Friendship, Bullying and the Impact of Inclusion
on Attitudes towards Children with Autism
By
Anna Cook
Thesis submitted for the award of Doctor of Philosophy
December 2018
School of Psychology
Faculty of Health and Medical Sciences
University of Surrey
Declaration of originality
This thesis and the work to which it refers are the results of my own efforts. Any
ideas, data, images or text resulting from the work of others (whether published or
unpublished) are fully identified as such within the work and attributed to their
originator in the text, bibliography or in footnotes. This thesis has not been submitted
in whole or in part for any other academic degree or professional qualification. I
agree that the University has the right to submit my work to the plagiarism detection
service TurnitinUK for originality checks. Whether or not drafts have been so-
assessed, the University reserves the right to require an electronic version of the final
document (as submitted) for assessment as above.
Signed:
Date:
ii
Abstract
Children with autism face many social challenges and these have been associated
with vulnerability to social exclusion and higher levels of bullying compared to the
general population. This can lead to long-term negative outcomes including damaged
self-esteem and mental health difficulties. Since the majority of autistic children in
the UK attend mainstream schools, the studies conducted for this thesis aimed to
explore under-researched areas such as the impact of inclusion, and in particular the
attitudes of neurotypical children towards their autistic peers. In Study 1, interviews
with autistic girls and their parents (n=22) revealed that girls experienced high levels
of bullying, school absenteeism and a tendency to mask their autism and that this was
more apparent in mainstream compared to special schools. In Study 2, interviews
with teachers (n=12) highlighted many challenges supporting autistic children, but
also identified some creative solutions and factors that control the extent to which
these were implemented. The next three studies explored attitudes of neurotypical
children and whether these could be changed through exposure and contact. Studies 3
and 4 (n=775) investigated attitudes of children in schools with high versus low
exposure to autism. Findings revealed that educational exposure led to an increase in
prosocial emotional responses to bullying and increased personal exposure facilitated
an increase in positive attitudes towards people with autism. Study 5 evaluated the
influence of contact with autistic peers through group music-making (n=49) on the
attitudes of their neurotypical peers. The intervention led to increased prosocial
emotional responses to a vignette depicting social exclusion of a child with autism.
In summary, autistic children face many challenges, which are not always addressed
by teachers in mainstream schools. Furthermore, the physical and social environment
of the school affects attitudes towards autistic children. Combining educational
exposure within inclusive school climates, and personal exposure through structured
intergroup opportunities, can improve responses to bullying and attitudes towards
autism, and may ultimately increase quality of life for autistic children in mainstream
schools.
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I dedicate this thesis to my father, Robert Vaughan Watkin (1936-2000),
who always dreamed of doing a PhD. He instilled in me a love for
learning, and showed endless pride in all my accomplishments.
iv
Acknowledgements
It is with great pride, and a little sadness, that I have reached the end of my PhD journey.
It has been a truly amazing experience that I will never forget. The support received both
personally and professionally has been immense and I would like to express my sincere
thanks to all those who guided and supported me throughout this journey. The biggest
thank you goes to my wonderful supervisor Professor Jane Ogden. Her unfaltering
encouragement and clear guidance provided me with such confidence and clarity every
step of the way. Not only this, but her personal support was incredible. When times were
tough, she would always lift my spirits, not once giving the impression of being too busy
to help. I could not have asked for a more brilliant supervisor. Huge thanks additionally
to my second supervisor Dr Naomi Winstone. I am deeply grateful for her authoritative
insights, methodological guidance, teaching opportunities and general reassurance
throughout the PhD. We three made a great team. I wish to thank Qube Learning, and
particularly Gavin Whichello for funding this PhD. I am so grateful for being given this
opportunity, only made possible through this generous sponsorship. Thanks also to
Maundy Todd for providing additional funds, enabling greater dissemination of research
findings. Massive thanks to the wonderful team of 25 research assistants (mostly fellow
PhD and Masters students) who made it possible to collect data from 1,050 children in six
schools…twice! I was overwhelmed by this huge level of support for my research. I
would also like to thank the wonderful friends I made in the department, and in particular,
two brilliant colleagues - Professor Bertram Opitz and Daniel Noon - for their invaluable
input throughout many stages of my studies. I am extremely grateful for their help and
support. I owe huge gratitude of course to all the individuals who participated in my
research. I was overwhelmed by the willingness of all those who gave up their time and
shared their stories. Thanks also to all the teachers who welcomed us into their schools
and of course to the children who participated. Various collaborators were instrumental in
enabling the research to take place, including Ian Dale, Head of Research, Monitoring
and Evaluation at the National Autistic Society, Nancy Gillio-Terry and Rebecca Askew
from Surrey Arts. Many thanks are due to them for their significant contributions. Last,
but definitely not least, I am deeply grateful for the love and support of my family and
closest friends. In particular, the thesis would not have been possible without the on-
going support of my husband, Bernie, who not only provided valuable input into my
studies through his technical advice, critical feedback on talks and eagle-eyed proof-
reading, but also gave me ample time, space and moral support. I am forever grateful.
Publications arising from this thesis
Cook, A., Ogden, J., & Winstone, N. (2017). Friendship motivations, challenges and the
role of masking for girls with autism in contrasting school settings. European Journal of
Special Needs Education, 33, 302-315.
[Study 1 in this thesis]
Cook, A., Ogden, J., & Winstone, N. (2018). The impact of a school-based musical
contact intervention on prosocial attitudes, emotions and behaviours: A pilot trial with
autistic and neurotypical children. Autism, 1362361318787793.
[Study 5 in this thesis]
Conference presentations
Cook, A., Ogden, J., & Winstone, N. (in preparation). The effect of exposure on
attitudes towards bullying and autism in schools. Poster presented at FHMS Festival of
Research Conference (20/06/18), University of Surrey
Cook, A., Ogden, J., & Winstone, N. (in preparation). The effect of exposure on
attitudes towards bullying and autism in schools. Poster presented at the International
Society for Autism Research, (9-12/5/18) – Rotterdam, Netherlands
Cook, A., Ogden, J., & Winstone, N. (in preparation). The effect of exposure on
attitudes towards bullying and autism in schools. Oral presentation at Centre for
Research in Autism & Education, (30/11/7), University College London
Cook, A., Ogden, J., & Winstone, N. (in preparation). The effect of exposure on
attitudes towards bullying and autism in schools. Oral presentation at the British
Education Research Association (BERA) conference (5-7/9/17), University of Sussex
Cook, A., Ogden, J., & Winstone, N. (in preparation). The effect of exposure on
attitudes towards bullying and autism in schools. Poster presented at the University of
Surrey Doctoral College Conference (25/7/17), University of Surrey
vi
Cook, A., Ogden, J., & Winstone, N. (in preparation). The effect of exposure on
attitudes towards bullying and autism in schools. Poster presented at the BPS Tackling
Bullying Seminar, (17/7/17) – Keele University
Cook, A., Ogden, J., & Winstone, N. (2017). Friendship motivations, challenges and the
role of masking for girls with autism in contrasting school settings. Oral presentation
(elevator pitch, 1st prize.) Faculty of Health & Medical Sciences Festival of Research
(20/6/17), University of Surrey
Cook, A., Ogden, J., & Winstone, N. (2017). Friendship motivations, challenges and the
role of masking for girls with autism in contrasting school settings. Poster presentation
at the British Psychological Society Conference (4/5/17) – Brighton
Cook, A., Ogden, J., & Winstone, N. (2017). Friendship motivations, challenges and the
role of masking for girls with autism in contrasting school settings. Oral presentation at
the School of Psychology Conference (28/4/17), University of Surrey
Cook, A., Ogden, J., & Winstone, N. (2017). The effect of exposure on attitudes
towards bullying and autism in schools. Oral presentation at a meeting of the
NAS/Cullum Centre Leadership Group (16/3/17), Salesian School, Chertsey
vii
Table of Contents
Chapter 1.....................................................................................................................1
Literature Review.......................................................................................................1
1.1 General introduction and scope of literature review........................................1
1.2 Inclusive policy and practice in mainstream school settings...........................8
1.3 Peer relations and social inclusion of children with autism in mainstream
schools...........................................................................................................17
1.4 The problem of bullying for children with autism.........................................26
1.5 Strategies for improving peer relations and reducing bullying of children
with autism....................................................................................................34
1.6 Theoretical framework...................................................................................44
1.7 Conclusions and aims of the thesis................................................................59
Chapter 2...................................................................................................................64
Study 1: Friendship motivations, challenges and the role of masking for girls
with autism in contrasting school settings: a qualitative study............................64
2.1 Introduction....................................................................................................64
2.2 Method...........................................................................................................67
2.3 Results............................................................................................................72
2.4 Discussion......................................................................................................79
Chapter 3...................................................................................................................84
Study 2: Balancing the challenges and solutions for teachers supporting autistic
pupils in contrasting school settings: a qualitative study......................................84
3.1 Introduction....................................................................................................84
3.2 Method...........................................................................................................86
3.3 Results............................................................................................................88
3.4 Discussion....................................................................................................102
Chapter 4.................................................................................................................108
Study 3: The effect of exposure on attitudes towards bullying and autism in
schools: A cohort study with a control group. Findings at baseline..................108
4.1 Introduction..................................................................................................108
4.2 Method.........................................................................................................112
4.3 Results..........................................................................................................118
4.4 Discussion....................................................................................................125
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Chapter 5.................................................................................................................128
Study 4: The effect of exposure on attitudes towards bullying and autism in
schools. A cohort study with a control group. Findings at follow-up..............128
5.1 Introduction..................................................................................................128
5.2 Method.........................................................................................................131
5.3 Results..........................................................................................................133
5.4 Discussion....................................................................................................145
Chapter 6.................................................................................................................151
Study 5: The impact of a school-based musical contact intervention on prosocial
attitudes, emotions and behaviours: A pilot trial with autistic and neurotypical
children....................................................................................................................151
6.1 Introduction..................................................................................................151
6.2 Method.........................................................................................................154
6.3 Results..........................................................................................................161
6.4 Discussion....................................................................................................167
Chapter 7.................................................................................................................174
Discussion................................................................................................................174
7.1 Overview......................................................................................................174
7.2 Summary of findings....................................................................................175
7.3 Synthesis......................................................................................................178
7.4 Implications for theory.................................................................................183
7.5 Implications for practice..............................................................................186
7.6 Methodological limitations and future research...........................................188
7.7 Conclusion....................................................................................................189
References................................................................................................................190
Appendices...............................................................................................................231
Appendix A – Study 1 Letter to Parents/Carers and Information Sheets..........231
Appendix B – Study 1 Consent Forms...............................................................235
Appendix C – Study 1 Interview Schedules......................................................238
Appendix D – Study 1 and 2 University Ethics Committee Approval..............242
Appendix E – Study 2 Information Sheet..........................................................244
Appendix F – Study 2 Consent Form.................................................................247
Appendix G – Study 2 Interview Schedule........................................................248
Appendix H – Study 3 & 4 Information Sheet...................................................250
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Appendix I – Study 3 & 4 Consent Forms.........................................................253
Appendix J – Study 3 & 4 Questionnaire...........................................................258
Appendix K – Study 3 & 4 PSHE Survey Consent Form..................................266
Appendix L – Study 3 & 4 PSHE Survey..........................................................267
Appendix M – Study 3 & 4 University Ethics Committee Approval................268
Appendix N – Study 4 Debriefing.....................................................................270
Appendix O – Study 5 Feasibility Study Interview Schedule............................271
Appendix P – Study Five Information Sheets....................................................272
Appendix Q – Study 5 Consent Forms..............................................................277
Appendix R – Study 5 Questionnaire.................................................................280
Appendix S – Study 5 University Ethics Committee Approval.........................288
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List of Tables
2.1 Study 1 Diagnostic information 69
2.2 Study 1 Description of the participants according to socio-demographics 70
2.3 Study 1 Themes and sub-themes derived from thematic analysis 72
3.1 Study 2 Description of the participants according to socio-demographics 87
3.2 Study 2 Themes and sub-themes derived from thematic analysis 89
4.1 Study 3 Skew and kurtosis values of baseline scores 118
4.2 Study 3 Differences in participant demographics by educational exposure
119
4.3 Study 3 Descriptive data and ANOVA results for responses to vignettes by educational exposure
121
4.4 Study 3 Descriptive data and ANOVA results for cognitive attitudes by educational exposure
124
5.1 Study 4 Skew and kurtosis values of change scores 134
5.2 Study 4 Differences in participant demographics by educational exposure
135
5.3 Study 4 Differences in participant demographics of completers and non-completers
136
5.4 Study 4 Descriptive data and ANOVA results for change in responses to vignettes by educational exposure
138
5.5 Study 4 Descriptive data and ANOVA results for change in cognitive attitudes to autism by educational exposure
141
5.6 Study 4 Descriptive data and ANOVA results for change in responses to vignettes by change in personal exposure
143
6.1 Study 5 Skew and kurtosis values of change scores 162
6.2 Study 5 Differences in participant demographics by group (NT children) 162
6.3 Study 5 Descriptive data and t-test/Mann-Whitney U results for change scores by group (NT children)
163
6.4 Study 5 Descriptive data and Wilcoxon signed rank test results for differences in scores between Time 1 and Time 2 in children with autism
165
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List of Figures
1.1 The reciprocal effects peer interaction model (REPIM) 23
3.1 Study 2 Illustration of the relationship between themes 98
4.1 Study 3 Difference in prosocial judgments and emotions by target type 122
4.2 Study 3 Difference in prosocial judgements and emotions by violation type 123
4.3 Study 3 Cognitive attitudes towards autism by educational exposure 124
5.1 Study 4 Change in prosocial emotions towards bullying by educational exposure
139
5.2 Study 4 Change in prosocial emotions towards bullying by educational exposure (three-way interaction)
139
5.3 Study 4 Change in prosocial emotions with low educational exposure 140
5.4 Study 4 Change in cognitive attitudes towards people with autism according to change in personal exposure
144
6.1 Study 5 Description of attendance for each group (contact vs. no contact) 155
6.2 Study 5 Mean scores at Time 1 and Time 2 for tendency to be a victim 164
6.3 Study 5 Mean scores at Time 1 and Time 2 for prosocial emotions 165
List of Acronyms
ACL Adjective checklist
ASD Autism spectrum disorder
HEES High educational exposure schools
HFA High functioning autism
LEES Low educational exposure schools
MLD Moderate learning difficulties
NAS National Autistic Society
NT Neurotypical
OBPP Olweus bullying prevention programme
PSHE Personal social & health education
SEN Special educational needs
SIT Social identity theory
SRC Specialist resource centre
TA Teaching assistant
xii
Chapter 1
Literature Review
1.1 General introduction and scope of literature review
Many children with autism face a number of challenges and these vary in magnitude
from one individual to another. For example, they may have poorer academic results
(DfE, 2014), behavioural difficulties (Macintosh & Dissanayake, 2006), and a
variety of social difficulties (Attwood, 2000; Bauminger et al., 2004; Bauminger &
Kasari, 2000; Calder et al., 2013; Rotheram-Fuller et al., 2010) including greater
exposure to victimisation and bullying (Humphrey and Symes, 2011). Given the
significantly higher levels of reported bullying prevalence rates for children with
autism compared to the general population, this thesis aims to explore peer relations
for autistic children, with a particular focus on bullying and the attitudes of
neurotypical children towards their autistic peers in mainstream school settings.
This chapter provides a general introduction to the area of focus, firstly outlining
definitions and prevalence of autism, then describing social deficits and the social
challenges these can cause for autistic children, and finally outlining the scope of the
literature review.
Definitions
Autism is a neurodevelopmental condition characterised by impaired social
interaction, difficulties communicating with other people and restricted and repetitive
patterns of behaviour, known as the ‘triad of impairments’ (Wing & Gould, 1979).
The National Autistic Society (NAS) describe it as ‘a lifelong developmental
disability that affects how people perceive the world and interact with others’ (NAS,
2018). Diagnosis is made using the Diagnostic and Statistical Manual of Mental
Disorders (DSM-5) and the International Classification of Diseases (ICD-10), which
provide criteria for identification of autism for use by clinicians. Autism is highly
heterogeneous in nature; known as Autism Spectrum Disorder (ASD), the social,
communication and behavioural impairments range from mild to severe, with those
at the mild end, and with average or above average IQ being described as ‘high
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functioning’. High functioning autism (HFA) includes Asperger Syndrome, which is
characterised similarly to autism, but without the early language impairments.
However, Asperger’s syndrome was removed as a separate diagnostic category in the
DSM-5 (2013).
Prevalence
There are around 700,000 people in the UK with autism – more than one in 100
(NHS Information Centre, Community and Mental Health Team, 2012). When
compared to prevalence rates from the 1960s (4.5 in 10,000, reported by Lotter,
1969), it appears that numbers of autistic people in the population are rising. Whilst
increased prevalence could reflect the wider criteria adopted by clinicians in recent
years, and also increased levels of training to identify and diagnose the disorder,
research continues to explore incidence rates (i.e. frequency of occurrence of new
diagnoses) to disconfirm hypotheses that increased prevalence might be related to
environmental effects, that may be leading to an ‘epidemic’.
The male-female ratio for the prevalence of autism is reported to be 4-5:1 (Kim et al.,
2011; Scott et al., 2002). Some studies suggest that the symptoms of autism are less
apparent in girls (Wolff & McGuire, 1995). For example, it is reported that boys
display more restrictive interests and odd/repetitive behaviours than girls (Haq & Le
Couteur, 2004; Hartely & Sakora, 2009) whereas girls are more likely to internalise
their symptoms (Mandy et al., 2012; Solomon et al., 2012). While various biogenic
models have explored the imbalance in prevalence between males and females
(Baron-Cohen, 2002; Skuse, 2000; Wing, 1981), other research has begun to explore
social factors that might be influencing the rate of diagnosis of girls (Attwood, 2006;
Hsiao et al., 2013; Kreiser & White, 2014), such as sociocultural factors influencing
the expression of autistic characteristics in females (Kreiser and White, 2014) and
social cognitive theories of gender expectations (Bem, 1981; Bussey et al., 1999) that
may lead them to hide autistic characteristics though modelling gender-appropriate
behaviour (Kreiser & White, 2014). These factors may partly explain the gender
imbalance. Indeed, recent media reports indicate that the under-diagnosis of girls is a
gender equality issue. In one recent media report (Devlin, 2018), Happé explained
how assumptions of autism being a male disorder, and bias towards recruiting male-
only participants, has led to a narrow definition of autism leading to substantial
2
numbers of girls going undiagnosed. Chapter 2 will explore friendship motivations
and the role of masking for girls with autism.
Social deficits of children with autism
Children with autism may have problems abstracting social meaning from situations
and hence experience difficulties in social situations. Cognitive deficits that may
influence their social abilities include difficulties with planning (Hughes, 1996),
inhibition (Corbett et al., 2009), memory (Goldberg et al., 2005) and flexibility of
thought (Corbett et al., 2009), i.e. ‘executive function’ (Ozonoff et al., 1991).
Early studies also suggested a tendency of those with autism to focus on small
details, rather than integrating pieces of information into a global whole, i.e. ‘weak
central coherence’ (Frith, 1989). Studies tracking the eye movements of children and
adults with autism found that they tend to focus on the mouths of people expressing
certain emotions in film clips rather than the eyes, which are more commonly
focused upon by neurotypical individuals to detect important social cues (Jones et al.,
2008; Klin et al., 2002; Spezio et al., 2007). Similarly when shown bio-motion
displays of a human body (i.e. represented by spots of light), children with autism
will focus on non-social aspects such as audio-visual elements, whereas neurotypical
children attend to the social meaning of the particular movements (e.g. clapping)
(Kin et al., 2009). Klin et al. deduced that people with autism develop social
knowledge in different ways, tuning into different elements in order to try to make
sense of the social world. It is important to consider the relationship between global
integration and local processing, however, since this is still unclear. Recent research
questions the assumption that weak central coherence necessarily leads to increased
local processing. Booth and Happé (2018) separated these mechanisms, testing
global integration independent from local bias. Their findings suggest reduced global
processing in participants with autism, supporting Frith’s (1989) earlier findings.
These provide an alternative perspective to theories of enhanced perceptual
functioning (Mottron & Burack, 2001; Mottron et al., 2006) or superior systemising
theories (Baron-Cohen, 2002) which claim superior local processing when global
processing is intact.
3
Early cognitive theories also suggested that people with autism demonstrate an
extreme ability to systemise - the ability to look for logical patterns and establish
laws that enable prediction – but lower ability to empathise (Baron-Cohen, 2002).
Empathy is closely related to ‘theory of mind’: the ability to recognise that others
have thoughts and feelings that are different to your own. Reduced theory of mind
has been thought to largely account for the social impairments associated with
autism. More recent studies however show that rather than autism predicting deficits
in empathy, co-occurring alexithymia (characterised by difficulties interpreting
emotional states) may account for the emotional deficits (Bird et al, 2010; Cook et al,
2013).
Despite some conflicting perspectives, cognitive deficits such as those affecting
executive function and global integration provide some understanding as to why
children with autism may have problems abstracting social meaning and hence
experience difficulties in social situations. Children in the school playground will be
presented with a range of social cues, and be expected to respond to them
appropriately in order to be accepted and included in social groups. By focusing on
non-social cues, they may fail to detect social meaning in situations, leading to a
number of social challenges outlined below.
Social challenges for children with autism
Development of the skills needed for social interaction, such as communication,
emotion regulation, conflict resolution and co-operation is fundamental to the
success of social relationships (Hartup & Laursen, 1993; Newcomb & Bagwell,
1995). Whilst neurotypical children acquire these basic skills through exposure and
implicit learning, modelling and trial and error (Meltzoff et al., 2009), the deficits
highlighted above may impact the development of children with autism, preventing
early opportunities to develop these skills. This can have negative consequences
since successful peer relationships have been found to promote positive social,
cognitive and emotional development (Hartup & Stevens, 1999), and conversely,
lack of such relationships leads to emotional and behavioural problems (Bagwell et
al., 1998; Hartup & Stevens, 1999).
4
The majority of children with autism experience significant difficulties with social
interactions (Fuentes et al., 2012; Hill & Frith, 2003). A systematic review of 24
studies addressing characteristics of friendship in school-age children with autism
(Petrina et al., 2014) found that children with autism are likely to have fewer friends
(lower still than other disability groups), lower duration of friendships, less
developed understanding of friendship and lower perceived quality of friendships
than neurotypical controls. Children with autism desire to fit in and not be rejected
(Carrington & Graham, 2001; Humphrey & Lewis, 2008). Indeed some children,
particularly girls, attempt to ‘mask’ their differences in an attempt to fit in, through
copying behaviours of their neurotypical peers (Attwood, 2006; Dean et al., (2016);
Dworzynsky et al., 2012; Kopp & Gillberg. 1992; Kreiser & White, 2014). However,
studies using networking surveys to investigate peer relationships in mainstream
schools find that children with autism are less accepted than their neurotypical peers
(Kasari et al., 2011; Rotheram-Fuller et al., 2010). Lack of peer acceptance can lead
to negative self-appraisal (Ladd & Tropper-Gordon, 2003; Sandstrom et al., 2003),
poor mental health (Bagwell et al., 1998; Grills & Ollendick, 2002) and greater risk
of victimisation (Bejerot & Mortberg, 2009; Humphrey & Hebron, 2015;
Chatzitheochari et al., 2014; Symes and Humphrey, 2010; Wainscot et al., 2008).
