Autism and Complex Communication Needs

• Kate Akers - Specialist Practitioners
• Nicholas Appleton - Specialist Teacher
• Ray Barry - Specialist Teacher
• Emma Bone - Specialist Teacher
• Joanna Chandler - Specialist Practitioner
• Colin Esrich - Specialist Teacher
• Stephen Fessey - Specialist Teacher and Autism/ CCN Team Lead
• Gemma Halstead - Specialist Teacher and Autism/ CCN Team Lead
• Kate Hulls - Specialist Teacher
• Nicky James - Specialist Teacher
• Anne Seymour - Specialist Teacher
• Sarah Summers - Specialist Teacher
• Kimberly Turnbull - Specialist Teacher

Contact the Autism team on autism@ worcestershire.gov.uk or 01905 844328

Autism is a difference in how someone processes and interprets the world (and other people). Neurodiversity describes the variation of brain responses across all of the population, with some brains being “neurodivergent” (noticeably different from the neuromajority). Autistic individuals could be described as neurodivergent.

Autistic people may:

• find it hard to communicate and interact with other people
• find it hard to understand how other people think or feel
• find things like bright lights or loud noises overwhelming, stressful or uncomfortable
• get anxious or upset about unfamiliar situations and social events
• take longer to understand information
• do or think the same things over and over (NHS, 2023)

What you might see in an educational setting

Differences with communication and interaction

Communication is a two-way process, and it is important that adults supporting autistic children are aware that communication is not simply verbal or “neuromajority”. A key aspect of the diagnosis criteria for autism is that autistic children have a difference in how they perceive and understand non-verbal communication. Given that around 80% of typical interaction is nonverbal, it means that a significant amount of communication and “clues” to intent and purpose are lost/misunderstood by autistic children. Autistic children will often talk about “not getting” social rules or the real intentions behind a person spoken communication. Some books written by autistic individuals emphasise this point of feeling “outside” of everyday social understanding (e.g., “Martian In The Playground” by Clare Sainsbury). Children with autism present with differences in how they communicate and also how they interpret other people’s communication.

Autistic children can struggle to read and understand other’s perspectives, thoughts, and emotions. This might present in different ways, with children appearing seemingly rude, for example, or they may “over-read” other people, leading to worry and anxiety. Many autistic children benefit from peers and adults being clearer in their thoughts and feelings and having the opportunity to practice interpreting them.

Differences and challenges maintaining friendships is a distinct part of the diagnosis criteria for autism and is a common area of difficulty for autistic children. Some autistic children might not struggle obviously in this area, whereas other present with challenges such as:

• having no friendships, although they would like them
• fixating on one particular friend
• believing they have a number of friendships when, in fact, the “friendships” are not reciprocal
• thinking they have no friends when they actually do, but cannot recognise this 

How can school support with differences in communication and interaction

• role-play ways to initiate interaction (adult and peers to model desirable behaviour)
• start at the child’s level and move at their pace when trying to develop interaction
• allow some time to be solitary
• start a social skills programme, e.g., Socially Speaking or Talkabout
• explicit and consistent modelling of positive social interactions, e.g.: turn taking and sharing
• work on Theory of Mind (understanding that other people have different thoughts and feelings to your own) through specific Theory of Mind intervention packages, over-modelling your own thoughts and feelings and collaborative games that encourage children to consider other’s viewpoints
• be aware that language may be interpreted literally and modify language used. Ensure what you say is what you mean
• use positive direction rather than telling the child “Don’t….” For example, “Don’t sit on the table” would be “Come and sit on the chair” and “No we are doing this now” could be “Yes, we can do that when we have finished this”
• keep facial expressions and gestures simple and clear
• allow quiet time where staff are not teaching; directing; talking
• arrange groups and classroom support flexibly to promote social interaction, language use and understanding.
• seating plans promote certainty and reassurance
• designated and pre-taught roles in group work
• learn table-top games such as board-games to encourage turn-taking skills
• teach some structured playground games
• use social stories to teach appropriate behaviour in specific situations and to assist in any areas of rigidity, e.g., perfection
• circle of Friends can be an effective strategy in improving peer understanding and support
• provide support during unstructured time such as appropriate and engaging clubs

Differences with processing information:

Autistic children often present with differences in Information Processing and, specifically, processing differences/difficulties around Receptive Language. Many autistic children will struggle with too much information and benefit from chunking of information, reduced instruction, and supportive visuals. Autistic children who are not supported in their Receptive Language processing may present as bored, off-task or disruptive.

