Disclaimer: This essay formed part of my work towards a Masters in Autism (note: 22-25) – due to that there was strict assessment criteria that had to be met. Please do not consider this assignment ‘research’ and please bear in mind I am not an academic. I appreciate the style of this writing may not be accessible to all; I intend to create a summary version when time allows.
‘Return to School’
(Lancashire County Council [LCC], n.d., p.7, para.7):
A Critical Analysis of Reintegration to Mainstream School for Autistic Children & Young People Experiencing Barriers to Attendance
By Jess Garner
POSITIONALITY:
I’m a late-identified autistic female and a former mainstream secondary teacher.
I don’t believe autism to be wrong, a deficit or something we ‘have’ that could be removed. Instead it’s our “way of being” (Sinclair, 1993, para. 8; Garner, 2023) therefore in line with a high percentage of autistic adults I choose identity-first language (Kenny et al., 2016). My preferred term for the non-autistic population is “predominant neurotype” [PNT] (Beardon, 2019, p.2).
I’m white, British, don’t have an intellectual or physical disability, am cis gender and fluent in speech. I recognise as such I have certain privileges accorded to me due to the position I hold in society.
My children are home educated having experienced ‘barriers to school attendance’ [BTSA] – our family has suffered emotional, financial, relational difficulty as a result of school failure. I accept my bias due to these experiences.
All these details are significant to my positionality and thus inevitably shape my source selection, reading and interpretation.
INTRODUCTION
The purpose of this paper is to provide a critical analysis of the aim and methods of reintegration to mainstream schools for autistic children and young people [ACYP] experiencing BTSA. I intend to explore how school non-attendance may be interpreted as ‘challenging behaviour’ [CB] by examining the historic context of this descriptor and connecting this to BTSA establishing how this compels within-person intervention compounded by the medical model of disability [MM] (Smart, 2009), the “pathology paradigm” [PP] (Walker, 2021, p.125) behaviourism and epistemic injustice [EI] (Fricker, 2007). I will explore how these foundations influence the aims and methods for reintegration, considering the ethical principle of nonmaleficence [EPN] (the avoidance of unnecessary harm) (Hall, 2010) chosen because teaching should be a profession with ethical grounding (Biesta, 2022) and one in which safeguarding from harm is paramount (Department for Education [DfE], 2022; DfE, 2023; DfE, 2023b).
SCHOOL ATTENDANCE
School attendance has received focus from the Government due to a decline in overall attendance following the COVID-19 pandemic (Gov. UK, 2022). However, there is evidence preceding the pandemic demonstrating historic BTSA for ACYP (Munkhaugen, 2017; O’Hagan, 2022). Additionally, there are alarming reports of unmet needs (National Autistic Society, 2021) and directly attributed to school: mental health difficulties (Hamilton, 2024), social isolation, loneliness, anxiety (Goodhall, 2018), bullying (Maïano et al., 2015), punishment, restraint, seclusion (ICars, 2023), and tragically suicidal ideation, attempts (Williams, 2021) and death by suicide (Atkinson, 2023). This is despite law, statutory and non-statutory guidance (Morgan et al., 2023) designed to ensure every child’s right to non-discriminatory education (The United Nations Convention on the Rights of the Child [ROTH], 1989; Education Act, 1996) that is in their best interests and supports development to their fullest potential (ROTH, 1989; Universal Declaration of Human Rights, 1948; United Nations Convention on the Rights of Persons with Disabilities, 2006; Equalities Act, 2010) with reasonable adjustments made to avoid unlawful discrimination and disadvantaged (Equality Act, 2010; SEND Code of Practice [SCoP], 2015; Special Educational Needs and Disability Regulations, 2014; Children and Families Act, 2014) and crucially where children and young people [CYP] are safeguarded from harm (Haves, 2023) including in school (DfE, 2022; DfE, 2023; DfE, 2023) though adherence to the EPN. Many suggest that there is little wrong with this framework however wrongful implementation (Rosenberg, 2023) and misunderstanding become embedded in policy (Charles, 2023) even with unlawful practice (Rosenberg, 2023). An example of such is the tension between ‘rights’ and ‘needs’ as problems arise where there are barriers to accessing aforementioned rights where needs are not identified or believed (Wood, 2019) perhaps largely due to the MM, PP and EI.
AUTISM: PP, MM & EI
At the core of the PP is an assumption there exists an ideal, normal neurocognitive style of being with divergence from this being innately wrong (Chapman, 2021; Walker, 2021). However, there’s no scientific basis for this (Annamma et al., 2013) instead it’s a socially constructed, prejudicial illusion serving to privilege the PNT neuromajority’s (Walker, 2021) expectations, communication, behaviour and cognition as superior (Catala et al,. 2021; Meadow, 2021; McClaren, 2014; Milton, 2014) and thus marginalise neurominorities (Walker, 2021) through notions of abnormality and disorder (Walker, 2021).
Societal views of autistic experience are firmly rooted in the MM – a view that positions disability as a within-person problem and conceptualises ‘disorder’ upheld by the PP (Smart, 2009; Milton & Moon, 2012). Observable behaviour and communication deviating from PNT norms (McClaren, 2014) form the basis of medical ‘diagnosis’ of autism as a neurodevelopmental disorder (APA, 2013; Milton & Moon, 2012; Smart, 2009) with persistent ‘symptoms’ in reciprocal social communication and interaction as well as restricted, repetitive patterns of behaviour, interests or activities (APA, 2013). However, the PP and MM judgements of human value have led to inequality (Catala et al,. 2021; Walker, 2021; Meadows, 2021; McClaren, 2014) and invalidation of autistic experience and identity (McClaren, 2014; Walker, 2021; Bertilsdotter Rosqvist et al., 2020). Yet the scientific-medical community both creates and upholds their epistemic credibility as autism experts through the MM and PP (Smart, 2009; Milton, 2014b; Holton et al., 2014; McClaren, 2014; Bertilsdotter Rosqvist et al., 2023; Legault et al., 2021; Botha, 2021) positioning their notions of remediation and cure through treatment and intervention aiming to fix faulty cognition and behaviour as morally necessary (DeThorne & Searsmith, 2020). As will be discussed, much of this forms the foundation of aims and methods for reintegration if ACPY experience BTSA.
When considering epistemic authority is it important to also examine the reverse – EI. Fricker (2007) considers EI as violation toward people in their capacity as ‘knowers’ arising from social power inequalities with those in power able to wield control over others on the basis of how social identity is conceptualised. Hermeneutical marginalisation (Fricker, 2007; Legault et al., 2021) occurs from “identity-prejudicial credibility deficit” (Fricker, 2007, p. 4) and for autists this is because of MM/PP prejudicial, dehumanising stereotypes (Minio-Paluello et al., 2009; McClaren, 2014; Yergeau, 2018) emerging from problematic theories such as deficits in Theory of Mind [ToM] (Baron-Cohen et al., 1985; Chapman & Botha, 2023) becoming popularised as fact and rendering autists unreliable knowers (Yergeau, 2018). Thus autistic people suffer hermeneutical injustice [HI], an injustice arising from limitations in access to knowledge that would aid self-understanding, because society’s hermeneutical resource as well as resultant policy and practice lacks autistic perspective (Bratu & Haenel, 2021; Fricker, 2007) favouring instead the MM, PP and PNT neuronormativity (Legault et al., 2021; Garner, 2023).
This prejudicial perspective of autistic experience (Holton et al., 2014; McClaren, 2014) permeates education guidance from Local Authorities [LAs] (West Sussex, 2022) for instance West Sussex guidance for BTSA includes MM framing of ACYP’s increased experience of anxiety because of “poor stress management… interpersonal difficulties… limited ToM” (p. 38, para.1-2) going on to Cognitive Behavioural Therapy [CBT] and gradual exposure as some of the preferred interventions – problems are firmly rooted in the MM, PP and thus ACYP. This theme continues with other LAs’ noting that limited social skills and inability to make friends (Staffordshire County Council, 2022) and inflexibility in thought (Manchester City Council, 2021) can be directly attributed to ACYP’s BTSA (Lancashire County Council, n.d.) resulting in avoidance of “challenging situations and seeking for ‘safety’ at home” (Manchester City Council, 2021, p.32, para.3). Small glimmers encouraging removal of systemic barriers (Birmingham City Council, 2020) are marred by numerous MM references positioning autism and ACYP as the cause of BTSA and framing this as CB.
