Hammersmith and Fulham
School Improvement and Standards
- Inclusion Services -
Autistic
Spectrum Disorders
Handbook
for
Mainstream Schools
2010
Acknowledgements:
This resource was developed by staff from
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School Improvement and Standards Division, Children’s Services
Psychology in Education Service
Queensmill School
Hammersmith and Fulham PCT Speech and Language Therapy Service
SENCO Steering Group
SENCO Forum
Children, Adolescent and Family Services
Cheyne Child Development Centre
together with a
 Support Staff Representative and
 Parent Representative
It was produced and published by the Inclusion Services, School Improvement and
Standards, Children’s Services, Hammersmith and Fulham
December 2010
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Contents
Chapter Title
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Page
Definitions of Autistic Spectrum Disorder/Autistic Spectrum Condition
Local and national guidance and legislation
The role of health professionals
Preparing for a pupil with ASD in a mainstream care or education setting
Developing social understanding
Developing communication and language
Analysing and developing behaviour for learning
Sensory perception and the role of the occupational therapist
Assessing the learning needs of pupils with ASD
Support for pupils in school and education settings
Transition
Support for parents and carers
Case study
Useful references, websites and contacts
Appendices
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6
8
10
12
13
15
17
19
20
23
25
27
28
30
3
1. Definitions of Autistic Spectrum Disorder (ASD)1 / Autistic Spectrum Condition
(ASC)
Autism affects how the brain functions and how a person perceives, processes, understands
and responds to information. All people on the autism spectrum are affected to a varying
degree in the following three areas:
 social and emotional understanding
 communication and language
 flexibility of thought and behaviour
This is known as the triad of impairments. A fourth area, differences in sensory
perception, may also affect pupils on the autism spectrum. Overall therefore, this means
that children on the autism disorder spectrum have difficulty with:
 Understanding social behaviour and conventions, and being able to recognise their
emotions and those of others
 Developing and using effective communication and language skills including speech,
gesture, facial expressions and intonation
 Problem solving and knowing how to adapt when a familiar situation is changed.
The effects of autism are not always obvious to others and it may be that adults do not
recognise such differences immediately. Autism is a pervasive developmental disorder and
not one that can be ‘cured’ as such. However, much can be done through careful and
considered support to minimise the impacts of autism on the daily life and functioning of the
young people it affects. It is also important to note that, despite having difficulties in the same
three areas, children on the autistic spectrum all have very different strengths and difficulties
and so will need individualised programmes of support. Such programmes of support need to
focus on the strengths of the individual as much as their difficulties or differences. A
diagnosis of ASD does not indicate a particular level of learning potential and therefore it is
essential to assess each child’s skills, strengths and abilities individually, and plan learning
accordingly.
The following terms and definitions are taken from the National Strategies IDP resource for
Autism
Term
Definition
Asperger’s Syndrome
A diagnostic category for a pupil of average or above average
intelligence with autism who is not delayed in learning to speak.
Atypical autism
A category used to cover those who have characteristics in
common with autism and Asperger’s syndrome but who do not
quite meet the criteria for either of these categories. It is also
referred to as pervasive developmental disorder not otherwise
specified (PDD-NOS).
Autism
A diagnostic category which may also be known as autistic
disorder, Kanner’s autism and classical autism.
Autism outreach
Many authorities have a team of staff who support schools and
families in their work with pupils on the autism spectrum. These
are often referred to as autism outreach teams, communication
teams or specialist teams.
1
For consistency, the term ASD has been used throughout this document.
4
Term
Autism spectrum condition
(ASC)
Differentiation
Definition
Term given to cover a range of subgroups including autism,
Asperger’s syndrome, atypical autism and PDD-NOS.
The action needed to respond to an individual’s particular
requirements to access the curriculum effectively.
Disability
A person has a disability if he or she has a physical or mental
impairment which has a substantial and long-term adverse
effect on his or her ability to carry out normal day-to-day
activities (Disability Discrimination Act (1995) Part 1, para. 1.1).
Educational psychologist
A psychologist who assesses the educational needs of pupils
(EP)
and recommends the type of support required.
Expressive language
The use of words and sentences, vocabulary and grammar.
High functioning autism
A pupil with autism who is of average or above average
intelligence but was delayed in learning to speak.
Multi-agency
Groups from different professions or disciplines.
Non-verbal communication Communication through the use of facial expressions, gesture
and body language.
Occupational therapist
A therapist who assesses an individual’s ability to perform
everyday tasks, and provides ideas on how to enhance
performance.
Pathological demand
Individuals who have some of the characteristics of autism and
avoidance
Asperger’s syndrome, but who find it extremely hard to follow
other people’s demands or agendas.
Pervasive developmental
A term used in DSM – IV, American diagnostic systems to
disorder (PDD)
group together certain clinical conditions. All the autism
spectrum disorders (autism, Asperger’s syndrome and PDDNOS) fall into this category. In addition, it includes Rett’s
syndrome and Heller’s syndrome (childhood disintegrative
disorder), which are generally not included as ASC because of
their characteristics and prognosis.
Pervasive developmental
Those who have characteristics in common with autism and
disorder not otherwise
Asperger’s syndrome, but who do not quite meet the criteria for
specified (PDD-NOS)
either of these categories. It is also referred to as atypical
autism.
Receptive language
Understanding what is communicated or written, including
vocabulary, grammar, stories and non-verbal communication.
Quality-first teaching
High quality provision for all children from all teachers and
teaching assistants.
Speech and language
A therapist who assesses an individual’s ability to communicate
therapist (SLT)
and their speech and language skills and devises programmes
to develop these.
Social and emotional
A DCSF programme designed to enhance understanding of the
aspects of learning (SEAL) importance of the social and emotional aspects of learning.
Special educational needs A term used to describe a pupil who is deemed to require
(SEN)
additional or different educational support from others of the
same age.
Special educational needs A person within school who is responsible for coordinating
coordinator (SENCO)
information and action for pupils with special educational needs.
5
2. Local and National Guidance and Legislation
Work with children/young people with autism in schools is covered by the same legislation
with regards to rights and support as any other child. Key documents are the SEN Code of
Practice 2001, the Children Act 2004, the Disability Discrimination Act 2005, the Equalities
Act 2010, and any relevant amendments.
Legislation and guidance exist to support and underpin good practice in responding to and
providing for children and young people who have recognised additional learning needs and
/or disabilities, ie special educational needs.
The SEN Code of Practice (2001) is the main guidance provided by the Department for
Education and sets out a pathway of support which all settings offering care and education
are expected to adhere to and importantly that parents/carers can expect them to adhere to.
The expectation is for practitioners to
 identify areas of need
 differentiate learning opportunities
 ensure that all children can access learning at their own starting point; and
 work in partnership with the parents/carers and with other professionals in recognising and
supporting learning needs.
In Hammersmith and Fulham, children with special educational needs (‘SEN’) of all types
have access to support in schools via each school’s SEN budget and also, where needs are
more severe, via the ‘decoupled funding’ budget. It would be expected that a child with an
ASD would access these resources. Support at this level will often be enough to produce
good progress in pupils with autism, especially those at the milder end of the spectrum.
Other relevant legislation includes the Special Educational Needs and Disabilities Act
(2001), which established legal rights for disabled students in pre- and post-16 education, the
Disabilities Discrimination Act (2005), which required organisations to make reasonable
adjustments to include disabled children and their family/carers; the Childcare Act (2006)
which gave local authorities a duty to improve the well-being of children, reduce inequalities,
and respond effectively to the needs of individual children. However, much of this has been
subsumed under the Equalities Act (2010) although preceding legislation still holds until
legally superseded.
There are several other recent documents that have been written as (national) guidance for
professionals working with children with autism, including:
 Autistic Spectrum Disorders: Good Practice Guidance (DfES and DoH; 2002)
 National Autism Plan for Children (The National Autistic Society; 2003)
 Inclusion Development Programme (IDP): Supporting children on the autism spectrum in
Primary and Secondary Schools (DCSF; 2009)
 Inclusion Development Programme (IDP): Supporting children on the autism spectrum:
Guidance for practitioners in the Early Years Foundation Stage (DCSF; 2009)
Statutory Assessment (see also the SENCO Handbook 2010)
Where the in-school resources have been found to be insufficient to ensure an appropriate
rate of progress, the school may request a statutory assessment which in turn may lead to a
statement of special educational needs. Before considering a request for a statutory
assessment however, it is important to involve the Psychology in Education Service and if
possible, particularly if the child is young, ensure a multi-disciplinary assessment (MDA) has
6
taken place. The outcomes and impact of the interventions developed as a result of these
professionals’ involvement should be included in any request for a statutory assessment as
these will have informed the school’s judgement that the rate of progress is not appropriate.
