# data[].attributes.attachment_link.title
EXAMPLE - 5 Point Scale - RATING 1 - Nov 2017

# data[].attributes.attachment_link.title
ABC_Chart_Form- To identify behaviour triggers

# data[].attributes.attachment_link.readable_text
What does the evidence say?

Sensory Strategies

Whilst there is a lot of research on the use of sensory strategies, the design of much of it is poor. A recent review considering the use of sensory strategies with pre-schoolers (Bodison & Parnham, 2018) found 11426 potential articles. However, only 24 were suitable to review, and only eight were used in the report. These numbers show that, although there is a huge amount of information written about sensory strategies, there are very few studies with a good research design.

The authors found that "insufficient evidence supports the effectiveness of regularly incorporating specific sensory techniques into classroom routines for pre-schoolers with ASD" (p.9). Their recommendation was to use the interventions cautiously. They found insufficient evidence for using weighted vests with children on the autism spectrum. It is felt that this study supports the AJOT recommendation for documentation and review when using sensory strategies.

There are two small case studies looking at sensory movement breaks. One case study (Mills & Chapparo, 2016) showed a drop in the number of daily behaviour incidents of a child with ASD after participating in sensory activity programme. The incidents dropped from 83 incidents prior to 14 incidents per day after the programme was used. Perez, Wong and Perryman (2019) were able to demonstrate that off task behaviour decreased in the three children that participated in their sensory activity schedule. It is important to note that in both of these studies the sensory programmes were created by an OT to support the children's specific needs.

Sensory Integration

Ayres ® Sensory Integration (ASI) treatment is very different to the use of sensory strategies, such as wobble cushions, fidget toys or weighted vests, commonly used in schools. One essential criteria of ASI treatment is that it is child led. A second essential criterion is that the child must be actively engaging in sensory experiences. There is a fidelity measure which aims to ensure that there is consistency with therapists using the ASI treatment approach (Parnham et al 2007).

Schaff et al completed a review of research looking at using ASI with children with autism in 2018. The authors only included studies where the sensory integration treatment met this fidelity measure. They reviewed five studies. Their results indicated strong evidence that ASI treatment provides positive outcomes for improving function and participation goals in children with autism. These goals were individualised for each child's needs. They also found a moderate degree of evidence to support the use of ASI to help to improve behaviours, and increase independence with self-care activities. There was only emerging but insufficient evidence to support the use of ASI to improve play, sensory motor and language skills.

An exciting piece of new sensory integration research in the UK

Whilst results are not yet available, an exciting piece of research is currently being completed at Cardiff University. Radell et al (2019) are running a trial comparing ASI to usual care in children with autism. They aim to recruit 216 children within the UK to participate in the trial. Half of the children will receive two sessions of ASI therapy a week for ten weeks. The other half, a control group, will receive the usual care provided. All sensory integration therapy will be scored against the fidelity measure. The study aims to provide high quality evidence on the clinical and cost effectiveness of ASI. The results should give clear data on the true effectiveness of ASI for children with autism.

Where to Next?

Next you might want to ready about more common sensory differences which present in autism. We recommend these articles

To learn even more about the senses we recommend our Free Introduction to Sensory Processing.
Page references
* Atwood, T., Evans, C., & Lesko, A. (2014). Been There. Done That. Try This! Philadelphia: Jessica Kingsley Publishers

Bodison, S. C., & Parham, L. D. (2018). Specific sensory techniques and sensory environmental modifications for children and youth with sensory integration difficulties: A systematic review. American Journal of Occupational Therapy, 72, 7201190040. https://doi.org/10.5014/ajot.2018.029413

** Hazen, E. et al (2014) Sensory Symptoms in Autism Spectrum Disorders Harvard Review of Psychiatry Volume 22 Number 2 March/April 2014

Parham, L. D., Cohn, E. S., Spitzer, S., Koomar, J. A., Miller, L. J., Burke, J. P., et al. (2007). Fidelity in sensory integration practice intervention research. American Journal of Occupational Therapy, 61, 216-227

Pfeiffer, B. A. (2012, June). Sensory hypersensitivity and anxiety: The chicken or the egg? Sensory Integration Special Interest Section Quarterly, 35(2), 1-4

Randell, R. et al (2019) Sensory integration therapy vs usual care for sensory processing difficulties in autism spectrum disorder in children: study protocol for a pragmatic randomised control trial. BMC Trials. https://doi.org/10.1186/s13063-019-3205-y

Schaaf, R. C., Dumont, R. L., Arbesman, M., & May-Benson, T. A. (2018). Efficacy of occupational therapy using ASI: A systematic review. American Journal of Occupational Therapy, 72, https://doi.org/10.5014/ajot.2018.028431

# data[].attributes.attachment_link.title
ASD and Sensory Processing Disorder - A Brief Introduction

# data[].attributes.attachment_link.description
Whilst there is a lot of research on the use of sensory strategies, the design of much of it is poor. A recent review considering the use of sensory strategies with pre-schoolers (Bodison & Parnham, 2018) found 11426 potential articles. However, only 24 were suitable to review, and only eight were used in the report.

# data[].attributes.attachment_link.description
Ambitious about Autism is the national charity for autistic children and young people. We stand with autistic children, young people and their families to champion rights, campaign for change and create opportunities.

# data[].attributes.body
STORIES FROM THE SPECTRUM

# data[].attributes.attachment_link.title
"Communication and empathy were huge issues when Daniel and I first got together seven years ago."

# data[].attributes.attachment_link.description
Kerise Vowles-Myers, autistic woman and interior designer

# data[].attributes.attachment_link.readable_text
Alison, what made you seek a diagnosis for Callum?

We noticed that Callum was different to other babies - we knew from the start. He didn't sleep, he cried a lot and became distressed if anyone but us held him.

As he got older, Callum refused to eat. He didn't make eye contact and he would often try and run off. Callum's nursery referred him to a speech and language therapist, and we were told that he may have semantic pragmatic disorder.

Callum was eventually diagnosed with Asperger syndrome at seven-years-old.

You had to fight to get Callum the right support. What was the process like?

Callum struggled at mainstream primary school and the support he needed wasn't there. His school finally applied for an Assessment for a Statement of Educational Needs (now changed to an Education Health and Care plan or EHCP) when Callum was nine.