Many studies show that autistic children have differences in their Executive Function as measured against “typical” development. Autistic children will often need support and scaffolding around the key skills of Executive Function and may present with need in some or all of the following skills: Manage time, Pay attention, Switch focus, Plan and organize, Remember details, Do things based on your experience, Multitasking.

How can school support with differences in processing information

• use simple, minimal language, e.g., sit here (KISS – Keep It Short, Simple)
• give instructions calmly and with positive expectation
• say what you mean – try to be direct (but approachable) in your communication
• interact with a consistent, overt approach – try to be a predictable presence in the child’s life
• precede all instructions with the child’s name so that they are aware that they are included in the instruction
• ensure the instructions are given in the correct chronological sequence
• give instructions one at a time or in manageable chunks
• unless there is a real choice, direct rather than asking. For example, avoid asking, “Would you like to read?” or expect the answer “no!”
• allow time for processing language. Up to 8 seconds may be required before the child is able to respond
• teacher explanation should be explicit and consistent. Schools should consider the function of a student’s behaviour (e.g., non-compliance as a difficulty with inflexible thinking).
• use visual cue cards and objects of reference
• reinforce verbal instructions with visual cues
• consider the use of ‘Work to do’ and ‘Work finished’ boxes
• use the child’s special interest positively
• adapt work as required, e.g., ‘green dot’ for go and ‘red dot’ for stop on hand-writing exercises
• an approach that incorporates routines, structured tasks, immediate reward systems.
• consistency within the classroom in terms of organisation, structure, routines, space and place with identified areas and routes.
• visual supports for tasks and/or personal organisation will be needed. This support may also be used to manage change e.g., visual timetables.
• now and Next Boards may be suitable
• Task Management Boards may be suitable
• individual workstation may be suitable
• use of IT such as a laptop (motor skills and engagement)

Differences with sensory perception and tolerance

Autism a neurological difference in how a person’s brain interacts with the world and this difference has an inevitable impact on a person’s sensory experience– the information our senses receive from the world and send to the brain. Autistic children report differences in their sensory experience of school in all of the sense areas (e.g., noise, smell, visual etc.). Increasingly, research indicates that the sensory environment and sensory needs of individuals is a major reason as to whether a lesson or school placement is successful.

Children with sensory differences to the “typical” experience may be under (hypo) or over (hyper) sensitive to particular sensory inputs, compared to the “typical” average.

How can school support with differences in sensory perception and tolerance

• ensure the child is provided with a ‘safe-haven’ (quiet area) to go to at break times and any other times of the day when ‘time-out ‘is required
• environmental Sensory Audit and reasonable adjustments
• individual Sensory allowances (e.g.: ear defenders) as need dictates
• consider the environment, taking into account sensory issues and develop a plan; Adaptations and reasonable adjustments shared with ALL staff.
• plan time-out (when to go; where to go; who with; how long for; what to do; when to return) at times decided by staff and shown on a visual timetable so that the child does not reach ‘sensory overload’
• consider introducing an individual workstation so that the child has its own space to complete work with minimal distraction. A visual timetable and all useful resources should be quickly to hand
• be aware that what might be considered a comforting touch by other children, may cause discomfort or even pain to a child with autism (e.g., hugs when upset)
• understand that the child may not be able to tolerate close proximity of others
• give the child ‘Sensory breaks’ and ‘Brain breaks’ when they are in or have been in a busy/noisy working environment