A statement of SEN will be provided by the local authority when the statutory assessment
concludes that “…the assessment and provision made by the school or early education
setting is appropriate but the child is nonetheless not progressing, or not progressing
sufficiently well”; in which case, “the LA should consider what further provision may be
needed and whether that provision can be made within the school’s or setting’s resources or
whether a statement is necessary.”
Following a statutory assessment, it will also sometimes be clear that the level of difficulty
(particularly but not exclusively in social and communication skills) is such that the young
person will find life at a mainstream school very difficult. If so, it may be appropriate for the
young person to attend a special school. Queensmill School is the Hammersmith and Fulham
provision for children with moderate to severe autism. The decision to place a young person
at this school will be taken by a panel of professionals from the Local Authority, in
consultation with the parents/carers and the school’s head teacher.
If a statement of SEN is agreed, the school will need to review it annually. Between these
formal reviews, practitioners and school staff will regularly record and evaluate the impact of
interventions on progress against specific targets developed by all involved, and in liaison
with other professionals involved and in collaboration with the parents/carers (and child,
where appropriate).
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3. The Role of Health Professionals
Diagnosis of ASD
These are made by teams of health professionals. It is a medical (not educational) diagnosis
and in Hammersmith and Fulham, the diagnostic teams are housed at two health service
provisions:
 the Cheyne Child Development Centre (CCDS), and
 the Children, Adolescent and Family Service (CAFS).
Children can be referred for assessments by schools, GPs and parents. The CAFS provision
is for young people whose GP is in Hammersmith and Fulham. School staff or other
professionals should not make casual references to autism (or the possibility of autism)
before a diagnosis has been made as this can be inaccurate and/or misleading, and cause a
high level of anxiety. It should be noted that there are several other factors that may impact
on a child to produce what may be misconstrued as symptoms of autism and ‘casual
misdiagnoses’ are common.
Cheyne Child Development Service
Cheyne CDC provides a service for children with special needs up to the age of 19 years, (but
see Speech and Language Therapy below).
Children in the south of SW6 are seen at the Central Team:
Cheyne Child Development Centre
Chelsea and Westminster Hospital
369 Fulham Road
London SW10 9NH
020 8846 6571
Children in the rest of the borough are seen at St Dunstan’s clinic:
Hammersmith and Fulham Child Development Team
St. Dunstan’s Clinic.
St. Dunstan’s Rd,
London, W6 8RB
020 8846 1601
Child, Adolescent and Family Service
Diagnosis can be provided from CAFS at Glenthorne Road, Hammersmith, although this is
only when the child is a current CAFS case. CAFS is an NHS service for children and young
people up to the age of 18. Contact details are:
Child, Adolescent and Family Service
48 Glenthorne Road
Hammersmith
W6 0LS
020 8483 1979
Web: www.wlmht.nhs.uk/hfcafs
Glenthorne Road CAFS also provides a generic Tier 3 Child and Adolescent Mental Health
Service (CAMHS) to children with significant behaviour and emotional difficulties. This
8
includes: psychiatry, family therapy, psychotherapy, nursing and clinical psychology. They
also have specific professionals who are experienced in working with children with a variety of
learning difficulties and can therefore provide input to children on the autistic spectrum with
emotional and/or behavioural difficulties.
Other Health Support Services:
Paediatrics: The Cheyne Child Development Paediatric team forms part of the diagnostic
service, additionally providing neuro-developmental assessment, investigation and review as
appropriate. The team works jointly with the therapy team.
Clinical Psychology: the Clinical Psychology Service forms part of the diagnostic team and
may provide a follow-up appointment with the parents/carers to provide further support and
advice on a whole range of issues to do with autism. This support may be offered on an
extended basis where appropriate (020 8846 1601).
Speech and Language Therapy: The Speech and Language Therapy Service can support
children with ASD, in developing more effective communication skills whilst at school. Contact
Kim Lewis, Principal Speech and Language Therapist Coordinator for Mainstream Schools in
Hammersmith and Fulham for more information, at:
Milson Road Health Centre
1 - 13 Milson Road
W14 0LJ
020 8846 6238
kim.lewis2@hf-pct.nhs.uk
NB For children under 5 years or until they enter reception class, speech and language
therapy input is provided by the teams at the Cheyne Child Development Service. They are
also part of the diagnostic team and can be contacted at the CCDS at Chelsea & Westminster
Hospital or St Dunstan’s Clinic
Occupational Therapy: The Occupational Therapy Service will often support children with
ASD, particularly those with sensory difficulties or those with fine and gross motor difficulties.
Contact St Dunstan’s Road Clinic (020 8846 1605) for more details.
Music Therapy: Children up to the age of 17 years with a diagnosis of ASD can be referred
to the Music Therapy service at Cheyne Child Development Service (020 8846 6472).
Specialist Social Worker: The part-time social worker works across all three boroughs
covered by Cheyne CDS (020 8846 1293).
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4. Preparing for a Pupil with ASD in a Mainstream Care or Education Setting
Provision for children with ASD is made in a variety of settings in Hammersmith and Fulham –
mainstream schools, special schools for autism or other special schools. To get the most out
of their education, children with ASD, wherever they are placed, must have their educational
and other needs addressed. This has implications for
 the class/subject teachers, in the planning and delivery of the curriculum as a whole and
individual lessons
 how the management of the school/care setting allows for the inclusion of children with
ASD,
 what targets are set in Individual Education Plans (IEPs),
 how support for behavioural, social and emotional needs is planned and carried out
 the work of the Special Educational Needs Co-ordinator (SENCO).
A whole-school approach is the most effective way of meeting the needs of children with an
ASD, regardless of type of provision. Whole school training is highly recommended to
enable all staff to understand the reasons for the child’s response to classroom tasks and for
their behaviour during lessons and break times. If staff do not know about ASD, then a child
might be incorrectly perceived as difficult or non co-operative.
Schools are advised to liaise with key professionals such as the Educational Psychologist and
the Speech and Language Therapist assigned to the school for advice and support. The
Queensmill Outreach Team will also help schools plan the most appropriate training for their
particular setting.
Schools may find it useful to complete an audit of confidence levels regarding skills and
knowledge (see Appendix 1: Potential indicators of effective practice in relation to the autism
spectrum and appendix 3: Self-evaluation checklist for the learner) to ascertain their strengths
and weaknesses.
Creating a supportive environment is crucial for maximising learning opportunities and
preventing challenging behaviour. Key professionals will advise on ways in which to structure
and organise the immediate environment. Many young children with ASD for example,
respond to an Individual Work Station to work through tailor made tasks. This is a distraction
free area, with in and out trays for organising the flow of work. A Visual Timetable of the day
will also help children with ASD understand the sequence of events and activities that they
are likely to encounter. A ‘safe haven’ may need to be created within the school to which the
child can go if and when they feel stressed.
It is important to identify the child’s individual aptitudes, interests, and existing skills in order to
build on these and to help the child engage with tasks, which may have less appeal. Schools
may find the Skills and Behaviour Checklist (see appendix) useful in identifying pupil needs
and priorities. For children who have limited language skills, a Communication Passport
(see http://www.communicationpassports.org.uk/Home/ for suggestions) can provide an
instant record of the child’s key characteristics for everyone to note.
Finally, every child is unique but there are particular strengths and skills that children with an
ASD seem more likely to develop than other children:
 An ability to focus on detail and to concentrate for long periods of time on a single activity.
Some children can give their sole attention to a task and achieve a high level of skill and
continue to work on tasks beyond the point at which their peers may tire
10
 A talent for learning facts and skills especially when presented in a way suited to their
learning style e.g. using lots of visual material
 An individual way of looking at the world and figuring out how the world works. These
idiosyncrasies can often be a source of interest and affection for families and people who
know the pupil well
 A powerful and unusual learning curve. Children with ASD may appear to ‘stand still’ in
their development for a while and then take an unexpected leap forward in their abilities
and skills. This pattern of development is usually associated with non-verbal skills e.g.
using building blocks, doing jigsaws, memorising facts and figures, mimicry, and
understanding things visually.