When we asked for support, we kept being fobbed off, or told there is no money. We were told, "you will never get a statement for him". When I discovered Callum's current school, I told the local authority's educational psychologist and SENCo (special educational needs co-ordinator) that I had found the perfect school. They all laughed at me and said he would never get a placement there.

The school's Statement application was refused by the local authority. We were told we had a right of appeal to the SEND Tribunal. The start of a two-year battle of three consecutive court appeals began.

That must have been incredibly hard for you both. How did you find out about our Education Rights Service and Clifford Chance?

Parents can represent themselves at tribunal, but the process is very complex and legalistic and I personally did not feel I could do it alone. Others successfully do and there is a lot of support out there, including organisations, advocates and parents who have been through the process. I also knew we couldn't afford the tens of thousands of pounds it can cost for legal representation.

I started searching the internet for support. I wasn't sleeping and I was terrified of going to court. But the thought of Callum going without help terrified me more. The delay in accessing support had a negative impact on Callum's mental health, and he was medically signed off school for six months. A friend encouraged me and told me that approximately 90% of parents' SEND appeals were successful.

Searching online, I found the National Autistic Society website and reference to Clifford Chance law firm, who in some exceptional cases offer pro bono representation.

I wrote a pretty emotional email begging for help and I received a call a few days later. After a few more calls I sent over the grounds of appeal I had written and I was very grateful to hear that they would be shown to the partners at Clifford Chance.

I will never forget the day I received the call to say that Clifford Chance would legally represent Callum. I cried my eyes out with relief.

You had to go to multiple tribunals to get the right support for Callum. What was it like going to Tribunal?

We had three consecutive tribunals for Callum, over two years.

After I appealed to the Tribunal for Refusal to Assess, the local authority agreed to assess a few weeks before the hearing.

The assessment took place and then the local authority refused to issue a Statement, instead issuing a Note in Lieu document. This was not legally binding; its contents of provision were inadequate and it was not worth the paper it was written on.

We had to appeal to the Tribunal again. This went to a hearing, where we were represented by Clifford Chance. I was absolutely terrified, but the judge and panel were amazing. They had a clear understanding of the evidence bundle and it felt like we were having our voices heard for the very first time.

We won, and the local authority were ordered to issue a Statement. They agreed that the Note in Lieu was inadequate and that Callum's needs were not being met, or understood.

However, when the Statement was issued, it was just a replica copy of the wording from the Note in Lieu, copied into the Statement. It was devastating.

So, we went to Tribunal number three, which was to dispute the inadequate contents and also to get the nearest school that could meet Callum's needs, named as his placement. The hearing took place over two days. It was tough and very draining.

Two weeks later, we found out we had won. We got the call from Christina, the lawyer at Clifford Chance who represented Callum in court, and we all cried. It remains one of the most special moments of my life and still makes me cry when I think about it.

The LA tried twice to appeal tribunal decisions to the Upper Tribunal. They were denied.

How did the National Autistic Society and Clifford Chance support you at this time?

The National Autistic Society and Clifford Chance brought expertise, experience, determination and continual support. There is no way we would have managed to navigate the complexities and procedures of the many challenges we faced during those traumatic two years.

As parents without legal support, it is like going to war when they (the local authority) have an army and all we have is a pop-gun. They have lawyers, barristers and teams of professionals at their disposal. Parents do not always have that luxury.

I think that Clifford Chance would agree that the cases were very challenging. We were so lucky to have the support of Christina, the lawyer who represented Callum during those two years. It was phenomenal to see how she managed to get such a deep understanding and grasp of our case. Christina was also supported by other lawyers and trainees from Clifford Chance. We were always put at ease and never made to feel a nuisance. I received some lovely messages from them when we won. It was emotional.

We also had the amazing support from a lady from the National Autistic Society Education Rights Service. She was my rock during one of the most difficult times of my life. She helped us understand what would happen at each stage of our case and she also worked so hard on our case. There was so much paperwork! On the days when things were very bad and we faced many setbacks, she would always pick up the phone and support me with constructive advice and listen to me.

As parents, knowing we had the National Autistic Society and Clifford Chance supporting us gave us the strength to carry on fighting. I am sure we would have given up after the first appeal without this support.

Without a doubt, the National Autistic Society changed Callum's life and has given him a bright future. Without the charity's service, support and advocacy I truly believe the lives of so many children would have a very different and negative outcome. This not only impacts on the child, but on the siblings, parents and extended family and friends. We are indebted to them forever.

Callum, what difference has going to a specialist school made for you?

The school is lot more attentive, the staff understand how to help me, and the work is more catered to the pace and abilities of each student. They focus on the children in the school. They care. It has made a huge difference to my life and I am very grateful for being able to go there and the help that I have received.

Alison, do you think your experience fighting for support for Callum make a difference when you were sorting out your younger son's education?

On a personal level, I feel the experience definitely empowered me to support my children. I have grown in confidence too.

I learnt so much from those cases. I have often been contacted by other families who are experiencing similar situations. It is fulfilling to be able to pass some of this knowledge on, to show other parents that it can be done and to never take no for an answer.

I have unfortunately had to go to Tribunal since for Callum's two siblings, but managed to file the appeal and represent myself. I have also had some fantastic support from SENDIASS (Special Educational Needs and Disabilities Information Advice and Support Service), who can also offer independent advice.

Thankfully all of our children are now settled in supportive and understanding schools that are able to meet their needs.

What advice would you offer to other parents facing similar issues?

The first thing I would say, would be to read the SEND Code of Practice. This is the law and details in sections how support must work. As it comes in sections, you can find the relevant part you need.

There are many organisations - like the National Autistic Society Education Rights Service, IPSEA (Independent Provider of Special Education Advice), and SENDIASS - who offer support and have copies of draft letters that you can use. Visit their websites and make contact with them.

As a parent, you know your child best. Trust your instincts and don't be afraid to ask questions and to challenge if required.

# data[].attributes.attachment_link.title
"Autism can be a gift because it can really help to give you that extra will-power, and you can get into things a lot more than many non-autistic people."

# data[].attributes.attachment_link.description
We noticed that Callum was different to other babies - we knew from the start. He didn't sleep, he cried a lot and became distressed if anyone but us held him. As he got older, Callum refused to eat. He didn't make eye contact and he would often try and run off.

# data[].attributes.attachment_link.title
"The only thing that will really help Andy at the moment is a return to normality - even if it's a different normal to the one we had before."

