High-Functioning Autism and School Refusal
Wednesday, July 10, 2024.
School refusal is a significant issue that many parents and educators face, especially when it involves children with high-functioning autism.
I experienced this daily with one of my foster kids.
High-functioning autism, often referred to as Autism Spectrum Disorder (ASD) without intellectual disability, includes folks who are capable of managing daily life independently but still struggle with social interactions, communication, and behavioral flexibility.
Understanding the intricate relationship between high-functioning autism and school refusal is crucial for developing effective strategies to support these children and their families.
What is School Refusal?
School refusal is not simply a child’s reluctance to attend school; it is a persistent difficulty that can result in extended periods of absence. Children with school refusal may experience severe anxiety, emotional distress, and physical symptoms such as headaches or stomachaches at the thought of going to school. Unlike truancy, school refusal is often driven by emotional and psychological factors rather than a desire to skip school.
High Functioning Autism and School Refusal: The Connection
Children with high-functioning autism are particularly susceptible to school refusal for several reasons:
Social Anxiety: Many children with high-functioning autism struggle with social interactions and can become overwhelmed in the school environment. The anxiety of navigating social complexities can lead to avoidance behaviors, including school refusal (Munkhaugen, Gjevik, Pripp, Sponheim, & Diseth, 2017).
Sensory Sensitivities: Schools can be sensory-overloading environments. Loud noises, bright lights, and crowded hallways can be distressing for children with sensory sensitivities, contributing to their refusal to attend school (Kerns et al., 2015).
Rigid Routines: Children with high-functioning autism often rely on strict routines and predictability. Any disruption to their routine, such as changes in the school schedule or a different classroom environment, can trigger anxiety and school refusal (Adams, Clark, & Simpson, 2019).
Academic Pressure: Although these children may not have intellectual disabilities, they can struggle with executive functioning skills such as organization, time management, and task initiation. The pressure to meet academic expectations can be overwhelming and lead to avoidance (Ashburner, Ziviani, & Rodger, 2010).
Research on High Functioning Autism and School Refusal
Research indicates that school refusal is prevalent among children with high-functioning autism. According to a study published in the Journal of Autism and Developmental Disorders, approximately 25-50% of children with autism spectrum disorder experience school refusal at some point during their education (Munkhaugen et al., 2017). This is significantly higher compared to neurotypical peers.
Another study highlighted in Autism Research points out that school refusal in children with high-functioning autism is often linked to heightened levels of anxiety and sensory processing difficulties. The study suggests that addressing these underlying issues is crucial for effective intervention (Kerns et al., 2015).
Strategies for Support
Collaborative Approach: Successful intervention often involves a collaborative approach between parents, teachers, and mental health professionals. Regular communication and teamwork can ensure consistent support across different environments (Adams et al., 2019).
Individualized Education Plan (IEP): An IEP tailored to the child’s specific needs can provide accommodations and modifications to help manage anxiety and sensory sensitivities. This may include a quieter workspace, breaks during the day, or modified assignments (Ashburner et al., 2010).
Cognitive Behavioral Therapy (CBT): CBT is effective in reducing anxiety and improving coping skills in children with high-functioning autism. Therapists can work with children to develop strategies for managing anxiety related to school (White, Oswald, Ollendick, & Scahill, 2009).
Sensory Integration Therapy: Occupational therapy that focuses on sensory integration can help children manage sensory sensitivities, making the school environment more tolerable (Kern et al., 2007).
Gradual Reintegration: A gradual reintegration plan can be beneficial for children who have been out of school for an extended period. This might start with brief visits to the school and gradually increase the time spent there (Adams et al., 2019).
Social Skills Training: Programs that teach social skills can help children with high-functioning autism navigate social interactions more confidently, reducing anxiety related to peer interactions (White et al., 2009).
Final thoughts
Understanding the unique challenges faced by children with high-functioning autism is essential for providing effective support across the board.
But we also need to focus more, in particular, on understanding the underlying causes of school refusal, such as social anxiety, sensory sensitivities, and academic pressure. This is essential.
It’s thoughtful, tailored strategies with collaborating parents and educators that can help these kids overcome school refusal and succeed in their educational journey.
Be Well, Stay Kind, and Godspeed.
REFERENCES:
Adams, D., Clark, M., & Simpson, K. (2019). The relationship between child anxiety and the quality of life of children, and parents of children, on the autism spectrum. Autism, 23(4), 873-883. https://doi.org/10.1177/1362361318782430
Ashburner, J., Ziviani, J., & Rodger, S. (2010). Surviving in the mainstream: Capacity of children with autism spectrum disorders to perform academically and regulate their emotions and behavior at school. Research in Autism Spectrum Disorders, 4(1), 18-27. https://doi.org/10.1016/j.rasd.2009.07.002
Kern, J. K., Garver, C. R., Carmody, T., Andrews, A. A., Trivedi, M. H., & Mehta, J. A. (2007). Examining sensory quadrants in autism. Research in Autism Spectrum Disorders, 1(2), 185-193. https://doi.org/10.1016/j.rasd.2006.09.002
Kerns, C. M., Kendall, P. C., Berry, L., Souders, M. C., Franklin, M. E., Schultz, R. T., ... & Herrington, J. (2015). Traditional and atypical presentations of anxiety in youth with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(11), 3641-3656. https://doi.org/10.1007/s10803-015-2511-7
Munkhaugen, E. K., Gjevik, E., Pripp, A. H., Sponheim, E., & Diseth, T. H. (2017). School refusal behaviour: Characteristics of the children, and perspectives of the parents and the school. Journal of Autism and Developmental Disorders, 47(7), 2252-2263. https://doi.org/10.1007/s10803-017-3131-1
White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29(3), 216-229. https://doi.org/10.1016/j.cpr.2009.01.003
