Educating children diagnosed with an autism spectrum condition is a serious business. Autistic children often face difficulties as they interact with and experience the world around them. Many also have additional challenges with their learning and behaviour and are at an increased risk of developing mental health problems. All this has serious consequences for their futures. Add to that the difficulty families often say they face in convincing the authorities to support the needs of their child, and you have an extremely difficult situation for parents in deciding what to expect from the education system.
Early diagnosis and intervention are now widely cited as giving children and families the best shot at improving later opportunities. Yet there are a diverse range of therapies and interventions available for children with autism, which vary widely in terms of their underlying philosophy, the way that they are delivered, the intensity of the programme (number of hours per week), the degree of parental involvement and the cost to families and to government.
One particular intervention, Applied Behavioural Analysis (ABA), has hit the headlines in the past week. It is the subject of a new documentary, “Challenging Behaviour”, screened on BBC4 on Tuesday 5 November. The programme examines the Treetops School, which strongly advocates the use of ABA, and also features people who are more critical.
Behavioural techniques like ABA incorporate basic learning principles, such as positive reinforcement, in an effort to change behaviour. The use of these principles is ubiquitous – in our homes, schools, in business and even by our government. That’s how children often learn to navigate their own environments in their youngest years, not touching hot radiators again or quietening down at the dinner table when parents offer them a reward. ABA harnesses these principles in order to increase appropriate behaviours and reduce or extinguish those that might cause harm or interfere with a person’s learning or everyday functioning.
This approach has been used extensively with children, young people and adults with autism in the UK and, especially, the US. But it has also spawned much controversy and criticism.
So what is all the fuss about? There are two key problems.
The first relates to claims from some of the most confident exponents of ABA that it could lead to “recovery” from autism. In 1987, Ivor Lovaas published a paper claiming that, with intensive intervention (~40 hours per week for two or more years, 1:1 with a therapist), just under half of children with autism made such marked improvements that they were reported to have “recovered”.
Many commentators (including autistic people themselves) take issue with these claims of ABA and its underlying goals. Lovaas himself once stated that his objective was to make autistic people “indistinguishable from their peers”. But this kind of cure/recovery claim has been deeply damaging. Sometimes such claims give parents false hope. It simply isn’t true that ABA can “cure” people with autism. Furthermore, the idea that we should be aiming for a “cure” in the first place is often dangerously insulting to autistic people themselves, who feel that a goal of “normalization” is not the best way forward for ensuring quality of life. These kinds of claims send out the message that an autistic life is not worth living.
The second problem lies in the claim by many ABA practitioners that it is “better” than other existing approaches in helping autistic children to learn and to settle into a better quality of life. It is frequently claimed that ABA has a better “evidence base” behind it and is more grounded in the scientific literature. The reality is, however, that ABA has rarely been tried-and-tested in rigorous randomized controlled trials. And nor has it been systematically compared with other approaches.
This is not a problem unique to ABA. In work recently conducted here at the Centre for Research in Autism and Education, we surveyed all of the research funded on autism in the UK between 2007 and 2011. We discovered that only 18% of research funding actually focused on the nature of educational and other therapeutic interventions. Individual parents and schools will have their own experiences and views, of course, about the programmes they employ but as scientists we actually know almost nothing about the quality of any one of them. So, sadly, at present there is no real evidence to suggest that one intervention is better than any other.
So what should parents and teachers do in a situation like this? How should they choose between all the different programmes on offer?
In the long run, the answer will involve doing the very best, world-class research on interventions to improve the educational chances of children with autism and to enhance their quality of life. But that does little to answer the pressing needs of parents and educators in the here-and-now.
I believe there are three principles that should guide all of us who try to help children with autism.