Literature focusing on bullying and victimisation indicates that many of the
characteristics considered to be the prime causative factors of bullying are typical of
children with autism, such as communication difficulties, inappropriate social
behaviour, low social status and reduced social competence (Bejerot & Mortberg,
2009; Card & Hodges, 2008; Garner & Stone Hinton, 2010; Horowitz et al., 2004). A
cyclic process can occur, whereby the experience of victimisation reduces the
motivation for further social interaction, limiting even more their opportunities to
develop social and communication skills (Humphrey & Symes, 2011). Research
addressing this cyclic process is urgently needed to reduce the social challenges and
their associated negative outcomes that are preventing children with autism from
accessing the same quality of life as their neurotypical peers.
Scope of literature review
Research outlined above describing the cognitive deficits of people with autism
provides some insight into differences in the way knowledge is developed about the
5
social world compared to neurotypical people. Difficulties abstracting meaning from,
and responding appropriately to social situations make them vulnerable in school
settings, where these skills are often necessary to be successfully included into social
groups. While children with autism desire to fit in, they are often less accepted and
frequently subject to victimisation, which can have a significant impact on their
academic progress, mental health and general wellbeing.
The literature review hence focuses on four main areas of research (corresponding to
chapters 1.2, 1.3, 1.4 and 1.5) that are fundamental to an exploration of these social
challenges:
1. Inclusive policy and practice in mainstream school settings
This chapter (1.2) provides a philosophical and historical overview of inclusion
policy in the UK, findings from research evaluating academic and social outcomes of
inclusion and the conflict between beliefs about social justice and the challenges of
implementing an inclusive school environment that sufficiently supports the needs of
children with special educational needs, and autism in particular.
2. Peer relations and social inclusion of children with autism in mainstream
schools
This chapter (1.3) explores friendship, peer acceptance and peer rejection including
the negative mental health outcomes of rejection. It also explores the effect of
disclosure versus de-emphasising the salience of autism and of school/peer group
norms on peer acceptance.
3. The problem of bullying for children with autism
In this chapter (1.4), differences in the prevalence of bullying between the general
population and autistic population are considered. Risk and protective factors and
some of the consequences for autistic victims of bullying are described. Furthermore,
factors leading to prejudice, discrimination and stereotypical perceptions of
neurotypical peers are explored, including factors affecting the likelihood of children
to intervene in bullying scenarios.
6
4. Strategies for improving peer relations and reducing bullying for children
with autism.
This chapter (1.5) explores the effectiveness of anti-bullying programmes and other
means to promote attitude change including information-based and contact-based
interventions designed to improve peer relations between autistic and neurotypical
children.
Chapter 1.6 will then present the theoretical framework for this thesis, followed by
conclusions from the literature review and an outline of thesis aims in 1.7.
7
1.2 Inclusive policy and practice in mainstream school settings
There are ongoing debates and opposing philosophical opinions regarding the
inclusion for children with special educational needs (SEN) in mainstream schools.
Some see the need for both mainstream and special schools settings, arguing that
rights of children to be given access to mainstream education must be balanced by
their rights to an effective education appropriate to their needs. Others take a more
idealist perspective, believing that that this undermines real inclusive policy
(Lauchlan & Grieg, 2015) and argue for universal education where children engage
in a common educational experience. Indeed, it is debatable whether certain children
feel more included in mainstream classrooms than in separate settings where they
may be more able to access the curriculum and engage in their learning (Norwich,
2008). The National Association of Head Teachers (2003) stated that the most
appropriate educational settings for a child is ‘the one in which they can be most
fully included in the life of their school community and which gives them a sense
both of belonging and achievement’ (Warnock & Norwich, 2010, p.34). However,
Norwich (2008) drew attention to the dilemma that exists in attempting to reconcile
the two values of providing educational provision to meet individual needs, and
instilling a sense of belonging and acceptance.
Inclusive education is therefore a concept that can be interpreted in different ways,
but there is general agreement that it denotes more than integration, but rather an
approach to education that responds to the needs of all children who are at risk of not
engaging fully in the life of the school (Woolfson, 2011). Characteristics placing a
child at risk vary widely including class, race, ethnicity, gender, sexuality and
disability, but for the purposes of this thesis, inclusion will be discussed in relation to
special educational needs, and specifically ASD. Furthermore, this section will focus
on the inclusion of children with autism in mainstream school settings.
In the UK, children with a diagnosis of an autism spectrum disorder will either attend
a special school (for autistic pupils, or for pupils with learning difficulties, physical
difficulties or a combination of both) or a mainstream school setting, some with
additional support (e.g. a teaching assistant for a set number of hours per week) or
with its own specialist resource centre (SRC) for students with autism. The majority
8
(73%) are placed in mainstream settings (DfE, 2015), and children with autism are
reported to be the fastest growing group of children with a statement of special
educational needs/Education Health and Care Plan in mainstream schools in England
and Wales (Audit Commission, 2002). Currently however, pupils with autism are
amongst the most likely to be excluded from school (Barnard et al., 2000; DfES,
2006) and are viewed as more difficult to effectively include than pupils with other
SENs (House of Commons Education and Skills Committee, 2006). Investigation of
inclusive policies is therefore fundamental given the increasing numbers of autistic
children attending mainstream schools.
International and UK Legislation
Inclusive policies vary from country to country. Some countries such as the
Netherlands offer separate special and general school systems, reflecting a highly
differentiated and decentralised system (Norwich, 2010). In contrast, other countries
adopt a fully inclusive approach. Norway and Finland, where educational aims are
associated with democratic values such as citizenship, social integration and national
cohesion (Arduin, 2015) adopt inclusive approaches, ensuring that adaptations reflect
the abilities and aptitudes of every child, and striving for an ethos of belonging to a
community (Nilsen, 2010). Rather than focusing on ‘where’ a child with SEN is
educated, their focus is more on ‘how’ through providing ‘optimal learning
conditions in the regular learning context’ (Norwegian Ministry of Education and
Research, 2014). Little is known however about the effectiveness of a fully inclusive
approach. Teachers in Italy, where a fully inclusive approach has been implemented
for over 40 years, have more recently questioned this approach due to insufficient
resources and training and doubts regarding its benefits for children with SEN
(Lauchlan & Fadda, 2012).
In England, recommendations emerged in the 1970s (e.g. The Warnock Report,
1978; UNESCO, 1994) favouring the enrolment of all children in mainstream
schools wherever possible. This was a deliberate move away from ‘integration’ (i.e.
merely the attendance of children with SEN in mainstream schools) (Ainscow, 1995)
towards full social and educational inclusion where children with SEN feel
welcomed and can thrive (Lauchlan & Grieg, 2015). Humphrey (2008) proposed a
definition of inclusion with four elements: students’ presence (without withdrawal
9
classes), participation (in educational experiences), acceptance (by teachers and
peers) and achievement (academic, social and emotional). Instead of deficits being
perceived as within the child (the ‘medical model’), the focus switched to assessing
the way provision should be adapted to respond to the diverse needs of children (‘the
social model’). A government Green Paper entitled ‘Excellence for All Children:
Meeting Special Educational Needs’ (DfEE, 1997) highlighted the government’s
commitment to the principle of inclusion. And in order to ensure greater commitment
in schools to meeting the needs of all pupils, the Special Educational Needs and
Disability Act, 2001 and Disability Discrimination Act, 2005 were introduced, which
required teachers to make ‘reasonable adjustments’ to their lessons to enable children
with SEN and disability to learn and be included in school life. Furthermore, the
Special Educational Needs and Disability Act stated that a child must be educated in
a mainstream school unless this is incompatible with the wishes of the parent or the
provision of efficient education for other children. This was developed further with
the Every Child Matters legislation (DfES 2004), which required a multi-agency
approach whereby services available in the community were integrated. It was also
embedded within the National Curriculum statutory inclusion statement, outlining
key principles for an inclusive curriculum: setting suitable learning challenges,
responding to pupils’ diverse needs and overcoming potential barriers to learning
(DfES, 2006).
Nevertheless, the number of pupils placed in independent special schools continues
to rise, which is believed to be due to difficulties meeting the needs of children with
SEN in mainstream schools settings (Ofsted, 2004). The change of government in
2010 saw the Conservative Party endorse special school provision, preferring to give
more choice to parents and removing the bias towards inclusion (DfE, 2011). This
position is endorsed in the SEN Code of Practice (DfE, 2014), which focuses on
ensuring the views of children are considered in decision-making and closer
integration of education, health and social care.
Research on the effectiveness of mainstream schools for children with SEN
Arguing from a human rights perspective, The British Council of Disabled People
(BCODP, 2005) believe that not supporting children with SEN in mainstream
schools is discrimination, and therefore an infringement of human rights. As such
10
they regard as unnecessary and unethical any research that compares mainstream
with special school education. Regardless of this, given that a range of school
settings exist in England, research into their effectiveness is vital in order to ascertain
whether or not children with SEN achieve better academic and social outcomes when
they receive their education in inclusive mainstream environments rather than special
school settings. Thomas et al. (1998) agreed, stressing that ‘it is crucial that the
principled policy decisions to provide inclusive education are rigorously monitored,
especially as recent evidence concerning the academic, social and emotional benefits
of integrative programmes is nowhere near as clear-cut as earlier evidence
promised.’ (Thomas et al., 1998. p.5-6). It has been argued that, whereby placement
in mainstream settings may deny access to vital specialist support needed to achieve
academic potential, placement in a special school setting may lead to social exclusion
(Frederickson & Cline, 2009). The findings from research nevertheless provide a
rather more complex picture, as will be discussed.
Academic outcomes of inclusion
Little research has compared the learning of children with autism in different school
settings. Some studies do however compare academic outcomes of children with
special educational needs. Lindsay (2007) concluded that of 1,373 papers reviewed
on the effectiveness of inclusive education for children with SEN only nine
compared children with SEN across specialist and mainstream settings. Of these,
most findings showed positive effects of mainstream settings for academic outcomes
(Carlberg & Kavale, 1980; Mykelbust, 2007). These were supported by a number of
other studies, showing better academic achievement of SEN pupils in mainstream
than in special school settings (Baker, Wang & Walberg, 1995; Lipsky & Gartner,
1996; Markussen, 2004; Ruijs & Peetsma, 2009). In contrast, other findings showed
no advantages of inclusive education over special education, except in reading
performance (Zigmond & Baker, 1995). Generalisations regardless of the type and
severity of SEN are problematic, however since children with SEN are not a
homogeneous group. Closer inspection of the findings by Carlberg and Kavale
(1980), for example, shows that pupils with cognitive impairments illustrate better
outcomes in mainstream settings whereas those who had behavioural or emotional
disorders or a learning disability showed better outcomes in specialist settings.
11
A further point to consider when comparing educational settings is the differentiation
of variables that are most relevant, i.e. the features of the curriculum, teaching
methods or other aspects of the school ethos and environment that might be
influencing the study outcomes (Kavale, 2002). For example, a study by Peetsma et
al. (2001) considered the characteristics of the education provided (i.e. adaptations
made to the curriculum and teaching delivery) when they compared the academic
development of primary school pupils with SEN in contrasting school settings. After
four years they found greater academic progress by pupils in the mainstream settings
compared to the special setting, but that this had no relationship with the
characteristics of education provided. They concluded that the academic outcomes
were the result of other factors such as individual characteristics relating to the child,
school and family. This exemplifies some of the methodological limitations faced in
inclusion research.
Social outcomes of inclusion
Evidence regarding social inclusion of children with SEN in mainstream schools is
also unclear. It is anticipated that attending the same local mainstream schools as
their siblings and local peers, children with SEN will have more opportunities to
engage in social relationships in the community (Kasari & Rotheram-Fuller, 2007;
Vaughn, Elbaum & Schumm, 1996). Indeed, research shows that social competence
of children with SEN has been found to progress more in mainstream settings than in
specialist settings (Cole & Meyer, 1991) although this may reflect a selection issue
rather than the setting causing the increase in social skills. In addition to social
competence, it is also important to examine social relationships. In a review by
Freeman and Alkin (2000), two studies (Evans et al., 1992 and Hudson & Clunies-
Ross, 1984) showed no difference in social acceptance between SEN and
neurotypical groups. However, in another study using sociometric data the large
percentage of SEN pupils in mainstream settings are classified as ‘rejected’ whilst
the large proportion of neurotypical pupils are classified as ‘popular’ (Frederickson
& Furnham, 2001). In addition, the stability coefficients were higher for the SEN
sample than the neurotypical sample, meaning that once a child with SEN is rejected,
it is more likely that they will remain rejected. (This is discussed further in Ch.1.3.)
While findings are inconsistent, again partly due to methodological limitations, it is
likely that the mere inclusion of pupils with SEN, and autism in particular into
12
mainstream schools may be insufficient to guarantee successful assimilation and may
instead cause loneliness, poor friendship quality and social network status (Kasari et
al., 2011; Locke et al., 2010). Indeed, findings from a meta-synthesis examining the
experiences of pupils with autism by Williams et al. (2017) suggest that mainstream
settings may accentuate their sense of being different from their neurotypical peers in
a negative way.
The conclusions drawn from studies comparing academic and social outcomes of
children in inclusive settings are therefore mixed. However, a qualitative study
carried out by Ofsted (2006) examined progress of pupils in different types of
provision, and while there was little difference in academic, personal or social
outcomes by provision type, differences were found in the quality of provision
categorised on the three dimensions of ethos, provision of specialist staff and
professional development for all staff. They concluded that key factors for good
progress are the involvement of a specialist teacher, good assessment, work tailored
to challenge pupils sufficiently and commitment from school leaders to ensure good
progress for all pupils.
Attitudes of social justice vs. challenges of implementation
While there is general agreement among teachers that inclusion is important for
reasons of social justice (Artiles et al., 2006; Polat, 2011), research indicates that
many teachers have little confidence in their capacity to support students with SEN,
(Ellis et al., 2008). Boyle et al. (2013) found that attitudes towards inclusion of 391
secondary school teachers in Scotland were very positive (particularly of female
teachers) but these were significantly less positive after one year of teaching.
Furthermore a survey of 46 head teachers and 299 primary school teachers (Croll,
2001) found that all head teachers and 98% of teachers believe there is still a place
for special schools, with many (one third) thinking more children should attend them.
This is to some extent influenced by the type of SEN, with cognitive and physical
disabilities being viewed as suitable for inclusion in mainstream settings (Forlin,
1995; Ward, et al., 1994) and social and emotional behaviour disorders being less so
(Avarmidis & Norwich, 2002). This corresponds with Carlberg & Kavale’s (1980)
findings relating to academic outcomes. It also reflects ASD-specific studies
reporting tensions caused by social/emotional difficulties affecting the quality of
13
teacher-pupil interactions (Emam & Farrell, 2009) leading to a decrease in positive
attitudes towards them (Robertson et al., 2003).
Some recent research indicates more inclusive attitudes (Forlin, 1995; Brady and
Woolfson, 2008; Idol, 2006; Boyle et al., 2013) but this may reflect a number of
factors such as more idealistic views of those new to the profession, completing
training courses that focus on inclusive practice, changes to legislation making it
illegal to discriminate against pupils based on their SEN (DfES, 2001) and also the
release of Removing Barriers to Achievement (DfES, 2004), which may have
provided teachers with more confidence to meet the needs of children with SEN.
Nevertheless, other recent studies found that mainstream teachers were less positive,
attributed difficulties as being inherent to the child and showing less willingness to
adapt their teaching, although these tended to reflect the views of teachers with less
training and experience of teaching children with SEN, (Woolfson et al., 2007; Brady
& Woolfson, 2008).
In particular, many teachers lack the training to adequately support children with
ASD (Dybvik, 2004; Gregor & Campbell, 2001; Robertson et al., 2003). There are
particular concerns facing teachers of children with ASD. Generic teaching strategies
that may apply to most pupils are not always sufficient for certain groups of pupils
with SEN (Norwich & Lewis, 2001). In addition to common features such as
involvement of parents and social interaction, autism-specific features need to be
implemented such as addressing their need for routine, visual cues and specific
generalisation strategies (Jordan et al., 1998). Level of ASD-specific training has
been found to be higher in schools with specialist resource centres (SRCs)
(Frederickson et al., 2010). In addition to this Frederickson et al. found they had
more ASD-friendly environments and a higher level of home-school collaboration
than schools without SRCs. Frederickson et al. (2010) argued that comparable
provision is feasible across both setting types with adequate staff training. One
fundamental difference however was the lower level of inclusion in mainstream
lessons of children with ASD in SRC schools. The alternative to this is a higher level
of teaching assistant (TA) support within mainstream classrooms. However, rather
than providing greater quality of inclusion, studies find that children with autism in
mainstream lessons are less likely to work independently or be socially included than
14
their peers when the TA is present (Alston, & Kilham, 2004; Howes, 2003; Symes &
Humphrey, 2012). It was found that this was due to the TA reducing opportunities
for pupils they support to interact with their peers.
In conclusion, while there is general agreement of the importance of inclusion for
reasons of social justice, there are on-going barriers to its effectiveness due to lack of
provision of specialist staff, adequate training and commitment to an inclusive school
ethos. Some argue that what is required is a societal change in attitudes, beliefs and
assumptions about disability, diversity and difference (Arduin, 2015) and consequent
teaching pedagogies that respond to individual difference, without drawing attention
to (and thus stigmatising) those who are less able (Florian & Black-Hawkins, 2011).
Others suggest a reconsideration of our concept of inclusion endorsing alternative
approaches, such as the combining of all types of provision in an inclusive education
service (Tutt, 2007) or focusing more on a interacting dimensions in a continuum of
provision (rather than the uni-dimensional approach) (Norwich, 2008). A recent
alternative model, entitled the ‘capability approach’, incorporates personal
characteristics, commodities/resources and the environment (Norwich, 2014;
Reindal, 2016). Based on the assumption that ‘an individual is disabled if he or she
cannot do or be the things he or she value doing or being’ (Mitra, 2006, p.241), this
may offer an alternative approach for inclusive education through highlighting
inequalities.
Summary
The focus of inclusion of children with special educational needs has shifted from the
individual child with SEN to the creation of a school environment that supports all
children. While studies evaluating the benefits of inclusion fail to provide clear
evidence for or against, inclusion continues to be the prevailing policy framework.
However, it is clear that teachers in mainstream schools face great demands such as
large class sizes and pressure to achieve ever increasing pupil outcomes for national
tests, league tables and Ofsted inspections while also meeting needs of children with
widely diverse backgrounds and abilities (discussed further in Chapter 3). Whilst
many schools are generally more aware of their responsibilities, some studies
indicate that the goals of inclusion, to make education more responsive to the needs
15
of all students, remain unmet (Barnard et al., 2000; Batten et al., 2006; Humphrey &
Lewis, 2008).
Since the prevailing emphasis in the UK is biased towards inclusion and personal
choice regarding school placement it is important that a whole-school approach to
inclusion is adopted (Booth & Ainscow, 2002; Humprhey & Symes, 2013) whereby
all staff have a clear understanding of what constitutes inclusion within their school
(Eldara et al., 2010), and sufficient resources are provided to cater for the needs of
all, including specific information and training on how best to implement these
resources (Lauchlan & Greig, 2015). Finally successful inclusion involves promoting
an inclusive ethos in the classroom in which everyone is accepted and supported by
the whole school community including their peers (Cross & Walker-Knight, 1997).
Peer group acceptance and rejection will be the focus of the next two sections
(Ch.1.3 and 1.4).
16
1.3 Peer relations and social inclusion of children with autism in mainstream
schools
A key element of inclusion for children with autism is that of peer relationships due
to the particular difficulties experienced interacting with other people. As mentioned
in Chapter 1.2, the opportunity to interact with neurotypical peers is greater in
mainstream school settings (Kasari & Rotheram-Fuller, 2007; Vaughn, Elbaum &
Schumm, 1996) and is perceived as one of the benefits of inclusion, since they can
develop their social skills (Cole and Meyer, 1991) while at the same time their peers
learn to become more accepting of difference (Boutot and Bryant, 2005; Kasari and
Rotherham-Fuller, 2007). Social outcomes for children with ASD are nevertheless
often reported to be negative (Cairns & Cairns, 1994; Chamberlain et al., 2003;
Symes & Humphrey, 2010).
Friendship
Research indicates certain characteristics that are necessary for friendship:
reciprocity and intimacy, more intense social activity, more frequent conflict
resolution and more effective task performance (Newcomb and Bagwell, 1995;
Hartup, 1996; Howes et al., 1994). In particular, during adolescence, aspects such as
loyalty, commitment, genuineness and potential for intimacy are especially important
(Bigelow & La Gaipa, 1980). The steps required in social interactions in order to
develop these characteristics may be challenging for children with autism. Explained
in terms of social information processing, these include encoding incoming
information, interpreting the information, searching for the appropriate response,
evaluating these responses and selecting the best and enacting the response (Dodge et
al., 1986). This may offer one explanation for the varying levels of success in social
interactions for children that differ in terms of their social-cognitive skills. The
difficulties faced by children with autism deciphering social expectations, intentions
and emotions (Baron-Cohen, 1988; Happe, 1994) or understanding contextual cues
in conversations (Sigman & Capps, 1997) can threaten to marginalise children with
autism from their neurotypical peers. This in turn leads to less engagement in social
interaction and less positive interaction behaviour (Bauminger et al., 2003), limiting
17
further their opportunities to develop understanding of these necessary
characteristics.
Peer acceptance and rejection
One method of exploring dynamics of peer relationships is to use ‘sociometry’, i.e.
the study of the organisation of a group and the position of individuals within it.
Researchers can investigate sociemetric status, i.e. the extent to which particular
individuals are accepted or rejected through asking their peers to nominate those they
like/would play with (positive nominations) and those they do not like/would not
play with (negative nominations). A review of many such studies in the 1980s and
90s was conducted by Newcomb et al. (1993) and concluded that popularity is
predicted by good interpersonal skills, low aggression and low withdrawal.
Conversely, rejected peer status was associated with aggression and withdrawal,
whilst neglected peer status was associated with less sociability and less aggression.
A more recent meta-analysis of sociometric assessment (Hymel et al., 2011)
confirmed stability of sociometric status over time, with the highest level of stability
in status found among ‘rejected’ children, i.e. those rejected at the start of a study are
still rejected or neglected four years later (Coie & Dodge, 1983).
The difference between neglected and rejected status is an important distinction. In
sociometry, neglected children are those who receive neither positive nor negative
nominations by their peers, whereas rejected children receive no positive
nominations but do receive negative nominations. It may be assumed that children
who are rejected and neglected would by default experience loneliness and social
withdrawal. Studies show that this isn’t necessarily true, and that while children who
are rejected score highly on self-reported loneliness, this isn’t the case for children
who are neglected (Asher et al., 1990). However, Qualter and Munn (2002) found in
a study measuring the peer rejection and loneliness of 640 4-9 year olds, that peer
rejection related to externalising problems whilst loneliness related more to
internalising and low self-esteem.
There is a more complex picture regarding the experience of loneliness for children
with ASD. Some studies indicate that children with ASD do not experience higher
levels of loneliness (Chamberlain et al., 2003), while others indicate that they do
18
(Bauminger & Kasari, 2000; Bauminger et al., 2003; Loche et al., 2010).
Furthermore, while neurotypical children report feeling less lonely when they have
friends (Bauminger & Kasari, 2000; Vanhalst et al., 2014), this is not the case for
children with ASD, who report loneliness even when they also have friends. The
conflict in results may in part be due to limitations in participants’ understanding of
the concepts of friendship and loneliness. While some children with autism may
desire to be alone, they can still experience loneliness (Bauminger & Kasari, 2000).
