DISCUSION DE LOS RESULTADOS

Children with autism experience differences in communication, social

interaction and flexibility of thinking and behaviour (DSM – 5, 2013). Their alternative

challenges for schools (Jordan & Powell, 1995). Many require explicit teaching of

skills and understanding, elements of the curriculum which are outside that usually

provided in mainstream schools (Whitaker, 2007). Schools contain a huge range of

potentially serious stressors for children with autism, including demands for social

interaction, sensory overload and limited levels of structure (Whitaker, 2007; Attwood,

2007; Kelly, Garnett, Attwood, & Peterson, 2008).

Challenges facing the autistic child at school include:

• _{Differences in the way the child processes information from the senses} • _{Differences in the way the child both initiates and understands social}

communication

• _{Differences in language usage and processing} • _{Bullying, loneliness and/or social isolation} • _{Anxiety and depression}

• _{Lack of academic progress as measured against intelligence predictors}

Sensory processing differences may provide a challenge for the autistic child at

school as he or she may experience an unusual response to any of the five widely

recognised senses (hearing, sight, touch, smell and taste) or to others such as vestibular

(balance), proprioception (body awareness) and interoception (pain, hunger, thirst –

internal body awareness) (DSM-5, 2013). The child may be both hyper- and hypo-

sensitive to sensory stimuli, often fluctuating between the two extremes (Jones, Quigney

& Huws, 2003; Iarocci & McDonald, 2006; Leekam et al., 2007). Understanding of this

element of autism is not new; sensory symptoms featured in the original descriptions of

autism (Asperger, 1944; Kanner, 1943), and were further explored by Wing (1979), and

differences play in the difficulties experience by pupils with autism in school has

increased during this century, not least through eloquent accounts written by people

with autism (for example, Grandin, 2000; Jackson, 2002; Williams, 1998) and discussed

in a range of research (for example, Bogdashina 2001, 2016; Jones et al., 2003; Little et

al., 2015; Ausderau et al., 2014).

School may pose a challenge in that autism involves a difference in social

communication and social interaction (DSM-5, 2013). The child with autism will have

altered communication for social purposes and may not communicate in a manner

appropriate for the social context (Van Bergeijk, Klin & Volkmar, 2008). He or she may

not change communicative style to match context or the needs of the listener, may

struggle to follow the rules for conversation and may not understand the use of verbal

and non-verbal signals to regulate interaction (Attwood, 2007). He or she may struggle

with inference, idioms, humour or metaphors and with understanding multiple meanings

that depend on the context for interpretation (DSM-5, 2013; Attwood, 2007). The issue

of language understanding and usage differences in autism has been somewhat confused

since 2013 by the creation of the condition Social (Pragmatic) Language Disorder in

DSM-5 (DSM-5, 2013), which appears to segregate many of the language related

elements of autism into this separate condition (Swineford, Baird, Thurm, Swedo, &

Wetherby, 2014). However, a diagnosis of Social (Pragmatic) Communication Disorder

can only be given after a diagnosis of autism has been ruled out (American Psychiatric

Association, 2013) so that all of the language differences described are likely also to be

present as part of the wider differences of autism (Swineford et al., 2014). The

presence of language differences within autism is well documented (for example,

Attwood, 2007; Mandy & Skuse, 2008). As reported in the Bercow Report (DCSF,

social, emotional and educational development. The anecdotal experience for people

with autism of trying to 'interpret' the language of school is articulated in the literature

(for example, Jackson, 2002; Sainsbury, 2000).

Barriers to social communication and social interaction can lead to a lack of

social acceptance, and to the experience of bullying (Attwood, 2007; Cappadocia, Weiss

& Pepler, 2012; Hebron & Humphrey, 2013; Kelly et al., 2008; Chamberlain, Kasari &

Rotheram-fuller, 2007; Rotheram-fuller, Kasari, Chamberlain, & Locke, 2010). The

need for support to develop peer relationships (for example 'Circle of Friends',

O'Connor, 2016) is the greatest reported concern of parents of children with autism

(NAS, 2015), with 62% of respondents in the NAS survey identifying it as the support

which they would most like for their child but do not get. The vulnerability of autistic

children in school to social exclusion and other forms of bullying is well recognised,

both in personal report (for example, Sainsbury, 2000; Jackson, 2002) and in research.

Batten et al. (2006) report that over 40% of children with autism have been bullied at

school. In 2016 Maı̈ ano, Normand, Salvas, Moullecand and Aimé undertook a systematic review and meta-analysis of the literature, concluding that 'school-aged

youth with ASD were found to be at greater risk of school victimisation in general, as

well as verbal bullying, than their typically developing peers' (p. 601). As well as name

calling, ostracising and excluding, physical taunts and ridicule, the child with ASD may

be vulnerable to being 'set up' to do things that get him into trouble, his social naivety

making him a target, as do his different behaviours and his social isolation (Atwood,

2007).

Anxiety and depression are prevalent in people with autism (Van Bergeijk,

are widely reported by people with autism (for example, Jackson, 2002) to be

contributory to feelings of anxiety. Research suggests that nearly half of children

diagnosed with autism may also meet diagnostic criteria for clinical anxiety

(Sukhodolsky et al., 2008). This pressure at school may be relieved for the young

person with autism by short breaks, something which many parents indicate as

something which they would like their child to receive in the school day (NAS, 2011).

Depressions in autism is reported as being above the average for the general

population (Chandrasekhar & Sikich, 2015; Matson & Williams, 2014; Rieski, Matson

et al., 2015; Ghaziuddin, 2005; Ghaziuddin, Weidmer-Mikhail & Ghaziuddin, 1998)

and research suggests that suicidal thoughts and attempts are significantly higher in

autism than the norm (Mayes, Gorman, Hillwig-Garcia & Syed, 2013).

Pupils with autism may underachieve academically at school according to

intelligence quotients predictors (Ashburner, Ziviani & Roger, 2008; Estes, Rivera,

Bryan, Cali & Dawson, 2011; Keen, Webster & Ridley, 2016). Explanations for this

underachievement include reduced ability to learn through imitation and observation

(Plavnick & Hume, 2013; Fleury et al., 2014) and the inability to disengage from

repetitive and stereotypical behaviours (Zandt, Prior & Kyrios, 2007). There is also a

lack of specialist provision available in mainstream schools, with parents highlighting

occupational therapy, support from mental health specialists and speech and language

therapy as supports which they would like their child to access but which they are not

receiving (NAS, 2011; 2015). Parents are requesting, additionally, support for their

children in the areas of daily living skills and leisure or play opportunities (NAS, 2015).