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5. Developing Social Understanding
Children with ASD have significant difficulties in sharing and understanding their own and
others’ thoughts, feelings, meanings and experiences. This is because they have not
developed a ‘Theory of Mind’ (‘ToM’), ie the ability to guess what others might be thinking
and feeling. ‘ToM’ difficulties also mean that children with ASD tend to assume that others
have in their heads what they have in theirs, and so they do not understand the need to
communicate what they are thinking. As a result, areas that are challenging to children with
ASD are:
 understanding the ‘invisible’ rules for behaviour
 establishing and maintaining friendships
 understanding the social intent of others
 processing social information
 responding appropriately to social initiations or expectations.
This is why children with ASD can display unusual or inappropriate behaviours, or appear
rude, dismissive or unfriendly. This is rarely intentional and usually a consequence of the
difficulties they are experiencing.
Children with ASD have to work much harder to understand how personal interactions and
friendships work: although they may want to have friends and to get on with others, they do
not know how to. Therefore, a child with ASD will need teaching and guidance on how to
share thoughts, feelings and experiences and develop social relationships. Some key social
skills are listed below:
 Sharing interests
 Understanding others’ emotions
 Making and maintaining friendships
 Understanding ‘personal space’
 Taking turns in games and conversation
 Understanding what others are thinking
 Sharing information
 Understanding facial expressions and body language
It should also be remembered that many social skills require an understanding of more
complex emotional responses, such as embarrassment, guilt or empathy; it may only be
possible to teach the more simple emotions such as sadness, happiness, etc to a child with
ASD.
It is important to structure social experiences and activities in a variety of settings across the
school day, as every interaction is an opportunity for the child with ASD to develop social
skills. Specifically designed social skills groups, using carefully selected peers as colearners, can be effective because, whilst play and social interaction is usually relaxing ‘down
time’ for most children, for children with ASD, it is often ‘work’. It is also important to
remember that although a child may have displayed a skill once, this will not necessarily
mean that s/he can repeat the skill or generalise it to other situations; s/he will need on-going
empathy, support and guidance to do so.
For all these strategies to be effective, it is important to have a clear understanding of each
child’s likes, dislikes, learning styles and abilities; this can be done through building up a
personal profile of the child, as mentioned throughout. Other interventions to support the
understanding of social behaviour are: Social Stories (Carol Gray I991), Circle of Friends
(Perske 1988), Comic Strip conversations (Carol Gray), and see Chapter 10 below)
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6. Developing Communication and Language
As noted in the previous chapter, in addition to difficulties with social and emotional
understanding, communication and language, flexibility of thought and behaviour (the triad of
impairments), children with ASD have difficulties with:
 Theory of Mind (‘ToM’ – see previous chapter) ie guessing how others are thinking and
feeling, and some degree of sensory sensitivities, and
 Joint attention skills ie the capacity of the child to attend to and respond to the social
communication of others.
In the early years, this lack of joint attention leads to issues such as missed cues within
communication, difficulties with learning vocabulary (since children rely on watching adults'
modelling to provide a linked reference to items and actions etc in order to learn meaning)
and a reduced ability to share meaning effectively with those around them. In later years, an
ongoing difficulty with joint attention can also significantly contribute to problems with
conducting two-way conversations. Further relevant information can be found in ‘The
SCERTS Manual: A Comprehensive Educational Approach for Children with Autism
Spectrum Disorders’, Prizant, Wetherby, Rubin, Laurent and Rydell (2005), Brookes
Publishing Company.
Overall therefore, children with autism have to work harder to understand how to interact with
others. The difficulties and abilities are unique to each child, but in addition to the noted
issues above, common concerns can include:
 A delay in acquiring and using functional language
 Difficulty in understanding speech
 Having unusual speech patterns
 Difficulties in using and understanding non–verbal communication
A child with ASD may have the ability to use speech, for instance they may be able to repeat
whole chunks of a favourite song or video, but may lack the ability to communicate effectively
with others or to tell others how they are feeling. Speech is only one method of
communication; it may be necessary to find other ways of helping the child to communicate
their needs, wants and feelings.
Due to difficulties with Theory of Mind, the child with ASD may have difficulty seeing the
purpose of communication; s/he may instead assume that you know what s/he knows and
feels, and therefore will not understand the need to tell you. When your actions clearly show
that you do not know what the child wants, stress and behaviours resulting from frustration
will often occur. It is important therefore to analyse what the child is trying to ‘say’ with
inappropriate behaviour, and give him/her the means to ‘say’ it in a more acceptable way. If
adults (and peers) can find ways to help the child to communicate more effectively, these
‘frustration’ behaviours are likely to reduce. However, the child may have difficulty in
communicating appropriately until s/he has the opportunity to learn to do so in a way that is
appropriate to him/her.
The two key points to remember are that the child needs to have:
1) a reason to communicate: this can be encouraged by the use of motivating materials and
activities and by creating situations in which the child must communicate to make
something happen; and
2) a means to communicate: communication is not just speech, so if the child does not have
speech, or his/her speech is not yet functional, then s/he needs to use other methods by
which s/he can communicate needs and wants. S/he may therefore use:
 Idiosyncratic vocalisations
 Signs
13
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Pointing
Gesture
Use of pictures, photos, symbols or objects
Written language
Once the relevant/appropriate methods of communication have been identified, the
inappropriate forms of communication should diminish.
To help the child further, and to help him/her to understand you and develop his/her own
expressive language, it is useful to bear the following points in mind:
 limit your language to words the pupil knows, and try to use the same words each time in
the same situation
 use short, simple sentences or phrases
 speak clearly, slowly, and WAIT – the child’s processing and response time might be very
much longer than for a pupil without ASD
 exaggerate your tone of voice and facial expression as children with ASD find non-verbal
cues hard to pick up on
 use gestures and other visual cues (pictures, objects, printed words) along with the spoken
word
 when the child is stressed or upset, reduce your spoken language even more and increase
the use of visual supports
 repeat back what the child has said, and expand on it slightly
 when the child is engaged in something that interests him/her, use simple language to
describe what s/he is doing – pairing actions with words will make it more meaningful
 work through the child’s interests
 say exactly what you mean – use short, direct phrases
 gain the child’s attention before attempting to communicate, but without saying, “look at
me” as children with ASD find eye contact difficult: say the child’s name
 get physically close if the child is comfortable with this, and speak quietly
Makaton (http://www.makaton.org/about/users.htm)
Makaton is a language programme which uses speech and hand gestures
simultaneously, supported by facial expression, eye contact and body language. Signs give
extra information which can be seen and help highlight the most important information words
in sentences. Makaton helps support both understanding and speaking. Through Makaton,
the child with ASD can also be supported to develop other important core communication
skills, such as eye contact, turn taking, making choices and sharing information.
Formal Makaton training is recommended to ensure staff can use signs effectively and
accurately. Information on local courses can be accessed via the Makaton website (see
above), or via the school’s speech and language therapist. Many therapists have themselves
received Makaton training and can be a useful resource for schools wishing to support
children in this way. For example, they may be able to provide some whole class sessions for
children to learn some basic daily signs, in order to support the more effective inclusion of a
child who benefits from this method of communication.
PECS (http://www.pecs.org.uk/index.htm)
PECS (Picture Exchange Communication System) is a highly structured communication
approach developed by a firm called Pyramid) that is often used effectively with children with
ASD. However, it is important that if school is to use PECS, staff are trained in it. The
training is two days long with Pyramid. Without this training, PECS is likely to be used
inaccurately or inappropriately and can therefore be ineffective.
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7. Analysing and Developing Behaviour for Learning
Many difficulties associated with autism spectrum disorders may result in unusual or
unexpected behaviours, either because the child is trying to communicate but does not
understand how to do so appropriately, or because s/he is having sensory difficulties.
Changing behaviour takes time. Once an intervention approach has been decided upon, it is
very important that it is consistently applied. This means that all adults working with the child
will need to respond in the same way every time the behaviour occurs, over an extended
period of time, until the desired behaviour is established. Lots of positive reinforcement (eg
praise) for every small step made will help. It is also important to address only one behaviour
at a time; it is difficult to develop appropriate interventions and measure their success
effectively if several behaviours are being addressed simultaneously.