CHALLENGING BEHAVIOUR & COMMUNICATION
BEHAVIOUR & COMMUNICATION
The DSM-V (APA, 2013) states autistic people have deficits in “communicative behaviors” (p.50). In simple terms some view behaviour as “how someone acts” concerned only with observable actions (NSW, n.d.) and this is echoed in the behavioural basis of the diagnostic criteria. However, Bergner (2010) laments that there seems no “consensus in the matter of what the concept of “behavior” means” (p.4, para.1) and calls for behaviour to be recognised as a highly complex phenomenon.
Relatedly, Watzlawick et al (1967) developed the Theory of Human Communication, proposing that all behaviour is communication whereby information is transmitted both through content (what is said) and relationally (how e.g. tone, facial expression) but that different personal experience will lead to various interpretations of content as relational aspects are decoded (ref 3). Wiener et al (1972) expanded this by asking whether behaviour as an “unconscious encoding of experience” (p.189, para.2) is a reliable notion if there isn’t a shared and known system of meaning to relational, non-verbal components. Thus distinguishing between non-verbal communication and non-verbal behaviour, the latter being unintentional but often still decoded as communication by observers and subject therefore to their worldview influencing interpretation (Wiener et al, 1972).
Upheld by the MM/PP, autists regularly experience misunderstanding when the PNT decodes autistic communication and behaviour and this has been reported as leading to rejection, social isolation and dominance of non-autistic styles of communication (Catala et al., 2021). Additionally, “expressive hermeneutical injustice” (Catala et al., 2021, p.9017, para.4) occurs when a speaker is misconstrued because of relational components (Watzlawick et al., 1967) for instance due to “(neuro)atypical verbal or non-verbal expressive styles” (Catala et al., 2021, p.9021, para.1). Coupled with aforementioned identity prejudice, expressive HI can lead to testimonial injustice [TI] whereby the hearer’s prejudice results in deflated levels of credibility afforded to a speaker’s testimony (Fricker, 2007). When autists are seen through the MM, responsibility for breakdowns in communication is placed firmly with the autistic individual (Milton, 2012). Milton (2012) positively reframed difficulties in communication with the Double Empathy Problem (DEP) suggesting that this breakdown is bi-directional and also challenging the assumption there exists a defined set of social norms (in line with Wiener et al (1972)). Watzlawick et al (1967) also stated “communicational interchanges are either symmetrical or complementary, depending on whether they are based on equality or difference” (Watzlawick et al, 1967, p. 70). Considering autistic minority status (Walker, 2021), MM framing and childism (McGreevy et al., 2024) ACYP are subject to communicative “dominance/submission” (Lutterer, 2007, p.3, para.2) significant when considering BTSA particularly when ACYP’s knowledge is ignored (McGreevy et al., 2024) and instead their behaviour rather than communication is decoded as ‘challenging’.
CB
The origin of ‘CB’ was The Association for Persons with Severe Handicap [TASH] and was intended initially to communicate challenges to services, carers and professionals to understand needs and provide support (thus aligned with social models of disability [SM]) rather than MM aligned within-person ‘challenge’ (The Royal College of Psychiatrists [RCoP], 2007). However, it’s evident that meaning derived from the term is actually far more fluid and contextual (RCoP, 2016; Bottema-Beutel et al., 2024) and in schools is predominantly MM rooted (Tolley, n.d.).
Two influential definitions of CB are that of Emerson et al., (1987) and RCoP (2007). Emerson et al., (1987) state that CB must be “of such intensity, frequency or duration that the physical safety of the person or others is placed in serious jeopardy, or behaviour which is likely to seriously limit or delay access to and use of ordinary community facilities” (p.8.) with patterns of behaviour being ongoing and being considered culturally abnormal (Clifford Simplican, 2009). Building upon Emerson’s work, RCoP (2007) state a definition should encapsulate behaviour with threat to “quality of life and/or the physical safety of the individual or others and… likely to lead to responses that are restrictive, aversive or result in exclusion” (p. 10, para.2). Further, CB is “… dangerous, frightening, distressing or annoying and that these feelings invoked in others are in some way intolerable or overwhelming” (RCoP, p.12, para.2). RCoP’S document is aimed to guide and influence professional practice and policy and although predominantly concerned with adults with “moderate to severe learning disabilities” (2007, p.12) it’s also stated “there are fundamental principles, values and guidance that are applicable across all groups who present behaviours that are challenging” (p.12, para.5) and indeed that they “also apply to understanding the behaviour of people with autism” (p.32, para.5) and “of relevance to professionals who work with children” (p.56, para.2). Despite all this, RCoP notes that, ‘‘“Challenging behaviour’ is a socially determined construct” (2016, p.4) therefore confirming communication, interaction and sense making of and between people that brings this concept into being rather than CB itself being objective reality (Bainbridge, 2014) echoing sentiments by Milton (2012) and Wiener et al (1972).
In summary, despite TASH’s intentions CB has become predominantly used to express within-person challenge (Heyman et al., 1998) and thus arguably compel intervention (RCoP, 2007; Clifford Simplican, 2019). Importantly however, RCoP (2007) also advocates for strong ethical standards and values (RCoP, 2007) referencing a summary of ethical considerations including nonmaleficence (RCoP, 2014). I feel these two aspects are distinctly in opposition when considering autistic people.
CB & AUTISM
Autists are routinely subjected to scrutiny (Pluquailec, 2018) and normative intervention (Milton, 2014) due to various interchangeable behaviours decoded by the PNT as “challenging… inappropriate… maladaptive and negative” (Bottema-Beutel et al., 2024, p.6, para.7). Bottema-Beutel et al, (2024) highlight that secondary impact from behaviour that attracts these labels has been shown in research to correlate and therefore not necessarily cause perceived negative impact. Of course also determining what is ‘problematic’ when behaviour is interpreted with a MM, PP, neuro-normative gaze may lead to prejudicial judgement of natural, benign, autistic behaviour and communication (AMASE, 2021) and thus interventions touted as effective are founded upon problematic MM/PP constructs steeped in ableism (Bottema-Beutel et al., 2021; Bottema-Beutel et al., 2024). An example may be the suppression of stimming judged as non-functional when many autists express value for regulation and joy (Knapp et al, 2019). Another, misinterpreting avoidance of a busy school canteen as maladaptive social anxiety (West Sussex, 2022) when it’s actually adaptive avoidance of sensory distress.
Considering BTSA it’s significant to note that noncompliance and avoidance (often related perceived or actual anxiety) are cited as CB in ACYP (Machalicek et al., 2007; Bottema-Beutel et al, 2024). Relatedly, Kaiser and Rasminsky (2021) found teachers ascribed the term to anything they found personally challenging or interfering highlighting further the contextual and subjective nature of interpretations of behaviour (Pluquailec, 2018; Stanforth & Rose, 2020; Bottema-Beutel et al., 2024). However, the power of the social identity of schools as reliable institutions of knowledge (Romdenh-Romluc, 2017) has the potential to shape ACYP’s experience through these pejorative language choices framing experience as CB (Bearss et al., 2015; Bottema-Beutel et al., 2021; Dawson & Fletcher-Watson, 2022).
CB & SCHOOL
Echoing fluidity in defining CB, language and notions of school non-attendance have also changed over time: ‘truancy’ (Brownstein, 2009), ‘phobia’, ‘refusal’ (Bodycote, 2022) and more recently ‘emotionally based school avoidance’ [EBSA] (West Sussex County Council, 2022). Bodycote (2022) notes these shifts between pathologising emotional or psychological experiences, framing CYP as delinquent or victims of parental failure coupled with the “process of habituation and institutionalisation” (Berger & Luckmann, 1966, as cited in Bodycote, 2022, p.5, para.4) established school attendance as social expectation. For many it is hard to imagine education without schooling (Fisher, 2021), indeed Ofsted’s Speilman asserts that “nothing beats being in a classroom, in front of a teacher” (Gov. UK, 2021, para.21) and thus we begin to see how school non-attendance may be conceptualised as CB in that it’s considered culturally abnormal (Clifford Simplican, 2009) and threatening “quality of life” (RCoP, 2007, p.10, para.2). Aforementioned legal rights have been used to justify pushing for 100% attendance (Children’s Commissioner, 2023) as we are told that school reduces inequality, improves physical and mental health outcomes, allows for transformational socialisation, development, optimised career opportunities (DfH&SC, 2020; DfE, 2022) and is of great importance to well-being and safety (DfE, 2022b) and schools are encouraged to communicate regular, positive and persuasive messages to parents selling the value of school and encouraging alignment: “School is an enriching environment that can help your child with their social and mental wellbeing” (DfE, 2023c, ‘Example Messages’) and attendance is part of “good behaviour” (Bennett, 2017, p.49, section 4.2.8). Non-attendance is equated directly to harm (Kearney, 2022) and therefore CYP experiencing BTSA must “return to school” through early intervention with the aim of reintegration (Lancashire County Council, n.d., p.7, para.7).