The distinction is critical and points to the need for ASD-specific measures.
Sociometric status of children with ASD
Less attention has been given to the social networks of children with autism.
However, Chamberlain et al. (2003) found children tend to form relationships with
others similar to themselves (known as ‘homophily’) and so children with autism
tend to be on the periphery of their classroom social structure and tend to associate
with a smaller group of children.
In a study of social acceptance and rejection of children with moderate learning
difficulties (MLD), Frederickson & Furnham (2004) adopted ‘social exchange
theory’ (Thibaut & Kelly, 1959), which proposes that people weigh up the potential
benefits and risks in social relationships. When applied to neurotypical populations,
those with greatest social acceptance are those with high benefit traits (e.g.
cooperation, prosocial behaviour) and low cost traits (e.g. disruptive, attention
seeking), and those with greatest social rejection show the reverse. Frederickson and
Furnham found that children with MLD are only socially rejected when there are low
benefits (prosocial behaviours), but not when there are high costs (i.e. social and
emotional difficulties). Contrariwise, children with MLD were socially accepted with
low levels of costly traits but weren’t expected to offer high levels of benefits. Using
the same theoretical model, Jones & Frederickson (2010) used sociometric tools with
86 children from mainstream schools (43 with ASD), to investigate social acceptance
and rejection in relation to peer-rated behavioural features. Students with ASD were
significantly less well accepted by their peers and had higher social rejection ratings
than students without ASD. While there were no between-group differences by
behavioural features in predicting social acceptance, they found social rejection to be
negatively associated with cooperation for both groups, but high levels of shyness
19
only positively associated with social rejection for non-ASD students. If shyness is
perceived as a ‘cost’ trait (i.e. a relatively asocial behaviour), this result reflects that
of Frederickson and Furnham (2004), i.e. that students with ASD are less likely to be
rejected based on high costs than their neurotypical peers. It also reflects Weiner’s
attribution theory, in that peers’ attitudes may be more positive if they view the
problems being beyond the autistic peer’s control (Weiner & Graham, 1984). Jones
& Frederickson therefore postulated that the lower likelihood of rejection may be due
to allowances being made for their problems and that making more visible the special
considerations to be given to students with ASD may in fact prevent antisocial
behaviours being perceived negatively.
Disclosure vs. de-emphasising salience of autistic traits/diagnosis
‘Visibility’ of a child’s condition (i.e. autism, Asperger’s, HFA etc.) leads to a much
larger debate regarding disclosure and the perceived advantages and disadvantages
for social inclusion. In support of Brewer and Miller’s (1984) theory that where a
social category is psychologically less significant it loses its power to organize (and
bias) people’s attitudes, Maras and Brown (2000) found that de-emphasising (down-
playing) the salience of disabilities led to less bias by non-disabled children than was
the case when more emphasis was placed on disability. They also found that children
in the ‘categorised’ condition (i.e. schools that place more emphasis on the
disabilities) were more likely to generalise their attitudes (in this case, negative
generalisations), i.e. transfer of feelings about a known peer with disabilities to other
unknown children with the same. Chapter 2 discusses the tendency of autistic girls in
particular to de-emphasise (or even mask) their autism (Attwood, 2006; Dean et al.,
2016; Dworzynsky et al., 2012; Kopp & Gillberg, 1992) by modelling the
mannerisms of their neurotypical peers in order to fit in.
In contrast, other studies found that full disclosure of a diagnosis leads to more
consistent social support in the classroom and the playground (Hewstone & Brown,
1986; Ochs et al., 2001). Ochs et al. reasoned that the success of inclusion is
primarily associated with neurotypical peers rather than teachers, but that positive
inclusion varies in relation to disclosure practices. In their observation of 15 children
with HFA (aged 8-12), when neurotypical peers were aware of the capabilities and
impairments of children with autism through receiving explanations about their
20
condition, they showed more attempts to make positive social interactions. In
contrast, children who hid their diagnosis were more likely to be subject to neglect,
rejection and scorn. They concluded that ‘It is unrealistic to expect that children
without autism, rooted in biology and culture, can shed their self-consciousness and
conventionality to imagine the world through autistic eyes. Yet, giving autism a
greater dialogic space in the school curriculum may enhance the perspective-taking
skills and nurture the creative potentialities of all children in inclusion classrooms.’
(Ochs et al., 2001, p.416).
Ochs et al.’s findings are supported by a study that adopted the theory of planned
behaviour (Ajzen, 1988) to investigate whether attitudes and perceived behavioural
control were significant predictors of children’s intentions to interact with children
with physical disabilities (Roberts and Smith, 1999). Their findings showed that
when children (aged 8-12 years) perceived interaction and friendship behaviour
towards disabled peers to be relatively easy to perform, they readily expressed an
intention to engage in these behaviours and when they were perceived as difficult
they expressed fewer intentions, even if they had a positive attitude towards them.
An explanation they give is the lack of knowledge or skills, rather than structural
barriers such as lack of opportunity, so suggested that providing neurotypical
children with more knowledge and practical skills for interacting with disabled
classmates might result in children feeling more in control of their behaviour,
resulting in more positive intentions and positive interaction. Knowledge-based
interventions are not always successful however (Swaim & Morgan, 2001) and this
will be discussed more fully in Ch.1.5.
School/peer group norms
One important element of the theory of planned behaviour (adopted by Roberts &
Smith, 1999 above) is the subjective norm, i.e. perceptions of the attitudes of
significant others in one’s group. Peer norms and school norms can be inclusive or
exclusive, and recent work has explored the influence of inclusive school norms on
attitudes towards peers in other groups (McGuire et al., 2015; Nesdale & Lawson,
2011). These studies, based on social identity development theory (Nesdale, 2004)
and social domain theory (explained in Ch.1.6) randomly assign inclusion or
exclusion norms, and test children’s attitudes according to these norms. Previous
21
research found that inclusive school norms could not moderate negative effects of
exclusionary peer group norms (Nesdale & Lawson, 2011). The motivation of
children of this age to present themselves positively to their peers is very strong
(Nesdale et al., 2005; Rutland et al., 2005) and can even increase their likelihood to
engage in bullying behaviours (Nesdale et al., 2008). However, McGuire, Rutland
and Nesdale (2015) adapted their school norm manipulation to be more explicit
stating that prejudiced attitudes were morally wrong and would lead to repercussions.
In contrast to Nesdale & Lawson (2011), results showed that the explicit, clearly
delivered inclusive school norm encouraged more positive intergroup attitudes, even
when the peer group had a norm of exclusion.
Importance of friendship for mental health
Studies show that compared to other measures such as IQ, school grades, attendance
and teachers’ ratings, peer ratings during childhood (at 8 years of age) were the most
likely to predict the need for mental health support over the course of the following
eleven years (with those who had needed support being 2.5 times more likely to have
had negative peer ratings) (Cowen et al., 1973). Nevertheless it is important to
question the direction of causality. Is low peer acceptance the cause of maladjusted
outcomes, or are there separate underlying problems that lead to
externalising/internalising behaviours which in turn lead to low peer acceptance?
(Parker & Asher, 1987). A longitudinal study explored the influence of both peer
rejection and friendship (age 10) on later adjustment (age 23) (Bagwell et al., 1998)
of 334 students in the US. They found that both had an impact on later well-being but
in different ways. Peer rejection predicted poorer life status, while both lack of
friendship and peer rejection predicted psychopathological symptoms. Positive peer
relationships are therefore an important element of children’s development.
For children with autism there are additional factors to address when considering the
causes and outcomes of peer rejection. A model by Humphrey & Symes (2010)
entitled the ‘reciprocal effects peer interaction model’ attempts to draw these factors
together to increase our understanding about how social outcomes for children with
ASD interrelate (Figure 1.1).
22
Figure 1.1. The reciprocal effects peer interaction model (REPIM) for understanding
negative social outcomes among included students with autistic spectrum disorder
(ASD) (Humphrey & Symes, 2011)
The model proposes that social outcomes are caused by two interrelated factors:
problems in social cognition leading to insufficient skills to build relationships; and
lack of understanding by the peer group leading to reduced acceptance, particularly
of behavioural differences associated with ASD. The combination of the two factors
results in reduced quality and frequency of peer interaction, which in turn lead to
increased bullying and rejection, isolation and loneliness and this creates a vicious
cycle whereby pupils with ASD have reduced motivation to make social contact and
neurotypical peers have reduced opportunities to learn about ASD (i.e. reciprocal
23
effects). Their findings from an observational study supported this model, showing
that included students with ASD spend more time engaged in solitary behaviours and
reactive aggression and less time in cooperative interaction with peers than students
with dyslexia or no SEN.
Acceptance vs. friendship
In light of the two interrelated factors outlined in the reciprocal effects peer
interaction model (i.e. lack of understanding by the peer group and individual
problems of social cognition), it is vital then to consider not only the social
acceptance by neurotypical peers, but also the individual elements of friendship
quality experienced by autistic peers. Whilst positive attitudes and acceptance are
important for successful social inclusion for children with autism, we should
question the weight given to social acceptance by peers in general as opposed to
developing supportive dyadic friendships (Parker & Asher, 1993). Parker and Asher
found that not all highly accepted children had friends and conversely, many low-
accepted children had friends. They asserted that the well-being of low-accepted
children might increase with satisfying one-to-one friendships.
Research indicates that, contrary to Kanner’s assertion that they have a ‘basic desire
for aloneness’ (Kanner, 1943, p.5), autistic children do in fact have a social desire for
relationships (Bauminger & Kasari, 2000). While they are reported to have fewer
friends (Cairns & Cairns, 1994; and shorter durations of friendship (Bauminger &
Shulman, 2003; Petrina et al., 2014; Kuo et al., 2013), there are similarities with
typically developing children in terms of the types of activities they like to engage in
during social interactions (e.g. video games, watching TV etc.) (Bauminger &
Kasari, 2000; Kuo et al., 2013). Nevertheless, friendship quality (in terms of
companionship, security-intimacy, closeness and help) is reported to be lower than
neurotypical peers (Bauminger & Kasari, 2000; Chamberlain et al., 2007; Kasari et
al., 2011), but Petrina et al. (2014) argue that this could be the result of their
narrower understanding of friendship. It should be pointed out that the characteristics
of friendship outlined at the start of this section are those considered to be necessary
for neurotypical individuals. Studies indicate that perceptions of friendship may be
different for people with autism or other disabilities. For example, using the
‘friendship quality questionnaire’ (Parker & Asher, 1990) a study by Heiman (2000)
24
found that intimacy was the key feature of friendship in adolescence among the
sample of 265 neurotypical children, whereas helpfulness, fun and entertainment
were the characteristics most important to those with disabilities (n=310). Different
expectations and priorities may therefore be impacting on the measurement scales.
(Differences in perceptions of friendship by girls with autism will be discussed in
Chapter 2.) Future research exploring friendships for children with autism should
therefore focus on quality of friendship (not simply social acceptance and/or
rejection) and a more complete understanding of what they perceive as friendship.
Summary
Despite the increased opportunities to develop social skills in inclusive school
settings, social outcomes are often negative. The characteristics necessary for
friendship may be difficult for a child with autism to understand, and therefore place
them at risk of marginalisation. In sociometric studies, children with autism are
significantly less well accepted and more rejected than their neurotypical peers.
Studies do however indicate that children make allowances for their peers with
autism, being more likely to accept them even with minimal expected benefits,
especially when they attribute their problems to factors beyond their control. While
some studies suggest that de-emphasising the salience of a disability reduces bias,
others found that disclosing a diagnosis led to more social support and positive
interactions, especially if combined with an increase in neurotypical children’s
knowledge and skills of how to interact with their autistic peers. Where schools make
efforts to provide this knowledge and skills and clearly deliver the expectations of an
inclusive school norm, the negative effects of exclusive peer norms can be
moderated. Finally, while peer rejection leads to a range of negative outcomes, when
coupled with lack of friendship these outcomes are more serious, including
psychopathological symptoms. Friendship quality, as perceived by individuals with
autism, and not just peer acceptance, is therefore essential to successful inclusion and
long-term well-being, and should be a focus for future research.
25
1.4 The problem of bullying for children with autism
Bullying is defined as having three elements: 1. an imbalance of power between
perpetrator and victim (i.e. the victim is outnumbered/smaller/less physically or
psychologically resilient); 2. an intention to cause harm; and 3. repetition (i.e. the
victim is targeted a number of times (Olweus, 1993; 1999). Smith and Sharp (1994)
refer to this as ‘a systematic abuse of power’ (p.2). There are various types of
bullying, including physical and verbal (known as direct bullying), and relational
(known as indirect bullying) (e.g. spreading rumours and social exclusion) or a
combination of bullying types (Olweus, 1993). While physical forms of bullying are
more often used by boys, girls tend to engage in more indirect/relational bullying
(Smith, Cowie & Blades, 2015). In addition cyber bullying is becoming an increasing
problem due to the increase in use of mobile phones and social media. Unlike
traditional forms of bullying, cyber bullies can be anonymous, and victims of cyber
bullying feel unable to escape due to the continual nature in which offensive material
can be posted about them.
Bullying in the general population
Research into bullying has increased greatly in the last two decades (Smith, 2014).
Incidence rates vary according to measurement criteria (e.g. time span and data
collection methods, which can include teacher/parent reports, self-reports by pupils,
peer nominations, direct observation and interviews/focus groups). However in
2011, a study of 35 countries conducted by the World Health Organisation (Roberts
et al., 2011) concluded that 34% of young people reported being bullied at least once
and 11% two or more times during the previous two months, although rates vary
significantly by country and region. Victimisation was also found to decrease with
age. In England, percentages reporting repeated victimisation (two or more times in
the last two months) were 15% of 11-year-olds, 14% of 13 year olds and 9% of 15
year olds. In a study by Smith et al. (2008) where 11-16 year old pupils were asked if
they had ever been bullied, 37% reported being bullied in a traditional way in school
and 3% had been cyber bullied in school, whilst 11% reported having been cyber
bullied out of school.
26
The research findings have led to tougher action to reduce bullying in schools.
Originating in Norway in the 1980s, following three school bullying-related suicides,
many countries now have legal requirements for anti-bullying policies in schools. In
England, schools are required to have an anti-bullying policy that complies with
legislation (Education and Inspections Act, 2006). Interventions developed to reflect
these policies will be discussed in Chapter 1.5.
Causes of bullying can be explained at many levels ranging from a broad societal
level (arising from media portrayal of violence and power imbalance) and
community level (e.g. socioeconomic factors) to school (i.e. school ethos and quality
of relationships) and family level (e.g. family dynamics and insecure attachment)
(Smith, Cowie & Blades, 2015). Chapter 1.6 provides a more detailed discussion of
the various theoretical perspectives from developmental psychology that underpin
aggressive/antisocial behaviour.
For those who are bullied, the consequences can be significant. Victimisation has
been associated with loneliness, school avoidance (Boivin et al., 1995; Kochenderfer
& Ladd, 1996), anxiety, depression, low self-esteem, physical complaints (Cook et
al., 2010; Farrington et al., 2012; Takizawa et al., 2014; Wolke et al., 2013), lower
educational attainment (Brown & Taylor, 2008) and higher likelihood of suicide
(Kim & Leventhal, 2008; Klomek et al., 2007).
Bullying of children with autism
Some bullying is identity-based, meaning that a victim is targeted due to being a
member of a particular group (usually one that is marginalised). Bullying related to
disability, learning difficulties and sexual orientation are particularly prevalent in UK
schools (Tippett et al., 2010). Disability-related bullying is well documented as being
significantly higher than bullying of non-disabled peers (Chamberlain et al., 2010;
Chatzitheochari et al., 2014; Watters, 2011; Holmberg & Hjern, 2008; Rose et al.,
2011).
Studies focusing specifically on bullying of autistic targets indicate that they are even
more vulnerable (i.e. higher levels of rejection and bullying and lower levels of
acceptance and peer support) than children with different kinds of SEN (e.g.
dyslexia) (Kloosterman et al., 2013; Symes & Humphrey, 2010), and that this is
27
particularly the case during adolescence (NAS, 2003; 2006; Wainscot et al., 2008).
Prevalence rates in studies of bullying of children with autism vary widely (again
dependent on methodology, timeframe etc.), with reports ranging from 38% bullied
in the past month (Zablotsky et al., 2014) to 94% in the last year (Little, 2002). The
Department for Education reported that 40% of children with autism have been
bullied at school (DfE, 2014) and this percentage rises to 59% for those with
Asperger’s syndrome (Reid & Batten, 2006). As with general bullying prevalence
rates, percentages vary according to measures, methodology and time-frames, but it
is clear that they are noticeably higher than most estimates of bullying prevalence in
the general population or indeed children with other disabilities/SEN.
This indicates that it is not having a disability/SEN per se but the specific
characteristics associated with autism. Possible reasons a disabled person might be
victimised include lower social acceptance (Card & Hodges, 2007), lack of social
skills (Garner & Stowe Hinton 2010; Wainscot et al., 2008) and other characteristics
associated with the disability that make them seem different (Horowitz et al. 2004;
Mishna, 2003). For people with autism, these are pertinent characteristics that may
lead them to exhibit socially incongruent behaviours (Wainscot et al., 2008) as well
as intense emotional/behavioural reactions when they are victimised, encouraging yet
more bullying (Gray, 2004). As the prime causative factors of bullying (Bejerot &
Mortberg, 2009), these characteristics place them at a more elevated risk than their
neurotypical peers. Having poor social skills and few friends can marginalise
children, leaving them unprotected from the social group (Delfabbro et al., 2006).
Klin, Volkmar and Sparrow (2000) referred to them as ‘perfect victims’ (p.6). Given
the political commitment to inclusion outlined earlier (Ch.1.2), their successful
participation and achievement may be at greater risk due to their heightened
exposure to bullying (Humphrey & Hebron, 2015). Indeed, a report by the All Party
Parliamentary Group on Autism (APPGA, 2017) highlighted bullying and isolation
as particular challenges currently faced by young people with autism in school.
Risk factors and protective factors
Studies investigating bullying in the general population identify peer rejection,
internalising problems, physical weakness and lack of friends to be among the main
risk factors (Hodges & Perry, 1999; Pellegrini et al., 1999; Smith et al., 2004). A
28
small number of studies have attempted to identify risk and protective factors for
bullying of children with autism (Cappadocia et al., 2012; Hebron & Hymphrey,
2014; Kasari et al. 2011; Little 2002; Reid and Batten 2006; Sofronoff et al., 2011).
Of those with autism, those most at risk include individuals with behavioural
difficulties, those who use public transport, those receiving external professional
support, individuals with Asperger’s syndrome, or milder social deficits, early
adolescents, those attending mainstream school and those with co-occurring
difficulties (Hebron & Humphrey, 2014; Humphrey & Hebron, 2015; Zablotsky et
al., 2014). Zablotsky et al. (2014) also found that those with co-occurring conditions
and a higher level of autistic traits were not only more likely to be victims, but also
bullies and bully-victims (i.e. holding both roles). This supported findings from a
national survey in the US that children with autism were four times more likely to
bully than those in the general population, but that when ADHD was controlled for,
the autistic children were no more likely to bully than the general population (Montes
& Halterman, 2007). Age is also reported to increase the risk of bullying. In contrast
to findings of decreased incidence of bullying with age from studies of the general
population, it appears this may not be the case for the autistic population, for whom
social difficulties may become more apparent as children enter adolescence
(Cappadocia et al., 2012; Hebron & Humphrey, 2014), indicating that increasing age
may also be a potential risk. Conversely, positive relationships, attending a special
school and higher levels of parental engagement and confidence are associated with
reductions in bullying (Hebron & Humphrey, 2014). A qualitative study by Cook,
Ogden and Winstone (2016) exploring boys’ experiences reported that where risk
factors related either to the individual (e.g. social difficulties) or the school culture
were not mediated by protective factors such as self-esteem, resilience or supportive
friends, various negative outcomes were identified as more likely, such as mental
health issues and effects on learning and friendships and that these were more likely
for those in mainstream school settings.
Little research explores risk factors for girls on the autistic spectrum, which may
reflect the higher rate of diagnosis in boys and also the higher prevalence of bullying
among boys in the general population (Cook et al., 2010). However, the increased
likelihood of girls to engage in indirect forms of bullying/relational aggression
warrants further exploration, and will be considered further in Chapter 2.
29
Consequences for autistic victims of bullying
While the consequences of bullying are worrying for the general population, studies
indicate these may be amplified for children with autism, with bullying being
associated with damaged self-esteem and mental health difficulties (Bellini, 2004;
Drahota, 2009; Kim et al., 2000) which can severely affect their ability to cope
(Gillott & Standen, 2007). Reid and Batten’s (2006) survey of parents and children
with autism found that bullying was associated with school refusal, decreased social
skills and relationships, interference with school work and mental health difficulties.
This was reflected in Hebron and Humphrey’s (2012) study indicating extreme levels
of anxiety and other emotional and behavioural difficulties and also in a study of
parent reports that showed significant associations between victimisation and
internalising mental health problems, communication difficulties and numbers of
friends (Cappadocia et al., 2012). Worryingly, rates of suicidal ideation and attempts
are 28 times greater among children with autism than their neurotypical peers
(Mayes et al., 2013; Rybczynski et al., 2018). Humphrey and Hebron (2015) refer to
this as a ‘double disadvantage’ (p. 857), i.e. higher prevalence of bullying and more
severe outcomes.
Prejudice, discrimination and stereotypical perceptions
The increased risk for autistic children in mainstream school settings requires further
investigation. The Reciprocal effects in peer interactions model (Humphrey &
Symes, 2011) outlined in Ch.1.3 provides a useful framework for understanding why
children with autism are at a heightened risk of bullying, highlighting the interrelated
factors of the autistic child’s social-cognitive deficits and the general lack of
awareness of the peer group.
Lack of awareness may result from the tendency for individuals to differentiate
themselves as far as possible from members of other groups, partly due to fear of the
unfamiliar (Hebb et al., 1968) and partly in order to maintain their own group’s
positive identity (Tajfel & Turner, 1979). Elements of social identity and
categorisation may therefore lead to bias and discrimination towards peers who are
dissimilar, particularly when uncertainty is a factor due to stereotypical perceptions
(Hogg, 2000, 2007). People with disabilities are at heightened risk of negative
30
stereotypical perceptions due to their stigmatised status (Juvonen & Weiner, 1993).
Stigmatised individuals are described as those whose attributes convey a social
identity that is devalued in particular social contexts (Crocker et al., 1998) and these
attributes become the basis for discrimination (Major & Eccleston, 2005). Autism is
not a controllable stigma (unlike being overweight for example), so discrimination
ought to be less extreme (Crandall et al., 2001; Crandall, Nierman & Hebl, 2009).
Despite not having perceived responsibility for their condition, however, people with
autism are not always visibly disabled, which would enable greater sympathy and
social support. Autism has often been described as a ‘hidden’ disability. In terms of
the ‘stereotype content model’ (Fiske, 2007), which categorises people on two
dimensions (warmth and competence), disabled people are perceived as warm but
incompetent and hence elicit pity and sympathy (Fiske et al., 1999; Fiske et al.,
2002). In contrast, those perceived to be low warmth and low competence elicit
contempt and either passive or active harm. Therefore victimisation of autistic peers
may result from their lack of visible disabled status and lack of peers’ ability to
understand the reason for their anomalous behaviours and differential treatment
(Humphrey & Symes, 2011).
