Supporting Social Inclusion For Students With Autism Spectrum Disorders Insights From Research and Practice

SUPPORTING SOCIAL INCLUSION FOR
STUDENTS WITH AUTISM SPECTRUM

DISORDERS
Drawing together contributions from experts at the forefront of research in the

field, Supporting Social Inclusion for Students with Autism Spectrum Disorders demon-
strates that social inclusion is a defining feature of successful education of students
with a spectrum disorder.
Divided into three parts, this book begins by proposing a contemporary and
operational definition of social inclusion that will help facilitate active engage-
ment by all stakeholders involved in supporting social inclusion within educational
settings. The relationship between well-developed social skills and positive social
outcomes is also explored, and subsequent chapters explicate and contextualize
social inclusion across a range of educational settings.The final chapters present case
studies and viewpoints from stakeholders central to the successful social inclusion of
students with the disorder.Through discussion of its findings, this book provides the
reader with a deep understanding of social inclusion and confirms its importance
in facilitating positive educational outcomes for students with Autism Spectrum
Disorder.
A unique contribution to the field, this book will be of key interest to post-
graduates, researchers and academics in the area of inclusive education and Autism
Spectrum Disorder. It will also appeal to those who research, study and work in the
areas of special and inclusive education, and developmental psychology.
Cathy Little is a lecturer in the Faculty of Education and Social Work, University
of Sydney, Australia.
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SUPPORTING SOCIAL
INCLUSION FOR
STUDENTS WITH
AUTISM SPECTRUM
DISORDERS
Insights from Research and Practice
Edited by Cathy Little

First published 2017
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2017 selection and editorial matter, Cathy Little; individual chapters, the contributors
The right of the editor to be identified as the author of the editorial material, and of the authors for
their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright,
Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by
any electronic, mechanical, or other means, now known or hereafter invented, including photocopying
and recording, or in any information storage or retrieval system, without permission in writing from
the publishers.
Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used
only for identification and explanation without intent to infringe.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
Names: Little, Catherine A., editor.
Title: Supporting social inclusion for students with autism spectrum
disorders : insights from research and practice / edited by Cathy Little.
Description: Abingdon, Oxon ; New York, NY : Routledge is an imprint of the
Taylor & Francis Group, an Informa Business, [2017] | Includes index.
Identifiers: LCCN 2016040123| ISBN 9781138189966 (hbk) |
ISBN 9781138189973 (pbk) | ISBN 9781315641348 (ebk)
Subjects: LCSH: Autistic children—Education—Social aspects. |
Inclusive education—Social aspects.
Classification: LCC LC4717.5 .S86 2017 | DDC 371.94—dc23
LC record available at https://lccn.loc.gov/2016040123
ISBN: 978-1-138-18996-6 (hbk)

ISBN: 978-1-138-18997-3 (pbk)
ISBN: 978-1-315-64134-8 (ebk)
Typeset in Bembo
by diacriTech, Chennai
CONTENTS
List of figures vii

List of tables ix
List of contributors xi
Acknowledgementsxvii
Introduction 1
Cathy Little
PART I
An introduction to social inclusion for students with
Autism Spectrum Disorder7
1 Social inclusion and Autism Spectrum Disorder 9

Cathy Little
2 Social inclusion for students with Autism Spectrum Disorder 21

Sunny Kim, Brittany Koegel and Lynn Kern Koegel
3 Bullying and social vulnerability of students with

Autism Spectrum Disorder 33
Sarah Feuerbacher,Travis Moore and Hannah Gill
4 Identity formation in individuals with Asperger Syndrome 45

Caitlin van der Walt
vi Contents
PART II
Social inclusion across the educational environment55
5 Social inclusion in the early years 57

Janice K. Lee, Jaclyn Joseph, Phillip Strain and Glen Dunlap
6 Social inclusion in the primary school years 71

Alice Jones Bartoli
7 The transition from primary to secondary school for students

with Autism Spectrum Conditions 84
Judith Hebron
8 Post-school social inclusion for adults with Autism in Australia 100

Michelle L. Bonati
PART III
Key stakeholders in the support of social inclusion115
9 The role of school communities in facilitating social inclusion 117

Cathy Little
10 Using typically developing peers as support for social inclusion

of children and adolescents with Autism in school settings 131
Jill Locke and Colleen Harker
11 The role of families in supporting social inclusion 144

Iva Strnadová
12 Influence of culture on social inclusion of children

with Autism 155
Kanokporn Vibulpatanavong
13 Social inclusion: A personal reflection 168

Stephen Shore
Index180
LIST OF FIGURES
7.1 A graph indicating the differences between groups

over time on the PSSM 90
7.2 A graphic representation of the main themes from the
thematic analysis 91
8.1 The mutually reinforcing outcomes of increased social
capital and social inclusion 103
8.2 The timeline of efforts to strengthen human rights related
to social inclusion for people with disability in Australia 106
9.1 A visual representation of Bronfenbrenner’s bioecological
systems theory, showing the nested layers, or systems of the
environment, and their relationship to the individual
student over time 120
13.1 An example of a bulletin board representing the stages
of an assignment 173
LIST OF TABLES
3.1 Steps for reducing bullying victimization in students with ASD 39

7.1 Studies focusing on the primary to secondary school transition of
young people with Autism 86
9.1 Teacher Attitudes Survey construct means 123
9.2 Component correlation matrix 124
LIST OF CONTRIBUTORS
Michelle L. Bonati is an Associate Lecturer in Special and Inclusive Education in

the Faculty of Education and Social Work at the University of Sydney. She earned
her PhD in Special Education at the University of Illinois at Urbana-Champaign,
USA. Her research interests include examining inclusive service learning as a
potential context for increasing peer interactions, teaching social skills, and provid-
ing meaningful access to the curriculum for students with disabilities. Her aim is to
improve post-school outcomes for students with ASD and intellectual disabilities,
with an emphasis on achieving self-determination and social inclusion.
Glen Dunlap, PhD, is a faculty member at the University of South Florida

(Tampa, FL) and the University of Nevada (Reno, NV). He works on several
research, training, and demonstration projects in the areas of applied behavior
analysis, positive behavior support, child protection, early intervention, autism and
other developmental disabilities, and family support. Glen has been active in the
field for more than 40 years and has served as a teacher, administrator, researcher,
and university faculty member. He has directed numerous research and training
projects and has been awarded dozens of federal and state grants. He has authored
more than 240 articles and book chapters, co-authored and edited six books, and
served on 15 editorial boards. Glen was a founding editor of the Journal of Positive
Behavior Interventions and is the current editor of Topics in Early Childhood Special
Education. Glen lives in Reno, Nevada, but continues to work on research and train-
ing projects in locations across the country.
Sarah Feuerbacher, PhD, LCSW-S earned a Bachelor of Arts in Social Work,

Master of Social Work, and Doctorate of Philosophy in Educational Psychology
from Baylor University. Dr. Feuerbacher is a Licensed Clinical Social Worker
Supervisor, Practical Parent Education Certified Parent Educator, and State of Texas
xii List of contributors
Parent Mediator/Facilitator. Dr. Feuerbacher is currently employed by Southern

Methodist University as Clinic Director of the Family Counseling Center and
teaches in the Graduate Department of Dispute Resolution and Counseling.
Dr. Feuerbacher’s clinical focus and public speaking specialization is in the area
of using holistic approaches in working with diverse individuals who have expe-
rienced multifaceted themes of abuse in order to identify and empower strengths
in intrapersonal and environmental systems that can create personal goals, positive
relationships, and healthy lifestyles.
Hannah Gill, LPC-I, earned her Bachelor of Science in Psychology and a Bachelor
of Music in Music Performance from the University of Florida and earned a
Masters in Counseling from Southern Methodist University. Hannah specializes in
working with children and their families, utilizing play therapy. Hannah is currently
working toward gaining licensure as a Licensed Professional Counselor and hopes
to gain licensure as a Registered Play Therapist in the near future. Hannah’s most
recent research endeavor involves examining the impact of participation in coun-
seling groups on the emotional and social cognition of individuals with Asperger’s
diagnosis on the Autism Disorder spectrum.
Colleen Harker, MS, is a Clinical Psychology doctoral student at the University of

Washington. Ms. Harker’s research is focused on helping community-based systems
implement and disseminate effective evidence-based interventions for children
with Autism Spectrum Disorder (ASD) in real world settings. Prior to her graduate
studies, Ms. Harker worked on a research study at the University of Pennsylvania
that examined the implementation of a school-based autism intervention in public
school classrooms.
Judith Hebron is an early career Research Fellow at the University of Manchester

and an Associate Fellow of the British Psychological Society. After teaching in the
secondary school sector for several years, her interest in educating young peo-
ple with additional needs led to her returning to university to teach and conduct
research in this area. Her main research interests are centred on improving the edu-
cational experience of young people with Autism Spectrum Conditions, including
research into peer relationships, bullying, and autism in girls. More broadly, she is
interested in child and adolescent well-being, educational inclusion, and develop-
mental psychology.
Alice Jones Bartoli is a senior lecturer in Psychology and the Director of the Unit
of School and Family Studies at Goldsmiths, University of London. Alice previously
worked in the Social Communication Disorders Clinic at Great Ormond Street
Hospital, and has also worked on projects examining outcomes related to social
inclusion in pupils with Autism Spectrum Conditions attending mainstream and
special schools.
List of contributors xiii
Jaclyn Joseph, PhD, BCBA, is the research and development coordinator at the
Positive Early Learning Experiences (PELE) Center of the University of Colorado,
Denver. Jackie’s professional and research interests include evidence-based inter-
ventions for reducing the challenging behaviors and improving the social emo-
tional competence of young children in home settings and in early education and
care classrooms.
Sunny Kim received her PhD in Education with an emphasis in Autism Spectrum
Disorders (ASD) from the University of California, Santa Barbara (UCSB) in 2014.
She is also a board-certified behavior analyst (BCBA).Throughout graduate school,
Dr. Kim worked closely under Drs. Robert and Lynn Kern Koegel, where she
received extensive training in Pivotal Response Treatment (PRT). She currently
works at the Koegel Autism Center as a program supervisor and is also the head
of the School Professional Socialization Training Project at UCSB. Dr. Kim has
received several extramural grants and published several peer-reviewed journal arti-
cles on improving social skills in individuals with ASD. Her research primarily
focuses on social skills training for students with ASD, school staff training, improv-
ing social pragmatic skills for individuals with ASD, and developing effective social
intervention models that can be implemented in the school setting.
Brittany Koegel received her PhD in special education and developmental dis-
abilities risk studies. Her interests are socialization skills for young adults with
Asperger Syndrome, academic motivation for children with autism, and commu-
nication for individuals with Autism Spectrum Disorders. Brittany is a Trainer
and School Program Director wih Koegel Autism: PRT Training and Services.
She specializes in training teachers, parents, and professionals in Pivotal Response
Treatment.
Lynn Kern Koegel, PhD, is the Clinical Director of the Koegel Autism Center at
the University of California, Santa Barbara. She has been active in the develop-
ment of programs to improve communication in children with autism, including
the development of first words, development of grammatical structures, and prag-
matics. Dr. Koegel is co-author and co-editor of major textbooks on autism and
positive behavioral support and is co-author of the bestselling book Overcoming
Autism: Finding the Answers, Strategies, and Hope That Can Transform a Child’s Life
(Penguin, 2004). Dr. Koegel is actively involved in providing support and inter-
vention services in school districts, both locally in California and throughout the
United States. Dr. Koegel, and her husband Robert, were awarded the first annual
recipient of the Sesame Street Children’s Television Workshop Award for brighten-
ing the lives of children.
Janice K. Lee, M.Ed, BCBA, is a member of the research faculty at the University
of Nevada, Reno. Her experience and interests include early childhood/special
xiv List of contributors
education, challenging behavior, positive behavior support, social emotional

competence, autism, working with families, and implementation science. Janice has
a master’s degree in early childhood special education, is a Board Certified Behavior
Analyst (BCBA), and is a doctoral student in early childhood special education.
Since 1995, she has worked with children, families, practitioners, and professionals
at the local, state, and national level as an educator, consultant, coach, trainer, and
technical assistance provider.
Cathy Little, PhD, is a lecturer at the University of Sydney, lecturing in the

field of Special Education, in the Faculty of Education and Social Work.
Dr. Little’s particular areas of interest and research lie in the areas of autistic
spectrum disorder (ASD), high support needs and positive behaviour support.
Dr. Little currently lectures at both undergraduate and postgraduate levels, as
well as supervising a number of research students. Cathy completed her PhD
with a thesis title: “Mainstream teacher attitudes and the social inclusion of stu-
dents with Asperger Syndrome (AS) in regular education classrooms”. To date
Cathy has presented her results at both national and international conferences.
Cathy acts as a consultant to schools for the support of students with ASD and
challenging behaviours and is a Board Member of Joseph Varga School, a special
school for students with ASD.
Jill Locke, PhD is an assistant professor at the Center for Mental Health Policy
and Services Research at the University of Pennsylvania Perelman School of
Medicine. Dr. Locke’s research interests are in developing and implement-
ing interventions designed to address social ability in children with Autism
Spectrum Disorder in school settings as well as exploring the ways in which
treatment gains in intervention programs are generalized and sustained over time.
Dr. Locke recently modified a proven-efficacious intervention designed to
address social ability in children with autism, so that it can be used by school per-
sonnel to facilitate engagement and play between children with autism and their
peers during recess periods. She piloted the newly manualized program with
one-on-one autism instructional aides and is currently examining its implemen-
tation and sustainment in public schools.
Travis Moore is a recent graduate from the Master of Science in Counseling pro-
gram at Southern Methodist University where he also completed his Bachelor of
Arts in Biology. His research focuses on marginalized groups and examines how
experiences of discrimination and stigma may shape the mental health of minority
group members (autism, LGBTQ, people of color). Travis also examines sexual
and gender identity development throughout the lifespan and how multiple per-
sonal identities interact with ego. His most recent area of research is in social and
self-efficacy factors in autistic adolescents and adults that may promote the mental
health of autistic individuals.You may reach Travis via email at trmoore@smu.edu.
List of contributors xv
Stephen Shore, diagnosed with “atypical development and strong autistic

t endencies” and “too sick” for outpatient treatment, was recommended for insti-
tutionalization. Nonverbal until four, and with much support from his parents,
teachers, wife, and others, Stephen is now a professor at Adelphi University
where his research focuses on matching best practice to the needs of people
with autism. In addition to working with children and talking about life on the
autism spectrum, Stephen presents and consults internationally on adult issues
pertinent to education, relationships, employment, advocacy, and disclosure
as discussed in his books Beyond the Wall: Personal Experiences with Autism and
Asperger Syndrome, Ask and Tell: Self-Advocacy and Disclosure for People on the Autism
Spectrum, and the critically acclaimed Understanding Autism for Dummies, and the
newly released DVD Living along the Autism Spectrum: What Does It Mean to Have
Autism or Asperger Syndrome. President emeritus of the Asperger’s Association
of New England and former board member of the Autism Society, Dr. Shore
serves in the Interagency Autism Coordinating Committee, Asperger Syndrome
and High Functioning Autism Association, United States Autism and Asperger
Association, and other autism-related organizations.
Phillip Strain, PhD is Professor of Early Childhood Special Education at the

University of Colorado Denver. He is the author of over 300 scientific papers with
a specific focus on autism, inclusive services and prevention of challenging behavior.
Iva Strnadová is an Associate Professor in Special Education at the University

of New South Wales in Sydney, Australia. She is also an Honorary Member of
the University of Sydney, Faculty of Education and Social Work, Australia. Her
research aims to contribute to better understanding and the improvement of life
experiences of people with disabilities. Iva’s previous research and ongoing research
interests include well-being of people with developmental disabilities (intellectual
disabilities and autism) and their families over the lifespan; lifespan transitions as
experienced by people with disabilities; women with intellectual disabilities; and
mobile learning for people with developmental disabilities.
Caitlin van der Walt is a Bachelor of Education (Primary) Honours graduate from
the University of Sydney. She completed her honours in the field of Asperger
Syndrome and Social Identity. Caitlin now works as a teacher of primary school–
aged students with ASD. The construction of identity for persons with ASD is an
area of research that continues to hold her interest and in which she is keen to
continue with further investigations.
Kanokporn Vibulpatanavong is currently a lecturer in Special Education at

Faculty of Education, Srinkharinwirot University, Bangkok, Thailand. She received
her PhD in Education from the Faculty of Education and Social Work at the
University of Sydney. Prior to her PhD study, Kanokporn was a project officer at
xvi List of contributors
UNICEF Thailand Country Office, working on educational projects in the six

Tsunami-affected provinces. Her research interests include reading development in
the Thai language, social inclusion of children with developmental disabilities, and
inclusive education in South East Asia. Kanokporn also writes stories for picture
books, five of which have been published. Her first book Why Elephants Are Afraid
of Mice? was given an award by Thailand’s Foundation for Children, while the series
of four picture books, “Heroes”, have been translated into Chinese.
ACKNOWLEDGEMENTS
Many people have generously shared their time, knowledge and expertise to help
write this book. I would like to thank:
• Any and all students who share in a diagnosis of Autism Spectrum Disorder.
Without question you make us better teachers and better people. It is a
privilege to be part of your network of support.
• All chapter authors who were willing to share their knowledge through their
contributions to this book. I thank you for your time, your generosity and your
commitment.
• Sarah Tuckwell and Alison Foyle from Routledge Publishers who have been
instrumental in seeing this book come to fruition.
• Finally I would like to thank David, Josh, Ben and Grace for their endless
patience and support in seeing this book come to life.
INTRODUCTION
Cathy Little
Appropriate and accessible education for all is, in essence, a matter of social j ustice.
Internationally this issue has come into focus increasingly over the past century
with the development of a series of statements and declarations on human rights,
which include the right to education for all, the rights of people with disabili-
ties, and the right to equitable and accessible education for people with disabil-
ities (see Salamanca Statement and Framework for Action on Special Education Needs
[UNESCO, 1994]; UN Convention on the Rights of Persons with Disabilities and
Optional Protocol [UN General Assembly, 2007]; World Declaration on Education for
All (UNESCO, 1990]).
The concept of inclusion in education worldwide advocates that students with
special needs can and should be educated in the same settings as their typically
developing peers with appropriate support services, rather than being placed in
special education classrooms or schools (Polat, 2011). For the majority of students
with Autism Spectrum Disorder (ASD) or Autism Spectrum Conditions (ASC),
their placement is within regular classes with regular students but with teachers
who often have limited experience or knowledge about their specific disability.
Of primary concern for students with Autism Spectrum Disorder, however, is that
due to the very nature of their disability, placement in a regular class may result in
‘exclusion’ because the teacher, the classroom and the school are not meeting the
student’s individual social needs.
Research has discussed how the unique social impairments of students with
Autism Spectrum Disorder requires targeted intervention to support active social
engagement with others (e.g. Lindsay, Proulx, Scott and Thomson, 2014). However,
in discussing successful inclusive practice, the focus appears to be placed on stu-
dents’ achievement of academic outcomes as the measure of success. Given the
nature of Autism Spectrum Disorder as primarily a social disorder, success for
2 Cathy Little
students with Autism Spectrum Disorder needs also to be measured in terms of

their social inclusion.
In recent years there has been more emphasis on the notion of social inclusion,
referring to a student being included beyond academic and classroom activities.
The term ‘social inclusion’ is itself a nebulous concept. Reviews of the literature
show that terms such as social integration, social inclusion and social participation
are used interchangeably and are assigned similar meanings (Bossaert, Coplin, Jan
Pijl and Petry, 2013; Koster, Nakken, Jan Pijl and van Houten, 2009). What then is
an acceptable, operational definition for the term social inclusion? The following
chapters bring together multiple sources of information collated and refined to
support the development of an informed and contemporary definition.
Examination of specific aspects of the social inclusion construct forms the
framework for this book. Part 1 defines social inclusion as a unique and fundamen-
tal principle of the inclusion process for students with Autism Spectrum Disorder,
and highlights the relationship between well-developed social skills and positive
social outcomes and self-concept for these students. Part 2 explicates and contex-
tualises social inclusion across a range of educational settings. The chapters in this
section discuss the unique social needs of students with Autism Spectrum Disorder
across a range of educational environments. Part 3 presents viewpoints from stake-
holders central to the successful social inclusion of students with Autism Spectrum
Disorder, namely teachers and school communities, peers and families. Influences
of culture and the impact this has on students social inclusion is also explored at
this point. A reflection by a person with Autism Spectrum Disorder of his journey
toward social inclusion, encompassing all the associated highs and lows, provides a
fitting conclusion to this section.
In Part 1, the discussion of the social inclusion construct begins in Chapter 1,
where Cathy Little introduces the reader to the construct through the lens of inclu-
sive education. Citing current research findings, Dr. Little provides an operational
definition of the term ‘social inclusion’, highlighting its importance for students
with Autism Spectrum Disorder.
The release of the Diagnostic and Statistical Manual of Mental Disorders
Fifth Edition (DSM-V) (APA, 2013) has seen revisions to the Autism Spectrum
Disorder diagnostic domain, resulting in a reduction of the diagnostic criteria into
two categories: persistent deficits in social communication and social interaction,
and restricted, repetitive patterns of behaviour, interests or activities. In Chapter 2,
Sunny Kim, Brittany Koegel and Lynn Koegel introduce the reader to the world
of Autism Spectrum Disorder, describing the unique and oftentimes idiosyncratic
behaviours of students with this diagnosis with particular emphasis on social skill
development.
Children with an Autism Spectrum Disorder are common targets for frequent
and chronic peer victimisation and bullying. In a synthesis of the literature regard-
ing the prevalence of bullying involvement in the Autism Spectrum Disorder
population from 2002 to 2013, Schroeder, Cappadocia, Bebko, Pepler and Weiss
Introduction 3
(2014) confirmed that children and youth with Autism Spectrum Disorder were
experiencing increased rates of bullying relative to the general population and
higher rates of victimisation than peers with other forms of disability. Discussion
of the impacts of poor and/or negative socially inclusive opportunities within the
educational environment can be found in Chapter 3 where Sarah Feuerbacher,
Travis Moore and Hannah Gill investigate the broad spread, often long-term,
impacts of bullying and the social vulnerability of students with Autism Spectrum
Disorder.
Despite the nature of Autism Spectrum Disorder as a social disorder, limited
attention has been given to the importance of social identity in individuals with
Autism Spectrum Disorder. In Chapter 4 Caitlin van der Walt describes how
identity is a complex and ongoing process that provides an insight into a person,
determining how others view them and how they come to understand and view
themselves.This notion of identity emphasises the complexity of the ongoing social
processes involved in the formation of identities, as they are continually constructed,
challenged, adjusted and changed through the process of social inclusion.
Socialisation is a skill that is as important as communicating, reading and writ-
ing and needs to be included in students’ learning programs. But how socialisation
is taught varies significantly given the age and educational setting of the child or
student. Part 2 presents a series of chapters that investigate the social inclusion
construct across different educational timeframes, with each chapter highlighting
the challenges to social inclusion that children and students with Autism Spectrum
Disorder face as a result of their social communication and behavioural difficulties.
In Chapter 5, Janice Lee, Phil Strain, Jaclyn Joseph and Glen Dunlap discuss social
inclusion for young children with Autism Spectrum Disorder across the preschool
years. From issues surrounding diagnosis and family-centred planning to choice
regarding preschool education, the chapter discusses the benefits of early inter-
vention for long-term success in developing children’s critical social behaviours.
Because children with Autism generally do not initiate interactions, social skills
training, including how to respond in social situations, should begin as early as
possible and continue throughout the child’s education. It is in these early years
that the foundations of these essential social behaviours begin to develop through
explicit and directed instruction.
For some children it may not be until they enter formal schooling that their
Autism features become clearly seen. When viewed alongside their peers, differ-
ences in communication, socialisation and behaviour can often become more
noticeable in a child with Autism Spectrum Disorder. In Chapter 6, Alice Jones
Bartoli examines social inclusion for students with Autism Spectrum Disorder
across the primary school years, where educators expect school age children to talk
and play with others, not to be alone on the playground or have problems fitting in
with the expectations of the teachers and students. Jones details how individualised
planning and evidence-based strategies are used to address the unique social needs
of primary school–aged students with Autism Spectrum Disorder.
4 Cathy Little
The social journey of the transition to secondary school is fraught with

c onvention, with rules for social interaction that are quite subtle and oftentimes elu-
sive to the adolescent with Autism Spectrum Disorder. In Chapter 7, Judith Hebron
explores the impacts of breaking these unspoken rules on the social inclusion of
young people with Autism Spectrum Disorder. Hebron reports that unless provided
with appropriate support, adolescents on the Autism spectrum can respond to the
stress created by the social world at this time through acting out behaviours, an
increased risk of depression and suicide.
The transition from school to adulthood can be particularly difficult for many
young people with Autism Spectrum Disorder. In Chapter 8, Michelle Bonati dis-
cusses research that relates to the transition to post-school environments for youth
with Autism Spectrum Disorder in the areas of education, employment and com-
munity living through the lens of the social inclusion construct, led by a commit-
ment to social justice, anti-discrimination and equity.
Part 3 presents a series of chapters examining the contribution of participants
recognised as fundamental to the successful social inclusion of children and students
with Autism Spectrum Disorder. Key stakeholders throughout this process include
teachers and school communities, peers, families and the student themselves.
Several influences impact every educational setting and can form a significant
part of the social inclusion process for students. In Chapter 9, Cathy Little inves-
tigates current research in the role school communities and educational environ-
ments play in facilitating socially inclusive opportunities for students with Autism
Spectrum Disorder. The ethos of the school is of vital importance. A commitment
by the school community to support inclusive practice, and an inclusive school
culture, all serve to create a socially and morally positive school setting for all staff,
students and families.
Difficulties that arise from impairments in social communication can affect the
student’s ability to interact in the classroom and impact negatively on their ability
to establish and maintain friendships over time.The most powerful way to promote
an accepting school environment is through raising awareness and increasing peers
knowledge about Autism Spectrum Disorder. In Chapter 10, Jill Locke and Colleen
Harker discuss the role of peers in the successful social inclusion of individuals with
Autism Spectrum Disorder.
In Chapter 11, Iva Strnadová discusses the role of family as a social skill interven-
tion that can enhance the social inclusion of a young person with Autism Spectrum
Disorder. The opportunities afforded a young child for rehearsal of socially com-
petent behaviours occur frequently in the home context, such as eating meals,
going shopping and interacting with relatives. The role of the family in supporting
the social development of their young child is well-documented and explicated
throughout this chapter.
Autism Spectrum Disorder occurs across all cultures. Children with Autism from
different cultures need different supports in order to be able to fully participate in
their communities. However, cultural beliefs and practices of a social group can add
Introduction 5
complexities to promoting social inclusion of children with Autism within that

group. In Chapter 12, Kanokporn Vibulpatanavong highlights the important role
culture plays in the social inclusion of persons with an Autism Spectrum Disorder.
All individuals are unique. For a young person with a diagnosis of Autism
Spectrum Disorder, their uniqueness is a defining characteristic of their identity.
Without question, any consideration of a student’s development must take into
account the relationships they have with those closest to them – their family, teach-
ers and peers.Yet these relationships are shaped by the combination of each student’s
individual qualities: their personality, behaviour, unique traits, attitude, interpersonal
skills and communication abilities, which in combination identify a distinct person.
In Chapter 13, Stephen Shore, a prominent member of the Autism community,
shares his personal journey of social inclusion, from early years and diagnosis to later
successes, both personal and professional.
Together the chapters combine to highlight the importance of social inclu-
sion as a defining feature for successful education of children and students with
Autism Spectrum Disorder. This book has utilised a definition of social inclusion
based on current research which has progressed from previous abstract, subjective
descriptions of a student’s ability to be socially included, to an explanation that
involves a more contemporary, active demonstration of a student’s inclusion in social
relationships.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders.
Fifth edition. (DSM-V). Washington, DC: Author.
Bosaert, G., Coplin, H., Jan Pijl, S., and Petry, K. (2013). Truly included? A literature study
focusing on the social dimension of inclusion in education. International Journal of Inclusive
Education, 17(1), 60–79.
Koster, M., Nakken, H., Jan Pijl, S., and van Houten, E. (2009). Being part of the peer group:
A literature study focusing on the social dimension of inclusion in education. International
Journal of Inclusive Education, 13(2), 117–40.
Lindsay, S., Proulx, M., Scott, H., and Thomson, N. (2014). Exploring teachers’ strategies for
including children with autism spectrum disorder in mainstream classrooms. International
Journal of Inclusive Education, 18(2), 101–22.
Polat, F. (2011). Inclusion in education: A step towards social justice. International Journal of
Educational Development, 31(1), 50–8.
Schroeder, J. H., Cappadocia, M. C., Bebko, J. M., Pepler, D. J., and Weiss, J.A. (2014). Shedding
light on a pervasive problem: A review of research on bullying experiences among chil-
dren with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(7),
1520–34.
UN General Assembly. (2007). Convention on the Rights of Persons with Disabilities and Optional
Protocol. New York: United Nations.
UNESCO. (1990). World Declaration on Education for All. New York: Author.
UNESCO. (1994). The Salamanca Statement and Framework for Action on Special Needs Education.
Paris: Author.
PART I
An introduction to social
inclusion for students with
Autism Spectrum Disorder
1
SOCIAL INCLUSION AND AUTISM
SPECTRUM DISORDER
Cathy Little
The term social inclusion can take on a distinct meaning dependent on the context
in which it is being used. When asked to define social inclusion, one’s answer is
very much determined by the situation to which they are applying the term. The
concept term ‘social inclusion’ appears primarily when discussing the representa-
tion of marginalized groups and individuals who have been pushed toward or kept
to the sidelines of society as a result of their exclusion from the typical activities
of the wider community (Bottrell and Goodwin, 2011). Marginalization impacts
society’s most vulnerable: the elderly, the infirm, people from low socio-economic
locales, the cultural minority, individuals with mental health concerns and persons
with a disability. Within the context of marginalization, social inclusion is often-
times defined by the concept of social exclusion, that is, exclusion from all aspects
of the broader community as a result of poverty or disadvantage. Social inclusion,
by definition, is the opposite of social exclusion. Thus, attempts at reframing social
inclusion for marginalized persons simply requires focus on remediation of those
areas where persons are excluded.
The context of social inclusion pertinent to this chapter, and to the majority of this
book however, is the context of education: the community of school and education
service provision, from early childhood centres to tertiary institutions and post-school
employments placements. The participants who form part of this educational com-
munity include, but are not limited to, students, teachers, school administrators, sector
level decision makers and families. Social inclusion in the educational context refers
to the inclusion of and active participation by all students in the school’s social agenda.
It relies on teacher’s active preparation for, and facilitation of, socially inclusive oppor-
tunities for students who, for a range of reasons, may be unable to perform the social
behaviours expected of the setting and which will support their functional inclusion
in social activities of education. One such group of students who require targeted
support for their social inclusion are students with an Autism Spectrum Disorder.
10 Cathy Little
This chapter will introduce the reader to the characteristics of a student with an
Autism Spectrum Disorder, highlighting the pervasive social difficulties inherent to
the disorder which can often inhibit social interactions and generate opportunity
for misunderstanding and social segregation. When discussing social inclusion for
students with an Autism Spectrum Disorder, one must consider the philosophy of
inclusion and how this practice affords students with an Autism Spectrum Disorder
equal opportunity for social engagement and participation. Discussion then centres
on the emergence of social inclusion as a distinct theoretical construct rather than
simply an element of the broader philosophy of inclusion. Framed within the liter-
ature, a current, contemporary definition of social inclusion is provided to conclude
the chapter.
Autism Spectrum Disorder

Autism Spectrum Disorder is an umbrella term used to describe a spectrum of dis-
orders characterised by impairments to social development, language and commu-
nication, and rigidity in both thought and behaviour (APA, 2013). Researchers and
medical professionals agree that the main features displayed by a person diagnosed
with an Autism Spectrum Disorder include difficulties in relating to or understand-
ing other people and social situations, difficulties in communication, and a lack of
imaginative ability, often substituted by obsessive, repetitive behaviour and a strong
resistance to change. The very nature of Autism as a spectrum of disorders poses a
number of issues around its variability and apparent erraticism. Solomon (2012)
states that as a society we don’t know what Autism is. He argues “The syndrome
[Autism] encompasses a highly variable group of symptoms and behaviours, and we
have little understanding of where it is located in the brain, why it occurs, or what
triggers it” (p. 221).
The release of the Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition (DSM-V) (APA, 2013) saw revisions to the ASD diagnostic domain, result-
ing in a reduction of the diagnostic criteria, restricting the previous three impair-
ments into two categories: persistent deficits in social communication and social
interaction, and restricted, repetitive patterns of behaviour, interests or activities.
Both diagnostic categories are ranked in terms of severity level – level 3 requiring
very substantial support, level 2 requiring substantial support, and level 1 requiring
support. These changes have seen the previous categories of the disorder merge
into one broad spectrum of Autism Spectrum Disorder, thus eliminating Asperger
Syndrome and other disorders from the diagnostic criteria.
Yet, despite its variability in presentation, there are several aspects of the dis-
order that hold true for all persons diagnosed. Firstly, Autism is a pervasive disor-
der, in that it affects almost every aspect of behaviour, sensory experiences, motor
functioning, balance, and inner consciousness Secondly, the etiology of Autism is
unknown. Over the years, several theories have been put forward as possible causes
of Autism in children. In 1967, Bruno Bettelheim, an Austrian-born child psy-
chologist, declared that Autism was the result of mothers withholding appropriate
Social inclusion and ASD 11
affection from their children and failing to make a good connection with them
(Bettelheim, 1967). In 1998, British former surgeon and medical researcher Andrew
Wakefield published, in the prestigious medical journal The Lancet, a paper in sup-
port of the claim that there existed a link between administration of the measles,
mumps and rubella (MMR) vaccine and the onset of Autism. Following his claim,
numerous large-scale studies were undertaken in an attempt to validate his find-
ings. None were able to reproduce his findings or confirm his hypothesis. Claims
were made that Wakefield had manipulated evidence and his paper was retracted
in 2010. A number of studies have ruled out any link between vaccines and Autism
(e.g., DeStefano, Price and Weintraub, 2013; Price et al., 2010) but doubt remains,
with skeptic groups maintaining there is a link between Autism and vaccination.
Research continues to search for a cause.
Thirdly, Autism is a lifelong, pervasive developmental disorder with no cure.
Since Kanner’s original description, society has learnt a great deal about Autism.
Dodd (2005) acknowledges, “In the past twenty years in particular, there have been
remarkable developments in our knowledge of what Autism is, why it happens, and
how it should be treated” (p. vii). Education for all is therefore central to under-
standing Autism and for supporting the individual diagnosed with this disorder.
The prevalence of persons diagnosed with an Autism Spectrum Disorder con-
tinues to rise. In the United States, figures from the Centers for Disease Control
and Prevention (CDC) reported that in 2009, “an average of 10 in 1000 children
aged 3 to 17 years were diagnosed with Autism, and in 2012, 1 in 88 children were
estimated to be diagnosed with ASDs” (Graff, Berkeley, Evmenova, and Park, 2014,
p. 158). In Australia, the 2012 Survey of Disability, Ageing and Carers (SDAC)
“showed an estimated 115,400 Australians (0.5 per cent) had Autism. This was a 79
per cent increase on the 64,400 people estimated to have the condition in 2009”
(ABS, 2014, p. 2). Consistent with overseas estimates, the prevalence rate was four
times higher for males than for females, with prevalence peaking in the five to nine
year age group.
Inclusion in education
In the past, students with Autism Spectrum Disorder tended to be segregated from
their peers. The trend in education now appears to be an increasing movement
towards educating all students with disabilities in regular education settings and/or
classrooms. The term ‘regular education’ can be interchanged with ‘mainstream’ in
the discussion of class placement options for students.
The literature surrounding inclusion describes the challenges faced by schools,
teachers and students when implementing inclusive practice (Greenstein, 2014;
Malinen, Savolainene and Xu, 2012). Teachers continue to have limited belief in
their preparedness to support students with special education needs both gener-
ally (Swain, Nordness and Leader-Janssen, 2012), and for students with an Autism
Spectrum Disorder (Humphrey and Symes, 2013; Lindsay, Proulx, Thomson and
Scott, 2013).
12 Cathy Little
Inclusive practice can occur in any number of settings: leisure activities,

c ommunity participation, employment, personal care routines and in education.
Dybvik (2004) stated, “the idea behind inclusion [in education] is that every
child should be an equally valued member of the school culture” (p. 45). This
quote reinforces a prominent theme in the inclusion debate, that inclusion is
not simply being a part of a place or setting, rather it is a concept grounded in
access and active participation for all students with a diverse array of needs (Swain
et al., 2012). Distinguishing between inclusive pedagogy, inclusive practice and
inclusive education within the specific context of a school and its community is
problematic because the term inclusion is so broadly defined (Florian and Black-
Hawkins, 2011). Humphrey (2008) proposed the use of a four-pronged defini-
tion of inclusion, that of “presence [of all pupils], participation, acceptance and
achievement” (p. 42). He argued that this definition gave opportunity to consider
inclusion as an ongoing process rather than “the rudimentary ‘inclusion as the
placement of pupils with special education needs (SEN) in mainstream schools’
definition” (p. 42).
The increasing numbers of students with an Autism Spectrum Disorder in
mainstream classes has posed several challenges for educators. The most common
challenges involve knowledge of effective and appropriate teaching approaches
(Frederickson, Jones and Lang, 2010; Odom, Cox and Brock, 2013), adjustments
to and accommodation of the curriculum (Shaddock, Giorcelli and Smith, 2007),
specific knowledge of the disorder (Swain et al. 2012), up-skilling and professional
development of teachers (Boud and Hager, 2012), and availability of appropriate
support and resources (Lindsay et al., 2014).
In recent years there has been more emphasis on the notion of social inclusion,
referring to a student being included beyond academic and classroom activities.
This emphasis has emerged as a result of the increased numbers of students with
disabilities accessing mainstream, or regular education classrooms. “As the prac-
tice of ‘mainstreaming’ students with disabilities in the general education environ-
ment gained momentum, it became apparent that simply moving children with
disabilities from segregated special schools and classrooms to the regular education
environment did not ensure their social integration” (Siperstein and Parker, 2008,
p. 120). The concern for students with an Autism Spectrum Disorder is that due to
the very nature of their disability, placement in a regular class may result in ‘exclu-
sion’ because the teacher, the classroom and the school are not meeting the student’s
individual social needs.
White, Scahill, Klin, Koenig and Volkmar (2007) highlight the lack of consider-
ation afforded to students’ social abilities when considering class placement, with
Segall and Campbell (2014) asserting, “Consistently, researchers have found that
cognitive ability is highly associated with regular class placement for students with
ASD” (p. 32). If teachers are to actively support the social engagement of students in
their classes, then the consideration of students’ social needs as part of the placement
process must become a reality.
Social inclusion
Yet, the term social inclusion is a nebulous one. Many studies use similar terms
to describe the same idea. ‘Social integration’, ‘social participation’ and ‘social
inclusion’ are often used interchangeably to describe the same concept. In 2009,
Koster, Nakken, Jan Pijl and van Houten undertook a review of the literature
published between 2000 and 2005 that focused on the social dimension of inclu-
sion in education. Implementation of selection criteria (i.e. empirical research or
literature review, published in international journals, aimed at pupils with special
needs in elementary or preschool and focused on the social dimension of inclusion)
returned 62 studies for examination. Following analysis, the authors found three
distinct terminologies, or umbrella terms used to describe the social dimension of
inclusion: social integration, social inclusion and social participation. Their review
addressed these three concepts in turn, detailing the explicit and implicit definitions
that emerged from the literature.
Of the 62 articles included in their examination, only six studies used the term
social inclusion. Yet, no explicit definition of the term was stated in any study;
only implicit definitions were alluded to. In the absence of an explicit definition
of social inclusion, Koster et al. (2009) described several common aspects reported
across these six studies: friendship, acceptance, interaction, relationships, social status
and bullying. The authors determined “the concept of social integration and its
related concepts, social inclusion and social participation, hardly seem to differ in
practice with respect to content, if at all” (p. 131). They claimed these three terms
were used interchangeably within the literature and were ascribed similar mean-
ings. Thus, they concluded that social participation should be used to refer to the
social dimension of inclusion. Social inclusion was rejected as a concept term as
“inclusion is an extensive concept which logically embraces the social dimension”
(p. 134).
Bossaert, Coplin, Jan Pijl and Petry (2013) closely replicated the Koster et al.
(2009) study, using literature from 2000–2008, with the intent of clarifying the
three concept terms describing the social dimension of inclusion in the secondary
education setting. Bossaert et al. sought to ascertain any parallels or differences
between their study and the previous review. Using the same sources and selection
criteria, Bossaert et al. selected 19 articles for use in their examination.
Once again results found social integration was the term most frequently used
in the research literature. Unlike Koster et al. (2009), Bossaert and colleagues (2013)
reported five of the seven articles that used the term social inclusion provided an
explicit definition of the term. Using narrative description Bossaert et al. identified
key themes central to each study’s definition. These themes closely mirrored those
of the previous study and included: peer acceptance, bullying, friendships and social
isolation. The authors concluded their findings closely paralleled those obtained
by Koster et al., thus confirming that terms such as social integration, social inclu-
sion and social participation are used interchangeably in the research literature and
assigned similar meanings.
14 Cathy Little
Within the literature, ‘social inclusion’ is described either as a counter term to

the process of ‘social exclusion’ (Raffo and Gunter, 2008) or simply alluded to as a
general term in the discussion of the social aspects of the larger, more general phi-
losophy of inclusion (Jones and Frederickson, 2010; Marks, 2013). However, there
exists a dearth of literature worldwide that presents evidence of inclusion as much
more than simply sharing the same space or environment as others (Armstrong,
Armstrong and Spandagou, 2011; Swain et al., 2012). Further, much has been writ-
ten of how the unique social impairments of students with an Autism Spectrum
Disorder require targeted interventions to support their active social engagement
with others (Kasari et al., 2011; Stitchter et al., 2012). It is with this support that this
writer contends the term social inclusion cannot be subsumed into the inclusion
vernacular but remains a valid and distinct construct for use.
Enactment of social inclusion in the school context

It is not enough to simply place students in regular classes and ‘hope’ that they
learn to socialise. Siperstein and Parker (2008) argued that moving students from
segregated, specialised settings into mainstream classrooms did little to guarantee
their social integration. The research of Chamberlain, Kasari and Rotheram-Fuller
(2007) recognised that the social inclusion of students with an Autism Spectrum
Disorder in regular classes is successful when supported by “the active efforts of
parents and teachers to make dramatic improvements in the social networking of
children with autism” (p. 239). By promoting social inclusion teachers can assist
with the formation of equal relationships with enhanced social engagement for stu-
dents. Teachers must be responsible for the provision of an environment that facil-
itates socially inclusive opportunities. “In order to give opportunities for students
to develop their social competence, more is needed than simply interacting with
others” (Roe, 2008, p. 151). Social inclusion is greatly influenced by a number of
elements within the student’s environment: peers, teacher, class and setting. For this
reason, placement of students with an Autism Spectrum Disorder into mainstream
classes needs to be made as part of a considered individualised process.
Student as influencer
Students with an Autism Spectrum Disorder display characteristics that can assist
them in their social inclusion. It has been found that students with Autism Spectrum
Disorder are often passionate about specific areas of interest and pursue those areas
with great enthusiasm (Attwood, 2003). This could provide students with Autism
Spectrum Disorder a way to interact with others in their class. It would be remiss
at this point not to acknowledge the strengths of students with Autism Spectrum
Disorder and to detail the benefits their presence can bring to a regular education
classroom. Students with Autism Spectrum Disorder possess unique ways of think-
ing and of seeing the world. For example, a student with Autism Spectrum Disorder
may be extremely knowledgeable about one or a number of particular topics of
interest, and know these topics intimately. If teachers recognise this expertise,
students can take on leadership roles in supporting peers to develop projects or
pieces of work based around this topic (Morewood, Humphrey and Symes, 2011).
Personality traits of young people with Autism Spectrum Disorder such as deter-
mination, dedication, and resiliency can produce a commitment to learning and to
overcoming academic challenges, with a view to long-term success in the educa-
tional arena (Carter et al. 2015). The ability to systematise, to deal with concepts
that have particular rules, allows some persons with Autism Spectrum Disorder
to excel in areas such as mathematics, technology and physics. Thus, persons with
Autism Spectrum Disorder have a number of strengths that facilitate a positive
contribution to the mainstream classroom.
Social skills
An essential component in the development of a positive school climate, and the
success of the student with Autism generally, is the development of social skills
(Stitchter et al., 2012). In order to participate as part of the school community,
students with Autism need to develop appropriate social behaviours. Research has
found that simply including or placing students with Autism in the general class-
room does not automatically lead to better socialisation outcomes for them (Hart
and Whalon, 2011). If we expect students with Autism to demonstrate appropriate
social behaviours in specific social situations, then explicit teaching of such skills is
required.
A consistent difficulty for persons with an Autism Spectrum Disorder is the
limited presence of social skills. Research has noted that difficulty in social inter-
action and understanding is a primary defining characteristic of Autism (Locke,
Rotheram-Fuller and Kasari, 2012). Hart and Whalon (2011) discuss how many
children misread social situations, leading them to act inappropriately. Aside from
inappropriate verbal comments, other socially inappropriate responses can include
the use of voice as inappropriately silly; too loud or aggressive tone; inappropriate
physical touching; rude, immature behaviour; and overreaction to both people and
stimuli.
In order to participate as part of the school community, students with Autism
need to develop appropriate social behaviours. Research has found that simply
including or placing students with Autism in the general classroom does not auto-
matically lead to better socialisation outcomes for them (Hart and Whalon, 2011).
If we expect students with Autism to demonstrate appropriate social behaviours in
specific social situations, then explicit teaching of such skills is required to facilitate
an acceptable level of social competence.
Difficulties that arise from impairments in social communication can affect the
student’s ability to interact in the classroom and impact negatively on their ability
to establish and maintain friendships over time (Locke et al., 2013). These include
difficulties in predicting others’ behaviour leading to avoidance of other students;
difficulties in understanding behaviour of self and others, and how this affects the
16 Cathy Little
way people think; an inability to deceive thus becoming the class ‘dobber’; and
difficulty in differentiating fact from fiction resulting in the inability to perceive
from another’s perspective (Rowley et al., 2012). Poor or inappropriate displays of
social competence can have damaging results. A serious problem for teachers is the
propensity of children with disabilities to be bullied.
A key element expressed in Kanner’s initial research was the indifference that
children with an Autism Spectrum Disorder appeared to have towards contact with
others and an apparent disinterest in social engagement with others in their environ-
ment. This has led the assumption that persons with an Autism Spectrum Disorder
do not want friends. Daniel and Billingsley’s (2010) study of friendship, however,
found all the students with an Autism Spectrum Disorder diagnosis in their research
were able to identify at least one friend. Using student self-reports combined with
interviews from parents and teachers and document reviews, they concluded that
having friends, recognising challenges in establishing friends, sharing interests, and
friendship stability over time were factors central to the establishment and mainte-
nance of friendships for students with an Autism Spectrum Disorder.
Thus, both in the classroom and on the playground, students with an Autism
Spectrum Disorder will require ongoing support and instruction to help them
recognise the effects of their actions on others, and how to become aware of their
own thoughts, feelings and attitudes. This awareness of self has been recognised
as vital, as is the recognition of feelings and emotions. Students with an Autism
Spectrum Disorder do not learn to socialise through observing and imitating
others due to a lack of awareness of the needs of others in relation to themselves
(Baron-Cohen, Tager-Flusberg and Cohen, 2000). Explicit instruction in appro-
priate social behaviours can be taught through targeted social skills instruction.
Direct instruction is required to increase the student’s awareness of the ways in
which people behave and how to interact with others.The learning of social skills
requires a prolonged and systematic effort for students, but it has lifelong impli-
cations. Research has shown that social skills are related to long-term adjustment
and prognosis for both individuals with and without Autism (Banda and Hart,
2010).
Relationships and social networks among students are a key issue in inclu-
sive education (Jan Pijl, 2007) and for the inclusion of students with an Autism
Spectrum Disorder (Locke et al., 2013). In a study investigating students’ knowledge
of Autism and attitudes toward integrated peers with an Autism Spectrum Disorder,
Mavropoulou and Sideridis (2014) found that when compared to a comparison
group, typically developing peers indicated greater knowledge of Autism and more
positive attitudes and behavioural intentions toward their classmates with an Autism
Spectrum Disorder as a result of contact through students’ inclusion in the general
education classroom. Peers in the class of a child with an Autism Spectrum Disorder
will need explanations and guidance in understanding and encouraging the friend-
ship abilities of their classmate. Students with an Autism Spectrum Disorder are
more likely to improve their social skills if their typically developing peers are
taught how to interact with them. The support of peers through peer-mediated
interventions has been found to be one of the most effective social interaction
interventions (Hart and Whalon, 2011; Locke et al., 2012).
This chapter proposes a revised definition of social inclusion, one that has pro-
gressed from an abstract, subjective description of a student’s ability to be socially
included, to an explanation that involves a more contemporary, active demonstration
of a student’s inclusion in social relationships.This revised definition is informed by
the voice of the student and the dynamic interplay with key figures in their imme-
diate educational environment.
Moving beyond a superficial definition of social inclusion as merely equity of
representation, this paper utilises a definition that recognises equity of recognition. This
views social inclusion as a dynamic process of recognition of individuals and groups
for who and what they are (Raffo and Gunter, 2008). For the purposes of this
chapter, the term ‘social inclusion’ is used as a framework for understanding the
meaningful participatory access of students with an Autism Spectrum Disorder into
regular education settings. It involves active levels of social involvement with teach-
ers and peers. It exceeds mere integration by encompassing a “psychological sense
of connection to others along with physical access and social interaction” (Misener
and Darcy, 2013, p. 4) with intangible factors, such as being “treated with dignity
and respect, being able to form and maintain friendships and intimate relation-
ships, and generally being able to live as equals in the broader community” (Schur,
Kruse and Blanck, 2014, p. 119).
Social inclusion for students with an Autism Spectrum Disorder can be defined
as the demonstration of at least one enduring, reciprocal friendship, and self-initiated, active
participation in group activities with acceptance shown by group members. This definition
affords a meaningful contribution to future research studies in this area owing to its
focus on students’ active demonstration of their participation in social relationships
rather than simply having the ability to do so (Bossaert et al., 2013).
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders.
Fifth Edition. (DSM-V). Washington, DC: Author.
Armstrong, D., Armstrong, A. C., and Spandagou, I. (2011). Inclusion: by choice or by
chance? International Journal of Inclusive Education, 15(1), 29–39. doi:10.1080/13603116.
2010.496192
Attwood, T. (2003). Understanding and managing circumscribed interests. In M. Prior (Ed.),
Learning and behavior problems in Asperger syndrome. New York: The Guilford Press, pp.
126–47.
Australian Bureau of Statistics. (2014). 4428.0 – Autism in Australia, 2012. Retrieved from
www.abs.gov.au/ausstats/abs@.nsf. Accessed 16 August 2013.
Banda, D. R., and Hart S. L. (2010). Increasing peer-to-peer social skills through direct
instruction of two elementary school girls with autism. Journal of Research in Special
Education Needs, 10(2), 124–32. doi:10.1111/j.1471-3802.2010.01149
Baron-Cohen, S., Tager-Flusberg, H., and Cohen, D. (2000). Understanding other minds:
Perspectives from developmental cognitive neuroscience. Second edition. Avon, UK: Oxford
University Press.
18 Cathy Little
Bettelheim, B. (1967). The empty fortress: Infantile autism and the birth of the self. University of
California, CA: Free Press.
Bossaert, G., Coplin, H., Jan Pijl, S., and Petry, K. (2013). Truly included? A literature study
Education, 17(1), 60–79. doi:10.1080/13603116.2011.580464
Bottrell, D., and Goodwin, S. (2011). Schools, communities and social inclusion. South Yarra,VIC:
Palgrave Macmillan.
Boud, D., and Hager, P. (2012). Re-thinking continuing professional development through
changing metaphors and location in professional practices. Studies in Continuing Education,
34(1), 17–30. doi:10.1080/0158037X.2011.608656
Carter, E. W., Boehm, T. L., Biggs, E. E., Annandale, N. H., Taylor, C. E., Loock, A. K., and
Liu, R. Y. (2015). Known for my strengths: Positive traits of transition-age youth with
intellectual disability and/or autism. Research and Practice for Persons with Severe Disabilities.
Published online June 26, 2015, doi:10.1177/1540796915592158
Chamberlain, B., Kasari, C., and Rotheram-Fuller, E. (2007). Involvement or isolation?
The social networks of children with autism in regular classrooms. Journal of Autism and
Developmental Disorders, 37, 230–42. doi:10.1007/s10803-006-0164-4
Daniel, L. S., and Billingsley, B. S. (2010). What boys with an autism spectrum disorder say
about establishing and maintaining friendships. Focus on Autism and Other Developmental
Disabilities, 25(4), 220–9. doi:10.1177/1088357610378290
DeStefano, F., Price, C. S., and Weintraub, E. S. (2013). Increasing exposure to antibody-stim-
ulating proteins and polysaccharides in vaccines is not associated with risk of autism.
Journal of Pediatrics, 163(2), 561–7. doi:10.1016/j.jpeds.2013.02.001
Dodd, S. (2005). Understanding autism. Marrickville, NSW: Elsevier Australia.
Dybvik, A. (2004). Autism and the inclusion mandate. Education Next, Winter, 43–9.
Florian, L., and Black-Hawkins, K. (2011). Exploring inclusive pedagogy. British Educational
Research Journal, 37(5), 813–28. doi:10.1080/01411926.2010.501096.
Frederickson, N., Jones, A. P., and Lang, J. (2010). Inclusive provision options for pupils
on the autistic spectrum. Journal of Research in Special Education Needs, 10(2), 63–73.
doi:10.1111/j.1471-3802.2010.01145.x
Graff, H. J., Berkeley, S., Evmenova, A. S., and Park, K. L. (2014) Trends in autism research:
A systematic journal analysis. Exceptionality: A Special Education Journal, 22(3), 158–72. doi:
10.1080/09362835.2013.865532
Greenstein, A. (2014). Is this inclusion? Lessons from a very “special” unit. International Journal
of Inclusive Education, 18(4), 379–91. doi:10.1080/13603116.2013.777130
Hart, J. E., and Whalon, K. J. (2011). Creating social opportunities for students with autism
spectrum disorder in inclusive settings. Intervention in School and Clinic, 46(5), 273–9.
doi:10.1177/1053451210395382
Humphrey, N. (2008). Including pupils with autistic spectrum disorder in mainstream
schools. Support for Learning, 23(1), 41–7. doi:10.1111/j.1467-9604.2007.00367.x
Humphrey, N., and Symes, W. (2013). Inclusive education for pupils with autistic spectrum
disorders in secondary mainstream schools: Teacher attitudes, experience and knowledge.
International Journal of Inclusive Education, 17(1), 32–46. doi:10.1080/13603116.2011.580462
Jan Pijl, S. (2007). Introduction: The social position of pupils with special needs in
regular education. European Journal of Special Needs Education, 22(1), 1–5. doi:10.1080/
08856250601082133
Jones, A. P., and Frederickson, N. (2010). Multi-informant predictors of social inclusion for
students with autism spectrum disorders attending mainstream school. Journal of Autism
and Developmental Disorders, 40(9), 1094–1103. doi:10.1007/s10803-010-0957-3
Kasari, C., Locke, J., Gulsrud, A., and Rotheram-Fuller, E. (2011). Social networks and
friendships at school: Comparing children with and without ASD. Journal of Autism and
Developmental Disorders, 41(5), 533–44. doi:10.1007/s10803-010-1076-x
Koster, M., Nakken, H., Jan Pijl, S., and van Houten, E. (2009). Being part of the peer group:
A literature study focusing on the social dimension of inclusion in education. International
Journal of Inclusive Education, 13(2), 117–40. doi:10.1080/13603110701284680
Journal of Inclusive Education, 18(2), 101–22. doi:10.1080/13603116.2012.758320
Lindsay, S., Proulx, M.,Thomson, N., and Scott, H. (2013). Educators’ challenges of including
children with autism spectrum disorder in mainstream classrooms. International Journal of
Disability, Development and Education, 60(4), 347–62. doi:10.1080/1034912X.2013.846470
Locke, J., Kasari, C., Rotheram-Fuller, E., Kretzmann, M., and Jacobs, J. (2013). Social
network changes over the school year among elementary school-aged children with
and without an autism spectrum disorder. School Mental Health, 5, 38–47. doi:10.1007/
s12310-012-9092-y
Locke, J., Rotheram-Fuller, E., and Kasari, C. (2012). Exploring the social impact of being a
typical peer model for included children with autism spectrum disorder. Journal of Autism
Malinen, O., Savolainene, H., and Xu, J. (2012). Beijing in-service teachers’ self-efficacy
and attitudes towards inclusive education. Teaching and Teacher Education, 28(4), 526–34.
doi:10.1016/j.tate.2011.12.004
Marks, M. (2013). Improving the social inclusion of children with autism spectrum disorders
(Unpublished master’s thesis). California State University, Northridge.
Mavropoulou, S., and Sideridis, G. D. (2014). Knowledge of autism and attitudes of children
toward their partially integrated peers with autism spectrum disorders. Journal of Autism
Misener, L. and Darcy, S. (2013). Managing disability sport: From athletes with disabilities
to inclusive organisational perspectives. Sport Management Review, 17, 1–7. doi:10.1016/
j.smr.2013.12.003
Morewood, G. D., Humphrey, N. and Symes, W. (2011). Mainstreaming autism: Making it
work. GAP, 12(2), 62–8.
Odom, S. L., Cox, A. W., and Brock, M. E. (2013). Implementation science, professional
development, and autism spectrum disorders. Exceptional Children, 79(2), 233–51.
doi:10.1177/001440291307900207
Price, C., Thompson, W., Goodson, B., Weintraub, E., Croen, L., Hinrichsen, V., Robertson,
A., Eriksen, E., Lewis, E., Bernal, P., Shay, D., Davis, R. L. , and DeStefano, F. (2010).
Prenatal and infant exposure to thimerosal from vaccines and immunoglobulins and risk
of autism. Pediatrics, 126(4), 656–64.
Raffo, C. and Gunter, H. (2008). Leading schools to promote social inclusion: Developing
a conceptual framework for analysing research, policy and practice. Journal of Education
Policy, 23(4), 397–414. doi:10.1080/02680930801923799
Roe, J. (2008). Social inclusion: Meeting the socio-emotional needs of children with vision
needs. British Journal of Vision Impairment, 26(2), 147–58. doi:10.1177/02646196080260
020101
Rowley, E., Chandler, S., Baird, G., Simonoff, E., Pickles, A., Loucas, T., and Charman, T.
(2012). The experience of friendship, victimization and bullying in children with an
autism spectrum disorder: Associations with child characteristics and school placement.
Research in Autism Spectrum Disorders, 6(3), 1126–34. doi:10.1016/j.rasd.2012.03.004
20 Cathy Little
Schur, L., Kruse, D., and Blanck, P. (2014). People with disabilities: sidelined or mainstreamed?
New York: Cambridge University Press. Cambridge Disability Law and Policy Series:
Chapter 5 – Social Inclusion, pp. 117–55.
Segall, M. J., and Campbell, J. M. (2014). Factors influencing the educational placement of
students with autism spectrum disorders. Research in Autism Spectrum Disorders, 8(1), 3–43.
doi:10.1016/j.rasd.2013.10.006
Shaddock, A., Giorcelli, L., and Smith, S. (2007). Students with disabilities in mainstream
classrooms: A resource for teachers. Canberra: DEEWR.
Siperstein, G. N., and Parker, R. C. (2008). Toward an understanding of social integration:
A special issue. Exceptionality, 16(3), 119–24. doi:10.1080/09362830802194921
Solomon, A. (2012). Far from the tree: Parents, children, and the search for identity. New York:
Scribner.
Stitchter, J. P., O’Connor, K. V., Herzog, M. J., Lierheimer, K., and McGhee, S. D. (2012).
Social competence intervention for elementary students with Aspergers Syndrome and
high functioning autism. Journal of Autism and Developmental Disorders, 42(3), 354–66.
doi:10.1007/s10803-011-1249-2
Swain, K. D., Nordness, P. D., and Leader-Janssen, E. M. (2012). Changes in preservice teacher
attitudes toward inclusion. Preventing School Failure, 56(2), 75–81. doi:10.1080/10459
88X.2011.565386
White, S. W., Scahill, L., Klin, A., Koenig, K., and Volkmar, F. (2007). Educational placements
and service use patterns of individuals with autism spectrum disorders. Journal of Autism
2
SOCIAL INCLUSION FOR STUDENTS
WITH AUTISM SPECTRUM DISORDER
Sunny Kim, Brittany Koegel and Lynn Kern Koegel
With current estimates that 1 in 68 children are diagnosed with Autism Spectrum
Disorder (ASDs) (Centers for Disease Control and Prevention, 2015), the num-
ber of students with ASD entering public schools has greatly increased since the
1990s (National Center for Education Statistics [NCES], 2014; Mazurik-Charles
and Stefanou, 2010; Scull and Winkler, 2011). Specifically, since 1992 the number of
students with ASD has increased by over 800 per cent (Individuals with Disabilities
Education Act, 2004; Aud et al., 2012).The Individuals with Disabilities Act (IDEA)
suggests that students with ASD be educated in the least restrictive environment
(LRE) alongside their typically developing peers.That is, recommendations are that
students with ASD be taught in the general education classroom with appropriate
support, instead of being educated in segregated special day class.
A key benefit of providing inclusive education to students with ASD is that
they have the greatest potential to learn and develop appropriate social skills from
their typically developing peers. In addition, when appropriate social interventions
are implemented in the inclusive school environment students with ASD have an
opportunity to develop meaningful and reciprocated friendships with their typi-
cally developing peers. This chapter will explore: (1) the social impairments in stu-
dents with ASD; (2) the importance of social interventions for students with ASD
in inclusive settings; and (3) a few evidence-based interventions to address the social
challenges for these students.
Social impairments in students with ASD