Useful Resources and links

• National Autistic Society National Autistic Society (autism.org.uk)
• Autism West Midlands Autism West Midlands | Supporting the Autistic Community
• Intensive interaction: Intensive Interaction - Fundamentals of Communication
• National Autistic Society: National Autistic Society (autism.org.uk)
• Ambitious About Autism: Ambitious about Autism | National charity for autistic children and young people
• Brain in Hand Brain in Hand: a professional digital support system
• Worcestershire OT and Paediatric therapy services have a useful YouTube channel with short videos on a range of topics: Worcestershire Children's Therapy Services - YouTube
• Umbrella Pathway Website (Worcestershire NHS Diagnostic route): Our Services | Herefordshire and Worcestershire Health and Care NHS Trust (hacw.nhs.uk)
• Mental Health support for Young People: Mental health help to children, young people and their families | School Mental Health (hacw.nhs.uk)
• National Autistic Society: National Autistic Society (autism.org.uk)
• Autism West Midlands: Autism West Midlands | Supporting the Autistic Community
• SENDIASS for advice and support: SENDIASS Worcestershire and Herefordshire (hwsendiass.co.uk)
• Education and Early Years Services training Training and CPD | Worcestershire County Council

The Autism team can offer support and advice to help learners with autism or similarly presenting complex communication needs to achieve their full potential. We will support you to build the capacity of your setting to meet the individual needs of children and young people from Early Years to further or higher education. It is our preferred method to empower the setting – and individuals within it – to be able to continue our work beyond our direct involvement to build a setting’s capacity and to benefit further young people.

Work with children and young people includes:

• detailed report to identify need and strategies 
• modelling specific strategies and resources 
• transition support 
• support with reintegration 
• supporting with emotionally based school avoidance 
• study, planning and organisation skills 
• individual pupil sensory profiles 
• one page profiles 
• emotional regulation 
• autism awareness mentor programme 
• advice on adapting the curriculum 

Developing whole-school autism provision:

• support to implement the graduated response 
• school autism-friendly audit 
• sensory audits 
• emotional Literacy sessions 
• evidence based approaches such as Lego based therapy, homunculi 
• peer awareness 
• development of lunchtime and after school clubs 
• consultation approach to improving provision 
• enabling family conversations 
• parent workshops 
• drop-in surgery

Our support is not limited to the solutions listed

Upon enquiry an adviser will recommend the hours required to address your specific concerns and ensure you get the best value from your SLA purchase. Schools can purchase bespoke time-based consultancy or packages of set hours. Purchase your services through our online store.

Access the online store

The Worcestershire Autism Mentor (WAM) programme enables a member of staff to become a mentor to children within the setting with autism.

Mentors will receive the training and support to effectively deliver an individualised programme of autism awareness to a pupil. This intervention is currently undertaken by a member of the Autism and CCN team and is among some of the most powerful and effective interventions that can improve the lives of young people with a diagnosis of autism. The Worcestershire Autism Mentor (WAM) will be able to work with the pupil to support them with their understanding of how their diagnosis affects them.

Programme overview

• theory and practical training
• close support from the Autism and CCN team to deliver the first full individual support programme with a pupil
• ongoing support from the Autism and CCN team 
• access to termly Mentor meetings, join a community of autism mentors for ongoing training and peer support

Programme details

Training will take place over set scheduled dates throughout the year in agreement with the school. Scheduled 90-minute Mentor meetings will take place 3 times throughout the year. Training and meeting dates will be published and available to book via CPD online.

The Worcestershire Autism Mentor (WAM) programme is not to address specific difficulties, such as attendance or anxiety related responses.  It is about opening the conversation around a diagnosis of autism in a gentle and supportive way; and arriving at outcomes that provide a basis for moving forward.

The increasing number of children and young people with autism presents challenges to staff at a time when resources are stretched and school leaders face many competing demands.

An understanding of autism in schools will improve the lives of children and young people on the autism spectrum.

Our highly experienced specialist teachers and practitioners can provide training on:

• autism awareness and understanding
• practical and strategic training for all
• levels of staff to support your school in meeting the needs of children and young people on the autism spectrum
• whole class strategies
• specific individualised strategies and interventions

We provide flexible, bespoke training to suit individual school needs. Training can be delivered as whole-day INSET or as twilight sessions.

To discuss your training needs

Contact the Autism and CCN team.

Email: Autism@worcestershire.gov.uk
Telephone: 01905 844328

Download: Request for involvement form Autism/CCN Specialist Teaching Referral 2022 (word document)

Download: SEND Eligibility Criteria for SEN, Disabilities and Inclusion Teams (PDF)