# data[].attributes.attachment_link.description
Kevin Chapman, YouTuber and parent to Andy, who is autistic.

# data[].attributes.headline
National Autistic Society - Leading UK charity for Autistic people

# data[].attributes.subject
National Autistic Society - Leading UK charity for Autistic people

# data[].attributes.attachment_link.description
We are the UKs leading charity for autistic people and their families. Since 1962, we have been providing support, guidance and advice, as well as campaigning for improved rights, services and opportunities to help create a society that works for autistic people.

# data[].attributes.attachment_link.title
Breathing Makes it Better & the Zones of Regulation

# data[].attributes.attachment_link.title
Help! Why is my child chewing on clothing and other things? - GriffinOT

# data[].attributes.attachment_link.description
GriffinOT explores this commonly asked question - Why is a child chewing on clothing or their sleeves or other objects? We also offer ideas on how to help.

# data[].attributes.attachment_link.readable_text
Research in Autism Spectrum Disorders published research on handwriting and autism. The researchers investigated whether handwriting skills in children with autism spectrum disorder (ASD) are related to visual perception, motor coordination, visual-motor integration, and executive functions.

Previous Research on Handwriting and Autism

Previous research provides additional information on handwriting skills:

in children with autism perceptual reasoning skills were significantly predictive of handwriting skills where motor skills were not.

children with ASD have a well-automated motor plan for simple handwriting movements when writing guides are present (Johnson, 2015).

children with autism and those with ADHD had faster handwriting speed but less accurate than controls at each task (Hughes, 2012).

that children with autism displayed poorer quality in forming letters but size, alignment and spacing were similar to their peers without autism (Fuentes, 2009).

Methodology of this Study on Handwriting and Autism

This recent study evaluated sixty 9-12-year-old children (30 with ASD and 30 typically developing). Testing included the following:

parents completed the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire.

the children completed the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI-V) and performed a story-writing task on a sheet of paper affixed to an electronic tablet to evaluate penmanship.

Results

Following data analysis, significant differences were found between children with ASD and children with typical development in:

in executive function

in all BRIEF scales

visual-motor integration and motor coordination sections of the VMI-V.

There was not a significant difference in the VMI-V visual-perception subtest.

In terms of predicting handwriting, visual-motor integration did not predict handwriting process measures. Executive functions-specifically working memory and shifting-did predict handwriting when writing a story in children with ASD.

The researchers concluded that executive functions, specifically working memory and shifting, play a large role in handwriting production in children with ASD (Rosenblum et al, 2019).

Resources to Help with Handwriting

Special Edition for Kids with ASD - Assistive Technology, Classroom Implementation Strategies & Resource Recommendations for Kids Who Struggle to Writedigital download is an assistive technology Resource Guide for OTs, parents and other professionals working with students with Autism Spectrum Disorder, over 50% of whom have educationally significant handwriting challenges that make it difficult/impossible for them to complete written schoolwork using paper and pencil. Research shows that these challenges tend to persist over time, no matter what handwriting therapies have been tried.

Dysgraphia Handwriting Intervention - Occupational Therapy Tools A: Formations digital download is a systematic, structured, efficient, & effective method to re-teach letter and number formation skills. Created by school-based OT, Thia Triggs, this intervention starts at the beginning and will allow you to guide your struggling writer to feel confident and successful, regardless of age.

Do you receive referral after referral for students with handwriting concerns? Are the teachers you work with feeling frustrated and overwhelmed with so little time to offer handwriting practice? ThisHandwriting Station Bundle Deal will save you TONS of time with these NO-PREP activities that encourage handwriting practice for your students. Set up a handwriting station in the classroom or at home so students can practice handwriting throughout the day in the classroom. Great for early finishers!

References:

Hughes, V. Handwriting study points to motor, memory problems in autism. Retrieved on 12/28/12 from Simons Foundation Autism Research Initiative at http://sfari.org/news-and-opinion/conference-news/2012/society-for-neuroscience-2012/handwriting-study-points-to-motor-memory-problems-in-autism.

Johnson, P. et al. Do children with autism and Asperger's disorder have difficulty controlling handwriting size? A kinematic evaluation. Research in Autism Spectrum Disorders
Volume 11, March 2015, Pages 20-26

Kennedy Krieger Institute. New Study Affirms Handwriting Problems Affect Children with Autism into the Teenage Years. Retrieved from the web on 11/23/2016 from https://www.kennedykrieger.org/overview/news/new-study-affirms-handwriting-problems-affect-children-autism-into-teenage-years

Rosenblum, S., Ben-Simhon, H. A., Meyer, S., & Gal, E. (2019). Predictors of handwriting performance among children with autism spectrum disorder. Research in Autism Spectrum Disorders, 60, 16-24.

# data[].attributes.attachment_link.description
Research in Autism Spectrum Disorders published research on handwriting and autism. The researchers investigated whether handwriting skills in children with autism spectrum disorder (ASD) are related to visual perception, motor coordination, visual-motor integration, and executive functions. Previous Research on Handwriting and Autism Previous research provides additional information on handwriting skills: in children with autism perceptual [...]

# data[].attributes.attachment_link.readable_text
One of the most important, challenging and controversial aspects of autism education is improving experiences and outcomes of autistic learners.

This process is far from straightforward. Autistic students share as many differences as they do similarities and to expect a single approach or intervention to meet the needs of all is naïve.

As I am often asked more in-depth questions about the whole-school saturation model, I hope this article supports a deeper understanding of how the model can be implemented in schools to support our autistic students.

What is the whole-school saturation model?

The whole-school saturation model (Morewood, Humphrey, & Symes, 2011) was originally developed to illustrate the principles of effective inclusion of autistic learners in a secondary mainstream school, however it is equally applicable to all educational phases and contexts.

The word 'saturation' is deliberately used to emphasise the need for autism-friendly principles and practices to permeate every aspect of school life. Prominence is also given to the integration and co-ordination of strategies, with the hope of avoiding a fragmented, 'programme for every problem' approach that is neither cost-efficient nor sustainable (Domitrovich et al., 2010).

The model is consistent with two primary theoretical tools that informed the work.

Aligned with Bronfenbrenner's (2005) bioecosystemic theory, the model highlights the importance of micro and mesosystem inter-relationships (for example, the peer group and classroom), whilst also drawing on more distal exo-system influences, such as school systems and policy.

