

The more easily recognized adaptation is that of the person who could be described as an introvert. The child (and subsequent adult) actively minimizes or avoids social engagement, recognizing that social interaction is indecipherably complex, overwhelming, and stressful. This conspicuous adaptation, therefore, is to choose (where possible) to be alone to accomplish things while not necessarily feeling lonely.

But we are increasingly recognizing those people with autism who are extroverts and highly motivated to socialize. For these people, there are two potential adaptations that facilitate social engagement.

The "Intrusive" Extrovert

The first of these two adaptations is to actively seek social experiences, even though the person may not be able to read all the subtle social signals that regulate and moderate the intensity of social engagement. Due to impaired theory of mind, those who have autism often have difficulties reading the nonverbal communication used in a social interaction. Their social behavior is then perceived as intrusive, intense, and irritating. A metaphor to describe this adaptation to autism is that of a driver who does not see the traffic signals (nonverbal communication) or abide by the traffic code (social conventions). They are unable to accurately read social situations and therefore act inappropriately. While there is considerable motivation for social interaction and making friends, these experiences may nevertheless be ended prematurely by the social partner. The consequence is that the person feels bitterly disappointed that conversations, friendships, and relationships are short-lived, and social popularity remains elusive. Another issue is that once friendship is achieved, the person can become possessive, idealizing their new friend with an intensity that is overwhelming. When the friendship or relationship ends, there can be intense despair and feelings of abandonment, betrayal, and of being misunderstood.

The "Camouflaging" Extrovert

The second adaptation for the person with autism who is an extrovert is to recognize their difficulties in reading nonverbal communication and in making and keeping friends. With this insight, they acquire successful social and interpersonal abilities by keenly observing peers and people in general, analyzing their social behavior, and interpreting and abiding by social rules and conventions, thus effectively camouflaging their social difficulties. The person creates a social "mask."

This chapter focuses on this third adaptation to autism-camouflaging-which was first recognized as an adaptation to autism by girls and women, but which we now recognize as also occurring with males (Lai et al. 2017). To understand the camouflaging process, it is important to first consider how the social development and abilities of girls and women who have autism may differ from boys and men who have autism.

The Developmental Profile of Girls and Women With Autism

Early Childhood

Clinical experience and parental reports indicate that girls who have autism have greater social motivation and engagement than their male peers. However, a characteristic of the girl with autism when playing with her peers is a tendency to be overly dominant and controlling or to be attracted to other girls with strong personalities who tell her what to do (Ormond et al. 2018). Parents often report that she is indiscriminate and excessive when expressing affection or extremely reticent or uncomfortable expressing affection, even with family members. Parents also describe extreme emotional meltdowns in particular situations, such as having to cope with a change in expectations or in response to specific sensory experiences (e.g., being in a crowded shopping mall). The despair and agitation are intense, and parents are often unable to distract or console the child.

Girls who have autism may decipher and analyze social experiences by replaying social events with doll play. Each doll represents a person and the reenactment helps clarify the social signals, conventions, and script. Girls who have autism can have a remarkable ability to engage in solitary imaginative play, creating imaginary worlds, and having imaginary friends, which provides an opportunity to create and rehearse social scripts. The child's teacher and parents may notice that she rarely engages with female peers, who she perceives as behaving in an incomprehensible way and following inexplicable social rules. When she is engaged in imaginary social play, there is no criticism or rejection.

In contrast, some girls avidly observe other girls playing and socializing and may copy or "clone" themselves after other girls, "borrowing" their gestures and phrases to achieve the social abilities needed when playing with peers (Ormond et al. 2018). The child may imitate gestures, facial expressions, and phrases, which are reenacted and rehearsed when she is alone. Parents may notice that she is more animated when imitating and engaging with her peers than when engaged with family members.

Early School Years

An adaptation in the early school years for girls who have autism can be a preference for playing with boys, as they are perceived as engaging in simpler and more logical play. She may become known as a tomboy, preferring to look androgynous and enjoying sports and physical, rather than conversational, interactions. She may prefer single, close friendships, a characteristic that may continue throughout her life.

Alternatively, she may try to be included with her female peers by developing an interest in expressing femininity in clothing and color coordination and becoming knowledgeable about the topics of conversation of her peers, such as popular films, television programs, and computer games.

