What changes can we make with school to help my autistic child attend again?

This article aims to provide ideas to help school become a place where your child can feel comfortable enough to engage with people and learning. Proactive adjustments and accommodations can help a child feel safer at school so that they can thrive (reasonable adjustments) so should always be agreed when areas of need have been identified. Examples of reasonable adjustments are provided, alongside ideas that can help stimuialte new ideas and ways of thinking about life at school.

Adjustments to reduce stress and strain at school to manageable levels

Reasonable adjustments need to be personalised and are often agreed through discussions between the child, school staff, and parents. A starting point for identifying a good reasonable adjustment is to highlight a need, or part of the school experience, that the child is struggling with. Adjustments need to be tried and reviewed, and at times altered, refreshed or removed as appropriate.

1) What is something my child is finding harder in their school-related experience (before the school day, getting in, during the school day, after the school day)?

2) What ideas could make the identified challenge or need feel manageable rather than overwhelming or unsustainable?

Adjustments can be made to the physical space, the way things are done, developing a shared understanding on a matter, how people communicate with the child, ways the child can communicate with others, and may also include new skill-building.

Set reasonable adjustments up in a way that embraces a scientific experiment attitude: let’s see what happens / what changes if we put this in place, setting a realistic review period to allow for the expected ups and downs of life.

PERMA model of flourishing (Seligman)

Reasonable adjustments can also focus on positive wellbeing. For example, a need could be for a child to be extended in their learning or skills in an area of special interest, or to have opportunities set up to experience a sense of fun or other positive emotions.

When thinking about making a school experience more motivating for the child (intrinsically), you can work through the elements of the PERMA idea of wellbeing and flourishing (Seligman). In this approach, adding and making adjustments that increase wellbeing and quality of life is the intervention, as opposed to being the outcome hoped for.

See if you can come up with ideas that may increase the experience of and/or opportunities for each ingrediant of wellbeing.

• P for Positive Emotions (happiness, comfort, contentment, excitement)

• E for Engagement (entering a state of flow)

• R for Relationships (a sense of feeling connected, valued, and respected by others)

• M for Meaning (a sense of doing something worthwhile and meaningful)

• A for Accomplishments (goals that have been met, new skills, achievements)

Self-Determination Model – our core needs of control, competence and relatedness with others (Deci and Ryan)

Another way to think about reasonable adjustments that go beyond the immediate triggers of stress is to consider underlying needs that most children experience. There is some overlap with the PERMA model above, but it can be useful to think about the child from multiple angles.

The needs model is sometimes called Self-Determination Theory (Deci and Ryan) and suggests that there are often three core needs that need to be fostered for people to feel motivated, well, and productive:

• Autonomy: The need to feel in control of one’s own behaviour and goals. This can link to how choice is given in ways that work for the child, as well as how much the child feels equal or able to take a leadership role in moments.

• Competence: The need to feel capable at tasks and skills, and to feel effective when facing challenges.

• Relatedness: The need to feel connected to, respected, and supported by others (while also having opportunities to support others).

Three Circle Model  – soothing, drive and threat (Gilbert)

Finally, to complement the other ideas when considering support for areas of need and reasonable adjustments, consider how the Three Circles model may be playing out for your child. Gilbert’s Three Circles model shows the different modes that a child may operate in during daily life. These modes can also be understood as systems that influence what may be motivating a child at any given moment. It can help to picture each mode as a circle, with each circle being bigger or smaller depending on how much the child is in it.

1) The Soothing System/Mode: When in this system, a child is able to feel calm, well, and safe. They may be open to giving and receiving kindness and care. Bonds are developed with others in this mode, and stress can be tolerated and managed more effectively. A starting point to increase opportunities for this system to develop or be activated more often is to think about times when the child may have been in this mode. What could be replicated to provide similar conditions? This may include creating ‘bridges’ and connections between the child and teachers they associate with positive experiences or thoughts. Weekly notes, check-ins, gifts, and positive interactions can be facilitated.

2) The Drive System/Mode: When in this system, a child is motivated and excited to learn, set goals, and work towards them. They may experience manageable stress, which can help them perform and focus. A useful starting point is to think about projects and topics the child is likely to feel fascinated by.