The 'general differences' position, in particular flexible provision, direct support and intervention that takes account of both individual and group differences, is another key element of the theory that supported the development of this work. (Lewis & Norwich, 2015).

The agent of change

The central and starting point of the model is the 'agent of change'. Typically, this would be the SENCO. There have been many debates as to the need for this role to also be a member of the school's leadership team as a crucial factor in determining whether the proposed innovations 'take hold'.

The agent of change pushes thinking and practice forward, often meeting with resistance. As such, energy, resilience, and good humour are useful traits.

Peer education and awareness

The role played by peers in determining the educational experiences and outcomes of autistic learners is vital.

We can intervene, support and educate peers in a number of ways.
Provide students with information
Firstly, we can improve peer awareness (and subsequently attitudes and behaviours) by providing students with information about autism.

Credible, likeable sources that are recognised as having authority are more persuasive: in a school context this may be a member of the SLT who has significant influence amongst students (Campbell & Barger, 2014).

Teachers can highlight similarities between students with and without autism, using explanatory information to increase understanding and provide guidance on how students can interact with and support their autistic peers.

Teachers can explore the achievements of individuals with autism (such as Stephen Wiltshire's outstanding cityscapes) to highlight the strengths that autism can bring and contribute to a positive ethos.

Focusing on amazing abilities, rather than disabilities, is an important message and incredibly powerful if highlighted by a peer.

Circle of friends
Given the inverse relationship between social support from peers and experience of victimisation and loneliness, peers can and should be used as a protective resource. An example of this is the circle of friends approach, in which a small group of typically developing peers form a support network around a focal child. This has to be a strategy agreed by both the focal child and family, and not something imposed.

Due to the preference (or need) for solitude expressed by some autistic children and young people, peer social support systems should be a resource to be drawn upon when needed rather than forced - an essential part of the personalised approach this model takes.
Sharing own voices
As part of the peer education strategy, young people and families are central to sharing their voices and supporting the work, ranging from direct sessions with other students (such as assemblies) and discussions with the agent of change to ensure autism-evidenced policy and practice is a core part of the model.

Direct support and intervention

Direct individual or small group interventions are required alongside a systemic whole-school approach.

These will need to balance consideration of individual needs as well as the strengths and difficulties associated with autism more broadly, in addition to other important contextual factors such as the setting.

Following some initial training, school staff can effectively implement a range of interventions. This has obvious implications for both the cost-effectiveness and sustainability of such work.

Interventions may focus on:

social skills

play

communication

challenging behaviour

flexibility

academic skills

school readiness skills

cognitive skills

motor skills

adaptive and self-help skills.

Direct support and intervention can also be an effective means through which to prevent or reduce victimisation of autistic children and young people, typically in the context of social skills interventions. This should be tailored to the needs of the individual student, but may:

include content designed to improve understanding of social cues in order to prevent social vulnerability

identify contexts in which the child is most vulnerable to bullying and develop appropriate strategies

role play bullying situations to teach response strategies and offer generic prevention strategies.

Flexible provision

Despite their sharing of common characteristics, no two autistic students are the same and provision therefore needs to reflect this diversity of need.
Timetables
Children's daily timetables need to be adaptable, so they may be withdrawn from lessons in which the cognitive and/or social demands are considered to be too high. These periods provide an excellent opportunity for specialist support and intervention of the kind noted above, or to pre-learn key concepts or language for future lessons.
Rules and routines
Being reasonably flexible with school rules and routines is also important. For example, some autistic learners experience disturbed sleep patterns and can arrive to school late. Such examples require staff to be prepared and understanding of the child's needs, allowing them time to get settled in a designated area and providing them with the tools to express their readiness to join the class.

A visual indicator such as a traffic light system is a good example of this, with another key element being the support and training of all staff, particularly the receptionist who may be the first adult met upon late arrival at school.
Dual-roll placements
In some cases, flexibility of provision may even extend to students having dual-roll placements through the development of formal partnerships between mainstream and specialist schools. The proportion of time spent in each setting can be reviewed periodically and adapted as necessary, with the flexibility allowing for that on a day-to-day and week-by-week basis.

Only 40% of teachers feel that they received adequate training to teach children with autism

This approach moves beyond polarised, simplistic debates about whether mainstream or special educational settings are 'the most appropriate' for students on the autism spectrum (e.g. Mesibov & Shea, 1996), recognising that a student's needs, and how and where these are best met, are likely to change over time.

Of course, the feasibility of such an approach is highly dependent on local contextual factors, including:

the availability of funding (although from experience these arrangements cost around a third of the cost of a full-time specialist placement)

the existence of different forms of provision or placement

the relationships between sites.

Building these kinds of systems and partnerships can have multiple, wide-ranging benefits, particularly with regard to the personalisation of provision and outcomes in preparation for adulthood.

Developing the school environment

Considering the environment is essential - not just the physical environment, but the emotional and social environment too.

Being explicit in communication, understanding emotional regulation in the context of whole-school approaches and supporting students during social times with planned and appropriate activities is crucial. These are core elements of the approach that must be embedded into whole-school policy and practice.

It is no good having an excellent provision in isolation, or whole-school policies that are at odds with individual plans.

Training and development of staff

My personal experiences indicate that teachers generally have positive attitudes towards autistic children, but struggle when dealing with the difficulties experienced in social and emotional understanding. These tensions can often influence the quality of their interactions with students, and potentially undermine the development of the positive relationships that underpin learning in the classroom.

Effective training and development in relation to autism is therefore crucial. Indeed, it has been identified by parents and carers as the single most important factor in improving the quality for provision.

Direct support and intervention can be an effective means through which to prevent or reduce victimisation of autistic children

Consistent with the general approach promoted in the model, this should be, 'regular, on-going and part of a commitment of all staff . . . a one-off twilight session is never going to suffice' (Morewood et al., 2011). This process should begin during initial teacher training, and where possible include placement in appropriate specialist settings.

It is also important for teachers to have a sense of personal responsibility for the learning of all students, particularly autistic learners, rather than this being seen as the domain of support staff or abdicating the responsibility to the school's SEND specialist.

Only 40% of teachers feel that they received adequate training to teach children with autism during their initial teacher training. Significant change is required, perhaps as part of a general shift towards more explicit and detailed consideration of special educational needs during this critical developmental phase in teachers' careers.