One of the defining characteristics of Autism Spectrum Disorder (ASD) is an
impairment in social development (APA, 2013). Research has documented
that without appropriate social intervention, students with ASD have difficulty
22 Sunny Kim, Brittany Koegel and Lynn Kern Koegel
interacting with their peers and exhibit low responsiveness, limited or nonexistent
initiations, reduced conversational reciprocity, and an overall difficulty sustaining
social engagement (DiSalvo and Oswald, 2002; Knott, Dunlop and Mackay, 2006).
Moreover, students with ASD rarely engage in reciprocal social interactions with
typically developing peers (Koegel, Koegel, Frea, and Fredeen, 2001) and are at
great risk for social isolation, poor friendships, and loneliness (Bauminger and
Kasari, 2000).
This lack of socialisation can also lead to long-term consequences for students
with ASD. For example, these social impairments may increase the risk of stu-
dents with ASD to develop secondary co-morbid disorders such as social anxi-
ety (Gillott, Furniss and Walter, 2001; Wood and Gadow, 2010) and/or depression
(Kim, Szatmari, Bryson, Streiner, and Wilson, 2000; Stewart, Barnard, Pearson,
Hasan, and O’Brien, 2006; Strang, Kenworthy, Daniolos, Case, Martin and Wallace,
2012). Simonoff, Pickles, Charman, Chandler, Loucas and Baird (2008) found that
individuals with ASD are up to 29.2 per cent more likely to develop a co-morbid
diagnosis of social anxiety compared to the general population. Strang, Kenworthy,
Daniolos, Case, Martin and Wallace (2012) found that 30 per cent of their sample
was in the clinical range for depression, which is a much higher rate than the gen-
eral population.
Students with ASD also report to be lonelier than their typically developing
peers (Lasgaard, Nielsen, Eriksen, and Goossens, 2010; Locke, Ishijima, Kasari, and
London, 2010). While these students yearn for friends (Beresford, Tozer, Rabiee,
and Sloper, 2007), their lack of social skills hinders their ability to form meaningful
friendships with typically developing peers. Instead, these students are often bullied
and teased in schools because of their differences (Humphrey and Symes, 2011;
Roekel, Scholte and Didden, 2010; Symes and Humphrey, 2010).
Importance of social interventions for students with ASD

In order to address the social deficits in students with ASD and ameliorate the pos-
sible co-morbid risk factors faced by these students, it is imperative to provide social
interventions. The literature suggests that targeting social areas in natural environ-
ments, such as school settings, are ideal because of the constant access to typically
developing peers and because such settings have the greatest potential for generali-
sation (Koegel and Koegel, 2012; Koegel, Robinson and Koegel, 2009).
The available literature on social interventions for students with ASD offers
some direction for researchers and practitioners. For example, having a structured
and predictable environment has been shown to improve social skills in students
with ASD (Ferrara and Hill, 1980; Mesibov and Shea, 1996). The involvement of
typically developing peers has also been shown to be an effective intervention
strategy for improving social interactions between students with ASD and typi-
cally developing peers (DiSalvo and Oswald, 2002; Harper, Symon and Frea, 2008;
Rogers, 2000; Smith, Lovaas and Lovaas, 2002). Research also suggests that imple-
menting the intervention in natural environments (such as the school setting) can
Social inclusion for students with ASD 23
result in more rapid treatment gains for students with ASD (Koegel and Koegel,
2006; Koegel and Koegel, 2012; National Autism Center, 2009; Reichow and
Volkmar, 2010).
Moreover, variables such as incorporating highly preferred activities into special-
ised activities (Baker, Koegel and Koegel, 1998; Koegel et al., 2012; Koegel et al.,
2012; Koegel et al., 2013), priming or prior experience with activities (Gengoux,
2009; Koegel, Koegel, Frea and Green-Hopkins, 2003; Zanolli, Daggett and Adams,
1996), setting up and maintaining cooperative arrangements (Dugan, Kamps,
Leonard,Watkins, Rheinberger and Stackhaus, 1995; Jull and Mirenda, 2011; Koegel,
Werner,Vismara and Koegel, 2005), providing peer-mediated interventions (Chan
et al., 2009; DiSalvo and Oswald, 2002; Mason, Kamps, Turcotte, Cox, Feldmiller
and Miller, 2014; Pierce and Schreibman, 1997), and using trained paraeducators to
facilitate social interactions (Feldman and Matos, 2013; Koegel, Kim and Koegel,
2014; Kim, 2014; Robinson, 2011) have been shown to be important variables in
providing an inclusive social environment that encourages students with ASD to
interact with their typically developing peers. These components, used in combi-
nation, have been shown to produce particularly large effects for improving social-
isation particularly in encouraging social participation, engagement, generalisation
to other settings, and development of reciprocated friendships (Koegel and Koegel,
2006; Koegel and Koegel, 2012). Each of these variables will be discussed in the
following section.
Evidence-based interventions
It is mandated, and best practice, that schools implement evidence-based programs.
That is, schools must implement programs that are supported by research. This sec-
tion will describe a few evidence-based programs that address social inclusion for
students with ASD in the school setting.
Specialized school activities. One line of research addressing social interventions
for students with ASD has shown that implementing specialized social interven-
tions in the form of “clubs” that incorporate the preferred interests of students with
ASD has been successful for improving social skills in these students (Baker et al.,
1998; Koegel, Fredeen et al., 2012; Koegel,Vernon et al. 2012; Koegel, Kim, Koegel
and Schwartzman, 2013). This type of intervention has proven to be effective for
improving social skills in students with ASD, and is applicable to all different grade
levels and to all students with varying functioning levels (Koegel, Freedan et al.,
2012; Koegel et al., 2013).
For example, Baker, Koegel, and Koegel (1998) conducted a study that created
lunch clubs using perseverative interests of students with ASD as the theme of a group
activity. Using a multiple baseline across participants design, the authors incorporated
perseverative interests of elementary school students with ASD into common play-
ground activities. For example, one of the participants had a perseverative interest
in state capitals, thus a state capital tag game was developed. As various state capitals
were called, students had to run to that state on a large playground map.The authors
found that implementing the activities that incorporated the perseverative interests
of the students with ASD led to increases in appropriate social interactions between
students with ASD and typical peers.The study also found that this type of interven-
tion resulted in generalization to other playground activities and an improved overall
affect for both students with ASD and typical peers.
Similarly, Koegel, Fredeen, Kim, Danial, Rubinstein, and Koegel (2012) and
Koegel, Kim, Koegel, and Schwartzman (2013) expanded this line of research by
incorporating child-preferred interests into club activities for adolescents with ASD.
For example, one of the participants had a preferred interest in movies. Therefore,
a movie trivia club that was available to all students at the high school was created.
The nice thing about this type of social intervention was that it was similar to
other clubs already available at the high school, thus the typically developing stu-
dents were unaware that it was created around a specialized theme. The researchers
found that incorporating the preferred interests of students with ASD into clubs
led to improvements in social engagement and verbal initiations for these students.
The researchers also found that both students with ASD and typically developing
peers self-reported happiness and enjoyment when participating in the social inter-
vention. Finally, the researchers found that a few of the participants were able to
develop reciprocated friendships with typically developing peers.
Anecdotally one of the participants had never been invited to hang out with
a typically developing peer, nor had he received a birthday invitation from a peer,
until he participated in the club designed around his perseverative interest (i.e.,
Movie Trivia Club). However, during the course of this study, he received multiple
invitations to hang out and invitations to birthday parties from typically develop-
ing peers who also participated in the same club. These studies demonstrate that
incorporating the preferred interests of students with ASD into clubs is a simple yet
effective social intervention model that is enjoyable for all students. Also, because
the students with ASD generally have accumulated a vast knowledge base in the
club theme, they are often viewed as the valued member of the peer group.
Priming. Often times, there is a complete lack of socialization or initiations
made by students with ASD, even when there is a presence of potential social
partners in close proximity. While there are many ways to increase socialization for
individuals on the spectrum, social priming is an effective evidence-based strat-
egy to increase social competence (Gengoux, 2009). Social priming is a strategy
that involves previewing an activity in a low-demand, highly reinforcing context
(Wilde, Koegel, and Koegel, 1992; Zanolli et al., 1996). For social priming, one
should preview a social game (e.g., Connect 4, card games, silly faces for elementary
school students) then provide the student access to the same game during a social
context, such as recess.
Priming should be done relatively close in time to the exposure of the activity,
such as either right before the exposure, after school the previous day, or the night
before at home. Research has shown that when children with ASD are primed,
it results in increased rates of initiations and higher levels of peer social interac-
tion. Further, children who are primed are able to excel as the more competent
peer during the social interaction. That is, they are often able to explain the game
directions to their peers, and demonstrate competence in the activity that was
primed.
While priming does not focus on teaching specific behaviors (initiations, com-
pliments, responsiveness), it focuses on teaching the reinforcing aspect of the social
game, and results in child competence with the activity. The reason social priming
is an ideal procedure and different from other approaches is that it functions as an
antecedent intervention and does not require the vigilance and intervention from
a treatment provider in the child’s natural setting with peers. This may be helpful
in reducing any stigmatization that may occur when instruction and feedback is
provided when peers are present.
In regard to overall social needs, priming is just one technique that should be
used in combination with other interventions for a comprehensive program tar-
geting a child with Autism’s social challenges. To date, most priming studies have
focused on verbal children with Autism. However, for this population it is a simple
technique that can be implemented immediately, with very rapid improvements,
often the first day after priming is implemented.
Cooperative arrangements. Another effective strategy to successfully promote
social interactions between students with ASD and typically developing peers is to
provide cooperative arrangements. Kim and Koegel (2012) suggest that providing
a context that promotes cooperative arrangements is crucial to the success of these
social games and activities. Cooperative arrangements are scenarios in which mate-
rials are arranged so that students with ASD and their typically developing peers
have to rely on each other in order to complete the task/activity (Jull and Mirenda,
2011; Koegel, Werner, Vismara and Koegel, 2005). By setting up and maintaining
cooperative arrangements, students with ASD are provided with a natural context
in which they may appropriately interact with their typically developing peers
(Koegel and Koegel, 2006).
Research has also shown that setting up cooperative arrangements can lead to
more frequent social interactions between students with ASD and typically devel-
oping peers. For example, Dugan, Kamps, Leonard, Watkins, Rheinberger, and
Stackhaus (1995) set up cooperative arrangements in an inclusive classroom set-
ting where individuals contributed their specific strengths during group interac-
tions. As a result of setting up cooperative arrangements, academic achievement
as well as social interactions between students with ASD and typically developing
peers improved. In addition, teachers and paraeducators, responsible for setting up
and maintaining cooperative arrangements, reported that it was simple and easy to
implement.
Research has also shown the positive benefits of cooperative arrangements
during play activities (e.g., non-academic periods). For example, Koegel, Werner,
Vismara, and Koegel (2005) assessed whether setting up cooperative arrangements
with mutually reinforcing activities during play dates would improve social inter-
actions between children with ASD and typically developing peers. The research-
ers found that when cooperative arrangements were in place, reciprocal social
interactions improved between children with ASD and typically developing peers.
On the other hand, when cooperative arrangements were not in place, children
with ASD exhibited lower levels of reciprocal social interaction with typically
developing peers. The results of this study highlight the importance of arranging
the environment in such a way as to promote reciprocal social interactions between
students with ASD and typically developing peers.
Peer-mediated interventions. As typically developing peers may have a contin-
uous dynamic interaction with adolescents with ASD, they have the potential to
foster an inclusive social environment where they can teach appropriate social skills
to students with ASD. Typically developing peers can also serve as role models for
how adolescents with ASD should socialize with peers.
The use of typically developing peers as intervention agents has been found to
be more effective in regard to improving the social skills in students with ASD than
the use of adults implementing the intervention (Bene, Banda and Brown, 2014;
Kasari et al., 2012). For example, Pierce and Schreibman (1997) taught typically
developing peers to implement components of Pivotal Response Treatment (PRT)
in order to socially engage students with ASD. Specifically, the authors trained the
peers using a multi-component training model (i.e., combination of modeling,
role-playing, and didactic instruction). The results of the study showed that when
typically developing peers were implemented PRT, the rates of verbal initiations
made by student with ASD increased and their newly acquired social skills gener-
alized to other untrained peers.
Similarly, Mason, Kamps, Turcotte, Cox, Feldmiller, and Miller (2014) trained
typically developing peers to provide appropriate prompts to students with ASD
in order to elicit appropriate social behaviors. The results of the study suggest that
when typically developing peers were trained to appropriately prompt students
with ASD, the social behavior (i.e., verbal communication directed to a peer) of stu-
dents with ASD all drastically improved. Studies such as these suggest that typically
developing peers can be ideal interventionists in the school setting.
A concern some have raised regarding the utilization of typically developing
peers as intervention agents is any potential negative effects it may have on these
students. Research, however, suggests that using typically developing peers does
not negatively impact their social status in the school setting (Locke, Rotheram-
Fuller and Kasari, 2012). In contrast, research suggests that typically developing
peers who serve as peer models to students with ASD become socially connected
to these students while maintaining a strong and positive role in their schools
(Locke et al., 2012).
Paraeducator support. In order for students with ASD to be successfully included
in their general education class, schools often provide a one-on-one paraeducator
for support. In fact, it has become standard practice for schools to rely on paraedu-
cators to help students with ASD receive an inclusive education alongside typically
developing peers (Giangreco, Broer and Edelman, 2010; Jones and Bender, 1993;
Riggs and Mueller, 2001;Young, Simpson, Myls and Kamps, 1997). Along with aca-
demic responsibilities, an essential role for paraeducators is to provide social support
for students with ASD (Etscheidt, 2005), however most are not adequately trained
and often provide too much or too little social support.
The literature suggests that paraeducators can be trained to fidelity to imple-
ment effective social interventions during non-academic periods (Feldman and
Matos, 2013; Koegel, Kim, and Koegel, 2014; Licciardello, Harchik, and Luiselli,
2008; Robinson, 2011). For example, Robinson (2011) trained four paraeducators
via video-feedback modeling to implement Pivotal Response Treatment (PRT)
during lunch recess. Specifically, a trainer modeled the correct implementation of
PRT in the natural setting for three consecutive days. The trainer then videotaped
the paraeducators implementing PRT. After the session, the trainer and each par-
aeducator watched the video clip together while the trainer provided feedback
to the paraprofessional. As a result of the training, the paraeducators’ involvement
and implementation of PRT increased while hovering decreased. In addition, the
students made positive gains in their individualized target goals related to social
communication and demonstrated either maintained or improved affect. The study
also found large and rapid improvements in the paraeducators’ performance, and
the author noted that this may be partially attributed to the training taking place
in the natural setting.
Feldman and Matos (2013) also trained three paraeducators to facilitate social
interactions between students with ASD and typically developing peers using PRT
during non-academic periods. The multi-component training consisted of a work-
shop, a field manual, and three days of on-site training. If a paraeducator did not
meet fidelity of implementation they were trained for an additional three days or
until they met fidelity. After training, paraeducators were able to appropriately and
successfully facilitate social interactions between students with ASD and typically
developing peers.
Finally, Koegel, Kim, and Koegel (2014) trained three paraeducators to fidel-
ity to implement specialized lunch club activities during non-academic periods
(i.e., lunch-recess). Specifically, paraeducators were trained to stand in an appro-
priate proximity, provide cooperative arrangements, and incorporate the preferred
interests of the student with ASD. The authors found that after the paraeducators
received training, they were able to provide an inclusive social environment to
students with ASD during lunch-recess. The authors also found that as a result
of training paraeducators, the social engagement for students with ASD greatly
improved. These studies demonstrate that with appropriate training paraeducators
may be ideal school personnel for developing and providing an inclusive social
experience for students with ASD.
Future directions
While the current literature on social inclusion for students with ASD offers some
optimism for practitioners and researchers that social skills of students with ASD can
improve, additional research in this area is warranted. The majority of the research
on social inclusion has been conducted with younger children. To date, there is
a paucity of research aimed at targeting socialization for adolescents and young

adults with ASD (Reichow and Volkmar, 2010). As recommended by the National
Research Council, it would be important to assess whether existing evidence-based
social inclusion programs could be as effective for adolescents and young adults
with ASD. Implementing and adapting existing effective programs may provide a
larger base of interventions from which to draw.
As school districts often encounter budget cuts, a viable alternative to the utili-
zation of paraeducator support is the use of typically developing peers as interven-
tion agents. For example, Giangreco, Halvorsen, Doyle and Broer (2004) suggest
the feasibility of a school-wide program where typically developing peers provide
academic and social support to students with disabilities. The authors suggest that
this may result in reciprocal benefits as well as counteract the common problem of
bullying.The development of this type of school-wide program may be an import-
ant area to examine and develop.
Finally, it is important to mention that many of the available research studies on
social inclusion for students with ASD lack long-term generalization and mainte-
nance data. That is, do the social skills that students with ASD acquired through
various social interventions carry over into the next school year? How much inter-
vention do these individuals need in order to develop meaningful and reciprocated
friendships? Finally, will targeting socialization during the elementary school years
combat co-morbidity during the adolescent years? In order to address these ques-
tions and concerns, additional research that assesses generalization and maintenance
data is highly warranted.
Summary
A main challenge for students diagnosed with ASD is social deficits. However, with
effective social interventions, students with ASD can, and do, develop appropriate
social skills. This chapter discussed several evidence-based social intervention pro-
grams that can be implemented in the school environment to address the social
challenges of students with ASD. In order to make the social experience positive
for these students, it is imperative that school personnel are adequately trained to
implement such interventions.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). Arlington,VA: American Psychiatric Publishing.
Aud, S., Hussar, W., Johnson, F., Kena, G., Roth, E., Manning, E., Wang, X., and Zhang, J.
(2012). The condition of education 2012 (NCES 2012-045). U.S. Department of Education,
National Center for Education Statistics. Washington, DC. Retrieved from http://nces.
ed.gov/pubsearch. Accessed 19 May 2015.
Baker, M. J., Koegel, R. L., and Koegel, L. K. (1998). Increasing the social behavior of young
children with autism using their obsessive behaviors. The Journal of the Association for
Persons with Severe Handicaps, 23, 300–8. doi:10.2511/rpsd.23.4.300
Bauminger, N., and Kasari, C. (2000). Loneliness and friendship in high-functioning children
with autism. Child Development, 71(2), 447–56. doi:10.1111/1467-8624.00156
Bene, K., Banda, D. R., and Brown, D. (2014). A meta-analysis of peer-mediated instruc-
tional arrangements and autism. Review Journal of Autism and Developmental Disorders, 1(2),
135–42. doi:10.1007/s40489-014-0014-9
Beresford, B., Tozer, R., Rabiee, P., and Sloper, P. (2007). Desired outcomes for children
and adolescents with autistic spectrum disorders. Children and Society, 21(1), 4–16.
doi:10.1111/j.1099-0860.2006.00008.x
Centers for Disease Control and Prevention. (2015). Autism Spectrum Disorders (ASDs).
Retrieved from www.cdc.gov/ncbddd/autism/data.html. Accessed 19 May 2015.
Chan, J. M., Lang, R., Rispoli, M., O’Reilly, M., Sigafoos, J., and Cole, H. (2009). Use of
peer-mediated intervention in the treatment of autism spectrum disorders: A systematic
review. Research in Autism Spectrum Disorders, 3, 876–89. doi:10.1016/j.rasd.2009.04.003
DiSalvo, C. A., and Oswald, D. P. (2002). Peer mediated interventions to increase the social
interaction of children with autism: Consideration of peer expectancies. Focus on Autism
and Other Developmental Disorders, 17(4), 198–207. doi:10.1177/10883576020170040201
Dugan, E., Kamps, D., Leonard, B., Watkins, N., and Stackhaus, J. (1995). Cooperative learn-
ing groups during social studies for students with autism and fourth-grade peers. Journal
of Applied Behavior Analysis, 28(2), 175–88. doi:10.1901/jaba.1995.28-175
Etscheidt, S. (2005). Paraprofessional services for students with disabilities: A legal analysis of
issues. Research and Practice for Persons with Severe Disabilities, 30(2), 60–80. doi:10.2511/
rpsd.30.2.60
Feldman, E. K., and Matos, R. (2013). Training paraprofessionals to facilitate social interac-
tion between children with autism and their typically developing peers. Journal of Positive
Behavior Interventions, 15(3), 169–79. doi:10.1177/1098300712457421
Ferrara, C., and Hill, S.D. (1980). The responsiveness of autistic children to the predictability
of social and nonsocial toys. Journal of Autism and Developmental Disorders, 10(1), 51–7.
doi:10.1007/BF02408432
Gengoux, G. W. (2009). Priming for games and cooperative activities with children with
autism: Effects on social interactions with typically developing peers. Dissertation Abstracts
International:The Sciences and Engineering, 69(8-B), 5024.
Giangreco, M. F., Broer, S. M., and Edelman, S. W. (2010). “That was then, this is now!”
Paraprofessional supports for students with disabilities in general education classrooms.
Exceptionality, 10(1), 47–64. doi:10.1207/S15327035EX1001_4
Giangreco. M.F., Halvorsen, A. T., Doyle, M. B., and Broer, S. M. (2004). “Alternatives to
paraprofessionals in inclusive schools.” Journal of Special Education Leadership, 17(2), 82–90.
Gillott, A., Furniss, F., and Walter, A. (2001). Anxiety in high-functioning children with
autism. Autism, 5(3), 277–86. doi:10.1177/1362361301005003005
Harper, C. B., Symon, J. B. G., and Frea, W. D. (2008). Recess is time-in: Using peers to
improve social skills of children with autism. Journal of Autism and Developmental Disorders,
38, 815–26. doi:10.1007/s10803-007-0449-2
Humphrey, N., and Symes, W. (2011). Peer interaction patterns among adolescents with
autistic spectrum disorders (ASDs) in mainstream school settings. Autism, 15(4), 397–419.
doi:10.1177/1362361310387804
Individuals with Disabilities Education Act Amendments of 2004, 20 U.S.C. § 1400 et seq.
Jones, K. H., and Bender, W. N. (1993). Utilization of paraprofessionals in special
education: A review of the literature. Remedial and Special Education, 14(1), 7–14.

doi:10.1177/074193259301400103
Jull, S., and Mirenda, P. (2011). Parents as play date facilitators for preschoolers with autism.
Journal of Positive Behavior Interventions, 13(1), 17–30. doi:10.1177/1098300709358111
Kasari, C., Rotheram-Fuller, E., Locke, J., and Gulsrud, A. (2012). Making the
connection: Randomized controlled trial of social skills at school for children with
autism spectrum disorders. Journal of Child Psychology and Psychiatry, 53(4), 431–39.
doi:10.1111/j.1469-7610.2011.02493.x
Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., and Wilson, F. J. (2000).The prevalence of
anxiety and mood problems among children with autism and asperger syndrome. Autism,
4(2), 117–32. doi:10.1177/1362361300004002002
Kim. S. (2014). Training paraprofessionals to improve social skills in students with autism spectrum
disorders (Doctoral Dissertation). Available from ProQuest Dissertations and Theses data-
base. (UMI No. 12206).
Kim, S., and Koegel, L. K. (2012). How to improve socialization for high school students through
school clubs. Santa Barbara, CA: University of California, Santa Barbara.
Knott, F., Dunlop, A.W., and Mackay,T. (2006). Living with ASD: How do children and their
parents assess their difficulties with social interaction and understanding? Autism, 10(6),
609–17. doi:10.1177/1362361306068510
Koegel, L. K., Koegel, R. L., Frea, W. D., and Fredeen, R. M. (2001). Identifying early inter-
vention targets for children with autism in inclusive school settings. Behavior Modification,
25(5), 745–61. doi:10.1177/0145445501255005
Koegel, L. K., Koegel, R. L., Frea, W., and Green-Hopkins, I. (2003). Priming as a method of
coordinating educational services for children with autism. Language, Speech, and Hearing
Services in Schools, 34, 228–35. doi:10.1044/0161-1461(2003/019)
Koegel, L. K., Robinson, S. E., and Koegel, R. L. (2009). Empirically supported intervention
practices for autism spectrum disorders in schools and community settings: Issues and
practices. Issues in Clinical Child Psychology, 2, 149–76.
Koegel, L. K., Vernon, T. W., Koegel, R. L., Koegel, B. L., Paullin, A. W. (2012). Improving
social engagement and initiations between children with autism spectrum disorder
and their peers in inclusive settings. Journal of Positive Behavior Interventions, 14(4), 1–8.
doi:10.1177/1098300712437042
Koegel, R. L., Fredeen, R. M., Kim, S., Danial, J., Rubinstein, D., and Koegel, L. K. (2012).
Using perseverative interests to improve interactions between adolescents with autism
and their typical peers in school settings. Journal of Positive Behavioral Intervention, 14(3),
133–41. doi:10.1177/1098300712437043
Koegel, R. L., Kim, S., Koegel, L. K. (2014). Training paraprofessionals to improve socializa-
tion in students with ASD. Journal of Autism and Developmental Disorders, 44(9), 2197–2208.
doi:10.1007/s10803-014-2094-x
Koegel, R. L., Kim, S., Koegel, L. K. and Schwartzman, B. (2013). Improving socialization
for high school students with ASD by using their preferred interests. Journal of Autism and
Developmental Disorders, 43(9), 2121–34. doi:10.1007/s10803-013-1765-3
Koegel, R. L., and Koegel, L. K. (2006). Pivotal response treatments for autism: Communication,
social, and academic development. Baltimore, MD: Brookes Publishing Company.
Koegel, R. L., and Koegel, L. K. (2012). The PRT pocket guide: Pivotal response treatment for
autism spectrum disorders. Baltimore, MD: Brookes Publishing Company.
Koegel, R. L., Werner, G. A., Vismara, L. A., and Koegel, L. K. (2005). The effectiveness of
contextually supported play date interactions between children with autism and typi-
cally developing peers. Research and Practice for Persons with Severe Disabilities, 30, 93–102.
doi:10.2511/rpsd.30.2.93
Lasgaard, M., Nielsen, A., Eriksen, M. E., and Goossens, L. (2010). Loneliness and social sup-
port in adolescent boys with autism spectrum disorders. Journal of Autism and Developmental
Disorders, 40(2), 218–26. doi:10.1007/s10803-009-0851-z
Licciardello, C. C., Harchik, A. E., and Luiselli, J. K. (2008). Social skills intervention for
children with autism during interactive play at a public elementary school. Education and
Treatment of Children, 31(1), 27–37.
Locke, J., Ishijima, E. H., Kasari, C., and London, N. (2010). Loneliness, friendship qual-
ity and the social networks of adolescents with high-functioning autism in inclu-
sive school setting. Journal of Research in Special Educational Needs, 10(2), 74–81.
doi:10.1111/j.1471-3802.2010.01148.x
Locke, J., Rotheram-Fuller, E., and Kasari. C. (2012). Exploring the social impact of being a
typical peer model for included children with autism spectrum disorder. Journal of Autism
and Developmental Disorders, 42, 1895–1905. doi:10.1007/s10803-011-1437-0
Mason, R., Kamps, D., Turcotte, A., Cox, S., Feldmiller, S., and Miller, T. (2014). Peer medi-
ation to increase communication and interaction at recess for students with autism
spectrum disorders. Research in Autism Spectrum Disorders, 8, 334–44. doi:10.1016/
j.rasd.2013.12.014
Mazurik-Charles, R., and Stefanou, S. (2010). Using paraprofessionals to teach social skills
to children with autism spectrum disorders in the general education classroom. Journal of
Instructional Psychology, 37(2), 161–9.
Mesibov, G. B., and Shea,V. (1996). Full inclusion and students with autism. Journal of Autism
and Developmental Disorders, 26(3), 337–46. doi:10.1007/BF02172478
National Autism Center. (2009). The National Standards Report: The National Standards
Project—Addressing the need for evidence based practice guidelines for autism spectrum disorders.
Randolph: National Autism Center.
National Center for Education Statistics. (2014). Children and youth with disabilities. Retrieved
from https://nces.ed.gov/programs/coe/pdf/coe_cgg.pdf. Accessed 19 May 2015.
Pierce, K., and Schreibman, L. (1997). Multiple peer use of pivotal response training to
increase social behaviors of classmates with autism: Results from trained and untrained
peers. Journal of Applied Behavior Analysis, 30(1), 157–60. doi:10.1901/jaba.1997.30-157
Reichow, R., and Volkmar, F. R. (2010). Social skills interventions for individuals with autism:
Evaluation for evidence-based practices within best evidence synthesis framework. Journal
of Autism and Developmental Disorders, 40(2), 149–66. doi:10.1007/s10803-009-0842-0
Riggs, C. G., and Mueller, P. H. (2001). Employment and utilization of para-educators
in inclusive settings. The Journal of Special Education, 35(1), 54–62. doi:10.1177/
002246690103500106
Robinson, S. E. (2011). Teaching paraprofessionals of students with autism to implement
pivotal response treatment in inclusive school settings using a brief video feedback
training package. Focus on Autism and Other Developmental Disabilities, 26(2), 105–18.
doi:10.1177/1088357611407063
Roekel, E. V., Scholte, R. H. J., and Didden, R. (2010). Bullying among adolescents with
autism spectrum disorders: Prevalence and perception. Journal of Autism and Developmental
Disorders, 40(1), 63–73. doi:10.1007/s10803-009-0832-2
Rogers, S. J. (2000). Interventions that facilitate socialization in children with autism. Journal
of Autism and Developmental Disorders, 30(5), 399–409. doi:10.1023/A:1005543321840
Scull, J., and Winkler, A. M. (2011). Shifting trends in special education. Retrieved from The
Thomas B. Fordham Institute website: http://edexcellence.net/publications/shifting-
trends-in-special.html. Accessed 19 May 2015.
Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., and Baird, G. (2008).
Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbid-
ity, and associated factors in a population derived sample. Journal of the American Academy of
Child and Adolescent Psychiatry, 47(8), 921–9. doi:10.1097/CHI.0b013e318179964f
Smith,T., Lovaas, N.W., and Lovaas, O. I. (2002). Behaviors of children with high-functioning
autism when paired with typically developing versus delayed peers: A preliminary study.
Behavioral Interventions, 17(3), 29–143. doi:10.1002/bin.114
Stewart, M. E., Barnard, L., Pearson, J., Hasan, R. and O’Brien, G. (2006). Presentation
of depression in autism and asperger syndrome: A review. Autism, 10(1), 103–16.
doi:10.1177/1362361306062013
Strang, J. F., Kenworthy, L., Daniolos, P., Case, L., Wills, M. C., Martin, A., and Wallace, G. L.
(2012). Depression and anxiety symptoms in children and adolescents with autism spec-
trum disorders without intellectual disability. Research in Autism Spectrum Disorders, 6,
406–12. doi:10.1016/j.rasd.2011.06.015
Symes, W., and Humphrey, N. (2010). Peer-group indicators of social inclusion among peo-
ple with autistic spectrum disorders (ASD) in mainstream secondary schools: A compara-
tive study. School Psychology International, 31(5), 478–94. doi:10.1177/0143034310382496
Wilde, L. D., Koegel, L. K., and Koegel, R. L. (1992). Increasing success in school through priming:
A training manual. Santa Barbara, CA: University of California, Santa Barbara.
Wood, J. J., and Gadow, K. D. (2010). Exploring the nature and function of anxiety in youth
with autism spectrum disorders. Clinical Psychology Science and Practice, 17(4), 281–92.
doi:10.1111/j.1468-2850.2010.01220.x
Young, B., Simpson, R. L., Myles, B. S., and Kamps, D. M. (1997). An examination of parapro-
fessional involvement in supporting inclusion of students with autism. Focus on Autism and
Other Developmental Disabilities, 12(1), 31–8. doi:10.1177/108835769701200104
Zanolli, K., Daggett, J., and Adams, T. (1996). Teaching preschool age autistic children to
make spontaneous initiations to peers using priming. Journal of Autism and Developmental
Disorders, 26(4), 407–22. doi:10.1007/BF02172826
3
BULLYING AND SOCIAL
VULNERABILITY OF STUDENTS WITH
AUTISM SPECTRUM DISORDER
Sarah Feuerbacher, Travis Moore and Hannah Gill
ASD and bullying, depression, and aggression
CASE STUDY: ERIK
Erik was a client enrolled in weekly group counseling with other individuals
with ASD. Erik enjoyed his life, his time in the group, and the friends he had
made in the group, regularly spending time playing video games with them
outside of group sessions. However, Erik frequently discussed how much he
struggled during severe bullying he endured when he was in high school. Erik
reported that he once threatened to tape a girl’s mouth shut because of her
frequent and intense bullying towards Erik. Erik also had a fascination with
everything related to the military, including weapons, fire, and death. As his
time in the group progressed, it became evident that Erik was increasingly
struggling with defining what was reality and what was imaginary as his fas-
cination became delusions, evidenced in group sessions when Erik described
graphic and vivid war scenes he insisted he experienced in real life.
Although individuals with disabilities are at an increased risk of bullying, there

are limited studies investigating predictors of bullying involvement (Zablotsky,
Bradshaw, Anderson and Law, 2014). According to Roekel, Scholte, and
Didden (2010), there has been an increase in bullying involvement in 2010,
with reports individuals have either been a witness to bullying, a victim of
bullying, or the bully themselves. Often, ASD individuals do not interpret bullying
situations accurately, which is more than likely a result of their lack of understanding
of social contexts of what is considered friendly, non-aggressive behavior.
34 Sarah Feuerbacher, Travis Moore and Hannah Gill
The pain caused by bullying and victimization is experienced markedly different

in individuals with ASD.These individuals may not have the ability for abstract cog-
nitive reasoning to understand emotions of extreme sadness, confusion, or anger, but
they do understand the pain of a physical injury, such as a cut, and also know how it
heals; therefore, self-injury may be used because physical pain is easier to both cope
with and understand. Furthermore, self-harming is used when there is a personal
feeling of a lack of power and control, usually over another person or an environ-
ment. An individual with ASD who is suffering from bullying may have a percep-
tion that there is not a trusted person or environment in which to safely release
that pain; therefore, they use themselves (i.e., their bodies) as an outlet for their pain
because it is the one thing they have control over. In other words, these individuals
can develop habits of creating pain they are controlling on the outside because it
relieves the pain that they feel on the inside, albeit only a temporarily relief.
Bullying through the lifespan

Developmental theory suggests that individuals who are in their teen years or func-
tion at an adolescent level, and who are encouraged to do things in which they can
be successful and where they are praised for their accomplishments, are more likely
to demonstrate diligence, persevere at tasks until completed, and put work before
pleasure. However, if they are instead ridiculed and bullied by peers, misunderstood
and punished by teachers and parents for their efforts, or find they are incapable of
meeting expectations, they develop feelings of inferiority about their capabilities
(Erikson, 1980).
Through the transition from childhood to adulthood, these individuals expe-
rience mixed ideas and feelings about the roles they are capable of playing in the
adult world and the specific ways in which they will fit into society, and they are
confronted by this role confusion in the face of an often potentially hostile world.
This experience significantly impacts self-confidence and may permanently change
one’s self-concept as they question if they are capable of being successful or if they
are worthless.They may experience signs of depression, which include sadness, lack
of energy or concentration, inability to enjoy things, withdrawal, irritability or anx-
iety, weight loss or gain, change in sleep patterns, pessimism or indifference, and/or
self-harming behaviors (Erikson, 1980).
Bullying in young children can cause somatic symptoms, anxiety, and depres-
sion (Tantam, 2012). Additionally, children recently diagnosed with ASD traits are
more likely to experience bullying than are their peers who are either diagnosed
earlier or their peers who are not diagnosed with ASD at all (Zablotsky et al.,
2014; Fekkes, 2006; Little, 2002; Carter, 2009). The power differential in relation-
ships characterizes the inchoate bullying relationship, and diagnosis, regardless of
type, further stigmatizes young children. Grade school bolsters a breeding ground
of budding social hierarchies.Thus, not fitting in due to social disadvantages such as
physical weakness or size, behavior, intellectual ability, and a lack of age-appropriate
interpersonal development marks these children as social outliers. To make
Bullying and social vulnerability of students with ASD 35
the situation worse, individuals with ASD are more vulnerable to bullying due to

their low self-esteem, decreased ability to navigate social situations, and concrete
thought processes. Delfrabbro et al. (2006) found that being labeled a social out-
lier indicates poor peer relationships, which is associated with being bullied. And
without the support of peer groups during grade school, children are more likely
to be marginalized and are at greater risk for victimization.
Both developmental and contextual perspectives are important in considering the
variables that influence victimization and bullying among children diagnosed with ASD.
Developmentally, a child’s age, gender, and severity of ASD symptoms may mold bul-
lying experiences. Forero et al. (1999) and Nansel et al. (2001) found that boys are
victimized more than girls, especially during the transition from middle school to high
school. Early on, high functioning individuals with ASD, previously recorded as Asperger
Syndrome, can sometimes get by in social settings. However, most continue to struggle
with social inclusion as they age (Cappadocia and Weiss, 2011). Sometimes, especially
during childhood and adolescence, the risk and occurrence of bullying leads parents to
try to ameliorate the problem by transferring their child to special education programs.
Youth diagnosed with ASD are greatly influenced by social contexts such as
peers and family. Children in grade school rely on family and peers as their primary
socialisation figures. Poor parent–child and child–child relationships relate to vic-
timization for these children (Cappadocia and Weiss, 2011). Indeed, peer and family
relationships to these children are indications of the chance of victimization.
High school and adulthood present complex challenges for ASD individuals.
Bullying, marginalization, and stigmatization persist throughout most adult ASD
individuals, but many tend to experience decreased victimization. Victimization
CASE STUDY: JASON
Jason, a 26-year-old who was in the weekly counseling group for individuals
with ASD, also presented with mild depression and reported victimization
of bullying consisting of verbal and physical abuse during his grade school
and middle school years. While Jason was classified as high functioning, the
bullying he received did not assuage simply based upon how highly he was
able to function in grade school, nor did it help in coping with the negative
experience during the aftermath as an adult. Developmentally, Jason’s social
interaction was delayed: he had extremely limited eye contact, his speech was
limited to aphorisms and colloquialisms, and his judgment of others' feelings
and actions were distorted. Contextually, Jason adapted to his surroundings
by learning how to shut himself off to the point of catatonia in an almost
immobile state of inaction and fear. He learned that his theatrical, creative self
was inappropriate not only from peers in school but also from his parents and
psychiatrists. As an adult, Jason’s behavior that was once an adaptive measure
to adhere to social norms became a debilitating condition that prevented him
from establishing meaningful and lasting friendships.
CASE STUDY: ROBERT
Robert presented to counseling with symptoms of depression and a self-

proclaimed lack of motivation in life. His identified treatment goals were
to increase his overall happiness, motivation, and well-being. He was a
middle-aged adult who had never been in a romantic relationship, had

recently moved to a large metroplex to attend a specialized technology pro-
gram, and consequently left all of his friends and family behind. Robert had
attended this program for three years when I met him. When I asked him
what his day-to-day life looked like, he stated that he attended weekly indi-
vidual counseling one time per week and also attended individualized train-
ing from one of his professors each week. That was all. I asked him if he had
any friends at the technology program, and he replied, “No.” I asked him
if he had ever talked to anyone while he was working on his coursework at
school, and he again said no. He did not know any of his classmates names,
despite participating in group counseling with some of them for multiple
terms in a row, as well as seeing some of them in multiple courses through-
out his time at the specialized technology program.
When processing past experiences, Robert stated that he had felt a sense
of belonging and “zest for life” in his high school years, when he was a mem-
ber of the band, and when he had four friends (as perceived by him). Robert
stated that he still stayed in touch with these former friends, and visited them
when he returned home. Since high school, Robert reported that he has not
made any new friends, nor did he have any family members in the area he
currently lived.
Robert never specifically said that he felt he was being “bullied”, but he
often discussed being excluded, ignored, and feeling misunderstood by his
peers. Robert discussed one instance where he attended a comic book club at
his undergraduate academic institution, and was told by others that he was
basically not welcome there. This instance, along with others, left Robert feel-
ing hopeless and resistant towards even attempting to socialize with his peers.
during grade school and early high school years can cause long-term loss of
self-esteem, with sensitivity to slights that can lead to problems at home in accept-
ing limit-setting, or with authority later in life. From client reports, those who
graduate from high school and enter the workforce are just as likely to experience
victimization as those who enter college life.
Consequently, bullying is an ongoing problem for ASD individuals regardless of
age, setting, or developmental stage. Furthermore, the bullying endured by this pop-
ulation in childhood can and often affects them throughout their life. In extreme
instances, these individuals can experience post-traumatic stress due to the bullying
they endured (Attwood, 2007).
Depression and aggression

Hurting people often also hurt people, and therefore it is not unlikely that
significantly depressed individuals may have thoughts of death, be it suicide or
homicide, and the school shooters (also known as “classroom avengers”) that our
society has experienced to date have had overwhelmingly similar characteristics to
those shared by individuals with ASD. Personal and psychological characteristics
include the following: mood is significantly depressed and expressed through anger,
sullen attitude, and social isolation; low tolerance for frustration and poor coping
skills to deal with emotions; appeared similar to others as children, but adults sensed
there was “something wrong” (teachers noticed these subtle differences, but par-
ents denied them); immature, socially inadequate loners with few friends; distrusts,
envies, and resents other teens who succeed in social groups; expresses boredom or
contempt for typical age-appropriate activities; rigid, inflexible mentality beyond
that of typical teens; not prone to extremes such as body piercing or tattoos, but
prefers military-style appearance that sets them apart from other students; external-
izes blame and perceives self as a victim/target of a system or group (DeBernardo
and McGee 1999).
In addition, they perceive themselves to have been rejected by their peers or
unfairly disciplined by teachers, administrators, or parents, which creates a narcissis-
tic superiority that is used to justify their aggression or violent behavior; therefore,
their motivation is revenge against those they believe have rejected them, and their
actions can be creative, well-rehearsed, and premeditated. Typical family character-
istics include: struggle to understand and connect with the child, even as early as
infant bonding and attachment complications; discipline that is inconsistent and/
or overly harsh; prevailing emotions of anger and hostility; poor sibling relation-
ships; and familiarity and proficiency with weapons that is commonplace within
the home (McGee and DeBernardo, 1999).
People don’t just “snap”; there are warning signs if someone is paying attention
that include the following: feeling victimized; deterioration of academic/work per-
formance; episodes of rage; fascination with violence, weapons, and killing; depic-
tion of violent themes through art, music, and writing; verbal threats of harming self
or others; exposure to real or imagined stressors and/or shame, ridicule, or public
humiliation; and rejection by peers or significant adults.
Helpful and harmful responses

There are unfortunately many harmful reactions that are used towards depressed
individuals with ASD, including reactions by those of family members and teachers
of the individual. These reactions may not even be done with bad intentions, but
out of lack of understanding, loss of hope, and exhaustion. They may believe the
person is only acting out or feeling depressed to get attention. In spite of this, even
if attention-seeking is part of their intention, that still is a warning that something
is not alright, and attention should be given to them. Attention-seeking behaviors
are simply the behavioral expressions of the underlying issues of low self-esteem,
lack of self-confidence, confusion, and hurt in a wounded individual who is expe-
riencing a tremendous amount of suffering. They may react to a depressed person's
low energy with criticism, yelling at the person for acting lazy or not trying harder.
They mistakenly believe that depression is just an attitude or a mood that a per-
son can shake off. Although it's important to be supportive, trying to cheer up an
individual or reasoning with him or her probably won't work to help depression
or suicidal feelings go away. Some people feel that they are weak in some way
because they are depressed, which can even be harmful if it causes them to hide
their depression and avoid getting help. Sometimes even people who are depressed
do not take their condition seriously. Depression can be so strong that it outweighs
a person's ability to respond to reason.
An individual with ASD who has been a victim of bullying and who is expe-
riencing depression will create coping mechanisms and patterns in order to be
resilient; sometimes the ways of coping are helpful, but sometimes they can be
harmful, despite the fact that they have allowed the individual to survive up until
that point. The only way a habit, pattern, or way of thinking and behaving can
be broken is if it is replaced with something else that works better for that per-
son. Therefore, professional counseling and appropriate therapeutic treatments
should be used immediately and consistently when a person is showing signs of
depression and/or thoughts of harming him/herself or someone else.
Beginning the journey to finding an effective and healthier coping mechanism
can be a very scary step for the individual to take, so it will require much patience,
support, and empathy on the part of the significant people in the individual’s life.
People are better able to deal with tough circumstances when they have at least
one person who believes in them, wants the best for them, and in whom they can
confide. The smallest interaction on a personal level can make a big impression and
leave a hurting individual feeling like someone cares, opening the door for them to
return if they need an adult to talk to in the future. Just talking about it may help
the person to feel less alone, less isolated, and more cared about and understood,
and talking may provide a chance to consider that there may be another solution.
Connecting with an individual on the Autism Spectrum can be accomplished using
the following listening techniques:
• Find a safe, non-judgmental space to talk.

