Autism: A Case Study Focusing On An Aspect Of Additional Learning Needs (ALN)

The area of Additional Learning needs that I will discuss in this case study is Autism. Autism is a complex life-long, neurological developmental disability that affects how people perceive the world, and their ability to interact with others (National Autism Society; 2018). Autism is a spectrum disorder (Carter, 2013) characterised by a triad of core deficits including Language and Communication, Social Skills and Behaviour (Carter, 2013; Redshaw and Smith, 2013). Children with Autism exhibit different levels of severity (Carter, 2013; National Assembly for Wales, 2009). The spectrum considers their level of the disability and the impact the condition has on their functioning (Fountain, Winter and Bearman, 2012; Peters, 2016; Redshaw and Smith, 2005); all individuals with Autism share certain difficulties, however, what one person on the spectrum can tolerate, another may not (NAS, 2019), and therefore every individual case is unique.

Children with Autism may appear to be absorbed in their own world (Mortimer, Hover and Hogden; 2005), and can struggle to effectively cope with social interactions (Kent et al, 2013); spontaneous communication with others may not happen instinctively (Brock and Seaman, 2018) and children with the condition may have difficulty forming friendships with their peers (Brown and Elder, 2014; NAS, 2018). However, research suggests that although many individuals with the condition have a deficit in social skills, there are children who have successfully integrated into the school social environment (Bauminger et al., 2010; Boutot & Bryant, 2005; Locke et al., 2017). This is evident with my target learner CW, who shares similar interests with his peers and enjoys discussing them. I will address this in section two.

The triad of deficits on the Autistic spectrum identifies that the ability to interact socially as a major challenge (Charman and Stone, 2008). Many children on the autistic spectrum require guidance to learn how to act in social situations. Children with Autism may desire social interactions, but can feel overwhelmed by new experiences, or may not understand how to engage (Autism Speaks, 2018). For many children with ASD, developing an understanding of social rules and cues, turn taking and reading expression is difficult (ADD REFERENCE). CW frequently becomes distracted in class, often talking over both his peers and the class teacher. Therefore, developing his social skills and understanding of how to communicate his feelings efficiently, is a priority to ensure he develops holistically whilst accessing the curriculum.

The main concern and area of development requires is CW’s behaviour. From my own experience working as a Special Needs Support Officer, I am aware that all behaviour is a form of communication (Spohrer, 2008). For children with Autism, it is vital to find the cause of the behaviour to support them in their holistic development. This could be feelings of frustration, stress, anger or confusion which I will discuss further in section three. The National Autistic Society (2018) highlights that self- harm (head-banging, face-slapping, biting, scratching or skin peeling), physical harm to others, pica (eating non-edible items) and smearing faeces are all common displays of behaviour for children with Autism. In section two, I will discuss how CW displays behavioural difficulties when he becomes frustrated or anxious.

A language and communication deficits complete the triad on the Autistic spectrum. Children with Autism may display atypical communication styles (Brown and Elder, 2014) including repetitive behaviours, echolalia and lack of eye contact (Applied Behaviour Analysis Guide,2019) Children may have difficulty with initiating interactions or responding to others (Mortimer, Hover and Ogden; 2005), which makes dealing with school, social interactions and working with adults difficult (REFERENCE). For children who are delayed in their use of language other methods of communication need to be established such as using visual aids, Makaton or hand gestures (ADD REFERENCE).