If she is effectively rejected by her peers, she may develop an interest in reading fiction, sometimes at a level in advance of her chronological age. Fiction can often provide insight into people's thoughts and feelings, which can give the child a better understanding of her peers. If she happens to enjoy the Harry Potter books, she may appreciate the thoughts and feelings of Hermione, who herself expresses many characteristics associated with girls who have autism; for example, all her friends at Hogwarts are male.

The girl may also show a greater interest in socializing with pets and animals rather than with peers. Animals accept you for who you are, do not tease and ridicule you, want to play with you, and are always genuinely pleased to see you.

She may not want her social confusion to be recognized by her teacher and peers, so she becomes very well behaved in class in order to be left alone. She also knows that if she is quiet, no one will notice her. She effectively suppresses her autism. However, when she returns home, she becomes a very different character-a Dr. Jekyll and Mr. Hyde transformation. She is no longer timid and shy, and she may be emotionally volatile, demanding, and angry. Parents frequently experience behavior that would never be expressed at school.

High School Years

The nature of female friendships changes throughout the school years, and the teenage girl who has autism may not understand the innate social "rules" of typical adolescent girls, such that when with female peers, she frequently makes social faux pas (Baldwin and Costley 2016). She may have difficulty understanding and responding to the subtle, nonverbal communication of typical teenage girls, such as eye rolling, shared glances, and giggling (Dean, Harwood and Kasari 2017).

Adolescent girls who have autism are extremely loyal, kind, and helpful friends. They rarely engage in gossip and are not "bitchy" or mean. These engaging qualities may be recognized by a typical girl, and a friendship may develop between them. The typical teenager can then provide social guidance and prompting and a sense of security, especially from the teasing, bullying, rejection, and humiliation by female peers.

If she has a small group of friends, she may be overly sensitive to conflict between her friends. She may take on the role of peacemaker and be eager to restore emotional harmony. If she belongs to a larger group of friends, she may have difficulty coping with too many opinions, egos, and factions within the group (Vine, Foggo, and Webster 2017).

She may not identify with or enjoy the interests of teenage female peers, such as fashion, makeup, boys, and dating. She may be less able to identify with her peers' construct of femininity. She may then question her own gender identity (Kanfiszer, Davies, and Collins 2017). By not enjoying the same interests, she is more likely to be ostracised, feel lonely, and be aware of and sensitive to derogatory comments such as "you are weird," which will affect her developing sense of self.

In contrast, she could become an expert in teenage fashion and know all there is to know about the popular boys. She may be aware of the social scripts of her peers and know what to say. However, if in her early school years she observed and imitated her peers but was still rejected, she may decide to have a paradigm shift in her persona, despising femininity and social and gender conventions. She may identify with marginal groups, deliberately defy social conventions, and engage in risky behavior.

The Adult Years

The teenage girl may have effectively camouflaged her autism. She may have "flown under the radar" and not have been considered for a diagnostic assessment for autism. Every day she has acted out the role of a typical girl, so much so that she should be awarded an Oscar for her performance. She has a superficial sociability that is effective, but exhausting. She also has a lack of social identity, other than being the person that others expect her to be.

This social acceptance and success will have been achieved at some psychological cost. There can be performance anxiety in social situations, as though she has been continually "on stage." The resulting stress may evolve into an anxiety or eating disorder.

She may be popular and socially successful, but this is achieved intellectually rather than intuitively. Like Cinderella at the ball, she can maintain the pretense for a while, but then becomes totally drained of mental energy and must return home to recover in solitude. The unrelenting mental exhaustion of processing social information and social expectations can lead to depression and even self-harm.

The consequences can be a lack of knowledge of her inner and true self, with some adult women saying, "I don't know who I am." This may lead to a lack of self-identity, low self-esteem, and prolonged self-analysis. She recognizes that her friendships and relationships are based on deceit, where she has presented a "false" identity. This increases her feelings of deep inner loneliness. She yearns to find, and be able to be, her authentic self, but is aware that when her true self is revealed, she may be rejected and despised. In this way, camouflaging aspects of autism, while successful in some respects, can contribute to the development of clinical depression.