• Connect through activity or play.
• Make brief statements and wait for a response.
• Honor the need for silence.
• Be quiet and really listen.
• Look for pain and fear behind aggression and anger.
• Convey admiration for the individual.
TABLE 3.1 Steps for reducing bullying victimization in students with ASD
Step Things to do
Step 1. Plan and develop a Cooperative work between teachers and

bullying program for students parents of students with ASD either by direct
with ASD meeting with parents or indirect meeting with
parents
Identify an individual student’s needs
Create multiple scenarios using the ABC
recording system (antecedent event–
behavior–consequence event)
Step 2. Educate the individual Provide students with ASD education about
student about bullying bullying
Discuss with these students what bullying
behavior entails in a concrete approach
Step 3. Teach how to cope with Introduce these skills explicitly and systematically
and report bullying to adults in in a controlled environment
a controlled environment and Utilize various types of behavior strategies (video
practice modeling, social story, role-play)
Train students with ASD on how to report
potential bullying incidents
Step 4. Teach controlled Provide opportunities to practice skills in a less

generalization controlled small group and finally in a larger
group environment
Include other students and siblings as a practice
partner in practice
Break down skills into components
Step 5. Implement a monitoring Plan how to monitor the program

system Develop a monitoring system (self-monitoring,
parents’ daily report card)
Check the students’ progress regularly
Source: Hong, E. R., Neely, L., and Lund, E. M. (2015). Addressing bullying of students with
Autism: Suggestions for families and educators. Intervention in School and Clinic, 50(3), 157–62.
doi:10.1177/1053451214542047.
Preparing students with ASD for bullying situations begins with education and
is maintained through training both students and teachers how to respond to bul-
lying or disrespectful behavior. Hong et al. (2015) constructed a step-wise model to
prevent and deal with victimization in a school setting (see Table 3.1):
Individuals with ASD and their caregivers can begin to decrease the risk of ASD
victimization and bullying by becoming educated about bullying, learning how to
cope with bullying, teaching controlled generalization, implementing a monitoring
system at school, and planning and/or participating in a prevention program.
Prevention program: A case study

Located at a counseling center on a university campus, weekly counseling groups
were held for a large cohort of adults with ASD. Participation in the groups was
not mandatory for these individuals; however, many of them chose to participate
in these groups for multiple terms. Most of these young adults had few or no
friends, and group members in the weekly counseling groups discussed their
lack of social relationships and how the lack of friendships affected their lives.
The research team consisted of a lead professor and several interns in the
university’s Masters of Counseling program. Together they created four highly
specialized processing groups that focused on the following topics with the
respective team names. The group “Teambuilding Taskforce” consisted of social
males participating in their first group curriculum which focused on increasing
social awareness, building peer empathy, and learning teamwork and cohesiveness.
The “Social Skills Squad” was a group consisting of quieter males participating
in their first curriculum which focused on self-understanding and interper-
sonal learning, extrapolating feelings and internal thinking processes, learning
self-catharsis, and increasing self-esteem. The “Communication Nation” was a
group of males who had successfully completed a previous group curriculum
and wished to continue participation in more advanced groups that focused on
engaging their strengths, finding community, and working to achieve fulfilled
lives. The “Female Force” was a female-specific group focusing on the unique
experiences that females with ASD encounter and supporting the differences
they have from their male counterparts. Each group had two co-facilitators and
between four and nine group participants, depending on the level of functioning
relative to each individual.
The counseling groups were aimed at increasing group members’ overall
well-being through strengthening their team building, social functioning, and com-
munication skills. The groups were primarily activity based. Typically, group facili-
tators assisted group members in completing a weekly activity and then processing
the activity as a group. Themes of the weekly sessions included self-esteem, social
development, verbal and nonverbal communication, feedback, encouragement, and
more. The theme and weekly activity for each group was specially chosen by the
group facilitators to meet the needs of the group; therefore, each group typically
had a different activity each week.
The researchers examined the impact of weekly group counseling on the
participants for the purpose of showing how powerful social inclusion can be
on the participants’ lives. To do this, the researchers assessed groups members’
functioning in multiple areas of their lives before they began participation in
the groups, and again after they completed eight weeks of participation in the
groups, which marked the conclusion of a group’s term. Holistic areas examined
included social life, view of self, school and work life, overall functioning, and
more. Furthermore, the researchers surveyed group members at the conclu-
sion of each week’s group session, asking them to note their current feelings,
rate their level of engagement during the group session, and identify other
characteristics relating to the weekly group session.
Social inclusion of participants

The research showed that these counseling groups were advantageous to indi-
viduals with ASD for numerous reasons. The counseling groups allowed these
young adults an opportunity to have regular contact with other similar-minded
individuals, an outlet in which they were able to discuss the daily strengths
and struggles in their lives, and an opportunity to gain a social network with
individuals who ideally did not judge them for the ASD characteristics they
possessed.
The research found that group members made significant progress in building
social skills through encouraging direct peer interaction and empathy towards
other group members. Furthermore, group participants reported an increase in
reported number of friends, an increase in ability to confront others and express
one’s emotions, an increase in sense of social cohesiveness as a group, and an
overall increase in self-esteem and self-confidence. The groups as a whole also
made significant progress in demonstrating increased teamwork and cohesive
skills through games and other team-building activities. These changes were
both reported by the group participants themselves and observed by the group
facilitators of all of the counseling groups.
CASE STUDY: AMELIA
Amelia initially came in for help with identity confusion, gender dysphoria,
and shame resulting from a lifetime of rejection, stigmatization, and bullying.
Amelia participated in the specialized technology program institute across the
courtyard from the university counseling clinic, and she sought services at
the clinic to work on coming out to peers and staff as transgender transition-
ing from male to female. Along with concurrent individual therapy, Amelia
joined the all-female group that focused on social skills, teambuilding, and
emotionally focused processing of previous social trauma. Initially, Amelia's
disposition was not unlike many individuals diagnosed with ASD: very little
eye contact, slow speech, and awkward sentence structure accompanied with
tonal patterns that did not match what was being said. Many times the group
facilitators found themselves wondering if they were being made fun of only
to later understand that Amelia's voice reflected her sarcastic humor, and
creative internal world.
(continued)
Not unlike many individuals with ASD, Amelia experienced bullying and
marginalization throughout middle school and high school due to her
communication and social deficits. She conveyed to me many times the strug-
gle of social interaction—never implying she did not want to socialize—and
worried that no one would ever accept her. During her individual therapy
time, she worked on what identity meant to Amelia and the issues surround-
ing the intimidating process of coming out to her family and peers. By helping
Amelia understand her own desire for emotional and social growth through
meeting her needs in the present moment during individual therapy, she was
able to create and experience a safe environment that allowed her to feel
comfortable enough to explore a different and more intimidating social
setting: group counseling.
For the purpose of processing their reactions, which could unintention-
ally be hurtful to Amelia, the female participants were told that a new group
member would be joining their group, and this individual was a transgender
woman seeking support and acceptance, just as they all had in joining this
particular group. Reactions were mixed, as with any social setting. However,
upon Amelia entering the group, the participants presented a bracelet to
Amelia tagged with the heartfelt message, “This is your confidentiality brace-
let; we promise to keep this group safe for you.”
While Amelia was in the female group, she found that other group mem-
bers were much more accepting than she originally imagined. Through indi-
vidual and group therapy, Amelia's belief that she was unwanted, abnormal,
and an outcast was challenged, if not contradicted, by being accepted by
both her counselor and other group members. “It's the first time in years I've
felt seen,” she said.
CASE STUDY: NATHAN
Nathan presented to group counseling at the counseling center with con-

cerns regarding his difficulty relating to and communicating with his family
members and friends. He struggled to maintain interpersonal connections
throughout the group sessions, and group members would often become
angered with him for his inappropriate comments and untimely interruptions.
For example, Nathan once interrupted the group by taking out his phone and
trying to show the facilitators his pictures and video clips while another group
member was sharing an intimate self-disclosure statement. Group members
frequently let their dissatisfaction with Nathan and his rude behaviors be
known, as they would frequently discuss their frustrations with Nathan during
the group sessions, as well as with the facilitators at the conclusion of group
sessions.
The last week of group, Nathan and his fellow members participated in
an activity called “Fill Me Up.” In this activity, group members were asked to
create a paper bag with two sides. On one side of the bag they were asked
to write down the traits that they brought to the group. On the other side
of the bag, group members were asked to write benefits they got from the
group (i.e., things that they learned throughout the group process, things
they gained from being a member in the group, etc.). Nathan completed
this activity two times, at the conclusion of two eight-week group sessions in
which he participated. In both of the times that he participated in the activity,
the one thing Nathan wrote was that what he gained from the group was
friends.
Nathan’s group facilitators believed that being a member of the coun-
seling group was the very first time Nathan felt accepted by his peers and
felt like he truly belonged in a group. At the end of Nathan’s time in group
counseling, he hugged his two group facilitators and told them that he
would miss them. The facilitators believed that this behavior was a direct
result of Nathan’s feelings of belonging and safety within the group, both
with the facilitators and with the group members.
Success stories
The researchers witnessed great success from the counseling groups. The major-
ity of the group members benefitted from participating in group counseling and
reported that they greatly enjoyed their time in the groups. Many chose to par-
ticipate in the groups for several terms, and all participation was self-initiated. The
following case studies are just two of the many examples which show the effective-
ness of group counseling and social inclusion for the ASD population.
Future needs
Further research is needed to explore additional benefits of counseling groups
for individuals with ASD. Literature reviews demonstrate the lack of research
connecting adults with ASD who have experienced bullying and depression, and
strategic, empirically based programming towards intervention for this subject
and population is either unknown or unavailable. Specifically, the researchers
believe it would be worthy to pursue identification of the beneficial piece(s)
of the counseling groups to the participants, be it the increase in social activity,
the comradery of the peer cohort, the accessibility of group facilitators as a sup-
port system, involvement in diverse activities linked to social skill building and
teamwork, the healthy release of emotions, the sharing of similar strengths and
challenges, or the process of counseling itself.
The researchers also suggest creating and studying a set, unchanging curricu-
lum to determine if benefits change or increase when the curriculum is repeated
on a consistent basis, and for multiple cohorts of individuals. Such a standardized
curriculum could allow for the dissemination of research and results to a larger
population and help towards the prevention of bullying, depression, and social
vulnerability experiences for all individuals with ASD.
References
Attwood, T. (2007). A complete guide to Asperger’s syndrome. London: Jessica Kingsley.
Cappadocia, C. M., Weiss, J. A., and Pepler, D. (2012). Bullying experiences among children
and youth with autism spectrum disorders. Journal of Autism and Developmental Disorders,
42(2), 266–77. doi:10.1007/s10803-011-1241-x
Cappadocia, M. C. and Weiss, J. A. (2011). Review of social skills training groups for youth
with Asperger Syndrome and high functioning Autism. Research in Autism Spectrum
Disorders, 5(1), 70–8. http://dx.doi.org/10.1016/j.rasd.2010.04.001
Carter, S. (2009). Bullying of students with Asperger syndrome. Issues in Comprehensive
Pediatric Nursing, 32(3), 145–54. doi:10.1080/01460860903062782
DeBernardo, C. R. and McGee, J. P. (1999). Preventing the classroom avenger’s next attack:
Safeguarding against school shootings. On The Move With School-Based Mental Health,
4(2), 1–5.
Delfabbro, P.,Winefield,T.,Trainor, S., Dollard, M.,Anderson, S., Metzer, J., and Hammarstrom,
A. (2006). Peer and teacher bullying/victimiation of South Australian secondary school
students: Prevalence and psychosocial profiles. British Journal of Educational Psychology,
76(1), 71–90. doi:10.1348/000709904X24645
Erikson, E. H. (1980). Identity and the life cycle. New York: Norton.
Fekkes, M. (2006). Do bullied children get ill, or do ill children get bullied? A prospec-
tive cohort study on the relationship between bullying and health-related symptoms.
Pediatrics, 117(5), 1568–74. doi:10.1542/peds.2005-0187
Forero, R., McLellan, L., Rissel, C., and Bauman, A. (1999). Bullying behavior and psycho-
social health among school students in New South Wales, Australia: Cross sectional study.
British Medical Journal, 319, 344–8.
Hong, E. R., Neely, L., and Lund, E. M. (2015). Addressing bullying of students with Autism:
Suggestions for families and educators. Intervention in School and Clinic, 50(3), 157–62.
doi:10.1177/1053451214542047
Little, L. (2002). Middle-class mothers’ perceptions of peer and sibling victimization
among children with Asperger’s syndrome and nonverbal learning disorders. Issues in
Comprehensive Pediatric Nursing, 25(1), 43–57. doi:10.1080/014608602753504847
Nansel, T. R. (2001). Bullying behaviors among US youth: Prevalence and association with
psychosocial adjustment. JAMA: The Journal of the American Medical Association, 285(16),
2094–2100. doi:10.1001/jama.285.16.2094
Roekel, E., Scholte, R. H., and Didden, R. (2010). Bullying among adolescents with autism
spectrum disorders: Prevalence and perception. Journal of Autism and Developmental
Disorders, 40(1), 63–73. doi:10.1007/s10803-009-0832-2
Tantam, D. (2012). Autism spectrum disorders through the life span. London: Jessica Kingsley.
Zablotsky, B., Bradshaw, C. P., Anderson, C. M., and Law, P. (2014). Risk factors for bully-
ing among children with autism spectrum disorders. Autism: The International Journal of
Research and Practice, 18(4), 419–27. doi: 10.1177/1362361313477920
4
IDENTITY FORMATION IN
INDIVIDUALS WITH ASPERGER
SYNDROME
Caitlin van der Walt
Asperger Syndrome
Around 1943, when Leo Kanner was positing the existence of a syndrome that has
since come to be called Autism, a physician from Vienna published a description of
a similar group of children he had observed in his medical practice who presented
with impaired communication and social interaction skills (Asperger, 1944). This
physician’s name was Hans Asperger. Asperger identified a consistent pattern of
different behaviours and abilities shared by these children that included “a lack of
empathy, little ability to form friendships, one-sided conversations, intense absorp-
tion in a special interest and clumsy movements” (Attwood, 1998, p. 11).
Despite the seminal use of Asperger’s paper throughout Europe in diagnos-
ing and assessing persons with the disorder, the term Asperger Syndrome was not
coined until Asperger’s work was translated into English. Gillberg published the
first diagnostic criteria for Asperger Syndrome in 1989, with revisions in 1991
(Gillberg, 1991; Gillberg and Gillberg, 1989). Later, in 1994, came the recognition
of Asperger’s work by the American Psychological Association with the inclusion
into the DSM-IV manual (APA, 1994) of 299.80 Diagnostic Criteria for Asperger’s
Disorder. Combined with autistic disorder, Rett’s disorder, childhood disintegra-
tive disorder and pervasive developmental disorder not otherwise specified (PDD-
NOS), Asperger’s Disorder was now formally a part of the spectrum of Autism
disorders.
The criteria for Asperger’s Disorder or Asperger Syndrome (AS) revolved
around two impairments: first, a focus on social interactions and second, a focus on
restricted and repetitive behaviour movement patterns, with the remainder of the
criteria ruling out Autism as an option (APA, 1994). The social interactions cate-
gory highlighted an inability for individuals to display appropriate social behaviours,
such as eye contact, appropriate facial expressions and the use of other non-verbal
46 Caitlin van der Walt
forms of communication. The repetitive behaviours category drew attention to

movements that are repetitive and stereotyped, such as hand flapping, together with
a persistent obsession with an acquired interest (APA, 1994).
Recent changes to the diagnostic criteria as a result of the publication of
DSM-V (APA, 2013) have resulted in Asperger Syndrome and other spectrum dis-
orders being subsumed into one diagnostic category, Autism Spectrum Disorder.
The changes to diagnostic criteria support the view of a number of researchers
(Attwood, 2004; Sansosti and Sansosti, 2012) that Asperger Syndrome is not an
essentially different disorder from Autism, but a variant of Autism located on the
spectrum of autistic disorders.The American Psychiatric Association (2013) believes
that by implementing an ‘umbrella disorder’ an improvement in the diagnoses of
ASD will be seen, making the diagnostic system clearer. It is argued that the use of
a continuum would be more beneficial in targeting the specific patterns of needs
presented by individuals, rather than ‘forcing’ individuals’ behaviours into specific
categories, such as AS (Tsai, 2012).
Contrastingly, other studies (Gibbs, Aldridge, Chandler, Witzlsperger and Smith,
2012) have considered the subset of individuals who, previously diagnosed with AS
under the DSM-IV, will no longer meet the criteria under the DSM-V, potentially
leaving individuals with significant AS-like characteristics undiagnosed. Recent
studies raise concern as to how the changes to diagnostic criteria found within the
DSM-V will impact early intervention programs, reducing funding and support
for this subset of individuals, which they previously received under the DSM-IV.
However, Giles (2014) has drawn attention to the individuals themselves, examin-
ing how these changes may affect their identity, proposing the idea that “. . . diag-
nostic criteria are not an arbitrary means of classifying psychiatric patients, but a
blue print for a social identity” (p. 180).
What is identity?
Identity is a complex and ongoing process that provides insight into a person, deter-
mining how others view them and how they come to understand and view them-
selves (Shakespeare, 1996). A social constructivist view of identity believes a person
demonstrates altered identities specific to their associated social relationships (Bagatell,
2007), indicating that identity is a continually changing notion, highly dependent on
one’s social environments. Further, it is believed that an individual’s self-concept is
influenced, both negatively and positively, through their memberships with various
groups (Turner, 1999). Holland, Lachicotte, Skinner and Cain (1998) presented the
idea that individuals have the capacity to act upon their own world and become
“social products” and “social producers” of their lives (p. 42), highlighting the power
and control one can have in the formation of their identity. This notion of identity
emphasises the complexity of the ongoing social processes involved in the formation
of identities, as they are continually constructed, challenged, adjusted and changed.
Giles (2014) suggests that individuals who believe their diagnosis forms part of
their selfhood and who believe they are at risk of losing their diagnosis may be fearful
Identity formation in individuals with AS 47
of the loss of their identity. Individuals with AS, for example, believe their diagnosis
gives reason for their noticeable differences and ‘abnormal’ behaviours. Macleod,
Lewis and Robertson (2013) highlight the positive connection between individuals
and their AS identity, stating that individuals expressed a desire to understand and
gain knowledge about themselves, which was made more accessible through their
diagnosis of AS. Furthermore, Fein (2012) found participants in his study considered
AS to be a part of who they were rather than a separate disease or illness, with the
strong belief that without their diagnosis they would not be the same person.
The stigma and discourse imposed on groups by those outside of the group
may affect the process of identity formation due to the negativity it can create.
Nario-Redmond, Noel and Fern (2013) suggest that stigma and discourse can pose
challenges to maintaining a positive self-identity, particularly when the individual
is concerned about their differences. Although this stigma and discourse may be
deemed as powerful, it does not dictate one’s identity (Bagatell, 2007). Ellemers,
Spears and Doosje (2002) suggest that if a group is devalued or stigmatised in soci-
ety, the social identity of the individuals associated with the group is weakened and
jeopardised.
Limited attention has been given however to the importance of social identity
in individuals diagnosed with AS. Charland (2004) states that as quickly as a psychi-
atric label can be bestowed on an individual, it can be taken away or significantly
changed, creating concerns for individuals who highly identify with their diagnosis.
Several studies have looked at the role and power a diagnosis has in the construction
of a person’s identity, with findings indicating a strong sense of identity formation
around the diagnosis of AS (Giles, 2014; Macleod and Johnston, 2007; MacLeod
et al., 2013). Beart, Hardy and Buchan (2005) argue the power of label identity
has been overlooked in previous years, stating disability identity has “. . . become
a person’s primary identity, over-riding other identities. . . ” (p. 49). This aspect of
identity leads to the question as to how changes to the DSM-IV (APA, 1994) diag-
nostic criteria may affect the identity of individuals with a current diagnosis of AS.
In order to gain an insight into the meaning of AS identity formation, indi-
viduals with AS need to be provided the opportunity to voice their experience
and journey to self-acceptance. Shakespeare (1996) likens one’s identity to the “. . .
stories we tell to ourselves and to others” (p. 95), emphasising the necessity to
provide the individual with an opportunity to tell their story. Recent research
involving individuals with AS have moved toward involving more interviews with
the individuals to provide greater insight and understanding of the experiences
and journeys associated with their diagnosis of AS (Harrington, Foster, Rodger
and Ashburner, 2013). Dhunpath (2000) suggests that this insight can be achieved
through the implementation of a life history framework, which can provide a more
in depth and intimate account of the individuals’ experiences, viewing the topic
from a personal perspective. The remainder of this chapter will discuss outcomes
from a small research study that investigated the connection one individual had
with his AS diagnosis and the potential effects the changes in diagnostic criteria
found in the DSM-V may have had on his self-identity.
Methodology
The study employed a life history framework in an attempt to gain a greater insight
into the formation of an individual’s identity. The life history framework high-
lighted the importance of considering personal recounts and narratives in estab-
lishing the relationship between identity construction and a diagnosis of AS. The
value life history methodology contributes to qualitative research is supported by
Dhunpath (2000), who states that one’s life is constructed through narratives, rep-
resenting lived experiences through personal stories.
Participants
Two participants were involved in this study, Anne and Max. Max was a 14-year-old
male with a diagnosis of Asperger Syndrome. Max had known of his diagnosis for
several years. Max lived at home with his parents and a younger sibling. He attended
his local mainstream secondary school, a place he liked. His mother, Anne, was also
interviewed to corroborate and provide extension to Max’s responses.
Procedure
Studies exploring identity utilise interviews as the foundation of their research,
allowing the perspectives and experiences of the individuals to be conveyed and
considered (MacLeod and Johnston, 2007). To this end, two interviews were
conducted with Max, both in his home, and one interview with Anne. All were
audio-recorded and later transcribed prior to analysis. The results were analysed
using grounded theory analysis methods, a systematic, qualitative procedure that is
used to generate a theory to explain a concept or process about a particular topic.
This process of analysis is particularly significant and useful for topics around iden-
tity, self and meaning (Charmaz and McMullen, 2011) making it relevant for the
design of this study. Interviews were coded, identifying the concepts, actions and
processes highlighted by the participant in each of the interviews (Stern, 1980).
Data were then synthesised into broader categories. By determining which catego-
ries were the most significant in the data, together with evaluating the content of
the subsequent categories (Harry, Sturges and Klingner, 2005), the most predom-
inant and significant categories that emerged were social identity and self-identity.
Findings
Max’s account highlighted how his past experiences, revolving around his AS diag-
nosis, shaped his identity, both personally and socially. The findings suggested a
strong relationship between Max’s identity and his diagnosis of AS, with him stat-
ing, “it [AS] is what I use to define myself . . . it is who I am.” This strong sense of
connection with his diagnosis was further highlighted through his response toward
the suggestion of the possible removal of his diagnosis of AS. Max replied, “. . . to be
honest with you I don’t think you could take it away, it’s what I use to define
myself.”
Self-Identity
Throughout the interviews Max expressed pride in his diagnosis and made strong
connections between AS and his self-identity. He reported considerable signifi-
cance on the importance of his diagnosis of AS, making many references to it as
part of who he is and what it means to him, “. . . I am proud of it . . . it’s just who
I am.” Anne, Max’s mother, affirmed that Max “. . . wears the badge [of AS] with
pride . . .” and is not ashamed of who he is, enjoying the fact that he is an individual
and not feeling the pressure of having to fit into the ‘teenage norm’. By embracing
his individuality, Max displayed a sense of self-worth that illustrated how he has
positively embraced his diagnosis of AS, suggesting that it is what makes him, him.
The acceptance of and comfort with his AS diagnosis, displayed through Max’s
responses, appears to stem from his understanding of self. These findings support
those of Punshon, Skirrow and Murphy (2009), whose results indicated the neces-
sity of gaining self-understanding for individuals with AS from an early age, and
the subsequent contribution of this self-understanding to the formation of a pos-
itive self-identity. It is apparent that Max’s diagnosis of AS provides for him an
explanation for his differences, equipping him with the knowledge required to be
accepting of and at peace with himself. Through this understanding Max is able to
form his identity, knowing how he ‘fits in’ and how his role in society may differ
compared to the role of others around him. In his interview, Max stressed that his
diagnosis helped him on his journey to accepting himself as he believed it gave
him reasons as to why he behaved the way he did, stating, “. . . it [AS] helped me
understand myself a bit better.”
It is through understanding and acceptance that individuals form their self-
identity, suggesting that AS is not simply something an individual has, but rather
a fundamental part of who they are (Bagatell, 2007). Max still recalls how he was
told about his diagnosis: “. . . technically I learnt about it one day before school
when I was complaining about my friends. . . .” Anne supports this recall of events,
remembering how she told Max about his AS after a friend was not interested in
playing with him anymore. Both Max and Anne implied that this event supported
the development of his identity as he learnt it [AS] was part of him, providing him
with a reason to be proud of his individuality.
When referring to himself, Max displayed confidence in who he was and his
diagnosis of AS, which Anne confirmed, stating that he is very secure and com-
fortable about his individuality and differences. Max highlighted his enjoyment
of being different, expressing, “. . . often I really enjoy actually being my own sort
of person . . .” which further emphasises the value he places on his self-identity.
Despite the pride and acceptance displayed when referring to himself and his per-
sonal identity, it was evident that at times Max’s pride and comfort did not filter
into his school life. This raises questions around his social identity and how he
perceives himself in this social environment.
Social identity
The ignorance of peers toward AS caused the most upset and concern for Max.
Throughout the interviews, the concern of peer ignorance and prejudice toward
AS, and therefore him, was highlighted by Max, implying his pride and acceptance
of himself was at times threatened by social reactions. It was clear that his social
identity was at times jeopardised due to the reactions of peers around him. Ellemers
et al. (2002) offer support, suggesting that individuals are more likely to identify
with a particular group if people around them have a greater understanding of the
group’s context. When Max was questioned about whether or not he liked having
a label of AS he responded, “I like it, but I wouldn’t tell my friends about it.” This is
a personal choice that has been shaped by his past experiences, which can be con-
cluded from his response, “. . . I don’t exactly like being insulted because of people
who are ignorant. . . .”
When interviewing Anne, it was apparent Max had been concerned about the
stigma associated with AS. Anne suggested that Max’s social insecurities derived
from the ignorance displayed by peers “. . . who tease him about his syndrome, often
calling him ‘Downs’ as Down syndrome is the only syndrome they are aware of. . . .”
This supports Max’s concerns that the ignorance of his peers is what leads to the
prejudices that are formed against him.These experiences have seen Max not being
true to himself in social situations, with Anne reporting, “. . . I can see it [insecurity]
when he says hello to peers as he is not himself and is trying to put on a face to fit
into the social norms. . . .” Punshon et al. (2009) found the same concerns, suggest-
ing that due to past social events where bullies targeted them, participants became
withdrawn from social interactions as a form of coping with the social pressures.
Campbell, Ferguson, Herzinger, Jackson and Marino (2004) indicated the need for
peer awareness and knowledge of AS in order to create a positive and inclusive
environment for individuals with AS, with their findings indicating a significant
difference in peer attitudes as a result.
Discourse that creates stigma often associated with AS causes further opportu-
nity for prejudices to be formed about it. Throughout the interview, Max com-
pared the prejudice of peers against AS to that of racism, expressing that “. . . being
insulted like that [due to ignorance] is sort of like racism to me”. This sends a
powerful message as it provides a comparison for people to engage in and relate to.
Max continued to state, “racism is relevant in schools . . . drug education is relevant
in school . . . why can’t Asperger syndrome education be relevant you know. . . .”
Anne explained, “. . . he has spoken to one of the psychologists at the school and has
suggested that AS should be covered during personal and health education, just like
racism is discussed, as he believes this may create a better awareness and therefore
suppress the ignorance.”
The analogy to racism was further expressed through Max’s desire for people to
understand and accept his diagnosis. Throughout the interview, techniques such as
questioning and relatable comparisons were used by Max to ensure the interviewer
had a clear understanding of how he felt. When explaining the prejudices people
had against him he asked the question, “Would you like it if someone insulted your
country in front of you?” This drew the researcher in, allowing them to connect
with the point Max was trying to make, emphasising the importance for others to
understand him and accept his differences for whom he is. MacLeod and Johnston
(2007) agree, reporting that individuals with a diagnosis have a desire to share their
experiences with professionals, thus providing an in-depth understanding of how
a diagnosis of AS contributes to their identity and what challenges they are faced
with as a result.
Although Max highlighted a range of concerns regarding the acceptance of
AS amongst his peers, it is evident that his connection to AS and his identity is
remarkably strong. During the interview he repeatedly stated, “it is what I use to
define myself . . . how would you define me, how would you define my differ-
ence?” This response further illustrates the role AS has had in Max’s journey of
self-understanding.
Through this current study, it can be implied that the subset of individuals who
will no longer be diagnosed with AS under the DSM-V may be impacted emo-
tionally due to a lack of understanding regarding their differences, impacting the
formation of their identity.
Future directions
This study involved a young adult and his mother. Conclusions about a whole
population cannot be drawn as the findings are only based on one individual’s
experiences (Zhan and Ottenbacher, 2001). Further studies in the field focusing on
multiple participants will help overcome these limitations, allowing more general
conclusions to be drawn. Due to the limited availability of studies associated with
identity and AS, further research concentrating on identity formation in individuals
with AS is needed. A larger scale study will allow greater generalised conclusions to
be drawn around identity formation.
Conclusion
Max’s explanations and reflections are of significant value to gaining insight and
understanding of individuals with AS. Due to the changes in diagnostic criteria,
it is important to have an understanding of how a diagnosis of AS has facilitated
in the construction of this subset of individuals’ identity and what the impacts
may be without this diagnosis and label. The findings indicate a strong connection
between a diagnosis of AS and identity formation, with the diagnosis allowing Max
to become accepting and proud of his individuality.
References
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders.
Fifth edition. Washington, D.C.: American Psychiatric Association.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders.
Fourth edition. Washington, D.C.: American Psychiatric Association.
Asperger, H. (1944). Die autistischen Psychopathen im kindesalter. Archiv fur Psychiatrie und
Nervenkrankheiten, 177, 76–136.
Attwood, T. (2004). Strategies to reduce the bullying of young children with Asperger syn-
drome. Australian Journal of Early Childhood, 29(3), 15–23.
Attwood,T. (1998). Asperger’s syndrome: A guide for parents and professionals. London, UK: Jessica
Kingsley Publishers.
Bagatell, N. (2007). Orchestrating voices: Autism, identity and the power of discourse.
Disability and Society, 22(4), 413–26. doi: 10.1080/09687590701337967
Beart, S., Hardy, G., and Buchan, L. (2005). How people with intellectual disabilities view
their social identity: A review of the literature. Journal of Applied Research in Intellectual
Disabilities, 18(1), 47–56. doi: 10.1111/j.1468-3148.2004.00218.x
Campbell, J. M., Ferguson, J. E., Herzinger, C. V., Jackson, J. N., and Marino, C. A. (2004).
Combined descriptive and explanatory information improves peers’ perceptions of autism.
Research in Developmental Disabilities, 25(4), 321–39. doi:10.1016/j.ridd.2004.01.005
Charland, L. C. (2004). A madness for identity: Psychiatric labels, consumer autonomy, and
the perils of the Internet. Philosophy, Psychiatry, and Psychology, 11(4), 335–49. doi:10.1353/
ppp.2005.0006
Charmaz, K., and McMullen, L. M. (2011). Five ways of doing qualitative analysis: Phenomenological
psychology, grounded theory, discourse analysis, narrative research, and intuitive inquiry. New York:
Guilford Press.
Dhunpath, R. (2000). Life history methodology: “Narradigm” regained. International Journal
of Qualitative Studies in Education, 13(5), 543–51. doi:10.1080/09518390050156459
Ellemers, N., Spears, R., and Doosje, B. (2002). Self and social identity. Annual Review of
Psychology, 53, 161–86. doi:10.1146/annurev.psych.53.100901.135228
Fein, E. (2012). The machine within: An ethnography of Asperger’s Syndrome, biomedicine, and the
paradoxes of identity and technology in the late modern United States. University of Chicago,
Division of the Social Sciences, Department of Comparative Human Development.
Gibbs, V., Aldridge, F., Chandler, F., Witzlsperger, E., and Smith, K. (2012). Brief report: An
exploratory study comparing diagnostic outcomes for autism spectrum disorders under
DSM-IV-TR with the proposed DSM-5 revision. Journal of Autism and Developmental
Disorders, 42(8), 1750–56. doi:10.1007/s10803-012-1560-6
Giles, D. C. (2014). “DSM-V is taking away our identity”: The reaction of the online com-
munity to the proposed changes in the diagnosis of Asperger’s disorder. Health, 18(2),
179–95. doi:10.1177/1363459313488006
Gillberg, C. (1991). Clinical and neurobiological aspects of Asperger syndrome in six family
studies. In U. Frith (ed.), Autism and Asperger syndrome. Cambridge: Cambridge University
Press, pp. 122–46.
Gillberg, C., and Gillberg, I. C. (1989). Asperger Syndrome – some epidemiological con-
siderations: A research note. Journal of Child Psychology and Psychiatry, 30(4), 631–8.
doi:10.1111/j.1469-7610.1989.tb00275.x
Harrington, C., Foster, M., Rodger, S., and Ashburner, J. (2013). Engaging young people with
Autism Spectrum Disorder in research interviews. British Journal of Learning Disabilities,
42(2), 153–61. doi:10.1111/bld.12037
Harry, B., Sturges, K. M., and Klingner, J. K. (2005). Mapping the process: An exemplar of
process and challenge in grounded theory analysis. Educational Researcher, 34(2), 3–13. doi:
10.3102/0013189X034002003
Holland, D., Lachicotte, W., Skinner, D. and Cain, C. (1998). Identity and agency in cultural
worlds. Cambridge, MA: Harvard University Press.
MacLeod, A., Lewis, A., and Robertson, C. (2013). “Why should I be like bloody Rain
Man?!” Navigating the autistic identity. British Journal of Special Education, 40(1), 41–9.
doi:10.1111/1467-8578.12015
MacLeod, A., and Johnston, P. (2007). Standing out and fitting in: A report on a support
group for individuals with Asperger syndrome using a personal account. British Journal of
Special Education, 34(2), 83–8. doi:10.1111/j.1467-8578.2007.00460.x
Nario-Redmond, M. R., Noel, J. G., and Fern, E. (2013). Redefining disability, re-imagining
the self: Disability identification predicts self-esteem and strategic responses to stigma. Self
and Identity, 12(5), 468–88. doi:10.1080/15298868.2012.681118
Punshon, C., Skirrow, P., and Murphy, G. (2009). The not guilty verdict: Psychological reac-
tions to a diagnosis of Asperger syndrome in adulthood. Autism:The International Journal of
Research and Practice, 13(3), 265–83. doi:http://dx.doi.org/10.1177/1362361309103795
Sansosti, J. M. and Sansosti, F. J. (2012). Inclusion for students with high functioning autism
spectrum disorders: Definitions and decision making. Psychology in the Schools, 49(10),
917–31. doi:10.1002/pits.21652
Shakespeare, T. (1996). Disability, identity and difference. In C. Barnes and G. Mercer (Eds.)
Doing Disability Research (pp. 94–113). Leeds, UK: The Disability Press.
Stern, P. N. (1980). Grounded theory methodology: Its uses and processes. Image, 12(1), 20–3.
doi:10.1111/j.1547-5069.1980.tb01455.x
Tsai, L. Y. (2012). Sensitivity and specificity: DSM-IV versus DSM-5 criteria for autism
spectrum disorder. American Journal of Psychiatry, 169(10), 1009–11. doi: http://dx.doi.
org/10.1176/appi.ajp.2012.12070922
Turner, J. C. (1999). Some current issues in research on social identity and self-categorisation
theories. In N. Ellmers, R. Spears and B. Doosje (eds.), Social identity: Context, commitment,
content. Oxford: Blackwell.
Zhan, S., and Ottenbacher, K. J. (2001). Single subject research designs for disability research.
Disability and Rehabilitation, 23(1), 1–8. doi:10.1080/09638280150211202
PART II
Social inclusion across the
educational environment
5
SOCIAL INCLUSION IN THE
EARLY YEARS
Janice K. Lee, Jaclyn Joseph, Phillip Strain and Glen Dunlap
A child’s first relationships develop from birth through early-established social

interactions with caregivers. These first relationships are necessary for survival
and form the basis for later social-emotional growth and development. Healthy
social-emotional development allows children to develop and maintain recipro-
cal and trusting relationships with others, effectively communicate, identify and
manage emotions, play and learn from their environment (Zero to Three, 2014).
Generally speaking, children who are typically developing learn and develop these
social and emotional skills without systematic supports.
For children diagnosed with Autism Spectrum Disorder (ASD), these early
social-emotional skills may not develop even when in supportive environments
with nurturing relationships. For individuals with ASD, social-emotional devel-
opment is delayed, and in fact, deficits in this domain are required for a diag-
nosis of ASD. Furthermore, when these early relationships do not develop in a
socially acceptable manner, the deficits continue to increase and early interven-
tion becomes vital for diminishing the effects of these deficits through targeted
instruction in social-emotional skills and competencies. In order for young chil-
dren with ASD to learn and practice these skills and develop competence and
fluency in the social-emotional domain, they need to be included with typi-
cally developing peers in supportive environments with nurturing relationships
(Strain, 2014).
As with any skill, be it in sports or a specific occupation, learning and practicing
the skills in the environment in which those skills will be used is essential. Isolating
or excluding young children with ASD from their typically developing peers will
only serve to exacerbate their deficits in social-emotional development (Strain,
2014). The natural environment provides limitless natural occasions for encounter-
ing typical social interactions that can be used as learning opportunities. For young
58 Janice K. Lee, Jaclyn Joseph, Phillip Strain and Glen Dunlap
children with ASD, targeted instruction in inclusive settings is necessary to develop

and become fluent in social emotional skills. Social development with adults and
peers is extremely important and should be included in any child’s educational plan
(National Research Council, 2001).
The importance of early childhood inclusion cannot be overstated. However, just
being around typically developing peers is not enough to support young children
with ASD in developing enduring peer relationships. Just as all young children need
support in developing enduring peer relationships, children with ASD require more
targeted and intentional opportunities to learn and practice age-appropriate social
skills. The Division for Early Childhood (DEC) and the National Association for
the Education of Young Children (NAEYC) published a joint position statement in
2009 stating that early childhood inclusion should include three fundamental fea-
tures: (a) access to learning opportunities for young children with disabilities (ages 3
through 5) that are varied in activity, setting, and environment; (b) full participation
of young children with disabilities in learning activities and play through the use of
tiered models of support; and (c) systems-level supports that include collaboration
among individuals involved in a child’s education, therapy and caregiving respon-
sibilities (DEC/NAEYC, 2009). In addition, in order to optimize outcomes for
all children, inclusive educational placements should also be individualized, ensure
active engagement, and promote the development of meaningful friendships for
young children with disabilities (Barton and Smith, 2014; DEC and NAEYC, 2009;
Odom, Buysse and Soukakou, 2011).
The purpose of this chapter is to summarize the current early childhood research
on inclusion, discuss the effective practices of social inclusion and introduce three
programs specifically designed to promote social inclusion for young children with
ASD. This chapter concludes with recommendations for future directions in sup-
porting young children with ASD in socially inclusive settings.
Current and relevant social inclusion research

The Early Intervention/Early Childhood Special Education (EI/ECSE) literature
is replete with studies confirming the efficacy of early childhood inclusion. For
example, research has shown that inclusive programs are at least comparable to, and
at times of higher quality than, segregated placements that do not enroll children
with disabilities (Buysse, Wesley, Bryant and Gardner, 1999; National Professional
Development Center on Inclusion (NPDCI), 2009; Odom, 2000; Wolery, n.d.). It
has also been found that early childhood inclusion is not more costly than spe-
cialized, segregated placements (Odom et al., 2001; Wolery, n.d.). Further, research
shows that teachers and parents of children with and without disabilities have
positive views about early childhood inclusion, and children with and without
disabilities benefit from attending quality inclusive early childhood settings (Brown,
Odom, Li and Zercher, 1999; Diamond and Haung, 2005; Cross, Traub, Hunter-
Pishgahi, and Shelton, 2004; Odom, 2000; Rafferty and Griffin, 2005).
Social inclusion in the early years 59
In inclusive early childhood settings, children with disabilities have e xperienced

positive growth in social skills, adaptive behaviors, literacy and language skills,
and cognition (Green, Patton Terry and Gallagher, 2014; Justice, Logan, Lin and
Kodaravek, 2014; Nahmias, Kase and Mandell, 2004; Odom, 2000; Rafferty, Piscitelli
and Boettcher, 2003; Strain and Bovey, 2011). These varied positive gains have also
generalized to other environments and maintained across multiple years for young
children with disabilities (Strain, 2014; Strain and Hoyson, 2000). Perhaps most sig-
nificantly, research has shown that early childhood inclusion offers young children
with disabilities access to peer models and the opportunity to form friendships
with children without disabilities (Buysse, Goldman, and Skinner, 2002; Odom
et al., 2006).
Implementing high-quality social inclusion

There is a growing body of evidence in the early childhood and early childhood
special education field that outlines the practices that promote optimal child out-
comes. Practitioners can use the DEC Recommended Practices (DEC, 2014) to
guide their efforts to provide young children with disabilities inclusive learning
opportunities that promote their development. A number of these recommended
and evidence-based practices are described in the following sections that outline
five key components of high-quality social inclusion. These critical components
include: (a) goal setting and planning learning opportunities; (b) incorporating all
young children in the classroom; (c) utilizing tiered models of support; (d) mea-
suring and assessing inclusion; and (e) training competent classroom teams and
staff. In combination, these practices work to create a socially inclusive setting
for all children, and more specifically, provide multiple learning opportunities for
children with ASD to learn and practice social interaction skills with same-age
peers.
Goal setting and planning learning opportunities

Important goals to consider when planning learning opportunities for young chil-
dren with disabilities are those that involve their social development and social
competence (Strain, 2014). The importance of social competence for young chil-
dren is highlighted in the EI/ECSE literature, and the DEC/NAEYC (2009)
position statement on early childhood inclusion specifies that the development of
friendships is an important goal for young children with disabilities to achieve in
their inclusive placements.To assess child social competence and to determine child
progress, it is recommended that inclusive programs consider functional goals that
are relevant for all young children (e.g., how many friends a child has) to determine
the extent to which a young child with a disability is fully included in the class-
room and also to track how well he/she is developing socially (Buysse, Goldman
and Skinner, 2002).
Incorporating all young children in the classroom

Quality early childhood inclusion requires that the social competence of all
children (i.e., children with and without disabilities) is promoted through planned,
varied, and regularly occurring social opportunities (Buysse et al., 2002; Strain,
2014). For example, Strain and Bovey (2011) and Kohler and Strain (1999) note the
importance of teaching peer-mediated strategies and friendship skills to children
with and without disabilities and of providing subsequent embedded and naturally
occurring opportunities for children to practice these skills and to receive rein-
forcement for using the skills throughout the day. Diamond and Huang (2005) and
Brown, Odom, Li, and Zercher (1999) also note the utility of peer-mediated inter-
ventions in addition to specifying other intervention strategies that can be used
to promote positive social interactions such as incidental teaching, teaching chil-
dren without disabilities about what it means to have a disability, and considering
environmental manipulations such as the seating arrangements of young children.
Overall, EI/ECSE practitioners must place high priority on the social development
and competence of all young children in inclusive settings, and opportunities to
learn and practice such skills, both independently and with the facilitation of adults,
is critical (Hollingsworth and Buysse, 2009).
Utilizing tiered models of support

Tiered models of support (e.g., Building Blocks [Sandall and Schwartz, 2008],
Pyramid Model for Supporting Social Emotional Competence in Infants and Young
Children [Fox, Carta, Strain, Dunlap and Hemmeter, 2010], and Recognition and
Response [Buysse and Peisner-Feinberg, 2010]) are viable ways to implement
high-quality early childhood inclusion (Barton and Smith, 2015). Tiered models of
support focus on the prevention of problems in young children (e.g., learning diffi-
culties, challenging behavior) and intervention for young children who need more
intensive instruction (Barton et al., 2015; Coleman, Buysse and Neitzel, 2006).Tiered
systems progress from the universal tier that focuses on instruction for all children
to the most individualized tier that involves the development of assessment-based
plans that outline how and when instruction will occur for particular skills for
specific children (Grisham-Brown, Pretti-Frontczak, Hawkins and Winchell, 2009).
Thus, these frameworks provide practitioners guidance for planning and scaffolding
classroom instruction in order to promote the engagement and learning of children
with and without disabilities in high-quality inclusive early childhood environments
(Buysse and Peisner-Feinberg, 2010; Grisham-Brown et al., 2009).
Measuring and assessing inclusion

With the varying factors that promote quality early childhood inclusion, it is
imperative that measures at different levels (i.e., child, classroom) are in place to
ensure that inclusive practices are implemented as they are intended to be, based on
the EI/ECSE literature (Barton and Smith, 2015). Odom (2000) notes that early
childhood inclusion should be measured at the child level in regard to outcomes
and also at the classroom and program level to ensure that children with disabilities
are attending high-quality inclusive settings. To measure the quality of inclusion at
the child level, it is recommended that practitioners use data collection for multiple
purposes (e.g., assessment, progress monitoring, decision making, tracking instruc-
tional opportunities) (Barton et al., 2015). To measure the quality of inclusion at
the classroom level, varying measurement tools have been discussed in the litera-
ture (e.g., Irwin, 2009; Soukakou, 2012; Strain and Bovey, 2011). These classroom
evaluation tools rely on the foundation of quality early childhood programs that is
provided by the developmentally appropriate practice (DAP) framework and also
on the evidence-and-practice-based recommended practices outlined by the DEC
Recommended Practices for young children with disabilities (Barton and Smith,
2015; Copple and Bredekamp, 2009; Division for Early Childhood, 2014). Barton
and Smith (2015) summarize eight evaluation tools that practitioners and programs
can use to measure the quality of inclusive early childhood classrooms and four
commonly used checklists for inclusive data collection at the child level.
Training competent classroom teams and staff

Both practitioners and parents have identified inadequate pre-service and in-
service training for high-quality inclusion as a concern regarding the experiences
and outcomes of young children with disabilities who attend inclusive early child-
hood placements (Rafferty and Griffin, 2005). To improve the quality of early
childhood inclusion, practitioners (e.g., early childhood educators, early childhood
special educators) must know how to implement inclusive practices with fidel-
ity, which necessitates that they be provided with effective learning opportuni-
ties to acquire the requisite skills (National Professional Development Center on
Inclusion, 2009; Rafferty and Griffin, 2005).
The EI/ECSE literature suggests that practitioners be provided with learning
opportunities to develop skills involving competencies such as consultation, col-
laboration, and the facilitation of positive child–child interactions to name a few
(Bailey, McWilliam, Buysse and Wesley, 1998; Hollingsworth and Buysse, 2009;
Buysse, Wesley, Bryant and Gardner, 1999). Particularly in regard to in-service
professional development learning opportunities, it is also suggested that adequate
dosage levels of instructional, practice-based coaching be provided to support prac-
titioners in their skill development (Fox, Hemmeter, Snyder, Binder and Clarke,
2011; National Center on Quality Teaching and Learning, 2015; Snyder, Hemmeter,
Artman-Meeker, Kinder, Pasia and McLaughlin, 2012; Strain, 2014).The support of
leadership and policymakers, and ultimately of the policies and procedures that they
develop, is essential for ensuring that evidence-based pre-service and in-service
practitioner training is available and provided for individuals working in inclusive
early childhood settings (Odom, Buysse and Soukakou, 2011; Stayton, 2015).
Effective models for social inclusion

Multiple effective models that promote the social inclusion of young children
with ASD exist. In this section, three of these models (i.e., Learning Experiences
and Alternative Program for Preschools and Their Parents [LEAP]; Project DATA
[Developmentally Appropriate Treatment for Autism]; Walden Early Childhood
Program) with research support are discussed. Although a comprehensive discussion
of these three models is outside the scope of this section, resources are provided for
additional information.
Learning Experiences and Alternative Program for Preschoolers

and Their Parents (LEAP)
The LEAP preschool model is designed to teach children with ASD social, com-
munication, cognitive, and pre-academic skills. Typically developing peers play a
key role in the targeted social experiences of a LEAP classroom and receive com-
prehensive training in facilitating social and communication skills with children
with ASD in order to capitalize on the natural social opportunities that exist in an
inclusive setting. The goal in a LEAP classroom is for a child with ASD to have a
minimum of 100 natural and planned social interactions each school day with peers
and adults. Although instruction in LEAP programs is organized with the assistance
of established curricula (e.g., Dodge, Colker and Heroman, 2002; McCord, 1995),
objectives for children with ASD are individualized and data are collected to mon-
itor progress towards those objectives. LEAP also includes a Family Skill Training
component that teaches families the strategies to teach their children new skills and
manage challenging behaviors in home settings.
A LEAP classroom typically includes 3-4 preschool-aged children with ASD
with 8–10 typically developing preschool-aged peers. A co-teaching arrange-
ment with an early childhood teacher and an early childhood special education
teacher is recommended, although a variety of teaching arrangements exist in
replication sites. A minimum of three adults must be present in LEAP classrooms.
Typically, the third adult is a speech and language specialist, occupational thera-
pist, or classroom assistant. The LEAP staff share instructional responsibilities in
a planned and purposeful way on a daily basis, using a transdisciplinary model
of service delivery. This allows all staff members to interact with the children in
similar ways to promote the generalization of skills and capitalize on the max-
imum number of learning opportunities available throughout the school day.
LEAP preschools typically have morning and afternoon sessions for three hours
each, five days per week.
Parents and caregivers of children with ASD are also included in this
transdisciplinary team and deliver instruction at home and throughout the com-
munity. Family skill training begins with nine modules of behavioral teaching strat-
egies and continues with families participating in intervention throughout the day
with their child. Families choose which interventions to implement by identifying

routines that are difficult during the day.
LEAP evidence. In addition to over 25 years of research support for the indi-
vidual components of the LEAP model, the efficacy of the LEAP preschool model
has been demonstrated through a randomized controlled trial (RCT) in which pre-
school classrooms were assigned to either the full-scale LEAP replication training
or to a comparison condition in which preschool staff were provided intervention
manuals only (Strain and Bovey, 2011). The study included programs from large
metropolitan districts, suburban districts, rural districts, geographic areas where all
staff had advanced degrees, geographic areas where personnel shortages were criti-
cal, districts that primarily provided inclusionary services, and districts where very
few children with Autism were in inclusive settings.
Following completion of the LEAP RCT, across all sites and all years, partici-
pants included: (a) 123 LEAP program teachers and 107 comparison teachers and
(b) 177 LEAP program children with Autism and 117 comparison children with
Autism. After two years of intervention, statistically significant effects were noted
for each outcome measure with effect sizes ranging from 0.59 to 1.21. Specifically,
full LEAP program replication participants showed significant improvement on
Autism symptoms, communication skills, cognitive development, positive social
behavior, and reductions in problem behavior (Strain and Bovey, 2011).
Project DATA (Developmentally Appropriate Treatment for Autism)

Project DATA is an inclusive program for preschoolers and toddlers with a
focus on improving children’s development and behavioral functioning and, in
particular, to facilitate successful interactions between children with ASD and their
typically developing peers.The intent is to offer children multiple opportunities for
successful social interactions every day by embedding systematic instruction into
all classroom routines and activities using data-based decision making. The core
characteristic of Project DATA programs is the delivery of a high-quality inclusive
early childhood experience where all children are treated first and foremost as chil-
dren who deserve the best early education that can be provided (Schwartz, Sandall,
McBride and Boulware, 2004). Project DATA includes support for the families of
children with ASD with home-based services, resource coordination, monthly net-
working meetings, special evening meetings for fathers, and transition support for
children exiting Project DATA and beginning new placements.
For preschool-aged children, Project DATA classrooms typically have nine
children with ASD and seven typically developing peers. Classrooms are staffed
with a head teacher, an assistant teacher, and two classroom aides, with specialized
services (e.g., speech, occupational, and/or physical therapy) provided in classrooms
(Schwartz, Sandall, McBride and Boulware, 2004). Classrooms generally have
morning and afternoon sessions for two and a half hours each session, five days per
week. Children with ASD also participate in an extended day for an hour and a half
each school day to receive individualized instruction on Individualized Education

Plan (IEP) goals.
For toddlers, Project DATA provides inclusive playgroups as the context for
opportunities to improve the development of social interactions and relationships
at an early age. Playgroups include five toddlers with disabilities (with no more than
two toddlers with ASD) with five typically developing toddlers. These playgroups
are staffed with a head teacher, an assistant teacher, and a classroom aide, and occur
twice a week for 1.5 hours per session (Boulware, Schwartz, Sandall and McBride,
2006). Specialized services, such as speech, occupational, and physical therapists,
provide consultation to staff and family members, and embed interventions within
the playgroup. Toddlers with ASD also receive individualized instruction on goals
and objectives identified in the child’s Individualized Family Service Plan (IFSP)
for two hours per session, three times a week. In addition, families receive a weekly
two-hour visit in their home or in the community to learn skills and strategies
with an expectation that they will provide an additional five hours per week of
instruction to their child.
Project DATA evidence. Several analyses have documented the success of Project
DATA’s effectiveness in improving skills of children with ASD across develop-
mental domains, as well as making significant gains in the use of speech to com-
municate, as well as with the ability to follow complex directions, imitate motor
skills, maintain toilet training during waking hours, demonstrate symbolic play, and
play cooperatively with peers (Boulware, Schwartz, Sandall and McBride, 2006;
Thomas and Schwartz, 2009). Furthermore, evidence has been provided showing
that the Project DATA model is effective with toddlers with ASD in making gains
in multiple functional and developmental domains (Boulware, Schwartz, Sandall
and McBride, 2006).
Walden Early Childhood Program

In Walden Early Childhood Programs, children with ASD are included in class-
rooms with a majority of typically developing peers.The focus of Walden programs
is to teach children with ASD appropriate social communication skills through the
use of incidental teaching in order to meet the needs of children with ASD and
their typically developing peers.
Walden includes a continuum of program services. The toddler program has a
center and home-based component and focuses on establishing sustained engage-
ment, functional verbal language, responsiveness to adults, participation with typi-
cally developing peers, and independent living skills.The preschool program targets
language expansion and beginning peer interaction training. The pre-kindergarten
program emphasizes elaborated peer interactions, academic skills, and school readi-
ness behaviors. The Walden Family Program teaches parents and caregivers how to
maximize their child’s progress and advocate for their child’s education and lifelong
community inclusion. Thus, Walden provides a continuum of services that begins
in the toddler years with services that include an intensive home-based program
for families and progress through pre-kindergarten programs, transition planning,

and advocacy preparation.
In Walden Programs, most children enter as toddlers and continue until kinder-
garten. Children receive at least 30 hours per week of planned instruction through-
out the year. Toddlers attend half-day sessions at the center with additional hours
provided in the children’s homes through the Family Program. The preschool and
pre-kindergarten programs are six hours per day, five days per week, with before
and after care to ensure that children with ASD are kept productively engaged
while attracting typically developing children who need full-day child care set-
tings. This adds up to 17.5 additional hours per week of engaged time for chil-
dren with ASD. Generally, there are two typically developing peers for each child
with ASD at the center, and in the toddler and preschool classrooms there is one
adult for every three children. In order to prepare children for kindergarten, pre-
kindergarten classrooms have one adult for every six children.
Walden Early Childhood Program evidence. The Walden Program was devel-
oped as an inclusive setting to promote the language and social development for
all children while providing a rich environment for children with ASD to learn
the essential skills in preparation for kindergarten and beyond. Analyses of key ele-
ments have shown that children with ASD who participate in Walden Programs
can (1) learn to expressively use prepositions to describe where desired items
are located (McGee, Krantz, and McClannahan, 1985), (2) learn to use age-
appropriate social phrases (McGee and Daly, 2007), (3) enter preschool with func-
tional, expressive language (McGee, Morrier, and Daly, 1999), and (4) increase
reciprocal interactions with peers (McGee, Almeida, Sulzer-Azeroff and Feldman,
1992). Additional studies have demonstrated that incidental teaching increases the
appropriate social behaviors of all children in the program, including children
with ASD (Morrier, McGee, and Daly, 2009), and that toddlers with ASD increase
the amount of time they spend in close proximity to other children in classroom
settings and make significant gains in using meaningful words by the time they
entered preschool (McGee, Morrier, and Daly, 1999). Follow-up data showed that
79 percent of Walden graduates were successfully included in numerous kinder-
garten classrooms at their local public schools and a majority of the graduates were
successfully participating in their schools and communities (McGee, Morrier, and
Daly, 2000).
Key features and summary of models

Although the models identified and described are distinctive in many ways, they also
share common features. One obvious feature is that the programs are all designed
to serve young children with ASD in inclusive settings with typically developing
peers. It is logical that special efforts would be paid to the development of classroom
designs and interventions that would make inclusion possible for these children.
And it is also logical that such efforts would be accompanied by empirical research
and evaluation.
Another common feature is that all three of the models are aligned with a
behavioral-educational orientation.That is, the emphasis of all three programs is on
systematic instruction in order to build social skills and positive peer interactions.
It is important to emphasize, however, that the instruction is embedded within the
overall context of high-quality early childhood education programs designed to
benefit all of the participating children, regardless of whether or not the child has a
disability. Furthermore, the instruction that is provided for the children with ASD
is generally delivered in a manner that is consistent with the procedures used for
all of the children. Although based on behavioral principles and aligned with the
discipline of applied behavior analysis, the instruction is naturalistic and delivered
in the ongoing context of group activities.
Even though instruction and support for the children with ASD is delivered in
the ongoing classroom context, the interventions are individualized. Children with
ASD in all three programs have individualized plans for instruction in all relevant
areas and, in particular, in social and communication development.Teachers meet to
design, monitor, and refine individualized instructional strategies on a regular basis.
An associated feature is that data are collected and summarized on the key target
behaviors for each child. Progress is assessed frequently and instructional programs
are modified if the data indicate that anticipated gains are not occurring at a desired
rate. All three programs rely on data collection and data-based decision making.
Aside from these shared characteristics, there is perhaps one overriding feature
that may be considered to be necessary for an effective, inclusive classroom model.
That feature would be a concerted dedication to achieve a fully inclusive and fully
participatory educational experience for all children, with a focus on the develop-
ment of positive peer relationships. All three models share this kind of commitment,
and it is this common mission that is the foundation of successful inclusion for
children with disabilities.
Conclusion and future directions

