Teaching social context to children with autism and why it’s vital for safeguarding

Tania writes: Today I'm so pleased to bring you a guest article from a highly respected head teacher of a school for children with complex autism in Surrey. Justin Price runs Freemantles School near Woking. The school also also regularly host seminars from top names in the world of ASD, including this one I wrote about, with Tony Attwood. Ther next is on Pathological Demand Avoidance in June.

Justin is especially passionate about children with autism learning about social context. This is a longer than usual article, but extremely important and I urge you to read and share as widely as possible.

The importance of understanding social context by Justin Price

The explicit and effective teaching of social context for children and young people with autism is a safeguarding imperative for all school and educational settings.

Frequently these days I find articles in the national press that are focussed upon the difficulties that young people with autism are having with coping with relationships and being out in the community. These issues usually end up with the young person being in trouble with the law. For example: stalking, a young man stabbing women as he perceives that they won’t allow him to lose his virginity and young people strapping bombs to themselves because they have become inadvertently involved  and groomed within terror groups.

Through my role as head teacher of a school for children with complex autism, I hear many other cases of less extreme but still very disquieting behaviour where young adults with autism have made serious errors, which have led to them being unable to function effectively and independently in society. Examples here include a student starting at university without understanding that he needed to wash and even change his clothes and a young man who, after his best friend had been mugged by someone who happened to be Asian, found his way onto far right-wing racist websites and believed everything he read there.

Whenever I read or hear these stories I am struck by the way in which the education system as a whole is continually letting down these young people. We are not teaching them what they really need to know and understand to be able to live successfully in society.

More fundamental perhaps is also the question of parents’ life aspirations for their children and the aspirations of children and young people themselves. I have recently started running training for parents on autism and happiness. The content is supported by the work of Peter Vermeulen, a director of the Centre for Concrete Communication, an education centre specialising in autism spectrum disorders in Belgium. Thus far, although it is a relatively small cohort, I have not had a single parent who rated the academic achievement of their child more highly than their eventual life satisfaction. As a parent myself, I believe that for all children, neurotypical or autistic, the vast majority of parents would rate their child's life satisfaction as more important than the qualifications that they achieve.

It is fair to say we have established that for children and young people with autism, there is a greater vulnerability in the most extreme cases of being exploited or committing crimes and, in many cases, of making basic social mistakes which are likely to lead to further cyclical feelings of increasing anxiety impacting negatively on fragile self-esteem.

Why is reading social cues so hard for autistic people?

However, we also need to highlight awareness of why this vulnerability exists, or what is at the root of this major issue. The work of Peter Vermeulen in his book Autism as Context Blindness, has demonstrated through recent brain research and science, that people with autism are unable to use their subconscious to identify the social cues in the way in which neurotypical people do. This appears to justify and clarify the argument that Ros Blackburn has made for many years in her public speaking about her experiences as an autistic woman; that she has no social instinct, no gut reaction that neurotypcial people appear to her to have.

This fact, that children and young people with autism are unable to 'unpick' the important clues in any social situation in the way that the rest of us learn to do - in far less time than it takes to blink -  is exactly what makes them far more vulnerable to social failure or being misled in social situations.

My personal belief, is that the anxiety that so often co-exists with autism is usually as a result of this lack of social understanding. Being unable to make sense of the world leads to a constantly fluctuating anxiety - which can influence sensory perceptions (as it is not clear what needs to be filtered) and causes the sensory difficulties. However I am aware that there are others who argue the reverse - that the inability to manage sensory input leads to the anxiety and I do recognise this as an alternative.

Whichever is the case, the primary objective for all school staff must be to comprehend that this inability to subconsciously and very quickly identify the pertinent social cues is the reason driving this lack of social understanding and to focus upon addressing it and the resultant anxiety.  The anxiety itself is a further fundamental block to learning which is often misinterpreted as bad or naughty behaviour and therefore punished. It is simply not enough for the aim of school staff to try and help the child or young person to cope with being in the mainstream class so that they can access the academic curriculum.

Why social skills groups don't work

Traditionally, where school and speech and language therapy staff have recognised the need to try and help pupils with autism to work on their social ability, the focus has been on Social Skills groups. Research has indicated that these are largely ineffective. I believe this is for two reasons: firstly, they are not aimed at where each individual child is and what their own motivations are, and secondly, they are aimed at teaching skills rather than teaching to understand situations and the context around them, which is what is really required.