While disability-related bullying is identified as a problem in UK schools, it is also
important to recognise that generalising about diverse populations (e.g.
disabled/autistic communities) fails to recognise the diversity within the broad label
and the particularities and context behind their vulnerability (Chakraborti & Garland,
2012). There are many complex variables leading to bullying, not simply prejudice
towards people with autism. Studies of hate crime (Woods, 2009) reveal that
offenders target victims because of their particular characteristics, which may or may
not be inspired by hatred or hostility or based on stereotyped information.
Chakraborti and Garland (2012) point out that it is not their disabled identity per se
that makes them vulnerable, but rather how that aspect intersects with other aspects
of their self and situational factors and context (social class, isolation, activities,
physical presence). For people with autism, characteristics such as age, gender and
severity of symptoms may influence their experience of victimisation (Bauminger &
Kasari, 2000; Williams & Guerra, 2007). Ch.1.6 discusses further the developmental
psychological theories that might explain aggression, bullying and antisocial
attitudes, particularly in relation to social identity and categorisation.
31
Prosocial bystander intentions
Bullying scenarios involve individuals taking on certain defined roles. In addition to
the roles of ‘bully’ and ‘victim’, Salmivalli et al. (1996) identified four additional
categories: ‘assistant bullies’, ‘reinforcers’, ‘defenders of the victim’ and
‘bystanders’ (i.e. outsiders). In one study, Salmivalli et al. (1998) found that 20-30%
of witnesses assisted or reinforced the bullying, while 20% were defenders and 26-
30% were bystanders. When a group of peers gathers to watch a bullying scenario, it
will last longer since the bully’s behaviour is reinforced through the attention
received (O’Connell et al., 1999). But if peers intervene, in over fifty percent of
times, the episode will stop immediately (Fekkes et al., 2005). Yet the likelihood that
children will intervene decreases with age (Rigby & Johnson, 2006; Trach et al.,
2010). To explore this further, Palmer et al. (2015) measured bystander intentions of
10-15 year olds in response to scenarios depicting verbal aggression. Their findings
supported previous research indicating a developmental decline in prosocial
bystander intentions. However, they also discovered that despite this decline, when
the victim is an ingroup member and the aggressor is an outgroup member
participants were more likely with age to report prosocial bystander intentions. The
findings also supported previous research by Jones et al. (2009) that examined the
effect of identification with a group and contrasting group norms on group based
emotions (emotions experienced from identification with a group) of 9-11 year olds.
Jones et al. found that identification with a group that bullies predicted shame, and
identification with a victim group predicted anger. They also found that group
emotions predicted action tendencies, with pride associated with affiliating with the
bully, guilt associated with making reparations to the victim and anger associated
with taking action (e.g. telling a teacher). These findings, together with those of
Palmer et al. (2015) indicate the importance of considering interpersonal processes
when considering interventions to increase prosocial responses and reduce
aggression in schools.
Summary
Positive peer relationships are essential for healthy social development (Killen,
Rutland & Yip, 2016). When relationships are antagonistic, such as those involving
bullying and victimisation, negative long-term consequences are likely to occur,
32
placing healthy development at risk. This is a particular problem for children with
autism due not only to specific characteristics making them more vulnerable, such as
lower social status and social skills (reflected in the higher incidence rates for those
on the autistic spectrum), but also to the more severely experienced outcomes such as
extreme levels of anxiety, other emotional and behavioural difficulties and higher
rates of suicidal ideation and attempts. Identity-based bullying has received increased
attention over the last ten years, partly in response to the UK government’s priority
to tackle bullying in schools. Further exploration of effective interventions are
nevertheless required, focusing both on interpersonal dynamics but also on
intergroup dynamics, through investigation of the effects of group norms, group
identity and stereotypes on bullying behaviours perpetrated towards children with
autism.
33
1.5 Strategies for improving peer relations and reducing bullying of children
with autism
Schools and local authorities are bound by equality legislation in the form of public
sector equality duties giving them responsibilities to ensure equality in policy-
making and delivery of services. Among other requirements, schools and local
authorities must “have regard to the need to: promote equality of opportunity
between disabled and other people; eliminate discrimination and harassment,
promote positive attitudes to disabled people; encourage participation of disabled
people in public life…” (Tippett, Houlston & Smith, 2010, p4).
One method of promoting equality of opportunity and encouraging participation of
children with autism is the implementation of child-focused interventions that
provide social skills training to support social engagement with others and/or
increase assertiveness to help them cope with challenging situations. These are
essential for equipping children with tools to help them socialise with their peers and
reduce the risk of victimisation. However, sometimes de-contextualised settings and
low generalizability (Koegel et al., 2009) reduce their effectiveness (as reported in a
meta-analysis by Bellini et al., 2007). In addition, by placing emphasis on the
individual deficits of the child with autism, it is possible that challenging the broader
contextual issue of prejudiced attitudes and behaviours of the wider peer group may
be overlooked. Instead, Dixon et al. (2012) described interventions such as re-
education, perspective taking, cooperative learning, common identification, empathy
arousal and intergroup contact as ‘the shining example of how social science
research on intergroup relations can promote a better society’ (Dixon et al., 2012,
p.413).
This section will therefore explore two kinds of strategies adopted by schools in
order to fulfil their equality duties: anti-bullying programmes and attitude change
interventions (e.g. information-based and contact-based).
Anti-bullying programmes
While it is a legal requirement for schools in the UK to have in place an anti-bullying
policy, and to respond appropriately to bullying incidents, responsive strategies are
34
often reliant on preventative measures which the school has in place (Tippett et al.,
2010). Many schools therefore utilise anti-bullying intervention programmes in an
attempt to reduce bullying incidents and in so doing, commit to guaranteeing a
satisfactory physical and psychosocial environment for all children. One of the first
programmes, upon which many subsequent programmes have been based, was the
Olweus Bullying Prevention Programme (OBPP), which aimed to create a prosocial
school environment, with clear rules about bullying, increased levels of supervision,
anonymous reporting of bullying incidents and a committee to coordinate the
programme (Merrell et al., 2008). In an evaluation of the intervention over two years,
Olweus found reductions in bullying of 50% from a sample of 2500 Norwegian
children aged 11-14 (Olweus, 1991). However, subsequent data collected from the
same sample a year later found an increase in bullying (Roland, 1989). Other studies
showing mixed findings from the use of the OBPP suggest that intervention fidelity
is an important factor: with decreases in bullying reported when fully implemented,
but increases after less conscientious implementation (Bauer et al., 2007; Hawkins et
al., 2002).
Other anti-bullying interventions adopt Salmivalli et al.’s (2005) participant role
theory, whereby children self-reflect according to the roles they usually play in
reality and those of the other roles pertinent to bullying incidents through the use of
role-plays. Children can also be trained to take on actual roles such as ‘befrienders’
who are assigned to be with a peer and support them through conflict resolution
(Cowie & Wallace, 2000). Again, evaluation of the participant role interventions
show that they vary in effectiveness, with some being reported as causing increased
stigmatisation (Smith et al., 2012). Greater effects were found however when more
time was spent on implementation (Cowie & Wallace, 2000), which points to the
challenge of separating out the effects of interventions that are effective/ineffective
from those which are properly/poorly delivered.
Despite this dilemma, many local authorities invest in anti-bullying programmes in
an attempt to deal with the harmful effects of bullying. A more recent intervention
based on participant roles is the Finnish KiVa approach (Salmivalli et al., 2011). This
approach targets the three levels of whole school, classroom and individual. Teachers
are provided with a theoretical framework and also material resources including a
35
virtual learning environment via a computer game, posters and high-visibility jackets
for playground supervisors. They teach children about the group processes in
bullying, having respect for others, emotions and how to have empathy for victims
and encourage them to intervene. After a bullying incident, discussions take place
with the pupils involved and victims are supported by high-status students. An
evaluation in Finland with a sample of 8,237 pupils aged 10-12 found that the
approach led to lower rates of victimisation and higher levels of defending victims.
Children also showed more anti-bullying attitudes and greater empathy towards
victims (Kärnä et al., 2011). Many other countries have started to adopt the KiVa
programme, including 17 primary schools in England and Wales, which are showing
statistically significant reductions in bullying (Hutchings & Clarkson, 2015).
A number of meta-analyses and systematic reviews have been conducted to examine
the effectiveness of anti-bullying interventions. Most show disappointing results.
For example in their meta-analysis of whole school interventions in Australia,
Europe and North America, Smith et al. (2004) found that effect sizes were mainly
small, negligible or even negative, indicating increased victimisation. Similarly, the
effect sizes in Ferguson et al.’s (2007) and Baldry and Farrington’s (2007) meta-
analyses were very small and in Merrell et al.’s (2008) meta-analysis, no particular
pattern of results could be inferred from the data and programmes were found to
influence knowledge and attitudes rather than influence actual bullying behaviours.
Before concluding that whole-school interventions are ineffective, it is important
however to consider the fidelity of implementation, which had not been reported in
most of the studies analysed, and also the methodological rigour of studies, i.e. lack
of standardised interventions, equivalent groups etc. (Ryan & Smith, 2009).
One meta-analysis that only considered studies with methodological rigour (e.g.
randomised experiments with experimental and control conditions, intervention-
control comparisons and age-cohort designs) did conclude the effectiveness of school
anti-bullying programmes (Ttofi & Farrington, 2010) with an average decrease in
bullying of 20-23% and in victimisation of 17-20%. Ttofi and Farrington attributed
the effectiveness of the interventions to more intensive programmes with a whole-
school anti-bullying approach. They also found that programmes worked better for
older children than younger children. Although this is not supported by the findings
36
of Smith (2010) and Kärnä et al., (2011) who found stronger effects in primary
school age children. Interestingly, Ttofi and Farrington (2010) also found that one
element, work with peers (strategies such as peer mediation, peer mentoring, and
bystander intervention) increased victimisation. Nevertheless, peer mediation
techniques have also been widely reported to be highly effective in improving social
skills (Chang & Locke, 2016; DiSalvo and Oswald, 2002; Harper et al., 2008;
Rogers, 2000; Smith et al., 2002; Mason et al., 2014; Pierce and Schreibman, 1997)
that are generalised to other settings (Koegel et al., 2012) and over time (Kasari et
al., 2012). These benefits must therefore be weighed against the risk of further
victimisation.
It is possible that the mixed research findings may have influenced a reduced
enthusiasm for direct anti-bullying measures in the originating country – Norway –
which has had a severe reduction in schools implementing the OBPP. It may also
account for the lack of a nationally-implemented anti-bullying programmes in the
UK. Nevertheless Anti-Bullying Week (organised by the Anti-Bullying Alliance)
was implemented in 2004, held on the 3rd week of November each year, and
emphasises the use of resources and events for use by schools.
One clear omission from evaluations of the effectiveness of many anti-bullying
programmes is a focus on bullying of individuals from particular minority groups
other than race/ethnicity, e.g. sexual orientation or disability. It would be interesting
to see bullying/victimisation data from students from these minorities within schools
running whole-school programmes. Studies focusing on bullying of children with
autism suggest strategies that approach bullying at multiple levels (i.e. individual,
peer, school and community) (Schroeder et al., 2014; Humphrey & Symes, 2010).
There are a number of factors that may be specific to the prevention of autism-
focused bullying, including considerations of the school environment and ways to
support social interactions that make them less likely to be rejected. These are
discussed below.
Attitude change interventions
Bullying of children with autism, or any disability, is often reported as being related
to perceived differences between autistic/disabled pupils and neurotypical pupils.
37
Addressing the concept of difference and diversity within the school ethos is
therefore a sensible way to encourage inclusive attitudes and tackle bullying (Tippett
et al., 2010), and is a strategy promoted by the National Autistic Society (2006) and
National Children’s’ Bureau (2007).
As we have learned from theories of social identity and social categorisation (see
Ch1.6), prejudiced attitudes can develop partly through fear of the unfamiliar (Hebb
et al., 1968) leading to stereotypical perceptions (Juvonen & Weiner, 1993). Since
prejudice is partly based on ignorance (Stephan & Stephan, 1984) education that
promotes acceptance of diversity may reduce prejudiced attitudes.
For children with autism, this could be particularly important, given the nature of the
condition. As previously discussed (see Ch. 1.3), children accept their peers with
moderate learning difficulties even with minimal perceived benefits and only reject
neurotypical, but not autistic, peers on the basis of shyness (Frederickson &
Furnham, 2004; Jones & Frederickson, 2010) indicating that certain allowances are
made. However, this is dependent on the salience of their difficulties being known,
with disclosure leading to more consistent social support (Hewstone & Brown, 1986;
Ochs et al., 2001). Given that autism is not always visible, their attributes might
become the basis for discrimination unless their condition is made salient, clarifying
to peers how the attributes are beyond their control (Weiner & Graham, 1984), and
hence motivating peers to show sympathy, rather than contempt (as indicated by the
stereotype content model (Fiske, 2007)) and enabling them to understand more fully
the reason for their behaviours and differential treatment (Humphrey & Symes,
2011). In addition, studies based on the theory of intended behaviour also found that
children have greater intentions to engage with children with disabilities if they
perceive this to be relatively easy (Ajzen, 1988) and that knowledge and practical
skills about how to do this may result in more positive interactions.
Schools can be helped to take advantage of these findings through taking steps
towards achieving an inclusive school climate that accepts and embraces diversity. In
an Australian study by Riekie, Aldridge and Afari (2017) dimensions of the school
climate (such as peer connectedness and affirming diversity) were found to positively
influence students’ moral identity, reflecting an earlier study’s findings that students’
identity development was enhanced when schools were accepting of difference
38
(Chentsova-Dutton & Tsai, 2010). Diversity should therefore be embraced through
initiatives for raising awareness and acceptance (van Vuuren et al., 2012).
Information-based interventions
One such method is to provide children with information about autism, to help them
to better understand its causes and characteristics and increase acceptance of
difference. The assumption with these interventions is that prejudice is the result of
ignorance about the outgroup (Hill & Augstinos, 2001). Studies exploring the effects
of information about particular disorders/disabilities on attitudes and behavioural
intentions have shown mixed results. For example, Friedrich et al. (1996) found that
information about Tourette disorder failed to improve attitudes or behavioural
intentions, and in another study, only attitudes, but not behavioural intentions
improved toward a blind child after a video and lessons about blindness (Siperstein
& Bak, 1980). The authors suggested that the lessons might have in fact accentuated
the differences leading to more negative behavioural intentions.
Autism awareness is minimal among children, with few having ever heard of autism
(Campbell et al., 2004; Magiati et al., 2002; Swaim & Morgan, 2001). Swaim &
Morgan (2001) investigated the impact of information about autism on the attitudes
and behavioural intentions of children (aged 8 to 12) towards autistic children. Not
only were attitudes less positive towards autistic than non-autistic children, they
found that information about autism did not affect ratings of either attitudes or
behavioural intentions.
A methodological limitation may have influenced findings however, in that the video
of the autistic boy displayed behaviours considered to be severe on the autistic
spectrum (i.e. rocking on his chair, hand flapping and echolalia) and the information
provided about autism was more descriptive than explanatory. In later studies
however, Campbell et al. (2004), Campbell (2007) and Campbell & Barger (2011)
found that children with prior awareness of autism show more positive attitudes but
had gaps in their knowledge about autism. One such study (Campbell et al., 2004)
involved showing 8-10 year olds a video of a child with autism displaying certain
behaviours, then giving half of them descriptive information about the child and the
other half both descriptive and explanatory information designed to increase their
39
understanding about autism. Findings showed that receiving explanatory information
improved behavioural intentions towards the child with autism, particularly for
younger children. However, in a similar study (Staniland & Byrne, 2013),
descriptive, explanatory and directive information about ASD improved knowledge
and attitudes, but failed to influence behavioral intentions (mirroring the findings of
Merrell et al., 2008 above and supporting Killen and Rutland’s (2011) social and
moral reasoning findings). Indeed, some research suggests that information
interventions are ineffective and even detrimental to intergroup attitudes since they
highlight stereotypic activities (Bigler, 1999).
Research in persuasion and attitude change offers a valuable perspective when we
consider knowledge-based interventions. There is a wealth of research into what
makes a persuasive message effective, one such contribution being the Yale
Approach (Hovland et al., 1953), which considers three variables: the communicator,
the communication and the audience. For example, the communicator must be a
credible source. Morton and Campbell (2007) found that 9-10 year olds reported less
positive attitudes when information was presented to them about ASD by their
parents than by their teacher. In terms of the message, a number of factors should be
considered including simplicity of comprehension, minimising repetition, framing in
terms of loss/gain and activating particular feelings (Blankenship & Hotgraves, 2005;
Leventhal et al., 1965). Finally consideration of the audience is key, with factors
such as self-esteem influencing susceptibility to opinion change, differences in the
responses of males vs. females, age and prior beliefs (Janis, 1954; Krosnick &
Alwin, 1989; Rutland, 1999).
Swaim and Morgan’s (2011) interpretation of their findings discussed above was that
Weiner’s hypothesis, that peers are more sympathetic if a condition is beyond an
individual’s control (i.e. attribution theory), does not apply to certain disorders, and
that attitudes may be related more to the nature of the condition than to the cause.
Instead, it may be the case that the lack of influence of information on attitudes, and
also the mixed results from other studies exploring these effects, may result from a
lack of consideration of these factors of persuasive communication, and that further
research is required with knowledge-based interventions more closely aligned to
findings from research in persuasion and attitude change.
40
Contact-based interventions
As an alternative to knowledge-based interventions, intergroup contact has been
found to be highly effective in reducing prejudice and discrimination between groups
and promoting prosocial attitudes. The contact hypothesis (discussed more fully in
Ch.1.6) proposes that prejudice arises from lack of knowledge and familiarity, but
that under certain conditions (equal status between groups, common goals,
intergroup cooperation, support from authorities and personal interaction) prejudice
can be reduced (Allport, 1954). Reflecting Ochs et al.’s (2001) findings that salience
leads to greater support, studies show that contact emphasizing the salience of a
category of disability results in more favourable outgroup attitudes than contact that
includes no emphasis (i.e. decategorises) (Cameron & Rutland, 2006).
Studies exploring the effect of intergroup contact on attitudes towards children with
disabilities are scarce. Townsend et al. (1993) found that children in New Zealand in
inclusive mainstream settings were more positive towards their peers with
intellectual disability than those in less integrated settings. A longitudinal study by
Maras and Brown (1996) measured social orientations towards children with severe
learning difficulties of nondisabled children in a mainstream primary school. They
found that contact with children with disabilities led to significantly more liking than
the control group (no-contact), which showed no change. The contact group also
categorized disabled peers using a wider range of dimensions, in contrast to the
control group who only categorized on the dimensions of gender and disability. More
recently, Gasser, Malti and Buholzer (2013) compared moral judgements and
emotions from nine and 12-year old children in inclusive and non-inclusive
classrooms regarding disability-based exclusion. Findings indicated that regardless of
educational setting children condemned disability-based exclusion. However, in the
younger age group those in inclusive settings exhibited more moral judgements and
emotions than those in non-inclusive classrooms. No such difference was found in
the older age group, indicating their increasing ability to understand moral
implications of exclusion without the need for extensive contact. Furthermore,
exclusion of a child with mental disability was considered less wrong than exclusion
of a child with a physical disability. This clearly has implications for children with
autism with coexisting intellectual disabilities due to the higher likelihood of
stigmatisation and rejection. Whilst Gasser et al.’s study focused on disability in
41
general, a study by Marvropoulou & Sideridis (2014) measured the knowledge and
attitudes towards autism of 475 children in contact (integrated school settings) and
no-contact conditions. Findings showed that responses of those in the contact group
indicated greater knowledge and more positive cognitive attitudes and behavioral
intentions towards peers with autism than children with no contact.
Studies of intergroup contact also have a developmental effect, whereby for
adolescents, contact leads to positive intergroup attitudes, whereas for early adults,
attitudes remain unchanged (Wölfer et al., 2016). Furthermore, in studies using
contact to develop autism awareness, older children needed further information-
based input (e.g. through discussions) to process cognitive aspects of ASD, in
contrast to younger children who showed no differences in knowledge according to
contact conditions (Marvropoulou & Sideridis, 2014). Interestingly this contrasts
with the findings of Campbell et al. (2004) mentioned above, i.e. that younger
children seem to be more influenced by descriptive and explanatory information than
older children. However, the latter studies were testing information-based
interventions only rather than comparisons between contact and information.
These findings demonstrate that adolescents should be targeted for the reduction of
intergroup bias and that information-based input should also be considered for this
group, but with careful consideration of its content and delivery in light of the
possible negative impact reported by Frederich et al. (1996), Siperstein and Bak
(1980) and Bell and Morgan (2000).
Finally, it should be recognized that not all intergroup contact is positive, e.g. if the
optimal conditions described by Allport (1954) are not met. Negative contact, such
as that experienced between groups in cultures where there is high conflict, can lead
to support for more aggression (Niwa et al., 2016). At a less extreme level, studies
indicate that contact must be direct and personal in order to improve attitudes
(Yuker, 1988). This was supported in a study by Slininger et al. (2000) who found
that only contact through structured cooperative games with disabled children led to
improved attitudes, in contrast with the non-structured contact group.
42
Summary
While child-focused interventions can be effective in increasing the social skills of
individual children with autism, broader whole-school approaches are needed to
reduce intergroup bias, prejudiced attitudes and bullying. Meta-analyses report mixed
findings for the effectiveness of anti-bullying programmes, but this may be due in
part to fidelity of implementation or poor study designs rather than the efficacy of the
intervention. The KiVa programme offers hope as a potentially successful method of
reducing bullying and victimization in schools. Little is known however about the
effectiveness of anti-bullying programmes on the victimization of particular minority
groups such as those with disabilities. An alternative method of reducing prejudice
and improving intergroup attitudes is to adopt approaches to promote awareness and
acceptance of diversity. Information-based interventions have often been found to
have an adverse effect, accentuating differences and leading to more negative
attitudes. It is conjectured that the communication methods often lacked observance
of proven methods of persuasion and attitude change for the age-groups under
investigation. More positive results have been reported in response to intergroup
contact between disabled/autistic and non-disabled/autistic children, leading to
increased knowledge and improved attitudes/behavioural intentions, particularly for
adolescents.
43
1.6 Theoretical framework
The thesis focuses on peer relations for children with autism, with a particular
emphasis on bullying and the attitudes of neurotypical children towards their peers
with autism in mainstream school settings. Over the course of the last century,
theories have been developed which can help to explain key themes to be explored in
this thesis – such as antisocial/aggressive attitudes and behaviours in children and
adolescents – from a number of different psychological perspectives including
cognitive, genetic, evolutionary and social learning paradigms. Their contribution to
our understanding of the above themes will be outlined, followed by a fuller
discussion of theories of psychosocial perspectives on intergroup relations,
specifically Social Identity theory, Social Domain theory and Intergroup Emotion
theory, as these are of particular relevance to issues of intergroup behaviour. Finally
this section will explore the role of contact as a possible solution to improve
intergroup relations.
Cognitive, genetic, evolutionary and social learning perspectives
Cognitive theories
Information processing theory emerged in the 1940s and 50s (Broadbent, 1958;
Miller, 1956; Shannon, 1948) explaining cognitive development in terms of the way
information is processed, i.e. attention mechanisms, working memory and long-term
memory. It states that as children grow, their cognitive capacity develops leading to
improvements in how they process information. Research on social information
processing shows that cognitive beliefs and expectations can influence how
information is processed. For example, highly aggressive boys have been found to
attribute ambiguous events (e.g. a ball hitting them in the playground) to acts of
intentional hostility (Dodge et al., 2013). In addition, information stored about early
childhood interactions contributes to their processing biases (Keil & Price, 2009) but
interventions have been found to reduce these biases and increase children’s ability
to respond appropriately to social problems. Information processing theory has
limitations, however, since it generally neglects the context of behaviour such as
44
goals, emotions and the environment, which may affect cognitive processing, so
findings may not be generalizable.