INTERVENTION: REINTEGRATION
Having established some of the reasons why reintegration is considered by some to be best for ACYP, in order to understand the methods used one must first examine an additional foundation from which this arises – beginning with behaviourism.
BEHAVIOURISM
Viewing behaviour as ‘communication’ (as discussed) is commonly used both for and against theories and practice of ‘behaviourism’ (Clifford Simplican, 2019; Tolley, n.d.). Behaviourism has been seminal in autism history whereby autistic experience has been observed and measured then changed and controlled through interventions such Lolvaas’ Applied Behaviour Analysis [ABA] (Pantazakos, 2019) and then social cognition and social skills interventions (Bottema-Beutel et al., 2018) all of which aim to reduce autistic behaviour and communication to be more comparable to that of the PNT and are founded upon aforementioned MM/PP notions of inferiority (Bottema-Beutel et al., 2021). Behaviourism is also a core approach in schools (Tolley, n.d.) and features in much of the BTSA guidance.
Watson is often referred to as the founder of behaviourism (Malone, 2014) whose work was most significantly expanded upon by Skinner (McLeod, 2024). Watson stated that “Psychology as the behaviorist views it is a purely objective experimental branch of natural science. Its theoretical goal is the prediction and control of behavior” (1913, para.1). Observable, quantifiable behaviour (Sam, 2013) is considered environmentally learned and irrespective of complexity, can be simplified as response to stimulus and thus – echoing the MM – can be conditioned (McLeod, 2024). Problematic also is the behaviourist claim of scientific objectivity (Watson, 1913) implying research outcomes are beyond researcher bias, values or personal experiences but this claim has been harmful in autism history (Botha, 2021b) with assumptions of accurate, untainted knowledge production (Soo Park et al., 2020) widely accepted by society due to the scientific-medical community’s epistemic authority (Botha, 2021b; Murray, 2023). I believe human experience, bias and values are inextricably linked to research and epistemological objectivity in autism research is unachievable and in fact systemic power imbalance is rife but unchallenged (Botha, 2021; Clark et al., 2021). Despite this, sadly much of society still favours MM/PP framing and disbelieves autistic testimony (Murray, 2023) and therefore behaviourist beliefs and methods with desires to change autistic people remain (Milton, 2014). I empathise with Melnyczuk’s (2019) concerns regarding behaviourists attempting to change other’s behaviour based on their subjective, normative assumptions and MM/PP beliefs of faulty communication and behaviour – including that deemed CB (Clifford Simplican, 2019; Pantazakos, 2019) and from these foundations arise some of the methods for BTSA reintegration.
Often the first step in this is ‘functional analysis’ [FA] which originated with Skinner who was interested in the causes of behaviour (Killeen, 2001). A reductionist view is taken and behaviour is broken down and analysed in small, component parts (McLeod, 2024). FA is recommended by many LAs derived from work by Kearney and Silverman (1990) (who were influenced by Skinner) with functions of school non-attendance conceptualised as: 1. avoiding fear or anxiety, 2. avoiding social situations, 3. gaining attention or reducing separation anxiety, 4. gaining tangible reinforcement (Thambirajah, 2008). Avoidance is considered a choice (akin to the behaviourist’s ‘response’ to stimulus) and the resultant advice is to resume school attendance quickly to avoid reinforcing (thus ‘conditioning’) this behaviour and it becoming entrenched (Knollmann et al., 2010; Finning et al., 2018). Tolley (n.d.) notes that the reductive nature of the FA is problematic for a number of reasons in that it does not account for complexity of human nature, for trauma nor for authentic sensory experience minus a neuronormative gaze. Behaviourism largely ignores inner experience (Kohn, 2018) and thus Delahooke (2019) suggests people are failed and blamed by analysing and targeting outward behaviour. I believe coupling this with MM beliefs of autistic faulty cognition and behaviour (Botha 2021) further reinforces within-person reintegration methods.
However, for those who reject behaviourism there is a desire to understand the complexity of inner experience considering such things as the sympathetic nervous system, sensory experience and also developmental stage and how these may lead to behaviour that cannot be considered choice (Tolley, n.d.) and instead non-attendance is viewed as “can’t, not won’t” (Fricker, 2023, title). There is acknowledgement of the very real trauma ACYP experience when forced into intolerable environments in school (NHS, n.d.) due to such aspects as sensory, social and academic overload, negativity from staff, lack of flexibility (Gray et al, 2023). With this comes a focus instead on changing environmental factors to accommodate and support (Fricker, 2023) concurrent with Beardon’s (2019) concept “autism + environment = outcome” (p. 11). Sadly, this is lacking in LA BTSA guidance and there is evidence arising from MM beliefs of “preemptive TI or testimonial quieting at a structural/institutional level” as professional guidelines do not include autistic perspective nor encouragement of garnering this (Catala et al, 2021, p. 9017, para.4) and so the true extent of these traumatic experiences is largely missing from the hermeneutical resource and instead methods are used to pursue reintegration despite the harm that may cause. Reconsidering narratives around school and school attendance these aims and methods are bolstered by many believing that harm is actually done by non-attendance (Bodycote, 2022) and not developing resilience to cope with challenge (Nuttall & Woods, 2013) or missing social experiences that may help ACYP overcome their social and communicative deficits (Lancashire n.d.). But Lees (2014) states that “schooling can cause physical, psychological, and emotional pain” (p.144) – something very clearly not acceptable as CYP should be safeguarded from harm including in school (DfE, 2022; DfE, 2023; DfE, 2023). Importantly therefore, what is considered to be harmful seems inextricably linked with personal and ethical beliefs with action then taken by those in positions of power to define this (Fives, 2016). ACYP (and indeed their parents) suffer EI as they are subject to the dominant MM and PP hermeneutical resource and systemic issues remain unaddressed (Saltz, 2022)..
METHODS
Informed by this distorted hermeneutical resource whereby schools are considered benign places with BTSA arising instead from being autistic (Lancashire County Council, n.d.) LAs largely position ACYP’s anxiety and avoidance as irrational (West Sussex, 2022) and CBT and behavioural intervention methods such as exposure-based desensitisation designed to achieve habituation are recommended (Thambirajah et al, 2008; Nutall, 2013; Knollmann et al., 2010; Finning et al., 2018). With autism “frequently used to challenge or dismiss epistemic agency” (Hamilton, 2024, p6, para.4) when ACYP communicate through words or actions a lack of safety they are regularly disbelieved and have emotion cues misread (Hallet & Kerr, 2020).
CBT is a type of therapy closely related to behaviourism (Thambirajah et al, 2008) used to treat a range of mental health difficulties focusing on how “thoughts, beliefs and attitudes affect your feelings and actions” aiming to overcome distorted, negative thought patterns and behaviours (MIND, 2024, para.1). CBT is reliant on the individual being able to identify and discuss their feelings and with differences and difficulties with interoception as well as prevalence of alexithymia for autistic people (Shar et al, 2026) this process may be unrealistic even if ethically sound. But, considering EPN ethically sound it may not be – CBT has been found to be unhelpful and even harmful as some consider it be gaslighting whereby the person’s thoughts and feelings are disbelieved and invalidated and instead they are told these are maladaptive – arising from behaviourism and the MM the ‘problem’ is firmly within-person (Saltz, 2022). Moyse (2021) found that ACYP experiencing BTSA were rejecting a harmful environment in a bid for self-protection and that they just wanted someone to listen to and believe them but that this didn’t happen. Connectedly, ACYP have been reported to state CBT doesn’t work for school anxiety/avoidance but TI again meant this perspective was dismissed because therapists in positions of power disagreed (Sharma et al., 2021). Echoing this, Maynard et al (2018) noted in their study that attendance increases following CBT didn’t necessarily match with decreasing anxiety. Some studies failed to even ask ACYP their thoughts on CBT with others stating that the reason ACYP report no change to their anxiety is because they lack ToM not because CBT hasn’t worked, researchers instead believing their behavioural measures were objective and reliable (Bergþórsdóttir, 2023). Pluquailec (2018) suggests that if it’s accepted that behaviour is an external manifestation of internal states then targeting behaviour communicates that the internal experience is unacceptable and the person is thus further pathologised for having the ‘wrong’ thoughts, feelings and experiences – this HI disadvantages and harms Autistic children in their ability to understanding and expressing their personal and social experience (Legault et al., 2021) – of school, sensory and social experiences and of BTSA.
