Author: Schools & Community Psychology Service

By Dr. Rose McGeown

Recent large-scale research has found that in the UK around 1 in 57 children are on the autistic spectrum, with around four boys being diagnosed for every one girl (4:1)[i]. Autism has long been thought to be much more prevalent in males than females, but new research suggests that the prevalence in females may be much higher than we previously thought[ii].

When considering the presentation of autism in girls and women, it is important to note that the key diagnostic criteria for autism remains true: Autism is a neurodevelopmental condition characterised by:

1. Persistent difficulties in social communication and social interaction across multiple contexts
2. Restricted, repetitive patterns of behaviour, interests or activities

However, what research is now telling us is that there are some key gender differences in the presentation of autism when comparing male and female individuals. Autistic females appear to present with more subtle difficulties and can appear more similar to their neurotypical peers[i]. This is leading to many girls having their needs inaccurately identified and missing out on timely support.

Difficulties with social communication and interaction

Restricted, repetitive pattern of behaviour, interests or activities

Similarly, differences with restricted and repetitive patterns of behaviours, interests or activities can be much more subtle for autistic girls[i]. Autistic girls tend to have typical interests for their age e.g. animals, music, books, TV series, art and drama etc., but the intensity of this interest is atypical. For example, they may want to talk about their special interest for long periods of time, favour their special interest over social interaction or begin to identify as a character they are interested in. Repetitive patterns of behaviour, or ‘stimming’, whereby an individual engages in repetitive movements to regulate themselves may also be more subtle in girls e.g. twirling their hair, shaking their leg, playing with a piece of blue tac in class, meaning that for teachers to notice that this child is feeling dysregulated is tricky.

References

i Roman-Urrestarazu, A., van Kessel, R., Allison, C., Matthews, F. E., Brayne, C., & Baron-Cohen, S. (2021). Association of race/ethnicity and social disadvantage with autism prevalence in 7 million school children in England. JAMA pediatrics, 175(6), e210054-e210054.

ii Loomes R, Hull L, Mandy WPL. (2017) What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. J Am Acad Child Adolesc Psychiatry.

iii Russell, G., Steer, C., & Golding, J. (2011). Social and demographic factors that influence the diagnosis of autistic spectrum disorders. Social Psychiatry and Psychiatric Epidemiology, 46(12), 1283–1293.

iv Cridland, E. K., Jones, S. C., Caputi, P., & Magee, C. A. (2014). Being a girl in a boys’ world: Investigating the experiences of girls with autism spectrum disorders during adolescence. Journal of autism and developmental disorders, 44(6), 1261-1274

v Sedgewick, F., Hill, V., Yates, R., Pickering, L., & Pellicano, E. (2016). Gender differences in the social motivation and friendship experiences of autistic and non-autistic adolescents. Journal of autism and developmental disorders, 46(4), 1297-1306.

vi Allely, C. S. (2019). The female phenotype of autism spectrum disorder: The ‘camouflage’hypothesis. Editorial Board Members.

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

viii Sutherland, R., Hodge, A., Bruck, S., Costley, D., & Klieve, H. (2017). Parent-reported differences between school-aged girls and boys on the autism spectrum. Autism, 21(6), 785-794.

Fathers have an impact upon the child’s cognitive, emotional, social and physical development (Allen & Daly, 2002).

Kim and Hill (2015) found in a meta-analysis of studies found that despite mothers having higher mean levels of involvement in their child’s education,fathers also equally showed a strong positive association for their involvement and their child’s academic achievements.

Fathers who are nurturing in their roles tend to have children with higher cognitive and receptive languagescores(Dubowitz et al., 2002) and fewer behavioural needs (Cooley & Unger, 1991).

 Jeynes (2015) found that across 66 studies, father involvement often yielded the largest effect sizes regarding positive outcomes for children of minority ethnic backgrounds. 

Inclusive practice for fathers in schools:

Child Protection
Ensure you are mindful of fathers’ rights when engaging in safeguarding issues. For example, consider what are the legal rights of fathers who may not live in the same home as their child? Do they retain parental responsibility? What are the legal parental arrangements?

Father Inclusive Schools
Foster an environment that acknowledges different types of family structures e.g., single fathers, same sex parents, fathers who are the main care-giver.

Contact 
Ensure fathers are included in all correspondence e.g., emails, letters and meetings, reports and exam results. Include fathers contact details in referral forms to outside agencies. 

Representation & Inclusion
Some research (Fetcheriet al. 2011)suggested that fathers are more likely to become involved in school activities if the facilitator is male. Are there ways in which we can be mindful of the gender ratio of staff and how we can include fathers to support school activities? What are the fathers’ skill set and how can you work collaboratively?

Accessibility
Allow for flexibility in meetings e.g., making use of online or hybrid models and adjusting timing to ensure fathers and working parents can attend. Use an interpreter for families where a father may have English as an Additional Language (EAL). Be mindful that fathers from other cultures may have different experiences of school engagement and may not be familiar with school systems. Continue to identify other barriers to involvement fathers may experience.

 

By Dr. Amy Couprie

Changes to this familiarity can bring about different feelings for different children, such as excitement, uncertainty, or fear. It is likely there will be a mix of emotions, possibly sadness at leaving primary school and excitement and/or fear at beginning secondary school.

A sense of security may be felt within some children knowing there will be some friends or peers attending the same school. These friendships may last but often children will make new friendships groups as they develop. Some common themes that arise from children who are transitioning to secondary schools are about:

How can Parents and Carers help?