Theories of social cognition focus on how people process, store and apply
information about others in social contexts, and thus provide an elaboration of
information processing theory. One example of this is the way people use schemas
(pre-existing assumptions about the way the world is organised). Schemas influence
attention and the receiving of new knowledge. When new information is received, a
person tries to fit it into current schemas. One example of a schema is a stereotype:
the categorisation of people causing an overestimation of similarities among people
with that category (Tajfel, 1959). This can lead to a ‘relative homogeneity effect’, i.e.
a tendency to perceive outgroup members as all the same and ingroup members as
more differentiated (Lee & Ottati, 1993). Furthermore, people who don’t fit within
the ingroup category are seen as distinctive and lead us to pay more attention to them
(Taylor & Fiske, 1978). This too can cause us to generalise from these distinctive
individuals to a group as a whole, particularly when we are unfamiliar with the
category (Quattrone & Jones, 1980). The stereotype content model places people on
two dimensions: warmth and competence (Fiske et al., 2007) and claims that all
group stereotypes are formed along these dimensions. Distinct emotions are
generated according to particular combinations of warmth and competence, such as
admiration, contempt, envy and pity, and these in turn predict distinct behaviours that
are active or passive, facilitative or harmful. Assessment of an outgroup member’s
level of threat predicts their level of warmth, whereas their status predicts their level
of competence. While individuals with high competence generate admiration (when
coupled with high warmth) and envy (when coupled with low warmth), low
competence can lead to pity where there is high warmth (groups include the elderly
and mentally disabled) and contempt where there is low warmth often leading to
hostility and active harm (groups include the homeless and welfare recipients). In the
context of this thesis, stereotypes of autism may arise due to unfamiliarity and the
inability of neurotypical children to fit various autistic characteristics into pre-
existing schemas. According to the stereotype content model, autistic individuals
perceived to have low competence and low threat (i.e. high warmth) may generate
pity leading to sympathy. Bullying is more likely to occur when they are perceived as
having low competence and low warmth (since this leads to contempt, hostility and
45
active harm). This could offer one explanation for the high levels of bullying and
peer rejection reported in earlier chapters.
Genetic and evolutionary perspectives
In contrast with views that aggressive behaviour in children is due to deficient
processing of social information (Crick and Dodge, 1996), or overestimation of
similarities of people in a stereotypical category (Tajfel, 1959), more recent thinking
provides alternative views; that aggression may be partly heritable, associated with
social competence and may be adaptive.
A number of genetic factors contribute to antisocial/aggressive attitudes and
behaviour. Twin studies indicate that genetic influences account for 41% of the
variance in antisocial behaviour, in contrast to shared environment (16%) (Rhee &
Waldman, 2002). However, a twin study by Tuvblad et al. (2006) exploring
antisocial behaviour in adolescents found that genetic influences were stronger in
adolescents from higher socioeconomic backgrounds whereas shared environment
was a stronger influence in lower socioeconomic backgrounds. Studies exploring
temperament and aggression show that children with a temperament that displays
early lack of control experience later externalising problems such as aggressiveness
(Caspi et al., 1995; Guerin et al., 1997). Temperaments are known to be partly
heritable. However, in their study of 442 males between birth and age 26, Caspi et al.
(2002) found that boys were only at high risk of antisocial/criminal behaviour if they
were maltreated in childhood and had low-activity MAOA (an enzyme that
metabolises neurotransmitters such as dopamine). Boys who were maltreated but
with high-activity MAOA had low risk. A meta-analysis by Byrd and Manuck (2014)
explored the interaction of MAOA, childhood treatment and antisocial behaviour.
They found that for males, MAOA moderated the effects of childhood maltreatment
on antisocial behaviours, but that no such interaction was present for females. This is
an example of the diathesis-stress model, which explains how some individuals are
more susceptible to adverse environmental conditions.
Contemporary evolutionary theory examines complex interactions of genes and
environments and argues that children are innately predisposed to behave towards
others in adaptive ways. For example, research shows that prenatal exposure to stress
46
hormones from the mother can lead to child behaviours such as fearfulness and
aggression (Pluess & Belsky, 2011) but, similar to Tuvblad et al. (2006) and Caspi et
al. (2002), this is dependent on and adaptive to environmental conditions (e.g. harsh
or supportive) (Frankenhuis et al., 2016). Adaptive elements can also be observed in
relation to prosocial and coercive behaviours used to negotiate status and gain access
to resources (Hawley, 2014). Resource Control theory (Hawley, 2003) suggests that
socially dominant individuals gain access to resources using certain strategies. In a
study by Hawley (2003) children who used both coercive (e.g. threats and
aggression) and prosocial strategies (e.g. reciprocity and help) have greater success
gaining resources (getting want they want, as reported by their teachers), are more
likely to be liked and have greater moral maturity. In addition, studies based on the
dominance hierarchy (Hinde, 1974) rank members of a group according to their
power and in studies of adolescent groups, more dominant peers are more popular
(Lansu et al., 2014). Hence aggression, whilst usually perceived as a negative
behaviour, can actually be a positive adaptation and provide skills needed in
adulthood.
Genetic and evolutionary perspectives therefore provide explanations for
antisocial/aggressive behaviours of individuals according to temperament,
overlapping genetic and environmental factors and adaptive elements such as
resource control and dominance. In the context of this thesis, these theories help to
elucidate possible causes of bullying behaviour of individuals in general, according
to heritable and environmental factors, although these do not explain more
specifically the cause of identity-based bullying, such as that perpetrated against
autistic targets.
Social learning theory
Social learning theorists believe that development comes primarily from experience
of the social world rather than heritable factors. Early proponents of learning theory
explored relationships between rearing practices and children’s personality
characteristics, particularly whether parental restrictiveness led to children’s
aggressiveness (Dollard et al., 1939; Sears et al., 1957; 1958). However, early studies
yielded disappointing results, likely to be due to deficiencies in their methodologies
but also the assumption that parental rearing is wholly responsible for the nature of a
47
child’s psychological development. In response to this Social Learning theory was
created (Bandura, 1977) to acknowledge the fact that we learn from other people
merely by observing or imitating them. A typical study involved the measurement of
children’s behaviours after observing an adult treating a large plastic doll (referred to
as the ‘Bobo doll’) in an aggressive manner (Bandura et al., 1961). Findings showed
that when the children were allowed to play with the doll, those who observed the
adult displayed far more aggressive behaviour towards it (modelling that of the adult)
than the children who had not observed the adult. This implied that children might be
influenced simply by watching violence on TV/film, or that people become bullies
by watching others successfully use bullying behaviour without consequences.
Social learning theory has been criticised as studies tended to lack validity due to
laboratory settings making findings less generalisable to the real world. In addition,
the theory does not take account of developmental aspects, i.e. the cognitive
transformations, which influence the ways in which children interpret experience at a
given age. Nevertheless, it has been helpfully applied to a variety of social problems,
and particularly aggression. For example, in dysfunctional families, coercive systems
can lead to oppositional behaviour in the child as a result of a rapid escalation of
conflict (Patterson & Maccoby, 1980; Smith et al., 2014). In contrast to functional
families that consistently apply consequences, children from coercive dysfunctional
families soon learn that parents react with volatility to misbehaviour but don’t follow
through with threatened punishments. Correlation has also been found between
inappropriate parental discipline (e.g. nagging and hitting) and high rates of bullying
behaviour (Curtner-Smith, 2000; Joussemet et al., 2008). Similarly, teacher reports of
such children’s oppositional behaviour indicate that their conduct problems are often
directed towards their peers (Smith et al., 2014).
A further application of social learning theory in the context of bullying is passive
reinforcement of bullying behaviour by peers watching the incident and condoning
their actions through lack of intervention (O’Connell et al., 1999). Bullies may also
then be modelling bullying behaviour to the witnessing peers, who may develop
beliefs that bullying will not lead to negative consequences and hence turn to
bullying themselves.
48
Social learning theory is therefore pertinent to this thesis since it emphasises how
observation of bullying behaviour can lead to imitation and how in school,
oppositional behaviour is often directed towards peers. It is applicable therefore to
the implementation of interventions designed to reduce bullying behaviours in
schools, broadly reflecting the aim of this thesis.
Summary of cognitive, genetic, evolutionary and social learning perspectives
The above perspectives have been highly influential in shaping our understanding of
the factors leading to the expression of antisocial/aggressive attitudes and behaviours
in children and adolescents. Cognitive theories focused on deficient processing of
information, genetic and evolutionary perspectives explored the extent to which
aggressive behaviour is heritable/environmental or indeed adaptive and in contrast
social learning theory suggested that aggressiveness is learned through experience of
the social world. In the context of this thesis, the perspectives provide insights into
why certain children are more or less likely to engage in bullying behaviours, such as
stereotypes, temperament, resource control and imitation. These theories place their
emphasis however on the causes of antisocial/aggressive behaviours of the individual
child, rather than the influence of identity or social norms and expectations on
attitudes, prejudices and discrimination. This will be considered in greater detail
below.
Psychosocial perspectives on intergroup relations
A great deal of recent research has looked at the dynamics of intergroup relations,
and in particular the development of moral reasoning in relation to identification with
a group, and the factors that might lead to social bias, implicit and explicit prejudice
towards other groups. Given the importance of the social and developmental context
of intergroup relations in schools, three theories – Social Identity theory, Social
Domain theory and Intergroup Emotion theory - are therefore discussed below,
followed by an outline of the way intergroup contact can offer a possible solution to
improve intergroup relations. These psychosocial perspectives represent the primary
theoretical framework for this thesis.
Social Identity Theory
49
It is well documented that social behaviour is influenced by social categories to
which we belong and relationships between these categories (Hogg & Vaughan,
1995). A group to which a person belongs, based on particular categories, is known
as the ‘ingroup’ and other groups to which a person does not belong are ‘outgroups’.
The effect of social categorisation was investigated by Tajfel et al. (1971) using the
minimal group paradigm (a methodology that manipulates participants’ social
categories to investigate the effect of categorisation alone on behaviour). Tajfel
(1982) found that mere categorisation leads to ethnic bias and competitive intergroup
behaviour. However, categorisation produces identification and discrimination only
if people identify with the category (Hogg, 2007, 2012; Marques et al., 2002).
Social identity theory (SIT) (Tajfel & Turner, 1979) is a theory of group membership
and intergroup relations arising from categorisation, social comparison and shared
ingroup characteristics. It is based on the premises that society has distinct social
groups with consequent status relationships, and that social categories provide
members of groups with a social identity, determining how one should behave and
think. Positive intergroup distinctiveness provides a favourable identity for members
of a group, so members strive to enhance their own group status and differentiate
themselves as far as possible from members of other groups. Research shows that the
two main motives for this are to increase collective self-esteem (Abrams & Hogg,
1988; Crocker and Luhtanen, 1990, Long and Spears, 1997) and to reduce
uncertainty, i.e. make life more predictable (Hogg, 2007, 2012; Marques et al.,
2002). Identifying with a group provides structure and a sense of self (Hogg et al.,
2007; Hogg et al., 2010).
Ingroup bias may therefore be the result of establishing a favourable identity, but
may also arise from derogating outgroups (Bennett et al., 1998; Brewer, 1979).
Whilst ingroup favouritism may not necessarily lead to discrimination towards
outgroup members, when there is greater uncertainty, members of an ingroup can
become more inward looking and intolerant of outgroups, sometimes leading to more
extreme ingroup favouritism, and intergroup differentiation and stereotypes.
Stereotypical perceptions arise when the process of categorisation leads to
‘depersonalisation’ (i.e. perceiving others not as unique individuals but as
prototypical embodiments of their social group).
50
Whilst social identity theory provides a clear explanation of factors affecting
intergroup relations in adults, developmental psychologists question whether it can
be applied to the study of children since it does not recognise that children’s social
cognition develops over time and that their group identities might be influenced by
age. In response, Nesdale (2004, 2007, 2008) developed the Social Identity
Development theory (SIDT), which is based on the same principles as SIT, but also
takes into account developmental changes. The theory suggests that ingroup bias and
outgroup prejudice develop as separate trajectories through childhood and that these
appear in four phases: up to 3 years of age, children don’t differentiate themselves
from others in particular categories (e.g. ethnicity); from 3 years, children acquire
ethnic awareness and begin to identify with their ethnic group; by 4-5 years they
develop ethnic preference, preferring their own ethnic group over other groups;
finally after 7 years, they begin to develop ethnic prejudice, i.e. negative evaluations
of the outgroup (Nesdale, 2004). To examine this theory, Nesdale, Maass, Durkin
and Griffiths (2005) used the minimal group design to manipulate social norms as
either inclusion or exclusion norms. At 7 years of age, when there was a norm of
inclusion, participants liked outgroup members if they posed no threat, but disliked
them if they posed a threat. In contrast, with a norm of exclusion, they disliked
outgroup participants, whether they posed a threat or not. However at 9 years of age,
their responses were more neutral (indicating their developing control of explicit
prejudice), but they still disliked outgroup members when there was an exclusion
norm and they posed a threat. The findings support the theory that prejudice develops
after 7 years of age, particularly when there is an exclusion norm, but also introduces
further concepts relating to the influence of social norms on social identity
development. Further evidence of this influence was presented by Nipedal, Nesdale
and Killen (2010), who found that group norms directly influenced children’s
attitudes towards included/excluded outgroup members. SIT and SIDT therefore
provide useful theoretical perspectives when considering possible explanations for
prejudice and discrimination towards children with autism. Children may identify
with particular categories that define their ingroup, such as ‘attractive’, ‘sporty’,
‘sociable’ or even ‘neurotypical’. In order to increase their self-esteem and reduce
uncertainty, SIT/SIDT suggests that they will attempt to differentiate themselves as
far as possible from outgroups (one such group being children with autism). When
51
combined with exclusive peer group norms and beliefs that autistic peers may pose a
threat, this leads to bias and adverse intergroup behaviour.
Social Domain Theory
Whilst SIT/SIDT focuses on group identity, it fails to differentiate the various
explanations for social/moral decisions provided by children at different
developmental stages. Consideration for social conventions alongside moral
development in relation to developmental stage and group identity is the focus of
Social Domain theory. Previous explanations of moral judgement and interaction in
childhood attempted to establish universal (domain-general) stages of development.
For example, Piaget (1932) demonstrated how younger children rely on authority
directives to differentiate right from wrong and that in later childhood they develop
autonomous beliefs regarding justice. Similarly Kohlberg (1971) argued for a
cognitive theory of morality, suggesting that young children are ‘premoral’, relying
on selfish desires to avoid punishment, but that by adolescence, they develop
conventional reasoning, i.e. ability to evaluate right and wrong based on social laws,
rules and obligations and that by adulthood, they have acquired principles of justice.
While the early cognitive-developmental theorists were highly influential in shaping
understanding of moral reasoning throughout the lifespan, by the mid-1980s studies
provided evidence that development of psychological, social conventional and moral
domains do not emerge successively, as previously suggested, but instead have their
own developmental trajectories (Killen et al., 2006; Turiel, 1989). Turiel (1983)
hence formulated the Social Domain model for understanding morality as distinct
from concepts of social conventions and psychological knowledge.
In contrast to the cognitive developmental approach, Social Domain theory proposed
that even young children can evaluate social transgressions on three different levels
(self, group and justice), that these equate to the three domains: the psychological
domain (the self and personal preferences); the societal domain (social conventions,
customs and group function); and the moral domain (fairness, justice, welfare and
rights of others) and that these constructs develop simultaneously (Killen & Rutland,
2011; Killen et al., 2006; Turiel, 1983). Children as young as 3 years old can
52
distinguish between types of transgression, such as hitting someone and wearing
pyjamas to school, evaluating hitting as wrong due to causing harm (moral domain)
and wearing pyjamas to school as wrong because it goes against traditions (societal
domain) (Killen & Rutland, 2013; Nucci, 2001; Killen et al., 2006; Turiel, 1989).
What does change with age, however, are the ways children prioritise reasons they
give (e.g. moral vs. social conventional) when making decisions about social
transgressions (Killen & Rutland, 2011). For example, social exclusion is a complex
example of a social transgression, and is sometimes perceived as morally wrong, but
other times considered legitimate to protect the effective functioning of a social
group. A large number of empirical studies have explored children’s social and moral
judgements and the underlying criteria they adopt in relation to the three domains
(Killen et al., 2006). In particular studies have focused on the relationship between
morality and group identity in relation to social exclusion judgements (Abrams &
Rutland, 2008; Abrams et al., 2008). For example Abrams et al. (2008) used the
minimal group paradigm to explore children’s judgements of loyal versus disloyal
behaviour and morally acceptable versus unacceptable behaviour. It was found that
older children (10-11 years) were more willing than younger children (5-7 years) to
exclude peers on the bases of group membership, but that they also favoured moral
principles when judging morally deviant individuals (from either group).
Furthermore, the stronger children’s identification with their group, the more likely
they were to use group-based judgements (e.g. deciding to exclude peers on the basis
of peer membership). However, moral judgements were not affected by how strongly
they identified with the group. The findings indicate that children’s social identity is
relevant to the group-based but not the moral-based domain.
In the context of this thesis, these studies have implications for children who either
exclude or judge favourably peers who exclude outgroup members (e.g. children
with ASD). Where NT children strongly identify with their ingroup, social domain
theory suggests that decisions to exclude ASD peers may be justified as legitimate in
order to protect group functioning (i.e. social conventional judgements), even when
they understand moral implications. Social domain theory therefore provides detailed
understanding of the complex nature of moral and group decision-making. It does
however place its emphasis on cognitive skills and reasoning and less so on
53
emotions, which research has found to be associated with behavioural intentions.
Group-based emotions are the focus of Intergroup Emotion theory, which is therefore
outlined below.
Intergroup Emotion Theory
Intergroup Emotion theory (Mackie, Devos & Smith, 2000; Smith, 1993) states that
emotions are generated through belonging to and deriving identity from one social
group rather than another. For example, collective guilt can arise if people feel their
group’s actions are under their control, motivating them to take action to rectify the
transgression (Branscombe and Doosje, 2004; Brown et al., 2008), whilst collective
shame occurs when a group’s actions reflect badly on the group’s image but is not
under their control, hence motivating them to avoid the event. Studies have shown
that the degree to which an individual defines himself or herself as a group member
determines the experience and intensity of emotion and also behavioural intentions
(Mackie et al., 1999). For example, Jones et al. (2009) assigned 9-11 year old
children to a group (either a group that bullies or is victimised or neither) to establish
a group norm, and measured their level of identification with the group. They found
that that group membership predicted group-based emotions and action tendencies.
Group based emotions of pride associated with the action tendency to affiliate with
the bully, guilt associated with making reparations to the victim and anger associated
with reporting to authorities. The study was interesting in that it indicated the
relevance of assessing emotions in children and that they respond emotionally even
though they may not be directly involved in events. Studies conducted for this thesis
will therefore address affective responses in addition to cognitive attitudes and
behavioural intentions in response to transgressions against children with autism.
Summary of psychosocial theories
In contrast to cognitive, genetic, evolutionary and learning theories, which place
emphasis on the social deficits of the individual child to explain aggressive attitudes
and behaviour, psychosocial perspectives, including the three theories outlined
above, consider the dynamics of intergroup relations and the factors leading to social
bias, prejudice and discrimination. Social Identity theory clarified how a person’s
54
social identity determines how they should think and behave, and how uncertainty
about members of other groups can lead to stereotypical perceptions and bias. Social
domain theory provided us with a developmental perspective, arguing that separate
psychological, social and moral domains have individual developmental trajectories
and account for the different ways children prioritise social and moral judgements
according to developmental stage. While Social Domain theory placed greater
emphasis on cognitive/reasoning skills, Intergroup Emotion theory proposed that
emotions are derived from identifying with a social group and that these link to
behavioural intentions. In the context of this thesis, psychosocial theories provide
important explanations for the reasoning children may give for transgressions against
their autistic peers, including maintaining a sense of self, reducing uncertainty and
protecting group functioning. They also provide methodological direction,
highlighting the relevance of assessing group emotions in addition to cognitive
reasoning.
While these perspectives provide explanations for the dynamics of intergroup
relations, the following theory – Intergroup Contact theory – provides a possible
solution to improve intergroup relations.
Intergroup Contact Theory
One method that has provided evidence for the reduction of prejudice and
discrimination between groups and promotion of morality is intergroup contact.
Intergroup contact theory (otherwise known as the Contact Hypothesis) proposes that
prejudice against outgroup members arises from lack of knowledge and familiarity
with the outgroup. It states that, under appropriate conditions (equal status between
groups, common goals, intergroup cooperation, support from authorities and personal
interaction), intergroup contact is one of the most effective ways to reduce prejudice
between majority and minority members (Allport, 1954). For example, Sherif (1966)
carried out field experiments with boys in summer camps in the US. Sherif found
that while simple contact failed to improve intergroup relations, implementing
superordinate goals that required interdependence for achievement led to greater
cooperation and the forming of new groups.
55
Individuals have a tendency to associate and bond with similar others, known as
‘homophily’ (Rubin et al., 2006). However, through communicating with other
groups, they are able to understand each other’s points of view, and consequently,
their prejudice diminishes. As a result, members of groups can ‘reconceptualise’ their
group categories, and increase the ability to take the perspective of, and empathise
with members of the outgroup. This can result in the challenging of negative
stereotypes, reduction of exclusive norms and facilitation of moral reasoning (Killen
& Rutland, 2011). Many studies have provided evidence of the effectiveness of
contact for reducing bias (Aboud et al., 2003; Feddes et al., 2009; Aboud, 2005;
Maras & Brown, 1996).
An extensive meta-analysis of 500 studies by Pettigrew and Tropp (2006) explored
whether or not intergroup contact can reduce prejudice. It focused on three
mediators: increase of knowledge about outgroup members through structured
contact; reduction of anxiety and expectations of threat; and increase of empathy
through contact with the outgroup. The results revealed that reduction of anxiety and
increased empathy are major mediators in contrast with increased knowledge. This is
supported by research looking at multicultural education, which assumes that
prejudice is the result of ignorance about the outgroup (Hill & Augustinos, 2001).
The lower significance of increased knowledge as a mediator also reflects previously
mentioned studies (in Ch.1.5) showing that information-based interventions are often
ineffective and even detrimental to intergroup attitudes, since they can reinforce the
negative stereotypes (Bigler, 1999).
Studies also show that prejudice is reduced through indirect contact (e.g. being aware
of cross-group friendships between members of own and another group) (Dovidio et
al., 2011; Killen et al., 2013; Wright et al., 1997). Cameron et al. (2007) suggested
this could be because when an ingroup member has an outgroup friend, that friend
(and the outgroup in general) is seen in a more positive light and indeed changes the
norm they believe their ingroup has about cross-group friendships. For example,
Cameron and Rutland (2006) used illustrated stories portraying friendships between
disabled and non-disabled children to explore whether placing salience on the
category of disability influenced children’s outgroup attitudes. Stories either
highlighted individual traits but gave no emphasis to the disability (decategorisation
56
approach) (Brewer & Miller, 1984), or highlighted the disability in addition to
individual traits (intergroup approach) (Brown & Hewston, 2005). In addition a
control condition used stories that were neutral (no attention given to either). They
found more favourable outgroup attitudes after stories based on the intergroup
approach. This indicates the importance of maintaining group boundaries in order to
generalize from the contact situation to the whole outgroup. Other research
highlights the importance of emphasizing both differences and similarities between
groups (also known as the Dual Identity model) (Cameron et al., 2007).