Part of the issue with trying to teach the Social Curriculum to children and young people with autism, is that the whole area of 'social' is so vast and all-encompassing that it is overwhelming for staff. This is even the case in special schools where there is already more flexibility to the curriculum, let alone for teachers in mainstream settings, where there is such a massive emphasis on the academic curriculum. The work of The Unwritten Rules of Social Relationships by Grandin, Temple, Barron, Sean (2005) Hardcover identify that the social factors number in the billions - and of course social rules change in different cultures, countries, and religions too!

This is the crux of the matter, perhaps – all schools are now admitting more and more children with more complex autism. Therefore senior leaders in mainstream and special schools need to be brave enough to accept and advocate for the fact that their pupils with autism will need to access less of the academic curriculum to ensure that they are able to have sufficient time to learn the social education that they need.

Social Understanding should be on the timetable along with Maths and English as a subject. Parents, teachers and all school staff will, of course, be crucial in helping to teach these areas. However, they too will require assistance and support to understand the reasons behind their children's difficulties with social learning and the techniques to help them to take on board the compensation strategies they'll need to live full and active lives in society. With these skills for life embedded, those who have the cognitive academic abilities and motivation will also have the social understanding to enable them to cope with local colleges to access further academic learning and qualifications, as well as accessing life.

The new OFSTED framework with its ever increasing emphasis on Safeguarding and the introduction of more personal development, offers an opportunity for schools to be able to justify taking such actions which will have a real impact on life chances.

Teaching social understanding needs to start early

While I opened with questions about the social misunderstandings that lead young people with autism into criminality and to sex and relationship misunderstandings, this isn't just about the way in which we teach children at secondary level. If a child hasn't been explicitly taught how to make sense of situations regarding friendship, emotions, empathy, etc. in primary school, then the more complex issues around sex and relationships, stalking, grooming, radicalisation and sexual exploitation will be impossible to teach. This will lead to pupils with autism being vulnerable to becoming the abuser or the victim. Therefore there is a very real need for this teaching to be throughout their education.

One of our main aims to support children with autism to learn social understanding, is to look at strategies that help them to generalise. Therefore, when we explain a situation, it's important to recognise that there are a number of possible solutions that we could provide, and also highlight that there may be other options that they could think of themselves. This will enable the children and young people to problem-solve for themselves when they come up against a new situation.  Research suggests that frequently, young people with autism try to apply exactly the same solution that worked on one occasion for all similar situations. (Neurotypical people will tend to identify a solution they used in a similar situation but ‘just know’ how to adapt it for the new context.)

Within our specialist setting we recently set about trying to list all the areas of social understanding that we want to support our young people to have mastered by the time they leave school at 19. The full list is imperfect as some areas are vast and the list is still incomplete; however there are 60 areas identified it is attached as an appendix to this article. Some of those we identified are:

• Managing my money
• Owning and looking after a pet.
• Road safety
• Using public transport
• Looking attractive or handsome
• Understanding the changes that happen to my body in puberty
• Managing my own emotions
• Understanding others emotions
• Finding and looking after friends. Letting friends look after you.
• Sex education and the laws around sex.
• Protection against radicalisation, extremism, sexual exploitation, exploitation of vulnerability, criminalisation.

Establishing a new curriculum for social context

The teaching of social understanding needs to be explicit and clear, unpicking what we do subconsciously. Presenting this information visually through drawings or text is often more effective as it reduces the need to process too much verbal information on a difficult topic. The need is to explain scenarios as realistically as possible. Additionally, wherever feasible, teaching in real life situations, always remembering to offer a number of solutions that people could use - to reinforce the fact that there is not one 'rigid' answer in social situations.

Some of this teaching can be successful in small or even larger groups of pupils who are then able to learn from one another. However individual tutorial work is an essential part of this work, and in order for these to be fully effective sessions the trusting relationship between the pupil and the member of staff is absolutely essential. In order to open up and share what they are finding difficult and accept solutions offered the pupil needs to be very confident in the member of staff they are working with.

At my own school, Freemantles, we are in the early stages of establishing a curriculum for teaching social context. A couple of examples may help to illustrate our experience so far:

• We have a child who at five years old, became very upset when he had misunderstood something or felt that he had made a mistake. When he arrived at the school his response to this was to become aggressive towards staff or peers. Although his anxieties still exist, they now display as frequent, repeated requests for a whiteboard until one is produced. He then calms as staff use a comic strip conversation to draw out the situation with him and identify what possible solutions would have been acceptable responses in the circumstances.

• Another five year old pupil paused the episode of Peppa Pig he was watching at home and asked his mother what she thought Peppa was thinking. This demonstrates that he had generalised the learning from school. In their social context lessons they had been working to help them develop Theory of Mind by watching Timmy Time and pausing the programme to ask the group to make suggestions about what characters might be thinking or might say if they could.