As mentioned, another approach used is exposure-based desensitisation aiming for habituation (Thambirajah et al, 2008) encouraging the individual to face fears and discomfort with the view they become acclimatised to ‘safe’ things being misconstrued as ‘unsafe’ (Zaboski, 2022). Zaboski (2022) states this does not violate the EPN however, ASAN (n.d.) considers any form of exposure therapy aimed at tolerating discomfort as unethical and advocates instead for supporting regulation, reducing painful stimuli through environmental change. Considering sensory experiences specifically there is evidence that autistic people do not habituate and that instead we “zoom in on life” (Fulton et al., 2020, p. 22) with adverse sensory experiences causing genuine terror and pain for some people and that this can have long lasting, negative effects (Fulton et al., 2020). This can deny access to “community facilities” (Emerson et al., 1987, p.8) due to being dangerous and frightening and negatively affecting “quality of life” (RCoP, 2007 p. 10, para.2). ACYP report significant difficulty as a result of school sensory environments but are not only subject to TI whereby they are disbelieved (Birkett, 2022) but worse still become subject to ableist and harmful desensitisation methods (ASAN, n.d.). Fear, anxiety and avoidance of trauma as a result of a toxic, harmful environment (Moyse, 2020) may be considered entirely rational and ACYP deserve to experience validation, unconditional acceptance of their authentic self (Heselton et al., 2022) and also learn how to care for their sensory needs, not be made to internalise feelings of wrongness (Pluquailec, 2018). In line with the social model of disability (Oliver, 1990), when schools enact this CB and do not accommodate their ACYP’s sensory needs they are actively disabling (Smart, 2009) their young people and arguably contributing to BTSA. Reclaiming TASH’s original sentiment that CB be viewed as a challenge to services, school staff must uphold their ethical responsibilities – not only EPN – but also to learn, especially from those in minority groups (Biesta, 2022).
Foulkes & Stingaris (2023) state that harm arising from school mental health interventions has been neglected in research. ASAN (n.d.) calls for close examination of interventions including listening to experiences from those who have undergone that intervention for full understanding. Understanding adverse effects that interventions can have is vital for working ethically (at the very least adhering to EPN) however voids in research and hermeneutical distortion (Lorenc & Oliver, 2014) means practitioners are often unaware of this and are instead working from harmful MM/PP perspectives with neuro-normative assumptions and goals (Hallett & Kerr, 2020; McGreevy et al., 2024). There are therefore legitimate concerns of iatrogenic harm as challenging real trauma through CBT and exposure therapy can indeed violate EPN (Joey, 2022). I am particularly concerned about the sense of thwarted belonging that may be developed through these interventions as reported by Moyse (2020) as this has been connected to suicide (Silva et al., 2023).
When the Education Secretary readily “admits SEND system isn’t working well ‘for anybody’” (Norden, 2024, title) and there is evidence that law, statutory and non-statutory guidance is not being followed (Rosenberg, 2023) can aims and methods for reintegration be considered ethical?
CONCLUSION
I believe there is systemic and ethical failure with ACYP experiencing harm and being denied an education due to school failure (Connolly et al., 2023) rooted in the MM, PP, behaviourism and EI. It is clear to me how the aim of and approaches to reintegration discussed may be seen as a violation of EPN – any intervention with the aim of school reintegration should be firmly focused on environmental change (Beardon, 2019) until which point the notion of reintegration into a toxic environment (Fisher, 2024) be unthinkable. Mandy (2022) comments that the environment is crucial in the mental health of autists with a need to shift from the MM/PP recommending instead “person-environment fit” and making adaptations that allow for the autist to “live well” (p.290, para.3). Importantly any vision of what ‘living well’ is must be constructed by not for autistic people (Chapman & Carel, 2022). There are success stories of ACYP having previously experienced BTSA in mainstream schools going on to experience success in Alternative Provision where there are more carefully managed sensory experiences, smaller classes and focus on trusting, empathic relationships where CYP are listened to and believed thus no longer suffering the harmful effects of EI (Goodhall, 2018; Gray et al, 2023) but this is not enough – CYP should not be subject to harm in the first place.
Cultivating a sense of ‘belonging’ – feeling “accepted, respected, included” (Goodenow & Grady, 1993, p.60) – is essential but only when we address the foundations of the environments we intend to include CYP in. We need ethical learning environments founded on safety and authenticity (Bertilsdotter Rosqvist et al., 2023; Stimpunks, 2024) and in order for this we need the Government, LA’s and schools to ‘neuroqueer’ (Walker, 2021) by unlearning and freeing from the shackles of neuronormativity (Stimpunks, 2024) to “lift the burden… weighing our children down” (Stimpunks, 2024, Intro’). Testimonial justice whereby prejudice is acknowledged, examined and dismantled and autistic testimony (irrespective of age) is wholeheartedly believed (Fricker, 2007) would enable knowledge about autistic experience to be created by autistic people and the neuromajority must then unquestioningly accept and use of this reformed hermeneutical resource (Legault et al., 2021; Romdenh-Romluc, 2017; Garner, 2023). Only then will we create learning environments where all CYP are “happy, curious, full of wonder & free to learn” (Stimpunks, 2024, ‘Transform and Liberate…’).
REFERENCES
AET. (2022). What is Autism? What is Autism? | Autism Education Trust
AMASE. (2021). On ‘Positive Behaviour Support’. On ‘Positive Behaviour Support’ – AMASE
Alstot, A. E., and Alstot, C. D. (2015) Behavior Management:
Examining the Functions of Behavior, Journal of Physical Education, Recreation and Dance, 86:2, 22-28, https://doi.org/10.1080/07303084.2014.988373
Annamma, S. A., Connor, D., & Ferri, B. (2013). Dis/ability critical race studies (DisCrit): theorizing at the intersections of race and dis/ability. Race, Ethnicity and Education, 16(1), 1–31. https://doi.org/10.1080/13613324.2012.730511
ASAN. (n.d.). For Whose Benefit?: Evidence, Ethics, and Effectiveness of Autism Interventions. Autistic Advocacy. https://autisticadvocacy.org/wp-content/uploads/2021/12/ACWP-Ethics-of-Intervention.pdf
Atkinson, E. Independent. (2022). Girl, 16, took own life at top boarding school after ‘hyper-fixating on first ever detention’. https://www.independent.co.uk/news/uk/home-news/caitlyn-scott-lee-wycombe-autism-b2329697.html
Bainbridge, C. (2014). What Is a Social Construct?. Very Well Mind. https://www.verywellmind.com/definition-of-social-construct-1448922
Baron-Cohen, S., Leslie, A., & Frith, U. (1985). Does the autistic child have a “theory of mind”?. Cognition, 21(1), 37-46. https://doi.org/10.1016/0010-0277(85)90022-8
Beardon, L. (2019). Autism & Asperger Syndrome in Children. Sheldon Press.
Beardon, L. (2023). Autopia: A vision for autistic acceptance and belonging. In The Routledge International Handbook of Critical Autism Studies (1st ed., Vol. 1, pp. 159–164). Routledge. https://doi.org/10.4324/9781003056577-16
Bearss K., Johnson C., Smith T., Lecavalier L., Swiezy N., Aman M., Scahill L. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: A randomized clinical trial. Jama, 313(15), 1524–1533.
Bergþórsdóttir, A. (2023). Reflections on CBT and Autistic Thinking. Third Space. https://www.thirdspace.scot/wp-content/uploads/2023/02/NAIT-Webinar-Slides-Reflections-on-CBT-and-Autistic-Thinking-03.02.23.pdf
Bennett, T. (2017). Creating a Culture: How school leaders can optimise behaviour. Gov.UK. https://assets.publishing.service.gov.uk/media/5a7506e4ed915d3c7d529cec/Tom_Bennett_Independent_Review_of_Behaviour_in_Schools.pdf
Berger, P. & Luckman, T. (1991) The Social Construction of Reality: A Treatise in the Sociology of Knowledge. London: Penguin Books Ltd.