First, any programme of intervention must acknowledge the huge breadth of autistic characteristics and the way in which individual autistic children change and develop over time. Autism is an incredibly complex and diverse condition, and the individual needs and capabilities of children must be considered as a whole, incorporating their communication needs, their social interactions, their ability to control their own behaviour to their own advantage, their potential sensory sensitivities (to touch and sound, for example). Programmes for autistic children must be individual and not focused on any one small dimension of the autistic spectrum.
Second, programmes of intervention should recognise the distinctive strengths of autistic children as well as the difficulties they face. Many autistic children have exceptional memories, display an exquisite focus of attention and have an aptitude for processing visual information. Even when those talents are not so readily identifiable, we must not assume that autism is incompatible with significant achievement and learning in many cases. We must be ambitious and have high aspirations even for those children that appear the most challenged, and even when it is very difficult for all concerned.
Third, and most important of all, given the paucity of good evidence that is available to teachers and clinicians, we must always acknowledge that we are partners in discovery with each individual autistic child and their families. We must be vigilant to the dangers of being dogmatically dedicated to any one therapeutic programme or set of ideas. Instead we should be open to listening to and working with the individual children and their families that we are trying to serve. Educators have as much to learn from the children with whom they work as those children do from them.
Finding the right education for autistic children remains very difficult for thousands of families across Britain. But if we keep these principles in mind, we will avoid the pitfalls that beset some of the approaches that are found in schools today.
Rob Webster and Peter Blatchford
This week the government’s long-awaited Children and Families Bill was presented to Parliament for its first reading. The Bill – which will prompt the biggest shake up of special educational needs (SEN) in 30 years – confirms one centrepiece proposal, heavily-trailed over the last 12 months: the replacement of statements of SEN with Education and Health Care Plans (EHCPs).
Statements are awarded to pupils with the highest level of SEN; they set out a pupil’s needs and the provision that he or she should receive to meet them.
These proposals follow ministers’ views that the current SEN system is unfit for purpose. But beyond parents’ genuine concerns about the statementing process, surprisingly little is known about the day-to-day teaching and support that pupils experience once a statement is put in place. Without such information, is the call for reform premature?
Findings from our Making a Statement (MaSt) project fill this gap and raise important points for policymakers to consider. Over 2011/12, we carried out minute-by-minute observations on 48 pupils in Year 5 who had statements for moderate learning difficulties or behavioural, emotional and social difficulties, and interviewed 200 school staff and parents.
The results show that the educational experiences of pupils with statements is characterised by a high degree of separation. Compared to average-attaining pupils, they spent over a quarter of their week away from their class, teacher and peers.
A clear point to emerge from the MaSt study was the almost constant accompanying presence of a teaching assistant (TA) in the locations – both in and away from the classroom –where pupils worked. Compared to average attaining pupils, we found that pupils with statements spent less time in whole class teaching with teachers, and were more than three times more likely to interact with TAs than teachers.
In many cases TAs also put together alternative curricula and prepared intervention programmes. They also had the main responsibility for verbally differentiating teachers’ tasks, often in the moment, having had little or no opportunity before lessons to meet or prepare with the teacher.
Teachers, on the other hand, rarely had as high a level of involvement in planning and teaching statemented pupils as TAs, or provided the extra level of differentiation these pupils needed. This is very likely to be connected to the gap in knowledge teachers especially had in knowing how to meet the needs of the particular statemented pupil in their class.
As a result of current arrangements, we found that whilst the support provided (largely by TAs) was clearly well intentioned, it seemed insufficient to close the attainment gap.
Not only did pupils with statements spent less time in whole class teaching with the teacher, but they also had almost half as many interactions with their classmates compared to other pupils. This, we argue, is likely to adversely affect their social development.
Spending a week at a time observing at close quarters, and discussion with practitioners and parents/carers, brought home how schools are making every effort to attend to the needs of pupils with statements amid a period of intense flux and uncertainty in schools and local authorities. However, findings from the MaSt project and our previous research – the Deployment and Impact of Support Staff (DISS) project – raise questions about the appropriateness of current arrangements.