Despite the promising findings of indirect contact, there is a growing body of
research focusing on actual intergroup contact between children. The majority of
studies explore attitudes towards members of groups from different ethnic/racial
backgrounds. For example, Feddes et al. (2009) explored German and Turkish (i.e.
majority and minority group) 6-10 year old children’s evaluations of each other at
two time points and found that across time, for majority group children, more cross-
group friendships predicted positive outgroup evaluations. Other studies support
these findings, indicating that higher levels of contact with outgroup members led to
less tolerance of exclusion of outgroup members (Brenick, 2009; Crystal et al.,
2008). While most intergroup contact research has been conducted on children’s
ethnic/racial attitudes, it is understood that intergroup contact can reduce prejudice
towards other categories such as gender, nationality and religion (Killen et al., 2013).
Studies looking at the influence on attitudes of contact with peers with disabilities are
scarce. However, a longitudinal study by Maras and Brown (1996) measured social
orientations towards children with severe learning difficulties of nondisabled
children in a mainstream primary school. They found that contact with children with
disabilities led to significantly more liking than the control group (no-contact), which
showed no change. The contact group also categorized disabled peers using a wider
range of dimensions, in contrast to the control group who only categorized on the
dimensions gender and disability.
It is important to point out however, that while intergroup contact has been found to
be positive for reduction of prejudice in the majority group, there may be
implications for the minority group. It has been suggested that it can lead to false
expectations about equality and fair treatment of the outgroup (Saguy et al., 2009)
57
and also a decrease in motivation to strive for social change to remedy their
disadvantaged position in society.
In the context of this thesis, intergroup contact theory provides a promising method
of improving intergroup relations between autistic and non-autistic children. Through
increasing knowledge and familiarity, they can be encouraged to understand each
other’s points of view, and even redefine their group categories, leading to
diminished anxiety, challenged stereotypes, and reduced prejudice. Intergroup
contact is hence the chosen paradigm for an intervention to improve prosocial
attitudes of children towards their autistic peers (Ch.6).
Summary
Many psychological theories have been proposed to explain antisocial attitudes and
behaviours including those derived from cognitive, genetic and behavioural
paradigms. These shed light on the factors leading to the expression of
antisocial/aggressive attitudes and behaviours in individual children. One focus of
this thesis is to explore the experiences of victimisation in response to
antisocial/bullying behaviours. Hence an understanding of factors leading children to
bully others is vital. Nevertheless it also encompasses a wider context, i.e. the
attitudes held towards a particular minority group (children with ASD) of children
within a majority group (neurotypical children) that could lead to prejudice and/or
discriminatory behaviour. As such, the main theoretical framework is based on
psychosocial theories of intergroup relations including Social Identity theory, Social
Domain theory and Intergroup Emotions theory. These theories provide explanations
of the complex relationships between group identity, morality, social conventions,
social norms and their influence on attitudes and behaviours. Thus, together with
Intergroup Contact theory, which provides a possible solution for improving
intergroup relations these provide the primary framework for the studies that follow.
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1.7 Conclusions and aims of the thesis
Summary of the literature reviewed
Autism is ‘a lifelong developmental disability that affects how people perceive the
world and interact with others’ (NAS, 2018), and affects around 700,000 people in
the UK. Due to differences in understanding of the social world, and difficulties
interpreting social cues, studies indicate that children with autism are often
stigmatised, making them vulnerable to peer rejection and victimisation in inclusive
school settings. Positive peer relationships are essential for healthy social
development and studies show that peer rejection and victimisation lead to a number
of serious long-term outcomes such as anxiety, depression, low self-esteem, school
avoidance and higher likelihood of suicide. The significantly higher bullying
prevalence rates for children with autism compared with those of the general
population are therefore concerning.
Whilst inclusion is the prevailing policy framework in the UK many of its goals
remain unmet, placing children with autism at even greater risk and pointing to the
need for specific information, training and a greater focus on building tolerance and
acceptance for neurodiversity. An inclusive school ethos can have a positive impact
on exclusive peer group norms. However, there are a number of factors influencing
the attitudes of neurotypical children towards their peers with autism, and how these
may lead to bias and discrimination. For example there are fundamental
developmental changes in the influence of psychological, social-conventional and
moral understanding that determine how children in particular age groups and
contexts will think and behave towards their peers in other groups.
Explanations based on social identity theory, social domain theory and intergroup
emotion theory provide us with essential understanding of these interrelated factors,
highlighting the influence of social group norms on social identity and the
development of moral understanding in relation to social conventional understanding
throughout the lifespan. Surprisingly, however, they have rarely been applied to
certain minority groups such as those with disabilities, or more specifically, autism.
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Attitudes towards people with autism can be mediated by social group norms and
also by interventions to increase awareness and acceptance of diversity, especially
when they focus on intergroup dynamics, group identity and stereotypes, and making
salient the autism-specific challenges in a way that is appropriately tailored
according to age and social context. Meta-analyses of anti-bullying programmes
reveal mixed findings, possibly due to fidelity of implementation. However, various
other attitude-change interventions have positive effects. While information-based
interventions can have an adverse effect, accentuating differences and leading to
more negative attitudes, studies of intergroup contact have proved to be highly
effective in reducing prejudice and discrimination between groups and promoting
prosocial attitudes, particularly among children and adolescents.
Under-explored areas in the existing literature
The literature reviewed relating to inclusion, peer-relationships and bullying of
children with autism indicates a need to consider some fundamental, scarcely
addressed questions relating to three broad areas. First, little is known about the
phenomenological experience of children with autism in inclusive compared to
special school settings. Research with autistic samples largely adopts quantitative
methodology, which provides valuable insights, but does not offer the rich
understanding of the perceptions and meaning-making of autistic individuals.
Qualitative research is therefore needed, not only to explore these perspectives in
depth, but also to ensure that the autistic community is engaging in research and is
being given a voice. Furthermore, the predominance of studies focusing on boys with
autism suggests the need to explore further the experiences of girls, particularly due
to the likelihood of more socially complex relational difficulties. Second, while
research focuses on the attitudes of teachers towards the inclusion of children with
special needs, little is known about how teachers from inclusive and special school
settings specifically address the needs of children with autism and promote an
inclusive school ethos. Finally, since the majority of children with autism are placed
in inclusive settings, there is a need to explore factors influencing the attitudes of
neurotpycial children towards their peers with autism. Previous research provides
evidence of peer rejection and high levels of victimisation among children with
autism. Less is known however about the impact of different kinds of exposure to
autism on neurotypical attitudes, and the effect these have on behavioural intentions.
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Recent studies adopting social domain theory provide plausible explanations for the
social-moral reasoning and behavioural intentions of children at different
developmental stages, but the vast majority of these studies explore ethnic/racial
bias, using the laboratory-based minimal group paradigm, and through emphasising
differences in cognitive beliefs and moral reasoning, neglect to examine affective
responses. Furthermore, studies exploring the influence of intergroup contact with
peers with disabilities (and autism in particular) on neurotypical attitudes are also
scarce. There is a clear need therefore to apply social domain theory to the study of
children’s attitudes to a wider range of minority groups, such as children with autism,
in ecologically valid settings. In addition, further studies are needed investigating the
influence of intergroup contact between autistic and neurotypical children, including
the impact this has on quality of attitudes, both cognitive and affective, to scenarios
involving transgressions against their autistic peers.
Aims of the thesis
This thesis therefore aims to explore these under-researched areas, extending the
field of research in peer relations for children with autism. It adopts a multi methods
approach in order to ensure the most valid and effective methodology for the specific
aims. Using qualitative methods, it aims to investigate the experiences of adolescent
girls with autism (continuing the work from a separate study with adolescent boys in
2016) and their parents, and the policies and practices adopted by teachers in
contrasting school settings. Using quantitative methods, it aims to explore the
attitudes of neurotypical children towards their peers with autism in mainstream
school settings. Specific aims of the thesis are as follows:
Aim 1: To explore the experiences of learning, friendship and bullying of adolescent
girls with autism and those of their parents, comparing accounts of those in
mainstream compared to special school settings.
Aim 2: To explore the wider contextual issues facing teachers of pupils with autism
in mainstream and special school settings.
Aim 3: To examine differences in neurotypical children’s attitudes towards bullying
and autism according to educational and personal exposure to autism.
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Aim 4: To evaluate the impact of a contact-based intervention using group music-
making on the prosocial attitudes of neurotypical children towards their peers with
autism.
Structure of the thesis
Study 1 (Ch. 2): Friendship motivations, challenges and the role of masking for girls
with autism in contrasting school settings: a qualitative study
This qualitative study explored experiences of learning, friendships and bullying of
girls with autism. Semi-structured interviews were conducted with 11 girls with
autism, aged 12 – 18 years, and one parent of each girl. Thematic analysis was used
to identify key themes relating to a number of social challenges and various
influences on these including their school setting.
Study 2 (Ch. 3): Balancing the challenges and solutions for teachers supporting
autistic pupils in contrasting school settings: a qualitative study
This qualitative study explored the experiences and attitudes of teachers in
mainstream and special school settings about policies and practices in their schools
relating to pupils with autism. Semi-structured interviews were conducted with 12
teachers – 6 from a mainstream setting and 6 from a special school setting. Thematic
analysis identified key themes relating to challenges supporting children with autism,
solutions they adopt and their perceived efficacy to implement these in relation to
factors that are often beyond their control.
Study 3 (Ch. 4): The effect of exposure on attitudes towards bullying and autism in
schools: A cohort study with a control group: findings at baseline
Furthering research on the influence of group norms and contact on changes in social
and moral reasoning, this longitudinal field study used an experimental design to
investigate differences in attitudes of neurotypical children (aged 11-12) in schools
with enhanced physical and social environments (purpose-built specialist centres for
pupils with autism) compared to those in schools without specialist centres. Survey
data from 960 participants provided baseline measures of prosocial judgements,
emotions and intended behaviours in response to bullying scenarios and cognitive
attitudes towards their peers with autism.
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Study 4 (Ch. 5): The effect of exposure on attitudes towards bullying and autism in
schools. A cohort study with a control group: findings at follow-up
This chapter presents the follow-up data from Study 3, evaluating changes in
attitudes of neurotypical children (N = 775) towards bullying scenarios and peers
with autism according to educational and personal exposure to autism.
Study 5 (Ch. 6): The impact of a school-based musical contact intervention on
prosocial attitudes, emotions and behaviours: A pilot trial with autistic and
neurotypical children
In line with previous research showing the benefits of music for facilitating social
cohesion and also research indicating the influence of intergroup contact on prosocial
attitudes, this pilot study used an experimental design to evaluate changes to
prosocial attitudes of younger children (aged 9-11) who either had contact or no
contact with autistic peers during a music programme designed to increase social
interaction. Survey data from 49 participants provided change scores in measures of
prosocial behaviour, sympathy, tendency to be a victim/bully and prosocial
judgements, emotions and intended behaviours in response to scenario depicting
social exclusion of a child with autism.
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Chapter 2
Study 1: Friendship motivations, challenges and the role of masking
for girls with autism in contrasting school settings: a qualitative
study
Overview
To date much research has focused on the experiences of boys with autism. This
first empirical chapter addresses the experiences of girls using a qualitative approach.
In particular, it focuses on their relationships with others and how these are impacted
upon by various factors, including whether they are in a mainstream or specialist
school setting.
2.1 Introduction
Chapter 1.1 indicated that the male-female ratio for the prevalence of autism is
reported to be 4-5:1 (Kim et al., 2011; Scott, Baron-Cohen, Bolton & Brayne, 2002).
Research samples are often based on this ratio, or include males only and this may
have biased our understanding of autism. This underrepresentation of females in
research has led to a recent rise in interest regarding girls with autism and sex/gender
differences (Devlin, 2018). Some believe that the ratio is likely to be closer to 2-5:1
(Kim et al., 2011; Mattila et al., 2011). The larger ratio reflects a growing belief that
the diagnostic tools (e.g. DSM-5) are not sensitive enough to capture how females
present their characteristics. Many girls who are diagnosed with autism display more
severe symptoms, leading to studies reporting that girls with autism are more likely
to have intellectual disability and more severe language and communication
difficulties (Centers for Disease Control and Prevention, 2007; Wing, 1981; Hartley
& Sikora, 2009). However, other research has explored how sociocultural factors
may influence the imbalance in diagnosis rates (Attwood, 2006; Hsiao et al., 2013;
Kreiser & White, 2014). For example, Kreiser and White (2014) suggest that
sociocultural factors influence not only the expression of autistic characteristics in
females, but also others’ perceptions of their behaviour. Likewise, social cognitive
theories of gender expectations (Bem, 1981; Bussey et al., 1999) propose that
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gender-appropriate conduct is learned through modelling the behaviours of people of
the same gender. For example, girls are often encouraged to be passive and
nurturing, and boys to be strong and dominant (Davis & Wilson, 2016). If girls are
expected to show greater sensitivity in relationships, their perception of negative
feedback to non-conforming behaviours may be perceived more strongly than for
boys, and in turn may lead them to hide autistic characteristics though modelling
gender-appropriate behaviour (Kreiser & White, 2014). This tendency has been
referred to as the ‘camouflage hypothesis’ (Dean et al., 2016; Dworzynsky et al.,
2012), i.e., the concealing of deficits to conform to social group norms.
While friendships between adolescent neurotypical girls tend to be focused on
smaller more intimate groups and the development of reciprocal friendships
(Blatchford et al., 2003; Buhrmester, 1990; Freeman & Kasari, 1998), this is not the
case for children with autism, who prefer to focus less on intimacy and more on
companionship (Bauminger et al., 2004; Bauminger & Kasari, 2000; Calder et al.,
2013). Calder et al. (2013) found that children with autism were content that their
friendships were perceived more as someone to play or ‘hang around’ with than
someone to bond with. Indeed, studies have shown that children with autism tend to
have significantly fewer friends than typically developing children (Bauminger &
Kasari, 2000) and the friends that they do report may in fact be ‘desired’ rather than
actual friendships, since they are not always verified by their parent. In their
secondary analysis of data (AIR-B, 2012; Kasari et al., 2011), Dean et al. (2014)
found that girls with autism were neither accepted nor rejected, but instead they
appeared to be ignored or overlooked, and given the importance of reciprocal
friendship among girls, the isolation placed them at greater social and emotional risk.
Friendships require good communication skills, perspective-taking ability, emotion-
reading ability and self-regulation (Calder et al., 2013), skills that people with autism
often lack due to their social deficits.
Being on the periphery of social networks may lead others to believe that people with
autism don’t want to have friends. This is a common misconception, and there is
increasing research showing this not to be the case (Mcgovern & Sigman, 2005).
Recent studies showed that autistic girls’ motivation for friendship is similar to their
non-autistic peers (Sedgewick et al., 2016). Sedgewick et al. measured motivation for
65
social contact and extent and nature of friendship experiences in adolescent girls and
boys with and without autism attending special schools. They found that autistic girls
had less severe social difficulties than autistic boys and also that autistic boys had far
lower motivation for friendships. The autistic girls’ social motivation was similar to
their non-autistic peers. Nevertheless, girls with autism did report many instances of
conflict in their friendships and Sedgewick et al. explained that this might be due to
their inability to respond to subtle social nuances, making them an easy target for
relational conflict.
Conflict and peer rejection may motivate them to conform to the social group norms
of neurotypical groups, by masking their non-conforming friendship behaviours
(Kreiser & White, 2014). Despite their attempts to replicate typical female friendship
norms, however, girls with autism may still have difficulty responding to subtler
distinctions in non-verbal communication, which can lead to adverse reactions from
peers, making them an easy target for relational conflict (Kresier & White, 2014;
Sedgewick et al., 2016).
As discussed in Ch.1.4, conflict between peers is a particular problem for young
people with autism. To date, however, little research has focused specifically on the
bullying of girls with autism. In neurotypical adolescents, boys tend to display overt
aggression, while girls use subtler means to display anger, such as spreading
rumours, gossiping, excluding, or ignoring (Card et al., 2008). This type of relational
aggression is more likely than physical aggression in girls (Crapanzano et al., 2010;
Crick & Grotpeter, 1995), and is also more socially complex. As a result of this,
girls with autism may not understand the behaviours of their peers, which in turn
may lead to them being more socially isolated (Cridland et al., 2014), as indicated in
the sociometric studies discussed in Ch.1.3, showing children with autism to have
significantly fewer friends than neurotypical children (Bauminger & Kasari, 2000;
Rotheram-Fuller et al., 2010).
Research into the experiences of girls with autism is limited, due partly to the
predominance of male diagnoses, but also since the majority of studies focus on
gender differences from a biogenic viewpoint or using quantitative methodology
(e.g. Baron-Cohen, 2002, 2004; Dworzynsky et al.; Gilberg et al., 1998; Hartley &
Sikora, 2009; McGillivray & Evert, 2014; Wing, 1981), which while valuable do not
66
offer the rich understanding of their perceptions of friendship that qualitative studies
can elicit. In addition, although in recent years qualitative studies have been
published (Cridland et al., 2012; Sedgewick et al., 2016; Tierney et al., 2016), they
haven’t located girls’ experiences alongside their parents’ and across school setting
types.
Aims
In light of these factors, the present study will focus on (i) the impact of level of
inclusion on the areas of learning, social relationships and bullying of girls with
autism, (ii) the perspectives of girls with autism and those of their parents with the
clear intention to elicit their own perspectives and to prevent one ‘voice’ from
obscuring the other, (iii) a deeper understanding of perceptions through the use of a
qualitative research design.
The aim of the study is to explore the perspectives of girls with autism and those of
their parents using a qualitative research design. In particular, the study aims to
explore experiences of learning, friendships and bullying in girls with autism
attending both specialist and mainstream schools and those of their parents.
2.2 Method
Design
A qualitative design was used with semi-structured interviews. Thematic analysis
(Braun and Clark, 2006) was used to analyse the data.
Role of the Researcher
The researcher’s role was to select participants, devise and conduct the interviews
and analyse the transcripts. A hermeneutical approach was used (Palmer, 1969),
meaning that the researcher has to be aware of their own pre-understanding (existing
knowledge, values and experience) of the topic of interest when they interpret the
accounts of participants’ experiences. Participants’ experiences are brought together
with the researcher’s to produce new understanding of the area of interest. In this
study, the researcher’s pre-understanding consisted of theoretical knowledge and
personal experience of parenting children with ASD.
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Participants
Participants were recruited from mainstream and special schools in Southeast
England through purposive sampling by emailing schools, advertising in the National
Autistic Society’s newsletter and making contact with individuals who had shown
willingness to take part through word-of-mouth. Inclusion criteria comprised females
in Years 7 – 13 with autism, who would be willing and able to engage with the
questions in the interview and communicate their experiences, and one of their
parents. A previous study was completed with boys (Cook, Ogden & Winstone,
2016) exploring their experience of the same areas. The reason for conducting
separate studies was that research indicates substantial neural differences between
girls and boys with autism leading to potential contrasts in emotional and cognitive
processing (Nordahl et al., 2015).
Twenty-two interviews were completed, ranging from 15 minutes to 46 minutes,
with half of the interviews lasting longer than 24 minutes: 10 mother-daughter dyads
(six from mainstream, four from special schools), and one father-daughter dyad
(from a special school). Mainstream schools are defined as those run by the local
council that principally meet the needs of pupils who do not have special educational
needs. Special schools are defined as those for which the main purpose is to provide
education for pupils with special educational needs. While inclusion criteria allowed
either parent to be interviewed, only one father responded, the remainder being
mothers. The daughters’ ages ranged from 12 to 18 and all had a diagnosis of an
autism spectrum disorder. Diagnostic information is shown in Table 2.1.
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Table 2.1
Diagnostic Information
Parents were all aged 40+ (except one who was in the 30-40 age range) and
represented a range of professions. The range of experiences that the participants
displayed was considered sufficient to answer the research question. However, while
all the girls interviewed were on the autistic spectrum, it cannot be stated that the
group was completely homogenous, since autistic traits and levels of severity are not
generalizable. Participant demographics are shown in Table 2.2. (All names are
pseudonyms, and some nicknames have been edited for anonymity.)
69
Name Diagnosis Age Agediagnosed
Comorbid diagnoses
Amy ASD 11 5 Speech and Language Difficulties
Chloe ASD 14 4 Anxiety, Global Developmental Delay
Holly ASD 15 10 ADHD, Dyslexia, Global Developmental Delay
Leah Autism 12 10 Attention Deficit Hyperactivity Disorder
Lily Autism 16 15 OCD, Facial Tic Disorder, Anxiety, Depression
Grace Autism 16 15 Epilepsy, Moderate Learning Difficulties
Zara Asperger’s Syndrome
13 12
Sophie Asperger’s Syndrome
16 11
Elizabeth Asperger’s Syndrome
14 7
Becky Asperger’s Syndrome
15 12
Lucy Asperger’s Syndrome
16 7
Table 2.2
Description of the Participants According to Socio-Demographics
Daughter ParentName School
YearEthnic Origin
Education Setting Type
Name Age Range (years)
Ethnic Origin
Occupation Highest Level of Education
Zara 9 WB MainstreamCo-ed Secondary
Mia 40-50 WB Classical Composer
Degree
Leah 8 MR MainstreamCo-ed Secondary
Emma 30-40 MR Adult Social Care Worker
A-levels
Sophie 12 WB MainstreamGirls’ Secondary
Kathryn 50+ WB Freelance Writer
Master’s Degree
Lily 12 WB MainstreamCo-ed Secondary
Jennifer 50+ WB SEN Support Manager – Primary School
Degree
Elizabeth 10 WB MainstreamCo-ed Secondary
Michelle
50+ WB Nurse at a Respite Centre
L3 Nurse Training
Amy 7 WB MainstreamCo-ed Secondary
Mary 40-50 WB Accountant Degree
Becky 11 WB SpecialCo-ed Junior/Secondary
Sarah 50+ WB Ex-teacher and now Carer for Becky
Master’s Degree
Chloe 10 WB SpecialCo-ed Secondary
Alistair 50+ WB Ex-Customs and Excise and now Carer for wife
A-Levels
Lucy 12 WB SpecialGirls’ Secondary
Rachel 40-50 WB Office Manager
O-Levels
Grace 12 WB Special Co-ed Secondary
Angela 50+ WB Independent supporter for Education & Health Care Plans
Degree
Holly 11 WB Special Co-ed Secondary
Dawn 50+ WB Youth Worker + nursery school teacher
Diploma
WB: white British; MR: mixed race.
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Procedure
A semi-structured interview explored the experiences of the participants within their
particular school setting, and consisted of broad, open-ended questions. The pupil
interview covered (i) experience of learning, (ii) experience of friendships and (iii)
experience of bullying. The parent interview covered their views on (i) their
daughter’s learning in school, (ii) their daughter’s friendships, (iii) their daughter’s
experience of bullying and (iv) different school settings in relation to bullying. The
semi-structured interview guide supported using flexible strategies, such as probes
when necessary (e.g. ‘can you give me an example of that?’). With the participants’
permission, the interviews were recorded and transcribed. (See Appendix C for the
full interview schedule.)
A favourable ethical opinion was received from the University Ethics Committee.
The information sheet stated that participation was voluntary and that participants
were able to withdraw from the study at any time without any explanation.