New approaches to teaching and learning

Difficulties experienced among autistic people arise not from individual 'deficits' in empathy and social cognition, but from a separation in the disposition and understanding of the non-autistic population (Milton, 2012).

How can we be more flexible in the way in which we organise educational provision for our autistic students? Rather than focusing on problems in imagination among autistic learners, should we not be more imaginative ourselves in thinking about approaches to teaching and learning? At their core, each of these questions requires us to more actively consider the perspectives of autistic students.

Whatever the specifics and personalised approach in adapting and implementing this model, one thing is certain: if we are not positive and solution-focused, who will be?
Further reading References

# data[].attributes.attachment_link.title
Autism and inclusion: the saturation model explained

# data[].attributes.attachment_link.description
One of the most important, challenging and controversial aspects of autism education is improving experiences and outcomes of autistic learners. This process is far from straightforward. Autistic students share as many differences as they do similarities and to expect a single approach or intervention to meet the needs of all is naïve.

# data[].attributes.attachment_link.title
Autism and behaviour: 'Dare to see the reasons behind behaviour' | Tes News

# data[].attributes.attachment_link.description
Violent behaviour: Scottish Autism challenges schools to see problematic behaviour not as malicious or intentional, but as the result of cumulative stress and anxiety

# data[].attributes.attachment_link.readable_text
Pupils with Tourette's just need the right support, not fear and misunderstanding, writes Suzanne Dobson

When a teacher first hears that they are about to have a child with Tourette's syndrome (TS) in their classroom they often feel anxious. What will the child be like? How will they affect the dynamic of classroom and will they have an impact on the other children?

TS can be poorly understood by teachers and fellow pupils but, with the right support, children with TS can generally function as successful and happy members of the school community.

What is Tourette's syndrome?

TS is a neurological condition which has a genetic basis and therefore has a hereditary element. It does not of itself reduce learning capacity or intellect.

One in 100 children have TS. This statistic holds good all round the world, apart from in sub-Saharan Africa were it is about half this number. Unfortunately, nobody knows why this reduction occurs. What it does show, however, is that TS is more common than you think and that most teachers will have taught a child with TS but will not have been aware of it. This is because for many children it is quite mild and they can cope without any intervention either from the medical profession or the teaching profession.

For a person to be diagnosed with TS, he or she must:

have two or more motor tics (for example, blinking or shrugging the shoulders) and at least one vocal tic (for example, humming, clearing the throat, or yelling out a word or phrase), although they might not always happen at the same time

have had tics for at least a year; the tics can occur many times a day (usually in bouts) nearly every day, or off and on; there should be a tic free period of no more than three months within the year

have tics that begin before they are 18 years of age; after this it is called Tic disorder, although the effects are identical.

There is no medication specifically for TS and those that exist often have unpleasant side effects. Especially with young children, the balance between controlling the tics and causing other problems must be finely balanced.
Only 12 per cent of children with TS have pure Tourette's (that is, just the tics). The other 88 per cent will have a number of co-morbidities such as ADHD, OCD or ASD.

Talk to the child

One of the key things for the successful integration of a child with TS at school is to talk to the child and the parents about how their TS affects them, what makes life harder and what makes it easier. One of the main things which makes a difference is for the class to be told about TS. It really helps if the young person can be part of this and talk about how it affects them. It could, though, be part of a wider programme about understanding difference, or maybe even a research project for groups to look at several neurological conditions or the different conditions children in the class have, such as epilepsy or diabetes. Many schools have peer support programmes or "friendship benches" which can help a child feel secure that there is someone who is there for them if they are having a bad day.

What aggravates tics?

Tics and other linked behaviour can be made worse if the child is anxious, for example if they have limited time to complete tasks, or if they feel they have to be quiet or discreet. Looking forward to birthdays, an outing or other much anticipated events can also provoke tics, as can tiredness, which is why sleep is so important. As with many other conditions, the changes around puberty also usually make tics worse.

In the classroom

Only around ten per cent of people with TS have the swearing tic coprolalia, so it is unlikely, although of course not impossible, that your young person will swear.

What is often more of a problem in school is the phenomena known as "non-obscene, socially inappropriate behaviour" (NOSI). This means that if you are bald, short, over-weight or have a lot of make up on, a TS child with this type of behaviour will often comment. It is hard to believe that, despite their comments, this is not what they are thinking. It's even harder to believe that they are as surprised and upset as you when those words leave their mouths, but that is the case. So, unlike with a toddler - when you can explain that their comments are not nice, will upset the person concerned and help them to learn not to do it - the tactic for a child with TS is to explain what's going on to the staff and children they interact with.

The one thing you really shouldn't do with a child with TS is ask them not to tic. It immediately becomes the only thing their brain wants to do. It is much better to sit with them and ask what their tic feels like before and during the tic. Is there anything that you could alter to make them tic less often? Some children can suppress their tics for a short while, but it requires a huge amount of concentration which means they won't be engaged with the lesson. Younger children, though, will probably not be able to suppress tics at all.

Because tics wax and wane and can be suggestible, people believe either that the student can control their tics or that they are using them as an excuse for negative behaviour. Of course, very occasionally this may be the case but usually it is just the normal course of TS.

Classroom support

Depending on how the tics manifest themselves, a seating plan can be really helpful. If you have a motor tic, sitting at the end of a row can help; some children prefer to sit at the back so no-one can watch them, while others prefer to sit at the front. Again, talking to the child and the parents can be key to understanding how to support your student.

Especially in high school, it is more difficult for teachers to have a close relationship with every child and many supply teachers may be wary of a child saying they have TS. Schools can use a "passport" which includes the child's picture and a brief description of what helps them, and what doesn't, signed by a member of the school's senior staff. Time out cards can be useful but they should have boundaries; this is even more important for younger children. There needs to be designated place for pupils to go to release their tics, along with some suggestion as to how long you expect them to be gone for. For younger children, it is useful to say "I will check on in you in five minutes and see if you are OK", and perhaps extend the number of visits depending on how the child is coping. It is better, though, if their tics can be accommodated in the classroom. Once other children understand what is going on and are not startled by their tics, the pupil with TS usually works well in the classroom, as they might do with general background noise.

For a teacher of a child with TS, it is important to trust yourself. Try to remove the words "Tourette's syndrome" from your interpretation of the situation and think about the actual tics and behaviours that you have before you. Realise that anxiety is anxiety and ADHD is still ADHD; then you will know that you have the skills to help the child with TS to grow and learn in your class.