3) Thre Threat System/Mode: When in this mode, a child may be vigilant for things going wrong or harm being experienced (physically or psychologically). They may feel anxious, angry, or ashamed, and are motivated to avoid situations and regain a sense of safety. A starting point here is often to identify the precise trigger points in the child’s school experience and reduce, remove, or adjust these so they feel more manageable again.

The child may move between these modes depending on what is happening around them. They may also have modes that are naturally more or less developed, meaning they can struggle to remain in one mode for long or become stuck in a particular mode that may not always be helpful. It

General ideas of supports and adjustments shared by parents

Here are ideas that children I have supported have benefited from in their school experience:

• Having a morning ritual for how ‘goodbye / see you later’ is done each day.

  • Having a clear task or responsibility to do immediately on arriving at school. This can be set as a weekly routine so each day has a different task to focus on in the first minute of the day.

  • Having a predictable set of sentences or actions completed with the parent that are associated with it being time to go into school.

  • Having a box that the child delivers something from home in each morning.

  • The teacher giving the child something to look after at the start of the day and return at break time.

  • Having a visual resource showing morning, afternoon and home time, where the child sticks their photo to track where they are in the day.

• Writing social stories about:

  • Getting to know adults in our lives (such as teachers) and learning that they are there to help in moments of need and encourage us to try new things.

  • Sometimes having to do things that feel stressful or worrying, with a focus on the supports available.

  • Family members spending time apart during the day but returning home to be together, including where parents may go and how they think of their children even when apart.

• If not currently attending school, having a named contact who sends notes, messages, video messages or activities home so the child still feels part of the school community.

• Setting up an interests club before school, at lunchtimes or after school.

• Informing children about new topic areas a week in advance so facts can be learnt at home, fostering confidence and interest.

• Creating shared understanding that some tasks require deeper thinking, supported by visual cues or gestures (e.g. pausing to prepare, engaging in thinking, taking risks, and stopping to regulate).

• Recognising that formal assessments often fail to accurately measure an autistic child’s true ability, and considering more holistic, extended assessment approaches.

• Giving children instructions and rules for new playground games to share with peers.

• Providing roles of responsibility that act as anchor points throughout the school day (e.g. monitor, helper, organiser).

• Using lanyards or badges to indicate roles or focus.

• Providing quieter entrances and exits.

• Having unwind activities available at the start or end of the day.

• Offering additional snack, drink and movement breaks.

• Using preferred sensory items (e.g. on a keyring).

• Creating meaningful purposes for work (e.g. contributing to a podcast or newsletter).

• Using marked zones to indicate where to sit or stand.

• Providing tents or den-like retreat spaces.

• Offering alternative spaces outside the classroom to complete work.

• Running homework clubs.

• Using bingo-style activities during unstructured time.

• Using a digital camera to help children identify spaces, activities and people they feel comfortable or stressed around.

• Marking frequently used routes with taped lines.

• Having a clear, manageable way for the child to request or signal for help.

Reviewing how much supports are helping

When reviewing the effectiveness of school-based strategies, differences often emerge between what a child reports at home and at school, and how they present in each setting. This can understandably cause adults to feel uncertain or worried about the effectiveness of supports and adjustments.

I recommend developing a series of continuums to support the review process, so that different aspects of wellbeing and effectiveness are held within discussions. I also encourage a focus on quality over quantity. By this, I mean reviewing the quality of the days the child has attended school, rather than relying solely on attendance percentages.

Here is an example of a set of continuums used by a child, their parents, and teacher when reviewing a support plan after four weeks. The child used ‘big stress’ and ‘small stress’ to describe overwhelming versus manageable stressors. Continuums can also be worded for teachers and parents to complete, allowing for the comparison and healthy discussion of differing perspectives.

Review Question	1/5	2/5	3/5	4/5	5/5
How often have I felt really into my work
How much have I felt able to manage big stress
How much have I felt supported by adults when feeling big stress
How often have I felt like I am doing well at something
How much have adults listened to me when I needed them to
How much do I feel that I belong here in my class
How satisfied am I about how the last 2 weeks have been
How optimistic do I feel about the next 2 weeks at school

If you would like support with thinking about these ideas in relation to your child, consultations can be booked with Dr Duncan Harris, Consultant Clinical Psychologist.