As children with ASD find it difficult to generalise new skills and behaviours, it is very
important that the child is helped to apply the new skills and ‘coping mechanisms’ to different
settings and environments, although they are likely to find this complex and tiring. The overall
goal is to help the child identify what they can do to help themselves, either personally or
through asking an adult or peers.
Functional Analysis: To understand what the child is trying to communicate or cause to
happen, it is important to gather information as to what happens before, during and after an
incident. This is called a functional analysis. From this information, staff can see if there is a
pattern to the behaviour and/or whether it is linked to a specific want or need. Staff can then
teach the child how to communicate this want or need more effectively, through one or more
of speech, gesture, symbols or photos.
Functional analysis and records of behaviour are often referred to as ABC charts (A =
Antecedent, or what was happening before the behaviour; B = the Behaviour, ie what actually
happened; C = the Consequence of the behaviour, ie what happened next). The following is
an example:
A: The child is in the classroom and sees the toys outside in the playground
B: The child screams and bangs on the door
C: The adult opens the door and the child goes through to the playground
Through this analysis, it is clear that the child will associate (ie learn that) banging on the door
is a successful method of communicating his/her need or desire to go into the playground.
However, the child needs to learn how to ask to go out, rather than continue to bang on the
door. Therefore the adults need to ensure this association/learning takes place, through their
own appropriate actions consistently and regularly presented, and positive reinforcement of
the child’s own appropriate actions. Through this, the child will understand that asking
(whether through vocalisation, symbol, gesture etc) to go out is appropriate behaviour and
banging on the door is not.
Responding to Sensory Needs: If the unusual or unexpected behaviours are because of
sensory needs, a different approach is necessary. A child with ASD who is rocking in their
chair may be seeking sensory feedback that will allow them to feel calmer. Preventing this
would make them more anxious and less able to settle and learn. Staff therefore need either
to allow the rocking or to find another activity that can offer the child the same calming
feedback. Occupational Therapists can help with this (see chapter 8).
15
Other positive strategies to use are:
 Frequent use of clear, meaningful visual support for the child so that s/he can make sense
of the school day
 Relaxation techniques: eg listening to music, using the computer, working on a special
interest project
 Emotion training: understanding facial expressions and body language (this will be
challenging for the child with ASD)
 Behaviour and feelings management: learning to apply appropriate activities to calm down,
such as requesting a break, asking for help, asking for some sensory equipment
 Positive reinforcers and motivators: using favourite toys, activities, verbal praise with or
after an required behaviour
 Prompting: learning a new skill with assistance to complete the task
 Token system: earning tokens in exchange for a positive reinforcer
 Ignoring: used with a positive reinforcer to learn an alternative way to achieve a desired
outcome
 Redirecting: offering a distracting activity (used to diffuse a difficult situation)
 Having access to a calm and quiet space.
16
8. Sensory Perception and the Role of the Occupational Therapist
The sensory needs of a child with ASD as identified by an occupational therapist (OT) are
related to the child’s difficulty in processing the sensory information (touch, movement, smell,
taste, vision, and hearing) they receive from the world around them. For most people, this
process is automatic: we hear someone talking to us, we recognise it as a voice talking in a
normal tone, and we respond appropriately. However, children with an ASD who have a
difficulty in this area won’t experience such interactions in the same way. They will interpret
the information differently and then respond to that information with emotional, motor, and
other reactions. For example, some children are over-responsive to the input their senses
receive and may feel as if they are being ‘bombarded’ with sensory information. They may try
to eliminate or minimise this perceived sensory overload by covering their ears or avoiding
being touched or being particular about clothing.
Conversely, some children are under-responsive and have a constant drive/need for sensory
stimulation. They may continually seek out stimulation by taking part in extreme activities
such as playing music loudly, or moving constantly. They sometimes won’t notice pain or
objects that are too hot or cold, and may need high intensity prompts or prompting to get
involved in activities. Others may have trouble distinguishing between different types of
sensory stimulation (eg light and heavy touch). It is also important to be aware that
responses to sensory input may be highly inconsistent and vary on a daily basis.
Occupational therapists promote skill development and independence in all daily activities.
The ‘occupations’ of childhood may include playing with friends, washing hands, using cutlery,
going to the bathroom, cutting with scissors, writing or mark making at school, running,
jumping, and sitting at circle time. The number and range of strategies applied by an
occupational therapist within a mainstream school may vary and can be influenced by the
student’s needs, the teaching environment and resources available.
Since children with an ASD often lack some of the basic social and personal skills required for
independent living, occupational therapists working with them may:
 Provide interventions and strategies to help a child appropriately respond to information
coming through the senses. Intervention(s) may include activities such as swinging,
brushing, and playing in a ball-pit; they are intended to help a child better understand and
manage his/her body in space.
 Facilitate play activities that instruct as well as aid a child in interacting and communicating
with others. For the OT specialising in ASD, this can translate specifically into structured
play therapies, which focus on building intellectual and emotional skills as well as physical
skills.
 Devise strategies to help the individual transition from one setting to another, from
interacting with one person to another, and from one life phase to another. For a child with
an ASD, this may involve calming strategies for managing the transition from home to
school.
 Develop adaptive techniques and strategies to get around apparent barriers to learning, for
example, teaching keyboarding when writing is highly challenging or selecting a weighted
vest to enhance focus.
 Recommend sensory equipment, monitor its use and evaluate its benefits2.
Through assessment, the OT can determine if the behaviour demonstrated by a child is
related to sensory needs or motor impairment. Intervention can often take the form of a
combination of regular occupational therapy sessions and home/school programme
2
Equipment can be borrowed from the Queensmill Sensory Library
17
suggestions. The OT provides activity and programme suggestions tailored to the needs of
the individual child.
Some children may need a ‘sensory diet’. This is a specific schedule of sensory activities
designed to help the child remain calm, relaxed, attentive and able to learn. The idea is that
this ‘diet’ will be provided throughout the day, whether by a trained therapist or by teachers,
teaching assistants or parents/carers. If a child receives appropriate intervention all day, he
or she will be better able to take part in typical daily activities, better able to focus, less likely
to "stim" (ie self-stimulate) eg flap, jump or spin inappropriately, and to cope with more
stimulating situations.
18
9. Assessing the Learning Needs of Pupils with ASD
Staff in schools may come across a variety of different profiles of pupils on the autism
spectrum. Levels of self-care, learning ability and independent skills can vary greatly, and a
pupil’s profile is often uneven. Because of this, normal tests and standardised assessments
may not pinpoint the strengths and weaknesses of the pupil very well. Therefore, a wider
range of sources of information are needed to create an accurate profile of the young person.
These will include the pupil, parents and carers, and other professionals.
Creating an individual passport or profile for a pupil is a useful technique to help everyone
understand the unique profile of the pupil, and how to help support, manage and reward each
pupil appropriately. Ideas for creating and using a passport can be found in Chapter 6 of the
online IDP Autism materials (see Appendix), from
http://www.communicationpassports.org.uk/Home/, or by consulting one of the professionals
listed below.
As well as finding out about and monitoring a pupil’s self-esteem and emotional well-being,
staff will need to ascertain the interests of the pupil and include these in the profile. It is likely
that learning about appropriate behaviour, social interaction and life/independence skills will
be as important and beneficial to the young person as educational support.
Profiling how the pupil reacts behaviourally to the variety of stimuli presented in the school
environment will be a key factor in keeping anxiety levels low. Using this information to adapt
the teaching environment is often the key to allowing the pupil to focus more readily on
teaching and learning.
It is important that schools consider how effectively key information on pupils on the autism
spectrum is shared and updated between staff and parents. All staff in the school should be
aware of the profile of any autistic learners as this will ensure a consistency of approach and
avoid creating confusion for the pupil.
In Hammersmith and Fulham there is a wide range of professionals who are available to
schools to help with profiling pupils and developing the teaching environment in order to
better include children with ASD :
 Queensmill outreach staff (including teachers, TAs, speech and language therapist and
occupational therapist)
 Educational psychologists
 The Sensory and Language Impairment Team (peripatetic teachers)
 Speech and Language Therapists
Please see Chapters 3, 12 and 14 for these and other contact details.
