Sunday, 13 November 2011

Asperger's Syndrome - Sally in the Sky with Diamonds

Timetable Russian Roulette. That is what we call the annual dissemination of teaching groups at the onset of the academic year. The Head of Department hands out that single sheet that holds the future. Much like the oracle at Delphi, a knowing nod, smile or expression that says “I’m sorry”, would accompany the ritual bestowing of the teaching class upon each teacher. “I’m sorry”, I could see that Ron was genuinely empathetic, “you have Sally this year.”

We have all taught the awkward kid that “just doesn’t get it.” The child who is so disorganised and doesn’t understand the simplest of instruction, the one that can’t remember from one minute to the other and doesn’t react to any hint or direct instruction to adjust behaviour. This student, in my case, is Sally. She is 12 years old and in her second year of secondary school. The first year was not the most successful of transitions and everybody has become acclimatised to the deathly hallows of a Sally Tantrum. It has even become an abstract noun. “What’s wrong with Mr J?” we would joke in the staff room. “Not much, he’s just having a sally…” It was only later in the year, after much work from the Special Education Needs Coordinator (SENco) that Sally was diagnosed with Autistic Spectrum Disorder (ASD), more specifically, Asperger’s Syndrome. 
Autistic Spectrum Disorder (ASD)
ASD encompasses a very wide range of behaviour. When we think of Autism or Asperger’s Syndrome, we (unfortunately) have a traditional image of repetitive behaviour; severe language impairment and images of Rain Man frequently pop into our imaginations.  This is not always the case. We also imagine that mainstream education is not the right place for a child with ASD. This is most certainly not the case either.

General Problems

Children with ASD generally face some (not all) of the following problems:
  •   Poor short term memory (executive memory)
  •   Difficulties with motor skills
  •   Limited understanding of instructions
  •   Disorganisation
  •   Problems with visual thinking and imagining (empathy is thus a problem)

They may also experience one or more of the following specific problems during the day:
  •   Slowed response to questions
  •   Information overload results in sleepiness or hyperactivity
  •   Panic attacks and anxiety
  •   A lack of curiosity
  •   Poor awareness of danger (health and Safety)
  •   Lack of understanding social cues and other people’s motives

Slow responses to questions:

It might look like Sally is not responding to me, but she is actually processing the question, instruction or task. I would say to Sally that I am going to ask her a specific question and then give her time to arrange the question and response in her mind. In the beginning she would shout out the answer as soon as she knew what she wanted to say. We worked on this together. I would stop her and remind her to wait for me to ask her the question first.  Now I can often see if she is ready to answer or she will say to me “I can answer now".

I also found that it is best to ask her assessment questions on a one-on-one way rather that whole class. To build her confidence, and alleviate overload, I tell her the question before hand, give her time to give the answer and then ask her to respond.

She often puts her hand up and volunteers an answer. In the beginning I experienced this as disruptive because I have moved on in the lesson while Sally was processing a previous question. I now use this as a positive opportunity; as a mid-lesson plenary or progress/exit reflection for the whole class.

Mono possessing – bite-size teaching

Sally can only process one thing at a time. Because her spoken communication is quite good and she often uses words that we find surprisingly advanced, we forget that her capacity to multi-task is diminished. Like many children that have attention problems (and quite often boys in Year 7 and 8), Sally is prone to mono processing and she needs to receive instructions one step at a time. This strategy works well for students with low reading ages as well and I found that it isn’t an intrusive strategy in my class.

I already use timed activities as a teaching strategy in my lessons. However, I realised that for Sally this causes anxiety if she has not fully processed the first step of the task. When I set the timer, I ensure her privately that she can take her time – but I keep an eye on her that she doesn’t get busy with other activities. I have her seated close to my teaching base so it is easy to keep an eye especially when she has information overload.

Information overload

Intellectual narcolepsy is something I am used to when I teach 16-year-old boys. But when Sally started falling asleep in my lessons, I became very concerned. I contacted her mother and asked if Sally gets enough sleep. “If Sally suddenly lies on her arms and becomes unresponsive to you, it might mean that she feels anxious about all the information she has to be busy with.”  I felt relieved that it was not my boring lessons that sent her into an enervated state. However, I found that this often happens when she has not yet coped with learning objectives and I wanted to move on in the lesson.

To help Sally I pre-printed a sheet with the lesson objectives on for her. As she enters the class she practises reading the objectives and at the start of the lesson everybody now knows that it is her task to read the objectives out loud to the class. Even after several months, she still lets me know that she has a reading age of 7 and that she will find reading the objectives difficult. I constantly ensure her that she can do it and that the class likes it when she reads the objectives.  While the rest of the class is busy with the starter activity, Sally practises reading the objectives. I found that she also likes being busy with the starter worksheets and quite often this is the most she manages in a lesson. The most important aspect of teaching Sally is time. I have learned that rushing myself and Sally always results into information overload.