Bergner, R. (2010). What is behavior? And so what? New Ideas in Psychology, 28, 1-9.]
Bertilsdotter Rosqvist, H., Stenning, A., & Chown, N. (2020). Introduction. In H. Bertilsdotter Rosqvist, A. Stenning, & N. Chown (Eds.), Neurodiversity Studies (pp. 1-12). Routledge.
Bertilsdotter Rosqvist, H., Milton, D., & O’dell, L. (2023). Support On Whose Terms? Competing Meanings Of Support Aimed At Autistic People. In D. Milton, & S. Ryan (Eds.), The Routledge International Handbook Of Critical Autism Studies (pp. 182-193). Routledge.
Biesta, G. (2022). “Teaching is not a moral profession” “An ethical teacher is not a good teacher”. Document > Transcript: teaching is not a moral profession (gtcs.org.uk)
Birkett, L., McGrath, L., & Tucker, I. (2022). Muting, filtering and transforming space: Autistic children’s sensory ‘tactics’ for navigating mainstream school space following transition to secondary school. Emotion, Space and Society, 42, 100872-. https://doi.org/10.1016/j.emospa.2022.100872
Birmingham City Council. (2020). #You’ve Been Missed: EMOTIONALLY BASED SCHOOL AVOIDANCE. download.cfm (forwardthinkingbirmingham.nhs.uk)
Botha, M. (2021). Academic, Activist, or Advocate? Angry, Entangled, and Emerging: A Critical Reflection on Autism Knowledge Production. Front. Psychol., 12(727542), 1-12. https://doi.org/10.3389/fpsyg.2021.727542
Bottema-Beutel, K., Park, H., & Kim, S. Y. (2018). Commentary on Social Skills Training Curricula for Individuals with ASD: Social Interaction, Authenticity, and Stigma. Journal of Autism and Developmental Disorders, 48, 953–964 . https://doi.org/10.1007/s10803-017-3400-1
Bottema-Beutel, K., Kapp, S. K., Lester, J. N., Sasson, N. J., & Hand, B. N. (2021). Avoiding Ableist Language: Suggestions for Autism Researchers. Autism in Adulthood, 3(1), 18–29. https://doi.org/10.1089/aut.2020.0014
Bottema-Beutel, K., McKinnon, R., Mohiuddin, S., LaPoint, S. C., & Kim, S. Y. (2024). Problems with “problem behavior”: A secondary systematic review of intervention research on transition-age autistic youth. Autism : The International Journal of Research and Practice, 13623613241229159-. https://doi.org/10.1177/13623613241229159
Bratu, C., & Haenel, H. (2021). Varieties of Hermeneutical Injustice: A Blueprint. Moral Philosophy and Politics, 8(2), 331–350. https://doi.org/10.1515/mopp-2020-0007
Brownstein, R. (2009). Pushed out. Teaching Tolerance. www.teachingtolerance.org.
Catala, A., Faucher, L., & Poirier, P. (2021). Autism, epistemic injustice, and epistemic disablement: a relational account of epistemic agency. Synthese, 199, 9013–9039. https://doi.org/10.1007/s11229-021-03192-7
‘Childism’. (2020). In Oxford Bibliographies. Childism – Childhood Studies – Oxford Bibliographies
Clark, T., Foster, L., Sloan, L., & Bryman, A. (2021). Bryman’s social research methods. (Sixth edition / Tom Clark, Liam Foster, Luke Sloan, Alan Bryman.). Oxford University Press.
Cleveland Clinic. (n.d.). Autonomic Nervous System. Cleveland Clinic. https://my.clevelandclinic.org/health/body/23273-autonomic-nervous-system
Clifford Simplican, S. (2019) Behaviors that challenge disability studies,
Disability & Society, 34:9-10, 1379-1398, DOI: 10.1080/09687599.2018.1552119 (check)
Challenging Behaviour Foundation [CBF]. (2022). Frequently Asked Questions: the term “challenging behaviour”. https://www.challengingbehaviour.org.uk/understanding-challenging-behaviour/frequently-asked-questions-the-term-challenging-behaviour/
Charles, M. (2023). We Know What You’re Doing. In F. Morgan, E. Costello, & I. Gilbert (Eds.), Square Pegs : Inclusivity, compassion and fitting in – a guide for schools (pp. 151-158). Crown House Publishing.
Chapman, R. (2021). Neurodiversity and the Pathology Paradigm Uncovering the forgotten history of normality. Psychology Today. https://www.psychologytoday.com/gb/blog/neurodiverse-age/202108/neurodiversity-and-the-pathology-paradigm
Chapman, R., & Botha, M. (2023). Neurodivergence‐informed therapy. Developmental Medicine and Child Neurology, 65(3), 310–317. https://doi.org/10.1111/dmcn.15384
Chapman, R., & Carel, H. (2022). Neurodiversity, epistemic injustice, and the good human life. Journal of Social Philosophy, 53(4), 614–631. https://doi.org/10.1111/josp.12456
Chapman, L., Rose, K., Hull, L., & Mandy, W. (2022b). “I want to fit in… but I don’t want to change myself fundamentally”: A qualitative exploration of the relationship between masking and mental health for autistic teenagers. Research in Autism Spectrum Disorders, 99, 102069-. https://doi.org/10.1016/j.rasd.2022.102069
Children’s Commissioner. (2023). Attendance is everyone’s business. https://assets.childrenscommissioner.gov.uk/wpuploads/2023/02/cc-response-to-persistent-absence-inquiry.pdf
Connolly, S. E., Constable, H. L., & Mullally, S. L. (2023). School distress and the school attendance crisis: a story dominated by neurodivergence and unmet need. Frontiers in Psychiatry, 14, 1237052–1237052. https://doi.org/10.3389/fpsyt.2023.1237052
Dawson, M., & Fletcher-Watson, S. (2022). When autism researchers disregard harms: A commentary. Autism : The International Journal of Research and Practice, 26(2), 564–566. https://doi.org/10.1177/13623613211031403
Delahook, M. (2017). Sensory Processing and Challenging Behaviors: Below the Iceberg. Mona Delahook. https://monadelahooke.com/1064-2/
Delahook, M. (2019). Why We Misunderstand Traumatized Children’s Behavioral Challenges and How We Can Do Better. Mona Delahook. https://monadelahooke.com/why-we-misunderstand-traumatized-childrens-behavioral-challenges-and-how-we-can-do-better/
Della Croce, Y. (2023). Epistemic Injustice and Nonmaleficence. Journal of Bioethical Inquiry, 20(3), 447–456. https://doi.org/10.1007/s11673-023-10273-4
Department for Education & Department of Health. (2015). Special educational needs and disability code of practice: 0 to 25 years: Statutory guidance for organisations which work with and support children and young people who have special educational needs or disabilities. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/ attachment_data/file/398815/SEND_Code_of_Practice_January_2015.pdf
DeThorne, L. S., & Searsmith, K. (2020). Autism and Neurodiversity: Addressing Concerns and Offering Implications for the School-Based SpeechLanguage Pathologist. Perspectives of the ASHA Special Interest Groups, 6, 184–190. https://doi.org/10.1044/2020_PERSP-20-00188
Department for Education [DfE]. (2022). Working Together to Improve School Attendance. https://www.gov.uk/government/publications/working-together-to-improve-school-attendance
DfE. (2022b). Back to school week – Everything you need to know about school attendance. Gov.UK. https://educationhub.blog.gov.uk/2022/09/02/back-to-school-week-everything-you-need-to-know-about-school-attendance/
DfE. (2023). Working Together to Safeguard Children. https://www.gov.uk/government/publications/working-together-to-safeguard-children–2
DfE. (2023b). Keeping Children Safe in Education. https://assets.publishing.service.gov.uk/media/64f0a68ea78c5f000dc6f3b2/Keeping_children_safe_in_education_2023.pdf
DfE. (2023c). Toolkit for schools: communicating with families to support attendance. Gov.UK. https://www.gov.uk/government/publications/working-together-to-improve-school-attendance/toolkit-for-schools-communicating-with-families-to-support-attendance
Department of Health & Social Care [Department for Health and Social Care]. (2020). Statement from the UK Chief Medical Officers on schools and childcare reopening. Gov.UK. https://www.gov.uk/government/news/statement-from-the-uk-chief-medical-officers-on-schools-and-childcare-reopening
Diagnostic and statistical manual of mental disorders: [DSM-5]. (5th ed.). (2013). American Psychiatric Association.