Further information

Suzanne Dobson is Chief Executive of the charity Tourettes Action:
www.tourettes-action.org.uk

# data[].attributes.attachment_link.description
Pupils with Tourette's just need the right support, not fear and misunderstanding, writes Suzanne Dobson When a teacher first hears that they are about to have a child with Tourette's syndrome (TS) in their classroom they often feel anxious. What will the child be like?

# data[].attributes.attachment_link.readable_text
This is our newest module which is now live.

Historically it was thought that women and girls were less likely to be autistic, however recent research has highlighted the challenges in identifying autism in women and girls. It is now recognised from research, clinical practice and anecdotal reports that many autistic females or those who demonstrate the less traditionally obvious traits of autism are not recognised. This can result in misdiagnosis, late diagnosis, or women and girls not being diagnosed at all.

It is often said that the differences that autistic women and girls experience are of a more subtle presentation, or may appear so to others. Some autistic women and girls feel that they are masking their autism to try and hide the fact that they feel different. They may copy behaviour from others around them, and can be exhausted by the constant effort to appear similar to other people, or might be unaware they are 'masking' in the first place. This more subtle presentation of autism is also a major barrier to clinicians and other professionals recognising autism and understanding the experiences of autistic women and girls.

As a result of this many women report feeling unsupported and not fully understanding themselves potentially resulting in mental health problems.

This module aims to support diagnosticians to better understand autistic female characteristics and therefore enhance confidence to diagnose those individuals successfully.

The philosophy of all our online modules is to put the autistic voice at the centre. This module has been developed in conjunction with autistic women and leading clinicians. Contributors have included a focus group of autistic women, autistic content writers including Lana Grant, Sarah Hendrickx and Dr Wenn Lawson and clinicians including Dr Judith Gould.

The module should take approximately 120 minutes to complete and will have a range of interactive features including exercises and scenario based learning, reflective activities, short film clips and questions to ask.

While managed by the NAS, the project will also be overseen by the Autism and Girls forum. The forum is an external reference group which was formed to raise awareness of autism in women and girls. Content development has also included filming with several autistic women and three leading clinicians, including Dr Judith Gould. Dr Gould has also been involved in reviewing the content.

Cost and availability

This module has been funded by the Pears Foundation, which is enabling us to offer the module for free for the first year.

Events and information

As well as our Women and Girls module, we have information on our website which explores some of the issues relating to autism and gender.

# data[].attributes.attachment_link.description
This is our newest module which is now live. Historically it was thought that women and girls were less likely to be autistic, however recent research has highlighted the challenges in identifying autism in women and girls.

# data[].attributes.attachment_link.readable_text
A common early sign of autism is that a child doesn't start to speak at the usual age. For parents, feeling that you can't 'reach' your child can be one of the most painful experiences in the world, and for children, being unable to say what they want and need can be very frustrating.

There's no magic pill, but there are systems that can make things easier. Sometimes parents have to develop some extra communication skills in order to meet their child where they're at. It's a challenge, but it's do-able - and if your child really struggles, even the most basic exchanges can make a world of difference to both your and their quality of life.

Collectively, these systems are known as AAC - alternative augmentative communication. ('Alternative' means a system that replaces speech, while 'augmentative' means one that goes alongside it. For children with autism, this can be a bit of a mix-and-match rather than an either-or).

Symbols

Spoken language can be a difficult thing for children with autism. Many are far more visual than verbal, and find it a lot easier to understand something they can look at than something they have to hear or say.

The use of symbols, when it comes to children with autism, generally means using pictures. People with autism tend to be concrete thinkers so a word which is supposed to represent something they see in the real world may pose some difficulty for them e.g. the word 'cup' doesn't look, sound or feel anything like a cup; it's just a noise that we've used to label it. It can be helpful for a child with autism to start with something a bit more tangible.

Common steps are:

An object: If your child is hungry, for example, encourage them to bring you a plate. (If explaining it to them doesn't work, you might put the plate in their hand and then 'pass' it back to yourself.) That's a pretty clear association. You might also designate one plate as the 'symbol' plate and use other plates for food to make it clear that the plate represents food rather than being just there to be filled.

A photograph: Use an image (preferably laminated, as it'll get a lot of wear) that's completely realistic and shows a plate. It's a step away from the concrete and towards the abstract, but the connection is still fairly clear.

A more abstract, stylized picture, accompanied by text: A picture of a plate that stands in for the generic concept, with the word 'food' printed underneath it. The more your child uses it, the more they'll associate the written word with the image, and the image with getting some food.

A card with just the word printed on it: If your child wants something to eat, they hand you the card labeled 'food'.

Each time your child gives you the appropriate symbol, you reward them, both with praise ('Good showing! Well done!') and by getting them what they ask for so they know that the system works. In this way, they come to see that communication is actually the most efficient way of getting what they want, and start seeing the point of using it.

This, of course, may be more support than your child needs: some children with autism may already be able to use some language, or might be able to use an abstract symbol right away. Where best to start with symbols will be, as with so many things, something best decided by those who know the child best - i.e. you.

There are a variety of formal systems - PECS (Picture Exchange Communication System) is a popular one - and it's a good idea to check out which, if any, your local health workers and school systems use. Getting formal systems set up can take time, though, so the home-based system above can be a good thing to try while you're waiting for the support to come through.

Signing

As with symbols, sign language is visible and thus a lot easier for some children with autism to understand. For a child who's struggling to speak, or who can speak but has trouble articulating their words clearly, a bit of signing can be a great support.

Before you tremble at the idea of learning a whole new language, don't worry: there are a lot of different kinds of signing. If you've watched a TV show with a sign language translator, for instance, it'll look pretty complicated - and it is, because BSL (British Sign Language) is a complete language just like English or Spanish, and to learn that you'll need support from a fluent or native speaker. However, there are simplified languages specifically designed to help out people with disabilities, and those are a lot easier to master.

Some examples include:

Makaton

This is a system designed to help all sorts of people who have problems speaking, from children with autism or Down syndrome to stroke patients; the Makaton Charity was established in 2007. It has a core vocabulary of about 450 words - which is a very solid foundation in basic communication - and a supplementary 'Resource Vocabulary' of over 7,000 concepts.

