Research Focus: Social well-being of autistic high school students in mainstream high schools in Norway

Social well-being of autistic high school students in mainstream high schools in Norway

By Ingjerd Skafle

Inclusive education is a political goal in Norway, meaning that students, regardless of their challenges, should attend their local mainstream schools which again should provide the support needed to fulfill their education. Special education schools still exist, but there is a political will that most students attend inclusive schools, also referred to as mainstream schools. This requires that the teachers have knowledge about the students’ conditions and diagnosis in order to meet their needs. However, how much do teachers in mainstream schools know about conditions such as for example autism? 

Autism spectrum disorder (ASD) is characterized by impairments in social communication and repetitive behaviors, highly restricted interests and/or sensory behaviors beginning early in life. The worldwide prevalence of autism is just under 1%, but estimates are higher in high-income countries (Lord et al., 2020). The prevalence is also higher among boys. Compared to girls, there are 4,4 times as many boys diagnosed with ASD in Norway (Surén et al., 2019). Many students with ASD have extra needs when it comes to their schooling, both in terms of subject matter and also matters concerning social issues, whereas others manage well with little or no extra support in either area. 

More students with ASD are enrolled in inclusive schools and colleges than ever before (Elias and White, 2018). There is considerable amount of literature on how to best facilitate a classroom in order to meet the needs of autistic students, and there are many factors to be considered, all depending on the needs of the autistic student. Measures can for example be taken with regards to seating in classrooms or teaching material. Autistic students can also benefit from using their special interest in learning, but also when practicing communication skills (Wood, 2019). However, this is not part of the standard curriculum in the education of a regular teacher, but for the most part belongs in special education curriculum. Nevertheless, most people know about autism and have formed an opinion about what the condition entails. In recent years many popular TV-shows and films like the Swedish-Danish TV-show Broen and the American TV-show The Big Bang Theory have had autistic characters, which also add to the public sentiment about autism (Nordahl-Hansen, 2017). While putting autism on the big screen definitely is part of normalizing the condition, it can also add to some stereotypical views about autistic people. One of the greatest myths about autistic people is that they do not want or need to be social. Although it is true that one of the core challenges has to do with understanding social codes, that does not mean that an autistic person does not want to be social – it can rather be that he or she does not know how to. This myth can trickle down to other forms of assumptions about how to best facilitate classrooms for autistic students. Teachers can be told to avoid eye contact with autistic students because it is so uncomfortable, or that they prefer to work alone as opposed to be part of group work. Also, teachers can be told that the autistic students should be granted permission to have their tablet or mobile, so that they can have the opportunity to withdraw from social settings. These advices are helpful for some with autism and can be used at certain times, but can also be completely the opposite of what some autistic students need or want. ASD is a complex diagnosis and autistic people are so different in their needs. In addition, one should ask oneself whether any student, regardless of their condition, should never be challenged? Where is the opportunity to grow and overcome social fears? Students with ASD have, like all students, the potential to learn and grow, and need therefore to participate in social arenas. 

School as a key social arena

In a study published in the international journal Journal of Autism and Developmental disorders (Skafle, Nordahl-Hansen & Øien, 2019) five students with Asperger syndrome were interviewed about their social well-being in mainstream high schools. Although the number of interviewees is too few in order to generalize, they share some interesting stories and perspectives worth noting when working with autistic students. The International Classification of Diseases and Related Health Problems (ICD-10) was still in effect in Norway when this study was undertaken. Thus, the participants were diagnosed with Asperger syndrome according to the ICD-10 manual. Asperger Syndrome is characterized by abnormalities of social interaction and a restricted, stereotyped and repetitive repertoire of interest and activities. Asperger Syndrome differs from other types of autism in that there is no general delay in language or cognitive development (World Health Organization, 1992). Asperger syndrome belongs in the autism spectrum, but according to the 11th revision of The International Classification of Diseases and Related Health Problems (ICD-11) Asperger syndrome will no longer be a diagnosis when ICD-11 comes into effect (WHO, 2019). 

The interviewees made it clear that high school was a very important social platform for them. They also viewed school as a place where they could learn more about being social. Many of them had experienced bullying or social exclusion in junior high school. High school, on the other hand, had been a new and positive start. Some of them explicitly said that they used school as an arena for social training.  Although it took a lot of energy to be social, it seemed to be necessary: 

Q – Do you feel you have become more social because of school?

A – Yes. I cant’t question that. Talking to people..being forced to talk to people..talking in class..just talking in general has helped me a lot. If I could not talk to new people, people with other opinions, my social life would have been ruined a long time ago. 

Overcoming Social Challenges

Furthermore, some of the informants expressed self-awareness with regards to their diagnosis, and had a clear idea about what they needed to practice on when it came to sociability. They put a lot of effort into understanding social codes, precisely because they knew that this was an area where they did not master that well. For example, one of the informants worried about whether or not he was supposed to smile his peers during breaks or not: 

– This is where I feel that the Asperger in me is most striking. When insecurity builds up inside of me. Should I do this? Is this wise? Is this dangerous? Even though it is not dangerous at all. 

Similarly, other participants expressed concern about social codes in both lessons and breaks, and in situations such as where one tries to engage in a conversation without knowing the topic on beforehand. This was perceived as quite stressful. However, what is important to note, is that it was looked upon as something that had to be dealt with, and not avoided.