Donaghy, B., Moore, D., & Green, J. (2023). Co-Occurring Physical Health Challenges in Neurodivergent Children and Young People: A Topical Review and Recommendation. Child Care in Practice, 29(1), 3–21. https://doi.org/10.1080/13575279.2022.2149471
Emerson, E., Barrett, S., Bell, C., Cummings, R. Hughes, H., McCool, C., Toogood, A & Mansell, J. (1987) The Special Development Team: Developing services for people with severe learning difficulties and challenging behaviours. University of Kent: Institute of Social and Applied Psychology.
Elicor, P. P. E. (2020). Mapping identity prejudice: Locations of epistemic injustice in philosophy for/with children. Childhood & Philosophy (Rio de Janeiro. Online), 16(36), 1–25. https://doi.org/10.12957/CHILDPHILO.2020.47899
Emerson, E., & Einfeld, S. L. (2011). Challenging behaviour (3rd ed.). Cambridge University Press.
Fisher, N. (2021). Changing Our Minds. Robinson.
Fisher, N. (2024). If Only The Problem with School was Attendance. Naomi Fisher Substack. https://naomicfisher.substack.com/p/if-only-the-problem-with-school-was?utm_source=post-email-title&publication_id=1062989&post_id=140483899&utm_campaign=email-post-title&isFreemail=true&r=2es5t5&triedRedirect=true
Fives, A. (2016). Who Gets to Decide? Children’s Competence, Parental Authority, and Informed Consent. In Justice, Education and the Politics of Childhood (pp. 35–47). Springer International Publishing. https://doi.org/10.1007/978-3-319-27389-1_3
Fricker, M. (2007). Epistemic injustice power and the ethics of knowing. Oxford University Press. Jessica Kingsley
Fricker, E. (2023). Can’t Not Won’t: A Story About A Child Who Couldn’t Go To School.
Fulton, R., Reardon, E., Richardson, K., & Jones, R. (2020). Sensory Trauma. Autism Wellbeing Press.
‘Gaslighting’. (n.d.). In Psychology Today. Gaslighting | Psychology Today
Garner, J. (2023). A Critical Reflection on the use of Social Skills Interventions for Autistic Children in Mainstream Education. (Masters Essay, Sheffield Hallam University).
Gillett-Swan, J., & Sargeant, J. (2018). Assuring children’s human right to freedom of opinion and expression in education. International Journal of Speech Language Pathology, 20(1), 120–127. https://doi.org/10.1080/17549507.2018.1385852
Goodenow, C., & Grady, K. E. (1993). The Relationship of School Belonging and Friends’ Values to Academic Motivation Among Urban Adolescent Students. The Journal of Experimental Education, 62(1), 60–71. https://doi.org/10.1080/00220973.1993.9943831
Goodhall, C. (2018). ‘I felt closed in and like I couldn’t breathe’: A qualitative study exploring the mainstream educational experiences of autistic young people. Autism & Developmental Language Impairments, 3, https://doi.org/10.1177/2396941518804407
Gore, N.J., Sapiets, S.J., Denne, L.D., Hastings, R.P., Toogood, S., MacDonald, A., Baker, P., and the PBS Working Group (in alphabetical order): Allen, D., Apanasionk, M., Austin, D., Bowring, D.L., Bradshaw, J., Corbett, A., Cooper, V., Deveau, R., Hughes, J.C., Jones, W., Lynch, M., McGill, P., Mullhall, M., Murphy, M., Noone, S., Shankar, R., & Williams, D. (2022). Positive Behavioural Support in the UK: A State of the Nation Report. International Journal of Positive Behavioural Support, 12(1).
Gov. UK. (2021). Education Secretary launches new attendance alliance. https://www.gov.uk/government/news/education-secretary-launches-new-attendance-alliance
Gov. UK (2022). How we plan to improve school attendance following the COVID-19 pandemic. https://educationhub.blog.gov.uk/2022/01/25/how-we-plan-to-improve-school-attendance-following-the-covid-19-pandemic/
Gray, L., Hill, V., & Pellicano, E. (2023). “He’s shouting so loud but nobody’s hearing him”: A multi-informant study of autistic pupils’ experiences of school non-attendance and exclusion. Autism & Developmental Language Impairments, 8, 23969415231207816–23969415231207816. https://doi.org/10.1177/23969415231207816
Hall, Barbara. (2010). Nonmaleficence and the Preparation of Classroom Teachers in Instructional Design. Journal of Elementary and Secondary Education.
Hallett, S. & Kerr, C. (2020) ‘You need support, validation, good coping skills. You need and deserve acceptance”: Autistic Adult Experiences of Counselling. Autistic Mental Health & Autistic Mutual Aid Society Edinburgh (AMASE). www.autisticmentalhealth.uk/counsellingrepor
Hamilton, L. G. (2024). Emotionally Based School Avoidance in the Aftermath of the COVID-19 Pandemic: Neurodiversity, Agency and Belonging in School. Education Sciences, 14(2), 156-. https://doi.org/10.3390/educsci14020156
Haves, E. (2023). Safeguarding in schools. UK Parliament. https://lordslibrary.parliament.uk/safeguarding-in-schools/#ref-1
Heselton, G. A., Rempel, G. R., & Nicholas, D. B. (2022) “Realizing the problem wasn’t necessarily me”: the meaning of childhood adversity and resilience in the lives of autistic adults, International Journal of Qualitative Studies on Health and Well-being. 17(1), 1-11. https://doi.org/10.1080/17482631.2022.2051237
Heyman, B., Swain, J., & Gillman, M. (1998). “A Risk Management Dilemma: How Day Center Staff Understand Challenging Behavior.” Disability & Society 13 (2): 163–82. https://doi.org/10.1080/09687599826768.
Heyne, D., Gentle-Genitty, C., Melvin, G. A., Keppens, G., O’Toole, C., & McKay-Brown, L. (2024). Embracing change: from recalibration to radical overhaul for the field of school attendance. Frontiers in Education (Lausanne), 8. https://doi.org/10.3389/feduc.2023.1251223
Holton , A., Farrell , L., & Fudge, J. (2014). A Threatening Space?: Stigmatization and the Framing of Autism in the News. Communication Studies, 65(2), 189-207. https://doi.org/10.1080/10510974.2013.855642
ICARS. (2023). The ICARS Report Restraint and Seclusion in England’s Schools. https://againstrestraint.com/icars-report/
Joey, Dr. (2022). For Whose Benefit?: Evidence, Ethics, and Effectiveness of Autism Interventions. Tik Toc. https://www.tiktok.com/@nd_psych/video/7120746859739565314?_r=1&_t=8jV6FltD1DF&social_sharing=1
Kaiser, B., & Rasminsky, J. (2021). Addressing Challenging Behavior in Young Children. National Association for the Education of Young Children.
Kearney, C. A., & Silverman, W. K. (1990). A preliminary analysis of a functional model of assessment and intervention of school refusal behaviour. Behaviour Modification, 149, 340–366.
Kearney, C. A., Benoit, L., Gonzálvez, C., & Keppens, G. (2022). School attendance and school absenteeism: A primer for the past, present, and theory of change for the future. Frontiers in Education (Lausanne), 7. https://doi.org/10.3389/feduc.2022.1044608
Kenny, L., Hattersley, C., Molins, B., Buckley, C., Povey, C., & Pellicano, E. (2016). Which terms should be used to describe autism? Perspectives from the UK autism community. Autism : The International Journal of Research and Practice, 20(4), 442–462. https://doi.org/10.1177/1362361315588200
King, N. J., Heyne, D., Tonge, B., Gullone, E., & Ollendick, T. H. (2001). School refusal: categorical diagnoses, functional analysis and treatment planning. Clinical Psychology and Psychotherapy, 8(5), 352–360. https://doi.org/10.1002/cpp.313
Klass, C.S., Guskin, K.A., & Thomas, M. (1995). “The Early Childhood Program: Promoting Children’s Development Through and Within Relationships.” ZERO TO THREE 16(2): 9–17.