Training and a greater awareness of Autism has led to an increased rate of diagnosis. Autism effects 1% of children in Wales (Holtom et al., 2016; Welsh Government, 2016; Pellicano, Dinsmore and Charman, 2014); in the last five years, the Welsh Government (2017) announced that the number increased by nearly fifty per cent. The impact the increased diagnosis rate will have, on both external support agencies and schools in regards providing their services, resources, and funding, will be significant (Knapp, Romeo and Beecham, 2009; Parkin, 2016). However, the new Alternative Learning Needs bill (Welsh Government, 2018) highlights the importance of education and training for practitioners to be able to support individuals with Autism to ensure an inclusive, holistic school experience (Estyn, 2018). I will continue to discuss this further,

The Learning Through Enquiry task guided my research into the new Alternative Learning Need Act which aims to offer greater support to children with Autism and their families. The current Special Educational Need Code of Practise relies on an assessment process that has been deemed by the Welsh Government (2018) as “inefficient, bureaucratic and costly, as well as being insufficiently child-centred.” The statementing process caused disagreements between parents and their local authorities, with the local authorities perceived as the gateway to ensuring suitable interventions were available for children with alternative learning needs (National Assembly for Wales, 2015). However, the new bill has three clear, core objectives: 1) a unified and legislated framework. 2) an integrated and collaborative assessment process with early planning, monitoring, and effective interventions. 3) A clear, open system to provide advice and information to all those involved (Estyn, 2018). The bill will ensure that all children with alternative learning needs will have an individual development plan (IDP) (Welsh Government, 2017), to be fully supported by school practitioners and external agencies.

Background Information Related to the Chosen Pupil

I identified CW for this case study through observations and discussions with my class mentor. CW is a ten-year-old boy who was diagnosed with Autism in Year 4. He lives with his Mum, Dad and younger sister. Research highlights the importance of a collaborative approach to support children with alternative learning needs (Browne, 2011; Mortimer, Hover and Ogden, 2005; Roulestone et al, 2012) and CW’s parents are extremely supportive, working with the school and outside agencies to ensure he has an inclusive school experience.

CW has support from the local authorities Behaviour Support and Learning Support Teams, his class teacher is the school ALNCO; an Educational Psychologist has been monitoring CW since Reception and although he was assessed for ASD, at the time he did not display enough traits for a diagnosis. In school, CW has access to regular 1:1 Thrive and ELSA sessions with the Special Needs Support Officer.

CW is an avid fan of technology and video games, and as mentioned previously, he enjoys discussing this with his peers and staff. However, CW finds it difficult to develop meaningful relationships, a common deficit for individuals on the spectrum (Conn, 2014; NAT, 2018). CW can be energetic and has a good sense of humour, often joking about how he can use a computer better than the teachers, and dancing around the classroom. However, in relation to the triad of deficits discussed, and research showing that children with Autism often display behavioural difficulties (Kimberly and Dunlap, 2012; Miller, 2009), CW often displays high-level disruption by hitting and pushing both pupils and staff. CW displays these behavioural difficulties when routines are changed, and things he feels a lack of control (NAT, 2018). Therefore, although CW is happy to discuss his interests with the class, his peers appear wary of him due to consistent low-level disruptions and violent outburst.

Observations of CW highlighted that he regularly refused to engage with academic work and prefers to follow his own agenda (Hannah, 2004). From discussions with CW’s specialist outreach teacher, it was noted that his struggle to access the curriculum and gain a holistic school experience is due to his difficulties in engaging and regulating his behaviour. CW is a capable boy. However, it can be difficult to support CW when he is feeling anxious, scared or separated. The interventions in section three will discuss how to support these issues.

To encourage CW to access the curriculum, he uses an iPad to type his work, which is then printed and placed in his book. This works well for CW since he enjoys using technology since it combines an interest with school work. CW is given different levels of work that he can choose from and is able to pick who he wants to work with during group work. This gives CW independence, and as mentioned previously, CW becomes frustrated when he feels he has a lack of control, therefore this gives him a feeling of being in control (Delfos, 2005).

Intervention strategies to support teaching and learning to move CW forward in his learning.

The behavioural and communication difficulties described in section two are significantly impacting CW’s access to the curriculum (Mesibov and Howley, 2003). Although CW receives a high level of support from the ALNCO and ELSA practitioner, he will need further support within the classroom to access the curriculum, reach his full academic potential and develop holistically. The following strategies are recommendations to support CW’s communication and behavioural difficulties.