19
10. Support for Pupils in School and Education settings
Because of the difficulties they experience, pupils with ASD will need changes to be made in
mainstream settings so that they can be successful learners. The following strategies can be
very helpful in mainstream settings:
TEACCH (Treatment and Education of Autistic and related Communication Handicapped
Children)
TEACCH is a system that allows adults to intervene, help structure and organise the day for
the child, reduce confusion, distractions and unnecessary information. This can make a
significant difference to the child with autism in a mainstream school by allowing him/her to be
calm, pay attention and learn successfully.
The TEACCH approach focuses on the individual with autism and the development of
strategies centred on their skills, interests and needs. The aim is to use TEACCH to promote
the child’s independence and self-esteem as a successful learner. Its use will prepare the
child to manage the day-to-day demands of a busy mainstream school setting more
effectively. It can also be used at home and eventually help prepare the young person for the
work place.
The specific elements that are recommended into mainstream classrooms are:
 segmenting specific areas of the classroom using screens, bookcases, by using taped lines
on the floor or desks
 a workstation for independent work
 a 1:1 work area
 a specified table and chair with photo
 carpet square for floor sitting
 an individual schedule.
Not all mainstream classrooms are able to add all of these, but a creative approach to making
some physical changes for the child will make life in the classroom much more manageable
and successful for all.
Training in TEACCH can be provided for the whole school staff by Queensmill Outreach staff,
either at a school or on the Queensmill site. Schools can also ask the Queensmill Outreach
Service to work with them to create, where possible, some parts of the environment that are
‘low-arousal’ ie where sensory distractions are limited. Outreach staff can also work with
class and school teams to plan activities and resources that will help children with autism to
access learning in the mainstream class. The principals of TEACCH can also be discussed
with educational psychologists.
Social Stories™ (see http://www.thegraycenter.org/social-stories)
Social Stories were originally devised in 1991 by Carol Gray for use with children with autistic
spectrum disorder and have since been used successfully with children, adolescents and
adults with ASD and other social and communication difficulties. A Social Story will describe
a social situation and the appropriate response and can be very effective to teach students to
handle problems/difficult situations in an appropriate way. It will be written for a specific
student in a specific situation; consequently, the style and content vary according to the age
of the student and the given event.
There are specific guidelines and criteria that need to be adhered to when writing Social
Stories so that they have the desired outcome (see website above). Training in and advice
20
regarding writing social stories can be provided by Queensmill Outreach Service and by the
Psychology in Education Service.
Circle of Friends
The Circle of Friends approach is often used to assist children with an ASD to develop their
social and communication skills as this is an area in which they will often have difficulties. A
circle will usually consist of a group of pupils who meet on a regular basis with a member of
staff and with the pupil with ASD. The group are encouraged to develop an understanding of
the ASD child’s behaviour and difficulties in order to develop strategies and practical solutions
jointly to help that child. Parents/carers of all involved need to give permission. Training in
setting up a Circle of Friends process within a mainstream setting can be provided by
educational psychologists, the SEAL (social and emotional aspects of learning) coordinator,
the Primary Inclusion Development Service, and specifically for autistic pupils, by Queensmill
Outreach Service.
SPELL (Structure, Positive, Empathy, Low-Arousal and Links with parents/carers and other
professionals)
The expectation is that each educational setting would have the above elements for its pupils
with autism (and for others too).
Structure: Children with ASD can find many everyday situations stressful and difficult. This
stress can be reduced through the use of visual cues, visual timetables, labelling, “Now/Then
Boards” etc., (as outlined above) as they help the child – and other children – to understand
the school day, eg, what is coming next, how long it might last, and what will happen after
that.
Positive: All children need a high degree of positivity, but children with autism should also be
given lots of praise for the considerable effort they have put in to achieve what others may be
able to achieve with ease. Similarly, parents and carers of children with ASD may need
support, help and encouragement.
Empathy: Through understanding ASD and the impact autism can have on the child and
his/her family, staff can start to empathise with some of their experiences. This in turn makes
it easier for the adults involved to adjust both their responses and the environment so that
some issues are reduced for the child, which in turn helps the child to learn and achieve.
Low Arousal: People with ASD usually have sensory sensitivities that can impact
considerably on their lives: they may find certain noises, lights, smells, textures very
distressing. Whilst other sensory insensitivities may be at a lower level, they can still distract
the child from the learning. Children with ASD respond well when they can have access to
some areas which are
 quiet and calm
 do not have fluorescent lighting
 do not have distracting details such as bricks or tiles
They will tend to work better in a small area that has blank screens around it so that they can
concentrate on their learning task. Being generally visual learners, they will also benefit from
lots of visual support and as little spoken language as possible. LBHF schools have access
to occupational therapists (see chapter 8) who can advise on materials and equipment that
can help.
Links: Children with ASD need consistency across the whole school and across the services
that support them. It is therefore important that all professionals working with the child
21
communicate effectively with each other. Communication with the parents and carers is also
essential so that school and home can work together wherever possible.
Use of visual cues and limited language (see Chapter 6 for more detail)
Any aspect of the TEACCH arrangements, Makaton, PECS or other visual support is
essential for the child with ASD, as pictures/photos/symbols or words are:





stable over time, whereas spoken words ‘disappear’ and can be easily forgotten
attract and hold the attention of visual learners such as those with ASD
reduce anxiety
make concepts more concrete
are helpful prompting techniques
Oueensmill Outreach Service
Queensmill Outreach Service provides support for staff in the successful management and
teaching of children with ASD in mainstream schools. The service has two strands:
1. Outreach staff from Queensmill School visit mainstream staff to help, support, train and
advise in any of the following:
 Whole staff training on autism which will include aspects of the longer training sessions
offered at Queensmill
 Further training in greater depth for some staff or all staff according to schools’ needs
 Observation of a particular child or children with ASD in the school to evaluate their
response to the educational environment and their ability to learn within it and suggest
strategies to improve that response
 Helping staff to set up physical structures within the classroom and around the school
and modelling their use
 Providing guidance on suitable teaching materials that motivate pupils with ASD and
which they are able to access
 Providing opportunities for staff to observe colleagues in Queensmill School.
 Liaising with parents/carers and outside agencies to promote inclusion and support for
pupils with ASD
2. ASD training held within Queensmill School including:
 Understanding autism – from awareness-raising through to Masters’ Degree level
 TEACCH (Treatment and Education of Autistic and other Communication Handicapped
Children)
 Visual support and cues for children with autism
 Behaviour Management of children with autism, including Functional Behavioural
Analysis
 Social Stories
 Occupational Therapy and autism – the use of Sensory Integration
 PECS (Picture Exchange Communication System), NB run by Pyramid
 Communication and language with children with autism
All training includes opportunities for course participants to spend time in a Queensmill class.
Autism Education Trust (http://www.autismeducationtrust.org.uk/)
A useful source of information and materials is The Autism Education Trust (AET). This was
launched in November 2007 with funding from the Department for Children, Schools and
Families, and is dedicated to co-ordinating and improving education support for all children on
the autism spectrum in England.
22
11. Transition
All children, whatever their stage of development, level of ability or understanding, will need to
go through transition processes. These range from changes within a single day as well as at
significant points in their development. Children on the ASD spectrum are likely to find
adjustment to a significant change in environment a challenge and will need planned,
coordinated support from all those involved in the change process. Knowing the child will
help inform what strategies you put in place to support their management of this change in
environment and in leaving behind and taking on new relationships.
There are some general questions that are helpful to ask in planning for changes, whether to
or from a setting:
 What ways of communicating work best with this child with ASD?
 What parts of the new day might be most frightening/unsettling?
 What does the child know about the changes to their routines?
 How are we going to communicate the coming changes most effectively?
 What links and familiar aspects will they encounter in their new setting?
 Will there be any visits to the new setting? Will this be helpful, and if so, when?
 Can the child revisit their old setting once they move? Would this be helpful?
 What new routines and structures to the setting/day are they going to experience when
they leave?
 Can any of these be introduced (where age appropriate) prior to the child leaving the
current setting?
 How are you going to support the child in preparing to face new expectations and
demands?
 How are you working closely with the parents/carers in supporting the child’s transition?
 How will the child’s cultural background impact on their experience of change?