Statements entitle pupils to a set number of hours of TA support. Yet, the DISS project found that compared to their peers, pupils who had the most support from TAs did less well academically, and this finding was especially clear for pupils with SEN.
With EHCPs replacing statements, a key message from our research is that the currency of statements should change from “hours” to “pedagogy”. We suggest EHCPs specify the pedagogical processes and strategies that will help meet carefully defined outcomes.
Crucially though, while we recommend the new SEN reforms do away with “hours”, we do not suggest they do away with TAs. Which is why, as well as thinking more inclusively about pupils with statements, schools and teachers also need to rethink the role of TAs. Our new book, Maximising the Impact of TAs provides guidance on this.
The Making a Statement project was an independent research project, funded by a grant from the Nuffield Foundation.
To download the MaSt project Final Report, and for more on our research, visit www.schoolsupportstaff.net
Peter Blatchford and Rob Webster
The government has announced plans that could change the way schools manage provision for some of the most vulnerable pupils. Both the injection of cash for pupils on free school meals via the Pupil Premium and the plan to give parents of pupils with a statement of special educational needs (SEN) control over their child’s SEN budget are part of the coalition’s drive to give schools and parents the power and resources to fund the expert support they need to progress.
Of course, the groups of pupils at whom these two funding sources are targeted are not the same, though they do overlap: the government’s own data show that pupils with a statement for SEN are twice as likely to be eligible for free school meals as their peers.
Much has been made of the devolution of power from the centre in the drive to close the attainment gap between disadvantaged pupils and their peers. Deputy Prime Minister Nick Clegg, for example, made a virtue of the freedom headteachers have to spend the £488 per child Pupil Premium. He wants to see schools innovate, then publicise the most effective strategies.
Over the last 15 years, teaching assistants (TAs) have become a central part of policy and practice in meeting the needs of lower-attaining pupils and those with SEN. Over this period, TAs have grown to comprise a quarter of the UK mainstream school workforce. The general sense is that using TAs to provide one-to-one and small group support to struggling pupils works well, and it is likely that schools will seek to extend this through the Pupil Premium. However, our research offers a word of caution.
Results first published in 2009 and described in our new book, Reassessing the Impact of Teaching Assistants: How Research Challenges Practice and Policy, raise concerns about the impact of TA support on pupils’ academic progress.
Our five-year study, the Deployment and Impact of Support Staff (DISS) project (the largest study of TAs worldwide) measured the effect of the amount of TA support on the academic progress of 8,200 pupils, while controlling for factors like prior attainment and level of SEN. Worryingly, our analyses across seven year groups found that those who received the most support from TAs consistently made less progress than similar pupils who received less TA support.
So, are we suggesting that schools and parents look elsewhere to invest their funds? Far from it. Blaming TAs would, in our view, be wrong. As other results from the DISS project show, it is the decisions made about – not by – TAs, in terms of their deployment and preparation, which are at fault.
We found that there has been a drift towards TAs becoming, in effect, the primary educators of lower-attaining pupils and those with SEN. Teachers like this arrangement because they can then teach the rest of the class, in the knowledge that the children in most need get more individual attention. But the more support pupils get from TAs, the less they get from teachers. What is more, our detailed analysis of classroom talk showed that compared to teachers, TAs’ talk to pupils tends to focus on task completion rather than developing understanding – most likely as a result of having limited opportunities to meet with teachers before lessons.
The government has not ringfenced Pupil Premium cash, but it will – via Ofsted and league tables – hold schools accountable for how it is spent. Our view – outlined in Reassessing the Impact of TAs – is that schools must undertake a fundamental rethink of the purpose and role of TAs if they are to get the best use from TAs and help disadvantaged pupils.
To this end we have been conducting a follow up study, funded by the Esmée Fairbairn Foundation, in which we have been collaborating with schools to develop and evaluate strategies for improving the use of TAs. The results of this research, which to date are extremely positive, will feature in a future blog.