If you want a quick guide to what Makaton looks like, an easy way to check it out is to switch on CBeebies or get onto YouTube and type in 'Mr Tumble' or 'Justin Fletcher'. (For those not in the UK, Justin Fletcher is a popular TV presenter and clown; Mr Tumble is the character he plays most often.) Many of his shows, particularly Something Special, use Makaton. You can teach yourself a lot of basic signs just by watching his shows, and schools often use a bit of Makaton to supplement their teaching.

Signalong

Signalong is based on BSL (British Sign Language), and uses its symbols unaltered as far as possible. Signalong places a high value on consistency in its presentation. Their reasoning is that if you don't always use the same hand and the same angle of the hand, a person with concentration difficulties can get confused and communication can break down. Signalong aims to be flexible in how you choose to sign - you can, for instance, choose which is your lead hand when signing - but precise once you've decided how you do it.

Signalong is a system with a broad range of vocabulary and can be used by both children and adults. It's what's described as a 'total communication system', which means that body language, facial expression and voice tone are always used to reinforce the word being signed.

Signed English

Signed English isn't the same as British Sign Language: it's a specific dialogue which has a sign for each word in spoken English. Their website includes a dictionary covering over 3,000 words, which can be a useful place to get started.

Baby Sign

You might have gone to a class, or known someone who went to a class, which taught 'baby sign', often using the signs as actions accompanying songs. The exact signs vary from country to country; British classes tend to use a simplified version of Makaton/BSL or Signalong. In general, the idea of baby sign is that it helps children communicate at an age where they haven't quite got the mouth-skills to form words and all systems use big, clear gestures. If you're already using these signs with your son or daughter, you may find it helpful to continue; a quick call to the teacher should let you know which system they based their baby sign on.

If you're choosing between symbols and sign language, each has its pros and cons. The main advantage of symbols over signs is that they're easy for outsiders to understand: a picture of a toilet will suggest 'I need the toilet' to pretty much anyone. The main advantage of signs over symbols is that you don't need to carry a file or pocketful of cards everywhere; if everyone in the family and the school has a basic vocabulary, it's as portable as spoken language. You could also use a bit of both if that doesn't confuse your son or daughter.

Exactly which form of signing you use is likely to be a judgment call: whatever gets your kid communicating has to be a good thing, and as with symbols, which one you choose is likely to be more a question of access than anything else. Talk to nursery or school staff, local professionals like occupational therapists, and anyone else who's likely to be a major player in your child's care, and see which signing systems, if any, are already in place. All of them have their merits: for you and your child, the best choice is almost certainly the one you can get everybody to cooperate with.

Language Apps

Mobile devices such as smartphones and iPads fascinate a lot of kids with autism, and there are, as a result, quite a lot out there specifically designed for them - either games to help learning concepts or AAC apps that allow them to pick out words. The latter can be quite expensive (though probably still cheaper than many AAC programs), but do sometimes make a big difference to a non-verbal child.

Whether or not these apps are helpful for you is going to depend very much on your child's age, maturity, personality and skills. It's likely you'll already have a gut feeling about whether tablet communication might be a help or a hindrance. If your child seems to have the potential to benefit from these apps, it's useful to know that they're out there: searching 'AAC apps' or 'assistive communication apps' in Google will turn up a lot of options.

An important reminder

It's important to remember that a child who needs AAC now is not necessarily a child who'll grow up to be non-verbal. Some people with autism never do get the hang of speech: for those people, AAC can be enormously important, making all the difference between frustration and a manageable life. On the other hand, many people with autism do master language as they grow up - there are performers, advocates, even rap artists who are on the spectrum - and AAC can be a way of laying the foundations. If you can give your child a way to grasp the concept of communication, that's the base from which you'll be building. When it comes to autism - and to families in general, really - any communication is good communication.

# data[].attributes.attachment_link.description
A common early sign of autism is that a child doesn't start to speak at the usual age. For parents, feeling that you can't 'reach' your child can be one of the most painful experiences in the world, and for children, being unable to say what they want and need can be very frustrating.

# data[].attributes.body
Really good description of what it is like having a conversation in you have autism.

# data[].attributes.attachment_link.readable_text
​ I have an autistic friend who is a maths teacher (amongst her other talents). She has a great way of explaining what being autistic is like and we often talk about the apparent anomaly between her confidence in speaking to someone 1:1 or to a whole group of students, as opposed to being in a group or party situation with lots of people to interact with. I love how she describes it....
On a one to one, there is, well, one interaction. When another joins in then there are 6 potential interactions, because there is each person interacting with each of the other two so that is 3 interactions, plus each person's interaction with the other 2, when the other 2 act as one in some way, eg opinion, agreement, etc. So 6 in total. Now, there is an easy way to work out the number of interactions for a given number of people. If there are 3 people then we simply need to multiply 3 by 2 by 1 = 6 This is written as 3! The exclamation mark is known as a factorial sign. So then one more person joins...now there are 4! Potential interactions which = 4 * 3 * 2 * 1 = 24 This may possibly be about my limit but mostly if I am one of the 4 people, but it's still a big challenge because now I am feeling all the unspoken undercurrents that 24 potential interactions produces. Throw into this several different personality types and possible tension between 2 or more of the people and it's possible to see how a storm can quickly brew of unspoken emotions, thoughts, etc.
However, I generally hang on in there, but know I'll pay the price with exhaustion and several recovery days where I avoid as much social interaction as possible. ( Just a note to add that I do of course sometimes 'do' social groups with friends I know well or am comfortable with, as a trusted group of friends makes a huge difference, as does having a focus such as, having a meal with friends, and because I am already familiar with the types of interactions which happen and the whole experience is less exhausting. the better I know people in the group, the easier it is, generally. I still don't 'do' social events and social groups often though.)
Now, a fifth person comes along, and this basically explodes in my head. 5! Potential interactions, that is 5*4*3*2*1 = 120 undercurrents which are cross-firing what is actually being said...add in a few looks, glances, smiles, frowns, tones of voice, buttings in, and there you have it, I'm gone, looking for the kettle and a quiet corner and maybe one person I know well enough to have a nice quiet brew with or better still friends' cat(s) who totally understand and retreated to quiet corners already. Add one more person...and now the potential number of interactions rises exponentially... 6! That's 6*5*4*3*2*1 = 720 7 people, 7! = 7*720 = 5040 potential interactions.
What generally happens though, is that the limit of a useful group is probably 4, though 3 is in my opinion better still. At 5, usually the quieter people give way to the more verbal, and melt into the background either gratefully or in some frustration. So this curbs the actual number of interactions, but not by much due to the unspoken emotions which flow like wifi among the group. I have come to realise that it must be an acute awareness of these ridiculous number of interactions, with equal awareness of the accompanying undercurrents that make the whole group experience feel to me as if I were being slapped in the face every nanosecond. The huge difference between a social group of say 5 people and a group which has gathered for a specific focus on say a film or lecture or even in some sense to play some sort of game or sport, is that if there is one focus that the group has then immediately it is in reality a one to one situation - almost, with each person in the group interacting mainly on the focus, and all 5 people also acting as one person interacting with the focus. Giving a public lecture, teaching or speaking to an audience is in reality a one to one situation, so, poses no threat. This is why teaching, speaking is no problem, or being taught etc., but groups - where's the kettle.

