An autism diagnosis doesn’t mean other special needs are being missed

An autism diagnosis doesn’t mean other special needs are being missed – it’s just the first step in the process, says Malcolm Reeve.

Between 2010 and 2016 the number of children with autism in schools in England nearly doubled. The percentage in secondary schools increased markedly, even more in special schools.

The broad SEN area of communication and interaction, in which autism sits, is the second most prevalent in schools in England, according to last year’s DfE census. The challenges we professionals face in meeting these needs is considerable, but they are not nearly as challenging as those faced by the parents or by the children themselves.

Over the many years I’ve worked with children who have autism, I can honestly say that I have never met two the same. Autism is a complex lifelong condition and it “plays out” very differently in every person.

This is partly because it is a spectrum disorder, so where the autistic person is along the spectrum determines how autism affects them and how it presents to others. It also has three distinct but related components that each affect the autistic person differently – communication, social skills and imagination (sometimes referred to as flexibility of thought).

No two children with autism are the same

These are known as the “triad of impairment”. People with autism also often have a sensory difficulty, which again affects them in a very particular way. The most common one is noise (which is why you might sometimes see a person with autism covering their ears), but any or all of the senses can be affected. Finally there are sub-types of autism that add to the complexity of diagnosis and need.

Phew! How does one unravel all that? There are some common principles so let’s work through them. It is in a deeper understanding of how individuals are affected that we begin to understand them and support their lives and learning.

For instance, I have recently been supporting a child who has normal language for her age but who is not interested in other people or their views and wants to tell the stories she is interested in, at all times. Her eye-contact is limited and she does not show an understanding of the nature of relationships or friendships (so she finds unstructured times such as play times very challenging).

She cannot understand her own feelings and explain them to others. In addition she has sensory difficulties with noise, which we have to recognise and plan for in the busy school setting. This mix means that she finds it difficult to manage in the classroom; the way forward will be devising a personal plan with things we can all work on together.

In this case, her diagnosis of autism was just the start of a journey towards a better understanding of her particular, complex needs. For this reason I was puzzled when I was asked to comment in last week’s Schools Week on how an autism diagnosis can miss other special needs. A diagnosis may just be the start of understanding a child better; not the end of a journey.

We have to be open and flexible to making the changes necessary to make education a success

We have to delve into each component area and consider sensory sensitivities alongside other possible concurrent conditions before we can really begin to understand and support a child properly.

As professionals supporting children with autism and their families, we need to understand the complexity of the issues that a diagnosis can bring and show our own flexibility of thought and practice in responding.

We have to be open and flexible to making the changes necessary to make education a success. We also need to listen very carefully to what the parents tell us and (if they are able to) what the child tells us themselves.

The SEN code of practice puts children and families at the centre. In working with children who have autism I have always found that the best education is provided when another triad is in place: the child, the parents and a service that understands the complexity of the issues and is always flexible in its response.


Malcolm Reeve is executive director of SEND and inclusion at the Academis Enterprise Trust

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