Other elements that are essential are to:
 Ensure that the whole staff team is aware of the importance of transition for children and
young people, through training, staff meetings etc.
 Ensure that the parents/carers are also aware of your transition policy and the importance
of sharing information with a new setting.
 Gain parents’/carers’ written consent to share information about their child.
 Make sure there is a proper handover of relevant information on individual children from
the current setting/school (or from home) to the new one. It is important that there is
continuity of sharing of information so that children’s adaptation to a new situation is as
smooth as possible and practitioners are supporting new children from a position of
knowledge.
 Ensure your admissions form includes the following areas (where age and setting
appropriate):
- developmental milestones
- medical history
- medication and care needs
- any communication and speech/language needs
- routines
- likes/dislikes
- food preferences
- dietary needs
- food allergies
- religious requirements
- comfort behaviours and objects
- strategies used at home to support them in areas of difficulty
23












- any other relevant family issues
Use the child’s portfolio and observations to build a picture before the child arrives.
Draw on information from the parents, along with information from any other appropriate
professional that may be involved with the child to support your knowledge base of the
child before they attend your setting, when needed.
Ensure that observation is a key tool in tuning into and meeting a new child’s needs.
Remember transition doesn’t finish as soon as the child steps into the new setting. The
settling in time is all part of the process.
Consider the new challenges children will face. Think about what is necessary and what
can be introduced over a period of time to lessen the stress of change on their sense of
self-esteem and well-being.
Make up a simple booklet with pictures of the new setting that can be shared with the
child.
Plan an open day when the children can visit the new setting, if appropriate.
Use circle times and stories to help children to prepare for change.
Puppets going through the same changes can help younger children come to terms with
their fears and concerns.
Ensure that everyone who has or will have contact with the children is included in the
transition pathway.
The new key person/teacher would benefit from visiting the child in their current setting, to
support their understanding of the child’s experiences so far.
Make sure the parents/carers as well as their children know what to expect in the new
setting. This is the job of both the old setting and the new setting, working together.
(Extracts adapted from ‘The good practice guide to successful transitions: Making change a
positive experience for children and young people’ EYCS 2007.)
24
12. Support for Parents and Carers
Life for parents/carers of children with ASD, as with any disabled child, can be very
challenging. Some parents/carers may take a long time to come to terms with a diagnosis of
ASD, and the difference that this is going to make to their child’s life and to family life in
general. As with most parents, they will be worried about their child’s future but with the
added dimension of ASD. Children with autism often have difficulties with food and may also
have irregular sleep patterns. They often go to bed late, rise early – or both! Once up, they
may need very close supervision for them to remain safe. This makes day-to-day living for
families even more stressful. Professionals working with parents and carers will need to be
sensitive to these home and family issues.
Queensmill Outreach Service, educational psychologists from the Psychology in Education
Service and clinical psychologists from CAFS and the CDC, can all offer training and advice
about autism and its management to parents.
Schools can be very effective in identifying the child’s strengths, and as with any child,
nurturing those strengths. Sharing these strengths and successes with parents and carers
can make a significant difference to families who may feel there is an over-emphasis on the
negative aspects of autism in society in general. Of course, as with all children, parents and
carers do also need to know about any challenging behaviours that are a concern for the
school. However, staff may well find such discussions useful as parents and carers are likely
to have helpful insights as to why this is happening and what can be done to help, as they
have probably experienced similar issues at home. Nevertheless, even if there are
difficulties, all parents and carers benefit from hearing good reports about their child, and
starting and finishing a conversation with positive points is always good practice.
Arranging opportunities for parents and carers of children with similar needs to get together in
the school can be very constructive. Although a ‘needs led’ group would be relevant to any
parents/carers of children with specific special needs, it can be particularly useful for
parents/carers of pupils with ASD. Parents/carers of an autistic child understand the complex
issues that other parents/carers are experiencing and through a network or group, they can
‘compare notes’ and help and support each other more effectively. Educational psychologists
and outreach staff from Queensmill can support mainstream schools in developing such
groups.
The borough also has a number of project providers who are offered inclusive, play-based
experiences for all children. In accordance with the Disability Discrimination Act 2005
providers must apply reasonable adjustments to enable a disabled child to access out of
school provision. The local authority provides advisory support through the Early Years and
Childcare Service. This offers training and day-to-day support for practitioners to ensure they
understand their role in providing for the additional needs that disabled children may have.
The process for placing disabled children in out of school care is as follows:




Requests for out of school childcare where additional support might be needed go through
the Contact and Assessment Service (CAS)
CAS refer the request to the Disabled Children’s Team (DCT)
The DCT present the request to the DCT Panel
The DCT Panel decide whether additional support is needed to access out of school care.
Where the panel agrees to fund additional support, a play assessment will be carried out in
the child’s home to support planning for the child’s arrival at the project. This information will
25
be shared with the project the child will be attending. The Early Years and Childcare Service
will then be responsible for setting up the placement for the child.
Some local and national organisations that can provide support for families are listed here:
Contact a Family
Contact a Family provides support, advice and information for families with disabled children,
no matter what their condition or disability. Family workers offer one-to-one help to families
caring for a child aged 0-19 years of age, with any kind of disability. They can offer support
over the telephone, through home visits or at events in the local area.
209-211 City Road, London, EC1V 1JN
Helpline: 0808 808 3555
Email: helpline@cafamily.org.uk; website: www.cafamily.org.uk
Disability Rights Commission
The Disability Rights Commission (DRC) was set up by government in April 2000 to combat
discrimination against disabled people.
DRC Helpline, FREEPOST MID02164, Stratford upon Avon, CV37 9BR
Tel: 08457 622 633; Textphone: 08457 622 644
Web: Disability Rights Commission
HAFAD (Hammersmith & Fulham Action on Disability)
HAFAD is a voluntary sector organisation which aims to empower disabled people to take
control of their lives. The broad aim of HAFAD's Agenda for Youth programme is to develop
an integrated service of out of school leisure and learning opportunities for young disabled
people in Hammersmith and Fulham.
Greswell Centre, Greswell Street, Fulham, London, SW6 6PX
Tel: 020 7471 8517; Mobile: 020 7471 8510; Fax: 020 7610 9786
Email: info@hafad.org.uk; Website: www.hafad.org.uk
National Autistic Society
A leading UK charity for people with autism (including Asperger’s syndrome) and their
families, providing information, support and services.
393 City Road; London; EC1V 1NG
Tel: 020 7833 2299; Helpline: 0845 070 4004 (Mon-Fri10.00-4.00); Fax: 020 7833
9666
Email: nas@nas.org.uk website: www.nas.org.uk
Young Minds - Parents and Professionals
A leading charity committed to improving the emotional well being and mental health of
children and young people and empowering their parents and carers.
48-50 St John Street, London, EC1M 4DG
Tel: 020 7336 8445; Parents Helpline: 0808 802 5544; Fax: 020 7336 8446
Email: please use contact form on website; website www.youngminds.org.uk
26
13: Case Study
Tom* - Changing Primary Schools within the Borough
Tom’s parents wished to change Tom’s school when a vacancy at their local school became
available. Tom was in Year 1. He had a diagnosis of Atypical Autism and held a Statement
of SEN. He was receiving 20 hours LSA support. Following the statutory process and after
appropriate consultation, the change of placement was agreed. The SENCO of the new
school then rang Tom’s current school to arrange a visit and meet his LSA and class teacher
for an update on his learning needs and strategies that were working well to support him.
Tom was very settled and the school had worked hard to ascertain his needs, organise the
environment, and devise activities and routines that supported his learning. The speech and
language therapist, educational psychologist, sensory and language impairment team and
Queensmill Outreach had all contributed to his start at the current school. The new school
was concerned that a change mid-year might be challenging for Tom, but the wishes of the
parent prevailed.
Tom in fact adjusted admirably to the change of school. He was helped by a newly appointed
LSA who read carefully through his statement and liaised closely with the SENCO and class
teacher on how to best support Tom in this initial period. All three members of staff attended
the TEACCH course run by the Queensmill Outreach Team, which was very useful in setting
up structured activities to reinforce new learning. Staff met with parents at the earliest
opportunity to discuss appropriate learning and social targets for his Individual Education
Plan. Parents contributed their views on ways in which Tom might develop basic literacy
skills e.g. he was a great computer enthusiast and might find simple spelling games and use
of the WORD programme motivating.