Killeen, P. R. (2001). The Four Causes of Behavior. Current Directions in Psychological Science : A Journal of the American Psychological Society, 10(4), 136–140. https://doi.org/10.1111/1467-8721.00134
Kizel, A. (2016). Enabling identity: The challenge of presenting the silenced voices of repressed groups in philosophic communities of inquiry. JOURNAL OF PHILOSOPHY IN SCHOOLS, 3(1), 16–39. https://doi.org/10.21913/JPS.v3i1.1298
Kapp, S. K., Steward, R., Crane, L., Elliott, D., Elphick, C., Pellicano, E., & Russell, G. (2019). ‘People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming. Autism : The International Journal of Research and Practice, 23(7), 1782–1792. https://doi.org/10.1177/1362361319829628
Kohn, A. (2018). It’s Not About Behavior. Alfie Kohn. https://www.alfiekohn.org/article/behavior/
Lancashire County Council [LCC]. (n.d.) Emotionally Based School Avoidance Guidance. lancashire-ebsa-guidance-strategy-toolkit-2023-update.pdf
Lees, H.E. (2014). Education without schools: Discovering alternatives. Bristol: Policy Press
Legault, M., Bourdon, J. N., & Poirier, P. (2021). From neurodiversity to neurodivergence: the role of epistemic and cognitive marginalization. Synthese, 199, 12843–12868. https://doi.org/10.1007/s11229-021-03356-5
Lewis, T. (2022). Ableism. TALILA A. LEWIS. https://www.talilalewis.com/blog/working-definition-of-ableism-january-2022-update
Lone, J. M. (2018). Philosophical thinking in childhood. In The Routledge Handbook of the Philosophy of Childhood and Children (pp. 53–63). https://doi.org/10.4324/9781351055987-6
Lorenc, T., & Oliver, K. (2014). Adverse effects of public health interventions: a conceptual framework. Journal of Epidemiology and Community Health (1979), 68(3), 288–290. https://doi.org/10.1136/jech-2013-203118
Lundy, L. (2007). “Voice” is not enough: conceptualising Article 12 of the United Nations Convention on the Rights of the Child. British Educational Research Journal, 33(6), 927–942. https://doi.org/10.1080/01411920701657033
Lutterer, W. (2007). The two beginnings of communication theory. Kybernetes, 36(7/8), 1022–1025. https://doi.org/10.1108/03684920710777793
Machalicek, W., O’Reilly, M., Beretvas, N., Sigafoos, J., & Lancioni, G. E. (2007). A review of interventions to reduce challenging behavior in school settings for students with autism spectrum disorders. Research in Autism Spectrum Disorders, 1(3), 229-246. https://doi.org/10.1016/j.rasd.2006.10.005
Maïano, C., Normand, C. L., Salvas, M. C., Moullec, G., & Aimé, A. (2015). Prevalence of School Bullying Among Youth with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. Autism Research, 9(6), 601-615. https://doi.org/10.1002/aur.156
Malone, J. C. (2014). Did John B. Watson Really “Found” Behaviorism? Perspectives on Behavior Science, 37(1), 1–12. https://doi.org/10.1007/s40614-014-0004-3
Manchester City Council. (2021). Anxiety Based School Avoidance. Corporate Style template – blue (manchesterparentcarerforum.org.uk)
Mandy, W. (2022). Six ideas about how to address the autism mental health crisis. Autism : The International Journal of Research and Practice, 26(2), 289–292. https://doi.org/10.1177/13623613211067928
Maynard, B. R., Heyne, D., Brendel, K. E., Bulanda, J. J., Thompson, A. M., & Pigott, T. D. (2018). Treatment for School Refusal Among Children and Adolescents: A Systematic Review and Meta-Analysis. Research on Social Work Practice, 28(1), 56–67. https://doi.org/10.1177/1049731515598619
McCabe, L.A., & Frede, E.C. (2007). Challenging Behaviors and the Role of Preschool Education. National Institute for Early Education Research Preschool Policy Brief, 16. https://nieer.org/wp-content/uploads/2016/08/16.pdf.
McGreevy, E., Quinn, A., Law, R., Botha, M., Evans, M., Rose, K., Moyse, R., Boyens, T., Matejko, M., & Pavlopoulou, G. (2024). An Experience Sensitive Approach to Care With and for Autistic Children and Young People in Clinical Services. The Journal of Humanistic Psychology. https://doi.org/10.1177/00221678241232442
McLaren, K. (2014). Interrogating Normal Autism Social Skills Training at the Margins of a Social Fiction [MA Thesis, Sonoma State University]. https://scholarworks.calstate.edu/concern/theses/mw22v614s
Mcleod, S. (2024). Behaviorism In Psychology. Simple Psychology. https://www.simplypsychology.org/behaviorism.html
Meadows, J. (2021). You’re Using the Word “Neurodiversity” Wrong. Medium. https://jessemeadows.medium.com/youre-using-the-word-neurodiversity-wrong-e579ffa816a8
McLaren, K. (2014). Interrogating Normal Autism Social Skills Training at the Margins of a Social Fiction [MA Thesis, Sonoma State University]. https://scholarworks.calstate.edu/concern/theses/mw22v614s
Michail, S. (2011). Understanding school responses to students’ challenging behaviour: A review of literature. Sage, 14(2), 156-171. https://doi.org/10.1177/1365480211407764
Milton, D., & Moon, L. (2012). The normalisation agenda and the psycho-emotional disablement of autistic people. Autonomy, Critical Journal of Interdisciplinary Autism Studies, 1(1), ISSN 2051-5189
Milton, D. (2014). So what exactly are autism interventions intervening with? Good Autism Practice, 15 (2). pp. 6-14. ISSN 1466-2973. (KAR id:62631)
Milton, D. (2014b). Embodied sociality and the conditioned relativism of dispositional diversity. Autonomy, Critical Journal of Interdisciplinary Autism Studies, 1(3), 1-7.
MIND. (2024). What is CBT?. MIND. https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/cognitive-behavioural-therapy-cbt/
Minio-Paluello, I., Baron-Cohen, S., Avenanti, A., Walsh, V., & Aglioti, S. V. (2009). Absence of Embodied Empathy During Pain Observation in Asperger Syndrome. Biol Psychiatry, 65, 55-62. https://doi.org/10.1016/j.biopsych.2008.08.006
Morgan, Fran., Costello, Ellie., & Gilbert, Ian. (2023). Square Pegs : Inclusivity, compassion and fitting in – a guide for schools. Crown House Publishing.
Moyse, R. (2021). Missing : the Autistic Girls Absent from Mainstream Secondary Schools. ProQuest Dissertations Publishing.
Murris, K. (2013). The Epistemic Challenge of Hearing Child’s Voice. Studies in Philosophy and Education, 32(3), 245–259. https://doi.org/10.1007/s11217-012-9349-9
Munkhaugen, E., Gjevik, E., Pripp, A., Sponheim, E., & Diseth, T. (2017). School refusal behaviour: Are children and adolescents with autism spectrum disorder at a higher risk?. Research in Autism Spectrum Disorders, 41-42, 31-38. https://doi.org/10.1016/j.rasd.2017.07.001
Murray, D. 2006. Coming Out Asperger: Diagnosis,Disclosure and Self-Confidence. London: Jessica Kingsley.
Murray, F. (2023) Autism & Scientism (PDF) Autism and Scientism (researchgate.net)
National Autistic Society. (2021). School Report 2021. https://www.autism.org.uk/what-we-do/news/school-report-2021
NHS. (n.d.). Understanding the reasons why a child may not want to attend school. Leicester Partnership NHS Trust. https://www.leicspart.nhs.uk/autism-space/education/understanding-the-reasons-why-a-child-may-not-want-to-attend-school/?fbclid=IwAR1BfG0uzOBnal44rR27U1jUYBF8qYMchY4SCOgZnrhx9zhYD8w4V6zDxME
Neumeier, S. (2018) “To Siri With Love’ and the Problem With Neurodiversity Lite”. Rewire News Group. https://rewirenewsgroup.com/article/2018/02/09/siri-love-problem-neurodiversity-lite/
NSW Government [NSW]. (n.d.). What is behaviour?. NSW Health. https://www.health.nsw.gov.au/mentalhealth/psychosocial/principles/Pages/behaviour-whatis.aspx
Norden, J. (2024). Keegan admits SEND system isn’t working well ‘for anybody’. TES. https://www.tes.com/magazine/news/general/gillian-keegan-admits-send-system-isnt-working-well-anybody
Nuttall, C., & Woods, K. (2013). Effective intervention for school refusal behaviour. Educational Psychology in Practice, 29(4), 347–366. https://doi.org/10.1080/02667363.2013.846848
O’Hagan, S., Bond, C., & Hebron, J. (2022). Autistic girls and emotionally based school avoidance: supportive factors for successful re-engagement in mainstream high school. International Journal Of Inclusive Education, Vol.ahead-of-print (ahead-of-print), 1-17. https://doi.org/10.1080/13603116.2022.2049378
Oliver, M. (1990). The politics of disablement. Basingstoke: MacMillan.
