Behavioral therapy

Autism and Girls: Navigating Challenges in the School Environment

By: Yetunde Oladunjoye

School can be a difficult challenge for anyone. From learning new topics to meeting new people, there's a lot to navigate. However, in the case of people with autism, this struggle can be especially demanding. With the ratio of autism diagnosed in young children estimated to be 3:1 in males vs. females, girls are disproportionately less likely to be diagnosed early enough to learn supportive skills to aid them in the academic environment¹.

Why is School Challenging for Girls with Autism?

School comes with many rites of passage, such as prolonged periods away from family, interacting with peers, learning completely new concepts or building on previous knowledge, and many more.

With the amount of time educators spend on the children in their classes, identifying challenges should be less difficult with their training. But reality shows a different story. A study looked at how well teachers could identify children that may benefit from an autism screening. The results revealed there was a bias towards males and reported autism appeared differently in females².

For the social aspect of school, girls were observed to prefer non-verbal communication to supplement their verbal communication. This was generally considered not an indication of autism according to teachers and was, unfortunately, hiding the girls’ difficulties because of stereotyped generalizations of how girls communicate³. A common technique used to navigate these conflicts is called masking.

Why Masking is Important to Understand

Masking is a social tactic where an individual mimics or imitates what they perceive to be as "normal" in social interactions. A good example of this is when people applaud after a performance. It is perceived as "normal" to clap after the end of a performance, regardless of one's enjoyment, since this is seen as respectful.

However, masking can be a stressful endeavor to do since peer imitation is constantly occurring in tandem with all of the other processes someone has to think about when engaging in social situations. It doesn't help when individuals can hide the true meaning of their words, adding a new complexity to the situation⁴.

Masking is used as a coping mechanism for many neurodivergent individuals to make their way through each day of new interactions. Add the complication of the school years being a time where all of your peers are finding their own style of communication simultaneously, and it can be incredibly frustrating.

What's next?

Autism in girls is a topic in need of more research and awareness. Not only does the general public need to learn more about this, but educators need to acquire more knowledge in how it uniquely presents in young girls to help reduce the heavy bias in identifying the condition in boys. Without adequate support from those who spend a majority of their time with these children (besides their parents), girls with autism unfortunately have to exert more effort to just get through their school days with how confusing it can be in such a transitional time. All things considered, it is a positive sign to see autism in girls gain more recognition as a topic to focus in both research and educational studies.

References

¹Loomes, R., Hull, L., & Mandy, W. (2017). What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 56(6), 466–474. https://doi.org/10.1016/j.jaac.2017.03.013

²Whitlock, A., Fulton, K., Lai, M.-C., Pellicano, E. and Mandy, W. (2020), Recognition of Girls on the Autism Spectrum by Primary School Educators: An Experimental Study. Autism Research, 13: 1358-1372. https://doi.org/10.1002/aur.2316

³Rynkiewicz, A., Schuller, B., Marchi, E., Piana, S., Camurri, A., Lassalle, A., & Baron-Cohen, S. (2016). An investigation of the ‘female camouflage effect’in autism using a computerized ADOS-2 and a test of sex/gender differences. Molecular autism, 7(1), 1-8. https://doi.org/10.1186/s13229-016-0073-0
⁴Tierney, S., Burns, J., & Kilbey, E. (2016). Looking behind the mask: Social coping strategies of girls on the autistic spectrum. Research in Autism Spectrum Disorders, 23, 73-83. https://doi.org/10.1016/j.rasd.2015.11.013

The Importance of Teaching Consent from an Early Age

By: Jordan Hoskinson, BCBA, LBA

Consent can seem like a complex topic to tackle, as both a clinician and as a parent to autistic children. What is consent? It’s defined as “permission for something to happen or agreement to do somethingᵃ.” This definition doesn’t seem to take into consideration where people are coerced or feel pressured into giving permission to be touched or to touch someone else. A much more inclusive definition of consent would be, “if the person agrees by choice and has the freedom and capacity to make that choiceᵇ.” The issue of who can be touched and how and in what context can be confusing for autistic children.

One way to avoid issues around these rules of physical touch is to teach children about consent. Physical touch, even something as innocent as a physical prompt to help someone hold a crayon, should not happen unless both people are on board with it. Our bodies are our own and we are the only ones who have the right to decide what we are comfortable doing with them.

As a parent, if my family is visiting my home and they wish to give my child a hug, my child has the right to say, “No, thank you” and to have that respected. By forcing my child into a situation where they might feel uncomfortable with physical touch, I’m teaching her that others have the right to make her body feel uncomfortable. Allowing someone to say no to physical touch should always be respected, whether it’s a family member, a peer, a doctor, or a therapist. 

As you teach your child about consent, be sure that you model what it looks like. Unless your child is in danger, don’t touch them unless you’ve received permission. If it seems as though they’ve had a rough day at school you can say, “Do you want a hug?” instead of just pulling them into your arms. This sort of consistency will help them learn what to do if they want to touch someone.

If you have a preverbal child, look for signs that touch may be unwelcome. This could look like backing away, pulling away, or engagement in ineffective behavior whenever you attempt to make physical contact.

Therapists and BCBAs at BASICS ABA Therapy are trained to ask all our clients’ permission before we offer any touch. This is one of the many ways that we teach self-advocacy. It’s never too early to teach your child about consent. It’s a lesson that every person—autistic and neurotypical—should be aware of and understand. When we learn about consent from an early age, we can grow up knowing how to give consent and also when to ask for consent from another person.

Footnotes:

ᵃhttps://bit.ly/3GGOYrJ

ᵇThe Code for Crown Prosecutors

Trauma Manual

When I first started in ABA, I was taught that if a kid threw a shoe at me, I should turn away from them because they wanted my attention. And you know what? As problematic as that approach was, it usually worked. When I became a foster parent, I was taught that if a child threw a shoe at me I should hug them because they needed my love. And you know what? It often worked. Over time those kids stopped throwing their shoes as their attachment became more secure. But sometimes they didn't. And no one had answers for families who parented kids from hard places who couldn't be ignored or loved out of throwing their shoes. No one had any resources that addressed this issue.

That’s why I developed this model, started presenting webinars, and wrote this handbook which you can purchase here:

My Trauma Informed Behaviorism Handbook walks practitioners start to finish through creating a Trauma Informed Intervention using behavior analytic principles. It helps look at trauma events through the lens of setting events and walks providers step by step through creating an intervention that addresses this setting event. 

In the full Trauma Informed Behaviorism Handbook: 

  • Readers learn to recognize and define a trauma event.

  • Readers learn how to apply trauma events as setting events.

  • Readers will learn how to implement a trauma informed antecedent intervention addressing trauma event setting events (TESE).

  • Readers will learn how to teach replacement behaviors and alternative behaviors that target the unique functions that maintain behavior for people who have experienced trauma events.

  • Attendees will learn how to teach consequence interventions that address the trauma event setting event (TESE).

At the end of the handbook, providers have access to a template to use this model for their future clients. 

I am super proud of this handbook and think this unique approach using behavior analytic principles and trauma informed ABA make this a must for all providers. You can purchase the handbook here!

https://www.beyondthebasics-dc.com/product-page/the-trauma-informed-behavior-management-handbook