Data analysis
Thematic analysis (Braun and Clark, 2006) was used to identify patterns in the data
and capture commonalities of experience and understanding whilst at the same time
enabling participants to be located within contrasting school contexts. A contextualist
approach was adopted, which assumes that individuals make sense of their
experience within social, cultural and historical contexts. The method was inductive:
themes were strongly linked to the data, rather than being fitted to analytic
preconceptions. Analytic stages involved familiarization with the data by the primary
author through several detailed readings of interview transcripts; summaries of key
points from each interview made and generation of initial thoughts and observations
followed by coding of the data in collaboration with the other researchers;
identification of initial themes and sub-themes and their connections; review and
finalization of themes and sub-themes ensuring they reflected coded extracts;
detailed analysis of themes and sub-themes, identifying how they fit into the broader
overall context. Agreement was achieved between researchers as an iterative process.
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Codes relating to each theme, including identification of their source (daughter,
parent or both) are shown in Table 2.3. Interpretations were checked against
participants’ stories to ensure they covered all parts of the data.
2.3 Results
Participants’ experiences reflected the following themes: i) motivation to have
friends; ii) challenges and; iii) the tendency to use ‘masking’ strategies to hide
certain characteristics of their condition, which can offer a solution, but also create
problems. These themes are discussed and illustrated with exemplar quotes.
Table 2.3 illustrates the themes and sub-themes arising from the coded extracts.
Table 2.3
Themes and Sub-Themes Derived from Thematic Analysis.
Theme Sub-theme Emerged from girl/parent/both
1. Motivation to have friends
Divergence of expectations of friendships with neurotypical peers
Wanting to fit in but lacking the skills to form and maintain them
Befriending those who are different
Parents
Both
Both2. Challenges
faced by girls with autism
Stress and anxiety Communication difficulties Friendship group difficulties Social isolation Bullying Absenteeism
BothParentsBothParentsBothParents
3. Masking their autism: both a solution and a problem
Solution: Making personal adjustments Concealing their label
BothParents
Problem: Internalising Late/missed diagnosis
ParentsParents
Theme 1: Motivation to have friends
It was apparent from most accounts that the girls wanted to have friendships and to
fit in with other girls, but their notion of having friendships did not always work out
successfully in practice. For example, Zara described how her desire to get along
with people was compromised by her way of thinking:
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I look towards myself and wish I could get along better with other people, but
that's just not the way I function. (Zara, daughter – mainstream school)
Most parents, and some of the girls, recognized a growing divergence between their
expectations of friendships, and those of their neurotypical peers. Holly explained
one of the reasons why she thinks she struggled to form friendships:
Some say to me that I'm young minded because I don't wear makeup and I
don't like the same things, and I don't go out and I don't think the same way
as them. But it's not that; it's just, I'm different. (Holly, daughter – special
school)
A number of the parents pointed out that their daughters were particularly immature,
or childlike for their age, and that this might have an impact on their social
interactions. Emma pointed out some of the differences between her daughter and the
other girls:
She's just so, so immature and childish still - she's Year 6 level maturity-wise.
She wants her hair in bunches…whereas I've seen some other girls in Year 8
and they've got, you know breasts, and short skirts and they've got mascara
and they've got highlights, and you think 'you can't be the same age, surely?'
(Emma – mother, mainstream school)
Angela described how her daughter Grace sees her sister successfully engaging with
other children and desires to have the same kinds of friendships. But once she is in a
social situation she lacks the skills to form or maintain these friendships:
It always goes spectacularly wrong…she likes the idea of it, so she'd love
getting dressed up and going, and she'd love to see everyone for about 5
minutes and then she's got no idea what to do next. None of them know how
to make conversations, how to carry an evening, how to structure and plan it.
(Angela – mother, special school)
Where successful friendships had been formed, they were often with other girls with
special needs, or who were different in some way. While this is expected for those
students in special school settings this tendency was also found in girls in
mainstream settings who tended to gravitate towards other girls with autism without
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realising it. For example, Sophie explained how she enjoyed being able to be herself
around those in a friendship group comprising of people her mother described as
being ‘on the outside’:
Well they were kind of just free and didn't really care too much what other
people thought, which is a lot like what I am. So they kind of just resemble
me, in a different way, so that's probably why I got along with them so much.
(Sophie – daughter, mainstream school)
Many of the girls talked about having a particular special interest, enabling them to
interact with other girls who held the same or similar interests. For example, Becky
explained how she enjoyed conversations about each of her friends’ areas of interest:
I love Dr Who, and she likes Harry Potter, and so we have these arguments
like which is better…And like we all have our different, I dunno, 'autistic
obsessions' - that's what we call them. One of my friends - her name’s [Jess] -
and she's obsessed with science, so we have arguments about if Dr Who is
real or not, and if it could happen. (Becky – daughter, special school)
Therefore, the girls indicated that they wanted friends and would like to fit in at
school, but their mothers described the factors that held them back such as their
limited social skills and observed diverging expectations of friendships compared to
their neurotypical peers. The tendency to befriend others with autism or other
differences enabled them to feel accepted and to be themselves.
Theme 2: Challenges faced by girls with autism
Many accounts were given by the girls and their parents of problems faced by the
girls, ranging from communication and friendship group difficulties to social
isolation, bullying and absenteeism. The girls’ difficulties were further exacerbated
by the general demands faced by people with autism. For example, many girls
reported high levels of stress and anxiety, resulting in them feeling overwhelmed and
upset:
My maths class is very noisy and, well, I find the questions quite hard
sometimes and I get stressed out…and I remember I uh, broke down and
cried in front of my maths teacher. (Chloe – daughter, special school)
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For some there were times when their anxiety and frustration overwhelmed them,
making them angry or aggressive. Some mothers reported that their daughters would
shout out inappropriately, or be rude to other people. Grace’s mother discovered that
she would sometimes be rude to avoid having to go on trips that might be stressful
and unpredictable. She recalled one occasion when she had responded rudely:
So perfect, because she didn't want to go. And she got to stay with the TA and
spend the day colouring in!... Grace hates novelty. Grace hates, hates, you
know, going off to London on the tube, she can do it, but she'd much rather be
home, colouring in. (Angela – mother, special school)
Some parents identified communication skills as a significant problem. Leah’s
mother, for example, described Leah’s lack of perspective-taking:
I've always said to her you know 'take it in turns when you’re speaking; it's
not all about you…', because she will get louder and louder and louder, and
it's all about her her her her her! So I'll say to her…‘just take into
consideration other people's thoughts'. But she just can't, you know. (Emma –
mother, mainstream school)
Most found it difficult to fit into friendship groups, which seemed to vary by school
type. In mainstream schools, there were reports of best friends, girls leaving groups,
re-forming new groups and regular fallings-out. For example, Leah seemed to be
continually leaving and joining groups with some negative consequences:
I'm not going to say it's the best anymore, because no, my friendship group –
we used to have a group, but then I kind of quit the group because my friends,
well there’s this one girl who just goes off with another group, and then just
does like secrets. (Leah – daughter, mainstream school)
Her mother gave a slightly different interpretation, indicating that Leah tended to
assume everyone is against her, and doesn’t correctly perceive friendship situations.
There were also problems with friendship groups in the special school settings, but
these presented in different ways. For example, Holly found it impossible to form
friendships in her class since they would take offence at anything she did. This was
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confirmed by Holly’s mother, who believed that it was usually the other pupils’
special needs that impacted on the friendships:
It's difficult to make mainstream friends if you're a little bit different. But it's
also difficult to make friends amongst special needs children because they're
also different and have their different problems and see things in different
ways. (Dawn – mother, special school)
Friendship groups were problematic but while girls in both setting types had
difficulty processing social information, those in special school settings had
additional challenges due to the social processing needs of their peers.
A second challenge regarding relationships was the inability to keep friends, and
more generally – social isolation. The girls told stories of how they are usually
picked last by team captains in PE, how they initiated social events more frequently
than their friends and how they no longer got invited to parties. Their mothers’
accounts were more detailed, indicating a particular sensitivity to this aspect. Many
mothers reported how invitations diminished over the years. Before she joined her
special school, Grace attended a mainstream junior school, which her mother
remembered being very cliquey:
It amazes me actually in retrospect about how inconsiderate everybody was.
We were just not included. In fact, it became just ridiculous about how un-
included we were, you know…she was never invited to any parties. (Angela –
mother, special school)
Girls from both types of school setting reported having been bullied. There was a
definite sense, however, that many of the incidents in special school settings were
due to other children’s special needs, and could not be defined as bullying since they
did not deliberately intend to cause harm. For example, Holly had experienced some
terrible occurrences, but she put it down to the immaturity and mindlessness of the
other pupils in her class. She described some of these incidents:
I've been whacked on the head by the door of a locker like when I'm getting
my stuff. I've been pushed, I've been punched, I've- I've had people call me a
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[hurtful name], and back then I didn't even know what they meant. (Holly –
daughter, special school)
Holly’s mother recognized that the pupils’ special needs were the likely cause, but
also felt that the school did not take the incidents seriously enough, since staff had
become attuned to the children exaggerating or embellishing their stories.
Nevertheless, she believed that Holly was extremely vulnerable and reported that she
would often break down when she returned home.
In contrast, the bullying endured by the girls in mainstream schools appeared more
intentional. Leah described some of these incidences:
In Physics, this boy chucks leaves at my face when we were going outside.
And then the same boy, he put glue on my face. And then, there's a group of
boys that always call me [hurtful name]. I try to ignore them, but then they
keep like, they keep spreading round - I hear people saying “call her [hurtful
name], call her [hurtful name]”. Or they call me other names that they know
I don't like, like 'Frankenstein’. (Leah – daughter, mainstream school)
Their experiences often led to school absenteeism. All reported cases of absenteeism
were from girls in mainstream school settings. Lily was regularly absent from school
and her mother described how this affected them at home:
So she just missed huge amounts of school. Her teachers-, I was forever
asking them to send work home. Sometimes they did, sometimes they didn't.
She used to go in for a little bit, and then not - caused a lot of anxiety in the
house. There was a lot of shouting in the house. It wasn't a happy house for a
couple of years. (Jennifer – mother, mainstream school)
The girls therefore faced many challenges. While problems relating to friendship
groups, social isolation and bullying were experienced by all of the girls to some
extent, there were differences observed between settings, with problems in
mainstream settings resembling those that might be considered typical of girls in this
age group, whereas those in special school settings reflected a more complex set of
issues. In addition, school absenteeism was more specific to mainstream settings and
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was reported not only to be a result of the challenges – often being attributed to the
girls’ inability to cope in school – but also as a challenge in itself.
Theme 3: Masking their autism
Transcending the themes above was an interesting observation made by some of the
parents, that their daughters could successfully hide their autistic characteristics.
Many reported how well their daughters coped or how they made adjustments to
their behaviour in order to fit in. As such, this ‘masking’ behaviour offered a solution
to some of their social difficulties. It could also pose a problem, if it led to a late or
misdiagnosis.
Masking as a solution. Many of the girls had very articulate speech and sometimes
their parents reported that they adopted the tone and mannerisms of other girls, such
as Zara, who would adopt the voice of a YouTube star, when she chatted to her
mother about her day. Leah went even further and consciously tried to change her
personality in an attempt to fit in:
I was like 'oh should I change into someone else', because no one actually
seems to be in the group so I, I thought if I changed to be like my other friend,
they'll listen to me, and they all did, so I was like, I'll keep it that way…I'm
changing because no one's actually listening to me and I always feel left out.
(Leah – daughter, mainstream school)
Some of the girls were also reluctant to be labelled, and preferred to conceal their
differences. Sometimes this was helpful, enabling them to feel included in friendship
groups. For example, Lily talked about how she had only told a few people about her
autism and has a different kind of relationship with those she has not told. This was
reinforced by her mother, who recognized the benefit of the diagnosis for Lily, but
respected her decision not make it more widely known:
She's not embarrassed by it, but also she doesn't want to be labelled by it
either, which is fair enough. For [Lily] it made a huge difference getting the
diagnosis. Really helped her a lot, it really did. But saying that, it's her
diagnosis, and she wants to be doing what other people do really. (Jennifer –
mother, mainstream school)
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Masking as a problem. A number of the girls were not diagnosed until the later years
of junior school, or even secondary school age. Lily’s mother reported that when Lily
was in Year 7 she started getting intense pain in her arm, and started to wonder if the
pain might be a physical manifestation of her stress and anxiety.
She had MRI scans, I think they thought she had cancer at one point, all sorts
of things, she saw so many professionals who didn't put two and two together
until she saw a neuro-something, who said there’s nothing wrong with her
arm and that it must be – so he referred to CAMHS [Children and Adolescent
Mental Health Services]. (Jennifer, mother, mainstream)
Some mothers thought their symptoms were missed due to their seeming ability to
cope at school. When they mentioned their suspicions they would often be met with
scepticism. For example, Sarah described the response she received from Becky’s
mainstream primary school:
At that stage she was masking and covering up quite well, and although we
were aware that there was something not quite right, every time I raised with
her teachers at the primary school, … they just said 'she's fine' you know,
'you're expecting too much, she's fine'. (Sarah – mother, special school)
Masking their differences appeared to be more common in mainstream settings and
often enabled the girls to feel that they belonged and prevented them from being
singled out by their peers. It did not always have positive outcomes, however, since it
carried the risk of symptoms being missed, and greater problems developing as a
consequence, such as falling behind at school and social difficulties.
2.4 Discussion
This study explored how girls with autism experience learning, friendships and
bullying. It provided valuable insights into the experiences of girls with autism and
gave an opportunity for them to explain these in their own words, reflecting the
recent impetus to giving the autism community a voice (Pellicano et al., 2014).
The results indicated that girls with autism may have perceptions of friendship that
are different to those of their neurotypical peers. Many of the girls had trouble
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maintaining friendships and showed lack of understanding in their social interactions.
These outcomes are of interest in light of research showing that whilst neurotypical
girls prefer to play in smaller groups focused on reciprocal friendship and
conversation (Blatchford et al. 2003; Buhrmester, 1990; Freeman and Kasari, 1998),
people with autism may have difficulty developing reciprocal friendship (Sedgewick
et al., 2016) and are more content with companionship rather than deeper bonds
(Bauminger et al., 2004; Bauminger and Kasari, 2000; Calder et al., 2013, Dean et
al., 2014). Despite these difficulties, there was general motivation to have friends, in
line with research by Sedgewick et al., (2016) showing that the motivation for
friendships of girls with autism was similar to that of their non-autistic peers. In the
present study, many examples were given of the girls’ impetus to form and maintain
friendships, though these were often also constrained by social inadequacies.
The girls faced many challenges, particularly due to social difficulties, and in special
school settings these were further complicated by the special needs of other children.
Many had been excluded from parties and social gatherings – reflecting research
findings relating to social isolation by Cridland at al. (2014), Bauminger & Kasari
(2000) and Rotherham-Fuller et al. (2010) – something that appeared to affect
parents more than the girls themselves. It may also be the case that the diminishing
invitations, and social isolation in general, could be related to diverging friendship
expectations, mentioned above. Parents often put this down to a level of immaturity
compared to their peers, and also observed their tendency to befriend other children
with special needs or other differences. Approximately half the girls had been
subjected to bullying, though again the experiences within special school settings
reflected a more complex set of issues that suggest the incidents couldn’t always be
defined as ‘bullying’. There were reports of physical and verbal bullying across
schools settings, but the friendship problems also highlighted relational aggression
(i.e. excluding, spreading rumours etc.), in line with previous research (Card et al.,
2008; Crapanzano et al., 2010; Crick & Grotpeter, 1995; Cridland et al., 2014).
Reports of school absenteeism came from those in mainstream settings only, and
were often attributed to an inability to cope in the school setting.
Transcending these areas, findings indicated that many girls would undertake
masking behaviours, reflecting findings by Attwood (2006), Dean et al. (2016),
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Dworzynsky et al. (2012) and Kopp & Gillberg (1992) who described a tendency of
girls with autism to imitate others in social interactions or camouflage their
difficulties. Attwood found that girls can be quite effective at imitating and
modelling the mannerisms, voice and personality of socially skilled people –
providing themselves with a superficial social competence, reflected by the finding
in the present study that masking could sometimes offer a solution to their social
difficulties.
At other times, masking potentially caused greater problems. Previous research has
found that children with better language skills are able to compensate for their
difficulties with social communication, through learning the rules (Happé, 1995), but
they may still lack the ability to appreciate the thoughts and feelings of others, or
detect the subtle cues required in reciprocal relationships (Baron-Cohen et al., 1985;
Tager-Glusberg, 2007). In the present study, this appeared to be the case for some of
the girls, who adapted their behaviours in an attempt to fit in, but often encountered
problems due to limitations in their social skills. It was possible that the tendency to
camouflage their deficits led to the internalisation of problems, particularly in Lily’s
case, something that has been found to lead to even greater stress and anxiety
(Bussey & Bandura, 1999; Keenan and Shaw, 1997; Kreiser & White 2014).
The masking may also have hidden the signs of autism from parents and teachers,
leading to reluctance to seek a diagnostic assessment. This was likewise reported by
Attwood (2006), who stated that boys are more likely to receive an earlier diagnosis
since they show greater signs of aggression, whereas girls with autism, particularly
those with advanced verbal skills and passive personalities, appear to be coping well.
This might account for the high male-female ratio for the prevalence of autism. The
perceived ability of girls to cope is problematic, not only since it can cause the
internalisation of their problems, but it could also mean that many are not being
diagnosed (Dworzynski et al., 2012) or being misdiagnosed (Begeer and Mandell,
2013), and hence the failure to provide early educational interventions, which have
been linked to better long-term prognoses (Lord, 1995).
Methodological limitations
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There are limitations of the present study to be considered. First, geographically,
participants were all from Southeast England for practical purposes, which may
reflect a higher socio-economic status of the girls and their families. Second, the
study was interview-based, requiring a degree of communication that may have led
to the underrepresentation of girls with poorer communication skills in the sample.
Further research might benefit from using participatory research models (e.g.
MacLeod et al., 2013) or activity-oriented interview methods as a means to
encourage openness in children less able to respond to the interview setting (e.g.
Winstone et al., 2014). Activity-oriented interview methods were not employed in
this study since all girls in the sample were capable of offering detailed accounts of
their experiences through semi-structured interviews alone. Finally, the female-only
sample prevented any direct comparison between males and females in relation to
their experiences at school. A separate study exploring the experiences of boys with
autism (Cook, Ogden & Winstone, 2016) did however indicate a greater focus on the
risk factors and protective factors relating to bullying, and how these might impact
on mental health, learning and relationships. This contrasted with the data from the
present study, suggesting that for girls there is a greater emphasis on friendship
expectations, motivations and masking, leading to the decision to present the data
separately.
Implications for inclusion and for practice
These findings have implications for inclusion. Girls in mainstream settings reported
a higher level of school absenteeism and an increased tendency to mask their autism
in order to fit in. In addition, while bullying was reported in both setting types, in
special school settings it may not have been deliberate, but rather, a reaction caused
by the special needs/disabilities of the perpetrators. Accordingly, placement into
mainstream schools may be linked to school absenteeism, bullying and a tendency to
mask their autism in order to fit in.
These findings also have implications for the development of interventions in
schools. There is scope for increased training of school staff concerning the academic
and social needs of pupils with autism. These findings indicate particular differences
in the social needs of girls with autism. Many programmes and interventions have
been developed to promote peer interaction skills for children with autism, based on
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the belief that long-lasting friendships lead to greater wellbeing (Calder, 2013). The
findings in this study indicate that girls with autism perceive and experience
friendships differently, so this should impact on the way interventions are developed.
Hence, rather than expecting girls with autism to develop deepening reciprocal
friendships as they move into adolescence, opportunities should be provided for them
to share company through joint activities where they have similar interests. This
might in turn enable them to feel more comfortable in social situations, and reduce
the need for them to mask their autism in an effort to fit in. Interventions should also
target bullying through increased awareness by staff and peers of the difficulties
faced by pupils with autism and a commitment to handling bullying properly when it
first arises.
Conclusion
In conclusion, perceptions of friendship may differ for girls with autism to those of
their neurotypical peers. While they were motivated to have friends, social
interactions were often affected by their social inadequacies. There is a need for
greater awareness in schools of their needs – both academic and social. This could
lead to the possibility of a better school experience, reduced absenteeism and reduced
need for masking behaviours, so that girls can be diagnosed and supported from an
earlier age, and also accepted by their peers without the need to make personal
adjustments.
Findings from this study, and a previous study interviewing adolescent boys with
autism using the same interview schedule (Cook, Ogden & Winstone, 2016) indicate
many concerning issues relating to the school experiences of children with autism
and the particularities of their school settings that may be influencing these. The next
chapter will therefore seek to elucidate further the impact of school type through
exploring wider contextual issues facing teachers of pupils with autism in these
contrasting settings.
Chapter 3
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Study 2: Balancing the challenges and solutions for teachers
supporting autistic pupils in contrasting school settings: a qualitative
study
Overview
The previous study explored the experiences of girls with autism and contrasted
these between mainstream and specialist school settings. This second empirical
study explores the experiences of teachers working in these different school setting
and examines how they manage the challenges they face.
3.1 Introduction
In the UK, the majority of children with a diagnosis of an autism spectrum disorder
(73%) are placed in mainstream settings (DfE, 2015), reflecting the drive for
inclusion emerging from the Warnock Report (1978) and Salamanca Statement
(UNESCO, 1994), further promoted by two key Acts; the Special Educational Needs
and Disability Act, 2001 and the Disability Discrimination Act, 2005, explained in
Chapter 1.2. These acts require teachers to make ‘reasonable adjustments’ to their
lessons to enable children with SEN and disabilities to learn and be included in
school life.
In contrast to specialist settings, where expertise and resources are tailored to the
needs of children with ASD/SENs, the expectations for mainstream teachers to
appropriately support those with ASD alongside their neurotypical (NT) peers poses
a challenge for their attempts to implement inclusive practice (Greenstein, 2014;
Malinen, Savolainene and Xu, 2012). For example, teachers are expected to meet the
needs of children whose challenges vary in magnitude from one individual to
another, and may include poorer academic outcomes (DfE, 2014), social difficulties
(Attwood, 2000), victimisation (Humphrey and Symes, 2011), anxiety and
depression (Wood and Gadow, 2010; Strang, et al., 2012) and behavioural
difficulties (Macintosh and Dissanayake, 2006). This is further exacerbated by the
increasing numbers of children with ASD in mainstream schools. In addition to
having specific knowledge of autism (Swain et al., 2012), teachers are expected to
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implement effective and appropriate teaching approaches (Frederickson, Jones &
Lang, 2010; Odom, Cox and Brock, 2013), to make adjustments to the curriculum
(Shaddock, Giorcelli and Smith, 2017), and provide suitable support and resources
(Lindsay et al., 2014).
While there is general agreement among teachers that inclusion is important for
reasons of social justice (Artiles, Harris-Murri and Rostenberg, 2008; Polat, 2011),
research indicates that many teachers have little confidence in their capacity to
support students with SEN, especially ASD (Humprhey & Symes, 2013; Lindsay,
Proulx, Thompson and Scott, 2013; Frederickson, Jones & Lang, 2010). In a study
involving case studies, classroom observations and a teacher attitudes survey, Little
(2017) found that while teachers supported the concept of inclusion, this wasn’t
always implemented at an operational level. Furthermore, the teachers’ responses
often implied that the students with ASD can create the barrier to social inclusion by
not ‘fitting in’. In addition to teachers’ limited confidence and capabilities, attitudes
such as this may also influence the implementation of inclusive practice. For
example, there is greater reluctance for the inclusion of students with more severe
disabilities and behavioural difficulties (Avramidis and Norwich, 2002; Mazurek and
Winzer, 2011). Disruptive behaviours are often the result of anxiety or frustration for
autistic children, but lack of understanding can lead a teacher to assume they are
unable to conform to school codes of conduct (Little, 2017).