The Stages in Camouflaging Autism

Research and clinical experience suggest a three-stage model of the camouflaging process (Hull et al. 2017). In the first stage, there is motivation to be successful socially and to develop friendships. The second stage is to acquire the ability to camouflage social confusion, social immaturity, and a delay in social reasoning. This is achieved by masking and compensation strategies. The third stage is short- and long-term consequences, including delaying a diagnostic assessment, access to appropriate support and understanding, and subsequent mood and psychological disorders.

We now have a questionnaire to explore whether a person engages in camouflaging in social situations (Hull et al. 2019). The Camouflaging Autistic Traits Questionnaire (CAT-Q) was developed from discussing aspects of camouflaging with adults who have autism describing their experiences. Exploratory factor analysis suggests three factors with the questionnaire, namely compensation, masking, and assimilation.

Compensation

This strategy is to learn and imitate body language, facial expressions, and conversational scripts. This knowledge can be achieved by observation of peers, but also by reading fiction or watching soap operas and films to acquire scripts and different personas. The girl may also be interested in studying psychology and may avidly read books on body language and friendship.

An alternative compensation strategy is to prefer the company of males, whose social dynamics are relatively simpler. Boys and men may be more accommodating of someone who is socially clumsy, but who clearly enjoys and is relaxed in their company.

Compensation can also be achieved by developing an interest and talent in science or the arts and becoming an author, artist, musician, singer, or multi-linguist. Social eccentricities are accepted and accommodated due to being valued by peers who recognize and admire a particular talent.

Another compensation strategy is to develop an interest in fictional heroes and superheroes and to have friendships based on shared interests, such as cosplay and Comic-Con, providing defined and recognized roles and camouflage by a costume.

Masking

The person's intention is to create a neurotypical persona by mimicking others, creating a social mask, and changing their personality (Cook, Ogden, and Winstone 2018; Hull et al. 2017). She plays with personalities. To be successful, this adaptation requires the ability to suppress anxiety, appear relaxed, and to constantly monitor social performance, subsequently reviewing that performance or masquerade when alone. It is also important to appear interested in other people and make appropriate eye contact and empathic gestures and comments. When the person is wearing the mask, it is crucial to ensure others do not perceive their discomfort or that their fluent and successful social abilities are an act.

Some adults have described that when they get dressed for school or work, their clothes become their costumes as they take the social stage. Family members will recognize the development of multiple personas, sometimes even knowing who provided the original persona or script.

Assimilation

The intention of this adaptation is to blend in and to appear normal. This means suppressing aspects of autism, such that autism is invisible. It requires the person to become a chameleon and for a brief while be "cured" of autism. This may improve their opportunities to develop and maintain friendships, relationships, and employment.

Strategies to achieve assimilation can include engaging in part-time schooling and employment to reduce the effects of exhaustion, and having a social network of friends and colleagues who have autism-that is, people who accept and encourage the person's autism.

Another strategy is to be very brave and determined to socialize, thus eventually acquiring social abilities that were previously elusive. We are increasingly recognizing that in some adults who have autism, there is a delay in achieving social skills, rather than an eternal absence. The social puzzle is finally solved.

It helps for the person to have a social guide and mentor who can provide positive feedback and explain social conventions, as well as the cues that determine what someone is thinking and feeling. The social mentor may be a family member or friend, a psychologist or therapist, or someone who has autism (Cook and Garnett 2018). Eventually, the characteristics of autism can become sub-clinical and do not cause clinically significant impairment in social, occupational, or other important areas of current functioning (American Psychiatric Association 2013).

Consequences of Camouflaging

Camouflaging may successfully hide the characteristics of autism. However, there are consequences. First, clinicians need to modify existing diagnostic instruments and create new ones that are standardized on girls and women with autism; it is important to recognize that those who do camouflage their autism may be (and often are) vulnerable to subsequent psychological disorders.