Orsati, F. T., & Causton-Theoharis, J. (2013). Challenging control: inclusive teachers’ and teaching assistants’ discourse on students with challenging behaviour. International Journal of Inclusive Education, 17(5), 507–525. https://doi.org/10.1080/13603116.2012.689016
Pantazakos, T. (2019). Treatment for whom? Towards a phenomenological resolution of controversy within autism treatment. Studies in History and Philosophy of Science. Part C, Studies in History and Philosophy of Biological and Biomedical Sciences, 77, 101176–101176. https://doi.org/10.1016/j.shpsc.2019.04.001
Pellegrini, D. W. (2007). School Non-attendance: Definitions, meanings, responses, interventions. Educational Psychology in Practice, 23(1), 63–77. https://doi.org/10.1080/02667360601154691
Pluquailec, J. (2018). Affective economies, autism, and ‘challenging behaviour’: socio-spatial emotions in disabled children’s education.
Reindal, S. (2008). A social relational model of disability: A theoretical framework for special needs education?. European Journal of Special Needs Education, 23(2), 135-146. https://doi.org/10.1080/08856250801947812
Rimmerman, A. (2012). Social Inclusion of People with Disabilities : National and International Perspectives. Cambridge University Press.
Romdenh-Romluc, K. (2017). Hermeneutical Injustice and the Problem of Authority. Feminist Philosophy Quarterly, 3(3), 1-21. https://doi.org/10.5206/fpq/2017.3.1
Rosenberg, D. (2023). What Goes Wrong. In F. Morgan, E. Costello, & I. Gilbert (Eds.), Square Pegs : Inclusivity, compassion and fitting in – a guide for schools (pp. 141-150). Crown House Publishing.
Royal College Of Psychiatrists, British Psychological Society And Royal College Of Speech And Language Therapists. (2007). Challenging behaviour: a unified approach. College report CR144. June.
Royal College Of Psychiatrists, British Psychological Society And Royal College Of Speech And Language Therapists. (2017). Challenging behaviour: a unified approach – update. College report FR/ID/08.
Royal College of Occupational Therapists [RCOT]. (2014). Learning Disabilities Professional Senate Statement of ethics for professionals who work in Learning Disability services post Winterbourne Vie. https://www.rcot.co.uk/sites/default/files/Statement-of-Ethical-Practice-post-Winterbourne-Sept2014.pdf
Saltz, A. (2022). How CBT Harmed Me: The Interview That the New York Times Erased. Disability Visibility Project. https://disabilityvisibilityproject.com/2021/11/11/how-cbt-harmed-me-the-interview-that-the-new-york-times-erased/amp/
Sam, M.S., (2013). “BEHAVIORISM,” in PsychologyDictionary.org. https://psychologydictionary.org/behaviorism/
Silva, C., Smith, P. N., Rogers, M., Joiner, T. E., Foote, B., & Van Orden, K. A. (2023). Clinically Significant Scores for Thwarted Belonging and Perceived Burden from the Interpersonal Needs Questionnaire (INQ-15). Crisis : The Journal of Crisis Intervention and Suicide Prevention, 44(5), 406–414. https://doi.org/10.1027/0227-5910/a000898
Sinclair, J. (1993). Don’t Mourn for Us. Our Voice, 1(3), Retrieved from http://www.autreat.com/dont_mourn.html
Schües, C. (2016). Epistemic Injustice and Children’s Well-being in Justice in Drerup, J., Graf, G., Schickhardt, C., Schweiger, G. (Ed.), Education and the Politics of Childhood: Challenges and Perspectives, (pp.155-170). Springer.
Shah, P., Catmur, C., & Bird, G. (2016). Emotional decision-making in autism spectrum disorder: the roles of interoception and alexithymia. Molecular Autism, 7(1), 1–10. https://doi.org/10.1186/s13229-016-0104-x
Sharma, S., Hucker, A., Matthews, T., Grohmann, D., & Laws, K. R. (2021). Cognitive behavioural therapy for anxiety in children and young people on the autism spectrum: a systematic review and meta-analysis. BMC Psychology, 9(1), 1–151. https://doi.org/10.1186/s40359-021-00658-8
Smart, J. (2009). The Power of Models of Disability. Journal of Rehabilitation, 75(2), 3-11. https://tinyurl.com/ytc88vm7
Soo Park, Y., Artino, A., & Konge, L. (2020). The Positivism Paradigm of Research. Academic Medicine, 95(5), 690-694.
Staffordshire Council Council. (2022). Emotionally Based School Avoidance:
Guidance for Educational Settings. Emotionally-Based-School-Avoidance-Guidance-SCC-EPS-Sept-2020-PDF.pdf (staffordshire.gov.uk)
Stanforth, A., & Rose, J. (2020). “You kind of don’t want them in the room”: tensions in the discourse of inclusion and exclusion for students displaying challenging behaviour in an English secondary school. International Journal of Inclusive Education, 24(12), 1253–1267. https://doi.org/10.1080/13603116.2018.1516821
Stimpunks. (2024). Neuroqueer Learning Spaces. Stimpunks. https://stimpunks.org/projects/neuroqueer-learning-spaces/
Stimpunks. (n.d.). In Glossary. Stimpunks. Neuronormativity – Stimpunks Foundation
Thambirajah, M. S., Grandison, K. J., & De-Hayes, L. (2008). Understanding school refusal : a handbook for professionals in education, health and social care. Jessica Kingsley.
Tolley, B. (n.d.). The problem with behaviorism. End Seclusion. https://endseclusion.org/articles/the-problem-with-behaviorism/
Universal Declaration of Human Rights (1948). United Nations. Universal Declaration of Human Rights | United Nations
Walker, N. (2021). Neuroqueer Heresies. Autonomous Press.
Wan Yunus, F., Bissett, M., Penkala, S., Kadar, M., & Liu, K. P. Y. (2021). Self-regulated learning versus activity-based intervention to reduce challenging behaviors and enhance school-related function for children with autism spectrum disorders: A randomized controlled trial. Research in Developmental Disabilities, 114, 103986–103986. https://doi.org/10.1016/j.ridd.2021.103986
Watson, J. (1913). Psychology as the Behaviorist Views it. First published in Psychological Review, 20, 158-177. Available at Classics in the History of Psychology — Watson (1913) (yorku.ca)
Watzlawick, P., Beavin, J. H., & Jackson, D. D. (1967). Pragmatics of human communication: A study of interactional patterns, pathologies, and paradoxes. W.W. Norton & Company
West Sussex County Council. (2022). Children Emotionally Based School Avoidance EBSA (PDF). Emotionally Based School Avoidance | West Sussex Services for Schools
Wiener, M., Devoe, S., Rubinow, S., & Geller, J. (1972). Nonverbal behavior and nonverbal communication. Psychological Review, 79(3), 185–214. https://doi.org/10.1037/h0032710
Williams, K. (2021). Non-attendance of autistic pupils and trauma. SEN Magazine. https://senmagazine.co.uk/autism/15226/non-attendance-of-autistic-pupils-and-trauma/?fbclid=IwAR0fG9IBx_hzJfL_NqyPchrOZnffmvSevv5T2Ez6t6LZuC5J7t0rglqtEw4
Wood, R. (2019). Inclusive education for autistic children : helping children and young people to learn and flourish in the classroom. London.
Yergeau, M. (2018). Authoring autism: on rhetoric and neurological queerness. Duke University Press.
Zaboski, B. A. (2022). Exposure Therapy for Anxiety Disorders in Schools: Getting Started. Contemporary School Psychology, 26(2), 235–240. https://doi.org/10.1007/s40688-020-00301-0
Zarkowska, E. & Clements, J. (2000) Behavioural concerns and autistic spectrum disorders explorations and strategies for change. Jessica Kingsley.