Other informants had found strategies to hide their insecurity in social settings:   

Sometimes during breaks I do something that is quite stupid. I pretend that I want to be alone because I don’t want to appear weak. So, I, for example, start to work on something on my laptop. 

It is probably not that uncommon to interpret the situation mentioned above to be that the autistic student wants or needs to be alone, which in this case was not true. In fact, as the example show, it can also be a strategy to hide that the student does not master the social codes of his or her peers. Therefore, it is important that when supporting the inclusion of autistic students in mainstream schools, the teachers and school staff should be careful not to accidentally support the autistic students’ unhealthy strategies. One of the informants was concerned about this matter:

  • No. Do not let the student be alone. For most people with Asperger’s want to talk to people. It is just an instinct. People want to be social. They just can’t force themselves to be so, so if you let them be by themselves because you think he or she does not want to be bothered, then you are just enabling that person to be socially excluded, and in worse case scenario being bullied.  

Meeting the needs of inclusive classrooms

In order to fulfill the political goal of inclusive classrooms more special education knowledge is needed in mainstream schools. As the example of the autistic students show, knowledge about ASD, and of course getting to know the needs of the individual student is key in order for them to thrive socially (Skafle et al., 2020). A Norwegian study showed that students with ASD are at a higher risk of school refusal behavior (Munkhaugen et al., 2017). Students with ASD are also at risk of being bullied (Van Schalkwyk et al., 2018). It is therefore essential that the teachers and school staff in mainstream schools have knowledge about ASD. Norway has a national strategy that spans from 2016 to 2025 to promote further education for teachers. However, special education is not a prioritized subject (Kunnskapsdepartementet, 2015). In order to achieve the goal of inclusive schools one would think that encouraging teachers to pursue further education in special education is necessary. 

Ingjerd Skafle

BIO

Ingjerd Skafle is a doctoral research fellow in medicine and health sciences at Østfold University College and the University in Oslo. Her research is on autism spectrum disorder and social media.

She has previously worked as a high school teacher in mainstream high school, and also as special education teacher for students with special needs.

SOURCES:

Lord, C., Brugha, T.S., Charman, T. et al. Autism spectrum disorder. Nat Rev Dis Primers 6, 5 (2020). https://doi.org/10.1038/s41572-019-0138-4

Kunnskapsdepartementet (2015). Kompetanse for kvalitet. Strategi for videreutdanning for lærere og skoleledere frem mot 2025. Retrieved from https://www.regjeringen.no/contentassets/731323c71aa34a51a6febdeb8d41f2e0/kd_kompetanse-for-kvalitet_web.pdf 

Munkhaugen, E.K., Gjevik, E., Pripp, A.H., Sponheim, E. & Diseth, T.H. (2017). School Refusal Behaviour: Are Children and Adolescents with Autism Spectrum Disorder at a Higher Risk? Research in Autism Spectrum Disorders, 41-42, s. 31-38.

Nordahl, T., Person, B., Hennestad, B.W., Dyssegaard, C.B., Vold, E.K., Martinsen, J.E., Wang, M.V., Paulsrud, P. & Johnsen, T. (2018). Inkluderende fellesskap for barn og unge. Ekspertgruppen for barn og unge med behov for særskilt tilrettelegging. Bergen: Fagbokforlaget. Retrieved from: <http://nettsteder.regjeringen.no/inkludering-barn-unge/nyheter/rapport-fra-ekspertutvalget-for-barn-og-unge-med-behov-for-saerskilt-tilrettelegging/>

Nordahl-Hansen, A. (2017). Atypical: a typical portrayal of autism? Lancet psychiatry4(11), 837-838. http://dx.doi.org/10.1016/S2215-0366(17)30397-8

Skafle, I., Øien, R., & Nordahl-Hansen, A. (2020). Secondary and Postsecondary Students with Autism Spectrum Disorder. Journal: Encyclopedia of Autism Spectrum Disorders, 1-4. https://doi.org/10.1007/978-1-4614-6435-8_102202-1

Skafle, I., Nordahl-Hansen, A. og Øien, R.A. (2019). Short Report: Social Perception of High School Students with ASD in Norway. Journal of Autism and Developmental Disorders. <doi: https://doi.org/10.1007/s10803-019-04281-w>

Surén, P., Havdahl, A., Øyen, A-S., Schjølberg, S., Reichborn-Kjennerud, T., Magnus, P., Bakken, I.J.L. og Stoltenberg, C. (2019). Diagnostisering av autismespekterforstyrrelser hos barn i Norge. Tidsskriftet Norske Legeforeningen. <DOI: 10.4045/tidsskr.18.0960> 

Van Schalkwyk, G., Smith, I. C., Silverman, W. K., & Volkmar, F. R. (2018). Brief report: Bullying and anxiety in high-functioning adolescents with ASD. Journal of Autism and Developmental Disorders,48, 1819–1824 https://doi.org/10.1007/s10803-017-3378-8

Wood, R. (2019). Autism, intense interests and support in school: from wasted efforts to shared understandings. Educational Review. doi:10.1080/00131911.2019.1566213

World Health Organization (1992). The ICD-10 Classification of Mental and Behavioral Disorders. Switzerland: WHO Library Cataloguing in Publication Data.

World Health Organization (2019). The ICD-11 Classification of Mental and Behavioral Disorders. Switzerland: WHO Library Cataloguing in Publication Data. Retrieved from https://icd.who.int/browse11/l-m/en

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