Pupils who are making such good progress in social understanding at such a young age have the potential to be able to make great social gains over their school lifetime.

Teacher training in autism skills is lacking

In order to understand and teach children with autism, and in particular to teach social understanding, successful teachers need to be considerably skilled. There is currently a lack of sufficiently expert training widely available to mainstream teachers nationally.

Frequently teachers are given substandard training in areas such as Social Stories^TM and Comic Strip Conversations. When these staff then try to write stories, they end up either being inadequately researched or very poorly written. This can have a doubly negative effect in terms of turning both teachers (“it doesn’t work”) and pupils (“I'm fed up with being told what to do”) off what are hugely underrated, excellent and effective strategies!

This issue of poor training is evident - a quick internet search of Social Stories illustrates the problem that everyone seems to think that they can write them. My own experiences of initial Social Stories training involved a half hour training on an INSET day! It left me with insufficient knowledge to write accurate and helpful stories. Carol Gray, the founder of Social Stories has trademarked the strategy and offers incredible insight into the effective use of the strategy to help children and young people to understand social situations.  To combat this misinformation Carol has launched her own website which gives accurate information and is involved in accrediting trainers who can train accurately to share the expertise. An important element of teaching Social Understanding is the characteristic “patient and supportive voice” Gray recommends for the work on Social Stories.

While there is often sub-standard training in these key strategies, there is also very little training in others such as understanding and teaching social context. Some positives are that the prerequisite training around understanding autism is improving for teachers across the country, especially with the establishment and growing influence of the Autism Education Trust. There also appear to be some pockets of good practice where proactive local authorities such as Northamptonshire have for offered high quality training from Carol Gray to relevant staff on a yearly basis for a number of years.

Using new research to improve autism teaching

Even with effective training and highly skilled teachers, we do need to accept that we are always trying to teach what we ourselves do subconsciously. Therefore we will sometimes get it wrong or forget to teach something and perhaps confuse the issue as a result. We are only human and cannot always get it right. As long as we are reflective and learn from these mistakes in the future, and work continually at improving this area of our teaching as we do in all subjects across the profession, it will lead to positive outcomes.

It is important that current research has recently given us the clarification that was always needed about why children and young people with autism so often struggle with social understanding. Now that we have this information we must act and ensure that we:

• Establish Social Understanding as a subject that needs to be taught to children and young people with autism and therefore allocate a time commitment for this area of learning.
• Train education staff and parents to teach the Social Understanding Curriculum effectively.
• Empower the next and future generations of children and young people with autism to succeed socially as well as academically so that they are appropriately safeguarded from their own vulnerability and we are able to better safeguard others in society from their misunderstandings.

Appendix: Areas to teach by age 19

• Planning my own life
• Planning my own diary
• Work skills
• How to work all day
• Managing my money
• Understanding how to food shop
• Cooking meals and snacks
• Eating enough healthy food
• Keeping my room clean
• Keeping the kitchen clean
• Learning how to do activities I enjoy independently.
• Owning and looking after a pet.
• Riding a bike
• Learning to drive
• Swimming
• Being independent
• Being able to go out on my own
• Road safety
• Using public transport
• Using a mobile phone
• Understanding toilet signs and using public toilets
• Understanding different cafes and restaurants
• Understanding different shops
• Going out at night
• Enjoying holidays
• Understanding airports
• Understanding being in a different country.
• Keeping myself clean
• Keeping my clothes clean
• Choosing my own clothes
• Choosing appropriate clothes for the season and weather
• Understand buying the right size clothes and shoes
• Looking attractive or handsome
• Understand and managing the barbers and hairdressers
• Understanding the changes that happen to my body in puberty
• To live on my own
• To live with friends
• Knowing how to ask for help
• Knowing when to ask for help
• Understanding my emotions
• Managing my own emotions
• Understanding others emotions
• Learning how to keep myself calm
• Understanding what helps me relax and feel good
• Understanding people
• Understanding Autism
• Finding and looking after friends. Letting friends look after you.
• Understanding the rules of chatting someone up
• Finding and looking after a partner. Letting a partner look after you.
• Sex education and the laws around sex.
• Keeping myself fit and healthy
• Understand what happens if you break the law
• Understanding what other people think looks odd
• Understanding what is safe and legal on the internet
• First aid
• What to do when you feel ill
• What to do if you feel very ill
• Understanding and managing visits to the doctors, dentists and the hospital.
• Understanding who to trust and who to ask if you are not sure about trusting.
• Protection against radicalisation, extremism, sexual exploitation, exploitation of vulnerability, criminalisation.