Diagnostic Instruments

Gender identity (more of an issue for five- to twelve-year-old children)

Sensory sensitivity

Social masking

Imagination

Imitation

Talent in music and languages

The primary diagnostic instrument for autism is the Autism Diagnostic Observation Schedule, or ADOS. This instrument has recently been criticized in research studies for not being standardized on sufficient numbers of girls and women who have autism, and not being sensitive to the more subtle characteristics in someone who is able to camouflage their autism (Lai et al. 2011; Langmann et al. 2017). Girls and women with autism are often able to mask their social difficulties during the short observation in a diagnostic assessment. The clinician training in the administration of the diagnostic tool and also the scoring system itself both need to be enhanced in order to recognize camouflaging when it occurs. This is particularly relevant in instances where it is anticipated that the person demonstrates typical complex gestures and facial expressions. It is important to be able to distinguish when these gestures and expressions are stylized imitations gleaned from the observation of peers, rather than authentic, age-appropriate nonverbal communication (Rynkiewicz et al. 2016).

We also need screening instruments specifically designed to identify autism in young girls and teenagers to indicate that a formal diagnostic assessment is warranted. We have developed the Questionnaire of Autism Spectrum Conditions, or Q-ASC (Ormond et al. 2018) to differentiate between the girls' and boys' profiles of autism. Research using this questionnaire indicates that females with autism, in comparison to their male peers, have different scores in the domains of:

The Q-ASC can also be used during a diagnostic assessment to explore with the child's parents those characteristics of autism that are associated with camouflaging that are not currently included in standardized tests.

The Q-ASC has recently been modified as a screening tool of adult women (Brown et al 2010). A copy of the questionnaire and scoring system is attached as an appendix to this document.

Psychological Effects of Camouflaging

Camouflaging can delay the diagnosis of autism, eliciting comments such as, "You're too social to have autism." This will also delay self-understanding and self-acceptance (Bargiela, Steward, and Mandy 2016). A delay in confirming the diagnosis will delay access to appropriate support networks and services for those who have autism.

Research has also confirmed that camouflaging is associated with poorer mental health outcomes and is not associated with wellbeing (Hull et al. 2019). Camouflaging may contribute to high levels of anxiety and the development of clinical depression. When a mood disorder is diagnosed, psychological treatments such as cognitive behavior therapy will need to be modified to accommodate the characteristics of autism (Attwood and Garnett 2016; Gaus 2018; Scarpa, Williams, White and Attwood 2013).

Psychotherapy needs to focus on the negative consequences of camouflaging, encourage self-acceptance, and facilitate ways to explain the characteristics of autism to friends and colleagues so that others can accommodate and appreciate those characteristics.

References

American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Washington, DC: American Psychiatric Association.

Attwood and Garnett (2016) Exploring Depression, and Beating the Blues: A CBT Self-Help Guide to Understanding and Coping With Depression in Asperger's Syndrome. London: Jessica Kingsley Publishers.

Baldwin, S. and Costley, D. (2016) 'The experiences and needs of female adults with high-functioning autism spectrum disorder.' Autism 20(4), 483-495.

Bargiela, S., Steward, R. and Mandy, W. (2016) 'The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype.' Journal of Autism and Developmental Disorders 46, 3281-3294

Brown, C.M., Attwood, T., Garnett, M. & Stokes, M.A., (2020). Am I Autistic? Utility of the GQ-ASC as an Autism Assessment in Adult Women. Autism in Adulthood 2, 216-226

Cook, A., Ogden, J. and Winstone, N. (2018) "Friendship motivations, challenges and the role of masking for girls with autism in contrasting school settings." European Journal of Special Needs Education 33, 302-315.

Cook, B. and Garnett, M. (2018) Spectrum Women: Walking to the Beat of Autism. London: Jessica Kingsley Publishers.

Dean, M., Harwood, R., and Kasari, C. (2017) "The art of camouflage: Gender differences in the social behaviours of girls and boys with Autism Spectrum Disorder." Autism 21(6), 678-689.

Gaus, V. L. (2018) Cognitive-Behavioral Therapy for Adults with Autism Spectrum Disorder: Second Edition. New York: The Guilford Press.

Hull, L., Petrides, K., Allison, C., Smith P., Baron-Cohen, S., Lai, M., and Mandy, W. (2017) '"Putting on My Best Normal": Social Camouflaging in Adults with Autism Spectrum Conditions.' Journal of Autism and Developmental Disorders 47(8), 2519-2534

Hull, L., Mandy, W., Chuan Lai, M., Baron_Cohen S., Allison, C., Smith, P. and Petrides, K. (2019) Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). Journal of Autism and Developmental Disorders 49, 819-833.