The provision of inclusive services for young children with ASD has made great
strides over the last 30 years. Services are available and fidelity instruments have been
developed along with coaching protocols and outcome data published. Building on
these accomplishments, we envision three priorities for future work. First, there is
a pressing need to study, disseminate, and implement strategies that result in the
expansion of quality inclusive services. Enrollment of children with ASD in these
high-quality settings is still a rare event (U.S. Department of Health and Human
Services and U.S. Department of Education, 2015). This work will demand efforts
at the public policy level and at the level of pre-service and in-service training and
support, as well as bold leadership by administrators who currently operate systems
with few, if any, high-quality inclusion options (Barton and Smith, 2015).
Second, we see a pressing need to address, in a data-based fashion, the many
myths that preclude inclusive options for children with ASD. These myths include
the notion that children need to be “behaviorally ready” to benefit from inclusive
services. Indeed, many programs for young children with ASD purport to be doing
this very thing … preparing them for inclusion. However, we are aware of no data
suggesting that this happens with any regularity. In fact, the opposite is demonstra-
bly provable. That is, once children begin their education in a segregated setting,
they stay there (Strain, 2015). A second pervasive myth is that children with ASD
cannot be provided with a sufficient intensity of instruction in inclusive settings.
While embedded instruction has at least a three-decade research history, there are
few examples in the literature where instructional opportunities have been tracked
for children with ASD. Finally the myth that inclusive environments are “too stim-
ulating” is pervasive, notwithstanding the fact that there is not one study of which
we are aware to directly support this myth. Of course, the primary basis of the “too
stimulating” myth comes from the sensory integration movement, which has yet to
yield evidence of effectiveness or relevance for young children with ASD (Barton
et al., 2015).
Finally, we think that preschool inclusion needs to be thought about as the
launch point and not the end point for inclusive opportunities. We base this idea
on results from a follow-up study on LEAP participants (Strain, 2015). Here, chil-
dren with ASD were followed for four years after the preschool experience. Based
largely on school district policy, some children were enrolled in developmentally
segregated kindergarten classes and then stayed there for the follow-up period. By
contrast, other children who were matched in level of Autism symptoms to the
developmentally segregated group were enrolled in inclusive kindergarten settings
and they remained in that type of setting for four years as well. At third grade, the
two groups differed fundamentally on measures of Autism symptoms, academic
achievement, language skills, and social skills, all heavily favoring the children who
experienced a continuation of inclusive education.These data suggest that the ben-
efits of inclusive settings for children with ASD may, in fact, be underestimated if
inclusion is limited only to the preschool years.
References
Bailey, D. B., McWilliam, R. A., Buysse,V., and Wesley, P. (1998). Inclusion in the context of
competing values in early childhood education. Early Childhood Research Quarterly, 13,
27–47. doi:10.1016/S0885-2006(99)80024-6
Barton, E. E., Reichow, B., Schnitz, A., Smith, I. C., and Sherlock, D. (2015). A systematic
review of sensory-based treatments for children with disabilities. Research in Developmental
Disabilities, 37, 64–80. doi:10.1016/j.ridd.2014.11.006
Barton, E. E., and Smith, B. J. (2014). Brief summary: Fact sheet of research on preschool inclusion.
Retrieved from www.pyramidplus.org/sites/default/files/images/Brief %20Inclusion%20
Fact%20Sheet%20.pdf. Accessed 9 November 2015.
Barton, E. E. and Smith, B. J. (eds.). (2015). The preschool inclusion toolbox: How to build and lead
a high-quality program. Baltimore, MD: Brookes.
Boulware, G., Schwartz, I. S., Sandall, S. R., and McBride, B. J. (2006). Project DATA for t oddlers:
An inclusive approach to very young children with autism spectrum disorder. Topics in Early
Childhood Special Education, 26(2), 94–105. doi:10.1177/02711214060260020401
Brown, W. H., Odom, S. L., Li, S., and Zercher, C. (1999). Ecobehavioral assessment in early
childhood programs: A portrait of preschool inclusion. The Journal of Special Education, 33,
138–53. doi:10.1177/002246699903300302
Buysse,V., Goldman, B. D., and Skinner, M. L. (2002). Setting effects on friendship formation
among young children with and without disabilities. Exceptional Children, 68, 503–17.
doi:10.1177/001440290206800406
Buysse,V., and Peisner-Feinberg, E. (2010). Recognition and response: Response to interven-
tion for PreK. Young Exceptional Children, 13, 2–13.
Buysse,V., Wesley, P. W., Bryant, D., and Gardner, D. (1999). Quality of early childhood pro-
grams in inclusive and noninclusive settings. Exceptional Children, 65, 301–14.
Coleman, M. R., Buysse, V., and Neitzel, J. (2006). Recognition and response: An early inter-
vening system for young children at-risk for learning disabilities. Full report. Chapel Hill: The
University of North Carolina, FPG Child Development Institute.
Copple, C., and Bredekamp, S. (eds.). (2009). Developmentally appropriate practice in early
childhood programs serving children from birth through age 8, Third edition. Washington, DC:
National Associated for the Education of Young Children.
Cross, A. F., Traub, E. K., Hutter-Pishgahi, L., and Shelton, G. (2004). Elements of success-
ful inclusion for children with significant disabilities. Topics in Early Childhood Special
Education, 24, 169–83. doi:10.1177/02711214040240030401
DEC/NAEYC. (2009). Early childhood inclusion: A joint position statement of the Division for
Early Childhood (DEC) and the National Association for the Education of Young Children
(NAEYC). Retrieved from www.naeyc.org/files/naeyc/file/positions/DEC_NAEYC_
EC_updatedKS.pdf. Accessed 9 November 2015.
Diamond, K., and Huang, H-H. (2005). Preschoolers’ ideas about disabilities. Infants and
Young Children, 18, 37–46.
Division for Early Childhood. (2014). DEC recommended practices in early intervention/early child-
hood special education 2014. Retrieved from www.dec-sped.org/recommendedpractices
Dodge, D. T., Colker, L., and Heroman, C. (2002). The creative curriculum for preschool, fourth
edition. New York: Teaching Strategies.
Fox, L., Carta, J., Strain, P. S., Dunlap, G., and Hemmeter, M. L. (2010). Response to inter-
vention and the pyramid model. Infants and Young Children, 23, 3–13. doi:10.1097/
IYC.0b013e3181c816e2
Fox, L., Hemmeter, M., Snyder, P., Binder, D. P., and Clarke, S. (2011). Coaching early
childhood special educators to implement a comprehensive model for promoting young
children’s social competence. Topics in Early Childhood Special Education, 31, 178–92. doi:
10.1177/0271121411404440
Green, K. B., Patton Terry, N., and Gallagher, P. A. (2014). Progress in language and literacy
skills among children with disabilities in inclusive early reading first classrooms. Topics in
Early Childhood Special Education, 33, 249–59. doi:10.1177/0271121413477498
Grisham-Brown, J., Pretti-Frontczak, K., Hawkins, S. R., and Winchell, B. N. (2009).
Addressing early learning standards for all children with blended preschool classrooms.
Topics in Early Childhood Special Education, 29, 131–42. doi:10.1177/0271121409333796
Hollingsworth, H. L., and Buysse,V. (2009). Establishing friendships in early childhood inclu-
sive settings: What roles do parents and teachers play? Journal of Early Intervention, 31,
287–307. doi:10.1177/1053815109352659
Irwin, S. H. (2009). SpeciaLink child care inclusion practices profile and principles scale. Winnipeg,
Canada: SpeciaLink-The National Centre for Child Care Inclusion.
Justice, L. M., Logan, J. A. R., Lin, T-J., and Kaderavek, J. N. (2014). Peer effects in early
childhood education: Testing the assumptions of special-education inclusion. Psychological
Science, 25, 1722–29. doi:10.1177/0956797614538978
Kohler, F., and Strain, P. S. (1999). Maximizing peer-mediated resources in inte-

grated preschool classrooms. Topics in Early Childhood Special Education, 19, 92–102.
doi:10.1177/027112149901900203
McCord, S. (1995). The storybook journey: Pathways to literacy through story and play.
McGee, G. G., Almeida, M. C., Sulzer-Azaroff, B., and Feldman, R. S. (1992). Promoting
reciprocal interactions via peer incidental teaching. Journal of Applied Behavior Analysis, 25,
117–26. doi:10.1901/jaba.1992.25-117
McGee, G. G. and Daly, T. (2007). Incidental teaching of age-appropriate social phrases to
children with autism. Research and Practice for Persons with Severe Disabilities, 32(2), 112–23.
doi:10.2511/rpsd.32.2.112
McGee, G. G., Krantz, P. J., and McClannahan, L. E. (1985). The facilitative effects of incidental
teaching on preposition use by autistic children. Journal of Applied Behavior Analysis, 18, 17–31.
doi:10.1901/jaba.1985.18-17
McGee, G. G., Morrier, M. J., and Daly, T. (1999). An incidental teaching approach to early
intervention for toddlers with autism. The Journal of the Association for Persons with Severe
Handicaps, 24(3), 133–46. doi:10.2511/rpsd.24.3.133
McGee, G. G., Morrier, M. J., and Daly,T. (2000).The Walden Early Childhood Programs. In
J. S. Handleman, and S. L. Harris (eds.), Preschool programs for children with autism, second
edition. Austin, TX: PRO-ED, pp. 157–90.
Morrier, M. J., McGee, G. G., and Daly,T. (2009). Effects of toy selection and arrangement on
the social behaviors of an inclusive group of preschool-aged children with and without
autism. Early Childhood Services, 3(2), 157–77.
Nahmias, A. S., Kase, C., and Mandell, D. S. (2014). Comparing cognitive outcomes among
children with autism spectrum disorders receiving community-based early intervention
in one of three placements. Autism, 18, 311–20. doi:10.1177/1362361312467865
National Professional Development Center on Inclusion. (2009). Research synthesis points
on early childhood inclusion. Retrieved from http://npdci.fpg.unc.edu/sites/npdci. fpg.unc
.edu/files/resources/NPDCI-ResearchSynthesisPoints-10-2009_0.pdf
National Research Council (2001). Educating children with autism. Catherine Lord and
James P. McGee (eds). Division of Behavioral and Social Sciences and Education.
Washington, DC: National Academy Press.
Odom, S. L. (2000). Preschool inclusion: What we know and where we go from here. Topics
in Early Childhood Special Education, 20, 20–7. doi:10.1177/027112140002000104
Odom, S. L., Buysse,V., and Soukakou, E. (2011). Inclusion for young children with disabil-
ities: A quarter century of research perspectives. Journal of Early Intervention, 33, 344–56.
doi:10.1177/1053815111430094
Odom, S. L., Hanson, M. J., Lieber, J., Marquart, J., Sandall, S.,Wolery, R., Horn, E., Schwartz,
I., beckman, P., Hikido, C., Chambers, J. (2001).The costs of preschool inclusion. Topics in
Early Childhood Special Education, 21, 46–55. doi:10.1177/027112140102100104
Odom, S. L., Zercher, C., Li, S., Marguart, J. M., Sandall, S., and Brown, W. H. (2006). Social
acceptance and rejection of preschool children with disabilities: A mixed-method analysis.
Journal of Educational Psychology,98,807–23.http://dx.doi.org/10.1037/0022-0663.98.4.807
Rafferty, Y., and Griffin, K. W. (2005). Benefits and risks of reverse inclusion for preschool-
ers with and without disabilities: Perspectives of parents and providers. Journal of Early
Intervention, 27, 173–92. doi:10.1177/105381510502700305
Rafferty, Y., Piscitelli, V., and Boettcher, C. (2003). The impact of inclusion on language
development and social competence among preschoolers with disabilities. Exceptional
Children, 69, 467–79. doi:10.1177/001440290306900405
Sandall, S. R., and Schwartz, I. S. (2008). Building blocks for teaching preschoolers with special needs.
2nd editon. Baltimore, MD: Paul H. Brookes.
Schwartz, I. S., Sandall, S. R., McBride, B. J., and Boulware, G. (2004). Project DATA
(Developmentally Appropriate Treatment for Autism):An inclusive school-based approach
to educating young children with autism. Topics in Early Childhood Special Education, 24(3),
156–68. doi:10.1177/02711214040240030301
Snyder, P., Hemmeter, M. L., Artman-Meeker, K., Kinder, K., Pasia, C., and McLaughlin,
T. (2012). Characterizing key features of the early childhood professional development
literature. Infants and Young Children, 25, 188–212. doi:10.1097/IYC.0b013e31825a1ebf
Soukakou, E. P. (2012). Measuring quality in inclusive preschool classrooms: Development
and validation of the Inclusive Classroom Profile (ICP). Early Childhood Research Quarterly,
27, 478–88. doi:10.1016/j.ecresq.2011.12.003
Stayton, V. D. (2015). Preparation of early childhood special educators for inclusive
and interdisciplinary settings. Infants and Young Children, 28, 4–12. doi:10.1097/
IYC.0000000000000030
Strain, P. S. (2014). Inclusion for preschool children with disabilities:What we know and what we should
be doing. Retrieved from www.pyramidplus.org/sites/default/files/images/STRAIN%20
PtrYC%20what%20we%20know%20%282%29.pdf. Accessed 9 November 2015.
Strain, P.S. (2015, April). Longitudinal outcomes associated with LEAP preschool for children with
autism: The case for rethinking early intervention. San Diego, CA: Council for Exceptional
Children Convention and Expo.
Strain, P. S., and Bovey, E. H. (2011). Randomized, controlled trial of the LEAP model of
early intervention for young children with autism spectrum disorders. Topics in Early
Childhood Special Education, 31, 133–54. doi:10.1177/0271121411408740
Strain, P. S., and Hoyson, M. (2000).The need for longitudinal, intensive social skill interven-
tion: LEAP follow-up outcomes for children with autism. Topics in Early Childhood Special
Education, 20, 116–22. doi:10.1177/027112140002000207
Thomas, C. and Schwartz, I. (2009). Analyses of five years of results from Project DATA
(Developmentally Appropriate Treatment for Autism), a high-quality early childhood special educa-
tion program for students with autism spectrum disorders. Seattle,WA: University of Washington.
United States Department of Health and Human Services and United States Department
of Education. (2015). Policy statement on inclusion of children with disabilities in early child-
hood programs. Retrieved from www2.ed.gov/policy/speced/guid/earlylearning/joint-
statement-full-text.pdf. Accessed 9 November 2015.
Wolery, M. (n.d.). Proposed benefits of preschool inclusion. Retrieved from http://ectacenter.org/
topics/inclusion/research/Benefits.asp. Accessed 9 November 2015.
Zero to Three (2014). Promoting social emotional development. In Behavior and Development.
Retrieved from zerotothree.org. Accessed 9 November 2015.
6
SOCIAL INCLUSION IN THE PRIMARY
SCHOOL YEARS
Alice Jones Bartoli
Introduction
The primary school years see a marked development in the importance of peer
relationships. The period of middle childhood and early adolescence is character-
ised by both new demands and opportunities for social and emotional growth, and
children’s conceptualisations and reliance on friendships for psychological support
has been demonstrated to develop alongside this. Young children tend to under-
stand friends in terms of activity sharing, and discuss friendships in rather concrete
terms. These pre-school friendships are typically less stable than later friendships,
but nevertheless appear to form an important basis for development of future
friendships. During the primary school years, an increasing proportion of children’s
social interactions involve peers. Peer groups increase in size, and require less close
adult supervision than for younger children. It is also increasingly the case that chil-
dren interact with their peers online, or by telephone.
Peers provide opportunity for socialisation, through shared knowledge and expe-
rience about emotions, reciprocity, cooperation and behavioural norms. Towards
the end of childhood, friendships are furthermore characterised by an increase in
shared intimacy. This is reflected in the activities typical of children across their
primary school education, from spending most of their time in active or pretend
play in the early years, to engaging in organised physical activities, or talking and
gossiping in middle childhood and pre-adolescence. Having one or two best friends
is of great importance to psychological adjustment, and can buffer the impact of
stressful events as well as positively correlating with self-esteem and negatively with
anxious and depressive symptoms (Newcomb and Bagwell, 1995). It is clear then,
that social relationships across primary school serve important purposes for social
and emotional development.
72 Alice Jones Bartoli
Children with Autism often find these shifts in the expectations and activities
associated with friendships difficult to navigate. It is common to read research that
suggests that children with Autism experience social exclusion, bullying or some
other dissatisfaction with their relationship with their peer group. This chapter will
consider the social inclusion for children with Autism during the primary school
years from several angles. Firstly, it is important to consider the context that children
with Autism are educated in, and how far learning disabilities and other common
comorbid conditions might impact on the development of social relationships. It is
also pertinent to think about how children with Autism conceptualise friendships,
and what they want in terms of social relationships with their peers during the
primary years. We will discuss the prevalence and experience of bullying, and think
about how typically developing children might consider their peers with Autism
when making a decision about whether they want to include them in their social
activities. This chapter will also consider the voices of parents and teachers, who
are intricately involved in developing the social lives of the children in their care;
alongside that, we will consider the evidence base for interventions.
Inclusion of children with Autism in mainstream classrooms has become
increasingly prevalent. International educational policy advocates inclusion of stu-
dents with special educational needs (SEN) in mainstream contexts and in many
countries, schools are required to make adjustments to enable children with SEN
to be included in school life. In the UK, around 73 per cent of children with
an Autism diagnosis and in receipt of special education support are educated in
mainstream schools (DfE, 2015). Education provision for children with Autism in
mainstream schools is typically characterised in one of two ways: children attend
their local school and are provided with additional support, typically from a teach-
ing assistant, a visiting Autism specialist and, possibly, therapy input from health
professionals; alternatively, children may be placed in a mainstream school which
has its own specialist unit or resource base for students with Autism. Different
amounts of time may be spent in the resource base or mainstream class depending
on the needs of the students, and the philosophy of the school. Although there
may be concerns about children being included in mainstream schools, but being
taught separately, resource bases can offer a student a gradation of inclusive expe-
riences appropriate to individual need and extend this with training and support
for mainstream staff (Frederickson, Jones and Lang, 2010).
Some children with Autism also have a learning disability characterised by low
cognitive ability, and many more have difficulties accessing the school curriculum
in different ways (Estes, Rivera, Bryan, Cali and Dawson, 2010). Estes et al.’s study of
nine-year-old children with Autism demonstrated that academic achievement was
often less than would be expected given their cognitive ability. They reported that,
after controlling for cognitive ability, social skills measured at six years of age were
the best predictor of academic attainment at nine years. Regardless of a child’s abil-
ity, school is often a challenging place for children with Autism. As well as difficul-
ties with social interactions, differences in sensory processing mean that it is often
difficult for a child to manage the demands of a busy classroom. In a study carried
Social inclusion in the primary school years 73
out by Ashburner, Ziviani and Rodger (2008), children with Autism were found to
have a greater number of sensory processing difficulties than their typically devel-
oping peers. These children were reported to have difficulty paying attention to
verbal instructions in the presence of background noise and those with atypical
sensory-seeking behaviour were more likely to show academic underachievement.
Sensory processing difficulties were associated with inattention to cognitive tasks
and hyperactive and oppositional behaviour – all likely to impair a child’s ability to
optimally access curriculum, and meet their academic potential. Sensory process-
ing difficulties also have the potential to impact on social participation. A child’s
capacity to be involved in play and social activities is an important part of childhood
learning. Atypical profiles of sensory processing have been demonstrated to nega-
tively predict social behaviour (Hilton et al., 2010). It may be the case that under-
standing more about the potential role of sensory processing in a child’s ability to
interact with their peers may provide a further avenue for intervention.
Friendships
Individuals with Autism are frequently perceived as having difficulties making and
maintaining peer relationships. Before considering outcomes related to social inclu-
sion for children with Autism, one of our first points of investigation should be about
what the children themselves perceive as successful social relationships, and what is
desirable. One systematic review (Petrina, Carter and Stephenson, 2014) consid-
ered 24 studies examining the nature of friendships for children and adolescents
with Autism.This review suggests that although most children with Autism consider
themselves, or are considered by others, to have at least one friend, they tend to have
fewer friendships (and of shorter duration) than their typically developing peers.
Children with Autism are also reported to spend less time with peers outside of
school, and spend the majority of the time that is with peers playing video games,
doing physical activities and watching television. Petrina and colleagues also report
that friendship quality, as reported by children with Autism, is routinely lower than
for typically developing peers. However, children with Autism have been shown to
benefit from having friendships with typically developing peers (Bauminger et al.,
2008).These friendships have been found to be more durable and stable than friend-
ships between two children with developmental disabilities. They also seemed to
have more fun together, were more responsive to one another, and demonstrated a
more complex level of coordinated play. It may be plausible that the ability to make
and maintain friendships with a typically developing peer rely on a multitude of fac-
tors, including the children’s own social and emotional abilities, and teacher/parent
support. However, it is likely that children who do have friendships with typically
developing children have increased opportunities to be involved in more complex
social and play situations, which offer useful learning opportunities.
Observational studies of children with Autism suggest that they spend more time
playing alone, and less in reciprocal interactions or initiating and responding to social
interactions with others (Bauminger, Shulman and Agam, 2003). However, more
recent observational research by Calder, Hill and Pellicano (2013) reported that the
majority of children with Autism in their study were observed to engage in high-
level social play, and made interaction initiation attempts with peers. This study also
reported that the majority of observed interactions were positive for the child with
Autism. Other observational studies of children with Autism in social situations have
attempted to capture specific areas of difficulty. For example, Attwood (2000) has
noted that children with Autism have difficulties sharing interests or enjoyment with
others and also find it difficult to join a group of children already at play. He also sug-
gests that children with Autism have difficulty ‘hosting’ play dates, manifested in their
inability to accept suggestions from the visiting peer, behave in a reciprocal manner,
share with the play mate and show sufficient conflict resolution skills.
Calder et al. also considered multiple perspectives on the friendship expe-
riences of primary-school age children with Autism: themselves, parents and
teachers. Children themselves were able to name a small number of children whom
they considered to be friends, and described friends in terms of companionship
(for example, ‘We play games with each other’ [p. 306]). With regards to under-
standing an affective component to friendship (e.g. support and mutual affection),
results were somewhat more mixed. Some children described friendship as being
supportive and caring, others did not – appearing emotionally disconnected, and
suggesting potential misunderstanding about the nature of friendships (for example,
‘[They’re my friends] because I try to catch them’ [p. 306]). Children also discussed
their difficulties with friendships, including feeling confused about whether they
were friends with other children or not, and sometimes a desire to be alone. Some
children discussed feeling left out and lonely as a result of not being involved in
certain friendship groups or social activities.
As a comparison, Calder et al. (2013) report that parents perceived their
children’s friendships as being different to those of other children. Some parents
suggested that their children often seemed to prefer to be alone, and that their level
of maturity compared to their peers impacted on their ability to understand the
subtleties of social interactions. Other parents talked about the attitudes of other
children being potentially problematic. Although few related incidences of bully-
ing, some parents talked about peers taking on a ‘caring’ role, rather than that of a
reciprocal friendship. Parents also talked about their own role in developing friend-
ships for their children, including providing direct instruction, facilitating contact
through inviting children over to play, and joining clubs and doing extra-curricular
activities (although some found this caused further difficulties for the children).
In a further study, Petrina, Carter and Stephenson (2015) spoke to parents of pri-
mary-school-age children with Autism about their priorities about friendship and
skills development. Parents reported being most concerned with the development
of social and emotional skills, with friendships coming third, although it seems sen-
sible to consider that friendships may be a natural consequence of well-developed
social and emotional skills.
The teachers’ interviews also discussed the nature of adult support required
for children with Autism to be involved in social interaction. Teachers discussed
noticing that periods of unstructured play could be particularly difficult, and that
they were frequently involved in encouraging their peers to think about how they
could include them. Teachers also considered how they balanced the needs and
desire of the children to sometimes be with others, and to sometimes spend time
alone.Teachers reported children with Autism to be ‘on the periphery of friendship
groups rather than being either socially involved or socially isolated’ [p. 308]. One
of the key difficulties in social interactions appeared to be the lack of understanding
or ability to apply social rules, including negotiation, reciprocating concern and
care and playing within the rules of a game. Teachers’ views on supporting children
with Autism were also sought by Frederickson, Jones and Lang (2010). Here, teach-
ers reported feeling under-skilled in developing social skills, seen to be critical for
children with Autism. Some teachers discussed the lack of specialist input for social
skills development, while one referred to a lack of time: ‘It would be nice if there was
time for him and the other children to have a social skills section and play games and talk
about rules, etc, but there’s just not the time to do that’ [p. 70].
One other useful method of exploring social inclusion of children with Autism
is social network analysis. Anderson and colleagues (2016) reported on one such
study aiming to examine predictors of social connectivity in children with and with-
out a diagnosis of Autism attending primary mainstream schools. The analyses used
social network modelling, and were able to consider the role of gender, age, class
size and intellectual ability. Information was collected at two time points, around
three months apart. Female students tended to fare better in larger classrooms, while
male students showed greater social fragmentation in the same setting (classes with
20 students or more). During the primary school period in particular, children tend
to prefer to play with children of their own sex. Anderson and colleagues suggest
that for girls, having more female peers to choose from is advantageous, whereas for
boys, whose relationships may rely more on physical and competitive play at this
point, having a large same-sex peer group is less important. This study also noted
the importance of quality of friendships over quantity. Children who had a greater
number of social connections at the first time point tended to show greater social
fragmentation across time compared to those who had a few relationships at the
first time point. It may be worth promoting good quality, solid friendships for chil-
dren with Autism in order for these to be maintained.
Understanding social exclusion

An increasing number of studies have examined what behaviours and abilities
are associated with, or predict, more positive social outcomes for children with
Autism. We have already considered the impact of sensory processing profiles, but
other profiles of functioning are also relevant. For example, in one study focus-
ing on children who were starting primary school, children with a diagnosis of
high functioning Autism had poorer levels of school and peer engagement, and
decreased self-regulation skills. Most pertinently, executive function skills predicted
both emotional and behavioural school engagement, while emotion regulation
predicted prosocial peer engagement. Importantly for children with Autism, the
relationship between effortful control and the first time point and later prosocial
peer engagement was moderated by diagnostic group, suggesting that good effort-
ful control was particularly important for children with Autism (Jahromi, Bryce
and Swanson, 2013).
One theory that has been put forward to explain decisions that children make
about forming social relationships with their peers with developmental disabilities
uses the model of social exchange (Frederickson and Furnham, 2004). This theory
explains motivation for affiliation with others in relation to the perceived costs and
benefits of interacting with them, set against some minimum level of expectation.
Previous research has suggested that typically developing students who experience
the greatest social acceptance are those who represented the highest ‘benefit’ traits
(e.g. co-operation) and lowest ‘cost’ traits (e.g. disruptive or help-seeking behaviour),
while those typically developing children experiencing social rejection showed the
reverse pattern. Frederickson and Furnham (2004) further reported a difference
between the behavioural profiles associated with social acceptance and rejection for
typically developing children, and those with moderate learning disabilities. They
suggested that social rejection was experienced by only those students with learn-
ing disabilities who failed to deliver the minimum benefits expected in terms of
‘benefit’ traits, and a higher than average level of ‘costly’ behaviours appeared to be
discounted. Conversely, those students with learning disabilities who were socially
accepted by their peers were characterized by low levels of ‘costly’ behaviours but
were not expected to offer high levels of ‘benefits’.
This theory was tested by Jones and Frederickson (2010) in an examination of
the factors that predicted social inclusion and rejection in a group of children with
Autism compared to their typically developing peers. In line with other research,
this study reported that, compared to typically developing peers, children with
Autism experienced greater levels of social rejection, and decreased levels of social
acceptance according to sociometric measures. However, of interest to the social
exchange theory, there were some differential predictors of social inclusion. For
example, for typically developing children, being rated by peers as ‘shy’ predicted of
social rejection. The same was not true for children with Autism, where there the
association between these ratings did not differ from chance. This finding can be
explained using social exchange theory in so far as the descriptor used for the peer
nomination of shyness also appeared to be appropriate for children with Autism
(‘this person is shy with other children, they always seem to work or play by them-
selves. It is hard to get to know this person’). It is supposed that children are able to
understand that children with Autism are unable to change this behaviour, and so
they discount it from their cost-benefit analysis of interacting with the child.
Outcomes associated with social exclusion

One of the key outcomes to consider for children who experience difficulties
with social inclusion is loneliness. Children with Autism have previously reported
themselves to have increased levels of loneliness compared to their peers, and these
feelings of loneliness were also found to relate to anxiety (see Kasari and Sterling,
2014 for a review). Another study focused on the predictors of self-perceptions
of loneliness in young children with Autism (Zeedyk, Cohen, Eisenhower and
Blacher, 2016). Here, 127 children with a diagnosis of Autism aged between 4 and
7 years of age were asked about their experiences of social interaction and relation-
ships at school, and about their feelings of loneliness. Around 30 per cent of chil-
dren reported that they felt lonely at school at least sometimes, but around 90 per
cent reported that they had people to play with (at least sometimes). It may be that
rather younger children with Autism are able to be supported to have successful
interactions with peers, and/or that schools are becoming more well-equipped to
offer that support. It is interesting to note that the greatest predictor of self-reported
loneliness in this young age group was parent reports of social skills. Further sup-
port might well be focused in this area, particularly for young children.
Bullying
One particular concern about children with developmental disabilities who are
included in mainstream school is bullying. Humphrey and Hebron (2015) present
evidence that children with Autism are at particular risk of bullying. Children with
Autism appear to fit a particular socio-cognitive profile that may predispose a child
to being a victim of bullying. Children who have difficulties understanding social
contexts, and who frequently occupy lower social status amongst their peer group
are often those who experience bullying. These children are also those who have
fewer supportive social relationships to draw on during bullying. Children with
Autism are also perceived as being ‘different’ to their peers due to their difficulties
conforming to typical social norms, and to understanding social rules.
Children with Autism appear to experience a higher prevalence of bullying
(Humphrey and Hebron, 2015). One other study focusing on parent reports of
bullying in children with Autism also noted that younger children were at greater
risk of being a victim of bullying (Cappadocia, Weiss and Pepler, 2012). It may be
that bullying of children with Autism decreases during the adolescent years due
to increased empathy in typically developing peers, or increased understanding of
Autism. In incidences of bullying, verbal or relational bullying was the most frequent
type reported. More frequent victimisation was also associated with poorer mental
health outcomes, particularly internalising difficulties, with an incidence of mental
health difficulties 11 times greater in those experiencing victimisation than those
who were not.This study is cross-sectional in nature, so it can not definitively exam-
ine direction of association, but it is likely that there is a bi-directional influence
between poor mental health and victimisation, where already vulnerable children
become targets for bullying, and the experience of bullying impacts further on their
fragile mental health. One further risk factor for victimisation was the level of com-
munication difficulty experienced by the child with Autism. Compared to children
who were not bullied, those who were victimised were approximately five times
more likely to have higher levels of communication difficulties. Such difficulties may
place children with Autism at particular risk for victimisation because these diffi-
culties impede their ability to engage with peers and form friendships. Cappadocia
and colleagues discuss these findings in the context of future bullying prevention
and intervention, and suggest that increased knowledge of Autism may help peers to
interact more positively with their peer with Autism, or to be more keen to inter-
vene in episodes of bullying.
Interventions
School-based social skills interventions
A number of child-focused social skills interventions have been developed, and this
chapter will focus on the effectiveness of those that are delivered at school. One
useful meta-analysis of 55 single-subject design studies suggests that school-based
social skills interventions are minimally effective for children with ASD (Bellini,
Peters, Benner and Hopf, 2007). According to this review, school-based social skills
interventions produced low treatment effects and low generalisation effects across
participants, settings, and play stimuli. Moderate maintenance effects were observed,
suggesting that gains made via social skills interventions are maintained after with-
drawal of the intervention. Potential reasons for the poor outcomes associated with
child-focused interventions include a relatively short length of intervention, and
the de-contextualised settings, which are likely to impede generalisability.
CASE STUDY: HARRY
Harry is a seven-year-old boy attending a mainstream primary school. He has

access to a classroom Teaching Assistant, but mainly manages classroom activ-
ities alone. Harry has a diagnosis of autistic spectrum disorder, and has very
good language skills. He is particularly interested in space, and has an in-depth
knowledge of planets, stars and space travel. Harry’s parents are concerned
that he seems increasingly adrift from his peer group. He is never invited to
birthday parties, or on play dates. He spends playtimes alone, usually read-
ing or talking with adults. Harry sometimes expresses the feeling that he is
lonely at school, saying that other children aren’t interested in the same things
as him, and that he doesn’t want to do what they are doing at playtimes.
Harry’s teachers say that other children do not actively reject him, or victimise
him; rather he is allowed to remain solitary. It is decided that a peer-medi-
ated intervention may help Harry to be more included in his class. A small
group of Harry’s classmates are selected to be involved; these children include
a boy that other children respect and appears popular, a girl who is particu-
larly empathic and interested in others’ feelings, and a boy who is also inter-
ested in astronomy, and who has shown the class his telescope before now.
The children work with an Educational Psychologist on a weekly basis for ten

weeks to better understand Autism, and how they might more successfully
interact with Harry on his own terms. During the sessions, the children are
invited to think about specific incidences where they find it difficult to know
how to interact with Harry, and these are problem-solved. During the inter-
vention, the children identify ideas that might make Harry feel more comfort-
able at school including specific activities to do during breaktimes. Following
the intervention, Harry reported that more children in the class were willing
to talk with him about his interests at breaktime, and his teachers reported
him being more involved in class activities. Harry’s parents did not report an
immediate increase in the number of play dates that he was invited on, but he
was invited to some birthday parties for the first time.
Peer-mediated interventions
One method to support the development of friendships for children with Autism
involves peer mediation. As described in Harry’s case study, typically developing
peers are guided and supported to facilitate social skills development through
increased interaction. The effects here are indirect, training peers, rather than the
child with Autism. Peer-mediated interventions have several advantages for children
with Autism. Firstly, schools are able to readily identify appropriate peers to take
part, and these peers may also themselves learn important skills; secondly, peers can
act as models for appropriate social behaviours; and finally, children with Autism can
use peers to practice their developing social skills. One review of this intervention
method (Chan et al., 2009) discusses methods common across peer-mediated inter-
ventions, including reinforcement of desired behaviours, peer modelling, prompt-
ing and verbal explanation and feedback. There are also different reported varieties
of peer-mediated intervention strategies, and this may well be one of its potential
strengths – it is important to be versatile in order for the intervention to match the
needs of an individual child. However, these reviews also note some difficulties with
the current research evidence base that may place a limit on the conclusions that
might be drawn. The first of these relates to collection of information about treat-
ment fidelity. Chan et al. note that many of the 42 studies that they review do not
include information about treatment fidelity, so we can not know to what extent
peers were able to carry out the intervention as planned, or how well they were
supported. One other potential issue is the relatively small number of ‘gold stan-
dard’ research studies conducted on peer-mediated interventions (with many stud-
ies reporting single-subject designs). One recent systematic review of randomised
control trials of peer-mediated interventions reported on just five studies, including
children of primary-school age (Chang and Locke, 2016). The review suggests that
these interventions resulted in participants improving in social skills (e.g. social initi-
ations, social responses, social communication) post-intervention.
One interesting study compared child-focused social skill training strategies

with peer-mediated methods, as well as a group who experienced both meth-
ods (Kasari, Rotheram-Fuller, Locke and Gulsrud, 2012). Reports from p arents,
teachers, children and independent observations of behaviour were collected pre-
and post-intervention, and after a 12-week follow-up period. In the child-focused
intervention, children were provided twice weekly sessions with a trained inter-
ventionist who focused on developing social skills according to the child’s own
needs.The trainer used didactic instruction, role-play and practice to develop skills.
In the peer-mediated intervention, three typically developing children from the
target child’s class were trained in strategies for interacting with children with
social communication difficulties at school. As for the child intervention, the small
group met with a trainer twice weekly for six weeks. Also similarly to the child
intervention, peers were taught social support via direct instruction, modelling,
role-playing and rehearsal to any children in their class that might have social dif-
ficulties. Results suggested that peer-mediated treatments yielded better improve-
ments than non-peer-mediated treatments on several outcomes and, importantly,
that those gains persisted to follow-up. Children with Autism who had taken part
in peer-mediated interventions received more peer nominations of friendship (also
from those peers who were not involved in the training), and were observed to be
less isolated in the playground. However, interestingly, the increases in peer nom-
inations about friendship were not always reciprocated by the child with Autism
– perhaps indicating a lack of realisation about opportunity, which may represent a
further target for intervention.
Taken together, these studies reporting on successes of peer-mediated
interventions point to school-based interventions being particularly powerful
for increasing the social opportunities and outcomes for children with Autism.
One other effect, which is so far untested, is that training peers may reduce inci-
dences of bullying aimed at children with Autism. Cappadocia and colleagues
(2012) suggest that peer education may be an important factor in reducing vic-
timisation. This shift away from clinic-based social skills training also represents
an understanding that children with Autism do not necessarily need to change
themselves in order to experience better social outcomes, rather providing peers
with an increased understanding of how to support and interact with a peer with
Autism is likely to be more effective.
Parent-assisted interventions for primary-age children

Although peers offer some useful naturalistic opportunities for social develop-
ment and increased inclusion, other intervention strategies have involved parents
as trainers. The parent-assisted Children’s Friendship Training (CFT) method
offers a clear and responsive framework for developing a range of skills and
knowledge related to social interaction with peers. As Carter et al. (2014) noted
following their interviews with parents of children with Autism, parents are
able to offer both direct instruction and facilitating access to a suitable peer
network. Parent-assisted CFT provides parents with a manualised approach to

aid their child to manage a range of social situations which include: creating
a social network (with aid of parent); discussion and information exchange
about mutual interests that may lead to joint activities; interacting with children
already playing together; play dates at home; and conflict negotiation and resolu-
tion (Frankel, Myatt, Sugar, Whitham, Gorospe and Laugeson, 2010). Treatment
consists of children and parents receiving 12 weekly hour-long sessions that hap-
pen concurrently, but separately. During the child sessions, children were trained
in conversational techniques, understanding the dynamics of group play, being
a ‘good host’ (see Attwood, 2000) and dealing with teasing. The parent sessions
focused largely on the socialisation ‘homework’, including a review of the most
recent, and preparing for the next. These homework assignments required par-
ents and children to use the skills they had been working on; this started with
a telephone conversation with another member of the group, and progressed to
joining a group of children playing in the community, and later to organising
and having a play date at home. In all cases, parents were involved in the prepa-
ration of the activity, and remained involved enough so that they could remind
the child about practised skills and behaviours in cases where it looked like there
might be problems.
In one evaluation of this method, 76 children with Autism were recruited into the
study, which compared an immediate CFT group with a delayed treatment group
(Frankel et al., 2010). Child outcomes were assessed using measures of social, adaptive
and play behaviours completed by parents and teachers, as well as child reports of
loneliness and self-perceived popularity. Measures were completed pre-intervention,
post-intervention and 12 weeks hence. Post-intervention scores compared to base-
line revealed modest changes in abilities and behaviour for the CFT group compared
to the delayed treatment group, although some of these changes did not persist to
the 12-week follow-up (notably, loneliness and self-perceived popularity). Although
follow-up beyond that 12-week period was not possible, the authors suggest that
gains from this programme may be cumulative, and that, for example, learning about
how to act during play dates may provide more opportunity for children and their
parents to host them, which may eventually result in increased social inclusion at
school (or in another extra-curricular context). One other gain from this programme
may be that parents gain in confidence and ability to support their child.
Conclusion
It is clear that the primary school years are characterised by a steady increase in
opportunities to develop close friendships, and the importance of those for healthy
psychological adjustment. Children with Autism often struggle with aspects of
developing social relationships, resulting in increased prevalence of loneliness and
dissatisfaction. However, school-based approaches to intervention appear to have
some potential for positive change, particularly those that focus on peers, rather
than trying to change the child with Autism themselves.
References
Anderson, A., Locke, J., Kretzmann, M., Kasari, C., and Network, A. B. (2016). Social
network analysis of children with Autism spectrum disorder: Predictors of frag-
mentation and connectivity in elementary school classrooms. Autism, 20, 700–9.
doi:10.1177/1362361315603568
Ashburner, J., Ziviani, J. and Rodger, S. (2008). Sensory processing and classroom e motional,
behavioral, and educational outcomes in children with Autism spectrum disorder.
American Journal of Occupational Therapy, 62, 564–73. doi:10.5014/ajot.62.5.564
Attwood, T. (2000). Strategies for improving the social integration of children with Asperger
syndrome. Autism, 4, 85–100. doi:10.1177/1362361300004001006
Bauminger, N., Shulman, C., and Agam, G. (2003). Peer interaction and loneliness in
high-functioning children with Autism. Journal of Autism and Developmental Disorders, 33,
489–507. doi:10.1023/A:1025827427901
Bauminger, N., Solomon, M., Aviezer, A., Heung, K., Brown, J., and Rogers, S. J. (2008).
Friendship in high-functioning children with Autism spectrum disorder: Mixed
and non-mixed dyads. Journal of Autism and Developmental Disorders, 38, 1211–29.
doi:10.1007/s10803-007-0501-2
Bellini, S., Peters, J. K., Benner, L., and Hopf, A. (2007). A meta-analysis of school-based social
skills interventions for children with Autism spectrum disorders. Remedial and Special
Education, 28, 153–62. doi:10.1177/07419325070280030401
Calder, L., Hill, V., and Pellicano, E. (2013). “Sometimes I want to play by myself ”:
Understanding what friendship means to children with Autism in mainstream primary
schools. Autism, 17, 296–316. doi:10.1177/1362361312467866
Cappadocia, M. C., Weiss, J. A., and Pepler, D. (2012). Bullying experiences among children
and youth with Autism spectrum disorders. Journal of Autism and Developmental Disorders,
42, 266–77. doi:10.1007/s10803-011-1241-x
Carter, E. W., Common, E. A., Sreckovic, M. A., Huber, H. B., Bottema-Beutel, K., Redding
Gustafson, J., Dykstra, J., and Hume, K. (2014). Promoting social competence and peer
relationships for adolescents with Autism Spectrum Disorders. Remedial and Special
Education, 35(2), 91–101.
peer-mediated interventions in the treatment of Autism spectrum disorders: A systematic
Chang, Y. C., and Locke, J. (2016). A systematic review of peer-mediated interventions for
children with Autism spectrum disorder. Research in Autism Spectrum Disorders, 27, 1–10.
doi:10.1016/j.rasd.2016.03.010
Department for Education. (2015). Special educational needs in England: January 2015. Retrieved
from www.gov.uk/government/statistics/special-educational-needs-in-england-january-
2015.
Estes, A., Rivera, V., Bryan, M., Cali, P., and Dawson, G. (2011). Discrepancies between
academic achievement and intellectual ability in higher-functioning school-aged chil-
dren with Autism spectrum disorder. Journal of Autism and Developmental Disorders,
41(8), 1044–52. doi:10.1007/s10803-010-1127-3
Frankel, F., Myatt, R., Sugar, C., Whitham, C., Gorospe, C. M., and Laugeson, E. (2010).
A randomized controlled study of parent-assisted Children’s Friendship Training with
children having autism spectrum disorders. Journal of Autism and Developmental Disorders,
40, 827–42. doi:10.1007/s10803-010-1127-3
Frederickson, N. L., and Furnham, A. F. (2004). Peer-assessed behavioural characteristics

and sociometric rejection: Differences between pupils who have moderate learning dif-
ficulties and their mainstream peers. British Journal of Educational Psychology, 74, 391–410.
doi:10.1348/0007099041552305
Frederickson, N., Jones, A. P., and Lang, J. (2010). Inclusive provision options for pupils
on the autistic spectrum. Journal of Research in Special Educational Needs, 10, 63–73.
doi:10.1111/j.1471-3802.2010.01145.x
Hilton, C. L., Harper, J. D., Kueker, R. H., Lang, A. R., Abbacchi, A. M., Todorov, A., and
LaVesser, P. D. (2010). Sensory responsiveness as a predictor of social severity in children
with high functioning autism spectrum disorders. Journal of Autism and Developmental
Disorders, 40, 937–45. doi:10.1007/s10803-010-0944-8
Humphrey, N., and Hebron, J. (2015). Bullying of children and adolescents with autism
spectrum conditions: A “state of the field” review. International Journal of Inclusive Education,
19, 845–62. doi:10.1080/13603116.2014.981602
Jahromi, L. B., Bryce, C. I., and Swanson, J. (2013). The importance of self-regulation for the
school and peer engagement of children with high-functioning autism. Research in Autism
Spectrum Disorders, 7, 235–46. doi:10.1016/j.rasd.2012.08.012
and Developmental Disorders, 40(9), 1094–1103.
Kasari, C., and Sterling, L. (2014). Loneliness and social isolation in children with Autism
Spectrum Disorders. In R. J. Coplan and J. C. Bowker (eds.), The handbook of solitude.
West Sussex, UK: Wiley Blackwell, pp. 409–26.
Kasari, C., Rotheram-Fuller, E., Locke, J., and Gulsrud, A. (2012). Making the connection:
randomized controlled trial of social skills at school for children with autism

spectrum disorders. Journal of Child Psychology and Psychiatry, 53, 431–9.
doi:10.1111/j.1469-7610.2011.02493.x
Newcomb,A.F.,and Bagwell,C.L.(1995).Children’s friendship relations:A meta-analytic review.
Psychological Bulletin, 117, 306. doi:http://dx.doi.org/10.1037/0033-2909.117.2.306
Petrina, N., Carter, M., and Stephenson, J. (2014). The nature of friendship in children with
Autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 8,
111–26.
Petrina, N., Carter, M., and Stephenson, J. (2015). Parental perception of the importance
of friendship and other outcome priorities in children with autism spectrum disorder.
European Journal of Special Needs Education, 30, 61–74. doi:10.1080/08856257.2014.943
566
Zeedyk, S. M., Cohen, S. R., Eisenhower, A., and Blacher, J. (2016). Perceived social com-
petence and loneliness among young children with ASD: Child, parent and teacher
reports. Journal of Autism and Developmental Disorders, 46(2), 436–49. doi:10.1007/
s10803-015-2575-6
7
THE TRANSITION FROM PRIMARY
TO SECONDARY SCHOOL FOR
STUDENTS WITH AUTISM SPECTRUM
CONDITIONS
Judith Hebron
Introduction
The move from primary to secondary school represents a significant ecological
shift in the lives of all young people. While it often involves heightened anxiety, it
can also be a time of excitement and keen anticipation at the prospect of entering
into a more ‘grown-up’ world and preparing for adult life. Nevertheless, young
people with Autism Spectrum Disorder (ASD) may be particularly at risk at this
time because the key challenges of transition are similar to some of the difficulties
encountered in those with Autism. The inclusion of students with ASD remains
a significant concern for educators, with poor social (e.g. difficulties in forming
friendships and bullying) and academic (e.g. lower attainment) outcomes often
reported. As a result, satisfaction with school and the ability to feel a valued part of
its community may be severely compromised.
The transition from primary to secondary school (henceforth referred to as
‘transition’ in this chapter) has the potential to be a critical point in the education
of young people with ASD, and yet research in this area remains relatively scarce.
This chapter explores transition of young people with ASD by first giving an over-
view of relevant research and then presenting new findings from a mixed methods
multi-perspective study conducted by the author in which a group of students
with ASD (and their typically developing peers) were followed across the transition.
In doing so, its aims were to expand the existing research base and gain a greater
understanding of how students with ASD become part of a new academic and
social community.
Transition from primary to secondary school 85
Review of the literature

Transition from primary to secondary school
The process of transition poses a number of changes and challenges for all chil-
dren, typically including increased school size and the number of pupils on
roll, a stronger emphasis on relative ability and competition than on effort and
improvement, and relationships with teachers that are often less personal (for a
detailed discussion of the differences between primary and secondary school,
see Coffey, 2013). Secondary school therefore requires a higher degree of self-
organisation among pupils, and in social terms they are moving from the protected
top of the social hierarchy to the bottom of a more complex one (Humphrey
and Ainscow, 2006). Despite these changes, research indicates that deleterious
effects, such as reduced academic progress, increased anxiety and social difficul-
ties, are transitory for most young people (Bloyce and Frederickson, 2012), and
that the experience of transition is often easier than anticipated (Waters, Lester
and Cross, 2014).
The challenges of transition may be greater for young people with special edu-
cational needs (SEN) compared to their typically developing (TD) peers, due to
increased academic and social difficulties. To date though, there has been relatively
little research in this area, with a focus on pupils with SEN as a homogeneous
group, rather than exploring differences between groups of learners whose needs
may vary greatly (Maras and Averling, 2006). Indeed, in the only systematic liter-
ature review on transition for young people with SEN, Hughes, Banks and Terras
(2013) found that just 17 per cent of transition studies focused on students with
SEN, and only five met their inclusion criteria for the review. The authors identi-
fied young people with SEN as being more vulnerable to anxiety, becoming the
victim of bullying, low academic self-esteem, and poorer psychosocial outcomes
compared to their TD peers.
Transition for young people with Autism – previous research

Research into the educational experience of young people with Autism has
identified a number of areas in which this group of young people may expe-
rience particular challenges compared to their TD peers. These include: poorer
academic outcomes and an elevated risk of exclusion (DfE, 2014), social vulner-
ability and victimisation (Sofronoff, Dark and Stone, 2011), anxiety and depres-
sion (Hebron and Humphrey, 2012), and behavioural difficulties (Macintosh
and Dissanayake, 2006). Similar to SEN transition research however, there
remains a lack of primary-secondary studies focusing on students with Autism.
Nevertheless, this is an area in need of better understanding, given that 70 per cent
of autistic students now attend mainstream schools in England (DfE, 2014).
A review of transition research literature revealed only 8 studies1 specifically
86 Judith Hebron
exploring the experience for young people with Autism. An overview of these
is provided in Table 7.1.
TABLE 7.1 Studies focusing on the primary to secondary school transition of young people
with Autism
Study Setting N Design Data Respondents
collection
Peters, R., and Brooks, R. England 17 Quant Post Parents

(2016). Parental perspectives
on the transition to
secondary school for
students with Asperger
syndrome and high-
functioning autism: a pilot
survey study. British Journal
of Special Education, 43(1),
75–91.
Mandy, W., Murin, M., England 28 Quant Pre/Post Students,

Baykaner, O., Staunton, S., parents and
Hellriegel, J., Anderson, S., teachers
and Skuse, D. (2015a). The
transition from primary
to secondary school in
mainstream education
for children with autism
spectrum disorder. Autism,
20(1), 5-13.
Coles, J. (2014). Transition England 10 Quant Pre Students

to secondary school: A and parents
comparison of parents’
and pupils’ concerns. Good
Autism Practice, 15, 70–80.
Dillon, G.V., and UK 15 Mixed Pre/ Parents

Underwood, D. M. (2012). Post1/
Parental perspectives of Post2
students with autism
spectrum disorders
transitioning from primary
to secondary school in
the United Kingdom.
Focus on Autism and Other
Developmental Disabilities,
27, 111–21.
(continued)
TABLE 7.1 Studies focusing on the primary to secondary school transition of young people
with Autism (continued)
Study Setting N Design Data Respondents

collection
Hannah, E. F., and Topping, Scotland 8 Quant Pre/Post Students

K. J. (2012). Anxiety levels
in students with autism
spectrum disorder: Making
the transition from primary
to secondary school.
Education and Training in
Autism and Developmental
Disabilities, 47, 198–209.
Tobin, H., Staunton, S., England 7 Qual Pre/Post Parents

Mandy, W., Skuse, D.,
Helligreil, J., Baykaner,
O., . . . Murin, M. (2012).
A qualitative examination
of parental experiences
of the transition to
mainstream secondary
school for children with an
autism spectrum disorder.
Educational and Child
Psychology, 29, 72–83.
Dann, R. (2011). Secondary England 6 Qual Pre/Post Students,

transition experiences parents and
for pupils with autistic teachers
spectrum conditions
(ASCs). Educational
Psychology in Practice, 27,
293–312.
Jindal-Snape, D., Douglas,W., Scotland 5 Qual Pre Students,

Topping, K. J., Kerr, C., parents and
and Smith, E. F. (2006). professionals
Autistic spectrum disorders
and primary-secondary
transition. International
Journal of Special Education,
21(2), 18–31.
The studies are all recent, conducted in the UK, with relatively small sample sizes,
and a range of methodologies, designs and respondents used. While this represents
considerable variation, there are a number of common themes in the findings which
88 Judith Hebron
begin to suggest some cautious generalisability. Of immediate note, however, is that

many of the findings in these studies are similar to those for TD students, with con-
cerns relating to the organisation and structure of the school, adapting to different
teachers, coping with new academic demands and homework, making friends and
bullying. In observing this similarity, Dann (2011) notes that, ‘Perhaps pupils with
ASC need more preparation (quantitative difference) due to their difficulties and
may experience a greater intensity of worry and difficulty’ (p. 305).
Central to a successful transition were coordinated efforts between primary and
secondary schools, during which the parents and young people were involved (e.g.
Tobin et al., 2012). This enabled students to be familiar with the new environ-
ment and staff prior to transition (e.g. Dann, 2011), while delays and inconsistent
approaches to transition were associated with less positive outcomes (e.g. Jindal-
Snape, Douglas, Topping, Kerr and Smith, 2006). Although parents sometimes felt
the need for more visits, a bespoke transition package was viewed favourably (e.g.
Peters and Brooks, 2016). Parents often expressed a desire for more support and
tended to be more anxious than their children (e.g. Coles, 2014), who frequently
viewed transition optimistically (e.g. Jindal-Snape et al., 2006). Knowledge of the
young person, both pre-, during and post-transition were more likely to result in the
student receiving suitable support, although positive staff attitudes and understanding
of Autism, as well as appropriate training were also considered vital (e.g. Dann, 2011).
Following transition, while many students appeared to cope well with the
academic demands of their new school, homework emerged as a concern.This may
have been exacerbated by a tendency for students to regard home and school as
separate environments with little or no overlap (e.g. Dillon and Underwood, 2012).
In addition, few young people were found to actively participate in extra-curricular
activities (Coles, 2014). Nevertheless, social relationships were extremely import-
ant in the majority of these studies, with peer acceptance, support and friend-
ship viewed very positively (e.g. Dillon and Underwood, 2012), and poor social
relationships (including being bullied) associated with problematic transition (e.g.
Peters and Brooks, 2016). Anxiety was mentioned in the majority of studies, but
with inconsistent findings. For example, Hannah and Topping (2012) did not find
any clear trends, while Peters and Brooks (2016) highlighted it as an issue, especially
at unstructured times of the day. Mandy and colleagues (2015b) acknowledge that
although they did not find any significant change in difficulties at the group level,
many young people in their sample already had high (and often undiagnosed) levels
of psychopathology at primary school that persisted across the transition. Of note
in this study is that a decline in bullying post-transition was also found.
Satisfaction with school and social inclusion among

young people with ASD at transition
The existing research base has identified that a successful transition for children
with ASD may be affected by many factors. Indeed, Peters and Brooks (2016) sug-
gest that there is no single barrier to a successful transition, while Hannah and
Topping (2012) note the importance of individual differences. Importantly, Mandy,

Murin, Baykaner, Staunton, Hellriegel, et al. (2015b) call for greater exploration
of the ‘social and educational processes that occur during this time which might
influence outcomes’ (p. 8): this represents a shift away from the more traditional
deficit-led approach (Billington, 2006) towards an acknowledgement that external
factors (i.e. the school ethos and environment) may be of equal or greater impor-
tance in securing successful outcomes.With these questions in mind, the study pre-
sented in the following sections explores how students with ASD experienced the
transition to secondary school with a particular focus on satisfaction with school
and social inclusion.
The study
This was a longitudinal mixed methods study. Participants were students with ASD
(N = 28, 23 male and 5 female) and a comparison group of TD students (N = 21,
16 male and 5 female), recruited from mainstream and special schools across the
North West of England and North Wales. There were four data-collection points:
• T1 = Year 6, final term of primary school

• T2 = Year 7 term 1, first year of secondary school
• T3 = Year 7 term 3, first year of secondary school
• T4 = Year 8 term 1, second year of secondary school
Each time point was approximately 6 months after the previous one, covering an
18-month period in total. Students completed the Psychological Sense of School
Membership (PSSM) scale (Goodenow, 1993) as a proxy of school satisfaction
and social inclusion across the transition. This widely used and validated question-
naire permits an understanding of ‘the extent to which [students] feel personally
accepted, included, respected and supported’ (p. 80) at their school. It contains 18
items (e.g. I am included in lots of activities at my school ) which are scored on a 5-point
Likert scale, with a mean score calculated. Questionnaire data were analysed statis-
tically using ANOVAs, and t-tests.2
In addition, 10 concurrent case studies were completed from among the ASD
group and involved students (11 including twins; 9 boys, 2 girls), their parents and
a key teacher. Interview data were analysed inductively and deductively using the-
matic analysis (Braun and Clarke, 2006). This qualitative element was considered
vital in order to give meaning to the responses given in the PSSM questionnaire, as
well as to provide explanatory accounts of the transition from first-person, home
and school perspectives.
Satisfaction with school across the transition

The results of the PSSM questionnaire are presented in Figure 7.1. It is encour-
aging to note that both groups demonstrated a good level of satisfaction with
school throughout the study (mean scores of 3 and above indicate a more
90 Judith Hebron
positive sense of school membership), but there were very different trends in the
two groups. Findings for the TD group were broad as expected, with students
experiencing less satisfaction with school when first starting in Y7 (T2), but
this stabilised by the end of the first year (e.g. Bloyce and Frederickson, 2012),
with evidence of a non-significant decrease at the beginning of the second year
(T3-4).
Contrary to expectations, students with ASD reported a significant increase
in their satisfaction with school from T1 to T3, in effect demonstrating the
opposite trend to their TD peers. In addition, while there was a significant dif-
ference between the ASD and TD students in levels of school connectedness at
T1 and T2, this was no longer the case at T3 and T4, with the gap narrowing
considerably, although there were indications of it starting to open up again
at T4. There are a number of potential explanations for the positive trends in
the ASD group in this study, and they offer cautious optimism to suggest that
transition to secondary school for young people with Autism may not be the
negative experience it is often hypothesised to be. However, of concern is the
downward trend in scores reported for both groups at T4, after a term of Y8,
with the ASD group reporting a greater fall in scores than the TD group. This
may be indicative of the gradual disengagement found in secondary school stu-
dents as they progress through the academic year groups (Coffey, 2013), but the
finding warrants further exploration. In order to avoid unnecessary repetition,
the PSSM findings are discussed in more detail with the case study findings in
the following section.
4.7
4.6
4.5
4.4
4.3
4.2
4.1
4
Time 1 Time 2 Time 3 Time 4
ASD group TD group
FIGURE 7.1 A graph indicating the differences between groups over time on
the PSSM
The experience of transition from students, parent

and teacher perspectives
Thematic analysis resulted in six main themes (as presented in Figure 7.2) that were
judged to encapsulate and reflect the experiences of participants during the transition
to secondary school.These themes are considered in turn and discussed in relation to
the PSSM findings in order to provide a comprehensive picture of the issues encoun-
tered during transition in relation to satisfaction with school and social inclusion.
Transition planning and management

Transition planning
Where transition worked well, there was a bespoke transition package in place that
was negotiated between primary and secondary schools as well as parents and stu-
dents. All students were involved in the transition open days, and this enabled them
to meet new peers and experience lessons. In addition, the majority of students
had additional visits that permitted further familiarisation and also the opportunity
to explore more specific concerns. Students valued transition books (with their
timetable, photographs of teachers, and maps) as well as being able to explore their
new school while the building was empty. One parent reflected immediately post-
transition: ‘He was right in the middle of the hustle and bustle and buying his food and
doing his thing and he was absolutely at home … usually he’s the one that’s got all the strug-
gling.’ For those students requiring the support of a teaching assistant, it was rarely
possible to meet the member of staff in advance, and this was a source of anxiety
ATTITUDE
TOWARDS AUTISM
SCHOOL
PRIMARY TO
TRANSITION–
SECONDARY
PLANNING AND RELATIONSHIPS
SCHOOL
MANAGEMENT
TRANSITION
COMMUNICATION SUPPORT
FIGURE 7.2 A graphic representation of the main themes from the thematic analysis
92 Judith Hebron
for parents in particular. Where key staff were able to meet the young people and
their parents pre-transition, this provided a useful point of contact and sense of
consistency.While time-consuming to put together, the benefits of a well-organised
transition plan clearly outweighed any disadvantages and parents felt reassured that
staff had taken time to understand their child.
Ongoing transition management