Now in a classroom there are often way more than 7 people to interact with! Often we ask children to work in groups and then expect them to know how to get on with it and work together. For an autistic child this can be a nightmare. Not only have they the amount of interactions to attend to and switch their attention to, there is often intolerable background noise from other groups and many other sensory demands.

In a school I often suggest that the teacher supports the autistic child to work with just one other person. In a pair, they can be much more successful in sharing ideas and the task to get it completed. You may need to teach or structure the task in a way that each child knows what their role is and what they are expected to do or produce. Learning to listen to each other and deal with differences of opinion or ideas is a challenge in itself (for both children in the pair). Many secondary children nI work with say that school life would be much better if teachers would let them work in a pair on shared tasks, rather than making them work in a group. Please consider what Hilary says about groups and the number of interactions when you are planning shared tasks to do in your lessons. And make sure the person who they work with is someone who will work well with them. Some children will get better at working in groups that are calm and well structured, others may take all their effort just to work with one other person right through to the end of their school days.
So here for you is a visual about how you can support partner work in your classroom. (Full social story can be downloaded below)

​ ​ ​This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

# data[].attributes.attachment_link.description
​ I have an autistic friend who is a maths teacher (amongst her other talents). She has a great way of explaining what being autistic is like and we often talk about the apparent anomaly between her confidence in speaking to someone 1:1 or to a whole group of students, as opposed to being in a group or party situation with lots of people to interac...

# data[].attributes.body
Attention Autism

# data[].attributes.attachment_link.title
Gina Davies: Attention Autism — Therapy Ideas Live

# data[].attributes.attachment_link.description
Gina Davies gives a 5-minute lightning talk about strategies for getting, keeping and sharing attention, at the tenth Therapy Ideas Live event. She talks through why traditional therapy approaches don't motivate children with autism and offers alternatives. Recorded live on 30 January 2014 in London, UK. http://therapyideas.org/live

# data[].attributes.attachment_link.readable_text
In a recent blog for Tes, I shared some of my top strategies for supporting learners with autism spectrum conditions (ASC) in the classroom.

Here is the second part of my advice for how to make learning accessible for these pupils.

1. Consult with pupils about your seating plan

When creating your seating plan, give priority to students with identified additional needs. When considering where to place a young person with ASC, consult with them to find out who they work well with and who is a distraction, although you will obviously have to use your professional judgement at the same time.

All young people with autism are different, so there are no hard and fast rules about where they should be seated in the classroom. Sensory distractions should be considered, but this can be tricky depending on the classroom and its location within the school. Careful seating arrangements can be useful in helping to promote friendships and positive relationships with peers.

2. Take a flexible approach to homework

Homework is the bête noir of many a young person with autism. This may be because they are confused about why they need to do work at home - after all, school is for work and home is for rest. Or, it could be that they are so incredibly drained from the stresses of the day that they actually just need time to unwind.

For some students, we have found that reducing homework to the core subjects - or eliminating it altogether, in more extreme cases - has been an enormous help.

Making sure that there is effective home-school communication around homework is also important. Sometimes students with ASC have forgotten what they need to do by the time they get home and if they do not have explicit and direct instruction they will struggle to know where to start.

I have made this mistake recently. I asked students to "learn their key words" on a list that I had given them, pertaining to their current unit of work. I found that some of my students with a diagnosis of ASC did learn their key words, but they didn't learn their meaning. I thought it was obvious what I wanted them to do. However, I clearly needed to be more explicit in my instruction.

"Camouflaged learning" is another option. One student I have worked with was excused from all homework because of the stress it caused at home. However, mum was keen to ensure the student did not fall behind. So teachers would email her homework so that she could subtly work with her child on these areas, without labelling it "homework". This will not work with everyone because it depends on the confidence and time commitments of the parents and carers, as well as the relationship between home and school - but it is something to consider.

3. Plan group work carefully

Group work can present lots of challenges to young people with ASC. However, collaboration plays a vital role in learning and is an essential life skill. The trick is to carefully select the members of groups. Do not allow pupils to select their own groups, as this can lead to all sorts of chaos and avoidable upset.

Ensure that the group work is structured and that each member has a role. Let any young people with ASC know in advance that a group work activity is coming up. This will help them to cope.

Most importantly, remember that while every young person with autism is different, there are ways of working together to ensure the best outcomes for each individual. The solutions may not be obvious at first and mistakes may be made, but it is about learning from these mistakes and collaborating with members of staff, outside professionals, parents and carers and, above all, with the young person themselves. After all, they are the true expert on what works best for them.
Gemma Corby is Sendco at Hobart High School, Norfolk. Her Sendco column for Tes runs every second Tuesday in term-time. To read Gemma's back catalogue, click here. Want to keep up with the latest education news and opinion? Follow Tes on Twitter and Instagram, and like Tes on Facebook

# data[].attributes.attachment_link.title
Three strategies for making learning accessible for pupils with autism

# data[].attributes.attachment_link.description
In a recent blog for Tes, I shared some of my top strategies for supporting learners with autism spectrum conditions (ASC) in the classroom. Here is the second part of my advice for how to make learning accessible for these pupils. When creating your seating plan, give priority to students with identified additional needs.

# data[].attributes.body
Attention Autism

# data[].attributes.attachment_link.title
Attention Autism Stage 2 with Claire from @wearetheSENco

# data[].attributes.attachment_link.description
Build attention and develop maths skills for young learners and those with SEND.