If you read this blog, you might notice that I have devoted a lot of time to the question of inclusion and specialization in the school system.  Why am I so obsessed with schools and school placement?

Well, I admit I hadn’t really thought about that question for the longest time – I just knew, from my own experiences and my observations of a couple of specialized schools in the community, that school placement can make a real difference in people’s lives.  But then I heard a talk by Peter Mundy, and he made the excellent point that school dominates autistic kids’ lives.  A lot of autism interventions just involve attending occasional sessions of some program, and that program will often end after a few months.  That severely limits the impact of that intervention program.  However, because kids are in school so often, changing the school environment is an intervention that can have a much larger influence.[1]

How do we do that?  Well, we could try implementing interventions at the school level.  I certainly don’t have any objection to such programs.  But even here, there are limits, because schools are usually trying to implement a whole bunch of programs at once.  You have your autism program, whatever it is (a peer-mediated intervention, maybe?), but maybe the school’s already working on an anti-bullying program, an anti-drug program, a reading program, and so on.  Even if we can dramatically improve teachers’ autism knowledge and even if we can successfully implement the program (which is great, don’t get me wrong), we still face the fact that the school environment is going to be fundamentally the same in many ways: we have the same physical structure, the same sensory demands, the same peer group, the same routines, etc.

We can be much more ambitious.  Instead of just sending kids to an intervention program for a few hours a week, and instead of just working to improve our existing school environment, we can offer individuals and families meaningful choices about the type of school they will be attending.  A mainstream school?  A specialized program for autistic kids?  Homeschooling?  Maybe there are other ideas we can try too, like mainstream schools where each class nevertheless include a mixture of kids of many different ages and grade levels.

I firmly believe that meaningful choice in school placement could have a huge impact – perhaps an impact on the same scale as early intervention!  Autistic students’ mental health challenges are often responses to negative experiences in their lived environments (Wood & Gadow, 2010), so ensuring that autistic students are in the right environment can protect against anxiety and depression.  Furthermore, in a more accepting peer group, we’ll have more opportunities to practice our social skills.  Thus, when we exit the school system and enter adulthood, we’ll be doing so with better skills, more confidence, and better mental health.

I suspect that many of autistic people’s failures in the adult transition are directly caused by horrible mental health, which is in turn likely the fault of a poor match between the individual and their school.

My hope in writing this post is that researchers will see the importance of autistic children’s school environments and begin to devote much, much more attention to this topic.  If I’m right about the enormous influence the school environment exerts on outcomes, we urgently need to have proof, so that we can advocate for reforms to the current system.  Although many children with disabilities now have access to specialized schools in the United Kingdom, it remains almost impossible for North American families to exercise meaningful choices about the educational environments of their autistic children.

We do have some data that point to advantages of specialized schools.  I’ve mentioned some studies in previous posts and I’m planning to mention more in the future.  However, these studies are limited in both number and methodology.  I think there is a great deal of room for more investigations, with the addition of additional outcome variables to strengthen our case.

Furthermore, the existing studies don’t really do much to control for the fact that children in specialized and mainstream settings are almost certainly going to differ from one another to start with.  However, could we not at least adopt a matched control approach in some studies?  It might even be possible to use a waitlist-control methodology to compare the outcomes achieved by students in specialized programs and the outcomes achieved by students who want to be in specialized programs but who are stuck in the mainstream.  Many specialized schools will surely be reluctant to use random assignment to allocate students to their program or to their waitlist, but perhaps there are schools somewhere where circumstances would permit such an approach.[2]  As a very junior graduate student, a matched-control or waitlist-control study of specialized schools is beyond my resources, but I’m releasing the idea into the ether in the hopes that someone with more seniority might pick it up.

 

What are your thoughts on this?  Comment below!

Footnotes

[1] Let’s imagine an intervention program that has weekly 2-hour sessions for a total of 12 weeks.  That’s a total of 24 hours of intervention.  However, when we consider all school operating hours rather than just instructional hours, American students spend about 1195 hours/year in school (National Center for Educational Statistics).  That’s a lot more hours!

[2] If not, I think the importance of this question would justify setting up such a school just so that we could study it.  After all, the United States spent $170 million on autism research in the areas of biology and risk factors in 2015 (Office of Autism Research Coordination, 2017).  However, I’m dumping this in a footnote because I recognize that it’s unlikely to happen in the present research climate.

References

Office of Autism Research Coordination, National Institute of Mental Health, on behalf of the Interagency Autism Coordinating Committee (IACC). (2017, October). 2014-2015 IACC autism spectrum disorder research portfolio analysis report. Retrieved from https://iacc.hhs.gov/portfolio-analysis/2015/index.shtml

Wood, J. J., & Gadow, K. D. (2010). Exploring the nature and function of anxiety in youth with autism spectrum disorders. Clinical Psychology: Science and Practice, 17(4), 281–292. https://doi.org/10.1111/j.1468-2850.2010.01220.x