Once the transition had taken place, it was vital that the transition plan was used
consistently and information passed on to relevant teaching staff. This was not
always the case, leading to breakdowns in communication and on occasion inap-
propriate strategies used in class with the student. In most cases issues were resolved
reasonably swiftly if the special educational needs co-ordinator was made aware and
intervened. However, in some cases, parents were not aware of a problem, and their
child did not mention anything until reaching a crisis point: ‘Just a simple phone call
or something just to say “we’re having this issue” – we could have stopped it right there and
then, […] we wouldn’t have had the whole big explosion at the end of the week.’
While the move into Y8 (T4) could be considered another transition to be
planned and managed, it was reassuring to note that neither the students nor their
parents expressed any significant concerns, and this was largely confirmed at T4
once Y8 had started. However, the findings from the PSSM do not support this,
with (albeit non-significant) decreases in school connectedness reported by the
end of the first term of Y8 (T4). This may reflect the gradual disengagement often
observed in secondary age students (e.g. Coffey, 2013) as they enter puberty and
are also faced with ever-increasing academic demands. Given the potential social
vulnerability of young people with ASD and the increasingly complex social
behaviour that is associated with adolescence, more research from a first-person
perspective is needed to explain this trend. This is discussed in more detail in the
‘Relationships’ section.
Communication
This is an important theme in previous ASD transition studies (e.g. Tobin et al.,
2012), and its salience was reinforced in this study.Where effective channels of com-
munication were open between home and school, the transition tended to go more
smoothly. Parents valued what could be considered a ‘primary school’ model of close
communication, and in some cases this was necessary in order to ensure continuity
and consistency between home and school. One parent commented: ‘It’s amazing,
it goes above and beyond really I think what’s reasonable … every day, at the end of the day,
both of them come out to see me and to hand over.’ While this level of support was only
needed in the short term and in a small number of cases, parents valued it highly.
More generally, parents appreciated being able to speak to or email trusted contacts
in the knowledge that they would be listened to and any concerns would be acted
on: ‘I’ve never phoned and not got through or not been able to get hold of them. If I’ve emailed
I’ve had a response within an hour or so, it’s really good, it’s very good communication.’
However, this was not a one-way process and teachers also appreciated good com-
munication from parents: ‘Everything we have done, we’ve had parental support for, you
know, we’ve developed over the time a good respect there.’ This sense of mutual respect was
vital, especially for parents who had previously experienced poor relationships with
schools and teachers.
Nevertheless, in a minority of cases, parents felt that some problems could have
been avoided if the school had contacted them. In addition, some parents simply
needed some reassurance early on in the transition that everything was fine: ‘I think
if I phoned up and pressed for answers I’ve got them, but I don’t think, I’ve not even had
anybody phone me just to let me know how he’s getting on.’ This was clearly distressing
for some parents who did not wish to contact the school unnecessarily for fear
of being seen as a ‘nuisance’. Lack of effective communication and understanding
between home and school could mask serious issues, as demonstrated by one case
study student whose transition ultimately collapsed, causing a great deal of distress
to the student and family.
Support
Students
All the students had differing needs, but it was apparent that support would be
required for the majority at least in the short term in order to maximise opportuni-
ties for social inclusion and academic progress. Some students needed high levels of
support (i.e. constant support from a teaching assistant), and this was likely to reflect
a social or emotional need as much as an academic one. Others benefited from hav-
ing a teaching assistant to ensure they remained on task during lessons, or a trusted
member of staff who could to provide advice and support if required: ‘I know I’ve
always got my teaching assistants nearby if I ever need some help.’ This underlines the
importance of school staff knowing the students as individuals with unique needs,
rather than making assumptions about the type and level of support required. Many
of the case study students excelled academically but encountered organisation or
peer group issues. In addition, all secondary school staff mentioned independence
as an important skill for the young people to develop. In ‘best practice’ cases, sup-
port was gradually withdrawn once the student was judged to be ready for greater
independence, although the teaching assistant tended to remain in the classroom as
a discrete support.
Parents
Parents often emerged as needing a high level of support from schools at transi-
tion. This is understandable given the significance of the change and was often
reflected upon in the light of previous poor experiences at primary school or
worries about having to get to know a new staff. Indeed, prior to transition,
parents expressed considerably more concerns than their sons and daughters: ‘It’s
94 Judith Hebron
all change, yeah. Everything changes and to be honest I’m quite freaked out by it. I think
I may be more … more nervous than he is, to be honest.’ Nevertheless, in light of the
positive communication that most parents had with the secondary schools, the
reality of transition tended to be better than anticipated. The same parent later
commented: ‘It was going to be a settling in year and well it hasn’t been a settling in
year it’s been a spectacular year!’
Relationships
New friendships and the peer group
Most of the students had experienced difficulties forming and maintaining friend-
ships in the past, although a number of them had successful primary school friend-
ships, some of which persisted into secondary school. While some of the students
continued to find it difficult to forge new friendships, there was a desire among
all of them to do so, with varying levels of success. However, it was encouraging
to note some very successful new reciprocal friendships for about half of the case
study students by the end of Y7 and into Y8. The common feature here was that
new friends had similar interests and were highly supportive of each other: ‘We’re
all kind of bookworms, so we’re always hanging out in the library together’ and ‘They’re
like really nice to me and they get my jokes, my jokes are horrible by the way!’ Some of
these new friendships were with other students on the autistic spectrum but often
they were not, perhaps reflecting the benefits of having a larger peer group at
secondary school. On the whole, secondary peers appear to have been supportive
and inclusive during the first year of secondary school, although there were indica-
tions that friendship groups were becoming more fluid, and the case study students
increasingly left out. While this may not have been a conscious decision, there was
a growing awareness among the case study students of their ‘difference’ from the
peer group but also a reluctance to be forced to conform to new social conventions:
‘Everyone has their own little clusters, it’s like they’re penguins grouping together into one
corner, it’s very funny to me.’
Bullying
All of the case study students had experienced teasing and bullying at some
point in their primary school years. It was therefore encouraging to note that
levels were no higher and may even have declined from T2 to T4. This would
support the higher levels of school satisfaction reported by the ASD students
on the PSSM as well as Mandy, Murin, Baykaner, Staunton, Hellriegel, et al.’s
(2015a) recent findings. However, approximately half of the case study students
did experience some bullying behaviour from peers in Y7, and this ranged from
physical attacks to social exclusion and teasing. In all cases this was very upset-
ting for the students, but both they and their parents reported that incidents had
been dealt with promptly and appropriately by the schools. Reporting of issues
could be problematic, and in a number of cases it was brought to the school’s
attention by peers or parents rather than the students themselves. Clearly this is
an area that warrants continued attention, both in terms of personal awareness
of bullying behaviour, as well as better educating the peer group and ensuring
staff remain vigilant (especially at unstructured times). The students were also
becoming increasingly involved in social media, and it is acknowledged that this
is more difficult to ‘police’ for parents and schools.
Attitude towards school

Making a ‘new start’
Many of the students were excited as well as apprehensive about their forthcoming
transition, and this was reiterated by parents and teachers: ‘He’s looking forward to
going […] that idea of challenge and being pushed and seeing a worth and value of his edu-
cation’ – primary school teacher. In several cases, especially where the young person
had experienced difficulties at primary school prior to ASD diagnosis, the move
to secondary was seen as an opportunity to be seen as an individual rather than
through the lens of a label or previous behavioural difficulties: ‘It’s been a completely
fresh start for all of us to be honest and I think for him, because they’re just taking him on
face value, although they know all the background, they are allowing him to start again which
is just, for me, is massive’ – parent. This notion of a fresh start continued over the first
year of secondary school was instrumental in many of the young people feeling a
genuine sense of inclusion in the school: ‘I thought it’d like be a bit weird moving, but
after a couple of weeks I felt like … now, I don’t even remember really going to that school, it
just feels like when I think of school I think of here.’
Academic considerations
For all of the young people, it took a few weeks to become used to the academic
demands and multiple subject staff at secondary school, although having a complex
timetable did not appear to cause any significant issues. This would suggest that the
highly structured environment of a secondary school may suit many young people
with ASD. Liking or disliking a subject seemed to depend more on the teacher and
his/her style rather than the actual academic content. Homework presented many
challenges for the young people. While some were highly organised and accepted
that homework must be completed punctually, others struggled to manage this at
the end of an already exhausting day, with one parent commenting: ‘It’s battlefield
homework because as far as she is concerned, school is for schoolwork and home is for doing the
things she wants to do at home.’ This issue was circumvented in most cases by the stu-
dents either completing homework during the school day (i.e. at lunchtime) or at
an after-school club. A further issue emerged in terms of some staff not explaining
homework tasks with sufficient clarity for students who interpreted instructions
literally (i.e. it is not enough to ask students to complete something if the teacher
also expects it to be submitted).
96 Judith Hebron
Extra-curricular activities
Similar to previous studies (e.g. Coles, 2014), few of the students in this study par-
ticipated in extra-curricular activities. While this sometimes reflected a reliance on
school transport, it also emerged that the participants needed time to rest after the
social demands of the day. This is an important consideration for schools, as young
people with Autism often manage the school day extremely well but have a result-
ing need to be able to relax and express any frustrations once they are home and
in a safe environment.
Autism and identity

Autism as a condition pervaded many aspects of the transition to secondary school,
and the findings are consonant with previous research (e.g. Dann, 2011) suggesting
that young people with Autism may experience aspects of transition more intensely
than their TD peers and so may require additional support.
Anxiety
Most of the young people in this study experienced high levels of anxiety and/
or frustration on occasion, and at levels that could be considered unusual for a TD
student. Similar to recent research findings (Mandy, Murin, Baykaner, Staunton,
Hellriegel, et al., 2015b), this level of psychopathology was already present in pri-
mary school for many of the students and only increased at transition in a minority
of cases. Staff understanding of triggers and warning signs could defuse potentially
difficult and upsetting situations, and often a clearer explanation or some ‘time out’
in a quiet area was sufficient for students to be able to manage their anxiety. Anxiety
was also experienced in some cases as a result of sensory sensitivities.While this was
something that mainstream schools sometimes struggled to understand, it is pleas-
ing to note that reasonable adjustments were often made (e.g. a pass to go to lunch
early to avoid busy corridors, permission not to wear a school tie).
Autism awareness among adults

Awareness of Autism among staff, other parents and the peer group varied greatly,
although all of the students were aware of their diagnosis. Where staff were well
trained and had a good understanding of Autism, students felt valued and safe in
their classrooms. In many cases this allowed the young people to be themselves and
enjoy the experience of education: ‘You don’t have to be someone you’re not, just be
yourself’ – student. However, this was not always the case, and a number of the stu-
dents and their parents (as well as some of the teachers) commented on difficulties
in ensuring that staff understanding was adequate, appropriate and did not rely on
outdated stereotypes. Parents of TD students could also demonstrate poor under-
standing of Autism, and in some cases this resulted in social exclusion.
Seeing past the label

In many cases, secondary school staff were proactive in valuing the students as indi-
viduals with their own often considerable strengths. This nurturing approach made
the overall experience of school more fulfilling and undoubtedly contributed to
the sense of school connectedness and inclusion most of these young people felt
within a few weeks of joining their new school: ‘She feels valued, she feels as if her
opinion does matter, they do listen to her’ – parent.
Recommendations and future directions

The findings from this study and previous literature highlight that transition is a
critical point in a young person’s social and educational development. There is evi-
dence for cautious optimism that it can be a positive experience for young people
with ASD and their parents when planned appropriately. Continued research is
warranted in this area, especially in terms of more mixed-methods studies that can
explore the processes underpinning transition, as well as flexible models of inter-
vention that accommodate the heterogeneous nature of ASD. In education terms,
there are a number of areas warranting attention and development, given that there
are no statutory transition requirements in many countries:
• There should be more sharing of good practice, as many schools have excellent
transition programmes in place.
• Schools need designated staff members to manage the transition of students
with ASD (as well as other potentially vulnerable students), and this needs to
begin well in advance of the actual transition.
• Bespoke transition plans are essential for many young people with ASD, and
manualised transition interventions that allow a flexible approach (such as
Mandy, Murin, Baykaner, Staunton, Cobb, et al., 2015a) may be very useful.
• Parents and students should be involved in transition planning, allowing ade-
quate time to become acquainted with the new school and key members of
staff.
• It is important to have an ‘Autism-friendly’ environment and ethos at the
school that encourages diversity.
• Schools must ensure adequate training of all staff in Autism awareness in
order to make students feel more valued and accepted as part of the learning
community.
• The social element of transition is vital to its success, as school contributes
significantly to a student’s social and emotional development.
Summary
The importance of a positive transition to secondary school cannot be underesti-
mated, and there is growing empirical evidence to suggest that this is achievable
98 Judith Hebron
for young people with ASD, provided that schools provide appropriate planning
and support. A successful transition is dependent on many factors and these will
be unique to each individual. However, common to all transitional arrangements is
the need to promote social inclusion by ensuring a nurturing ethos that embraces
difference and diversity; getting to know the young person as an individual while
understanding and accommodating their needs; supporting and communicating
with parents; and remaining vigilant to social vulnerability and bullying from the
peer group. In doing so, there is evidence that young people with ASD can quickly
feel a keen sense of inclusion and belonging in their new school, which in turn will
contribute to a positive experience of education.
Acknowledgements
The author’s study presented in this chapter was jointly funded by the Leverhulme
Trust and the University of Manchester Simon Fellowship. Sincere gratitude is
extended to the students, parents and teachers involved in the study, without whose
contribution this research would not have been possible.
Notes
1 In addition to the research reviewed, Mandy, Murin, Baykaner, Staunton, Cobb, et al.
(2015a) present the findings of an intervention study using the original transition study
participants as a control group. The study is not included here as the focus is not on
intervention studies; however, it is recommended for readers seeking an intervention for
transitioning students with Autism.
2 The author can be contacted for further details of the statistical analyses.
References
Billington, T. (2006). Working with autistic children and young people: Sense, experience
and the challenges for services, policies and practices. Disability and Society, 21(1), 1–13.
Bloyce, J., and Frederickson, N. (2012). Intervening to improve the transfer to secondary
school. Educational Psychology in Practice, 28, 1–18.
Braun,V. and Clarke,V. (2006). Using thematic analysis in psychology. Qualitative Research in
Psychology, 3(2), 77–101. doi: 10.1191/1478088706qp063oa.
Coffey, A. (2013). Relationships: The key to successful transition from primary to secondary
school? Improving Schools, 16(3), 261–71.
Coles, J. (2014). Transition to secondary school: A comparison of parents’ and pupils’ con-
cerns. Good Autism Practice, 15, 70–80.
Dann, R. (2011). Secondary transition experiences for pupils with Autistic Spectrum
Conditions (ASCs). Educational Psychology in Practice, 27, 293–312.
DfE. (2014). Children with special educational needs: An analysis. Nottingham. Nottingham: DfE
Publications.
Dillon, G. V., and Underwood, D. M. (2012). Parental perspectives of students with autism
spectrum disorders transitioning from primary to secondary school in the United
Kingdom. Focus on Autism and Other Developmental Disabilities, 27, 111–21.
Goodenow, C. (1993). The psychological sense of school membership among adolescents:

Scale development and educational correlates. Psychology in the Schools, 30(1), 79–90.
Hannah, E. F., and Topping, K. J. (2012). Anxiety levels in students with autism specrtum
disorder: Making the transition from primary to secondary school. Education and Training
in Autism and Developmental Disabilities, 47, 198–209.
Hebron, J. S., and Humphrey, N. (2012). Mental health difficulties among young people with
autistic spectrum disorders in mainstream secondary schools: A comparative study. Journal
of Research in Special Educational Needs. doi:10.1111/j.1471-3802.2012.01246.x
Hughes, L. A., Banks, P., and Terras, M. M. (2013). Secondary school transition for children
with special educational needs: A literature review. Support for Learning, 28(1), 24–34.
Humphrey, N., and Ainscow, M. (2006). Transition club: Facilitating learning, participation
and psychological adjustment during the transition to secondary school. European Journal
of Psychology of Education, 21, 319–31.
Jindal-Snape, D., Douglas, W., Topping, K. J., Kerr, C., and Smith, E. F. (2006). Autistic spec-
trum disorders and primary-secondary transition. International Journal of Special Education,
21(2), 18–31.
Macintosh, K., and Dissanayake, C. (2006). Social skills and problem behaviours in school-
aged children with high-functioning Autism and Asperger’s disorder. Journal of Autism and
Developmental Disorders, 36(8), 1065–76.
Mandy, W., Murin, M., Baykaner, O., Staunton, S., Hellriegel, J., Anderson, S., and Skuse,
D. (2015a). The transition from primary to secondary school in mainstream education
for children with autism spectrum disorder. Autism, 20(1), 5–13. doi: 10.1177/
1362361314562616.
Mandy, W., Murin, M., Baykaner, O., Staunton, S., Cobb, R., Hellriegel, J., Anderson, S.,
Skuse, D. (2015b). Easing the transition to secondary education for children with autism
spectrum disorder: An evaluation of the Systemic Transition in Education Programme for
Autism Spectrum Disorder (STEP-ASD). Autism , 20(5), 580–90. doi:1362361315598892.
Maras, P., and Averling, E. L. (2006). Students with special educational needs:Transitions from
primary to secondary school. British Journal of Special Education, 33, 196–203.
Peters, R., and Brooks, R. (2016). Parental perspectives on the transition to secondary school
for students with Asperger syndrome and high-functioning autism: A pilot survey study.
British Journal of Special Education, 43(1), 75–91.
Sofronoff, K., Dark, E., and Stone, V. (2011). Social vulnerability and bullying in children
with Asperger syndrome. Autism, 15(3), 355–72.
Tobin, H., Staunton, S., Mandy, W., Skuse, D., Helligreil, J., Baykaner, O., Anderson, S.,
Murin, M. (2012). A qualitative examination of parental experiences of the transition to
mainstream secondary school for children with an autism spectrum disorder. Educational
and Child Psychology, 29, 72–83.
Waters, S. K., Lester, L., and Cross, D. (2014). Transition to secondary school: Expectation
versus experience. Australian Journal of Education, 58(2), 153–66.
8
POST-SCHOOL SOCIAL INCLUSION
FOR ADULTS WITH AUTISM IN
AUSTRALIA
Michelle L. Bonati
Australia is at a crossroads. As a society, Australians can change the current course for
adults with Autism. Legislation has been enacted, and a national disability insurance
scheme is being rolled out as part of the National Disability Strategy 2010-2020
(Commonwealth Council of Australian Governments, 2011). All of these efforts are
intended to address the increasing social exclusion of people with disabilities. For
adults with Autism Spectrum Disorder (ASD) and their families, entering adult-
hood and leaving school can seem like walking toward a precipice. Young men
and women with ASD often do not know if they will have the needed support to
achieve their goals. Many have already experienced years of social exclusion in their
education experiences and communities (Biggs and Carter, 2016). A clear path to a
more inclusive society is needed with a commitment from the government and our
community members to support adults with ASD. Financial support and removal
of attitudinal barriers are needed so that adults with ASD can attend tertiary edu-
cational institutions, maintain employment, access living accommodations in the
community, and freely participate in daily life.
The purpose of this chapter is to discuss the key theoretical and practical issues
related to post-school social inclusion for adults with ASD living in Australia. Social
capital theory will provide a framework for discussing the intersecting concepts of
quality of life and social inclusion. This chapter will focus on a conceptualisation of
social inclusion that emphasises individuals with ASD having valued social roles
through community participation and interpersonal relationships. Historical and
current efforts in Australia to address issues related to social exclusion and disadvan-
tage for adults with ASD will be explored. Current practices that support or pose
barriers to the social inclusion of adults with ASD in the areas of transportation,
tertiary education, employment, and community living accommodation will also
be discussed.
Post-school social inclusion 101
Disability is an evolving concept. Notions of disability as intrinsic to a person

with a focus on deficits have been pushed aside in favour of a social-ecological
model (Oliver, 2013). The preamble of the UN Convention on the Rights of
Persons with Disability (2006) asserts that disability is conceived as the interaction
between environmental and attitudinal barriers and persons with impairments. It is
the interplay of these contextual factors that prevents individuals from participating
in society as those without a disability.
Conceptualisations of Autism as a disorder have also changed over time, with
greater specificity in defining criteria and an emphasis on determining the level of
support an individual needs (Mehling and Tasse, 2016). Recently, the fifth edition of
the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced a new
diagnostic label of Autism Spectrum Disorder (ASD) to replace pervasive devel-
opmental disorders (PDD) (APA, 2013). The updated criteria also require specify-
ing co-occurring conditions, including intellectual disability, language impairment,
medical conditions, or mental health conditions. The emphasis is placed on the
conceptualisation of a spectrum, which means that the population of individuals
with ASD represent a vastly heterogeneous group that share commonalities of vary-
ing degrees for central characteristics of the disorder.
An ASD diagnosis often is a requirement for gaining access to support and
health-related services, and the greater specificity and reduced sensitivity of the
revised DSM-5 may result in adults who previously met eligibility criteria no lon-
ger receiving a diagnostic label for Autism (Wilson et al., 2013). As children with
ASD become adults, there are often general improvements in the severity of Autism
characteristics (Woodman, Smith, Greenberg and Mailick, 2014); however, ASD
is still a life-long disorder (APA, 2013). Although social communication impair-
ments, restrictive interests, and repetitive behaviours are central characteristics of
ASD described in the DSM-5 (APA, 2013), it is the interaction between these
challenges and societal barriers that determine the extent of social inclusion for
people with ASD. The social-ecological model of disability focuses on the level of
support an individual requires and the needed changes to the environmental con-
text to enable full participation (Mehling and Tasse, 2016). Consequently, people
with ASD with relatively low support needs may not realise social inclusion due to
the severity of environmental or attitudinal barriers present in a local context.With
people with ASD comprising approximately 1 to 2 percent of the global population
(CDCP, 2016), governments have a responsibility to ensure that adults with ASD
are included as part of the fabric of each community in which they live.
Social capital: Quality of life and social inclusion

for adults with ASD
Explorations of the meaning and impact of social capital extend back to the late
19th century when Tocqueville first described the concept of social connectedness,
in which people looked out for each other because it was mutually beneficial
102 Michelle L. Bonati
(Putnam, 2000). Two of the thought leaders in the field of social capital theory,
Putnam (2000) and Coleman (1988), focus on the collective benefits of social
capital that arise from reciprocal actions based on trust and solidarity of people
within a social network. As a society, we can accomplish more than as individuals,
and these benefits accrue through our relationships with others. The third major
leader in social capital theory, Bourdieu, focused on the individual benefit derived
from social capital and noted the negative potential of social capital as a means to
exclude and maintain social inequality (Bourdieu, 1986). The potential negative
implications of social capital can be concerning for people with disabilities, who are
often considered to be in the out-group, whether through bullying, discriminatory
practices in employment, or a lack of options for accommodation in the commu-
nity (Parsons, 2015).
More recently, the development of social capital has been proposed as a means
to promote positive adult outcomes for individuals with disabilities (Trainor,
Morningstar, Murray and Kim, 2013). Secondary school educators need to ensure
students with disabilities have the opportunity to develop social capital during
their transition years. Social capital can be promoted through inclusive education,
development of communication and social skills, expansion of social networks, and
options to become socially connected within their communities (Biggs and Carter,
2016). After high school, the challenges are greater to address the structural, attitu-
dinal, and skill-based issues related to developing social capital for adults with ASD.
By using social capital theory, we can reframe issues from focusing on individual
deficits to further explore and come to understandings about the complexities of
structures and interactions that may inhibit positive outcomes (Trainor et al., 2013).
Quality of life
Social capital theory emphasises the importance of our support network for our
quality of life, and interdependence is a desired outcome for adults with ASD
(Wehmeyer and Schalock, 2001). To quote from the adapted Old English poem
by John Donne, “No man is an island, entire of itself ” (Donne, 2016, Para 1).
Social capital is necessary to achieve and maintain our quality of life (Brown,
Cobigo and Taylor, 2015). While we often focus on developing skills to promote
independence, people live within societies that require and enjoy the reciprocal
nature of our interactions with other humans (Wehmeyer and Schalock, 2001).
Quality of life serves both as an overarching principle for addressing the needs
of an individual through a focus on person-centred planning and as a means to
evaluate the services and providers in achieving the desired outcomes for people
with disabilities (Schalock,Verdugo, Gomez and Reinders, 2016). Quality of life can
be conceptualised as a framework comprised of eight dimensions that encompass
personal well-being (Wehmeyer and Schalock, 2001). These dimensions include
“personal development, self-determination, interpersonal relations, social inclu-
sion, rights, emotional well-being, physical well-being, and material well-being”
(Schalock et al., 2016, p. 2). These core dimensions are considered to be the same
for people with disability as those that are valued by people without disabilities
(Wehmeyer and Schalock, 2001).
Considering the ecological nature of quality of life, strategies for improvement
should include a systems perspective (Bronfenbrenner, 1979), by addressing issues
related to individual, organisational, and societal levels (Schalock et al., 2016).
Understanding the quality of life status of individuals with disability can guide
directions for development through person-centred planning and intervention at
the individual level. Examining quality of life outcomes for adults with ASD can
direct needed changes to policies and programs and improve the attitudes toward
Autism at the organisational and societal levels (Schalock et al., 2016). Quality of
life measures must be sensitive enough to detect changes to ensure that progressive
policy changes are not undermined by an apparent lack of progress (Brown, Hatton
and Emerson, 2013). Subjective indicators of quality of life need to include the per-
spectives of adults with ASD, as the majority of literature has only employed parent
perspectives (Muller and Cannon, 2016; Parsons, 2015).
Social inclusion
Social inclusion can be described as being nested within the broader concept of
quality of life as a desired outcome for people with ASD (Wehmeyer and Schalock,
2001). It has been defined in a variety of ways within the literature (Martin and
Cobigo, 2011). According to the Commonwealth’s Social Inclusion Board, “being
socially included means that people have the resources, opportunities and capabili-
ties they need to” learn, work, engage, and have a voice (Commonwealth Australian
Social Inclusion Board, 2012, p. 12). Simplican, Leader, Kosciulek, and Leahy (2015)
exclude resources or factors that support participation in the community from
their definition and include interpersonal relationships as essential to social inclu-
sion. This chapter will focus on a conceptualisation of social inclusion that empha-
sises outcomes related to individuals with ASD having valued social roles through
community participation and interpersonal relationships, with the understanding
that resources, such as social capital, can mutually reinforce social inclusion (see
Figure 8.1). An increase in social capital can provide additional opportunities to
participate in the community and the interpersonal relationships developed can
further enhance social capital.
Social Social
capital inclusion
FIGURE 8.1 The mutually reinforcing outcomes of increased social capital and
social inclusion
Indicators of social inclusion within the quality of life framework include

community participation, valued social roles, and supports provided by a social network
(Simplican et al., 2015). Community participation includes tertiary education,
employment, and community activities, such as leisure activities, volunteering, and
accessing services.The concept of valued social roles is grounded in Wolfensberger’s
(1983) influential work on Social Role Valorization. People who are marginalised
can be supported to achieve the “good things in life” if they are afforded access to
valued social roles (Wolfensberger, Thomas, and Caruso, 1996, p. 12). A person’s
social network is comprised of all of the people with whom he or she regularly
interacts, including family, friends, co-workers, and acquaintances (Wrzus, Hänel,
Wagner and Neyer, 2013). Social networks share social capital through access to
informational, physical, or emotional support (Trainor et al., 2013). Moderating
factors for social inclusion include a protection of rights, community member atti-
tudes, accommodation in the community, and accessible transportation (Brown
et al., 2015). Mediating factors for social inclusion include the individual’s intel-
lectual functioning (Woodman et al., 2014), communication skills, social skills, and
self-determination (Howlin and Moss, 2012). Together, these objective indicators
and an individual’s perceptions of satisfaction determine the extent of social inclu-
sion experienced by an adult with ASD.
Similar to findings for adolescents (Biggs and Carter, 2016), adults with ASD
have been found to have lower levels of quality of life measures with social partic-
ipation being the factor most negatively impacted (van Heijst and Geurts, 2014).
The majority of adults with ASD with high support needs were not employed and
had limited engagement in the community (Graetz, 2010). Most adults with ASD
lived in their family home, and their parents had no expectation that they would be
able to live in the community. Leaving secondary school can cause an even greater
dependence on parents for adults with ASD and consequently lower the quality of
life, not only for the individual but their family as well (Howlin and Moss, 2012).
A two-pronged strategy is needed to achieve social inclusion for adults with ASD
post-school. First, systemic, structural barriers need to be confronted and addressed.
Second, person-centred approaches are needed to address individual capability and
needed supports to ensure adults with ASD can access opportunities for social
inclusion. Both of these approaches can be conceptualised through a framework
of developing social capital. Collective effort to develop social capital can benefit
others that are not directly involved in its creation (O’Brien and Fathaigh, 2005).
For example, disability advocates and legislators can collaborate to create laws to
prevent discrimination against the broader community of people with disabili-
ties. Policies and initiatives can also be implemented to combat negative attitudes
toward disability and provide funding support and resources necessary to achieve
quality of life outcomes. The purpose of these changes would be to ensure people
with ASD and other disabilities have access to the benefits of social capital and are
socially included in society.
The second approach occurs at the individual level through evidence-based
strategies to enhance communication skills, social skills, and self-determination, with
the provision of personalised supports. A key factor in social capital is the expected
reciprocal nature of interaction; therefore, it is necessary to provide opportunities to
enhance personal growth for adults with ASD, so that they might benefit maximally
from a more inclusive society (Schalock et al., 2016).
Past and present efforts to improve social inclusion

for adults with ASD
Efforts of the Australian government directed at social protection of individuals
with disabilities can be traced to the implementation of income support provi-
sions through the Commonwealth Invalid and Old-Age Pensions Act, enacted in
1908 (Mays, 2015). Firmly rooted in a medical model of disability, these provisions
focused on a deficit approach concerning a lack of capacity to work.
Efforts aimed specifically at eliminating discrimination and promoting social
inclusion for people with disabilities began in earnest when the spotlight on dis-
ability rights issues was brought forth by the International Year of Disabled Persons
in 1981 (Government of Western Australia Disability Services Commission, n.d.).
The push from advocacy groups led to the first national survey of people with dis-
abilities conducted by the Australia Bureau of Statistics in 1981 (Australian Bureau
of Statistics, 2014). The Handicapped Persons Review and the resulting New
Directions Report (Commonwealth Minister for Community Services, 1985) was
a ground-breaking move forward by including the voices of people with disabilities
and their family members through an extensive consultation process. The primary
findings of the report noted the dissatisfaction with services and the barriers present
to social inclusion.
After the Australian government began to determine how many people with
disability were living in the country and recognised the challenges these individuals
faced in obtaining social inclusion, various legislation and policies have consequently
been implemented. Reports and reviews followed to evaluate their impact and to
identify barriers that remained. Undeniably, in the last 30 years, progress has been
made (Volkmar and Wolf, 2013), but this must be tempered with the fact that the
voices of people with disability today echo issues identified in the New Directions
Report (Bigby and Wiesel, 2011). Although not a complete timeline of historical
events, Figure 8.2 and the subsequent discussion provide an overview of events,
major pieces of legislation, policy, reviews, and reports of efforts to address social
inclusion impacting people with disability in Australia, in particular, adults with ASD.
Following the release of the New Directions Report (1985), the Australian
Government enacted the Commonwealth Disability Services Act (Commonwealth
Attorney-General’s Department, 1986). This legislation was to replace a previous
law that focused on providing segregated settings for people with disability for
accommodation, day programs, and employment (Commonwealth Attorney-
General’s Department, 1974). The Disability Services Act aimed to provide peo-
ple with disabilities with services that were more responsive and supports that
would promote integration in the community and employment (Commonwealth
Handicapped
International Year Disability Commonwealth
Persons Review & Disability Services
of Disabled Discrimination Act Disability Strategy
the New Directions Act 1986
Persons 1981 1992 1994
Report 1985
UN Convention on Australia ratifies

Disability Standards
Disability Standards the Rights of CRPD 2008 and Shut Out Report
for Accessible Public
for Education 2005 Persons with Optional Protocol 2009
Transport 2002
Disability 2006 2009
The National National Disability Review of

National Disability Disability Care and
Disability Insurance Insurance Scheme Accessible
Strategy Support Report
Scheme Act 2013 (Rollout to be Transport Standards
2010–2020 2011
2013 complete 2020) Final Report 2015
Review of Disability
Standards for Willing to Work
Education Final Report 2016
Report 2015
FIGURE 8.2 The timeline of efforts to strengthen human rights related to social
inclusion for people with disability in Australia
Attorney-General’s Department, 1986). This approach took new consideration for

how people with disability should be afforded opportunities to be a part of society,
but was limited by the focus on integration (i.e. fitting into society with supports)
rather than inclusion (i.e. changing society to accommodate and accept the diver-
sity of its people).
Under pressure from self-advocates and disability rights organisations, the
Australian government enacted legislation in recognition that people with disabil-
ities and their associates experience discrimination (WWDA, n.d.). The Disability
Discrimination Act (DDA) of 1992 made it illegal to discriminate against someone
who has a disability in several aspects of life, including employment, education,
and accommodation (Commonwealth Attorney-General's Department, 1992). The
passage of the DDA represented a historic movement forward for the protection of
rights of Australian people with disabilities.
Other significant pieces of legislation, evaluation reports, and policies followed
the enactment of the DDA, bringing us into the current era of reforms and efforts
aimed at improving social inclusion for people with disability, including those with
ASD. These included the development of Disability Standards under the DDA
(1992). Most importantly to the current direction of disability policy related to social
inclusion is the UN Convention on the Rights of Persons with Disability (CPRD)
(UN, 2006), which is an international instrument ratified by Australia in 2008. The
CPRD prompted the landmark Shut Out Report, which detailed the persistent social
exclusion that people with disability in Australia experience (FaHCSIA, 2009).
Two national disability strategies, the Commonwealth Disability Strategy of 1994
(Commonwealth Department of Social Services, 1994) and the National Disability
Strategy 2010-2020 (Commonwealth Council of Australian Governments, 2011),
were enacted as the national policy to promote social inclusion. The Disability Care
and Support report (Commonwealth Productivity Commission, 2011) provided the
extensive economical and rights based rationale for creating the National Disability
Insurance Scheme (NDIS) (NDIS, 2015).
Social inclusion: Community participation and

interpersonal relationships
The key indicators of social inclusion for adults with ASD will be described within
the context of the Disability Standards under the DDA (1992), the CRPD (UN,
2006), and the NDIS (2015). Two sets of Standards enacted under the DDA, the
Accessible Transport Standards (Commonwealth Attorney-General’s Department,
2002) and the Disability Standards for Education (Commonwealth Attorney-
General’s Department, 2005) represent two drivers of social inclusion for adults
with ASD. Together these Standards provide opportunities for community par-
ticipation and to enhance outcomes related to valued social roles and increased
social networks. Recent reviews of both Standards reveal that considerable more
progress is necessary (Commonwealth Department of Infrastructure and Regional
Development, 2015; Commonwealth Department of Education and Training,
2015). The more recently adopted CRPD and NDIS will provide the context to
examine social inclusion issues related to employment and accommodation.
Transportation access. Opportunities for social inclusion often are predicated on the
ability to get to and from the locations in the community to access services, participate
in leisure activities, and to seek and maintain employment (Lubin and Deka, 2012).
For individuals with ASD, community mobility skills have been found to be a strong
predictor of competitive employment in the community (Simonsen and Neubert,
2012). Adults with ASD are less likely than people without disabilities to drive a car
and are reported to have greater challenges learning to drive than adults without ASD
(Daly, Nicholls, Patrick, Brinckman and Schultheis, 2014). Therefore, people with
ASD may choose to use public transportation or may rely on it to provide opportuni-
ties to engage in employment and to participate in the community.
The Disability Standards for Accessible Public Transport 2002 are intended to
provide legal guidance to meet the requirements of the DDA (1992) for public
transportation operators (Commonwealth Attorney-General’s Department, 2002).
These Standards have been reviewed twice since their implementation, with the
findings of the 2012 review released in 2015 highlighting barriers that remain
(Commonwealth Department of Infrastructure and Regional Development, 2015).
Barriers to public transportation for adults with ASD include the availability of ser-
vices, especially in less urban areas (Currie, 2009), issues related to communication
access, and perceptions of lack of safety (Lubin and Deka, 2012). Other potential
transportation barriers include lack of accommodation for support workers or assis-
tive animals travelling with adults with ASD and environmental barriers related to
aversive stimuli, such noise levels, crowding, or lighting. Aligning with the CPRD
general obligations (UN, 2006, Article 4f), universal design considerations could
remove transportation barriers for adults with ASD and improve the experience
of mainstream riders. Some examples include increasing the number of quiet train
cars, clear symbol support for information communication, and visual alerts for
routes during travel.
Tertiary education. For many young adults, the next step after high school is
to enrol in a tertiary education program to earn a degree or qualification (Muller
and Cannon, 2016). Attending university confers additional benefits for develop-
ing social capital through access to social opportunities, employment, and valued
social roles (Senate Standing Committee on Education and Employment, 2016).
Unfortunately, few adults with ASD attend university to be able to accrue these
benefits (Muller and Cannon, 2016). For adults with ASD who can meet academic
standards, many will struggle with the transition to the less structured environment
of a university (Volkmar and Wolf, 2013).
Under the DDA (1992), the Disability Standards for Education 2005 were enacted
to address issues related to discrimination and harassment in education and training,
including at the tertiary level.The key focus of the legislation is on ensuring students
with disabilities can engage in education “on the same basis as” all other students
(Commonwealth Attorney General’s Department, 2005). In the most recent DSE
review (Commonwealth Department of Education and Training, 2015), one of the
identified barriers to tertiary education for adults with disabilities concerns the lack
of explicit focus on transition periods for students.The 2010-2020 National Disability
Strategy describes supporting students’ transition to further education and employ-
ment as a current commitment priority (Commonwealth Council of Australian
Governments, 2011). Young adults with ASD leaving high school are often unpre-
pared for tertiary education due to a lack of transition planning (Cai and Richdale,
2016). Seamless transition to tertiary education requires a collaborative effort between
high schools, outside agencies, and tertiary educational institutions. Two programs
in Australia seek to support the transition process. The Commonwealth’s National
Disability Coordination Officer Programme has regional centres throughout Australia
to facilitate connections between students, support agencies, and educational insti-
tutions in the transition to tertiary education (Commonwealth Department of
Education and Training, 2015).The Australian Disability Clearinghouse on Education
and Training provides online resources to support the transition to tertiary education
for adults with ASD, such as advice for obtaining needed adjustments (ADCET, n.d.).
Employment. The adage holds true, “It is not what you know, but whom
you know” when adults with ASD search for employment. Granovetter’s (1973)
seminal paper described the importance of social networks for employment, in
particular, those of acquaintances or so-called weak ties, to provide important infor-
mation leading to job opportunities. The influence of social capital from family
connections and status is also evident, as adults with ASD, who come from families
with higher socioeconomic backgrounds, are more likely than families with lower
socio-economic status to gain employment (Roux et al., 2013).Too few adults with
ASD can access and maintain open employment. Those that are employed tend to
be in menial, low wage jobs (Howlin and Moss, 2012).
Developing capacity for employment is also an important factor for adults with
ASD to gain social inclusion.Work-related skills can be addressed through systematic
instruction in secondary school and vocational support on the job (Agran, Hughes,
Thoma and Scott, 2016). Greater functional skills, such as the ability to tell time, use
money, and navigate public transportation are associated with a greater likelihood
of gaining employment for adults with ASD (Roux et al., 2013). Engaging in paid
work during secondary school is a significant predictor of employment after high
school (Simonsen and Neubert, 2012). Being able to maintain employment is often
predicated on the quality of a person’s social interactions in the workplace. In a
study examining employers’ perceptions of essential social skills needed for employ-
ment, those related to production skills were valued most highly (Agran et al.,
2016). These include skills such as requesting clarification of unclear directions and
following instructions immediately.
Both the DDA (1992) and Article 27 of the CRPD (2006) address the issue
of prohibiting discrimination in the workplace for people with disabilities, with
Article 27 emphasising the creation of inclusive work environments and having
opportunities for choice in the labour market (UN, 2006, Article 27). Most recently,
the Willing to Work Report produced by the Commonwealth Human Rights
Commission (2016) provided recommendations for addressing the persistent low
employment figures for people with disabilities and consequently high levels of
poverty. Recommendations included developing a national action plan to eliminate
the factors associated with discrimination, including negative attitudes and disabil-
ity stereotypes of community members and employers. Additional efforts to combat
disability stereotypes are needed, such as the Don’t DIS myABILITY campaign,
which highlights how people can create more inclusive communities and informs
the public of actions that are discriminatory (NSW Department of Family and
Community Services, 2016). Unless attitudes of employers and colleagues are posi-
tive, and supports are provided to assist adults with ASD in navigating the complex
social world of workplaces, the desired outcomes of employment related to social
inclusion cannot be achieved.
Community living accommodation. One of the general principles of the CRPD
(UN, 2006) is to ensure, “full and effective participation and inclusion in society”
(UN, 2006, Article 3c). Being able to live within the community in mainstream
accommodation is an objective indicator of social inclusion for adults with ASD
and also a moderating factor for opportunities for community participation and
developing interpersonal relationships. In a recent review of the literature on adults
with ASD, on average, 48 percent continued to live at home (Howlin and Moss,
2012). Although fewer adults with ASD are now living in high congregate care
facilities (Eaves and Ho, 2008), deinstitutionalisation is not complete in Australia.
A newly implemented person-centred approach to disability support that aligns
with the aims of the CRPD (2006) and the National Disability Strategy to pro-
mote social inclusion, choice, and control, gradually began its implementation in
2013 (Commonwealth Council of Australian Governments, 2011). Previously, rigid
block-funding arrangements were established for people with disabilities who required
additional supports (Dowse et al., 2016). Under the former provisions, adults with
ASD had limited choice in supports or accommodation arrangements (FaHCSIA,
2009). The National Disability Insurance Scheme Act 2013 (Commonwealth
Attorney-General’s Department, 2013), which provides the legislative framework for
the National Disability Insurance Scheme (NDIS), establishes the aims and structure
of this new model for supporting people with disability in Australia.
Although not solely focused on housing support, the NDIS provides adults with
ASD with innovative options for community living that were not allowed under
the former system. Instead of receiving a placement in a group home environment,
where one might live with multiple strangers in neighbourhoods isolated from the
community and services, an adult with ASD could establish one of several hous-
ing arrangements through creative use of individualised funding (YDAS, 2013).
A recent news report described three female friends with disabilities who pooled
their NDIS support plan resources to be able to rent a home together and to flexi-
bly schedule supports as needed (Perkins, 2016). Being able to select whom you live
with, and where, provides options to increase the social inclusion and social capital
of adults with ASD through regular access to community activities that match the
person’s interests and opportunities to extend social networks.
The implementation of the NDIS raises some concerns regarding if there will
be enough highly qualified service providers within this market-based context of
supports. Another issue is whether people with complex needs will be able to com-
pete to receive services from the providers that are available (Dowse et al., 2016).
Individuals with ASD and other related disorders comprise the largest disability
group of NDIS participants, with 31 per cent of the total participants nationally
(NDIA, 2016). The evidence is unclear at this point, but adults with ASD who
exhibit behavioural challenges might encounter barriers to obtaining needed sup-
ports if providers can select from participants who need fewer supports (Anglicare
Tasmania, 2015).
Social inclusion involves a complex set of processes to support community par-
ticipation and development of meaningful interpersonal relationships for adults
with ASD. The extent of a person’s social inclusion also depends on the individual’s
subjective perceptions of their experiences. Social inclusion involves a component
of the broader conception of quality of life and is mutually reinforced through
development of social capital (Simplican et al., 2015). Social capital is a currency
in which we gain access to information and other resources through our social
network of family, friends, colleagues, and acquaintances. Australia has made the
commitment to provide disability support on a national scale through the NDIS. It
is imperative that no matter which way the political wind blows that the financial
commitment to fully implement the NDIS is carried through and the aims of the
National Disability Strategy are realised. The implications of its success or failure
are too great, with so many adults with ASD and other disabilities demanding that
they are no longer shut out from society.
References
Agran, M., Hughes, C., Thoma, C. A., and Scott, L. A. (2016). Employment social skills:
What skills are really valued? Career Development and Transition for Exceptional Individuals,
39, 111–20.
American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental
disorders. Fifth edition. Arlington,VA: American Psychiatric Publishing.
Anglicare Tasmania. (2015). The uncounted costs: Choice and control for people with behaviours of
concern. Tasmania: Author.
Australian Bureau of Statistics (2014, April 16). 4430.0 - Disability, ageing and carers, Australia:
Summary of findings, 2012. Quality declaration – summary. Retrieved from www.abs.gov
. a u / A u s s t a t s / a b s @ . n s f / 0 / F B 6 3 2 AC 7 C 7 7 3 2 9 2 B C A 2 5 7 7 FA 0 0 1 1 C 4 8 D ?
OpenDocument. Access date 12 November 2015.
Australian Disability Clearinghouse on Education and Training (ADCET). (n.d.). How to
transition to tertiary education: Helpful hints for people with autism spectrum disorder. Retrieved
from www.adcet.edu.au/students-with-disability/Autism-transition/. Access date 20
August 2015.
Bigby, C., and Wiesel, I. (2011). Encounter as a dimension of social inclusion for people
with intellectual disability: Beyond and between community presence and participation.
Journal of Intellectual and Developmental Disability, 36, 263–7. doi:10.3109/13668250.2011.
619166
Biggs, E. E., and Carter, E. W. (2016). Quality of life for transition-age youth with autism
or intellectual disability. Journal of Autism and Developmental Disorders, 46, 190–204.
doi:10.1007/s10803-015-2563-x
Bourdieu, P. (1986). The forms of capital. In J. Richardson (ed.), Handbook of theory and
research for the sociology of education. New York: Greenwood Press, pp. 241–58.
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design.
Cambridge, MA: Harvard University Press.
Brown, R. I., Cobigo, V., and Taylor, W. D. (2015). Quality of life and social inclusion across
the lifespan: Challenges and recommendations. International Journal of Developmental
Disabilities, 61(2), 93–100. doi:10.1179/2047386914Z.00000000092
Brown, I., Hatton, C., and Emerson, E. (2013). Quality of life indicators for individuals
with intellectual disabilities: Extending current practice. Intellectual and Developmental
Disabilities, 51, 316–32. doi:10.1352/1934-9556-51.5.316
Cai, R.Y., and Richdale, A. L. (2016). Educational experiences and needs of higher education
students with autism spectrum disorder. Journal of Autism and Developmental Disorders, 46,
31–41. http://doi.org/10.1007/s10803-015-2535-1
Center for Disease Control and Prevention (CDCP). (2016, March 31). Autism spectrum dis-
order (ASD): Data and statistics. Retrieved from www.cdc.gov/ncbddd/Autism/data.html.
Accessed 20 August 2015.
Coleman, J. S. (1988). Social capital in the creation of human capital. The American Journal of
Sociology, 94, S95–S120.
Commonwealth Attorney-General’s Department. (1974). Handicapped persons assistance act
(Number 134 of 1974). Canberra: Author.
Commonwealth Attorney-General’s Department. (1986). Commonwealth disability services act
(1986). Canberra: Author.
Commonwealth Attorney-General’s Department. (1992). Commonwealth disability discrimina-
tion act (1992). Canberra: Author.
Commonwealth Attorney-General’s Department. (2002). Disability standards for accessible pub-

lic transport (2002). Canberra: Author.
Commonwealth Attorney-General’s Department. (2005). Disability standards for education
Commonwealth Attorney-General’s Department. (2013). National disability insurance scheme
act (2013) no. 20. Canberra: Author.
Commonwealth Australian Social Inclusion Board. (2012). Social inclusion in Australia: How
Australia is faring. Second edition. Canberra: Author.
Commonwealth Council of Australian Governments. (2011). 2010–2020 National disability
strategy. Canberra: Author.
Commonwealth Department of Education and Training. (2015). 2015 Review of the disability
standards for education 2005: Final report. Canberra: Urbis.
Commonwealth Department of Families, Housing, Community Services and Indigenous
Affairs (FaHCSIA). (2009). Shut out: The experience of people with disabilities and their
Families in Australia. National Disability Strategy Consultation Report. Canberra: National
People with Disabilities and Carer Council.
Commonwealth Department of Infrastructure and Regional Development. (2015).
Review of the disability standards for accessible public transport (2002): Final report. Canberra:
Author.
Commonwealth Department of Social Services. (1994). Commonwealth disability strategy of
1994. Canberra: Author.
Commonwealth Human Rights Commission. (2016). Willing to work: National inquiry into
employment discrimination against older Australians and Australians with disability. Canberra:
Author.
Commonwealth Minister for Community Services. (1985). New directions: Report of the hand-
icapped programs review. Canberra: Author.
Commonwealth Productivity Commission. (2011). Disability care and support: Report no. 54.
Canberra: Author.
Currie, G. (2009). Australian urban transport and social disadvantage. The Australian Economic
Review, 42(2), 201–8.
Daly, B. P., Nicholls, E. G., Patrick, K. E., Brinckman, D. D., and Schultheis, M. T. (2014).
Driving behaviors in adults with autism spectrum disorders. Journal of Autism and
Developmental Disorders, 44(12), 3119–28. doi:10.1007/s10803-014-2166-y
Donne, J. (n.d.). Meditation XVII. The Literature network. Retrieved 6 May 2016.
Dowse, L., Wiese, M., Dew, A., Smith, L., Collings, S., and Didi, A. (2016). More, better, or
different? NDIS workforce planning for people with intellectual disability and complex
support needs. Journal of Intellectual and Developmental Disability, 41, 81–4.
Eaves, L. C., and Ho, H. H. (2008).Young adult outcome of autism spectrum disorders. Journal
of Autism and Developmental Disorders, 38(4), 739–47. doi:http://dx.doi.org.ezproxy1
.library.usyd.edu.au/10.1007/s10803-007-0441-x
Government of Western Australia Disability Services Commission (n.d.) 1981 – International
year of disabled persons. Retrieved from www.disability.wa.gov.au/understanding-
disability1/understanding-disability/history-of-disability-services/1981---international-
year-of-disabled-persons/
Graetz, J. E. (2010). Autism grows up: Opportunities for adults with autism. Disability and
Society, 25, 33–47. doi:10.1080/09687590903363324
Granovetter, M. S. (1973).The strength of weak ties. American Journal of Sociology, 78, 1360–80.
Howlin, P., and Moss, P. (2012). Adults with autism spectrum disorders. Canadian Journal of
Psychiatry, 57, 275–83.
Lubin, A., and Deka, D. (2012). Role of public transportation as a job access mode.
Transportation Research Record: Journal of the Transportation Research Board, 2277, 90–7.
doi:10.3141/2277-11
Martin, L., and Cobigo, V. (2011), Definitions matter in understanding social inclusion.
Journal of Policy and Practice in Intellectual Disabilities, 8: 276–82. doi: 10.1111/
j.1741-1130.2011.00316.x
Mays, J. (2015). Australia’s disabling income support system:Tracing the history of the disabil-
ity pension from 1908 to today. Australian Journal of Social Issues, 50, 253–76.
Mehling, M. H. and Tasse, M. J. (2016). Severity of Autism spectrum disorders: Current
conceptualization, and transition to DSM-5. Journal of Autism and Development Disorders,
46, 2000–16.
Muller, E., and Cannon, L. (2016). Parent perspectives on outcomes and satisfaction lev-
els of young adults with autism and cognitive impairments. Focus on Autism and Other
Developmental Disabilities, 31, 92–103.
National Disability Insurance Agency (NDIA). (2016, March 31). 11th quarterly report to
COAG Disability Reform Council. Retrieved from www.ndis.gov.au/sites/default/
files/documents/Quarterly-Reports/11-report-coag.pdf. Accessed 6 May 2016.
National Disability Insurance Scheme (NDIS). (2015, December 10). Measuring out-
comes of the NDIS for people with disability. Retrieved from www.ndis.gov.au/
media-outcomes-framework-pilot. Accessed 12 February 2016.
NSW Department of Family and Community Services. (2016). Don’t DIS myABILITY.
Retrieved from www.dontdismyability.com.au/
O’Brien, S., and Fathaigh, M. (2005). Bringing in Bourdieu’s theory of social capital:
Renewing learning partnership approaches to social inclusion. Irish Educational Studies,
24(1), 65–76. doi:10.1080/03323310500184509
Oliver, M. (2013). The social model of disability: Thirty years on. Disability and Society, 28,
1024–26, DOI: 10.1080/09687599.2013.818773
Parsons, S. (2015). “Why are we an ignored group?” Mainstream educational experiences
and current life satisfaction of adults on the autism spectrum from an online survey.
International Journal of Inclusive Education, 19, 397–421. doi:10.1080/13603116.2014.93
5814
Perkins, M. (2016, June 17). A housing problem solved is a pleasure shared. The Age. Retrieved
from www.theage.com.au/victoria/a-housing-problem-solved-is-a-pleasure-shared-
20160613-gphri1.html#ixzz4CU9DOa2a. Accessed 30 June 2016.
Putnam, R. D. (2000). Bowling alone: The collapse and revival of American community. New York:
Simon and Schuster.
Roux, A. M., Shattuck, P. T., Cooper, B. P., Anderson, K. A., Wagner, M., and Narendorf, S. C.
(2013). Postsecondary employment experiences among young adults with an autism
spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry,
52, 931–9.
Schalock, R. L.,Verdugo, M. A., Gomez, L. E., and Reinders, H. S. (2016). Moving us toward
a theory of individual quality of life. American Journal on Intellectual and Developmental
Disabilities, 121, 1–12. doi: 10.1352/1944-7558-121.1.1
Senate Standing Committee on Education and Employment. (2016). Access to real learning:
The impact of policy, funding and culture on students with disabilities. Canberra: Author.
Simonsen, M. L., and Neubert, D. A. (2012). Transitioning youth with intellectual and
other developmental disabilities: Predicting community employment outcomes. Career
Development and Transition for Exceptional Individuals, 36, 188–98. doi:10.1177/
2165143412469399
Simplican, S. C., Leader, G., Kosciulek, J., and Leahy, M. (2015). Defining social inclusion
of people with intellectual and developmental disabilities: An ecological model of social
networks and community participation. Research in Developmental Disabilities, 38, 18–29.
doi:10.1016/j.ridd.2014.10.008
Trainor, A. A., Morningstar, M., Murray, A., and Kim, H. (2013). Social capital during the
postsecondary transition for young adults with high incidence disabilities. The Prevention
Researcher, 20(2), 7–10.
United Nations (UN). (2006). Convention on the rights of persons with disabilities.
New York: Author.
van Heijst, B. F., and Geurts, H. M. (2014). Quality of life in autism across the lifespan:
A meta-analysis. Autism, 19, 158–67. doi:10.1177/1362361313517053
Volkmar, F. R., and Wolf, J. M. (2013). When children with autism become adults. World
Psychiatry, 12, 79–80. doi:10.1002/wps.20020
Wehmeyer, M. L., and Schalock, R. L. (2001). Self-determination and quality of life:
Implications for special education services and supports. Focus on Exceptional Children,
33(8), 1–16.
Wilson, C. E., Gillan, N., Spain, D., Robertson, D., Roberts, G., Murphy, C. M., Maltezos,
S., Zinkstok, J., Johnston, K., Dardani, C., Ohlsen, C., Quinton Deeley, P., Craig, M.,
Mendez, M A., Happé, F., and … Murphy, D. G. (2013). Comparison of ICD-10R, DSM-
IVTR and DSM-5 in an adult autism spectrum disorder diagnostic clinic. Journal of
Autism and Developmental Disorders, 43, 2515–25.
Wolfensberger, W. (1983). Social role valorization: A proposed new term for the principle of
normalization. Mental Retardation, 21, 234–9.
Wolfensberger, W., Thomas, S., and Caruso, G. (1996). Some of the universal “good things
of life” which the implementation of Social Role Valorization can be expected to make
more accessible to devalued people. SRV/VRS: The International Social Role Valorization
Journal/La revue internationale de la Valorisation des rôles sociaux, 2(2), 12–4.
Women With Disabilities Australia (WWDA). (n.d.). Legislation and policy. Retrieved from
http://wwda.org.au/govtdis/govtdisoverview/. Accessed 20 February 2016.
Woodman, A. C., Smith, L. E., Greenberg, J. S., and Mailick, M. R. (2014). Change in autism
symptoms and maladaptive behaviors in adolescence and adulthood: The role of positive
family processes. Journal of Autism and Developmental Disorders, 45, 111–26. http://doi.
org/10.1007/s10803-014-2199-2
Wrzus, C., Hänel, M.,Wagner, J., and Neyer, F. J. (2013). Social network changes and life events
across the life span: A meta-analysis. Psychological Bulletin, 139(1), 53–80. doi:10.1037/
a0028601
Youth Disability Advocacy Service (YDAS). (2013). Housing and support for younger people
with disabilities transitioning to independent living: Elements for success in the design and
implementation of DisabilityCare Australia, a national disability insurance scheme. Victoria:
Author.
PART III
Key stakeholders in the
support of social inclusion
9
THE ROLE OF SCHOOL COMMUNITIES
IN FACILITATING SOCIAL INCLUSION
Cathy Little
Inclusion currently forms the basis of educational policy for students with a
disability in Australia, the USA, the UK, and in most western countries. It can
be argued that there are three principal drivers of inclusive practice: social justice
principles, legislative requirements, and research findings or evidence (Foreman
and Arthur-Kelly, 2008). First, the discourse that argues inclusive education is based
upon the ideals of social justice (Artiles, Harris-Murri and Rostenberg, 2008; Polat,
2011) and appropriate and accessible education for all is, in essence, a matter of
social justice. Internationally, this issue has come into focus over the past cen-
tury with the development of a series of statements and declarations on human
rights, which include the right to education for all (UNESCO, 1990), the rights of
people with disabilities (UN General Assembly, 2007), and the right to equitable
and accessible education for people with disabilities (UNESCO, 1994).
A second factor impacting on inclusion is the governing legislation and legal
policy that mandates the right for all students to access an equitable and appropri-
ate education. For example, changes to legislation in both the United States (e.g.,
Individuals with Disabilities Act (IDEA) of 1990, modified 1997 and amended
in 2004) and British legislation (e.g., 1993 Education Act), saw a move to pre-
scribed educational services for students with disabilities. In 1994 the Salamanca
Statement (UNESCO) called on all governments to adopt an inclusive education
policy through the enrolment of all students in regular schools.
In Australia, the Disability Discrimination Act (Commonwealth Attorney
General’s Department, 1992) and the Disability Standards for Education
(Commonwealth Attorney General’s Department, 2005) set out to eliminate dis-
crimination against a person on the grounds of disability and reinforce the right
to education of students with a disability on the same basis as students without a
disability. Although the Disability Discrimination Act does not specify the s etting
118 Cathy Little
where students with a disability should be educated, there is an expectation

that regular classroom teachers would be able to meet the diverse needs of their
students.
Knowledge of what teachers and researchers know to be effective educa-
tional practice for students with individual learning needs, supported through
the research literature, is noted as a third factor impacting upon inclusion. One
of the factors influencing the effective implementation of inclusive practice is
teacher attitude. Although it appears that teachers tend to support the concept
of inclusion as a social and educational principle, their validation at an opera-
tional level and their demonstration of inclusive principles appears to be strongly
related to their perceptions of students’ disabilities, with more reluctant views
expressed towards the inclusion of students with more ‘severe disabilities’ and
students with behaviour disabilities (Avramidis and Norwich, 2002; Mazurek and
Winzer, 2011).
A predominant assertion in the available research argues that a relationship exists
between proximity to disability and attitude materialisation. Li and Wang (2013)
argue that “limited interactions between persons with and those without disabil-
ities can serve to increase negative attitudes due to the reinforcing of pre-existing
stereotypes, negative perceptions and lack of knowledge pertaining to persons with
disabilities”. Schoean, Shannon and Tansey (2009) add that a salient factor influ-
encing attitudes toward persons with disabilities is “the social context in which
contact occurs” (p. 14) contending that attitudes towards persons with disabili-
ties are moderated on the basis of particular social context and specific disability.
Whilst Schoean et al.’s (2009) articulation of the importance of social context is
useful in understanding what contributes to the development of negative attitudes
toward persons with disabilities, the persistent contention “regarding the type of
social context necessary to change attitudes in those interactions with persons with
disabilities” (p. 15) remains.
Every child has the right to an education (UN General Assembly, 1989), and
every educational experience begins with enrolment into an educational setting.
Several factors impact the inclusion of students in the education process. The ethos
of the school is of vital importance. Recognised as an essential area of utmost
importance to the education of students who required special education provi-
sion was the need for schools to know and understand each child and, without
question, seek help and show skill in meeting individual needs (Warnock, 1979).
A commitment by the school community to support inclusive practice, and an
inclusive school culture, serve to create a socially and morally positive school setting
for all staff, students and families. Students with an Autism Spectrum Disorder for
example, placed in regular or mainstream education classes, along with their class-
mates, families and class teacher form a unique classroom community embedded
within a whole school structure governed by administration, policy and legislation.
The impact of a student with an Autism Spectrum Disorder in the classroom and
school community can be shaped by numerous elements. Family involvement and
support, peer interaction and relationships, curriculum needs and personal strengths
The role of school communities 119
can all be considered as influencers on the perceptions held by members of the

school community. For students with an Autism Spectrum Disorder, their indi-
vidual attributes will also include those core competencies attributed to students
on the Autism spectrum: communication difficulties, idiosyncratic behaviours, a
unique sensory profile, and a marked impairment in social skills. These core com-
petencies combine to shape each individual and can have a marked impact upon
members of the school community, specifically the teacher, and the shaping of their
attitudes.
Regrettably, perceptions of and attitudes toward students with an Autism
Spectrum Disorder by members of the school community are often based on
students’ externalising behaviours, such as hitting, kicking, and self-stimulating
behaviours. Oftentimes, these presenting behaviours are the result of frustration
and anxiety. Due to a lack of understanding, these behaviours are often deemed
representative of the student and their perceived inability to conform to the schools
behavioural expectations. Brown, Odom and McConnell (2008) described the use
of appropriate behavioural strategies as essential to the display of social compe-
tence and fundamental to being socially included. The maintenance of less than
positive perceptions and attitudes toward the behaviour of students with an Autism
Spectrum Disorder serves to hinder student’s social engagement and interactions
with others and restrict their social inclusion in all aspects of school life.
The path toward social inclusion for students with an Autism Spectrum Disorder
can be traced from its existence as a subset of the broader concept of inclusion
generally, through the educational setting via enrolment to the educational oppor-
tunities afforded by classroom teachers. Underpinning these opportunities of social
inclusion for students are the dynamic relationships between ‘key players’ in the
students’ educational environment. In this chapter, the active interactions between
these key players in the educational environment are examined within the frame-
work of bioecological systems theory (Bronfenbrenner, 2001).
Bioecological systems theory

