Adapt and thrive: article published in SEN Magazine issue 51

Here is a reproduction of an article I wrote that was recently published in the UK's SEN magazine.

Adapt and thrive

Zoe Thompson puts the case for prioritising the development of flexible, adaptive thinking in children with autism

I recently attended the National Autistic Society’s Annual General Meeting where I met a 64 year old with Asperger’s syndrome who, I discovered, lived near me. I gave him a lift home and on the way he told me about his life. He said that because his parents did not understand him, he had often been “farmed out” to relatives; school had been “a nightmare” and he had had pervasive difficulties holding down a job (despite a MENSA level IQ); he had got into a terrible financial tangle because he didn’t understand anything about money unless it was cash, and he had missed out on two opportunities he identified (with hindsight) as potential relationships because he couldn’t read the signals at the time. 

My friend identified his biggest lifelong challenge as the difficulty he has responding adaptively to the myriad of interpersonal challenges related to navigating the world on a day-to-day basis. 

Another adult with autism who is a research associate at the University of Maine recently wrote that “social encounters are dynamic occurrences that require spontaneity, flexibility, and adaptation”. All encounters, in every sphere of life, are social encounters. Such adaptation is often required on a moment-to-moment basis and it is this lack of flexibility in thinking that is one of the most difficult challenges for those with autism.

General awareness about autism and support services for people with autism have undoubtedly improved since some of my friend’s earliest experiences, but the principles that drive the provision of health, education and social care services for people with autism in this country have not moved very far at all in the last 40 years. Cutting edge research into the brain, autism and child development is giving us a clear message about what can be achieved for people with autism, yet despite this, our services are still compensating for the impairments resulting from autism instead of addressing them.

The mainstream response to the anxiety resulting from difficulties coping with uncertainty in children with autism within educational settings has historically been to adapt the environment so that uncertainty is minimised and to entrench children with autism in the predictability of routines. In some ways, it is an understandable response, as predictability decreases anxiety, but the consequence is that we amplify rigid thinking instead of helping children with autism to develop the flexible thinking that will enable them to have a more adaptive range of responses. 

In the education sector, even the most up to date inclusion tools funded by government advocate compensating for or working around the difficulties that pupils on the autism spectrum present with. There is no mention of helping pupils develop flexible, adaptive thinking to help them better access both the academic curriculum and the hidden social curriculum. 

Compensations and accommodations have their place – they are vital supports whilst a pupil is working on developing flexibility. However, we do children no favours if we are working around their difficulties and applying strategies that make them fit more appropriately into the box of our educational system instead of working directly on the difficulties – which would lead to greater independence and autonomy.

An excellent analogy of this can be found in the book Learning as we Grow (Buerkens, Roon & Kowalczyk 2009). The authors state that “If a child is diagnosed with a reading disability, we typically apply remediation approaches to help them learn to read. At various points we may use compensations, such as books on tape, to support them. However, our goal is to remediate or correct the problem that is preventing them from reading, so that they can become functional readers. In my professional experience, I have yet to come across a situation where adults believe that for an eight-year-old child who is not yet reading, we should just compensate for that and give them books on tape for the rest of their lives!  Remedial efforts are undertaken to get to the root of the problem and overcome the issues that are preventing successful reading.”

Peter Hobson, in The Cradle of Thought, shows how the foundations for flexible, adaptive thinking are developed as a result of the engagement between infant and caregiver in the early years. The infant “borrows the thinking” of the caregiver to decide what to do when faced with uncertainty. 

This can be seen clearly in the “visual cliff” experiment where the baby is unsure whether or not to cross what looks like a steep drop to obtain a colourful toy. 

To help decide what to do, the baby references her mother (looks to her for information). When greeted with an anxious face, the baby withdraws, but when greeted with a positive, cheerful face, the baby proceeds to cross the visual cliff.

Children with autism fail to develop this experience-sharing type of referencing because they have veered away from the typical path of development where interpersonal engagement acts as the “cradle” for the development of higher-level thinking skills. Consequently, competencies such as anticipating, appraising, evaluating, reflecting, monitoring, contextual processing and forward planning (commonly known as executive functioning) are all impaired in autism.

This explains why children with autism avoid change and uncertainty and why change and uncertainty lead to such high levels of anxiety in autism. As neuro-typicals (non autistics) we all know how it feels when we are presented with a new experience or with novel information: when we have not yet developed the competencies to deal with the new or novel, it creates fear or, at the very least, anxiety, and we resist or withdraw from it.

Some autism researchers and practitioners believe that it is possible to help children with autism develop flexible, adaptive thinking in order to better equip them with the range of competencies they need to flourish in an ever-changing world. This can be achieved by using the natural developmental pathway of typical (non-autistic) children as the framework.  Barbara Rogoff, Professor of Psychology at Santa Cruz, shows in her book, Apprenticeship in Thinking, how typical children in every culture of the world learn to become problem solvers by taking part in the “guided participation relationship” with their primary caregiver/s. 