Suggested Strategies

Tokens to earn rewards: From discussions with CW’s outreach teacher, we agreed to use tokens as an incentive to complete set work. Using rewards as an incentive is a commonly used classroom management technique (Burnett, 2002; Payne, 2015; Schunk, 2014; Shriller & O’Flynn, 2008) for CW tokens will be earnt by following rules, starting his work and practising his handwriting. Children with Autism enjoy repetitive behaviour and most have strong obsessions or interests which are used as coping mechanisms and fundamental for supporting their wellbeing (NAT, 2018). CW is an avid fan of technology. Therefore, if he completes his work, he will be allowed reward time to peruse his interests of iPad games.

Social Stories: Children with Autism may struggle to master social and communication skills (Brock & Arciuli, 2014; Hill et al., 2014; Kokina & Kern, 2010). Social situations can cause anxiety (Schohl et al., 2014) and children may become overwhelmed when a routine is changed, or they are placed in an unfamiliar enviroment (Kokina and Kern, 2010; NAS, 2016). Social stories model appropriate social interactions; they can support a child with Autism by explaining a scenario, addressing which social cues are appropriate, encouraging children to understand different perspectives, and suggesting an appropriate response, through a story format (More, 2012; Spencer, Simpson & Lynch, 2008).

Social stories are practical resources to prepare children with ways to appropriately respond to specific, everyday situations. Social stories encourage children with additional needs to understand their own behaviour and to recognise that all people behave in a different ways (Davidson et al., 2015; Spencer, Simpson and Lynch, 2009) Therefore, social stories will help CW learn how to manage and develop his ability to regulate his emotions, especially anxiety and anger. They can guide CW by teaching him coping strategies for unplanned classroom transitions and changes by providing methods on how to address the situations (Wehman, 2012).

The 5-point scale: Children with Autism tend to have higher levels of stress than those not on the spectrum (Smith, 2002). Stress is often brought on by changes in routine, the environment and feelings a lack of control, which can lead to anxiety or aggressive behaviour (Buron, 2005). However, Attwood (2006) acknowledges that the better an individual with ASD can understand their emotions, the more able they will become at expressing them appropriately. To support children in addressing and regulating their emotions, whilst teaching social and emotional concepts, Buron (2005) developed the 5-point scale. This scale can measure levels of: voice, behaviour, stress or frustration by categorising five different levels, breaking down expectations and developing strategies that can be used by the children to effectively bring the level down (Buron, 2005; Buron, 2007). When children are aware of the scale and each level of expectation, practitioners can wear a small scale on a lanyard as a visual reminder to prompt children in remembering their regulating strategies.

Strategy Chosen to Implement

Earning tokens for reward time: Prior to beginning this intervention, I ensured that there were plenty of opportunities for CW to have his reward time, that an iPad was always available, and that all practitioners had a clear understanding that CW would be allowed reward time after completing a section of work.

CW currently completes most of his work on an iPad, however he must try to write to improve his handwriting. When CW completes his hand-written work, he will be rewarded with tokens to earn reward time.

The effectiveness of the intervention: This intervention is beginning to have a positive effect on CW whilst ensuring that he has access to the curriculum. As previously mentioned, children with Autism can cause harm or damage to pupils, staff or property when can interfere with their ability to function in the classroom (Minshawi Nf et al., 2014). CW understands that displaying positive behaviour and trying his best will earn him tokens for reward time and enjoys working towards a goal.

Summary and Recommendations

As mentioned in section two, CW presents deficits in communication and behaviour. After discussions with the ALNCO and outside agencies, it was noted that for CW to reach his full potential, we would have to develop how he communicates his feelings of insecurity. The interventions recommended should have a positive impact on CW’s holistic development.

Ensuring CW has access the curriculum by using rewards as an incentive to work had a positive impact on CW’s academic development. However, to ensure CW develops holistically, I would recommend using a reward system alongside the 5-point scale to ensure that he learns how to manage his emotions.