Sociological research in the area of human development proposes: “Human beings
create the environments that shape the course of human development. Their
actions influence the multiple physical and cultural tiers of the ecology that shapes
them, and this agency makes humans active producers of their own development”
(Bronfenbrenner, 2005, p. xxvii). To embed this proposal in an educational context,
one could argue that the focus of the educational setting is the student, in this case a
student with an Autism Spectrum Disorder. The actions of key participants, teachers,
students, peers, administrators, and the broader school community, both shape and
inform the multiple and unique environments that surround the student with Autism
Spectrum Disorder, and subsequently influence their human development.
Bioecological systems theory (Bronfenbrenner, 2001) recognises the unique
characteristics of the student and acknowledges the dynamic, bi-directional inter-
relations of a myriad of environmental influences from the systems surrounding
120 Cathy Little
that young person. Bronfenbrenner’s framework concedes that the relationships a

student has with the people and events in the environments that surround them
impact on their development. Bronfenbrenner’s revised bioecological theory also
added to his original ecological systems theory, the component of time, con-
ceptualised as the chronosystem (Figure 9.1). Bronfenbrenner postulated that an
individual’s interactions within and across the various systems that surround them
would change over time.
This chapter uses the bioecological framework to explore the impact of rela-
tionships both within and between key players in the school community who both
influence and shape the social inclusion of a student with Autism Spectrum Disorder.
At the centre of the system lies the individual student. One of this student’s many
unique characteristics is their Autism Spectrum Disorder diagnosis. Surrounding
the student, in the microsystem, is the student’s family, friends, teacher/s and peers.
The next layer, the mesosystem, includes the broader school community and the
Principal/Administrator. An exosystem of family friends, neighbours, and support
and welfare agencies comprises the next layer. The policies and legislation central
to education and disability, accompanied by prevailing attitudes and issues of social
justice, are part of the macrosystem that encompasses all the internal layers. The
chronosystem can be defined as the student’s educational life course, from pre-
school enrolment through to post-school employment. Using this bioecological
framework, the expressed belief system of individuals, administrators, teachers,
students and peers, can be compared to the practice and policy enacted within the
Macrosystem
Exosystem
Mesosystem
Microsystem
Student
Chronosystem
FIGURE 9.1 A visual representation of Bronfenbrenner’s bioecological systems

theory, showing the nested layers, or systems of the environment, and their
relationship to the individual student over time
educational environment to determine the impact on the social inclusion of the

student with an Autism Spectrum Disorder.
Numerous studies report the positive social outcomes of inclusive education
(Boutot, 2007), de Boer, Jan Pijl and Minnaert, 2011). But mere exposure to dis-
ability through contact is not sufficient for positive attitude or behavioural change
for mainstream participants and can in fact have the opposite effect (Sullivan and
Glidden, 2014). In discussing successful inclusive practice, much focus appears to be
placed on students’ achievement of academic outcomes as the measure of success.
Given the pervasive social needs of students on the Autism spectrum, success for
these students needs also to be measured in terms of their social achievements or
social competence.
A student’s social competence is defined as when he or she displays behaviours
which, when used, must be effective in achieving his or her social goals and when
the selection of these behaviours is appropriate for the context (Stitchter, O’Connor,
Herzog, Lierheimer and McGhee, 2012). Given that social benefits occur as a result
of active facilitations by educators in promoting social interactions (Carter, Sisco,
Chung and Stanton-Chapman, 2010), how social inclusion is supported and facili-
tated by participants in the school community must be explored.
A number of participants within the educational community are critical to
the development and facilitation of socially inclusive opportunities for a student
with an Autism Spectrum Disorder. Of significant importance are the actions of
families, peers, Principals and Administrators, teachers, and students with an Autism
Spectrum Disorder. This chapter will address the contributions of school admin-
istrators and of teachers in the enactment of social inclusion through a discussion
of findings from a research study exploring mainstream education primary teacher
attitudes toward the social inclusion of students with an Autism Spectrum Disorder.
Teacher attitudes
The inclusion of a student with an Autism Spectrum Disorder in a regular class
can often present the class teacher with a challenge to their existing beliefs and
pedagogy and a feeling of uncertainty in regards to instruction and management,
arising as a result of the student’s unique learning and behavioural style. Globally,
research highlights teachers’ concerns of lack of knowledge, lack of support systems
and overriding legislative policy as obstacles to the inclusion process (e.g., de Boer,
et al., 2011; Lindsay, Proulx, Thomson and Scott, 2013). Further research suggests
that general education teachers of students with an Autism Spectrum Disorder have
limited knowledge about the specific traits and idiosyncrasies that define these stu-
dents’ learning styles and behaviours (Boyle,Topping, and Jindal-Snape, 2013; Osler
and Osler, 2008). For regular education teachers with little, if any, knowledge of
these traits, having to teach a student identified with an Autism Spectrum Disorder
can prove confronting and challenging at both a personal and professional level.
Teacher preparedness, knowledge of and attitude towards Autism Spectrum
Disorder have been found to have a significant impact on students’ school
122 Cathy Little
experience. Poor teacher knowledge and attitudes have been reported as having
a significant detrimental effect on students’ participation in school (Eldar, Talmor
and Wolf-Zuckerman, 2010). Positive teacher attitude equates to more successful
outcomes for students. Several studies report how teacher attitudes directly influ-
ence students’ attitudes and behaviour, and the subsequent success of educational
environments in encompassing the principles of inclusion (e.g., Avramidis, Bayliss
and Burden, 2000; de Boer et al., 2011; Sharma, Loreman and Forlin, 2012).
The teacher is the central focus of any classroom. Their attitude toward their
students can be a crucial determinant of the educational experience. When

exploring the study of teacher attitudes, elements investigated at the operational
level include: teachers’ knowledge of Autism Spectrum Disorder; their professional
pedagogy and personal skills and experience; opportunities for professional devel-
opment; the provision of sector level support; and the element of collaboration.
These elements have a two-way effect in that they both inform and affect the
teacher, and in return, are moulded and developed by the teacher in response to
new and changing beliefs and attitudes.With these elements in mind the study pre-
sented in the following sections explores teacher attitudes toward students with an
Autism Spectrum Disorder, with a particular focus on social inclusion.
The study
Methodology
The research design used for the study was a mixed-methods investigative study,
combining the use of surveys and embedded case studies. The Teacher Attitudes
Survey comprised 24, 5-point scale Likert response questions and 10 open-ended
questions, each designed to investigate four constructs of teacher attitude identi-
fied from the literature: attitudes toward inclusion generally, teacher effectiveness,
academic climate, and social inclusion. Five case studies, each involving four ‘key
players’ (a student with an Autism Spectrum Disorder, their teacher, the Principal
and a self-reported peer group) were also undertaken.Within each case study, inter-
views were held with the ‘key player’ participants alongside a series of classroom
observations of the student and teacher. The interviews were administered one-
on-one, researcher to participant, and followed a semi-structured, standardised,
open-ended format, wherein the same questions were asked of all participants
in the same position across each of the five case studies. The focus of classroom
observations was around the observable behaviours of inclusion, social interac-
tion, peer interaction and response to teacher behaviours. Classroom observa-
tions of teacher behaviours were made using the Mainstream Version of the Code for
Instructional Structure and Student Academic Response (MS-CISSAR) instrument of
the EcoBehavioral Assessment Systems Software (EBASS) (Greenwood, Carta, Kamps
and Delquadri, 1993). Student social behaviours were observed using the schedule
based on the model of social interaction (Doble and Magill-Evans, 1992).
Results
Teacher Attitudes Survey
Two hundred and one primary regular education teachers completed the Teacher
Attitudes Survey. Using SPSS, the Cronbach Alpha returned a figure of 0.842 indi-
cating good internal reliability. An initial overview of teachers’ attitudes toward
inclusion, their effectiveness in supporting students with an Autism Spectrum
Disorder, the academic climate in which they were employed, and their under-
standings of social inclusion was made by comparison of means of each of the
research constructs. Results showed that three of the constructs (attitudes toward
inclusion, academic climate, and social inclusion) returned positive mean scores
(Table 9.1).Teacher effectiveness, however, returned a mean score of 1.97, placing it
on the negative side of the scale, indicating teachers felt less positive in supporting
students with an Autism Spectrum Disorder.
The mean score for the social inclusion construct was 3.10, indicating teachers
had an overall very strong, positive response to this construct, and an awareness
of ‘The social well-being of students’ (mean 3.37) and ‘The individual social needs of
students’ (mean 3.07); this also demonstrated their recognition of the importance
of ‘Facilitating opportunities for enhancing social engagement’ (mean 2.88), and ‘Providing
socially inclusive opportunities’ (mean 3.24) for students with an Autism Spectrum
Disorder.
Table 9.1 shows a difference between the mean scores for the social inclusion
(3.10) and teacher effectiveness (1.97) constructs. A paired sample t-test was under-
taken using these two constructs to examine the difference between teachers’ per-
ceptions of their knowledge of and effectiveness in supporting students with an
Autism Spectrum Disorder and their attitude toward the social inclusion of these
students. The paired t-test returned a statistically significant difference between
these two constructs. The mean teacher effectiveness result (M = 1.09, SD = 0.60)
was statistically lower than the mean social inclusion result (M = 3.10, SD = 0.38),
t(189) = −24.99, p < 0.0001 (two-tailed). The mean difference in constructs was
1.12 with a 95 percent confidence interval ranging from −1.21 to −1.03. The eta
TABLE 9.1 Teacher Attitudes Survey construct means
N Minimum Maximum Mean Std. Deviation
Teacher effectiveness 194 0.29 3.57 1.9794 0.60469
Attitude toward inclusion 197 0.83 4.00 2.3291 0.59867
Academic climate 196 0.40 3.80 2.4214 0.62573
Social inclusion 194 1.17 4.00 3.1091 0.38500
Valid N (listwise) 187

124 Cathy Little
squared statistic (0.76) indicated a large effect size, thus indicating a substantive
finding (Field, 2009).
The final analysis performed on the Likert response items was an exploratory factor
analysis, designed to test the assumption that a more positive teacher attitude would
result in greater facilitation of socially inclusive opportunities for students with an
Autism Spectrum Disorder. Results suggested the relationship between teacher effi-
cacy and impact on academic achievement was positive, with the component correla-
tion matrix (Table 9.2) showing a small positive correlation between factors 1 and 3
(r = 0.30). Further, there appeared to be a limited relationship between Factor 2,
which represented social inclusion, and each of the remaining three factors. This
result provides modest evidence that these primary teachers do not perceive social
inclusion as something that needs to be taught within the educational environment.
Further, the lack of correlational evidence between social inclusion and the other
three constructs suggests that the teachers may not have the knowledge to do this.
Analysis of the open-ended items of the survey highlighted the recognition by
primary teachers of the need for ongoing professional development in their quest
to support the inclusion of students with an Autism Spectrum Disorder. A range
of qualitative responses supported the consistently high agreement of partici-
pants with the Likert scale items querying the necessity of professional learning.
Participants indicated a need for professional learning in the areas of inclusion and
provision of social opportunity for students with an Autism Spectrum Disorder
alongside in-services in effective, evidence-based teaching strategies for these
students. In-class support was reported as essential to a teacher’s inclusive practice.
Extra financial support and additional resources (e.g., equipment, technology) were
also perceived as necessary supports for inclusion.
Teachers gave strong, consistently positive responses to items relating to the con-
struct of social inclusion and supported their answers with examples of a range of
social opportunities provided in their classrooms (e.g., groupwork, structured play).
However, contrary to the results of the Likert-scale items where teachers were
positive about their role in promoting socially inclusive opportunities, responses to
the open-ended questions revealed that when planning for their students with an
Autism Spectrum Disorder, teachers reported greater consideration in academic
planning for students than social planning.
TABLE 9.2 Component correlation matrix
Component 1 2 3 4
1 1.000 0.169 0.301 −0.021
2 0.169 1.000 −0.088 0.027
3 0.301 −0.088 1.000 −0.087
4 −0.210 0.027 −0.087 1.000

Case studies
In each of the five case studies, (CS1–CS5) interviews were conducted with the
target student, (S), their teacher (T), a nominated peer group (PG) and the school
Principal (P). Observations were made of teacher practice and student behaviour
in each of the five mainstream classroom settings. Data from the case studies were
broken down and examined in an attempt to provide answers to the research
questions. Using the systematic coding principles of grounded theory developed by
Strauss and Corbin (1998), the coding techniques used included open coding, axial
coding and selective coding. Analysis of findings associated with the social inclusion
construct disclosed an interplay between responses of the adult participant groups
(i.e., teachers and Principals) and the student participant groups (i.e., students and
peer groups) of this study. For the purposes of the following discussion, the focus
will centre on the teacher and Principal key players and draw out convergences and
disparities between their responses.
Both teachers and Principals drew from their previous experiences throughout
the interviews.This experience, combined with their knowledge of Autism Spectrum
Disorder, professional knowledge, and judgements and understandings of effective
instruction were shared with selective codes within the teacher effectiveness con-
struct. Social inclusion was a selective code reported by both teachers and Principals.
Examination of the open codes and categories that conceptualised this code, however,
found greater focus on the barriers to social inclusion and less to the way this con-
struct was facilitated in the mainstream environment.
In their interviews teachers from the case studies said they worked hard to
create an environment of acceptance in their classrooms by “Trying to encourage
everyone” (Case Study 4-Teacher, CS4-T) and “Teaching the class how to get
along and see things through other people’s eyes” (CS2-T). Limited evidence
was found through the observations, however, to support this claim. Observed
instances of positive encouragement directed toward any student in the class
were recorded as occurring less than 20 per cent of the entire observational
period. Further, analysis of the teacher dialogue in the classroom revealed it to be
directed toward academic content rather than social activity in each of the case
study classrooms, with the average percentage of academic directed talk between
the three cases calculated as approximately 78 per cent. Another finding contrary
to teachers’ provision of social opportunities for their students with an Autism
Spectrum Disorder was the seating allocation of their students. Three of the five
students sat alone while the rest of their class sat in small groups. Teachers’ active
support of their students’ preferred isolation appeared to do little to promote
their active social involvement in any way.
Despite reporting groupwork as a strategy for social engagement in their inter-
views, only one teacher, (CS4-T), used groupwork as a mode of instruction in
any of the observational sessions. Three teachers reported their target student was
allowed to disengage themselves from groupwork activities if they chose to, saying
126 Cathy Little
“If it gets too much then she can work by herself ” (CS1-T) and “He doesn’t like
to work with anyone so he can stop” (CS5-T). In Case Study 3, the target student’s
active refusal to participate in any type of group activity was not contested by his
teacher. With recent research citing the benefits of peer-mediated interventions
for students with an Autism Spectrum Disorder (Hart and Whalon, 2011; Locke,
Rotheram-Fuller, and Kasari 2012) the absence of groupwork as an instructional
strategy reinforces the purported limited knowledge base of the teachers in the case
studies regarding effective teaching strategies for students with an Autism Spectrum
Disorder.
In the interviews, all teacher participants reported using social skills programs
in their classes to promote social engagement. However, despite reporting use of
these programs, at no time during the observations was any social skills instruction
observed or alluded to by any teacher participant. This result is at odds with the
literature that reports students with an Autism Spectrum Disorder require direct
teaching of social skills and skills in effective social communication (McGillicuddy
and O’Donnell, 2014).
When asked what they believed social inclusion was for students with an
Autism Spectrum Disorder, responses were varied. Responses from the Teacher
Attitudes Survey saw participants respond, “included in all ways”, and “acceptance
by peers and self ”. Yet the responses from the case studies were less affirming.
When responding to questions investigating social inclusion, both teachers and
Principals predominantly reported perceived barriers to students’ social inclu-
sion, positing the students themselves as constituting a barrier. One teacher
described her student as “all consuming and manipulative”, reporting that her
behaviour “scared away other students”. Another teacher (CS4-T) placed the
onus for social inclusion squarely on the shoulders of the student, mentioning
numerous times how it was up to him to “fit in” and “know how to interpret
the other kids”.
Student factors, such as the behaviour of the student and their perceived abil-
ities, were used as a benchmark for inclusive attitudes. Student participants were
described by both teachers and Principals using labels, such as “that was ASD”, and
“she’s interesting”, as well as their interests, “he likes to play video games”, with the
onus placed on the student with an Autism Spectrum Disorder having to ‘fit in’ to
social situations. The concept of the student with an Autism Spectrum Disorder as
‘different’ when compared to typically developing peers was influential in shaping
attitude.
The role of peers in the social inclusion of students with an Autism Spectrum
Disorder was important. Peers’ knowledge of Autism Spectrum Disorder and the
acceptance of a student for whom he was saw one student from the case studies
socially included with his peers and his classmates. In the remaining case studies,
evidence from teachers, peers and the school Principal indicated that the target
student was shown little acceptance or understanding by peers and remained
socially isolated for the duration of the study.
Discussion
Results found that the attitudes of the teacher played a significant role in the
quality of the interactions within the student’s environment. Within the microsys-
tem, teacher, student and peers were engaged in multiple interactions, both one-
way and bi-directional. Results confirm that students’ social developments were
impacted by these interactions. Positive, reciprocal interactions between the student
and members of their microsystem (e.g., CS4) saw the target student included in
class activities with numerous, positive illustrations of social inclusion. Less positive
interactions (e.g., CS2 and CS3), where the student was rejected by peers, com-
bined with no opportunity for social interaction as facilitated by the teacher, saw
these students experience little to no social inclusion.
The impact of the mesosystem on the student’s social inclusion was also noted. Each
Principal’s interactions with the microsystem of the target student either enhanced or
detracted from their social inclusion. The reported influence of Principals served to
undermine the confidence of the teacher who, in turn, provided limited opportunity
for social inclusion of the student. Both teachers and Principals reported attribution
to the holding of power and control regarding decision-making. For teachers, this was
reflected in the locus of control code, indicating they believed decisions were made for
them, rather than by them (e.g.,“I don’t have anything to do with that.That decision is
made by the execs [executive]” – CS2-T). Principals, however, reported themselves to
be the sole decision-maker in their schools (e.g., “I assess, I look, I make the decision
as to the class they will go into” – CS4-P), perceiving him or herself to be the power
holder:“Most teachers here have given me their power because they don’t know what
they’re doing” (CS1/2-P).
Social inclusion was a selective code reported by both teachers and Principals.
Examination of the open codes and categories that conceptualised this code how-
ever, found greater focus on the barriers to social inclusion and less to the way this
construct was facilitated in the mainstream environment.
Bronfenbrenner (2005) postulated that an individual’s interactions with the
systems that surround them would change over time. Thus, the chronosystem
reflected the cumulative experiences a person has over their lifetime.This reflection
of the influence of time was illustrated in Case Study 4. Both Jacob* (student with
an Autism Spectrum Disorder) and his peers had been friends for many years: “We
started at pre-school together” (Jacob). As Jacob and his friends grew up together,
through their interactions with each other, greater understanding and acceptance
developed between them. This enduring friendship resulted in successful social
inclusion for Jacob a number of years later.
An integral member of the students’ microsystem is the family. Family was a
factor mentioned by all ‘key player’ groups except the peer group. Students reported
their place in the familial structure but did not elaborate in any detail as to the
quality of relationship they had with their family. Principals and teachers men-
tioned the role of families in the school community, but did not detail the nature of
the relationships between the target student and their family.
128 Cathy Little
Findings from the questionnaire and case studies generally suggested primary
teachers were positive in their attitude toward inclusion generally, but lacked confi-
dence in their abilities to put these beliefs into practice, reporting low self-efficacy
and limited knowledge in the area of Autism Spectrum Disorder. Higher order
decision-making processes and ‘systemic blinkering’ were elements that further
contributed to teachers’ low self-efficacy. Overwhelmingly teachers requested a
need for ongoing professional development and additional resources to support
and inform their provision of socially inclusive opportunities for students with an
Autism Spectrum Disorder.
When discussing the understandings of social inclusion by key participants, one
must refer to the definition used for the study. Social inclusion was defined as the
consideration of the student with an Autism Spectrum Disorder as an accepted
member of a group, exhibiting at least one mutual friendship and participating
actively and equally in group activities. Results from the Teacher Attitudes Survey
intimated that while teachers voiced the importance of the social well-being of
students, the in-depth analysis of case study data indicated that active engage-
ment in planning for students’ social participation and inclusion in group activities
was not apparent. In comparison, the target student participants and peer groups
reported greater awareness of the concepts of friendships and values of acceptance
than their adult contemporaries, thus intimating a greater understanding of the core
underpinnings of social inclusion.
Conclusion
Teacher attitudes are formed and shaped by affective, cognitive and behavioural
processes, framed by previous experiences and personal judgements (Segall and
Campbell, 2014). These processes influence the way in which teachers perceive
themselves and their students, and serve to guide the overt response behaviours
used within the context of the educational environment. Despite positive demon-
strations in attitude toward the inclusion of students with an Autism Spectrum
Disorder, primary teachers have limited knowledge as to how to facilitate these
students’ social inclusion. The onus lays with future research as to how to best
harness this positive affect. The onus lays with future research as to how to trans-
form teachers positive attitudes into affirmative behavioral enactment of socially
inclusive opportunities for students with an Autism Spectrum Disorder.
References
Artiles, A. J., Harris-Murri, N., and Rostenberg. (2008). Inclusion as social justice: Critical
notes on discourses, assumptions and the road ahead. Theory into Practice, 45(3), 260–8.
doi:10.1207/s15430421tip4503_8
Avramidis, E., and Norwich, B. (2002). Teachers’ attitudes towards integration/inclusion:
A review of the literature. European Journal of Special Needs Education, 17(2), 129–47.
doi:10.1080/08856250210129056
Avramidis, E., Bayliss, P., and Burden, R. (2000). A survey into mainstream teachers’
attitudes towards the inclusion of children with special educational needs in the ordi-
nary school in one local education authority. Educational Psychology, 20(2), 191–211.
doi:10.1080/713663717
Boutot, E. A. (2007). Fitting in: Tips for promoting acceptance and friendships for stu-
dents with autism spectrum disorders in inclusive classrooms. Intervention in School
and Clinic, 42(3), 156–61.
Boyle, C.,Topping, K., and Jindal-Snape, D. (2013).Teachers’ attitudes towards inclusion in high
schools. Teachers and Teaching: Theory and Practice, 19(5), 527–42. doi:10.1080/13540602.
2013.827361
Bronfenbrenner, U. (Ed.). (2005). Making human beings human: Bioecological perspectives on
human development. Thousand Oaks, CA: SAGE Publications Inc.
Bronfenbrenner. U. (2001).The bioecological theory of human development. In N. J. Smelser
and P. B. Baltes (eds.), International encyclopedia of the social and behavioral sciences.Volume 10.
New York: Elsevier Science Ltd., pp. 6963–70.
Brown, W. H., Odom, S. L., and McConnell, S. R. (Eds.). (2008). Social competence of young
children: Risk, disability and intervention. Baltimore, MD: Paul H. Brookes.
Carter, E. W., Sisco, L. G., Chung,Y. C., and Stanton-Chapmen, T. L (2010). Peer interactions
of students with intellectual disabilities and/or autism: A map of the intervention litera-
ture. Research and Practice for Persons with Severe Disabilities, 35(3-4), 63–79. doi:10.2511/
rpsd.35.3-4.63
Commonwealth Attorney General’s Department. (1992). Disability discrimination act. Canberra:
Author.
Commonwealth Attorney General’s Department. (2005). Disability standards for education
de Boer, A., Jan Pijl, S., and Minnaert, A. (2011) Regular primary schoolteachers’ attitudes
towards inclusive education: A review of the literature. International Journal of Inclusive
Education, 15(3), 331–53. doi:10.1080/13603110903030089
Doble, S. E., and Magill-Evans, J. (1992). A model of social interaction to guide
occupational therapy. Canadian Journal of Occupational Therapy, 59(3), 141–50.
doi:10.1177/000841749205900304
Eldar, E., Talmor, R., and Wolf-Zukerman, T. (2010). Successes and difficulties in the
individual inclusion of children with autism spectrum disorder (ASD) in the eyes
of their coordinators. International Journal of Inclusive Education, 14(1), 97–114.
doi:10.1080/13603110802504150
Field, A. (2009). Discovering statistics using SPSS. Third edition. London: Sage Publications.
Foreman, P., and Arthur-Kelly, M. (2008). Social justice principles, the law and research,
as bases for inclusion. Australasian Journal of Special Education, 32(1), 109–24.
doi:10.1080/10300110701839964
Greenwood, C. R., Carta, J. J., Kamps, D., and Delquadri, J. (1993). Ecobehavioral assessment
systems software (EBASS): Observational instrumentation for school psychologists. Kansas City,
KS: Juniper Gardens Children’s Project, University of Kansas.
Hart, J. E., and Whalon, K. J. (2011). Creating social opportunities for students with autism
spectrum disorder in inclusive settings. Intervention in School and Clinic, 46(5), 273–79.
Li, C. and Wang, C, K, J. (2013). Effect of exposure to Special Olympic Games on attitudes
of volunteers towards inclusion of people with intellectual disabilities. Journal of Applied
Research in Intellectual Disabilities, 26, 515–21. doi:10.1111/jar.12053
Lindsay, S., Proulx, M.,Thomson, N., and Scott, H. (2013). Educators’ challenges of including
children with autism spectrum disorder in mainstream classrooms. International Journal of
Disability, Development and Education, 60(4), 347–62. doi:10.1080/1034912X.2013.846470
130 Cathy Little
Locke, J., Rotheram-Fuller, E., and Kasari, C. (2012). Exploring the social impact of being
a typical peer model for included children with autism spectrum disorder. Journal of
Autismand Developmental Disorders, 42(9), 1895–1905.
Mazurek, K., and Winzer, M. (2011). Teacher attitudes toward inclusive schooling: Themes
from the international literature. Education and Society, 29(1), 5–25. doi:http://dx.doi.
org/10.7459/es/29.1.02
McGillicuddy, S. and O’Donnell, G. M. (2014). Teaching students with autism spectrum
disorder in mainstream post-primary schools in the Republic of Ireland. International
Osler, A. and Osler, C. (2008). Inclusion, exclusion and children’s rights: A case study of
a student with Asperger Syndrome. Emotional and Behavioural Difficulties, 7(1), 35–54.
doi:10.1080/13632750200507004
Polat, F. (2011). Inclusion in education: A step towards social justice. International Journal of
Educational Development, 31(1), 50–8. doi:10.1016/j.ijedudev.2010.06.009
Schoen, B., Shannon, C, D. and Tansey, T. N. (2009). The effect of contact, context, and social
power on undergraduate attitudes toward persons with disabilities. Journal of Rehabilitation,
75(4), 11–8.
Segall, M. J., and Campbell, J. M. (2014). Factors influencing the educational placement
of students with autism spectrum disorders. Research in Autism Spectrum Disorders, 8,
31–43.
Sharma, U., Loreman, T., and Forlin, C. (2012). Measuring teacher efficacy to imple-
ment inclusive practices. Journal of Research in Special Educational Needs, 12(1), 12–21.
doi:10.1111/j.1471-3802.2011.01200.x
Stitchter, J. P., O’Connor, K. V., Herzog, M. J., Lierheimer, K., and McGhee, S. D. (2012).
Social competence intervention for elementary students with Aspergers Syndrome and
high functioning autism. Journal of Autism and Developmental Disorders, 42(3), 354–66.
doi:10.1007/s10803-011-1249-2
Strauss, A. L., and Corbin, J. M. (1998). Basics of qualitative research:Techniques and procedures for
developing grounded theory. Second edition. Thousand Oaks, CA: Sage.
Sullivan, E. and Glidden, L., M. (2014). Changing attitudes toward disabilities through
unified sports. Intellectual and Developmental Disabilities, 52(5), 367–78. doi:http://dx.
doi.org/10.1352/1934-9556-52.5.367
UN General Assembly. (1989). Convention on the rights of the child. United Nations, Treaty
Series, volume 1577. New York: United Nations, p. 3.
UN General Assembly. (2007). Convention on the rights of persons with disabilities and optional
protocol. New York: United Nations.
UNESCO. (1990). World declaration on education for all. New York: Author.
UNESCO. (1994). The Salamanca statement and framework for action on special needs education.
Paris: Author.
Warnock, M. (1979). Children with special needs: The Warnock report. British Medical
Journal, 1, 667–8.
10
USING TYPICALLY DEVELOPING
PEERS AS SUPPORT FOR SOCIAL
INCLUSION OF CHILDREN AND
ADOLESCENTS WITH AUTISM IN
SCHOOL SETTINGS
Jill Locke and Colleen Harker
Social impairment may be the most challenging and pervasive core deficit that
affects children and adolescents with Autism Spectrum Disorder (ASD) (Kasari
and Rotheram-Fuller, 2007). Social challenges, particularly apparent in school
settings, have a lasting impact on peer relationships of children and adolescents with
ASD (Bauminger and Kasari, 2000; Locke, Ishijima, Kasari and London, 2010). The
Individuals with Disabilities Education Act (IDEA, 2004) mandates that children
with disabilities, including ASD, be educated within the general education envi-
ronment with typically developing peers whenever appropriate. The inclusion of
children and adolescents with ASD in general education classrooms is an increas-
ingly common practice to ensure they are educated in the least restrictive learning
environment. However, placement of children and adolescents with ASD in prox-
imity with typically developing peers is necessary but not sufficient for promoting
social engagement (Odom and Strain, 1984). Rather, children and adolescents with
ASD require ongoing support, facilitation, and structure to be socially successful in
school settings (Simpson, de Boer-Ott and Smith-Myles, 2003).
Peer models
Peer-mediated interventions have shown promise in addressing this issue (e.g.,
Rogers, 2000; Chan et al., 2009). Peer-mediated interventions comprise training
same-age or older typically developing peers (e.g., classmates) on skills to engage
132 Jill Locke and Colleen Harker
children with ASD (Bellini, Peters, Benner and Hopf, 2007; Rao, Beidel and
Murray, 2008; Chan et al., 2009; Kasari, Rotheram-Fuller, Locke and Gulsrud,
2012). Peer-mediated approaches are either indirect, in that the expert facilitator
works exclusively with the peer models rather than the target students with ASD,
or concurrent, in that the expert facilitator works with both students with ASD
and their peers simultaneously. In schools, peer-mediated interventions most
frequently take place during the recess/lunch period or as a pull out service.
Schools serve as important service delivery systems for all students, particularly
students with ASD (Locke, Kratz, Reisinger and Mandell, 2014). As children and
adolescents spend a majority of their day at school, it is critical to capitalize on
possible intervention opportunities in which they can practice new skills. Peer-
mediated interventions are particularly relevant in school settings, as schools pro-
vide ample opportunities in which children and adolescents with ASD can interact
with typically developing peers within a natural context (Bellini et al., 2007). The
number of peers present within schools provides a large selection of potential inter-
vention agents, which may mitigate implementation barriers commonly faced by
teachers and other school staff (e.g., lack of time, resources) (Bellini, et al., 2007;
Chan et al., 2009; Locke et al., 2014b).
Although adult-delivered, one-on-one supports are typical in school settings,
an overreliance on these methods may hinder students from fully participating
in the social opportunities available within inclusive settings (Hemmingsson,
Borell and Gustavsson, 2003). Furthermore, social skills interventions are not
only more ecologically valid when delivered by peers than by adults but also may
be more effective (Gerber, Finn, Achilles and Boyd-Zaharias, 2001; Giangreco,
Broer and Edelman, 2001; Hemmingsson et al., 2003; Carter and Kennedy, 2006;
Kasari et al., 2012). The use of peer models may create a more inclusive climate
and culture for children and adolescents with ASD at school, thereby encourag-
ing generalization and maintenance of skills that are often not achieved when
using an adult as the interventionist (Chan et al., 2009; Kasari, Locke, Ishijima
and Kretzmann, 2013).
Peer-mediated approaches
To date, peer-mediated approaches have the largest evidence base for improving
social functioning in children and adolescents with ASD (Haring and Breen,
1992; Sainato, Goldstein and Strain, 1992; Kamps, Potucek, Lopez, Kravits and
Kemmerer, 1997; Pierce and Schreibman, 1997; Laushey and Heflin, 2000;
McConnell, 2002; Bellini et al., 2007; Kasari et al., 2012). In the f ollowing section,
we briefly review the most common peer-mediated approaches, including
peer modeling, networking, tutoring, and mentoring (Utley, Mortweet and
Greenwood, 1997; DiSalvo and Oswald, 2002; Carter and Kennedy, 2006; Zhang
and Wheeler, 2011; Bohlander, Orlich and Varley, 2012; Kasari et al., 2012). These
methods differ in the roles that peer models play (i.e., direct vs. indirect), as
Peer supports 133
well as the format (i.e., group vs. individual), and the target of the intervention
(i.e., social vs. academic).
Peer modeling involves pairing a socially competent peer model with a student
with ASD in order to demonstrate appropriate social behaviors (Utley et al., 1997;
Zhang and Wheeler, 2011; Kasari et al., 2012). In peer modeling, peers do not
provide any direct intervention; rather, they merely model behaviors (e.g., sharing,
requesting, joining in play). This approach also may include video modeling in
which students with ASD watch a video of a peer model demonstrating desired
behaviors (Nikopoulos and Keenan, 2004; Bellini and Akullian, 2007). Peer model-
ing often is used as a component of peer-mediated and other social skill interven-
tions, in which the student with ASD watches the peer model, practices the skill,
and receives feedback on his or her performance.
Conversely, peer networking combines adult- and peer-mediated strategies
to create a broad support system in the classroom for students with ASD (Utley
et al., 1997; Garrison-Harrell, Kamps and Kravits, 1997; Zhang and Wheeler, 2011;
Kamps et al., 2014). In peer networking interventions, peers both initiate social
interactions with students with ASD and model appropriate behaviors. Peer net-
works often are informal and typically include a small group of peer models that
are instructed to integrate target students with ASD into appropriate peer groups
within classroom, cafeteria, and playground settings (Utley et al., 1997; Kasari et al.,
2012; Kamps et al., 2014).
Peer tutoring or peer mentoring is another peer-mediated approach that
involves pairing peer models with target students with ASD to promote curricular
and social interaction skills through structured, dyadic, one-to-one instructional
interactions (Utley et al., 1997; Rogers, 2000; DiSalvo and Oswald, 2002). Peer
tutors and mentors often are taught specific strategies on redirecting, engaging, and
scaffolding behaviors for target students with ASD (Bohlander, Orlich and Varley,
2012; Kasari et al., 2012). Peer tutoring and peer mentoring create opportunities
for students with ASD to interact with socially competent peer models to learn
academic tasks as well as social-communication skills (DiSalvo and Oswald, 2002;
Bohlander, Orlich and Varley, 2012).
Peer-mediated intervention strategies and formats vary depending on the
intended outcome. Many school-based peer-mediated interventions strive to pro-
vide opportunities for social interactions between children and adolescents with
ASD and their peers. Peer models are taught a specific set of skills through direct
instruction, prompting, modeling, role playing, and reinforcement that entail: iden-
tifying isolated students, initiating and responding to social interactions, organiz-
ing play activities, redirecting and ignoring inappropriate behaviors, monitoring
behavior requests, sustaining engagement in games, mediating conflict, and serving
as tutors for schoolwork and recreational activities (Odom and Strain, 1986; Kamps
et al., 1992; Morrison, Kamps, Garcia, and Parker, 2001; Kamps et al., 2002; Orsmond,
Krauss and Seltzer, 2004; Kasari et al., 2012; Locke et al., 2014b). Adult facilitators
typically cue peer models to use the strategies with students with ASD (Rogers,
2000; Koegel, Werner, Vismara and Koegel, 2005; Bauminger et al., 2008; Harper,
Symon and Frea, 2008; Licciardello, Harchik, and Luiselli, 2008). Often, peer mod-
els are given homework assignments or “missions” to practice learned skills with
students with ASD (Kasari et al., 2012; Reichow and Volkmar, 2010).
The majority of research investigating social interventions for individuals with
ASD has focused on preschool and elementary school–aged children (Reichow and
Volkmar, 2010). There is a dearth of research about social skills interventions, par-
ticularly peer-mediated interventions, for students with ASD in secondary school
(Reichow and Volkmar, 2010). To date, peer-mediated intervention strategies for
students with ASD in middle and high school have mirrored those of elementary
school, though the content and context have differed (Carter and Hughes, 2005).
This continues to be an area that warrants further research.
Peer-mediated intervention outcomes

Students with ASD are often on the periphery of the social structure within
their classroom (Chamberlain, Kasari and Rotheram-Fuller, 2007; Kasari, Locke,
Gulsrud and Rotheram-Fuller, 2011; Locke, Kasari, Rotheram-Fuller, Kretzmann
and Jacobs, 2013). Peer-mediated interventions have been shown to improve the
social network centrality (i.e., social connections, peer acceptance, and classroom
inclusion) of students with ASD (Kasari et al., 2012). Other studies also have shown
promise in the use of typically developing peer models in supporting children
and adolescents with ASD in the classroom. Specifically, peer-mediated interven-
tions including peer modeling, networking, tutoring, and mentoring have led to
improvements in non-verbal social skills (e.g., eye contact, joint attention), play skills
(e.g., turn-taking), and reciprocal social-communication skills (e.g., conversations,
initiations, responses) as well as greater social interaction and increased friendships
for children and adolescents with ASD (Strain and Kohler, 1995; Roeyers, 1996;
Kamps et al., 1997; Laushey and Heflin, 2000; Carter and Kennedy, 2006; Bass and
Mulick, 2007; Jung, Sainato and Davis, 2008; Owen-DeSchryver, Carr, Cale and
Blakeley-Smith, 2008; Kasari et al., 2012). Furthermore, peer-mediated interven-
tions may complement traditional school-based social skills interventions and lead
to greater skills generalization for students with ASD (Schmidt and Stichter, 2012).
Selection of peer models

In elementary school, teachers frequently are responsible for selecting appropriate
peer models for children with ASD. In doing so they often must consider logistical
and social factors. Logistical factors might include a student’s school attendance
and academic performance to ensure that he or she will be present for training and
intervention activities and capable of completing any missed schoolwork (Campbell
and Marino, 2009; Kamps et al., 2014; Owen-DeSchryver et al., 2008).Teachers also
must consider social factors in selecting peer models. These selection criteria vary
and are typically based on teachers’ perceptions of who may be a good peer model.
Peer supports 135
Because teachers are rarely present during recess, they tend to select children as peer
models based on classroom characteristics and behaviors. Typically, selected peers
are obedient, self-confident leaders in the classroom who are considered socially
competent, prosocial, popular, and already have some interest and connection to
children with ASD, and willingness to participate in the intervention (Jackson and
Campbell, 2009; Locke, Rotheram-Fuller and Kasari, 2012; Kamps et al., 2014).
It is thought that children comprising these qualities may be more empathetic
or understanding of children with ASD and more willing to socially engage with
them as compared to non-peer models (Locke et al., 2012). There also is anecdotal
evidence that suggests that elementary-aged girls may be more likely than boys to
take on a “care-taking role,” and be more nurturing and responsive when acting as
peer models for children with ASD (Center and Curry, 1993; Chamberlain et al.,
2007; Owen-DeSchryver et al., 2008).
Garrison-Harrell and colleagues (1997) operationalized the selection of peer
models in their study of a peer network intervention for children with ASD by
using children’s social network status, or social positioning within their classroom.
Students completed a formal peer rating system and listed their friendship nomi-
nations (who they prefer to hang out with), which teachers then reviewed for peer
model selection to determine which students might be appropriate peer mod-
els. Despite consistencies in the factors used by teachers and researchers to select
peer models across studies, these characteristics have yet to be empirically tested to
determine which qualities encompass the ideal peer model.
Social demands dramatically change between elementary and secondary school;
therefore the criteria used to select elementary school–aged peers may not be
appropriate for selecting adolescent peer models. Peer relationships undergo signif-
icant change during adolescence as the nature of friendship shifts from gameplay
to deeper relationships that focus on commitment, closeness, security, intimacy,
and acceptance (Buhrmester, 1990; Berndt and Savin-Williams, 1993; Shulman,
Laursen, Kalman and Karpovsky, 1997). Peer relationships become more complex
and interactions more nuanced, making it difficult for adolescents with ASD to
navigate this new social landscape (Adreon and Stella, 2001; Locke et al., 2010). To
compound this issue, typically developing adolescents may be more aware of stu-
dents who may have a disability and less malleable in changing their attitudes and
behaviors towards adolescents with ASD (Humphrey and Lewis, 2008). As a result,
fewer established guidelines exist for selecting suitable peer models for adolescents
with ASD compared to those for elementary school–aged children.
There also are additional logistical factors to consider when implementing
peer-mediated interventions in middle and high school settings as compared to
elementary school, which may influence how peer models are selected to partic-
ipate. For example, in middle and high school, students have different schedules
and switch classes as often as six or more times a day; therefore, there is limited
consistency in the composition of the peer group throughout the day. Additionally,
there are fewer opportunities for unstructured social interaction in middle and
high school, as classes involve more independent work (Carter and Kennedy, 2006).
Consequently, adolescents must take advantage of other opportunities to socialize at

school (e.g., in the hallways between classes, at lunch, during extra curricular activ-
ities), which may be difficult for students with ASD to navigate. Consideration of
these logistical factors and others is important as they may affect the feasibility and
effectiveness of peer-mediated interventions (Carter and Kennedy, 2006).
To date, studies of peer-mediated interventions for adolescents with ASD have
relied on both logistical considerations (e.g., shared classes) and social characteristics
(e.g., social competence) when selecting peers. Schmidt and Stichter (2012) based
their peer selection criteria on those used by McEvoy and colleagues (1990) and
Kerr and Nelson (1983), which ultimately included: willingness to participate; good
attendance record; history of compliance with instructions; ability to make up any
missed school work; frequent and appropriate interactions with peers; and task
follow-through. Haring and Breen (1992) required that adolescents with ASD and
peer models had at least one mainstreamed class together and the same on-campus
job. They also required that the adolescents had interacted before in the past and
that they shared common hobbies and interests. Lastly, the authors ensured that the
adolescents with ASD agreed with the selection. After peers were recruited to par-
ticipate, they were then asked to identify two to four friends to participate. Similar
to elementary age children with ASD, the selection criteria for adolescent peer
models has yet to be empirically tested and the ideal peer model may likely vary by
context (e.g., classroom period, school, etc.).
Impact of being a peer model

Even though the extant literature points to many ways in which peer models have
helped students with ASD, parents, teachers, and school administrators often raise
concerns about possible social, behavioral, and academic consequences of being a
peer model (Ferraioli and Harris, 2011). Concerns have arisen that peer models
will miss valuable instruction time, emulate the inappropriate behaviors of children
with ASD, and/or experience negative social consequences from their peers for
associating with children with ASD (Ferraioli and Harris, 2011; Locke et al., 2012).
However, these concerns have not been substantiated in the literature. In fact, peer
models are more socially well connected with peers in their classroom’s social struc-
ture, have higher quality friendships, receive more friendship nominations, and are
more connected to children with ASD as compared to non-peer models at both
pre- and post-intervention (Locke et al., 2012). These findings suggest that the
social status of peer models is not negatively impacted by their participation in
peer-mediated interventions. Research also indicates that peer-tutoring interven-
tions may actually improve the academic performance of peer models that were
initially performing below grade level pre-intervention (Cushing and Kennedy,
1997; Shukla, Kennedy and Cushing, 1998; Shukla, Kennedy and Cushing, 1999).
Few studies have systematically examined outcomes for peer models partici-
pating in peer-mediated interventions for children with ASD. In one of the few
published studies on this topic, Locke and colleagues (2012) used empirical data
Peer supports 137
(e.g., friendship nominations, social network centrality rankings) to examine the

social impact of being a peer model. Though peer models reported a significant
increase in connections to children with ASD between pre- and post- intervention,
there were no other notable changes in social outcomes (though importantly there
were no declines in the social status of peer models). The authors suggested that it
may be harder to detect positive intervention effects for peer models, given their
already high social status in the classroom (Locke et al., 2012). Interestingly, in this
study the social status of non-peer models improved from pre- to post-intervention
suggesting that there may be collateral benefits for all children in a classroom in
which a peer mediated intervention is implemented for children with ASD (Locke
et al., 2012).
Other studies have used focus groups and surveys to elicit the opinions of
peer models about their experience participating in peer-mediated interventions
for high school students with disabilities, including ASD (Copeland et al., 2004;
Hughes et al., 2001). Peer models endorse several benefits of being a peer model,
including improved attitudes about individuals with disabilities, as well as increased
knowledge and comfort interacting with peers with disabilities (Hughes et al.,
2001; Copeland et al., 2004).
Peer burden and burnout

Peer models may face challenges when selected to help children with ASD. Aside
from the personal sacrifice and/or relinquishing recess periods or other free time,
peer models may feel obligated to help their peers with ASD. Over time, this may
prove burdensome for peer models, and they may succumb to various difficul-
ties, demands, and pressures that may lead to burnout (Reiter and Vitani, 2007).
Research is needed to determine the factors that sustain the involvement of chil-
dren and adolescents in peer-mediated interventions over time to assuage the pos-
sibility of burnout (Carter and Kennedy, 2006).
School supports
Schools planning to implement peer-mediated interventions for students with ASD
should take into account a number of considerations, including group composition
(i.e., number of peer models), intervention method (e.g., peer networks, peer tutor-
ing), oversight (i.e., teacher support), context (i.e., where the intervention will take
place), intervention goal (i.e., social or academic), and training needs (e.g., time, staff
support, curricula) to ensure the success of the program. Furthermore, in addition
to didactic social skills instruction, it is important that schools provide opportunities
for peer models and students with ASD to interact in and out of the classroom. Of
particular interest is determining the number of peer models needed to prevent
peer burnout while also averting stigmatization for students with ASD. This ques-
tion has yet to be empirically tested, and the results may be different depending on
the age of the peers and the functioning level of the student with ASD.
Future directions
Despite the promise of peer-mediated interventions, several important questions
remain unanswered that warrant future research. These areas are of critical impor-
tance to understand for replication studies as well as widespread implementation in
schools. First, though many studies report the fidelity of the expert adult facilitator
working with the peer models, the implementation fidelity (e.g., adherence, quality
of delivery, exposure) of the peer models is notably absent from the literature, save
for a few studies.This issue may be due to the fact that few peer-mediated interven-
tions have manuals with strict fidelity guidelines and many approaches share over-
lapping strategies (e.g., peer modeling, peer tutoring, peer mentoring, etc.). Thus, it
may be difficult to parse out specific steps of one particular peer-mediated inter-
vention approach to measure implementation fidelity. Furthermore, the intended
treatment goal of the intervention (i.e., academic or social skills) may determine
whether it is possible to measure implementation fidelity, as social skills may require
more flexible settings (e.g. on the playground or cafeteria) where strict fidelity may
be difficult to capture. Future studies also should examine the generalization of
skills to other students, beyond peer models (Hughes et al., 2012).
Additionally, there is a need to further examine the social characteristics of typ-
ically developing students who make the most effective peer models for children
and adolescents with ASD. Understanding the social profiles of peer models may
help determine under what conditions peer-mediated interventions should be
implemented. Moreover, rather than relying exclusively on teacher nominations,
peer models should be selected based on the social networks of students within
the classroom, to identify peers who are already socially connected to the student
with ASD. It also has been suggested that students with ASD should be involved in
selecting peer models, which may increase their buy-in in the intervention (Carter
and Kennedy, 2006). To date, these issues have not been systematically studied.
Research in this area has the potential to benefit the large and growing number of
children with ASD in inclusive school settings.
References
Adreon, D., and Stella, J. (2001). Transition to middle and high school: Increasing the
success of students with Asperger Syndrome. Intervention in School and Clinic, 36, 266–71.
doi:10.1177/105345120103600502
Bass, J. D., and Mulick, J. A. (2007). Social play skill enhancement of children with autism
using peers and siblings as therapists. Psychology in the Schools Special Issue: Autism Spectrum
Disorders, 44, 727–35. doi:10.1002/pits.20261
Bauminger, N., and Kasari, C. (2000). Loneliness and friendship in high-functioning children
with autism. Child Development, 71, 447– 56. doi:10.1111/1467-8624.00156
Bauminger, N., Solomon, M., Aviezer, A., Heung, K., Gazit, L., Brown, J., and Rogers, S. J.
(2008). Children with autism and their friends: A multidimensional study of friendship
in high-functioning autism spectrum disorder. Journal of Abnormal Child Psychology, 36,
135–50. doi:10.1007/s10802-007-9156-x
Peer supports 139
Bellini, S., and Akullian, J. (2007). A meta-analysis of video modeling and video self-modeling
interventions for children and adolescents with autism spectrum disorders. Exceptional
Children, 73, 264– 87.
Bellini, S., Peters, J. K., Benner, L., and Hopf, A. (2007). A meta-analysis of school-based social
skills interventions for children with autism spectrum disorders. Remedial and Special
Education, 28, 153–62. doi:10.1177/07419325070280030401
Berndt, T. J., and Savin-Williams, R. C. (1993).Variations in friendships and peer-group rela-
tionships in adolescence. In P. Tolan and B. Cohler (eds.), Handbook of clinical research and
practice with adolescents. New York: John Wiley, pp. 203–19.
Bohlander, A., Orlich, F., and Varley, C. (2012). Social skills training for children with autism.
Pediatrics Clinics of North America, 59, 165–74. doi:10.1016/j.pcl.2011.10.001
Buhrmester, D. (1990). Intimacy of friendship, interpersonal competence, and adjust-
ment during preadolescence and adolescence. Child Development, 61, 1101–11.
doi:10.1111/j.1467-8624.1990.tb02844.x
Campbell, J. M., and Marino, C. A. (2009). Brief report: Sociometric status and behavioral
characteristics of peer nominated buddies for a child with autism. Journal of Autism and
Developmental Disorders, 39, 1359–63. doi:10.1007/s10803-009-0738-z
Carter, E. W., and Kennedy, C. H. (2006). Promoting access to the general curriculum using
peer support strategies. Research and Practice for Persons With Severe Disabilities, 31, 284–92.
doi:10.1177/154079690603100402
Center, Y., and Curry, C. (1993). A feasibility study of a full integration model developed
for a group of students classified as mildly intellectually disabled. International Journal of
Disability Development and Education, 40, 217–23. doi:10.1080/0156655930400308
peer mediated interventions in the treatment of autism spectrum disorders: A systematic
Copeland, S. R., Hughes, C., Carter, E. W., Guth, C., Presley, J., and Williams, C. R. (2004).
Increasing access to general education: Perspectives of participants in a high school peer
support program. Remedial and Special Education, 26, 342–52. doi:10.1177/0741932504
0250060201
Cushing, L. S., and Kennedy, C. H. (1997). Academic effects of providing peer support in
general education classrooms on students without disabilities. Journal of Applied Behavior
Analysis, 30, 139–52. doi:10.1901/jaba.1997.30-139
DiSalvo, C. A., and Oswald, D. P. (2002). Peer-mediated interventions to increase the social
interaction of children with autism: Consideration of peer expectancies. Focus on Autism
and Other Developmental Disabilities, 17, 198–207. doi:10.1177/10883576020170040201
Ferraioli, S. J., and Harris, S. L. (2011). Effective educational inclusion of students on
the autism spectrum. Journal of Contemporary Psychotherapy, 41, 19–28. doi:10.1007/
s10879-010-9156-y
Garrison-Harrell, L., Kamps, D., and Kravitz, T. (1997). The effects of peer networks on
social- communicative behaviors for students with autism. Focus on Autism and Other
Developmental Disabilities, 12, 241–54. doi:10.1177/108835769701200406
Gerber, S. B., Finn, J. D., Achilles, C. M., and Boyd-Zaharias, J. (2001). Teacher aides and
students’ academic achievement. Educational Evaluation and Policy Analysis, 23, 123–43.
doi:10.3102/01623737023002123
Giangreco, M. F., and Broer, S. M. (2005). Questionable utilization of paraprofessionals in