Kanfiszer, L., Davies, F. and Collins, S. (2017) "I was just so different: The experiences of women diagnosed with an Autism Spectrum Disorder in adulthood in relation to gender and social relationships." Autism 21(6), 661-669.

Lai, M-C., Lombardo, M.V., Pasco, G., Ruigrok, A.N.V., et al. (2011) "A Behavioral Comparison of Male and Female Adults with High Functioning Autism Spectrum Conditions." PLoS ONE 6(6).

Lai, M., Lai, M-C., Lombardo, M.V., Ruigrok, A.N.V., et al. (2017) "Quantifying and exploring camouflaging in men and women with autism." Autism 21(6), 690-702.

Langmann, A., Becker, J., Poustka, L., Becker, K., and Kamp-Becker, I. (2017) "Diagnostic utility of the autism diagnostic observation schedule in a clinic sample of adolescents and adults." Research in Autism Spectrum Disorders 34, 34-43.

Ormond S., Brownlow C., Garnett, M. Rynieszka, A, and Attwood, T. (2018) "Profiling Autism Symptomatology: An Exploration of the Q-ASC Parental Report Scale in Capturing Sex Differences in Autism." Journal of Autism and Developmental Disorders 48(2), 389-403.

Rutherford, M., McKenzie, K. and Johnson, T. (2016) "Gender ratio in a clinical population sample, age of diagnosis and duration of assessment in children and adults with autism spectrum disorder." Autism 20(5), 628-634.

Rynkiewicz, A., Schuller, B., Marchi, E., Piana, S., et al. (2016) "An investigation of the 'female camouflage effect' in autism using a computerized ADOS-2 and a test of sex/gender differences." Molecular Autism Brain, Cognition and Behavior 7:10.

Scarpa, A., Williams White, S., and Attwood, T. (2013) CBT for Children and Adolescents with High-Functioning Autism Spectrum Disorders. New York: The Guilford Press.

Vine Foggo, R.S. and Webster, A.A. (2017) "Understanding the social experiences of adolescent females on the autism spectrum." Research in Autism Spectrum Disorders 35, 74-85.

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Autistic Girls and Women - Dr Tony Attwood

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This is chapter 1 in Autism and Girls by Tony Attwood and Michelle Garnett, published by Future Horizons. Until recently, the gender ratio for autism was estimated as four boys for each girl. However, clinicians are increasingly receiving referrals for diagnostic assessments of girls and women, and a recent research study has established a ratio of two to one (Rutherford, McKenzie and Johnston 2016).

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A social enterprise supporting people on the autistic spectrum and the people around them.

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Limpsfield Grange Girls with Autism - Video

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Limpsfield Grange Girls with Autism - Video

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This was made by the autistic students at Limpsfield Grange School to raise awareness of girls with autism and was sponsored by vInspired. This film has certainly raised awareness and ITV have made a one hour documentary about the school, we await the transmission date.

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The Students of Limpsfield Grange School and Vicky Martin (Author)

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Buy M is for Autism Illustrated by The Students of Limpsfield Grange School and Vicky Martin (ISBN: 9781849056847) from Amazon’s Book Store. Everyday low prices and free delivery on eligible orders.

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Can You See Me?: A powerful story of autism, empathy and kindness - Book

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Can You See Me?: A powerful story of autism, empathy and kindness - Book

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Can You See Me?: A powerful story of autism, empathy and kindness eBook : Scott, Libby, Westcott, Rebecca: Amazon.co.uk: Kindle Store

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I am an Aspie Girl: A book for young girls with autism spectrum conditions - Book

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I am an Aspie Girl: A book for young girls with autism spectrum conditions - Book

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By simply, clearly and positively explaining the social differences associated with Asperger's Syndrome, or Autism Spectrum Disorder, in young girls, this book will help Aspie Girls aged 5-11 to understand their diagnosis, recognise their unique strengths and celebrate their differences, and find ways of coping with difficulties. This positive and celebratory book also contains helpful discussion points for parents and professionals to explore further with the girls in their care.