The class teacher, as a newly qualified teacher, was supported by the SENCO in finding ways
to include Tom in lessons, appropriate homework to set etc. He has responded well to a
Social Skills Group and is forming friendships within the class, learning ways to initiate
conversations.
One of the real successes of the year has been a Social Story compiled jointly by the
Queensmill Outreach teacher and the speech and language therapist. Both brought slightly
different versions but in discussion with the school, the final version met with pupil and parent
approval and addressed the task in hand.
Tom’s Statement of SEN is just about to be formally reviewed and reflects an extremely
positive two terms.
*not pupil’s real name
27
14. Useful references, websites and contacts
See also Chapters 3 and 12, and websites throughout the text.
Contacts:
Early years service, Additional Learning Needs and Opportunities Team
Jacqueline Goddard (Jacqueline.goddard@lbhf.gov.uk)
Tel: 020 8753 2165
Psychology in Education Service
Alison Cuthill, Principal Educational Psychologist (Alison.cuthill@lbhf.gov.uk)
Tel: 020 8753 3718
Sensory & Language Impairment Team
Gabrielle Nyman (Gabrielle.nyman@lbhf.gov.uk or gnyman.205@lgflmail.org)
Tel: 020 8811 8190
Speech and Language Therapy
Kim Lewis, Principal Speech and Language Therapist Coordinator for Mainstream Schools in
Hammersmith and Fulham (kim.lewis2@hf-pct.nhs.uk)
Milson Road Health Centre, 1 - 13 Milson Road, W14 0LJ
Tel: 020 8846 6238
Hammersmith & Fulham information sharing enquiries
Alison Ross-Dow, Data Protection officer (Alison.ross-dow@lbhf.gov.uk)
Tel: 020 8753 2455
Early Years’ references:
DOE study of the transition from the Foundation Stage into Key Stage 1: www.nfer.org.uk,
www.naeyc.org (Transition is a Journey)
‘The good practice guide to successful transitions: Making change a positive experience for
children and young people’ EYCS 2007
‘Ready to use Self Esteem Activities for Young Children’, 1997, Jean R Feldman, Ph.D.,
Jossey-Bass
‘Children Starting School’, Hilary Fabian, 2002, David Fulton Publishers Ltd
‘Transitions in the Early Years’, Hilary Fabian, 2002, Routledge Falmer Education Publishers,
Rosemary Roberts (Ed Tina Bruce)
‘Self-esteem and Early Learning: Key people from birth to school’, 2002 Paul Chapman
Publishing
‘Contemporary issues in the Early Years’, Gillian Pugh & Bernadette Duffy (Eds), fourth
edition 2006, Sage Publications
‘Walking the Talk’, Giles Barrow & Trudi Newton (eds) (2004), David Fulton
28
‘Young children at school in the inner city’, Barbara Tizard, 1988, Lawrence Erlbaum
Associates Ltd.,
Curriculum Guidance for the Foundation Stage, 2000
Early Years Foundation Stage 2007
Occupational Therapy references:
http://autism.about.com/od/whatisautism/a/OTBasics.htm
http://www.suite101.com/content/occupational-therapy-for-autism-a48626
Kranowitz C.S. (2005) The Out of Sync Child
Kranowitz C.S. Szklut S. Balzer-Martin L. Haber E. & Sava D.I. (2001) Answers to Questions
Teachers Ask about Sensory Integration: Forms, Checklists and Practical Tools for Teachers
and Parents
Yack E. Aquilla P & Sutton S. (2002) Building Bridges Through Sensory Integration
29
Appendices:
Appendix 1: Potential indicators of effective practice in relation to the autism spectrum
Appendix 2: Skills and behaviour checklist
Appendix 3: Self-evaluation checklist for the learner
30
Potential indicators of effective practice in relation to the autism spectrum
(compiled by Glenys Jones and Annette English
based on the DfES Good Practice Guidance in ASD, 2002)
For each of the items, rate on a four-point scale, as follows:
1
well-developed practice
2
working towards this
3
little or no work on this
4
don’t know
You could also rank these in terms of how important you think these aspects are, as follows:
E
essential
H
highly desirable
D
desirable
Suggestions on how this checklist might be used
o
Consider the extent to which each statement is true.
o
Is the practice evident across the whole school/unit or service?
o
Is it implemented or followed by just some or all the staff?
o
Are there ways in which it can be further developed or elaborated?
o
Add in other items which you feel are important
o
Modify the wording of items to clarify more exactly what is meant
o
Use it as an instrument to generate debate on your working practice and its rationale
31
Number Aspect of practice
1
2
3
4
5
6
7
8
9
10
11
12
The environment has been modified to take account
of sensory issues
Families and staff work closely together
13
Staff provide support to families out of hours
14
Good communication systems exist with health,
education, social and voluntary agencies
Work is done to ensure smooth transitions within and
between classes and schools
15
16
17
18
19
20
21
22
23
32
Staff are aware of referral routes if they suspect a
pupil is on the autism spectrum
There is a named person in the school/service, to give
general information on the autism spectrum and
specific information about individual pupils
Information-sharing occurs between staff within and
outside school/service
There is an up to date bank of resources on the
autism spectrum
There is a policy on working with pupils on the autism
spectrum
Data is kept on staff training on the autism spectrum
and conference attendance
External agencies are consulted when drawing up
policy/provision on the autism spectrum
Pupils on the autism spectrum are involved in
decision-making
Activities, timetables and their delivery are modified
as necessary for particular pupils
Generalisation opportunities are provided
Staff have knowledge and links with other providers
offering similar services to consider similarities and
differences/ strengths and weaknesses/sharing of
resources (eg all types of provision for pupils on the
autism spectrum in the area)
Visual cues and systems are used to aid
communication and understanding
Staff acknowledge the effort involved for pupils on the
autism spectrum in trying to understand our social
rules and systems
Staff have high expectations and give high levels of
support to pupils on the autism spectrum
Staff know that physical intervention is particularly
difficult for pupils on the autism spectrum and would
never use this except in exceptional cases.
Activities are well organised and planned and
individuals given advanced details of these and
warned of any changes to familiar routines
Pupils on the autism spectrum are given time to follow
their special interests and activities
Staff view challenging behaviour as the result of an
interaction of factors, relating to the environment and
the demands made on the pupil
Rating Comments Importance
24
26
Pupils on the autism spectrum are given time to be
alone in the school day
Staff let knowledge about the autism spectrum and
the pupil determine their response
Staff acknowledge the importance of play
27
Staff are able to get to know individual pupils very well
28
Staff have considered how to reduce stress for staff
and pupils
Staff accept difference and do not hold the view that
the only acceptable way of being is to ‘pretend to be
normal’
Staff are committed to including pupils in activities
with mainstream peers
Staff share information with other staff in a formal way
when they return from conferences and courses
There have been discussions on how staff work with
parents
The general ethos is to fit the school/service to the
pupil rather than changing the pupil to fit the
school/service
Staff adopt a calm, quiet approach and give pupils
lots of time to process and respond to instructions
Staff use minimal speech and provide visual cues to
make their requests clear to pupils
Staff have opportunities to discuss how they work with
pupils and aim for a consensus in certain key areas of
practice
Staff know that pupils on the autism spectrum are
more likely to be teased and bullied than other pupils
and take steps to prevent this
Pupils on the autism spectrum are given clear
instructions on what to do in ‘free’ time during lessons
and at break-times
Strategies and support provided for pupils continue
for as long as is needed as pupils move from one
class or school to another
Staff new to the school are given documents which
describe key policies and principles which underpin
the school’s practice and are given opportunities to
observe other staff
25
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
33
The National Strategies
Primary and Secondary Inclusion Development Programme
Skills and behaviour checklist
Note:
This checklist is an aide-mémoire to indicate the many areas where information needs to be gathered
on a pupil on the autism spectrum of any age or intellectual ability. It gives ideas on the skills you
might assess. You can add to this if you want, to suit the pupil(s) with whom you are working.
Name of the pupil:
Gender:
Date of birth:
Date on which the form was completed:
Completed by:
Relationship to the pupil:
Tick the items or parts of items which pupils can do.
You can add further comments if you wish.