If we put Hobson’s “cradle” with Rogoff’s “guided participation”, we get a framework for the development of flexible, adaptive thinking and social and emotional development in children with autism. A handful of specialist autism schools are now using an approach based on this framework. Outlined below are some of the developmental steps they are focusing on together with examples of activities that can be used when working on developing each area of competence.

Helping children share experience

Experience sharing through interpersonal engagement is unique to humans. Children with autism miss this developmental step with the result that they find it very difficult to share emotional reactions, feelings, thoughts and ideas with others.

A child can work with their “guide” on an activity that lends itself to experience sharing, for example, when playing Buckaroo there are lots of opportunities to share excitement, anticipation and trepidation, and to celebrate each other’s success of responding to a challenge during the game.

Helping children take different perspectives and think flexibly

This involves examining, observing or thinking about something from someone else’s point of view in order to have a more flexible range of response to it.

Perspective taking underpins flexible thinking: we borrow someone else’s views on something to generate options about what to do when presented with uncertainty or challenge. To develop perspective taking, a guide can help a child to compare and contrast their views with the views of others. In its simplest form, this could involve teacher and child looking at the shape of a cloud and sharing their views. It could look like a rabbit and it could also look like a duck. Both views are valid – just different perspectives.

Helping children collaborate

This everyday interaction comes easily for most children, but those with autism miss the developmental steps, such as social referencing and joint attention, which are key to collaboration.

It is possible to work on collaboration by setting up activities where the child has an authentic role and needs to work with their guide to achieve a common goal. For example, when building a wall of cardboard boxes, a child needs to reference (look towards) the guide to make sure their “brick” is going in the right place.

If there is a problem with the placing of the brick, the guide can draw the child’s attention to this by using a vocalisation such as “Uh oh!” The child then has an opportunity to repair the interaction by adjusting the placing of the “brick”. Repair during an interaction is essential; in a truly collaborative interaction, partners take account of each other’s views and adjust their own actions accordingly.

Helping children cope with setbacks and challenges

We cope with setbacks and challenges and learn from mistakes by drawing on our episodic memories of experiences that are similar but different to the current situation, to help us decide what to do.

Research shows that this special kind of memory is impaired in autism. It is possible to use different activities that incorporate small challenges which the child can repair or resolve.  This could include simple games like Buckaroo and Jenga or everyday activities in the home such as putting the rubbish out, making the beds, sorting the washing or making lunch. The guide can then subtly highlight the child’s competence in managing the challenge. The highlighting helps the child to lay down an episodic memory that is then filed away to be used as a reference point in future when presented with a similar challenge. Strengthening episodic memory supports the development of resilience and self-esteem.

Helping children solve problems creatively

We solve problems creatively by thinking of solutions we may have used before in similar circumstances and finding the best fit, “good enough” approach to coping with real life problems. 

This follows on from perspective-taking; it is possible to use activities where the child discovers that there is no right answer, that there is more than one way to achieve a goal and that the solution does not have to be perfect. For example, when playing ball, the ball can be thrown (there are multiple ways to throw: higher, lower, backwards, through the legs), rolled, carried on something else or batted with a racquet.

Conclusion

Life is full of uncertainty, unpredictability, setbacks and challenges. Our education and social care systems need to embrace cutting edge thinking about autism, so that we can help people with autism develop the competencies that are needed to successfully navigate through the choppy waters of everyday life.

Addendum

End of article.  What I wasn't allowed to say in the article was that the guided participation that I am referring to is of course what underpins the autism intervention Relationship Development Intervention (RDI).  It is RDI that has influenced the teaching methodology in Bright Futures School.  It's encouraging to note that whilst there aren't yet that many schools that are embracing this type of approach as a whole school approach, there are an increasing number of education practitioners who are beginning to incorporate 'mindful guiding' into their relationships with pupils and fellow staff members. 

Some of you will know that I am in training to become an RDI Consultant myself.  This has opened up a whole new world of likeminded people who are striving towards similar goals from across the globe, through the RDI Community Platform - an online system that allows Consultants and Consultants in Training to share ideas and experiences, to access e-learning and to manage ongoing communications with the families they are supporting.  There is also a community for parents who are following an RDI programe. It's a veritable goldmine of ideas and support and a fantastic training resource.  It's here that I have 'met' with folk from around the world who are building this guiding approach into their teaching.

I am really looking forward to the day when, as staff at Bright Futures School, we can collaborate with the RDI Consultants of families at our school who are running home programmes of RDI to ensure that the guiding experiences that are offered at school complement and elaborate on the child's home programme.  The beauty of the RDI Platform is that we (school staff, parents and RDI Consultant) will all be able to have an ongoing case management dialogue.  How's that for a dynamic approach??

I love it when a plan comes together.......we're not there yet but are heading in the right direction.