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I am an Aspie Girl: A book for young girls with autism spectrum conditions

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Buy I am an Aspie Girl: A book for young girls with autism spectrum conditions by Danuta Bulhak-Paterson (ISBN: 9781849056342) from Amazon's Book Store. Everyday low prices and free delivery on eligible orders.

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Helping You to Identify and Understand Autism Masking: The Truth Behind the Mask - Book

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Helping You to Identify and Understand Autism Masking: The Truth Behind the Mask - Book

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Helping You to Identify and Understand Autism Masking: The Truth Behind the Mask

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Buy Helping You to Identify and Understand Autism Masking: The Truth Behind the Mask by Kendall, Emma (ISBN: 9798611220085) from Amazon’s Book Store. Everyday low prices and free delivery on eligible orders.

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The Asperger's and Me: Girl with the Curly Hair - Book

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The Asperger's and Me: Girl with the Curly Hair - Book

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The Asperger’s and Me: Girl with the Curly Hair

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Buy The Asperger’s and Me: Girl with the Curly Hair by Rowe, Alis (ISBN: 9780956269324) from Amazon’s Book Store. Everyday low prices and free delivery on eligible orders.

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Libby Scott: Do's and Don'ts for an Autistic Child

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Libby Scott: Do's and Don'ts for an Autistic Child

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Short breaks for children and young people with SEND (0-18 years) – London Borough of Bromley

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Short breaks for disabled children and young people and their carers

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https://issuu.com/bromleychildrenproject/docs/asc_flipbook?fr=sZmY5NjYyOTgyMDU

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Seeking a Diagnosis for Autism or ADHD

If you suspect your child or young person may have autism or ADHD, it’s important to seek a professional diagnosis to ensure they receive the appropriate support and interventions. Here are the steps you can take:

1. Observe and Document: Keep a detailed record of your child’s behaviours, challenges, and any patterns you notice. This information will be valuable during consultations with healthcare professionals.

2. Consult Your GP: Schedule an appointment with your General Practitioner (GP). Share your observations and concerns. Your GP can provide initial assessments and refer you to specialists if needed.

3. Right to Choose: In England, you have the legal right to choose the healthcare provider for your child’s assessment under the NHS Right to Choose scheme. This means you can select a provider that best meets your child’s needs, potentially reducing waiting times.

4. Specialist Referral: Your GP may refer you to a paediatrician, child psychologist, or a specialist in neurodevelopmental disorders. These professionals can conduct comprehensive evaluations.

5. Educational Support: Inform your child’s school about your concerns. Schools can offer support and may conduct their own assessments or provide referrals to educational psychologists.

6. Assessment Process: The assessment may include interviews, questionnaires, and observation of your child in different settings. It aims to understand your child’s developmental history and current functioning.

7. Diagnosis and Next Steps: If a diagnosis is made, the specialist will discuss the findings with you and provide recommendations for interventions, therapies, and support services.

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Phab (local places are Sydenham, Sevenoaks & Gravesend)

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Phab (local places are Sydenham, Sevenoaks & Gravesend)

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Phab Clubs are places to belong, places to thrive where disabled and non-disabled people come together to socialise, have fun and build lifelong friendships.

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Pyramid is committed to providing free materials to professionals and caregivers to support your efforts with your learners. Below you will find a variety of helpful samples, information, data forms, and assessment materials. Be sure to visit our Support at Home page as well for a range of free activity videos, lesson plans, and picture grids, along with other downloadable resources. For those in need of additional support, we also offer live remote sessions with a Pyramid consultant. Remote consultation provides immediate support to families and teams based on your learner's needs. To learn more or to schedule a session, email us: pyramiduk@pecs.com.

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Free PECS Symbols and Activities from PECS UK

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Want some help with setting up activities to promote the use of PECS with your learner? Help is at hand in our FREE materials hub

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Sibling Support Pack - Witherslack Group

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The Impact of ADHD & Autism on Family Dynamics

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Sibling Support Pack - Witherslack Group

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Disability Living Allowance (DLA) - Download Your Free Guide - Cerebra

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Our guide takes you through each question on the DLA form, giving you explanations of what they mean and tips on how to answer them. Please note this guide is for England and Wales only.