The other students in my class found Sally’s sleeping disruptive. I explained to them that she is taking a break and to be fair I included a break session in every lesson. After approximately 20 minutes I have everybody stand up, turn around, stretch and then sit down again. This is our time out and everybody, including Sally and myself, benefit from this. I also use my strategy to remove the stimulus (as I discussed in Low-level disruptive behaviour last week) when Sally’s behaviour becomes too disruptive. It took some time but the other students in the class now don’t respond to Sally’s behaviour.

Not all students with Asperger’s will fall asleep when they have information overload. Some might get up and walk out of the class, become busy cleaning up the area around them or repetitively open and close the classroom door. Sally's mum suggested that a light tap on the shoulder is the best way to re-focus her again. It is always best to talk with parents about strategies they use to avoid information overload. 

Executive Memory

The child with Asperger’s Syndrome can often be described as being impulsive and off task; even hyper-active. Many people claim that children with Asperger’s have comorbidity with ADHD. This can be debated. In the case of Sally this is very much true. She often goes off task or if the conversation in science is about velocity, she will want to talk about a car they were driving in while going on holiday. If not stopped she can talk the whole hour, jumping from one topic to another. I found it best to kindly redirect her to the velocity question and explain to her that she needs to remember to think about science and not her holiday. Sally also forgets what she is supposed to do to complete the activity: read a text or find words.

Sally might often be late to lesson, this is often because she gets confused between going to lesson or lunch. At the start of the day she might feel anxious about her PE kit and even if PE is at the end of the day, she will not be able to deal with the problem at the appropriate time. She is often found to wonder around in the building. We now have an arrangement with all the adults in the building that if they see her, they know she are not truanting and they escort her to the correct lesson.  We arranged with her mum that her timetable is always kept in the second section of her bag, in an orange folder and everybody knows not to remove the timetable from the folder as it makes her anxious.

Classroom Management

Seating Plan

The best place to seat Sally is close to me. Not all children with ASD shy away from social interaction. I found that it is ok to have Sally seated as part of a group as this helps her to develop some social skills. During group activities it is best to explain to her what her role during the activities is. She loves group games and being involved with group activities but when things don’t go her way she gets anxious.

Some children with Asperger’s don’t do well during group activities and it is best to have a set of language games or a favourite activity ready for days when group work forms the spine of a lesson.

Body Language

Sally finds it very difficult to read body language. I often use body language to manage behaviour in my lessons. Crossing my arms at the front of the class and waiting for silence, or the hands up signal, has no meaning for her. I have to walk to her and say that I am now going to put my hands up in the air and that when I do that I want everybody to be quiet.

Verbal Reminders

Many teachers use humour as a very effective tool to manage classroom activities. Sally finds this difficult to understand. She takes tongue in cheek remarks as literal and this has caused her great confusion and even anxiety. That doesn’t mean that I don’t use humour, I just explain the humour as well as the intended effect to her in a very literal way afterwards.

Using Your Opera Voice (shouting)

Sally seems to not really respond outwardly to a teacher’s “opera voice”. She has told me that when she is on the receiving end of the cadenza (shouting), it does distress her. She does not know how to respond and will often show no response. This is not because she doesn’t care about what the teacher is saying, she just doesn’t know how to respond.

Consistency, Consistency, Consistency

The key word in working with a child with ASD is routine. Consistency in routine is particularly true for subjects such as D&T and Science where experiments health and safety is crucial.

Sally will follow a routine religiously once it has been put in place. She has elected herself to be the “Class Monitor”, telling me who have been doing what. This has been a source of conflict and I have had to be honest with the class and explain that out of bounds Sally will report behaviour to me and that it is not “snitching” or “tattling”.

Sally took some time to get used to my routines. It was not necessary to change my routines just for her. However, consistency in the procedures in my lessons was beneficial to all my students.

However I found that when I planned to do something out of the ordinary, I had to let Sally know some time in advance (a day or so). She felt very anxious when I suddenly took the class outside for a lesson and she was not able to join in the learning. When Sally has time to prepare herself, she is great in outdoor lessons.


I expect Sally to adhere to the same rules as all students. That being said, giving her a sanction is a different ball game all together. I found that it is best to discuss sanctions with her mother. Sally once made a highly inappropriate comment during lesson. My immediate reaction was to reprimand her immediately. but I did not follow up with a sanction. This gave the student on the receiving end of Sally remark a sense that social justice did not occur. I received the phone call soon after the end of the day. Charlie’s mother wanted to speak to me about my lesson today.
I realised that I should have talked to Charlie as well and explain that there will be social justice, and that to ensure that such a comment doesn’t happen again we have to make sure Sally understands why what she said was offensive. By the time I could call Charlie’s mother, the Head Teacher had received a call and what was a small oversight on my behalf became an official complaint. I phoned Charlie’s mother and invited her to come to the school. I explained to Charlie’s mother that giving Sally a sanction was not that easy and that I needed to talk with her mother first. We set a day and time for me to give her feedback about what the actions I was going to take.