inclusive schools: Are we addressing symptoms or causes? Focus on Autism and Other
Deveiopmental Disabilities, 20, 10–26. doi:10.1177/10883576050200010201
Haring, T., and Breen, C. (1992). A peer mediated social network intervention to enhance
the social integration of persons with moderate and severe disabilities. Journal of Applied
Behavior Analysis, 25, 319–33. doi:10.1901/jaba.1992.25-319
Harper, C.B., Symon, J.B.G., and Frea,W.D. (2008). Recess is time-in: Using peers to improve
social skills of children with autism. Journal of Autism and Developmental Disorders, 38,
815–26. doi:10.1007/s10803-007-0449-2
Hemmingsson, H., Borell, L., and Gustavsson, A. (2003). Participation in school: School assis-
tants creating opportunities and obstacles for pupils with disabilities. Occupational Therapy
Journai of Research, 23, 88–98. doi:10.1177/153944920302300302
Hughes, C., Copeland, S. R., Guth, C., Rung, L. L., Hwang, B., Kleeb, G., and Strong, M.
(2001). General education students’ perspectives on their involvement in a high school
peer buddy program. Education and Training in Mental Retardation and Developmental
Disabilities, 36, 343–56.
Humphrey, N. and Lewis, S. (2008). “Make me normal”: The views and experiences of
pupils on the autistic spectrum in mainstream secondary schools. Autism, 12, 23–46.
doi:10.1177/1362361307085267
Individuals with Disabilities Education Act of 2004, Pub. L. No. 108-446, § 101, 118 Stat.
2647 (2004).
Jackson, J. N., and Campbell, J. M. (2009). Teachers’ peer buddy selections for children with
autism: Social characteristics and relationship with peer nominations. Journal of Autism and
Jung, S., Sainato, D.M., and Davis, C.A. (2008). Using high-probability request sequences to
increase social interactions in young children with autism. Journal of Early Intervention, 30,
163–87. doi:10.1177/1053815108317970
Kamps, D., Leonard, B. R., Vernon, S., Dugan, E. P., et al. (1992). Teaching social skills to
students with autism to increase peer interactions in an integrated first-grade classroom.
Journal of Applied Behavior Analysis, 25, 281–8. doi:10.1901/jaba.1992.25-281
Kamps, D. M., Potucek, J., Lopez, A., Kravits, T., Kemmerer, K. (1997). The use of peer
networks across multiple settings to improve social interaction for students with autism.
Journal of Behavioral Education, 7, 335–57.
Kamps, D., Royer, J., Dugan, E., Kravits, T., Gonzalez-Lopez, A., Garcia, J., Carnazzo, K.,
Morrison, L., and Kane, L. G. (2002). Peer training to facilitate social interaction for
elementary students with autism and their peers. Exceptional Children, 68, 173–87.
doi:10.1177/001440290206800202
Kamps, D. M., Thiemann-Bourque, K., Heitzman-Powell, L., Schwartz, I., Rosenberg, N.,
Mason, R. A., and Cox, S. (2014). A comprehensive peer network intervention to improve
social communication of children with autism spectrum disorders: A randomized trial in
kindergarten and first grade. Journal of Autism and Development Disorders, 45(6), 1809–24.
doi:10.1007/s10803-014-2340-2
Kasari, C., Locke, J., Gulsrud, A., and Rotheram-Fuller, E. (2011). Social networks and
friendships at school: Comparing children with and without ASD. Journal of Autism and
Developmental Disorders, 41(5), 533-44. doi: 10.1007/s10803-010-1076-x.
Kasari C., Locke, J., Ishijima, E., and Kretzmann, M. (2013). Peer acceptance, social engage-
ment and friendship: Critical social goals for children with autism spectrum disorders. In
Gerhardt, P., (ed.). Social skills and adaptive behavior in learners with autism spectrum disorders:
Current status and future directions. Baltimore, MD: Brooke Publishing, pp. 171–84.
Peer supports 141
Kasari, C., and Rotheram-Fuller, E. (2007). Peer relationships of children with autism:
Challenges and interventions. In Hollander, E., and Anagnostou, E. (eds.). Clinical manual
for the treatment of autism. Washington, DC: American Psychiatric Publishing, pp. 235–57.
Kasari, C., Rotheram-Fuller, E., Locke, J., and Gulsrud, A. (2012). Making the connection:
Randomized controlled trial of social skills at school for children with autism. Journal of
Child Psychology and Psychiatry, 53, 431–9. doi:10.1111/j.1469-7610.2011.02493.x
Kerr, M. M., and Nelson, C. M. (1983). Strategies for managing behavior problems in the classroom.
Columbus, OH: Merrill.
Koegel, R. L., Werner, G. A., Vismara, L. A., and Koegel, L. K. (2005). The effectiveness of
contextually supported play date interactions between children with autism and typi-
cally developing peers. Research and Practice for Persons with Severe Disabilities, 30, 93–102.
doi:10.2511/rpsd.30.2.93
Laushey, K. M., and Heflin, L. J. (2000). Enhancing social skills of kindergarten children with
autism through the training of multiple peers as tutors. Journal of Autism and Developmental
Disorders, 30, 183–93. doi:10.1023/A:1005558101038
Licciardello, C. C., Harchik, A. E., and Luiselli, J. K. (2008). Social skills intervention for
children with autism during interactive play at a public elementary school. Education and
Treatment of Children, 31, 27–37. doi:10.1353/etc.0.0010
Locke, J., Ishijima, E. H., Kasari, C., and London, N. (2010). Loneliness, friendship quality
and the social networks of adolescents with high-functioning autism in an inclusive
school setting. Journal of Research in Special Educational Needs, 10, 74–81. doi:10.1111/
j.1471-3802.2010.01148.x
Locke, J., Kasari, C., Rotheram-Fuller, E., Kretzmann, M., and Jacobs, J. (2013). Social
network changes over the school year among elementary school-aged children with
and without an autism spectrum disorder. School Mental Health, 5, 38–47. doi:10.1007/
s12310-012-9092-y
Locke, J., Kratz, H., Reisinger, E., and Mandell, D. S. (2014). Implementation of evidence-based
practices for children with autism spectrum disorders in public schools. In Beidas, R., and
Kendall, P. (eds.). Child and adolescent therapy: Dissemination and implementation of empirically
supported treatments New York: Oxford University Press, pp. 261–76.
Locke, J., Olsen, A.,Wideman, R., Downey, M. M., Kretzmann, M., Kasari, C., and Mandell,
D. S. (2014b). A tangled web:The challenges of implementing an evidence-based social
engagement intervention for children with autism in urban public school settings.
Behavior Therapy, 46(1), 54–67. Retrieved from www.sciencedirect.com/science/
article/pii/S000578941400074. Accessed 14 April 2015.
Locke, J., Rotheram-Fuller, E., and Kasari, C. (2012). Exploring the social impact of being
a typical peer model for children with autism spectrum disorders. Journal of Autism and
McConnell, S. R., (2002). Interventions to facilitate social interaction for young children
with autism: Review of available research and recommendations for educational inter-
vention and future research. Journal of Autism and Developmental Disorders, 32, 351–72.
doi:10.1023/A:1020537805154
McEvoy, M. A., Shores, R. E., Wehby, J. H., Johnson, S. M., and Fox, J. J. (1990). Special
education teachers’ implementation of procedures to promote social interaction
among children in integrated settings. Education and Training of the Mentally Retarded,
25, 267–75.
Morrison, L., Kamps, D., Garcia, J., and Parker, D. (2001). Peer mediation and monitoring
strategies to improve initiations and social skills for students with autism. Journal of Positive
Behavior Interventions, 3, 237–50. doi:10.1177/109830070100300405
Nikopoulos, C. K., and Keenan, M. (2004). Effects of video modeling on social initiations
by children with autism. Journal of Applied Behavior Analysis, 37, 93–6. doi:10.1901/
jaba.2004.37-93
Odom, S. L., and Strain, P. S. (1984). Peer-mediated approaches to promoting children’s
social interaction: A review. American Journal of Orthopsychiatry, 54, 544–57. http://dx.doi.
org/10.1111/j.1939-0025.1984.tb01525.x
Odom, S. L., and Strain, P. S. (1986). A comparison of peer-initiation and teacher-antecedent
interventions for promoting reciprocal social interaction of autistic preschoolers. Journal
of Applied Behavior Analysis, 19, 59–71. doi:10.1901/jaba.1986.19-59
Orsmond, G. I., Krauss, M. W., and Seltzer, M. M. (2004). Peer relationships and social and
recreational activities among adolescents and adults with autism. Journal of Autism and
Developmental Disorders, 34, 245–56. doi:10.1023/B:JADD.0000029547.96610.df
Owen-DeSchryver, J. S., Carr, E. D., Cale, S. I., and Blakeley-Smith, A. (2008). Promoting
social interactions between students with autism spectrum disorders and their peers in
inclusive school settings. Focus on Autism and Other Developmental Disabilities, 23, 15–28.
doi:10.1177/1088357608314370
Pierce, K, and Schreibman, L. (1997). Multiple peer use of pivotal response training social
behaviors of classmates with autism: Results from trained and untrained peers. Journal of
Applied Behavior Analysis, 30, 157–60. doi:10.1901/jaba.1997.30-157
Rao, P. A., Beidel, D. C., and Murray, M. J. (2008). Social skills interventions for children with
Asperger’s Syndrome or high-functioning autism: A review and recommendations. Journal
of Autism and Developmental Disorders, 38, 353–61. doi:10.1007/s10803-007-0402-4
Reichow, B., and Volkmar, F. R. (2010). Social skills interventions for individuals with autism:
Evaluation for evidence-based practices within a best evidence synthesis framework.
Journal of Autism and Developmental Disorders, 40, 149–66. doi:10.1007/s10803-009-0842-0
Reiter, S., and Vitani,T. (2007). Inclusion of pupils with autism: The effect of an intervention
program on the regular pupils’ burnout, attitudes, and quality of mediation. Autism, 11,
321–33. doi:10.1177/1362361307078130
Roeyers, H. (1996). The influence of nonhandicapped peers on the social interactions of
children with a pervasive developmental disorder. Journal of Autism and Developmental
Disorders, 26(3), 303–20. doi:10.1007/BF02172476
Rogers, S. (2000). Interventions that facilitate socialization in children with autism. Journal of
Autism and Developmental Disorders, 30, 399–409. doi:10.1023/A:1005543321840
Sainato, D. M., Goldstein, H., and Strain, P. S. (1992). Effects of self-evaluation on preschool
children’s use of social interaction strategies with their classmates with autism. Journal of
Applied Behavior Analysis, 25, 127–41. doi:10.1901/jaba.1992.25-127
Schmidt, C., and Stichter, J. P. (2012). The use of peer-mediated interventions to promote
the generalization of social competence for adolescents with high-functioning autism
and Asperger’s Syndrome. Exceptionality: A Special Education Journal, 20, 94–113. doi:10.1
080/09362835.2012.669303
Shukla, S., Kennedy, C. H., and Cushing, L. S. (1998). Component analysis of peer support
strategies: Adult influence on the participation of peers without disabilities. Journal of
Behavioral Education, 8, 397–413. doi:10.1023/A:1022801215119
Shukla, S., Kennedy, C. H., and Cushing, L. S. (1999). Intermediate school students with
severe disabilities: Supporting their social participation in general education classrooms.
Journal of Positive Behavior Interventions, 1, 130–40. doi:10.1177/109830079900100301
Shulman, S., Laursen, B., Kalman, Z., and Karpovsky, S. (1997). Adolescent intimacy revisited.
Journal of Youth and Adolescence, 26, 597–617. doi:10.1023/A:1024586006966
Peer supports 143
Simpson, R. L., de Boer-Ott, S. R., and Smith-Myles, B. (2003). Inclusion of learners with
autism spectrum disorders in general education settings. Topics in Language Disorders,
23(2), 116–33.
Strain, P. S., and Kohler, F. W. (1995). Analyzing predictors of daily social skill performance.
Behavioral Disorders, 21, 78–87. Retrieved at www.jstor.org/stable/23888332. Access date
14 April 2015.
Utley, C. A., Mortweet, S. L., and Greenwood, C. R. (1997). Peer-mediated instruction and
interventions. Focus on Exceptional Children, 29, 1–23.
Zhang, J., and Wheeler, J. J. (2011). A meta-analysis of peer-mediated interventions for
young children with autism spectrum disorders. Education and Training in Autism and
Developmental Disabilities, 46, 62–88. Retrieved from www.jstor.org/stable/23880031.
Access date 14 April 2015.
11
THE ROLE OF FAMILIES IN
SUPPORTING SOCIAL INCLUSION
Iva Strnadová
Introduction
The importance of social inclusion is demonstrated by a number of leading
international documents, such as the UN Convention on the Rights of the Child
(United Nations, 1989). Article 23 clearly states that “. . . a mentally or physi-
cally disabled child should enjoy a full and decent life, in conditions which ensure
dignity, promote self-reliance and facilitate the child’s active participation in the
community”.
Families of children and young people play a crucial role in their offspring’s
social inclusion (Burford, 2010). This is especially true for families of young people
with Autism Spectrum Disorder (ASD). For example, parents were instrumental in
calling for educational and social provision for their children with Autism, as well as
advocating for acceptance of Autism as “a different way of thinking and behaving,
which should be accepted and respected”, rather than being perceived as a disorder
(Langan, 2011, p. 200).
Families of children with ASD have been in the center of research interest for
decades, with a focus on the stress experienced by these families (for a review of
research on parenting stress in families of children with Autism please see Hayes and
Watson, 2013), coping over time (Gray, 2006), impact on siblings (Macks and Reeve,
2007) and grandparents’ experiences (Margetts, Le Couteur and Croom, 2006;
Miller, Buys and Woodbridge, 2012). The research findings suggest that positive
parenting practices influence socio-emotional and cognitive-linguistic outcomes of
children with Autism (Siller and Sigman, 2008; Smith and Anderson, 2014).
In this chapter the role of the family in supporting the social inclusion of their
child with ASD will be examined, with a particular focus on self-determination,
self-advocacy, social skills development, and home–school collaboration. Two
case studies will be presented to demonstrate how families and schools can work
The role of families in supporting social inclusion 145
together in improving social inclusion of students with Autism Spectrum Disorder

across the spectrum.
Social inclusion: The role of the family

Difficulties in the area of social communication and social interaction are one
of the key characteristics of Autism Spectrum Disorder (American Psychiatric
Association, 2013), which result in poor peer relationships (Locke, Ishijima, Kasari
and London, 2010). Social isolation, social rejection and high levels of loneliness
experienced by children with Autism have been frequently reported (Jones and
Frederickson, 2010; Lasgaard, Nielsen, Eriksen and Goossens, 2010; Locke et al.,
2010), and this experience seems to continue into the adulthood of people with
ASD (Mazurek, 2014). Brown, Ouellette-Kuntz, Hunter, Kelley and Cobigo (2012)
studied the unmet needs of 101 Canadian families of school-aged children with
ASD, and highlighted the lack of friends children with ASD had, as well as the
lack of social activities available for them. Furthermore, they found an alarming
lack of available social skills training and programs, which are essential for social
inclusion of children and young people with ASD. Locke et al. (2010) studied 20
American adolescents with and without ASD and concluded that while adolescents
with ASD did identify their best friend, most of them remained isolated or on the
periphery of their classrooms. Similarly Chamberlain, Kasari and Rotheram-Fuller
(2007) found in their investigation of the involvement of 398 children with ASD
in American mainstream classrooms that while the participating children with ASD
avoided social isolation, they still remained on the periphery of the classroom, and
experienced lower acceptance than their neurotypical peers. Chamberlain et al.
refer in their findings to a case of a successfully included girl with ASD who had
the highest social network of all students with ASD included in the study.This was a
result of her mother’s intervention – after seeing her daughter being isolated during
breaks, she involved the teachers, therapists and parents of her daughter’s class-
mates. She and a speech therapist rehearsed social interactions with her daughter,
following social scripts. The mother also organised a party for her daughter’s girl-
friends. This example illustrates the crucial role that families of children with ASD
have in their child’s social inclusion, and to what extent home–school collaboration
is important to the process of social inclusion of students with ASD.
In their review of secondary school literature on social integration, social inclu-
sion and social participation, Bossaert, Colpin, Pijl and Petry (2013) identified the
following key themes: (a) reciprocal relationships (i.e., mutual friendship and social
networks or cohesive subgroups subthemes), (b) interactions (i.e., free time together,
working together on tasks, participation in group activities and social isolation
subthemes), (c) perception of the pupil with special educational needs (SEN) (i.e.,
self-perception of peer acceptance, self-perception of social interactions, satisfaction
at school and loneliness subthemes) and (d) acceptance by classmates (i.e., social
preference, social rejection, social support and bullying subthemes). All of these key
themes are areas of concern for families of children with disabilities (Overton and
146 Iva Strnadová
Rausch, 2002), and especially of children with ASD (Chamberlain et al., 2007).
These themes are also areas in which family involvement is crucial. It is families
who teach their children social skills, especially the skills essential for developing and
maintaining friendships. It is also families who monitor their child’s acceptance by
peers, and often raise concerns in this area with their child’s school (Chamberlain
et al., 2007).
Fostering self-determination
There are a number of ways in which parents can support social inclusion of
their children. First and foremost, it is essential to focus on developing the self-
determination of their children with ASD. Self-determination is defined as
“acting as the primary causal agent in one’s life and making choices and deci-
sions regarding one’s quality of life free from undue influence or interference”
(Wehmeyer, 1996, p. 24). Self-determination encompasses a number of skills,
such as choice-making, decision-making, problem-solving, self-awareness, self-
advocacy, and self-efficacy. There is a body of evidence proving the link between
a level of students’ self-determination and their positive outcomes in adult-
hood (Zhang, Wehmeyer, and Chen, 2005). Therefore promoting students’ self-
determination is viewed as an essential part of education nowadays, especially
when it comes to students with disabilities. It is also acknowledged that not
only teachers, but also parents play a pivotal role in fostering their child’s self-
determination, with parents understanding the importance of self-determina-
tion (Carter, Lane, Cooney, Weir, Moss and Machalicek, 2013). As highlighted by
Carter et al. (2013), parents are in a distinctive position to observe their child’s
self-determination skills across a variety of settings, such as their home, the
community, and other non-school environments. There are a number of ways
in which parents can develop and nurture the self-determination of their child
with ASD, such as providing opportunities to make decisions (e.g., about which
extracurricular activity they wish to be involved in), and helping them to make
connections between their goals and their actions.
An important aspect of self-determination is developing children’s knowledge
of their own disability and how it may portray to other people in their envi-
ronments (e.g., their literal responses might be viewed as arrogance). Obtaining a
solid understanding of one’s strengths as well as a disability’s symptoms allows for
identifying appropriate strategies to develop social skills to address these. Yet, it is
surprising that some students with ASD, while receiving support at their school, are
not aware of having a disability. For example in Danker, Strnadová and Cumming’s
(unpublished data) study on student well-being of high school students with ASD,
it became apparent that a number of high school students with ASD recruited for
the study were not aware of having ASD, therefore their parents and teachers asked
the researchers not to reveal this information to these students. This is alarming, as
not having knowledge of one’s disability does not allow for sufficient development
of self-determination and self-advocacy.
Understanding one’s disability is also important from an advocacy point of

view. It is usually parents who act as advocates of their children with ASD. They
are the ones to notice first that their child is socially isolated or even bullied,
and they act on these situations. As important as this is, children with ASD need
to learn how to appropriately advocate for themselves. This includes having an
awareness of their needs and available adjustments. Interestingly enough, self-
advocacy was perceived as only somewhat important in Carter et al.’s study
(2013) of 627 American parents of children with intellectual disability and
Autism. This demonstrates the need to raise parents’ awareness of self-advocacy
and its importance for their child’s future, as well as to provide parents with rel-
evant tools and strategies.
Social skills development

Developing social skills, particularly the skills that are important for establishing
and maintaining friendships, is another area that can be supported in the home
environment. These skills can include: (a) changing a game when a friend is bored,
(b) interrupting appropriately, (c) making empathetic statements, (d) showing
appreciation, (e) staying calm, (f) taking turns, (g) taking responsibility for one’s own
behaviour, and (h) initiating and maintaining social conversation (Leaf, Dotson,
Oppenheim-Leaf, Sherman and Sheldon, 2011; Ostmeyer and Scarpa, 2012).
An approach that has been found to be particularly useful to teach conversation
skills to students with ASD is self-management (Koegel, Park and Koegel, 2014).
When using self-management, children and young people with ASD are asked to
observe a specific aspect of their behaviour, and to self-record whether and when
the observed behaviour occurred (Wilkinson, 2008). Walton and Ingersoll (2013)
however pointed out that most of the research on social skills for children and
young people with ASD was conducted with those with high-functioning Autism.
This leaves children with low-functioning Autism, and particularly those who have
Autism and severe intellectual disability, a rather forgotten population.
One of the things that families can do in regards to the social skills develop-
ment of their children is simply reminding them to apply the skills they already
possess in diverse circumstances and situations. Parents can also encourage their
children with ASD to use social skills applications on mobile devices. There is
an emerging research evidence of the effectiveness of using mobile devices by
children and adults with ASD to learn social skills (Strnadová, Cumming and
Draper Rodriguez, 2014). Applications of mobile devices can be a successful plat-
form for using evidence-based practices to learn social skills. For example, video
modelling and social narratives (Odom, Collet-Klingenberg, Rogers, and Halton,
2010) are the basis for mobile apps, such as stories2learn™, Social Skills Builder™,
or iPrompts™. Furthermore, children with ASD can role-play the acquired skills
with their p arents. It is also important to focus on practicing generalisation of the
skills learned, in which a child’s sibling or grandparents can be of a great assistance
(Hong, Neely and Lund, 2015).
148 Iva Strnadová
In supporting their child’s social inclusion, families sometimes need the support
and guidance of professionals, especially when it comes to supporting their child in
areas such as behaviour management and social skills development (Derguy, Michel,
M’Bailara, Roux and Bouvard, 2015; Papageorgiou and Kalyva, 2010). In their
review of parent education programs available for parents for children with ASD,
Schultz, Schmidt and Stichter (2011) identified that most of these programs focus
on behavioural and communication techniques, with most of these targeting parents
of children aged up to 5 years of age. Some of these programs were designed for
both children with high-functioning ASD and their parents (Weiss, Viecili, Sloman
and Lunsky, 2013).There is clearly a need for such programs to also target parents of
teenagers and young adults with ASD.
Peer acceptance and role of home–school collaboration

Peer perception and acceptance of children with ASD are of critical importance
within the concept of social inclusion (Bossaert et al., 2013). While it could be
argued that families of children with ASD have limited opportunities to influence
how classmates perceive their child, it does not mean that families have no influ-
ence in this matter. For instance, when reviewing the results of a study exploring
strategies used by 13 Canadian teachers for including children with ASD, one of
the recommendations for successful inclusion was to build a rapport with parents,
including the development of an open communication system (Lindsay, Proulx,
Scott and Thomson, 2014). In other words, home–school collaboration is i mportant
for peer-acceptance of a child with ASD, and parents can be of great support to
school efforts.Teachers and parents can discuss strategies for raising disability aware-
ness in schools, such as inviting self-advocates to speak about their experiences.
In cases when students with ASD decide to disclose their disability in a class and
talk about their experiences, parents can support their children in preparing such
a disclosure and the potential discussions/questions that would arise from other
students. Role-play can be successfully used in such circumstances.
CASE STUDY 1
Rosie is a 13-year-old Caucasian girl with high-functioning Autism. She lives

with her parents and two younger brothers in a metropolitan city. She enjoys
playing the piano and reading science books. She is fascinated with microbi-
ology and would like to become a clinical laboratory scientist when she grows
up. She feels lonely, having only one friend, who is imaginary.
Rosie’s parents are concerned about her social isolation. Any time they
came to collect Rosie after school, she was on her own, not engaging with her
classmates. When they raised this issue with Mrs. Clamsy, Rosie’s classroom
teacher, she indicated that Rosie was also alone during breaks. As she spent
most of this time reading her favourite books, and given she was not being
bullied, Mrs. Clamsy did not see any issue with the situation. Rosie’s par
ents however disagreed, and raised their concerns about Rosie not having
friends, as well as their frustrations with Rosie’s lack of inclusion. Mrs. Clamsy
and Rosie’s parents agreed that this issue should be discussed at Rosie’s next
Individualised Educational Plan (IEP) meeting. Prior to the meeting, Rosie pre
pared a PowerPoint presentation, highlighting her thoughts on the issue. She
expressed that she feels lonely at school, and wished to have friends she could
spend time with. She however did not feel comfortable about some expres-
sions of friendship that she observed in her classrooms, such as girls greeting
each other with a hug, or sharing lunch by biting into each other’s sand-
wiches, which Rosie found highly unhygienic.
At the IEP meeting, Rosie, her parents, Mrs. Clamsy, and Rosie’s speech thera
pist discussed ways in which Rosie could be more socially included. Given her
struggles with small talk, her speech therapist prepared a set of social scripts,
which were to be practiced both at her speech therapy sessions and at home
with her parents. Mrs. Clamsy suggested that Rosie could participate in a new
extracurricular activity introduced in the school, a biology club, which would
allow her to meet peers with similar interests. Rosie was very excited about this
proposition, however also a bit concerned about how she would be accepted
in the biology club. She asked Mrs. Clamsy about students attending. Rosie’s
mother realised, when hearing the students’ names, that she knew the mother
of one of these students well, and decided to talk to her to encourage her
daughter’s acceptance and involvement with Rosie.
Mrs. Clamsy also promised to utilise group work in classes as well as peer
tutoring to encourage other students to engage with Rosie. Rosie’s speech
therapist recommended that Rosie use the QuickCues™ mobile app at home.
She explained to Rosie and her parents that this was a social script application
designed to support teenagers with Autism in learning the social skills related
to communication and life skills. She also suggested the Social Skills Builder™
app, which consisted of real life situations in different settings, including high
school and the community.
Following the IEP meeting, Rosie practised the initial interactions she might
have at the biology club at home as well as at the sessions with her speech
therapist. Her mother also met with the mother of Amy, a girl who attended
the biology club. They arranged a weekend visit at Rosie’s place to intro-
duce the girls. Later on Amy introduced Rosie to the biology club, and as she
was well-liked among her peers, Rosie became actively involved in this new
social network. Rosie also tried both apps suggested by her speech therapist.
(continued)
150 Iva Strnadová
Later on she was introduced to the FriendMaker™ app, which she found
particularly useful in understanding some of the hidden rules of social inter-
actions, as well as in learning skills such as entering into conversations and
scheduling get-togethers. Mrs. Clamsy invited a speaker from the Autism Self-
advocacy Group. Mrs. Golden was a specialist in computer programming, and
spoke about her experiences growing up, challenges she faced, and the ways
she overcame these. Students were allowed to ask questions, and this pre-
sentation was followed by a class discussion about diversity and peer accep-
tance. Over a period of 6 months, Rosie’s position in her classroom improved,
she had regular interactions with her classmates during breaks, and she was
invited to their birthday parties. Furthermore she developed a friendship with
Amy and two boys in the biology club.
CASE STUDY 2
Peter is 12-year-old boy with Autism Spectrum Disorder and an intellectual

disability. He lives with his mother, younger sister and grandparents. Peter’s
parents divorced when he was 7 years old, and his father is not in any contact
with Peter and the rest of the family. Peter’s family is of Asian background.
Peter attends a special school, where he remains socially isolated most of the
time. Peter has limited verbal skills, and often communicates his frustrations
through aggression towards others and self-injurious behaviours. He also has
difficulties with his impulse c ontrol. His classmates tend to avoid interaction
with him, with an exception of Jane who sometimes plays with him. Peter’s
mother and his grandparents are worried about his future.
Peter’s mother arranged a meeting with Mr. Grant, Peter’s class teacher,
to discuss her concerns. Mr. Grant explained what the school was doing to
address Peter’s needs, such as conducting a functional behavioural analysis
to identify what triggered Peter’s aggressive and self-injurious behaviours.
Peter’s mother was especially concerned about his self-injurious behaviour,
which was manifested by Peter h itting his head against a wall or a floor. The
behavioural observations conducted at school indicated that Peter engaged
in these behaviours when asked to complete a task while being tired.
Mr. Grant suggested a joint effort by the school and family, which was wel-
comed by Peter’s mother, to teach Peter functional replacement behaviours.
Peter’s mother also raised concerns about her son’s ability to make friends.
Mr. Grant agreed that focusing on the development of skills important for
friendships should be discussed at the next IEP meeting.
Peter’ mother and grandparents talked with Peter about friendships. Peter
prepared (with his mother’s help) a presentation about his perspectives on his
friends in his class using the KeyNote™ app. From his perspective, Jane was
a friend he liked to play with. When this was presented at Peter’s IEP meet-
ing, a discussion followed about what a friendship looks like and what friends
do to be recognised as friends. Mr. Grant and Peter’s occupational therapist
prepared a visual social story to accompany this conversation. Mr. Grant also
mentioned that Jane sometimes found it difficult to play with Peter, as he
does not take turns in games, and he often does not want to change to a dif-
ferent game when Jane gets bored with the one they are playing. Everybody
agreed to focus on turn taking as the next step in strengthening Peter’s friend-
ship with Jane. Mr. Grant suggested using the Power Card Strategy (Daubert,
Hornstein and Tincani, 2015), a visual aid–based intervention, which would
be very suitable, given it would allow the use of Ninja Turtles, a great interest
of Peter’s. A Ninja Turtles motif was printed on Peter’s cards, and the targeted
behavior was taking turns. Peter also practiced turn-taking at home, with his
mother, grandparents and younger sister.
Following an intervention, Peter learned to communicate his needs in a
more appropriate way, and the occurrence of his aggressive and self-injurious
behaviours decreased. He enjoyed using the Ninja Turtle cards, and gradu-
ally learned to take turns during a game on most occasions. This resulted in
numerous occasions when not only Jane, but also other classmates played
with him. Peter’s mother also noted improvement in the relationship between
Peter and his sister.
Future directions
Families of children and young people with ASD play a pivotal role in supporting
their child’s social inclusion. Their involvement in the development of the social
skills of their child, as well as in fostering his/her self-determination, is critical for
their child’s future outcomes. While this has been acknowledged by a number of
researchers, it would be unfair to expect families to bear the main responsibility for
their child’s inclusion. As highlighted by Bossaert (2013), there are four main aspects
of social inclusion, with two of them placing expectations of active involvement on
the child with a disability (reciprocal relationships and interactions), while the other
two place expectations on the child’s environment (perception of the student with
ASD and acceptance by classmates). In other words, social inclusion can be achieved
by the active involvement of all relevant stakeholders, i.e., of a child with ASD, his/
her family, teachers, classmates and their families. Home–school collaboration is a
cornerstone of these efforts.
The importance of one’s self-determination skills for successful social inclusion
cannot be underestimated. While there are documented efforts of the fostering
of these skills in the school environment, families need a raised awareness of the
importance of the development of self-determination skills across all environments
152 Iva Strnadová
including the home. Teachers can suggest useful ways that parents can support the
development of their child’s self-determination skills. It is particularly important
that parents discuss what it means to have Autism, some characteristics related to
Autism that the child has, and ways to make the best use of these.
Teaching social skills and role-playing the acquired skills is another important
area where parents can be of significant help. In order to do this effectively, more
educational programs in this area are needed. It is essential that these programs
can be accessed in diverse modes (such as evening classes, a weekend program, or
online), given the limited availability of many parents. Furthermore, more research
needs to focus on the social skills development of children with low-functioning
Autism (particularly those with ASD and severe intellectual disability).
Summary
This chapter explored the ways that families can support the social inclusion
of their children with ASD. Particular focus was given to development of self-
determination, self-awareness, self-advocacy, and social skills. The importance of
home–school collaboration was also highlighted. The case studies of Rosie and
Peter illustrated some strategies used by families to support the social inclusion of
their children with high- and low-functioning Autism. The author also provided
suggestions of how families of children with Autism Spectrum Disorder can be
supported in the process of social inclusion of their children.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders:
DSM-5. Washington, DC: American Psychiatric Association.
Bosaert, G., Coplin, H., Jan Pijl, S., and Petry, K. (2013). Truly included? A literature study
Education, 17(1), 60–79.
Brown, H. K., Ouellette-Kuntz, H., Hunter, D., Kelley, E., and Cobigo,V. (2012). Unmet needs
of families of school-aged children with an autism spectrum disorder. Journal of Applied
Research in Intellectual Disabilities, 25(6), 497–508. doi:10.1111/j.1468-3148.2012.00692.x
Burford, G. (2010). Families: Their role as architects of civil society and social inclusion.
Practice: Social Work in Action, 17(2), 79–88. doi:10.1080/09503150500148081.
Carter, E. W., Lane, K. L., Cooney, M., Weir, K., Moss, C. K., and Machalicek, W. (2013).
Parent assessments of self-determination importance and performance for students
with autism or intellectual disability. American Journal on Intellectual and Developmental
Disabilities, 118(1), 16–31. doi:10.1352/1944-7558-118.1.16
Danker, J., Strnadová, I., and Cumming, T. (unpublished data). A multiple perspectives approach
on the well-being of students with autism spectrum disorders. A doctoral research study. UNSW
Ethics (HREC) number: HC14251.
Daubert, A., Hornstein, S., and Tincani, M. (2015). Effects of a modified power card strategy
on turn taking and social commenting of children with autism spectrum disorder play-
ing board games. Journal of Developmental and Physical Disabilities, 27, 93–110. doi:10.
1007/s10882-014-9403-3
Derguy, C., Michel, G., M’Bailara, K., Roux S., and Bouvard, M. (2015). Assessing needs in
parents of children with autism spectrum disorder: A crucial preliminary step to target
relevant issues of support programs. Journal of Intellectual and Developmental Disability. doi:
10.3109/13668250.2015.1023707
Gray, D. E. (2006). Coping over time:The parents of children with autism. Journal of Intellectual
Disability Research, 50(12), 970–6. doi:10.1111/j.1365-2788.2006.00933.x
Hayes, S. A., and Watson, S. L. (2013). The impact of parenting stress: A meta-analysis of
studies comparing the experience of parenting stress in parents of children with and
without an autism spectrum disorder. Journal of Autism and Developmental Disorders, 43,
629–42. doi:10.1007/s10803-012-1604-y
Hong, E. R., Neely, L., and Lund, E. M. (2015). Addressing bullying of students with Autism:
Suggestions for families and educators. Intervention in School and Clinic, 50(3), 157–62.
doi:10.1177/1053451214542047
and Developmental Disorders, 40, 1094–1103. doi:10.1007/s10803-010-0957-3
Koegel, L. K., Park, M. N., and Koegel, R. L. (2014). Using self-management to improve the
reciprocal social conversation of children with autism spectrum disorder. Journal of Autism
and Developmental Disorders, 44(5), 1055–63. doi:10.1007/s10803-013-1956-y
Langan, M. (2011). Parental voices and controversies in autism. Disability and Society, 26,
193–205. doi:10.1080/09687599.2011.544059
Lasgaard, M., Nielsen, A., Eriksen, M. E., and Goossens, L. (2010). Loneliness and social
support in adolescent boys with autism spectrum disorders. Journal of Autism and
Developmental Disorders, 40(2), 218–26. doi:10.1007/s10803-009-0851-z
Leaf, J. B., Dotson, W. H., Oppenheim-Leaf, M. L., Sherman, J. A., and Sheldon, J. B. (2011).
A programmatic description of a social skills group for young children with autism. Topics
in Early Childhood Special Education, 32(2), 111–21. doi:10.1177/0271121411405855
Locke, J., Ishijima, E. H., Kasari, C., and London, N. (2010). Loneliness, friendship
quality and the social networks of adolescents with high-functioning autism in an

inclusive school setting. Journal of Research in Special Educational Needs, 10(2), 74–81.
doi:10.1111/j.1471-3802.2010.01148.x
Macks, R. J., and Reeve, R. E. (2007). The adjustment of non-disabled siblings of chil-
dren with autism. Journal of Autism and Developmental Disorders, 37(6), 1060–67. doi:10.
1007/s10803-006-0249-0
Margetts, J. K., Le Couteur, A., and Croom, S. (2006). Families in a state of flux: The expe-
rience of grandparents in autism spectrum disorder. Child: Care, Health and Development,
32(5), 565–74. doi:10.1111/j.1365-2214.2006.00671.x
Mazurek, M. O. (2014). Loneliness, friendship, and well-being in adults with autism spectrum
disorders. Autism, 18(3), 223–32). doi:10.1177/1362361312474121
Miller, E., Buys, L., and Woodbridge, S. (2012). Impact of disability on families:
Grandparents’ perspectives. Journal of Intellectual Disability Research, 56(1), 102–10.
doi:10.1111/j.1365-2788.2011.01403.x
154 Iva Strnadová
Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., and Halton, D. D. (2010). Evidence-
based practices in interventions for children and youth with autism spectrum disorders.
Preventing School Failure, 54(4), 275–82. doi:10.1080/10459881003785506
Ostmeyer, K., and Scarpa, A. (2012). Examining school-based social skills program needs and
barriers for students with high-functioning autism spectrum disorders using participatory
action research. Psychology in the Schools, 49(10), 932–41. doi:10.1002/pits.21646
Overton, S. and Rausch, J. L. (2002). Peer relationships as support for children with dis-
abilities: An analysis of mothers’ goals and indicators for friendships. Focus on Autism and
Other Developmental Disabilities, 17(1), 11–29.
Papageorgiou, V., and Kalyva, E. (2010). Self-reported needs and expectations of parents of
children with autism spectrum disorders who participate in support groups. Research in
Autism Spectrum Disorders, 4(4), 653–60. doi:10.1016/j.rasd.2010.01.001
Schultz, T. R., Schmidt, C. T., and Stichter, J. P. (2011). A review of parent education pro-
grams for parents of children with autism spectrum disorders. Focus on Autism and Other
Developmental Disabilities, 26(2), 96–104. doi:10.1177/1088357610397346
Siller, M. and Sigman, M. (2008). Modeling longitudinal change in the language abilities of
children with Autism: Parent behaviors and child characteristics as predictors of change.
Developmental Psychology, 44(6), 1691–1704. doi: 10.1037/a0013771
Smith, L. E., and Anderson, K. A. (2014). The roles and needs of families of adolescents with
ASD. Remedial and Special Education, 35(2), 114–22. doi:10.1177/0741932513514616
Strnadová, I., Cumming, T., and Draper Rodriguez, C. (2014). Incorporating mobile
technology into evidence-based practices for students with autism. In N. Silton (Ed.),
Innovative technologies to benefit students on the autism spectrum. Hershey, PA: IGI Global,
pp. 35–52. doi:10.4018/978-1-4666-5792-2.ch003
UN General Assembly. (1989). Convention on the rights of the child. United Nations, Treaty
Series, vol. 1577, p. 3. New York: United Nations.
Walton, K. M., and Ingersoll, B. R. (2013). Improving social skills in adolescents and adults
with autism and severe to profound intellectual disability:A review of the literature. Journal
of Autism and Developmental Disorders, 43(3), 594–615. doi:10.1007/s10803-012-1601-1
Wehmeyer, M. (1996) Self-determination as an educational outcome: Why is it important
to children, youth and adults with disabilities? In D. Sands and M. Wehmeyer (eds.), Self-
determination across the lifespan: Independence and choice for people with disabilities. Baltimore,
MD: Brookes.
Weiss, J. A., Viecili, M. A., Sloman, L., and Lunsky, Y. (2013). Direct and indirect psychoso-
cial outcomes for children with autism spectrum disorder and their parents following a
parent-involved social skills group intervention. Journal of the Canadian Academy of Child
and Adolescent Psychiatry, 22(4), 303–9.
Wilkinson, L.A. (2008). Self-management for children with high-functioning autism spectrum
disorders. Intervention in School and Clinic, 43(3), 150–7. doi:10.1177/1053451207311613
Zhang, D., Wehmeyer, M. L., and Chen, L. J. (2005). Parent and teacher engagement in
fostering the self-determination of students with disabilities: A comparison between the
United States and the Republic of China. Remedial and Special Education, 26(1), 55–64.
12
INFLUENCE OF CULTURE ON
SOCIAL INCLUSION OF CHILDREN
WITH AUTISM
Kanokporn Vibulpatanavong
The Universal Declaration on Cultural Diversity, UNESCO (2002) defines

culture as “the set of distinctive spiritual, material, intellectual and emotional fea-
tures of society or a social group”. Culture “encompasses, in addition to art and
literature, lifestyles, ways of living together, value systems, traditions and beliefs”
(UNESCO, 2002). The rights to cultural identity are integral parts of human
rights as stated in major international human right documents. For example,
the Convention on the Right of the Child (United Nations, 1989) states that
education should aim at developing respect for the child’s own cultural identity,
language, and value. The rights to cultural identity for person with disabilities
are also recognized in the Convention on the Rights of Persons with Disabilities
(United Nations, 2006), stating “persons with disabilities shall be entitled, on an
equal basis with others, to recognition and support of their specific cultural and
linguistic identity” (Article 30).
Culture is a social phenomenon, as it “results from human interaction”
(UNESCO, 1968, p. 3). A thought or an action must be shared by at least two per-
sons to be considered a culture (Ferraro, 1998). Culture is not inherited biologically
(Haviland, Prins, McBride and Walrath, 2010) but is learned. Rather than from
active teaching processes (Henderson and Bryan, 2011), culture is learned through
socialization with others, such as “listening to, observing, and assessing those social
interactions” (Bonder and Martin, 2013). However, cultural ideas or behaviors can
be so well learned that they seem natural (Andersen and Taylor, 2007) because from
a very young age, or even from birth, children start learning their culture from their
parents. Once a behavior is adopted as a culture, the behavior is enforced by the
social approval of people within the group. In order to be a member of a group, an
individual needs to adhere to the expectations of the group, and a failure to do so
may cause the individual to be socially excluded (Keillor, 2012).
156 Kanokporn Vibulpatanavong
Culture influences how we perceive ourselves and others (West and Turner,
2011). Thus, it also influences how we interact with and relate to others in the
society. For example, each culture interprets disability differently (Ukpokodu and
Ukpokodu, 2012). How people with disabilities perceive themselves, how they are
perceived by others, and the roles that they take on or are given within a society
varies from culture to culture. According to Groce (1999), social acceptance and
resources for support of people with disabilities are influenced by three categories
of cultural beliefs: explanations of why a disability occurs (e.g., a result of God’s
punishment, or an evidence of God’s trust in the parents to take care of the child),
human attributes the society finds important (e.g., if intellectual strength is more
valued in the society than physical strength, physical disability may be less limiting),
and anticipated roles in the future of people with disability (e.g., whether to grow
up to be independent, or to depend on others) (Groce, 1999).
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition (DSM-V) (American Psychiatric Association, 2013), persons with Autism
Spectrum Disorder are persons with (1) difficulties in social communication and
social interaction, and (2) restricted, repetitive patterns of behavior, interests, or
activities. While restricted patterns of behaviors and interests can intensify social
communication and social interaction difficulties for people with Autism (Moldin
and Rubenstein, 2006), social communication and social interaction difficulties can
also intensify restricted patterns of behaviors and interest in people with Autism
(White and Schry, 2011).
Autism occurs in all cultures (Baron-Cohen and Bolton, 1993). However, cul-
tural beliefs and practices of a social group can add complexities to promoting
social inclusion of children with Autism within that group. Cultures influence how
family interpret and cope with Autism ( Jegatheesan, Miller and Fowler, 2010), how
parents choose treatments for their child (Ennis-Cole, Durodoye and Harris, 2013),
how practitioners diagnose Autism (Kang-Yi, Grinker and Mandell, 2013), and
how people in the communities perceive individuals with Autism and their families
(Kwang Hwang and Charnley, 2010).Adding to the complexities is the difficulties of
children with Autism to learn and understand certain aspects of the culture. As cul-
ture is learned through socialization, difficulties in social communication and social
interaction can reduce the opportunities of children with Autism to participate in
social situations. Even when children with Autism participate in social situations,
they may not interpret the situations correctly due to difficulties in understand-
ing other people’s point of views and non-verbal communications. While children
with Autism do not display behaviors according to the cultural expectations, the
opportunities for them to be socially included in the community are even more
reduced. To further complicate the picture, several countries are becoming more
multicultural (Geisinger, 2003). Children with Autism and their families may not
be from the dominant culture of the society, and thus they may have to cope with
additional issues, such as whether a child with Autism should learn the dominant
language only, or also learn his or her parents’ native languages ( Jegatheesan, 2011).
Therefore, teachers and professionals need to understand the additional issues that
Influence of culture on social inclusion of children with Autism 157
children with Autism and their families might face ( Jegatheesan, 2011), and attempt
to promote social inclusion of children with Autism in a way that is respectful to
their cultural identities.
Thailand is a country in the Southeast Asia region with a population of over
60 million people. It borders Laos to the Northeast, Burma to the Northwest and
West, Cambodia to the Southeast, and Malaysia to the South. The official language
of the country is Thai. Ninety-four point six per cent of the population practice
Buddhism, 4.6 per cent Islam, 0.7 per cent Christianity, and 0.1 per cent other
religions or have no religion (National Statistical Office, 2011). The number of
children with Autism in Thailand is not clearly known, however in a review of the
prevalence rate of Autism in several countries worldwide by Kopetz and Endowed
(2012), 180,000 children in Thailand were diagnosed with Autism.
This chapter discusses cultural influences on the social inclusion of children
with Autism. It uses Thailand and Thai culture as a case example; however, studies of
other countries are also included for further explanation and for comparison.Three
central aspects of culture relevant to the inclusion of children with Autism are
discussed: (1) religious and local cultural views of Autism, (2) language issues con-
cerning Autism, and (3) cultural perceptions of social skills of children with Autism.
In writing this chapter, an interview was conducted with ten Thai parents whose
children with Autism are receiving support in a provincial special education center
in Thailand, and with regular teachers and special education teachers in two public
schools in the same province. A Buddhist monk, who taught Dharma to a regular
school in Bangkok, was also interviewed for specific understanding of Buddhism in
relation to the social inclusion of children with Autism.
Religious and local cultural views of Autism

Central to culture is religious and local cultural perception. In the following s ection,
studies relevant to theistic religions’ views of Autism are examined and discussed.
This is followed by a discussion of how Buddhism, a non-theistic religion and the
religion practiced by the majority of people in Thailand, influences the social inclu-
sion of children with Autism.
There is limited research on how religions influence the social inclusion of
children with Autism. While Buddhism believes in natural laws that govern lives,
several other widely practiced religions are theistic, believing in the will of God. In
Islamic religion, Jegatheesan et al. (2010) revealed that South Asian Muslim immi-
grant families living in the United States relied on their religion in making sense of
Autism. The Muslim parents believed that they were blessed to be chosen by Allah
to take care of his child, because they were moral, or resilient, or that Allah was test-
ing their spiritual qualities. In addition, a Shiite Muslim family in this study believed
in reincarnation and karma, and that the mother and the child may have unfinished
business in their past life. According to the researchers, the religious perspectives of
the parents influenced them “to raise their children as normally as possible, incor-
porating them into ordinary social, linguistic, and religious practices at home and
in the community” ( Jegatheesan et al., 2010, p. 98). Findings from studies by Tait
and Mundia (2012) on Bruneian families, and Hersinta Suroso (2012) on Indonesian
families, found Muslim families tended to interpret Autism positively. However,
some families felt that their faith was challenged, and that without explanations,
their neighbors may not understand about Autism. Nevertheless, Tait and Mundia
(2012) explained that attributing Autism to external causes, such as a divine bless-
ing or a divine test, resulted in higher acceptance of children with Autism and less
self-blame in parents.
In a Jewish ultraorthodox community in Israel, Shaked and Bilu (2006) found
that mothers of children with Autism believed that their children were of higher
spiritual status.They believed that their child was not capable of intentionally com-
mitting sin so their child would remain pure in this life, or that their child was less
spiritually restricted and was more capable of seeing the divide presence, or that
their child was a reincarnation of a righteous person who had been born to correct
one small flaw committed in the previous life. However, some of the mothers also
expressions concern over their children’s behaviors, and believed that they had to
overcome sufferings in life for spiritual growth.
These studies show us that in different theist religions, there are parents who are
able use their religion as a framework for interpreting Autism positively in ways that
are helpful to them in coping with challenges, supportive to the development of
their children, and subsequently beneficial to the social inclusion of their children.
If parents are able to do so, there is a good chance that people in the communities,
with the support of religious organizations and professionals working with children
with Autism, are also able to interpret Autism in a positive light and make the com-
munity more inclusive for children with Autism.
In Buddhism, however, there is no god. Situations in life are explained through
the law of conditionality, also referred as the law of dependent condition (Ratanakul,
1999). Based on the law, all things in life are interdependent as causes and effects.
Included in the law of conditionality is the law of karma, a subtle law in which
actions lead to consequences. Buddhist people in Thailand often attribute disability
to “karma” (Proyer, 2014), the past deeds of the child with disability or of their
families in the past or the present life.
In an interview with a group of parents, a father of a child with Autism shared, “I
believe it was karma, because in my side of the family, there is no history of Autism.
Also, there is no history in my wife’s family.” A mother of a child with Autism
explained the delay in the diagnosis as,“Why do I found out when she was nine? . . .
Why didn’t they tell me? Until she was nine, several people told me to go see a
doctor. I think it’s about karma. Really, I had just found out, it took me 8–9 years.”
As a result of her belief in karma, the mother committed to Buddhism practices
such as praying and meditation:
I pray and mediate, and make wishes . . . I pray every day for my daughter, for
my family, my husband, for her to have better development, for her to be in
the community, to get along with other children, and teachers, I feel that she
is getting better, I believe . . . I pray for “Chaokamnaiwain” (the persons she is

in debt to in the past life). . . . Whatever she did wrong, if I practice dharma, I
hope my good deeds will go the Khukamkhuwain (the persons who shared
past deeds together).
Ratanakul (1999, p. 20) explains that karma in Buddhism “does not lead to fatal-
ism, nor to pessimism”. It does not entail “complete determinism” (Ratanakul,
1999, p. 20). In the interview with a Buddhist monk for this book chapter, he
elaborated:
Kam (Karma) mean actions. It’s about causes and effects. Whatever one does,
the person will receive the consequences. . . . As you sow, and so shall you
reap. But that does not mean that one should be discouraged. If you think
like this, it’s finished, no more courage. . . . There is a saying that there is a jar
half filled with water. There is a spoon of salt mixing with the water, and you
cannot separate them. Water is compared to good deeds. Salt is compared to
bad deeds. . . . If we add more salt, the water will be so salty that it cannot be
drunk. But if you add more water, the salt will be diluted and you may not
taste the salt anymore. We may have committed bad deeds but if we do more
and more good deeds, the bad deeds cannot affect us, just like that we cannot
taste the saltiness of the water.
The Buddhist monk also further stressed that it is important for persons with
disability to further develop through practice.
In Buddhism, we talk about working with what we have, the best persons are
not the persons who own the best things, but are persons who make the best
of what they have. We must further develop ourselves. There is a Buddhist
saying . . . humans are noble through practice. . . . People with disabilities need
to think that they can develop themselves, in our own ways, not the same
ways as other people. . . . We add on, develop from what we have.
Some Buddhist parents rely on the principles of karma in explaining the occur-
rence of Autism and other related challenges in their lives (e.g., the delay in the
diagnosis). The religious belief gives parents some answers and helps them reach a
level of acceptance so they can move forward. Similar to the studies on the theist
religions discussed above, the principles of karma can be interpreted positively.
Although it is possible there are parents who may develop a deterministic attitude
(i.e., feeling helpless, believing there is nothing they can do to change the situation),
these parents can be supported by professionals and Buddhist monks to reinterpret
karma in the way that allows them to promote the development of their child with
Autism.
Community members’ perceptions of children with Autism can also be influ-
enced by the belief in karma. According to Kilbort-Crocker (2012) the belief in
karma can both “encourage the social inclusion of people with disabilities” or “serve
to isolate them” (p. 20). Some people may see disability as the fault of the person,
because they [the person] accumulated bad merit in their past life. As a result, there
may be “a lack of initiative by the community to provide services to improve qual-
ity of life and opportunities, and an overall lack of compassion” (Kilbort-Crocker,
2012, p. 20). However, the principles of virtuous existence, called Brahmavihara, are
often emphasized in the lives of Buddhist people in Thailand. The four principles
include “metta” (ability to be kind or to share happiness with others), “karuna”
(ability to share in others’ sufferings and also act in order to help), “mudita” (the
ability to rejoice in the happiness of others), and “upekka” (equanimity towards
both good and bad situations in life) (Naemiratch and Manderson, 2009). Through
practicing Brahmavihara, Buddhist people believe that they can accumulate good
merits, which, according to the law of karma, will positively enhance their lives.
Brahmavihara underpins the Thai social values of giving and helping other people
(Naemiratch and Manderson, 2009) and promotes the social participation of per-
sons with a disability.
In interviewing a group of teachers from a Buddhist-based school, the teachers
were asked what they thought about educating children with Autism in regular
settings. One teacher said, “One must have ‘metta’. This is the core. It must be their
past karma. If we don’t help, who will?” Another teacher added:
We accept all children; at least we allow them to be in the community, to

be with friends. . . . We think about Bapbunkhuntode (good merits and bad
merits). If we do not accept them, where are they going to go? If they were
our children, and no one would accept them. We accept them because of
‘bun’ (good merits). . . . Our teachers here receive ‘bun’. No matter how hard
it is, we think of it as ‘bun’. Every morning, there is bun and it is refreshing.
It’s a profit. We don’t just receive salary. We also receive ‘bun’. The more we
do, the more ‘bun’ we receive.
The Buddhism beliefs in Thailand can be interpreted in the way that promotes
acceptance of children with Autism into regular settings and encourages regular
children to try to understand their peers with Autism. In the Buddhist-based school
noted above, students are taught to have compassion for and to help other students.
Buddhist practices, such as listening to Dharma, making food offerings to Buddhist
monks, and participating in meditation sessions, both in school and at temples, gives
children with Autism opportunities to be a part of the community.
In addition to the religious beliefs, in Thailand there is a prevailing social per-
ception of ‘songsarn’ toward persons with disabilities (Naemiratch and Manderson,
2009). Depending on the context, songsarn can mean empathy, compassion, or pity
(Kilbort-Crocker, 2012). Thai people often feel ‘songsarn’ when other people are
in difficult situations, or are less fortunate than themselves. At another school in the
same province, when teachers were asked how they help children accept children
with Autism, a teacher said, “Mostly, the school director will do it at the beginning
of the semester. Class teachers also ‘melt together’ the children in their classrooms,
telling regular kids that they are ‘nasongsarn’, we have to take care of them, help
them, and forgive them.” A special education teacher at the center also stated that:
When we talk about Pikarn (disability), there is always the word ‘songsarn’.
It creates misunderstanding to Thai people. When I talk about working at a
special education center, a center for children with disability, people come
in here thinking it is depressing, it is ‘nasongsarn’. I work here thinking it
is my profession. It is my job. I develop potentials. For me, ‘songsarn’ gives
depressing feelings.
‘Songsarn’ can be advantageous to persons with disabilities in obtaining inclusion

or employment (Kilbort-Crocker, 2012) but it can also create the perception
that persons with disabilities are of lower status. According to Naemiratch and
Manderson (2009), some people with disabilities may accept ‘songsarn’ from other
people as they view it as compassion or ‘metta’ and ‘karuna’ in Brahmavihara.
Some may also pragmatically accept it for the advantages of being included in
the society, such as getting a job. However, some may reject ‘songsarn’ as they
view it as ‘sompech’ or pity, which has negative connotations (Naemiratch and
Manderson, 2009).
‘Songsarn’ can subtlety create stigma toward persons with disabilities (Naemiratch
and Manderson, 2009). By feeling ‘songsarn’, Autism may not be seen as a part of
social diversity, but as a ‘deficit’, or an ‘unfortunate occurrence’. In school, ‘song-
sarn’ may facilitate social acceptance but it may lead to lower learning expectations
for children with Autism. Students with Autism may not be expected to learn the
skills they need for the future, as the teacher said, “to take care of them, help them,
and forgive them”. In addition, ‘songsarn’ may not lead to equality in a friendship.
When asked whether students with Autism approach other students during free
time, a teacher in the Buddhist school answered, “No, they usually stay as they are.
Regular children approach them. Mostly, students see them as younger siblings, not
as friends.”
Language issues concerning Autism