Self-care skills
A
Dressing and undressing skills
1
Recognises own clothes
2
Can undo easy buttons/zips
3
Can do up easy buttons/zips
4
Can put on pants/vest/shirt/trousers/skirt
5
Can put on socks/shoes
6
Dresses appropriately according to the weather
B
Eating and drinking skills and diet
1
Eats mushy food only
2
Uses a spoon effectively
3
Uses a fork
4
Uses a knife to push food on fork/to cut food
5
Drinks hot/cold drinks: likes…..../dislikes……..
6
Eats a wide/medium/limited/very limited range of foods: (please
comment)
C
34
Toileting skills
Tick if pupil
can do this
1
Wears nappies during the day
2
Uses the toilet when taken
3
Indicates when needs the toilet
4
Goes to the toilet independently and meets all needs
5
Tasks with which pupil needs help in toileting are:
D
Washing/showering skills
1
Can wash/dry hands without help
2
Can recognise the need to wash hands
3
Will use the shower after PE without any problems
Independence skills
E
Can cross the road safely, without help
1
Can go to a shop and buy items without help
2
Can use public transport without help
3
F
Speech, language and communication
1
Makes sounds only; it is difficult to understand the meaning
2
Makes meaningful sounds
3
Makes word-like sounds
4
Says single words which are communicative
5
Speaks in two-word phrases which are communicative (e.g. ‘want
biscuit’)
6
Can speak in phrases which are copied or created by self
7
Can speak in sentences which are copied or created by self
35
8
Give three examples of the instructions the pupil can understand when you only
use words, and in a situation which is not a regular event
(e.g. ‘Get your coat’; ‘Go to the office and ask the secretary for the list of items
we need for the school trip‘)
G
Sensory sensitivity
1
Seems sensitive to sound/sight/touch/smell/taste
NO/YES
Please specify:
H
Sociability
1
Withdrawn
2
Socially interested
3
Actively avoids others
4
Seems formal or rather indifferent to others
Academic skills
Drawing and writing skills
I
1
Can write over/copy name
2
Can write own name from memory
3
Can write other words from memory without help
4
Can use a pencil or pen without difficulty
5
Can use a computer to word-process work
36
6
Can write a descriptive account when asked ‘Write a story
about…’
7
Can give written answers to questions
8
Can write a creative story when asked ‘Imagine you are…’
9
Spelling age is:
10
Can write ………number of lines in a 20-minute task
J
Reading skills
1
Knows which way to hold a book
2
Can find a particular book when asked
3
Can point out words when asked
4
Can point to pictures when asked
5
Has a favourite story which is:
6
Can point out letters when asked
7
Can read own name
8
Can say the letter sounds
9
Can read the words of a story
10
Reading accuracy age is:
K
Number skills
1
Can say out loud the numbers from 1 to 10 in order
2
Can count out objects up to 2/5/10/20
3
Can name the number symbols from 1–5/5–10/11 onwards
4
Can match the number symbol to the number of objects up to
______________
years
Reading comprehension age is:
5/10/15/20+
5
Can do addition/subtraction/division/multiplication up to totals of
10/100/1000
L
Computer work
1
Can switch computer on/use the mouse/type
numbers/words/create animations
2
Enjoys playing the following types of games on the computer:
M
Free time activities
37
1
Activities enjoyed in free-choice time alone are:
2
Activities enjoyed with an adult are:
3
Activities enjoyed with another child are:
Behaviours which may be a problem to others
N
Possible behaviours
1
Insists on the same route/particular item (e.g. cup, chair)/conditions (e.g. lights
on)/familiar routines being adhered to: NO/YES (please specify)
2
Shouts out the answer/hits others/screams/swears/destroys property:
NO/YES (please specify)
3
Spinning: spins self or objects/watches spinning objects
4
Flapping: flaps hands or objects
5
Rocking body
6
Other, please specify:
7
Behaviour at school, as compared to home is:
less difficult/similar/more difficult
8
General level of activity at school is:
very active/reasonably active/passive
O
38
What is your biggest problem in teaching this pupil?
P
What would the pupil say was their biggest problem?
Q
Areas in which the pupil is most interested are:
R
Areas in which the pupil is most skilled are:
S
The pupil’s most appealing features are:
T
Activities or items which can be used as incentives or motivators are:
U
Any other comments:
39
The National Strategies
Primary and Secondary Inclusion Development Programme
Self-evaluation checklist for the learner
Note: The self-evaluation tool should be completed by learners before and after using the resource to
identify existing knowledge and understanding and the areas in which they might enhance their skills.
Members of leadership teams in schools may encourage staff to complete the self-evaluation tool
before and after using the DVD-ROM or online materials and share the results to produce an audit of
knowledge and skills. This audit could help leadership teams prioritise areas for development.
Codes used:
K – knowledge
A – adjustment to practice
My knowledge and understanding of the autism
spectrum and adjustments to practice
1K
Unit 1: What is the autism spectrum?
I know the main areas affected in pupils on the
autism spectrum.
2K
I have some knowledge of the early development of
pupils on the autism spectrum.
3A
I take action to find out how a pupil on the autism
spectrum is affected in these areas.
4A
I alter my approach in the light of this information.
5K
6K
Unit 2: Social and emotional understanding
I know why social interaction with peers and adults
is hard for a pupil on the spectrum.
I know that the pupil has difficulty in being aware of
and understanding his or her emotions and those of
others.
7A
I adjust my communication style to facilitate
interactions with pupils on the autism spectrum.
8A
I use strategies to facilitate the social inclusion of
pupils on the autism spectrum.
9K
10K
11A
40
Rate 1–4
1 = not very confident
4 = very confident
1
2
3
4
Unit 3: Communication and language
I know some of the ways in which the
communication of pupils on the autism spectrum
differs from typical pupils.
I know some of the specific difficulties in the
understanding and use of speech and non-verbal
language (e.g. gesture, facial expression) that pupils
on the autism spectrum experience.
I use additional forms of communication when
working with a pupil on the autism spectrum.
My knowledge and understanding of the autism
spectrum and adjustments to practice
12A
13K
I adjust my language to help the pupil understand
spoken instructions.
Unit 4: Flexibility of thought and behaviour
I know that a pupil on the autism spectrum has great
difficulty with change and in predicting what might
happen next.
14K
I know that pupils on the autism spectrum have
difficulty in knowing what to do at break and lunch
times.
15A
I show pupils clearly what is to happen within the
day, within the classroom and within a task.
16A
I put structure and predictability into unstructured
times such as break, lunch and free-choice times.
17K
Unit 5: Sensory perception and responses
I know that pupils on the autism spectrum may be
oversensitive or under-sensitive to sights, sounds,
taste, smell and touch.
18K
I know that sensory issues in school can create
serious challenges and barriers to some pupils on
the autism spectrum.
19A
I assess both the sensory environment and a pupil’s
responses to sensory input.
20A
I modify the sensory input and challenges to pupils
on the autism spectrum, where necessary.
21K
Rate 1–4
1 = not very confident
4 = very confident
1
2
3
4
Unit 6: Know the pupil
I know that the profile and skills of an individual pupil
on the autism spectrum is very uneven and can vary
a great deal between pupils on the spectrum.
22K
I know that it is important to involve the pupil,
parents and carers in obtaining information on a
pupil’s needs, strengths and interests.
23A
I engage parents and carers in compiling a profile of
the pupil’s strengths and needs.
24A
I engage the pupil on the autism spectrum in
compiling a profile of the pupil’s strengths and
needs.
41
25K
Unit 7: Curriculum priorities and inclusive practice
I have knowledge of how pupils on the autism
spectrum might be affected across subject areas or
within my own subject area.
26K
I know the key features which make for inclusive
practice for pupils on the autism spectrum within a
mainstream school.
27A
I make adjustments to enable a pupil on the autism
spectrum to access the subject areas I teach.
28A
I work to inspire an inclusive ethos in school in
relation to the attitudes of other pupils and my work
with parents and carers.
29K
Unit 8: Sources of support
I know the people within school from whom I can get
advice and support regarding pupils on the autism
spectrum.
30K
I know some sources of information, external to the
school, on the autism spectrum.
31A
I read and contribute to the information about pupils
on the autism spectrum which is shared with
colleagues in the school.
32A
I can list the ways in which I include parents and
carers in supporting their children in school.
Total score out of 128
42