In the end we had a repair and rebuild meeting between Charlie and Sally. I met with Charlie first and explained that he should not expect the normal body language, facial expressions and tone of voice that will be typical of an apology.

Sally’s sanction was to be in a detention for an hour. This was agreed with her mother and Charlie’s mother also found this to be an acceptable consequence. I used the hour to help Sally understand that some words are hurtful. Her mother and I agreed on a specific example to explain this to her. My conversation with her was reinforced at home.

Contact Home

The parents of children with ASD are always on the alert. This is a syndrome that has an impact on the whole family. Sally’s mother is very good with communication, but to ensure that we support her as much as possible, we agreed that the SENco will always be the primary contact from the school’s side. In the case where Sally needed to receive a sanction, it was my colleague who phoned her mother and helped me to set up a meeting to discuss an appropriate sanction for Sally.

Social Development

Sally is very open about her ASD and given the opportunity she will talk freely about it. This is not always the case and as with all behaviour difficulties one size does not fit all. Sally often tells her peers that she is autistic and even though this is a positive, we as a school have had to ensure that all students have respect for the condition and for Sally. This was not dealt with through whole school assemblies, but rather by keeping our ears to the ground and having many individual conversations with students where we suspected they didn’t understand.  

Sally tends to misinterpret social cues from her peers. This can cause conflict and she gets quite explosive: Sally has developed a very strong right hook! We are trying to establish a procedure where she remembers to come to the SENco when she gets angry. This has not been too successful and we all still need to keep our eyes open during break and lunch times. If she gets into a skirmish, all the adults in the school, and the peer leaders know to bring both parties to the SENco to sort the problem out.

I enjoy having Sally in my class. She helped me to look at my own teaching (and learning) in a new way. When she is anxious and has a "sally", I know I have to adjust my practise. When she has a  good day I feel invigorated and proud. She reminds me of the song Lucy in the Sky with Diamonds, because when she has a good day, she sparkles. 

This time the Timetable Russian Roulette rolled in my favour.  

Below are a list of general strategies that are quite useful. I coloured the strategies that worked well for me to support Sally.

General Strategies

  • Prepare the pupil before the session/lesson by outlining what it will be about
  • Support oral presentations /explanations with charts, diagrams, pictures, real objects or mime
  • Set tasks with clear goals and write worksheets in step-by-step form
  • If pupil becomes anxious allow him/her to remove self to an agreed calm-down area
  • Seat pupil in an area of classroom free from busy displays and distractions
  • Teach/use clear classroom routines, e.g. have all pupils hold an object when it is their turn to talk. Display classroom rules and routines, illustrated by pictures, for pupil to refer to. Illustrate them visually – for example, use a traffic light system to indicate whether pupils can talk or not, or symbols for different noise levels (partner voices, group voices, classroom voice, playground voices)
  • Use a visual way of showing the pupil what they/the class will be doing, such as a sequenced series of pictures (a visual timetable) , clock face divided into sections, or written list
  • Use short simple instructions. Give one at a time and check for understanding. Repeat instructions in same words rather than different ones. Write instructions down as a list for pupil to tick off when completed.
  • Use pupil’s name before asking a question or giving an instruction
  • Avoid or explain metaphorical language and idiom like ‘pull your socks up’, ‘it’s raining cats and dogs’, ‘in a minute’
  • Explain any changes of routine to the pupil in advance
  • Involve the pupil by asking direct, concrete questions at their level of understanding
  • Support writing with writing frames, templates (e.g. writing up a science experiment), mind maps, gapped hand-outs
  • Allow pupil to work alone rather than in a group where possible. If  in a group, give clear roles within the group and put the rules and roles into writing
  • Use visual prompts on cards or photos , or consistent non-verbal signs (sit, look, listen, hand up, wait , quiet)  to show pupil the social behaviours expected
  • Prevent repetitive questioning by giving pupil a set number of question cards to give you each time they ask a question – when cards are gone, no more questions
  • Don’t ask the pupil to talk or write about imagined experiences
  • Avoid tasks which depend on empathy (e.g. in literature, history, geography, PSHE and citizenship)
  • Set explicit and clear expectations e.g. how many lines to write, how many questions to answer, how long to listen (use timer)
  • Put a green ‘start’ dot on the pupil’s book and a line to show where to finish. Use in and out boxes for work to be done and work that is finished.
  • Provide pupil with a symbol card to display when he or she wants help
  • Expect to teach pupil social skills e.g. what to say/do when praised, how to ask for help. Always tell the pupil what to do rather than what not to do.
  • Provide a structure for unstructured time e.g. chess club rather than break time outside
  • Model to the pupil that making mistakes is OK and a part of the learning process
  • Use incentives based on pupil’s interests e.g. a pause every hour to focus on their interest or obsession, once they have completed their work
  • If pupil goes off at a tangent, direct conversation back to the topic in  hand. 'Right now we are talking about volcanoes’
  • Use immediate and individualised reward systems e.g. collecting a number of stickers

Also see a review on Worth Reading.

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