Language is another aspect of culture. It is a tool for social communication and
interaction. Language both reflects and influences social perceptions. In the

following section, the words for Autism in different languages and how these influ-
ence the social perception of Autism are presented. The manner in which different
languages pose different difficulties for children with Autism is then examined.
A discussion of the language issues of children with Autism in multicultural com-
munities concludes this section.
The words for Autism in different languages can influence people’s percep-
tion of Autism. In some Asian languages, such as Punjabi, Bengali, and Gujarati,
there is no word for Autism (Dobson, Upadhyaya, McNeil, Venkateswaran and
Gilderdale, 2001). When there is no word for something in a culture, it could

mean that the concept is not fully embraced as a part of the culture. Translation
of the word ‘Autism’ using existing words in the language can cause misun-
derstanding and confusion (Corbett and Perepa, 2007). Without the word for
Autism in a language, promoting the understanding of Autism in the culture can
be difficult. However, without labels, it could also be that the culture assimilates
individuals with disabilities into their culture (Wilder, Dyches, Obiakor and
Algozzine, 2004).
In some languages, the English word is adapted for use, such as ‘Autismo’ in
Spanish or Italian (Wilder et al., 2004; Bernier and Gerdts, 2010). Similarly, in
Thailand, there is no Thai word for Autism. The English word ‘autistic’ is used both
as a noun instead of the word ‘Autism’, and as an adjective such as ‘dek autistic’
meaning children with Autism (children autistic). The noun ‘Autism’ is not often
used in the Thai language. According to the Classification and Definition of Persons
with Education Disabilities, announced by the Thai Ministry of Education (2009),
there are Thai words or phrases for the nine types of disabilities except Autism.
Persons with Autism are referred to as ‘Bukkon autistic’ (person autistic). According
to Dobson, Upadhyaya, McNeil, Venkateswaran and Gilderdale (2001), using the
English word and giving the explanation for the concept may cause Autism to be
seen as a foreign concept.
In other languages, there are words for Autism which may have negative conno-
tations. In Japanese, the word for Autism is ‘jihei-sho’, meaning ‘self-closure symp-
tom’ (Suzuki, 2015). While Autism is a neurological impairment, the term may
create misunderstanding that Autism is a psychological disorder similar to depres-
sion (Suzuki, 2015). In the Korean language, the word for Autism is ‘chapae’, which
means being close in on oneself (Grinker, 2004). The term may suggest that the
child was once ‘opened’ but is now ‘closed in’ as a result of trauma, causing blame
on the mother (Grinker, 2004).
The words used for Autism may influence the social perceptions of Autism.
However, it is also possible that the social perceptions of Autism have resulted in the
use of the terms. In writing this chapter, there is no intention to suggest that a Thai
word for Autism needs to be coined, or words for Autism in other languages need
to be changed. However, to promote an understanding of Autism that will promote
social inclusion, careful efforts need to be made in explaining what Autism is and
that Autism can occur in all cultures.
Language is a tool for social communication and social interaction. Inappropriate
use of language can lead to misunderstandings and disapproval which can impede
social inclusion. Different languages pose different challenges for children with
Autism. According to Amaral, Dawson and Geschwind (2011), in the Korean lan-
guage, children with Autism may have difficulties using language to indicate social
ranks. In order to express politeness and respect, honorifics need to be used in every
sentence. A child with Autism may mistakenly speak to an elderly woman in the
way one should speak to a younger sister, or speak to a younger sister in the way
one should speak to an elderly woman (Amaral, Dawson and Geschwind, 2011).
In the Thai language, in order to politely address superiors, acquaintances, or

strangers, polite particles ‘ka’ or ‘krab’ need to be added at the end of the sentence.
The particle ‘ka’ is used when the speaker is female, and ‘krab’ is used when the
speaker is male. In school, the particles ‘ka’ and ‘krab’ are not often used when
informally talking to classmates or younger students. In addition, in the Thai lan-
guage, speaking briefly or curtly can be considered impolite. To be polite, speakers
need to speak softly and use extending sounds (Smalley and Prasithrathsint, 1989).
According to the interviews with teachers in the Buddhist-based school, students
with Autism sometimes talk to adults without adding particles at the end of the
sentence, or without extending sounds, which can make them sound curt and
impolite. A boy with Autism also mistakenly used ‘ka’ in place of ‘krab’ as he was
surrounded by females rather than males.
In order to promote social inclusion for children with Autism, language-
specific issues need to be considered. Further investigation needs to be conducted
into understanding how different languages can differently influence social
acceptance of children with Autism. Training materials for promoting understand-
ing of children with Autism may need to be specifically designed for speakers of
each language.
Children with Autism in multicultural environments also face challenges with
respect to language issues. In their review of eight studies, Drysdale,Van der Meer,
and Kagohara (2015) reported that bilingualism does not appear to have a nega-
tive impact on the language development of children with Autism. South Asian
Muslim American immigrant families thought their native language was important
for their child with Autism in communicating with non-English speaking family
members, particularly with elders who frequently helped take care for the child.
( Jegatheesan, 2011) Being able to communicate in their native languages helped
children with Autism participate in family social life and cultural activities con-
ducted in their native languages. In addition, Arabic language is important for a
child in participating in religious life, such as saying prayer, and attending religious
ceremonies. However, the English language, the language of the dominant cul-
ture, is also important to participating in the mainstream community ( Jegatheesan,
2011). In being exposed to two languages, some children learn the two languages
equally well, while some may be more proficient in one language (Bird, Lamond
and Holden, 2011). In order to promote social inclusion for children with Autism
in a multicultural environment, in order to fully participate in their community,
children with Autism may need to learn both the skills required for their native
culture, as well as that of the mainstream culture.
Cultural perceptions of social skills of children with Autism

Social skills are importance for children with Autism to be socially accepted by
community members and to establish friendships. However, socially appropriate
behaviors differ from culture to culture (Perepa, 2014). In a study by Perepa (2014),
parents from minority ethnic communities in the United Kingdom (UK) felt that
some behaviors essential for living in the UK were considered inappropriate in

their own culture. A Somali mother felt that using gestures was inappropriate in
her community, and a South Asian father thought that looking directly into adults’
eyes while talking to them was considered disrespectful or overconfident. However,
both recognised the importance and necessity of these skills when interacting with
people in the UK.
In Thailand, when teachers and parents were asked about the social skills Thai
children with Autism need, several teachers and parents responded that they
expected the children to be able to offer a ‘wai’. Wai is a Thai traditional form of
greeting, performed by putting the palms of the hands together at chest level, with
the elbows at the sides of the body.Wai can also be used for when saying ‘thank you’
and ‘sorry’. The placement of the hands and the lowering of the head are slightly
different depending on whether the wai is offered to someone of higher status,
equal status, lower status, or to a Buddhist monk. The person who is of lower status
should be the first to offer a wai to the person who is of higher status. In school,
students offer a wai once to teachers in the morning and once before going home,
but do not offer a wai to classmates or younger students. During the interviews,
teachers talked about a student with Autism that, after learning to offer a wai,
offered a wai to everyone, including younger students.
While most of the parents and teachers indicated they would like children with
Autism to be able to follow Thai social etiquette, Thai social etiquette can be com-
plex and difficult to learn. For example, Thai persons need to lower their heads
and bend their bodies forward while walking pass persons of higher status. It is
also disrespectful to stand next to a seated elderly person, as it is more polite for
a younger person to sit down on the floor next to the elderly. The inability by
students with Autism to display complex, socially expected behaviors is often inter-
preted as impoliteness by people who do not understand Autism. This misunder-
standing often results in overt social disapproval.
Socially acceptable social skills are different across cultures. In designing an inter-
vention to promote social skills, it is important to understand the social expecta-
tions of the culture. It is also important to understand the additional challenges of
children with Autism in multicultural communities.The social skills required when
interacting with members of a person’s culture can be different from the social
skills required in the mainstream culture. Involving parents in designing social skill
intervention is important for promoting the successful social inclusion for children
with Autism.
Conclusion
Culture is a way of living, and thus encompasses all areas of lives. In this chapter,
three main aspects of cultures are discussed: religious and local perceptions of
Autism, language, and socially acceptable behaviors. Culture influences social
perceptions and social acceptance of children with Autism. Individuals with
Autism and their families from different cultures face different challenges.
In multicultural communities, there are also additional challenges as children

with Autism and their families need to both participate in their own culture
and that of the mainstream culture. Understanding of the culture is important
in promoting social inclusion for children with Autism. Individuals with Autism
and their families need to be involved in planning interventions and elimi-
nating barriers to participation in society. Programs for supporting individuals
with Autism and their families, and programs for promoting professionals and
community members’ understanding of Autism need to be designed by taking
culturally specific issues into consideration.
Certain aspects of a culture can facilitate social inclusion for persons with dis-
abilities. However, there may be some aspects of a culture that do not align with
human rights approaches toward disability. It may not be possible to change the
culture rapidly, and in certain circumstances attempts should not be made to change
the culture without careful considerations. For example, while the perception of
‘songsarn’ in Thailand can subtlety create stigma towards persons with disabilities,
it can also be interpreted as compassion, and can be pragmatically used to increase
social participation for persons with disabilities. It may not be an ideal approach to
negatively criticize the perception of ‘songsarn’, or aggressively attempt to elimi-
nate the perception of it, without working toward setting up effective systems of
support for persons with disabilities.
Efforts should be made to ensure that cultural beliefs and practices coexist to
help promote human rights approaches toward support for persons with a disability.
Parents from religions discussed in this chapter used their religions as a framework
for interpreting Autism in a positive light. Therefore, religious organizations and
relevant professionals have the potential to support community members in inter-
preting Autism in a way that positively promotes the social inclusion of persons
with Autism.
References
Amaral, D., Dawson, G., and Geschwind, D. (2011). Autism spectrum disorders. New York:
Oxford University Press.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders.
Fifth edition. Washington, DC: Author.
Andersen, M. L., and Taylor, H. F. (2007). Sociology: Understanding a diverse society. Fourth
edition. Belmont, CA: Wadsworth.
Baron-Cohen, S., and Bolton, P. (1993). Autism:The facts. New York: Oxford University Press.
Bernier, R., and Gerdts, J. (2010). Autism spectrum disorders: A reference handbook. Santa Barbara,
CA: ABC-CLIO.
Bird, EK, Lamond E, and Holden J. (2011). Survey of bilingualism in autism spectrum
disorders. International Journal of Communication Disorders, 47(1), 52–64. doi:10.1111/
j.1460-6984.2011.00071.x
Bonder, B., and Martin, L. E. (2013). Culture in clinical care: Strategies for competence. Thorofare,
NJ: SLACK Incorporated.
Corbett, C. and Perepa, P. (2007). Missing out? Autism, education and ethnicity: The reality for
families today. London: National Autistic Society.
Dobson, S., Upadhyaya, S., McNeil, J., Venkateswaran, S., and Gilderdale, D. (2001).
Developing an information pack for the Asian carers of people with autism spectrum
disorders. International Journal of Language and Communication Disorders, 36(Suppl. 1),
216–21. doi:10.3109/13682820109177887
Drysdale, H., van de Meer, L., and Kagohara, D. (2015). Children with autism spectrum
disorder from bilingual families: A systematic review. Review Journal of Autism and
Ennis-Cole, D., Durodoye, B. A., and Harris, H. L. (2013). The impact of culture on autism
diagnosis and treatment: Considerations for counselors and other professionals. The
Family Journal, 21(3), 279–87. doi: 0.1177/1066480713476834
Ferraro, G. (1998). The cultural dimension of international business. Third edition. Upper Saddle
River, NJ: Prentice Hall.
Geisinger, K. F. (2003). Testing and assessment in cross-cultural psychology. In J. R. Graham
and J. A. Naglieri (Eds.), Handbook of psychology: Assessment psychology, vol. 10.Hoboken,
NJ: John Wiley and Sons, pp. 95–117.
Grinker, R. (2004). Unstrange minds: Remapping the world of Autism. Journal of Autism and
Developmental Disorders, 34(2), 211–22.
Groce, N. E. (1999). Disability in cross-cultural perspective: Rethinking disability. The Lancet,
354, 756–7.
Haviland, W. A., Prins, H. E. L., McBride B., and Walrath, D. (2010). Cultural anthropology:The
human challenge. Thirteenth edition). Belmont, CA: Wadsworth.
Henderson, G., and Bryan, W. B. (2010). Psychosocial aspects of disability. Fourthedition.
Springfield, IL: Charles Thomas.
Jegatheesan, B. (2011). Multilingual development in children with autism: Perspectives of
South Asian Muslim immigrant parents on raising a child with a communicative disorder
in multilingual contexts. Bilingual Research Journal, 34, 185–200. doi:10.1080/15235882.
2011.597824
Jegatheesan, B., Miller, P., and Fowler, S. (2010). Autism from a religious perspective: A study
of parental beliefs in South Asian Muslim immigrant families. Focus on Autism and Other
Developmental Disabilities, 25(2), 98–109. doi:10.1177/1088357610361344
Kang-Yi, C. D., Grinker, R. R. and Mandell, D.S. (2013) Korean culture and autism spec-
trum disorders. Journal of Autism and Developmental Disorders, 43(3), 503–20. doi:10.1007/
s10803-012-1570-4
Keillor, B. D. (2012). Winning in the global market: A practical guide to international business success.
Santa Barbara, CA: Praeger.
Kilbort-Crocker, H. (2012). Living with disability in Mae Wan: An in-depth examination of
disabilities in rural northern Thailand. Honors thesis, University of North Carolina at
Chapel Hill.
Kopetz, P. B., and Endowed, E. (2012). Autism worldwide: Prevalence, perceptions, accep-
tance, action. Journal of Social Sciences, 8(2), 196–201.
Kwang Hwang, S. and Charnley, H. (2010). Making the familiar strange and making the
strange familiar: Understanding Korean children’s experiences of living with an autistic
sibling. Disability and Society, 25 (5), 579–92. doi:10.1080/09687599.2010.489305
Moldin, S. O., and Rubenstein, J. L. R. (2006). Understanding autism: From basic neuroscience to
treatment. Boca Raton, FL: Taylor and Francis Businesses.
Naemiratch, B., and Manderson, L. (2009). Pity and pragmatism: understandings of disability in
northeast Thailand. Disability and Society, 24(4), 475–88. doi:10.1080/09687590902879106
National Statistical Office (2011). Executive summary: The 2011 survey on status of society and
culture. Retrieved from: http://web.nso.go.th/en/survey/data_survey/560624_2011%20
Survey%20on%20Status%20of%20Society%20and%20Culture.pdf
Perepa, P. (2014) Cultural basis of social ’deficits’ in autism spectrum disorders. European
Journal of Special Needs Education. 29(3), 313–26. doi:10.1080/08856257.2014.908024
Proyer, M., (2014). Educational environments of children with disabilities in greater Bangkok –
accepting disability and leading a happy life in a transiting urban area. PhD thesis, University
of Vienna.
Ratanakul, P. (1999). Buddhism, health, disease, and Thai culture. In H. G. Coward and
P. Ratanakul (eds.), Cross-cultural dialogue on health care ethics. Waterloo, Ontario: Wilfrid
Laurier University Press, pp. 17–33.
Shaked, M., and Bilu, Y. (2006). Grappling with affliction: Autism in the Jewish ultra-
orthodox community in Israel. Culture, Medicine and Psychiatry, 30, 1–27. doi:10.1007/
s11013-006-9006-2
Smalley, W., and Prasithrathsint, A. (1989). Language use in Thailand. Oxford: Pergamon Press.
Suroso, H. (2012). How religious beliefs influence understanding of disability: A study
of Muslim family’s perception on Autism. Published online http://www.academia
.edu/7760168. Retrieved 25 October 2015.
Suzuki, S. (2015). Autism and manga: Comics for women, disability, and Tobe Keiko’s with
the light. In M. Toku (ed.), International perspectives on Shojo and Shojo manga: The influence
of girl culture. New York: Routledge.
Tait, K. and Mundia, L. (2012). The impact of a child with autism on the Bruneian family
system. International Journal of Special Education, 27(3), 1–14.
Thai Ministry of Education. (2009). Ministerial Notification on Categories and Criteria
on Disability. Retrieved from www.ohchr.org/Documents/HRBodies/CRPD/Future/
CRPD.C.THA.1-ENG.doc. Accessed 1 August 2013.
Ukpokodu, O. N., and Ukpokodu, P. (2012). Contemporary voices from the margin: African educa-
tors on African and American education. Charlotte, NC: Information Age Publishing.
UNESCO. (1968). Meeting of experts on cultural rights as human rights, UNESCO, Paris, 8-13
July 1968. Paris: UNESCO.
UNESCO. (2002). Universal declaration on cultural diversity. Paris: UNESCO.
United Nations. (1989) Convention on the rights of the child. Geneva: United Nations.
United Nations. (2006). Convention on the rights of persons with disabilities. New York: United
Nations.
United Nations Human Rights Office of the High Commissioners. (2014). The conven-
tion on the rights of persons with disabilities: Training guide (Professional Training Series no. 19).
New York and Geneva: United Nations.
West, R., and Turner, L. (2011). Understanding interpersonal communication: Making choices in
changing times. Boston, MA: Wadworth.
White, S. W., and Schry, A. R. (2011). Social anxiety in adolescents on the Autism spec-
trum. In C. A. Alfano and D. C. Beidel (eds.), Social anxiety in adolescents and young adults:
Translating developmental science into practice. Washington, DC: American Psychological
Association, pp. 183–201.
Wilder, L., Dyches, T., Obiakor, F., and Algozzine, B. (2004). Multicultural perspectives on
teaching students with autism. Focus in Autism and Other Developmental Disabilities, 19,
105–13. doi:10.1177/10883576040190020601
13
SOCIAL INCLUSION: A PERSONAL
REFLECTION
Stephen Shore
From the viewpoint of a person on the Autism spectrum this chapter explores
reframing curricular and instructional modifications to have a greater focus on mean-
ingful social inclusion. By employing the nine categories of academic adjustments
outlined in the work of Cole, Horvath, Deschenes, Ebeling, and Sprague in 2000, the
author makes suggestions on how these modifications can be customized to meet the
diverse needs of students with Autism and other conditions while embedding into the
routine of the class session benefitting all students and p romoting meaningful inclusion.
Introduction
Social inclusion is all encompassing. Inclusion in the academic, employment,
community, and other domains all have something in common, and that is
communication – which is socialization. Unless one is by themselves and not
interacting with others, be it face-to-face, electronic, or by other means, one is
communicating and thus engaged in social interaction.
As the emphasis in this book is on education, focus will be on reframing
academic curriculum modifications as promoting successful and meaningful social
interaction as an integral part of teaching subject material in school with the goal of
generalizing to life after graduation. Rather than occurring in a specific place, social
inclusion is a mindset that can be applied both by individuals striving to integrate
people with Autism into the fabric of life and by persons on the Autism spectrum
seeking satisfying, deeper involvement with all others.
Inclusion from the beginning

After a year and a half of typical development I was struck with a sort of regres-
sive “Autism bomb” where I lost functional communication, had meltdowns, and
withdrew from the environment. In brief, I became a severely affected child on the
A personal reflection 169
Autism spectrum – to the point where doctors recommended separation from my

family. At that time a diagnosis of Autism was tantamount to a life sentence to an
institution with little to no hope of inclusion in the greater society. Fortunately, my
parents believed in me, refuted the professional recommendations for institutional-
ization, and convinced the diagnosticians to place me in a center for “children with
atypical development” in a year’s time.
However, my parents took that year to implement “an intensive home-based
early intervention program emphasizing movement, music, sensory integration,
narration and imitation” (Antony and Shore, 2015, p. 36). At first, my parents’
attempts to get me to imitate them failed and they were discouraged. It is commonly
mentioned in education that it is important or even necessary for the student to
imitate the teacher to learn.Whether it’s penmanship, mathematics, physical educa-
tion, or even in apprenticeship situations the student is expected to watch, process,
generalize to themselves, and imitate.
Yet, perhaps due to neuronal differences in people on the Autism spectrum,
imitation becomes impossible, especially at a young age. Maybe out of despera-
tion, or due to a possible flash of insight, my parents flipped their efforts around to
imitate my sounds and actions, and entered into my world. In doing so they began
the long process of including me in family activities, which led to further, albeit
hard-won, successes in school and beyond.
The foundation for successful social inclusion begins with believing in the
competence of the individual and meeting them where they are. My parents
accepted me for who I was.Yet at the same time, they realized that significant inter-
vention and work was needed if I were to lead a fulfilling and productive life. My
parents had no background in education or psychology. All they knew is that they
had to do anything they could to reach their child. And they did!
Preschool
With speech beginning to return at age four, I was admitted to the school where
their diagnosing professionals initially recommended institutionalization. Upon
re-evaluation, based on the work my parents had done, I was upgraded from a diag-
nosis that included strong autistic tendencies, atypical development, and psychotic
to neurotic. Things were looking up.
The center I attended subscribed to then-current psychologically oriented
beliefs of Autism being caused by poor parenting. In contrast to today, teachers were
prohibited from sharing the day’s events with the parents of the child.The rationale
was that parental queries such as whether their child ate lunch that day was framed
as a parent really wondering if the school was a better caretaker of the child than the
parent was (Shore, 2003). At that time, it was thought that such weighty questions
could only be addressed by highly trained psychologists.
Fortunately, even in that climate, I was lucky enough to have a teacher who
understood the importance of play in initiating social contact with others. For
example, realizing that the children in her class expressed interest in trains, she would
170 Stephen Shore
begin with us playing individually in close proximity. Gradually, she would add
sections of tracks to our stations until they were all connected and we would visit
the stations of our classmates. Even though this activity occurred in the late 1960s
it appears my teacher understood the importance of developing social interaction
through areas of common interest. After a year at this children’s center for “atypi-
cally developing” children, I started regular school kindergarten at age 6.
The terror and wonder of elementary school and insights

for improving social inclusion
Although initially, kindergarten was uneventful, both my classmates and teacher
soon knew that my styles of social interaction and learning were very different.
Unfortunately, those differences were often met with bullying from my classmates
and lack of understanding from my teacher. Walking around the class repeating the
letter “B” and communicating attempts by trying to get them to imitate noises and
made-up words did not endear me to my classmates. The strategies of today such
as Social Stories™ (Gray, 2015), Power Cards (Gagnon, 2001), conducting social
autopsies, and the 5-point scale (Buron and Curtis, 2012), along with the concepts
of role playing and video modeling, would have been great in helping me under-
stand how to interact with my classmates.
Academically, I was usually about a grade behind in most of my subjects and often
pleasantly surprised when I was promoted to the next grade. Had current knowl-
edge of special education existed at that time I probably would have divided my time
between special education, with support of a paraprofessional, and a resource room.
In the next section I will examine a set of academic modifications to curriculum
(Cole, Horvath, Deschenes, Ebeling and Sprague, 2000). Designed for the general
education teacher, the nine categories of curricular adaptations can be designed to
emphasize social inclusion for students with Autism and other special needs.
Nine domains of accommodation

Often I find educators get lost in a sea of potentially thousands of curriculum
modifications and feel adrift as to which one or ones to implement to best benefit
the individual with Autism or other special education needs. As a result, I find it
beneficial to group these adjustments made to academic material and their delivery
into nine domains as adapted from the nine categories of accommodation described
by Cole, Horvath, Deschenes, Ebeling, and Sprague (2000) and also mentioned in
Understanding Autism for Dummies (Shore and Rastelli, 2006). Fitting into one or
more of these categories, these areas provide a nice framework to think about
modifications to curriculum and instruction. The domains are:
1. Size
2. Time
3. Level of Support
4. Input
5. Difficulty
6. Output
7. Participation
8. Alternate Activity
9. Substitute Curriculum
Each of these modifications will be reviewed as to how they can be customized

to individual needs and worked into the routine of class instruction. Effectively
supporting children with Autism or other special needs requires a focus on under-
standing the person as an individual. When you’ve met one person with Autism, you’ve
met one person with Autism. Certainly there are commonalities amongst people on the
Autism spectrum.Yet, there is great diversity within individuals who have Autism.
Additionally, in order to maximize social interaction it’s important to seek ways
modifications can be designed so other students can also benefit from the adapta-
tions promoting meaningful social inclusion of the student with Autism or other
differences.
Size or quantity of information

Adapt the number of items that the learner is expected to learn or complete.
For example, an instructor could reduce the number of s pelling words that must
be learned at a given time from 20 new spelling words each Friday to 10 new items.
Much of the time this will work. However, in wanting to maximize potential of the
student I may consider having him or her take a quiz of 10 words on Tuesday with the
remaining 10 on Friday with the rest of the students. Often the student will be suc-
cessful in splitting the test in this manner as what was really needed was a reduction in
the size or quantity of information to process at a given time: in other words, smaller
chunks of information. An additional important facet is that this strategy elevates
the curriculum modification to an accommodation. Accommodations equalize the
chances of an individual’s success to that of everyone else.
However, it is possible to take this accommodation one step further by modify-
ing the curriculum so that the entire class takes two tests of 10 spelling words every
week. Students are being assessed equally with no need to provide special accom-
modation to the single individual as he or she is included in the spelling assessment
just like everyone else.
An important criterion of successful curricular and instructional adjustments is
that they can be integrated into the educational flow of the class where everyone
benefits as described above.
It was first or second grade and students where asked to memorize the spelling
meme “I before E except after C and words with long A’s such as neighbor and
weigh”. I was embarrassed that even with the help of my classmates that I was
unable to memorize the passage as fast as everyone else. Perhaps working in partners
and focusing on remembering only half of the passage at a time would have helped.
172 Stephen Shore
Then after achieving success the other half could be addressed. Implementing this
strategy on a class-wide level would have the additional benefit of being more
socially inclusive.
Time
Adapt the time allotted and allowed for learning, task completion, or testing (or
assist with management of time).
A common response to the modification of time is to provide a longer period
of time for completing a project, study, or otherwise demonstrating mastery of the
subject. Although this strategy often works, the challenge facing the person with
Autism may have less to do with the actual time required to complete the task and
more to do with the management of that time. For example, many students may have
difficulty properly scheduling their time to complete a long-term project such as
a grade school science paper requiring the steps of determining a topic statement,
conducting research, and developing an outline, followed by rough and final drafts.
Suppose this year “Edward”, a student with Autism, is included in your class.
Although he engages in class discussion well, one of his accommodations is to pro-
vide an advanced organizer for all class sessions and for any long-term assignments.
Being truly interested in helping Edward, and perhaps some other students in your
course, you wonder if there’s a way to rework your instruction to accommodate
Edward as part of the general instruction to the class.
Initially, it may be tempting to take Edward aside during a break or lunch to
chart out a timeline with intermediary deadlines for each of the components
of the assignment. While this may help the student with executive functioning
needs there are often other students in a class facing similar challenges – possibly
to a lesser degree. Therefore, including the development of a timeline during the
introduction of the assignment with the entire class will benefit everyone and
Edward no longer needs to be pulled aside and treated differently than everyone
else. That said, there are times it is very fair to treat students differently, which will
be addressed at a later time.
Taking this concept a step further, perhaps there’s a student needing more sup-
port than just talking about and drawing out a timeline. A bulletin board could be
set up with columns representing the stages of the assignment (see Figure 13.1). As
each stage is approved the work gets posted to the board as a visual reminder for
everyone of their progress in completing this long-term project.
Students like seeing their work on the board. Principals like seeing student work
displayed as they make their room inspections. And parents like seeing their chil-
dren’s work hanging on the wall.
Should it be the case that Edward needs additional support in grasping the
concept of intermediary deadlines, putting him in charge of pinning the student
work on the board as the “bulletin board monitor” is a strategy that could be
used. If Edward is still challenged with the concept of time management maybe
Mr. Lot Earth Sciences Grade 8
Topic Sources Outline Rough Final

Sentence Draft Draft
The cause of (date) 1.xxxxx Title Title

Author The phases The phases
earthquakes Title... A. yyyy
B. zzzzz of the Moon... of the Moon...
g the Author (date)

Explainin Title...
1.xxxxx Title Humankind
seasons A. yyyy The theory of The theory
of
B. zzzz Evolution... Evolution...
Author (d z
ate)
Why tides Title...
Title Earthquakes
occur 1.xxxxx
On all On all
A. yyyy
continents... continents...
B. zzzzz
How can instruction be engineered to benefit the entire class?

39
Figure 13.1 An example of a bulletin board representing the stages of an assignment
a classmate can be chosen to work with Edward to make sure he gets the work
pinned to the correct column. Edward’s support needs, up to hand over hand
guidance, will be provided. By initially providing more support to the entire
class followed by integrating Edward as a full participant in related class activities,
Edward’s needs are met and the preparation for his education benefits the rest of
the class as well.
In undergraduate school I enrolled in the honors section of Physics of Music.
While the course title and description sounded fascinating to me the course, unfor-
tunately, was taught in a very dry and boring manner. The honors component was
essentially a term paper on a topic of our choosing. I chose the trombone, which
has many interesting physical properties in the production of its sound. However
once the professor approved the topic statement, we were left to our own to turn
in a completed paper at the end of the semester. The executive functioning chal-
lenges proved to be too great and I ended up dropping the honors section. Had the
professor provided more guidance on intermediary steps for completing the paper
maybe I would have been successful.
Level of support
Increase the amount of personal assistance with a specific learner.
Due to the number of students in a class, educators face significant challenges in
providing sufficient support for all of their students’ needs, even when there are one
174 Stephen Shore
or more paraprofessionals in the room. Engaging other classmates for peer tutoring
and working in teams that include students with Autism can be helpful. At the very
least the other students learn how to work with an individual on the Autism spec-
trum and possibly become friends.
However, working in groups can be particularly challenging for students with
Autism due to the load of having to process multiple conversations and social inter-
actions at once. Preparing the student with Autism with clear explanations of their
role in the group based on their ability can be of great help. In fact clear explanation
of all the roles for group work will be helpful for the entire class.
I found group work particularly difficult in grade school as it was hard for
me to negotiate my role with my classmates and determine what I needed to do
and how to get it done, all while socially integrating with three or four or more
group members. Greater clarity from the instructor would have been a very useful
support.
Input
Adapt the way instruction is delivered to the learner.
Whereas most individuals on the Autism spectrum are visually based (including
me!) the key word is most! Like with the rest of the population, learning styles differ
between people with Autism. The learning style of a person on the Autism spec-
trum will be to an extreme. So extreme, that unlike the general population who
can still achieve sufficient functionality with the weaker learning modalities, the
person on the Autism spectrum may have access to only a single modality at a very
high level at the expense of the others. Visual aides, concrete examples, hands-on
activities, and learning content put to rhythm and/or melody can all be helpful for
diverse learners.
This makes it incumbent upon educators to engage as many senses as possible
during instruction. In the previous example discussing the management of time,
while developing a timeline of intermediary deadlines accesses the visual and
auditory modes, having the student actually place the classmates’ work in the appro-
priate column employs the kinesthetic sense as well.
Although this example is at the college level, it still can be generalized to
education at all levels. In taking a course in qualitative research for my doctoral pro-
gram in special education I was totally mystified by the professor’s verbal explana-
tion of the process of going from general to specific in the introductory section of a
qualitative research proposal. Part of the challenge may have come from that many
of us on the Autism spectrum tend to be inductive rather than deductive thinkers.
In other words, we tend to need a number of specific examples from which we
can make broad generalizations, which is opposite from the style required for the
qualitative paper.
After a week of futile discussions with the professor and remaining mystified
it suddenly occurred to me that if I converted her words into a graphic made
up of pouring words and phrases into the wide mouth of a funnel with them
coming out the other end in a thin, concise stream, then the process made much
more sense. Overall the instructor was good at what she did. However, I needed to
develop a graphical representation of the concept in order to bridge the gap in my
understanding.
Output
Adapt how the student can respond to instruction.
Output is just the flip side of the processing coin of input. The number of
ways a student can demonstrate mastery of a subject is only limited by the
imagination of the instructor and student combined. Some examples include
responses that are typed, spoken, or pointed at using an assistive communica-
tion device, or even d rawing mind maps. The following discussion illustrates an
example of a student who advocated for himself and even suggested a reasonable
accommodation.
The assignment was to make an annotated list of the components of the
electronic music lab including their functions and interconnectivity. The student
waited until the others left and straightforwardly disclosed his ADHD, which
greatly slowed his penmanship and made it all but illegible. He then stated that he
should accept a failing grade now due to those challenges … or … might he have
permission to draw a map of the electronic music studio to depict the functions of
the components.
Suppose I took the stance that the student should know how to write s imple
paragraphs at this time. And if he could not do so, than perhaps he should drop
the course in favor of him taking a developmental writing class and return next
year when he was ready. However, something told me to let him draw a map
of the studio as he suggested. It was clear that he knew his way around the
equipment.
Being that it was the middle of the semester I knew this student had greater
mastery of the electronic music lab than all the other students, and in some ways
was more advanced than I. Clarity in the goal of assessment is vital here. If the goal
is to measure content then it is the responsibility of the instructor to remove undue
barriers to that student’s success. Not doing so would have caused a student having
the greatest amount of mastery of this subject to potentially receive the lowest
grade in the class – which would be invalid. On the other hand, if I wanted to eval-
uate his writing than it would have been incumbent on me to remove the physical
barrier of writing such as allowing him to use a scribe or speech-to-text software,
provide the answers orally, or use other means.
Difficulty
Match the skill level of the child to the challenge of the work.
There are situations where no matter how many curriculum modifications are
made and how much support is provided, a student may not be able to achieve
176 Stephen Shore
at the same level as their classmates. Therefore, the primary goal for modifying
curriculum or instruction is meaningful inclusion. For individuals in this situa-
tion, adjustments to skill level, problem type, or rules on how the student may
approach their work to ensure they are learning to the greatest extent possible yet
participating in the class benefits everyone.
For example, while it is a worthy goal that a person should be able to engage in
mental arithmetic, for those unable to so, providing a calculator will enable func-
tioning in mathematics. Later, s/he may be able to perform mathematical calcula-
tions without supportive devices.
Multiplication and division were very difficult for me in elementary school.
Fortunately I discovered a slide ruler type contraption called a “multiplier pen-
cil box” and “cheated” when solving multiplication problems. Shortly, I realized
this device could also be used to reverse-engineer the mysteries of long division.
Eventually, I learned the multiplication and division tables through sheer repetition.
Although it was unlikely that teachers understood at that time, the opportunity to
use this device alone in my bedroom in a low stress environment was exactly what
I needed to master multiplication and division. Had I been allowed to use this low-
tech assistive device in the classroom, it would have enabled me to be included in
the mathematically oriented games that the teacher would sometimes have her class
do towards the end of math instruction.
Participation
Make needed modifications to keep the student meaningfully involved.
Also falling into the category of an adjustment that does not rise to the level
of accommodation, it is important for participation to be meaningful to everyone.
For example, suppose a nonspeaking yet very vocal student is included in a chorus
class. Additionally, this student paces. However when pacing, the student is mostly
silent. Frequently vocalizing, it appears meaningful inclusion of this student will be
challenging as this student will have difficulty standing in place and maintaining
pitch, rhythm, and other aspects of singing in a choir.
Focusing on what the student can rather than can’t do will be much more
helpful. Clearly this individual needs to move. There may be body to envi-
ronmental issues related to sensory processing or other reasons, which can be
interesting to ponder. However, finding ways for the student to engage the need
to move may be fruitful. Some possibilities may include keeping tempo on a per-
cussion instrument or improvisational movement to the music where the student
may have an unexpected skill.Yet another possibility might be to have the student
march about the auditorium carrying a flag that is relevant to the music. Finding
a few other students to volunteer to engage in these activities as well will keep
the individuals with special needs from being isolated. In this way the student’s
need to move, the challenges of singing in a group, and the need for meaningful
participation are meaningfully addressed.
Alternate activity
Adapt the goals or outcome expectations while using the same materials.
Again in the same category of a modification rather than an accommodation,
an example from this category might involve expecting a student to locate just the
continents of world rather than the countries and which continents they belong
to or playing a simplified percussion part in a concert. Giving the widely varying
skillset often accompanying Autism its possible that the student may have skills in
areas way beyond the peers.
For example, a child with a deep interest in weather in hurricane- or tornado-
prone states might prepare and deliver a report to the class on causes and safety
when this type of weather occurs. If the student has difficulty communicating in
the spoken word there are many assistive communication devices that could be
used. Third grade found me with a fascination in deep space exploration, which
spurred me to give a presentation on the solar system.
Alternate curriculum
Instruction and materials are varied to meet individual student goals yet remain
aligned with the curriculum and prepare the student to return to the class with
their regular education peers where possible.
For example, a person having difficulty with penmanship due to motor control
issues might be pulled aside for a brief period of time from a writing class to learn
how to type on an AlphaSmart™ or other keyboard device in preparation for
returning to their peers for in-class writing assignments. However, this temporary
“pull out” from the regular classroom activities must not result in “geographical”
inclusion where a student is physically in the same room but works on often unre-
lated materials to the subject at hand, usually with a paraprofessional. This type of
“geographical inclusion” misinforms the regular education students that those with
special needs are very different creatures from the “rest of us” which is totally con-
trary to the philosophy of inclusion.
As a member of grade school musical ensembles, I remember the director asking
students experiencing difficulty playing their part to leave the rehearsal to learn
their part in a practice room. The expectation was that they would return upon
learning their music. This is a good example of alternate curriculum.
The Musashino Higashi Gakuen: An interesting inclusion

model from Japan
Just outside of Tokyo the Musashino Higashi Gakuen practices inclusion at the
schoolwide level. For most people in Japan the Musashino Higashi Gakuen is
2,500-student expensive, elite regular education school with a long waiting list
to attend. However, a knowledgeable observer would note that about a third of
178 Stephen Shore
the student body is on the Autism spectrum and is engaging with the rest of the
pupils.
Translated to Daily Life Therapy in English, their approach focuses on the three
pillars of physical activity, emotional regulation, and intellectual stimulation for
leading a balanced life. After a period of Initial Stage Guidance the students with
Autism are integrated into classrooms of up to 40 students to a single teacher.
Part of what makes this education work for students with Autism is the
emphasis on community. Whereas in most Western societies, additional support
is provided by educational personnel such as teachers and paraprofessionals, in
the Musashino Higashi Gakuen, this support is provided by the classmates them-
selves whenever possible. In addition to benefitting both students with Autism
and the rest of the class there are two important implications for life in the adult
world. Be it at work, in the community, etc., graduates of the Musashino Higashi
Gakuen will have greater understanding as well as hopefully acceptance and
appreciation of individuals with Autism in the adult worlds of employment, the
community, etc. Similarly the students with Autism will have benefitted from
extended contact and support with the regular education students, easing the
way for integration as adults.
Another interesting aspect about this approach is that it’s the only education
method that is used for both regular education and for students on the Autism spec-
trum. A smaller branch – the Boston Higashi School – employs the same teaching
strategies. However, only children with Autism are taught in this school.
Conclusion
As with Autism, inclusion is also a spectrum of involvement for people with dif-
ferences and disabilities. While 100 per cent inclusion is a goal to strive for, it is
not always possible or even advisable when resources of teacher education, time,
materials, and space are unavailable – especially when academic and/or behavioral
challenges exceed what an educational institution is able to provide in a given
situation.
However, academic and social accommodations are actually merely extensions
of good teaching practice. With greater attention paid to differences in learning
styles and social interaction, “regular” education becomes more accessible to a
greater diversity of students to the benefit of all involved and society as a whole.
What is good for individuals on the Autism spectrum tends to be good for every-
one else as well.
Through the lens of academic modifications to curriculum and delivery of
material we have explored how meaningful inclusion of students with Autism can
be accomplished while benefitting the class as a whole. Inclusion is meaningful
when both the individual with special needs and the other students benefit from
the interaction. Rather than an afterthought, inclusion in education, employment,
and society as a whole is a right of all humans regardless of ability.
References
Antony, P., and Shore, S. (2015). College for students with disabilities:We do belong. London: Jessica
Kingsley Publishers.
Buron, K., and Curtis, M. (2012). The incredible 5 point scale: The significantly improved and
expanded second editions; assisting students in understanding social interactions and controlling their
emotional responses. Lenexa, KA: AAPC Publishing.
Cole, S., Horvath, B., Chapman, C., Deschenes, D., Ebeling, G., and Sprague, J. (2000).
Adapting curriculum and instruction in the inclusive classroom: A teacher’s desk reference. Second
edition. Bloomington, IN: The Center for School and Community Integration, Institute
for the Study of Developmental Disabilities.
Gagnon, E. (2001). Power cards: Using special interests to motivate children and youth with Asperger
syndrome and autism. Lenexa, KA: AAPC Publishing.
Gray, C. (2015). The new social story book, revised and expanded 15th anniversary edition: Over
150 social stories that teach everyday social skills to children and adults with autism. Arlington,
TX: Future Horizons.
Shore, S. (2003). Beyond the wall: personal experiences with Autism and Asperger Syndrome.
Shawnee Mission, KS: Autism Asperger Publishing Company.
Shore, S., and Rastelli, L. (2006). Understanding autism for dummies. New York:Wiley and Sons.
INDEX
Amaral, D. 162 bullying: primary school years 77–8;

Anderson, A. 75 transition from primary to secondary
Anderson, S. 35, 86, 87, 88, 94 school 94–5
Ashburner, J. 73 bullying and social vulnerability of students
Asperger Syndrome see identity formation with Autism Spectrum Disorder 33–44;
in individuals with Asperger Syndrome bullying through the lifespan 34–6;
Attwood, T. 74 “classroom avengers” 37; depression
and aggression 37; future needs 43–4;
Baird, G. 22 helpful and harmful responses 37–9;
Baker, M. J. 23 holistic areas 40; poor peer relationships
Banks, P. 85 35; prevention program 40–1; social
Bauman, A. 35 inclusion of participants 41; steps for
Baykaner, O. 86, 87, 88, 94 reducing bullying victimization 39;
Beart, S. 47 success stories 43
Bettelheim, Bruno 10
bilingualism 163 Cain, C. 46
Billingsley, B. S. 16 Calder, L. 74
Bilu,Y. 158 Campbell, J. M. 12
bioecological systems theory 119–21 Cappadocia, M. C. 80
Bossaert, G. 13, 145, 151 Carter, E. W. 146, 147
Bourdieu, P. 102 Carter, M. 74
Bovey, E. H. 60 Case, L. 22
Brahmavihara 160 Centers for Disease Control and Prevention
Breen, C. 136 (CDC) 11
Broer, S. M. 28 Chamberlain, B. 14, 145
Bronfenbrenner. U. 120, 127 Chandler, S. 22
Brooks, R. 86, 88 Chapman, C. 168, 170
Brown, W. H. 60, 119 Charland, L. C. 47
Buchan, L. 47 Charman, T. 22
Buddhism 158 Children’s Friendship Training (CFT) 80
‘Bukkon autistic’ persons 162 “classroom avengers” 37
“bulletin board monitor” 172 Cobb, R. 88
Index 181
Cole, S. 168, 170 incorporating all young children in

Coles, J. 86 the classroom 60; LEAP model 62–3;
Cooney, M. 146, 147 measuring and assessing inclusion 60–1;
Coplin, H. 13, 145 peer relationships 58, 66; Project DATA
Corbin, J. M. 125 63–4; randomized controlled trial 63;
Cox, S. 26 tiered models of support 60; training
culture see influence of culture on social competent classroom teams and staff 61;
inclusion of children with Autism Walden Early Childhood Programs 64–5
Cumming, T. 146 Ebeling, G. 168, 170
Ellemers, N. 47
Danial, J. 24
Daniel, L. S. 16 families, role of in supporting social
Daniolos, P. 22 inclusion 144–52; case studies 148–51;
Danker, J. 146 fostering self-determination 146–7;
Dann, R. 87, 88 future directions 151–2; key themes 145;
Dawson, G. 162 mobile devices 147; peer acceptance and
Delfabbro, P. 35 role of home–school collaboration 148;
Deschenes, D. 168, 170 social skills development 147–8; special
developmentally appropriate practice (DAP) educational needs 145
framework 61 Fein, E. 47
Dhunpath, R. 47, 48 Feldman, E. K. 27
Diagnostic and Statistical Manual of Mental Feldmiller, S. 26
Disorders, Fifth Edition (DSM-V) 2, 10, Fern, E. 47
101, 156 Forero, R. 35
Diamond, K. 60 Fowler, S. 157
Didden, R. 33 Fox, J. J. 136
Dillon, G.V. 86 Fredeen, R. M. 24
Disability Discrimination Act (DDA) Frederickson, N. 75, 76
106, 117 Frederickson, N. L. 76
Division for Early Childhood (DEC) 58 Furnham, A. F. 76
Dobson, S. 162
Dodd, S. 11 Garrison-Harrell, L. 135
Dollard, M. 35 Geschwind, D. 162
domains of accommodation 170–7; Giangreco, M. F. 28
alternate activity 177; alternate Gilderdale, D. 162
curriculum 177; difficulty 175–6; input Giles, D. C. 46
174–5; level of support 173–4; output Granovetter, M. S. 108
175; participation 176; size or quantity of Groce, N. E. 156
information 171–2; time 172–3
Doosje, B. 47 Halvorsen, A. T. 28
Douglas, W. 87 Hammarstrom, A. 35
Doyle, M. B. 28 Hannah, E. F. 87, 88, 89
Drysdale, H. 163 Hardy, G. 47
Dugan, E. 25 Haring, T. 136
Dybvik, A. 12 Hart, J. E. 15
Hebron, J. 77
early years, social inclusion in 57–67; Hellriegel, J. 86, 87, 88, 94
current and relevant social inclusion Hill,V. 74
research 58–9; developmentally Holland, D. 46
appropriate practice framework 61; Hong, E. R. 39
effective models for social inclusion Horvath, B. 168, 170
62–6; goal setting and planning learning Huang, H-H. 60
opportunities 59; implementing Hughes, L. A. 85
high-quality social inclusion 59–61; Humphrey, N. 12, 77
182 Index
identity, Autism and 96 Learning Experiences and Alternative

identity formation in individuals with Program for Preschoolers and Their
Asperger Syndrome 45–51; definition Parents (LEAP) 62–3
of identity 46–7; impairments 45; least restrictive environment (LRE) 21
methodology 48–9; self-identity 49–50; Leonard, B. 25
social identity 50–1 Lewis, A. 47
Individuals with Disabilities Act 117 Li, C. 118
influence of culture on social inclusion Li, S. 60
of children with Autism 155–65; Locke, J. 75, 136, 145
bilingualism 163; Brahmavihara 160; London, N. 145
Buddhism 158; ‘Bukkon autistic’ Loucas, T. 22
persons 162; cultural perceptions of Lund, E. M. 39
social skills of children with Autism
163–4; Islamic religion 157; Jewish Machalicek, W. 146, 147
ultraorthodox community 158; karma MacLeod, A. 47, 51
159; language issues 161–3; learning of Manderson, L. 161
culture 155; religious and local cultural Mandy, W. 86, 87, 88, 94
views of Autism 157–61; ‘songsarn’ Martin, A. 22
social perception 160; Thai Mason, R. 26
language 163 Matos, R. 27
Ingersoll, B. R. 147 Mavropoulou, S. 16
Ishijima, E. H. 145 McConnell, S. R. 119
McEvoy, M. A. 136
Jan Pijl, S. 13, 145 McLellan, L. 35
Jegatheesan, B. 157 McNeil, J. 162
Jindal-Snape, D. 87 measles, mumps and rubella (MMR)
Johnson, S. M. 136 vaccine 11
Johnston, P. 51 Metzer, J. 35
Jones, A. P. 75, 76 Miller, P. 157
Miller, T. 26
Kagohara, D. 163 mobile devices 147
Kamps, D. 25, 26, 135 models for social inclusion 62–6; key
Kasari, C. 14, 75, 136, 145 features 65–6; LEAP 62–3; Project
Kenworthy, L. 22 DATA 63–4; Walden Early Childhood
Kerr, C. 87 Programs 64–5
Kerr, M. M. 136 Moss, C. K. 146, 147
Kilbort-Crocker, H. 159 “multiplier pencil box” 176
Kim, S. 24, 25, 27 Mundia, L. 158
Klin, A. 12 Murin, M. 86, 87, 88, 94
Koegel, L. K. 23, 24, 25, 27 Murphy, G. 49
Koegel, R. L. 23, 24, 27 Musashino Higashi Gakuen 177–8
Koenig, K. 12
Kohler, F. 60 Naemiratch, B. 161
Kosciulek, J. 103 Nakken, H. 13
Koster, M. 13 Nansel, T. R. 35
Kravitz, T. 135 Nario-Redmond, M. R. 47
Kretzmann, M. 75 National Association for the Education of
Young Children (NAEYC) 58
Lachicotte, W. 46 National Disability Insurance Scheme
Lane, K. L. 146, 147 (NDIS) 107
Lang, J. 75 Neely, L. 39
language issues 161–3 Nelson, C. M. 136
Leader, G. 103 Network, A. B. 75
Leahy, M. 103 Noel, J. G. 47
Index 183
Odom, S. L. 60, 119 Project DATA (Developmentally

Appropriate Treatment for Autism) 63–4
Parker, R. C. 14 Psychological Sense of School Membership
peer models: access of young children (PSSM) scale 89
with disabilities to 59; impact of being Punshon, C. 49
136; selection of 134–6, 138; typically
developing peers serving as 26, 131–2 randomized controlled trial (RCT) 63
peer relationships: change during Ratanakul, P. 158
adolescence 135; difficulties making and religious views of Autism 157–61
maintaining 73; early years 58, 66; marked Rissel, C. 35
development in the importance of 71; Robertson, C. 47
poor 35, 145; social challenges and 131 Rodger, S. 73
Pellicano, E. 74 Roekel, E. 3
Pepler, D. 80 Rotheram-Fuller, E. 14, 136, 145
Perepa, P. 163 Rubinstein, D. 24
personal reflection 168–78; “bulletin
board monitor” 172; domains of Salamanca Statement 117
accommodation 170–7; inclusion Scahill, L. 12
from the beginning 168–9; “multiplier Schmidt, C. 136
pencil box” 176; Musashino Higashi Schmidt, C. T. 148
Gakuen 177–8; parenta queries 169; Schoen, B. 118
preschool 169–70; terror and wonder of Scholte, R. H. 33
elementary school 170 school-based social skills interventions 78;
Peters, R. 86, 88 see also primary school years, social
Petrina, N. 74 inclusion in
Petry, K. 13, 145 school communities, role of in facilitating
Pickles, A. 22 social inclusion 117–28; bioecological
Pierce and Schreibman (1997) 26 systems theory 119–21; case studies
Pivotal Response Treatment (PRT) 26 125–6; component correlation matrix
post-school social inclusion for adults with 124; externalising behaviours 119;
Autism in Australia 100–10; community microsystem 120, 127; Salamanca
participation and interpersonal Statement 117; social inclusion
relationships 107–11; National construct 123; study 122–8; teacher
Disability Insurance Scheme 110; past attitudes 121–2
and present efforts to improve social school settings see typically developing
inclusion 105–6; quality of life 102–3; peers, use of in school settings (support
social capital 101–2; social inclusion for social inclusion)
103–5; Social Role Valorization 104; school shooters 37
timeline of efforts to strengthen human Schultz, T. R. 148
rights for people with disability 106; Schwartzman, B. 24
transportation access 107–8; valued Segall, M. J. 12
social roles 104; weak ties 108 self-determination, definition of 146
primary school years, social inclusion self-identity 49–50
in 71–81; bullying 77–8; Children’s Shaked, M. 158
Friendship Training 80; friendships Shakespeare, T. 47
73–5; international educational policy Shannon, C, D. 118
72; interventions 78–81; opportunity Shores, R. E. 136
for socialisation 71; outcomes Sideridis, G. D. 16
associated with social exclusion 76–7; Simonoff, E. 22
parent-assisted interventions 80–1; Simplican, S. C. 103
peer-mediated interventions 79–80; Siperstein, G. N. 14
school-based social skills interventions Skinner, D. 46
78; social exclusion 75–6 Skirrow, P. 49
priming 24 Skuse, D. 86, 87, 88, 94
184 Index
Smith, E. F. 87 92–3; experience of transition from

social capital 101–2 students, parent and teacher perspectives
social exclusion 75–6; outcomes associated 91–7; identity, Autism and 96; literature
with 76–7 review 85–8; new friendships and the
social inclusion and Autism Spectrum peer group 94; primary to secondary
Disorder 9–17; Autism Spectrum Disorder school transition 86–7; recommendations
10–11; enactment of social inclusion 97; relationships 94; satisfaction with
in the school context 14; equity of school across the transition 89–90;
representation 17; inclusion in education satisfaction with school and social
11–12; social inclusion 13–14; social skills inclusion 88–9; special educational needs
15–17; student as influencer 14–15 85; study 89; support 93–4; transition
social inclusion for students with Autism planning and management 91–2
Spectrum Disorder 21–8; evidence-based Turcotte, A. 26
interventions 23–7; importance of social typically developing (TD) peers, use of
interventions for students with ASD in school settings (support for social
22–3; least restrictive environment 21; inclusion) 131–8; future directions 138;
paraeducator support 26; peer-mediated impact of being a peer model 136; peer
interventions 26; Pivotal Response burden and burnout 137; peer-mediated
Treatment 26; priming 24; social approaches 132–4; peer-mediated
impairments in students with ASD 21–2 intervention outcomes 134; peer models
Social Role Valorization 104 131–2; peer relationships 131, 135; school
social vulnerability see bullying and social supports 137; selection of peer models
vulnerability of students with Autism 134–6; social demands, changing 135
Spectrum Disorder
Solomon, A. 10 UN Convention on the Rights of the
Spears, R. 47 Child 144
special educational needs (SEN) 12; family UN Convention on the Rights of Persons
and 145; international educational with Disability (CPRD) 101, 106
policy on 72; perception of the pupil Underwood, D. M. 86
with 145; transition management and Upadhyaya, S. 162
92; young people with, challenges of
transition for 85 valued social roles 104
Sprague, J. 168, 170 van de Meer, L. 163
Stackhaus, J. 25 van Houten, E. 13
Staunton, S. 86, 87, 88, 94 Venkateswaran, S. 162
Stephenson, J. 74 Volkmar, F. 12
Stichter, J. P. 136, 148
Strain, P. S. 60 Wakefield, Andrew 11
Strang, J. F. 22 Walden Early Childhood Programs 64–5
Strauss, A. L. 125 Wallace, G. L. 22
Strnadová, I. 146 Walton, K. M. 147
Survey of Disability, Ageing and Carers Wang, C, K, J. 118
(SDAC) 11 Watkins, N. 25
weak ties 108
Tait, K. 158 Wehby, J. H. 136
Tansey, T. N. 118 Weir, K. 146, 147
Terras, M. M. 85 Weiss, J. A. 80
tertiary education 108 Whalon, K. J. 15
Tobin, H. 87 White, S. W. 12
Topping, K. J. 87, 88, 89 Wills, M. C. 22
Trainor, S. 35 Winefield, T. 35
transition from primary to secondary school Wolfensberger, W. 104
for students with Autism Spectrum
Conditions 84–98; attitude towards school Zercher, C. 60
95–6; bullying 94–5; communication Ziviani, J. 73

Supporting Social Inclusion For Students With Autism Spectrum Disorders Insights From Research and Practice

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Supporting Social Inclusion For Students With Autism Spectrum Disorders Insights From Research and Practice

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SUPPORTING SOCIAL INCLUSION FOR

STUDENTS WITH AUTISM SPECTRUM

Drawing together contributions from experts at the forefront of research in the

Edited by Cathy Little

ISBN: 978-1-138-18996-6 (hbk)

List of figures vii

1 Social inclusion and Autism Spectrum Disorder 9

2 Social inclusion for students with Autism Spectrum Disorder 21

3 Bullying and social vulnerability of students with

4 Identity formation in individuals with Asperger Syndrome 45

5 Social inclusion in the early years 57

6 Social inclusion in the primary school years 71

7 The transition from primary to secondary school for students

8 Post-school social inclusion for adults with Autism in Australia 100

9 The role of school communities in facilitating social inclusion 117

10 Using typically developing peers as support for social inclusion

11 The role of families in supporting social inclusion 144

12 Influence of culture on social inclusion of children

13 Social inclusion: A personal reflection 168

7.1 A graph indicating the differences between groups

3.1 Steps for reducing bullying victimization in students with ASD 39

Michelle L. Bonati is an Associate Lecturer in Special and Inclusive Education in

Glen Dunlap, PhD, is a faculty member at the University of South Florida

Sarah Feuerbacher, PhD, LCSW-S earned a Bachelor of Arts in Social Work,

Parent Mediator/Facilitator. Dr. Feuerbacher is currently employed by Southern

Colleen Harker, MS, is a Clinical Psychology doctoral student at the University of

Judith Hebron is an early career Research Fellow at the University of Manchester

education, challenging behavior, positive behavior support, social emotional

Cathy Little, PhD, is a lecturer at the University of Sydney, lecturing in the

Stephen Shore, diagnosed with “atypical development and strong autistic

Phillip Strain, PhD is Professor of Early Childhood Special Education at the

Iva Strnadová is an Associate Professor in Special Education at the University

Kanokporn Vibulpatanavong is currently a lecturer in Special Education at

UNICEF Thailand Country Office, working on educational projects in the six

students with Autism Spectrum Disorder needs also to be measured in terms of

The social journey of the transition to secondary school is fraught with

complexities to promoting social inclusion of children with Autism within that

Autism Spectrum Disorder

Inclusive practice can occur in any number of settings: leisure activities,

Within the literature, ‘social inclusion’ is described either as a counter term to

Enactment of social inclusion in the school context

Social impairments in students with ASD

Importance of social interventions for students with ASD

a paucity of research aimed at targeting socialization for adolescents and young

ASD and bullying, depression, and aggression

CASE STUDY: ERIK

Although individuals with disabilities are at an increased risk of bullying, there

The pain caused by bullying and victimization is experienced markedly different

Bullying through the lifespan

the situation worse, individuals with ASD are more vulnerable to ­bullying due to

CASE STUDY: JASON

CASE STUDY: ROBERT

Robert presented to counseling with symptoms of depression and a self-­

Depression and aggression

Helpful and harmful responses

• Find a safe, non-judgmental space to talk.

Step 1. Plan and develop a Cooperative work between teachers and

Step 4. Teach controlled Provide opportunities to practice skills in a less

Step 5. Implement a monitoring Plan how to monitor the program

Prevention program: A case study

Social inclusion of participants

CASE STUDY: AMELIA

CASE STUDY: NATHAN

List of figures vii

1 Social inclusion and Autism Spectrum Disorder 9

2 Social inclusion for students with Autism Spectrum Disorder 21

4 Identity formation in individuals with Asperger Syndrome 45

5 Social inclusion in the early years 57

6 Social inclusion in the primary school years 71

8 Post-school social inclusion for adults with Autism in Australia 100

9 The role of school communities in facilitating social inclusion 117

11 The role of families in supporting social inclusion 144

13 Social inclusion: A personal reflection 168

7.1 A graph indicating the differences between groups

3.1 Steps for reducing bullying victimization in students with ASD 39

the situation worse, individuals with ASD are more vulnerable to bullying due to

Robert presented to counseling with symptoms of depression and a self-

In inclusive early childhood settings, children with disabilities have e xperienced

where students with a disability should be educated, there is an expectation