Parents and Carers can play a key role along with schools to support their children with the transition to secondary school. Parents may benefit from a workshop on how they can help to prepare their child. Things they can do include:

• Visiting potential schools with their child and gaining their views. They will have the opportunity to speak with current students to ask informal questions. Attending open days provide children with the ability to familiarise themselves with new staff, the building, locating different departments and toilets.
• Planning the route and doing a few test runs so they become familiar with the route. It may be worth noting the stop if they are catching a bus or pointing out landmarks (e.g. take the road by the church on the corner). Apply for a free bus pass in advance if needed (as not all drivers will allow them on without one).
• Ensure the child has got their full P.E uniform by the time they begin, some schools also hold second hand uniform sales.
• Allow the child to take more responsibility for getting themselves up in the morning by setting an alarm, packing their own bag, getting their own breakfast. Many schools have electronic or cashless systems for school dinners, but it may be useful to practice buying their own food from a local café or shop in case they need to manage using cash.
• Parents can also be anxious about the transition to secondary school some of this may depend on whether their child has got into their preferred school. It’s important to set aside their own views and feelings as children will absorb these feelings. Its important they start school with a happy mindset.

Supporting children with Special Educational Needs/Disabilities

Children with SEND may need additional support with the transition to secondary school depending on the individual needs of the child. Things to consider may include:

• Sharing key information/ SEND support plans/ EHCPs with the SENDCo or inclusion – This will help the school to prepare arrangements such as preparation for placing additional staff or resources.
• Considering transport arrangements.
• Some children may require a phased entry where the child or young person goes for a few hours a day or some days during the week to begin with. Some schools provide activities over the summer prior to beginning to help with a phased entry.
• Create a Social Story to help them know what to expect in their new school.
• Some children may benefit from extra support with making friendships and so encouraging attending different fun activities or clubs the school may offer can help them to begin to feel more comfortable in different social environments and making new friendships. They may also benefit from role-playing different social situations.

By Dr. Mollie Higgins

In addition to the general risk factors for EBSA, autistic young people experience a number of differences which further increase their feelings of anxiety in the school environment.

• Differences in identifying and describing their own and others’ emotions
• Emotional regulation difficulties
• Differences in sensory processing and finding the sensory environment overwhelming e.g. loud corridors, different smells, busy classrooms
• Difficulties understanding and predicting social situations and managing interactions with others
• Worries around change or transitions e.g. moving between classrooms, changes to timetables, supply teachers
• Executive functioning and organisation difficulties – remembering books, homework, equipment
• Masking – try to ‘fit in’ or attempting to appear more neurotypical by changing their behaviour and internalising any anxiety
• Experiencing performance anxiety related to the schoolwork or exams
• Rigid or inflexible thinking about school

These challenges mean that some autistic students try and manage their anxiety by avoiding school altogether. When we avoid something, our anxiety immediately reduces, but it makes it more difficult to attend school in the future. An important way of supporting attendance is speaking with students directly to hear their views and opinions about what might reduce their anxiety and help them attend school.

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Ten autistic secondary-age students were asked to describe the best type of school and the worst type of school. This technique is known as The Ideal School and is based on Personal Construct Psychology. Five key themes were identified and the key points are summarised below:

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How can schools help?

The following ideas for adjustments were suggested by autistic young people. Which adjustments has your school already implemented? Which other adjustments could you make within your school?

Autonomy and student voice:

• Actively listen to students’ views, opinions and ideas
• Involve students in decisions that affect them e.g. the school uniform policy, style of lessons, individual vs group work, how school is decorated, the lunch menu, the subjects they take.
• Allow students some autonomy over their day e.g. use of an exit card or time in a separate space when students identify a need.
• Encourage an environment where students can speak freely and feel comfortable asking for help by promoting open discussions and responding to their ideas without judgment.
• Aim to reduce power imbalances between students and staff by valuing students’ input and ideas.
• Aim for fair and reasonable rules that take into consideration the views and needs of all students.

Adjustments to meet individual needs:

• Consider the purpose and amount of homework set for students.
• Create opportunities for breaks throughout the day including use of a separate calm room.
• Consider sending work home if a students is absent, without expectation for completion.
• Consider the appropriateness of detentions and other consequences on a case-by-case basis.
• Embed more creative, engaging, interactive lessons that actively involve students in their learning.
• Ensure key information is clearly explained using visuals.
• Check whether students have understood the task.

The school environment:

• Consider the sensory needs of students including reducing the noise level, allowing use of a separate space and allowing students to leave lessons earlier to access quieter corridors.
• Create opportunities for background music and adjustable lighting.
• Consider adaptations to the school uniform to meet sensory needs.
• Create separate calm rooms away from the classroom that are designed and decorated collaboratively with students.
• Consider increased access to green space e.g. lessons outside.
• Consider whether there are opportunities for students to have access to animals at school.
• Aim to create a bright, welcoming environment with students’ work on display.
• Where possible, provide access to facilities such as libraries, science laboratories and sporting activities.

Strong relationships:

• Prioritise a relational approach across the school.
• Ensure staff understand the value of positive relationships with students.
• Avoid shouting, raised voices, using sarcasm or publicly questioning absence in front of students.
• Ensure staff treat all students with respect and understanding.
• Create opportunities for students to spend time with peers e.g. at break and lunch time and in group work and discussions.
• Ensure lessons are tailored to students’ interests where possible, to increase motivation and their ability to support one another with learning.
• Facilitate conversations relating to difference to encourage tolerance and acceptance amongst students.
• Ensure clear and reasonable boundaries are maintained by staff.
• Avoid stereotyping, labelling or grouping autistic students together.
• Seek opportunities for staff to engage with training relating to SEN and ASC.

For further support with gathering pupil voice, making suitable person-centred adaptations, or individual support plans for increasing pupil attendance, please contact your link EP.