A successful school experience for children with ASD therefore requires active
commitment by teachers to the facilitation of academic and social opportunities.
Attitudes caused by lack of knowledge, together with lack of support systems can
have adverse effects on student’s participation at school (Eldar, Talmore and Wolf,
Zuckerman, 2010; Avramidis, Bayliss and Burden, 2000; de boer et al., 2011;
Sharma, Loreman and Forlin, 2012) and are obstacles to inclusion (de Beor et al.,
2011; Lindsay, Proulx, Thomson and Scott, 2013).
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Aim
While previous studies have explored the attitudes of teachers towards inclusion, less
is known about the experiences, thoughts and beliefs of teachers about policies and
practices in place for pupils with autism. Given the contrast in expertise and
resources between school setting types, a deeper exploration of teacher experiences
from both setting types is needed. In light of this, the aim of the present study is to
use qualitative methods to explore the perspectives of teachers from both mainstream
and specialist settings, regarding the needs of pupils with autism and how they and
their schools address these needs.
3.2 Method
Design
A qualitative design was used with semi-structured interviews. Thematic analysis
(Braun and Clark, 2006) was used to analyse the data.
Role of the researcher
The researcher’s role was to select teachers, devise and conduct the interviews and
analyse the transcripts. A hermeneutical approach was used (Palmer, 1969), meaning
that the researcher has to be aware of their own pre-understanding (existing
knowledge, values and experience) of the topic of interest when they interpret the
teachers’ accounts. Participants’ accounts were brought together with the
researcher’s own perspective to produce new understanding of the area of interest. In
this study, the researcher’s pre-understanding consisted of theoretical knowledge and
personal experience of parenting children with ASD.
Participants
Participants were recruited from mainstream and specialist schools in Southeast
England through purposive sampling by phoning/emailing schools and making
contact with individuals who had shown willingness to take part through word-of-
mouth. Inclusion criteria comprised teachers who would be willing to discuss their
beliefs about the needs and experiences of pupils with autism and the policies and
practices regarding autism in their schools.
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Twelve teachers were interviewed: six from mainstream and six from specialist
schools. Mainstream schools are defined as those run by the local council that
principally meet the needs of pupils who do not have special educational needs.
Specialist schools are defined as those for which the main purpose is to provide
education for pupils with special educational needs. Participants worked in varying
roles, including head teacher, deputy head teacher and SENCo. Demographic
information is shown in Table 3.1. (All names are pseudonyms.)
Table 3.1
Description of the Participants According to Socio-Demographics
Name (Pseudonym)
AgeRange (years)
Ethnic Origin
School Type
Position Highest Level of Education
Alison 50+ WB M Director of Special Needs PG DiplomaBeth 40-50 WI M Deputy Head MastersRobert 40-50 BA M SENCo MastersIsobel 50+ WB M SENCo MastersChristine 40-50 WB M SENCo, German Teacher BA/PGCELiz 40-50 WB M SENCo MastersNick 20-30 WB S Deputy Head MastersRichard 30-40 WB S SENCo MastersJanet 50+ WB S SENCO, Assistant Head,
Exams Officer, English Teacher
Masters
Jill 40-50 WB S Head Teacher PG DiplomaCatherine 40-50 WB S Deputy Head, Head of
lower school, Head of well-being
PG Cert. in Special Needs
James 40-50 WB S Head Teacher PhDWB: White British; WI: White Irish; BA: Black African; M: Mainstream; S: Special.
Procedure
A semi-structured interview explored participants’ thoughts and beliefs about the
policies and practices in place in their schools regarding pupils with autism and
consisted of broad, open-ended questions. The interview covered participants’ beliefs
about (i) how well the school provides for pupils with autism, (ii) how pupils with
autism manage their learning, (iii) how pupils with autism manage friendships at
school and (iv) how the school handles problems of bullying. All interviews took
place in their respective schools. The semi-structured interview guide supported
using flexible strategies, such as probes when necessary (e.g. ‘can you give me an
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example of that?’). With the participants’ permission, the interviews were recorded
and transcribed. (See Appendix G for the full interview schedule.)
A favourable ethical opinion was received from the University Ethics Committee.
The information sheet stated that participation was voluntary and that participants
were able to withdraw from the study at any time without any explanation.
Data analysis
Thematic analysis (Braun and Clark, 2006) was used to identify patterns in the data
and capture commonalities whilst at the same time enabling teachers to be located
within contrasting school contexts. A contextualist approach was adopted, which
assumes that individuals make sense of their experience within social, cultural and
historical contexts. The method was inductive: themes were strongly linked to the
data, rather than being fitted to analytic preconceptions. Analytic stages involved
familiarization with the data by the primary author through several detailed readings
of interview transcripts; summaries of key points from each interview made and
generation of initial thoughts and observations followed by coding of the data in
collaboration with the other researchers; identification of initial themes and sub-
themes and their connections; review and finalization of themes and sub-themes
ensuring they reflected coded extracts; detailed analysis of themes and sub-themes,
identifying how they fit into the broader overall context. Agreement was achieved
between researchers as an iterative process. Interpretations were checked against
teachers’ stories to ensure they covered all parts of the data.
3.3 Results
Teachers’ accounts reflected the following themes: i) challenges for teachers
supporting children with autism; ii) creative solutions to facilitate achievement and;
iii) transcending theme: influence of factors occurring at the ‘chalk face’. These
themes are discussed and illustrated with exemplar quotes. Overall, it is argued that
there is a balance between the challenges for teachers and their ability to offer
creative solutions to these challenges. In turn, this balance is influenced by the
factors occurring at the ‘chalk face’ of the day-to-day job of being a teacher that
determine whether it is either the challenges or solutions, which are ultimately
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realised. Unless stated, reference to pupils/girls/boys in the results denotes
pupils/girls/boys with autism. Table 3.2 provides an outline of themes and sub
themes.
Table 3.2
Themes and Sub-Themes Derived from Thematic Analysis.
Theme Sub theme1. Challenges for teachers supporting
children with autism Addressing social difficulties Identifying learning needs Recognising triggers for anxiety
2. Creative solutions to facilitate achievement
Teacher Practices Contact with peers Extra-curricular Opportunities
3. Transcending theme: Influence of factors occurring at the ‘chalk face’
Theme 1: Challenges for teachers supporting children with autism
Teachers gave accounts of a number of challenges they faced in their attempts to
support the needs of children with autism in their school. These particularly relate to
addressing their social difficulties, identifying specific learning needs and
recognising triggers for their high levels of anxiety that can impact on all aspects of
their school experience.
There were many accounts of attempts to support pupils with friendship difficulties;
variability in friendship motivation and lack of understanding of what friendship
means.
Pupils’ perceptions of friendship were described as different to those of neurotypical
peers. In particular, teachers explained that many pupils lacked understanding of the
concept of friendship, believing that someone can’t be a friend if they have different
interests, or don’t play by their rules. Some described how pupils don’t even
recognise friendships that are there, and the need for them to spend time explaining
what friendship is. Richard relayed a conversation he had with a boy in Year 9:
He said, 'I don't have any friends at school.' And he is a very popular boy.
He's an absolutely lovely lad; the other kids love him. He's constantly doing
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social things... His perception is he's got no friends, and when kind of pushed
on that he says, “I don't have anything in common with them; we don't have
any common ground” he says, kind of, “my interests are unique to theirs”. So
from his perspective, even though pupils are very friendly and nice to him,
they don't have the same interests as him and therefore they're not his friends.
(Richard, Specialist school)
Teachers described frequently having to deal with incidents where pupils felt they
were being bullied, and the pupils’ subsequent deep-held resentment resulting from
the perceived act of bullying. Christine explained how pupils might amplify fairly
common incidents:
I think, you know, our environment as well – because we're all boys –
sometimes there is a lot of hustle and bustle, and sometimes the ASD boys
interpret a bit of barging or a bit of pinching of gloves or, which is a daily,
you know - it's a daily occurrence. But to them, that's a big thing. (Christine,
Mainstream School)
Similarly, Richard told a story about how one boy perceived a situation as severe
bullying by his peers, when there was in fact no malicious intent:
A really fascinating story with another pupil who's saying a lot at the moment
that he's being bullied by other pupils in his year group…he said that at
lunchtime, people are always kicking the football at him, and then when it
came down to it, he's in goal…he's a goalkeeper and they're actually scoring
goals …and he's interpreted it as people kicking the football at him. (Charlie,
Specialist school)
Even after being informed about others’ lack of harmful intentions, or being provided
with social skills to cope with an altercation, there were accounts of pupils holding
deep-held resentments, leading to hostility for extended periods:
Some of them will not let go easily, so what you and I will say, “yeah, yeah, it
happened yesterday, yeah” – we move on…some of them might find it very
difficult to move on from that situation. (Robert, Mainstream School)
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Teachers (mainly from mainstream schools) gave examples when they’d been called
upon to deal with incidents where pupils actually had been bullied for being different
(e.g. displaying unusual behaviours, making inappropriate comments etc.). Beth
described an incident that ended with hospitalisation, after Year 11 pupils bullied a
new boy in Year 10:
He was a vulnerable lad, this new student into year 10. But he was also an
expert in martial arts. The year 11s went on the playground to seek him out
and, to challenge him, and it ended badly on their part…And after that people
came forward …and they brought in pictures taken in school, with this lad,
and somebody had drawn, like, a dick on his back, of his shirt, in a lesson,
taken a photograph of it, and posted it on Facebook. (Beth, Mainstream
School)
In addition to pupils’ role as target, teachers also gave accounts of occasions when
they had needed to manage pupils with autism committing violations towards others.
This was sometimes attributed to their literal interpretation of events, and was often
unintentional. Teachers sometimes needed to explain how pupils’ comments might
be perceived as racist for example:
Sometimes we get some girls on the spectrum who just can't cope with
anybody who looks different, and so if they're a different colour, they find that
really hard because it's a difference and it's not because - they don't, dislike
them, or they don't, you know, they just find that difference - they can't deal
with it … because they're unpredictable. They just don't understand their
context. They're just like “Oh, but this person isn't like me… because you
know, people, humans are like me so if you're not like me, then are you a
human?” (Jill, Specialist school)
Further challenges reported by teachers related to dealing with differences in their
learning. For example, it was sometimes difficult to assess pupils’ understanding due
to differences in language development. High-level language (for instance when
talking about their special interest) can mislead teachers into thinking their
understanding of a concept is high when this might not always be the case:
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So if you ask someone to talk about what they love, of course they can talk
about it articulately, and what people tend to do with autistic people, because
they're autistic, they let them talk about what they want. So they don't go
beyond that. So it's around the language, it's around inferential reasoning.
It's around being able to take information, manipulate it, and give back your
opinion taking into account everybody's opinion. (Catherine, Specialist
school)
They also struggled to engage pupils due to their rigidity of thinking. For example,
some pupils would refuse to do their homework due to difficulties associating
schoolwork with home. Other times teachers struggled to engage pupils if they didn’t
believe a particular subject was beneficial to them, or if it failed to relate to their
special interest:
We have a very able young scientist in the key stage 2 department, who just
loves chemistry - loves blowing things up, love experiments. And our focus at
the moment is trying to teach him that chemistry is a bigger subject than just
that, because he knows a hundred different chemicals…but he needs to
understand that there are other areas of that subject to explore and that to do
very well he’ll need to learn those too…its trying to encourage them to come
out of their comfort zone into other areas. (Nick, Specialist school)
Perhaps the factor seen as the greatest challenge for pupils with autism, and requiring
particular attention by teachers, was anxiety. Many accounts were provided of times
when learning, friendships and general wellbeing had been severely affected by high
levels of anxiety. Alison shared a story about how deeply she’d been affected by a
girl in Year 9 who was struggling to cope in the school environment:
And she said, “I know I'm different, I know I'm antisocial” and the tears
began to roll down her face and she said, “I just, I just want to be quiet”…
and she said, “when I was at junior school I used to stamp my feet and
scream at people…sometimes here, I want to stamp my feet and scream at
people”, … I think at the minute what worries me about her is her anxiety's
high.…I would say she's the most isolated one I could think of all our little
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group. So yeah, she made me quite sad yesterday. (Alison, Mainstream
School)
Similarly, Isobel described how individual attention was required during exams for
one boy in Year 13, who found them particularly stressful environments:
We have a boy in year 13 who's got really top cat scores, who's really bright,
but just took ages to cope with the pressure of exams. And if he got to a
question he couldn't do, he couldn't move beyond that. So we had to try
giving him different sheets of the exam paper - because then he'd rip it up as
well. So we'd have to give him like, one sheet at a time, you know. So on the
whole, I think that the exam system and the whole stress of schools - problems
are bound to form. (Isobel, Mainstream School)
As well as the school environment, teachers described the challenge of identifying
how social pressures might cause anxiety. Jill explained how pupils constantly
suppressed their natural responses, and instead model the behaviour of others. This
leads others to believe they are coping, but in fact they are holding it in throughout
the day, then releasing the stress when they get home. One example of this was Lucy,
a pupil in Year 11:
Lucy was talking about how at the end of the day she deconstructs all the
sentences that she's had. She analyses them and then she plans all of her
interactions for the next day. And then if her interactions don't go the way
she's planned the - it's a bit like running a laptop with loads and loads of
different programmes going on, and in the background she's analysing, well
why didn't that go that way? and what am I going to do to rescue it?…it takes
her six hours to go to sleep because she is literally reliving her day - I mean
that's exhausting! (Sarah, Specialist school)
Sarah, and many other teachers were concerned that the anxiety associated with these
encounters could lead to mental health problems, exhaustion and isolation.
Challenges for teachers in supporting the needs of children with autism were
therefore far reaching and were reported across both setting types, including
developing understanding of a range of social difficulties, identifying factors
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influencing their learning and the triggers for anxiety, which they perceived as
impacting severely on the pupils’ school experience.
Theme 2: Creative solutions to facilitate achievement
Teachers reported a number of creative solutions to facilitate achievement for pupils
with autism. These factors link to theme 1, in that an increased potential to adopt
creative solutions was associated with a reduction in the impact of the challenges for
teachers supporting children with autism. These included teacher practices, contact
with peers, and extracurricular opportunities available to pupils with autism.
Many examples were given of practices employed by teachers in their school to
support pupils with autism. A key strategy adopted, particularly in specialist school
settings, was the provision of a clear structure to the day, through appropriate use of
timetables and visuals, managing transitions and alerting pupils of potential change
in advance.
Probably the simplest example would be to ensure that there's a very clear
structure for the students to follow in terms of their timetable and if there are
going to be any changes to a student's school day, for example if it's a trip, or
if the teacher's off sick and there's a cover teacher in place, then we would
ensure that the students know in advance what the changes are to the day.
(James, Specialist school)
Similarly, a great deal of attention was given to the clear use of language in specialist
school settings. This is particularly important, given the language difficulties
outlined in theme 1.
Staff are very aware of language, of concept imagery: that may be what the
boy learnt in science about a table is completely different to the table he'll sit
at - so we know that they can't transfer knowledge…We have a very heavy
focus on language in terms of making sure instructions are given clearly, and
in the order that you want the child to do things. So we don't say “before you
go out to break, hand your homework in”, because we know if you, the
chances are you'll go out to break and then hand your homework in.
(Catherine, Specialist school)
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Monitoring levels of anxiety displayed by pupils with autism, and strategies for
managing it, were also seen to greatly influence pupils’ daily experiences. Jill was
concerned that in mainstream schools there is high pressure for results and staff,
while specialists in their subject, may not have time to monitor the various mental
health issues of pupils in the class. She did, however, describe simple methods of
monitoring anxiety levels that work in her school:
We have things like stress thermometers in classrooms, which is a visual
display…which basically, the girls come in in the morning and put their name
as to where they're kind of feeling emotionally and then if it's obviously a red
or an orange then we probably need to deal with that straight away, but that's
a great way of flagging to us, without having to have a conversation about it.
Got things like calm boxes all over so that we're, you know the idea is that
we're teaching the girls to self-regulate right from the beginning. (Jill,
Specialist school)
Teachers also gave examples of where they had provided social communication
support for pupils with autism. These included social skills clubs, grouping according
to personalities/mannerisms and helping them to conceptualise what a friend is, such
as this example from Janet:
We've got two boys in year 7, who've never had friends before, and at the
moment it's quite difficult because that friendship is becoming the all-
consuming thing and they haven't got the rules right. And so, we are putting
into place a half an hour a week so that they can explore that friendship out
of the classroom…what they do and what they don't do with friends in school.
(Janet, Specialist school)
Besides teacher practices, teachers felt that the achievement of pupils with autism
was also affected by contact with their peers. Establishing friendships and enjoying
shared interests had the potential to produce positive outcomes. Many teachers
identified a tendency for pupils with autism to befriend other pupils with autism,
often through their mutual interests. Computer games often formed a common
interest that bonded the boys together. Teachers felt that this was key to successful
friendships for the pupils with autism, and some schools made special arrangements
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for them to use electronic devices during break-times as a means enabling social
interaction:
If one of them gets their phone out…when you see them outside at break time,
they'll all be flocked around. You know they're not really having
conversations, it's the interest that has brought them together - and you really
do see that. And you know, but, but they're comfortable with those people
being around them, because they know that they share those same interests.
(Christine, Mainstream School)
The achievement of pupils with autism also seemed to be associated with the extra-
curricular opportunities available to them, such as social skills groups and clubs.
Mainstream schools had social skills groups, usually occurring during lunch times,
whereas in specialist school settings social skills training was woven more
extensively into the school day. Richard described the range of opportunities
available to pupils in his school:
We've got group communication groups, social thinking groups, we've got
groups where they're sort of practising social skills. There's, sort of, both
formal and informal groups. There's something called 'the girls' group', but
it's more of an informal one, so it's just led by one of the LSAs [learning
support assistants] and it's got lots of magazines and sort of chatting and so
on. Whereas you have the sort of more formal group communication where
they're sort of led by a speech language therapist and looking at specific
areas. (Richard, specialist school)
In addition to social skills groups, many schools provided clubs for pupils to join
based around their interests, ranging from Minecraft, Wii and science fiction to board
games and football. Isobel’s school recognised that many of the pupils don’t tend to
join the more competitive sports clubs, so were missing out on vital social sporting
opportunities. So they decided to open an additional needs sports academy after
school. They were careful to make it open to all to avoid segregation, but at the same
time prevent it being dominated by those were are best at sport:
Out of that, one of the TAs has started up - it is a football team, but it's just
for kids with additional needs, and they go out and they play matches, and
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that's brilliant because then they see that, it gives them a lot of self-esteem,
actually, because then they've represented the school as well. (Isobel,
Mainstream School)
The second theme therefore pointed to the potential of teachers and schools to offer
creative solutions to facilitate achievement for pupils with autism through various
teacher practices, contact with peers and extra-curricular opportunities. Creative
solutions were apparent in both setting types, and revealed a wide range of ideas that
schools could adopt to reduce barriers to learning and achievement for pupils with
autism.
Theme 3: Transcending theme: Influence of factors occurring at the ‘chalkface’
Transcending themes 1 and 2 were the factors influencing teachers’ working lives
each day at the ‘chalkface’. These factors can be seen to affect best practice, and in
particular, the teachers’ potential to offer creative solutions. Specifically, the factors
influenced the extent to which challenges or creative solutions were given greater
prominence. Some factors led to the belief that challenges outweighed their
capability to facilitate achievement. Others tipped the balance the other way leading
to the sense that challenges only had the potential for negative outcomes without the
implementation of creative solutions. This relationship is illustrated in Figure 3.1 and
will be explained more fully with quotes from teachers below with reference to
differences between mainstream and specialist settings.
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Figure 3.1. Relationship between themes
Factors reported to affect this balance included educational ideology, teacher
attitudes, staff expertise/training, workload/pressures, physical environment and
heterogeneity of ASD.
Educational ideology was defined as the way in which schools support pupils with
autism. For some schools, a general approach was reported, e.g. adopting a number
of general policies and strategies to support pupils with special educational needs,
e.g. social skills group, time-out cards, quiet spaces and diversity week. Other
schools tended to adopt a more individualised approach, getting to know individual
pupils and taking action to meet their needs, managing transitions, monitoring mental
health problems, grouping according to social needs and holding regular staff
meetings to discuss different perspectives. Catherine described how, in addition to a
general attentiveness of teachers to their difficulties, staff also dealt with each
problem arising as a distinct case requiring an individual response:
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We have a policy that if a child refuses to do something, you have to ask
yourself all the different reasons it could be why he's refusing to do that. Is it
because he's cross with you? Is it because he had an argument with his mum?
Is it because he hasn't understood? Is it because he can't cope with that
change? So all the time the teachers are trying to think, where is this coming
from? (Catherine, Specialist school)
Teachers’ attitudes towards inclusion and neurodiversity also influenced the balance
between challenges and solutions. For example, Jill talked about the necessity for
societal change in the way people with autism are perceived and understood. She
advocated providing young children with an understanding that everybody is
different and how neurodiversity is beneficial to society:
I think that there's something around the destigmatisation of autistic kids and
people, so I think a lot of the social narrative around autism has, particularly
in America, well in America it's about cures, and broken people, and I think
in this country it's a little bit like “aww, and oh, isn't it a shame?” and that
kind of catastrophising of autism. … Actually if we can just be more flexible
in our approach and have better neuro-diversity, then actually there'll be less
of a problem. If we start seeing the benefits of the way that autistic people
think rather than focusing on the deficits that they find difficult, that's the key
to it, isn't it? (Jill, Specialist school)
Staff expertise and training were also seen as key factors and clearly varied widely
between special and mainstream school settings. Inevitably, specialist schools tended
to hire teachers who are experienced in SEN, trained all staff in autism and had
access to speech and language therapists, occupational therapists and other therapies
(usually, though not always on site). Therapy could sometimes be integrated into a
holistic approach. For example, Catherine explained that one goal of the speech and
language therapy was to help pupils to express their emotions, since this is an area
they find challenging, and that this goal would be implemented as a team including
the therapist, pastoral mentor, form tutor and the parents. Similarly, Janet described
how their occupational therapist helps all children in the school with sensory and
physical difficulties (not just those with an Education & Health Care Plan):
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She's is absolutely brilliant and is always willing to go the extra mile and to
provide training, and anything else she can do - and will do things that will
benefit the whole, because she knows that a lot of our boys have got
sensory/physical difficulties as well. She came up, in consultation with one of
us,…with a fine and gross motor skills programme. And that takes part, a lot
of that takes part in our PE lessons. (Janet, Specialist school)
Conversely, teachers from some mainstream settings reported workload/other
pressures interfering with additional training in autism. It was clear that all teachers
had a genuine desire to support pupils with autism, but that in mainstream settings in
particular, the reality was that other pressures and commitments could prevent some
of the solutions from being implemented. Alison expressed this clearly in relation to
training materials she distributes to school staff:
I think when I compare this school to other places I've worked, the school has
a greater level of interest, and I think where teachers don't read and don't
look at the information, it's not that they're not interested, it's just that they
have so much to do. They're trying to get the next thing done. (Alison,
Mainstream School)
Similarly Isobel explained how training in autism couldn’t always be prioritised due
to the other continuing professional development (CPD) commitments:
It goes in cycles, so last week in, we had the ASD specialist teacher come and
do some training with all of the support staff. They did want to with all of the
teacher staff but by the time they asked us to do that we already had our CPD
in place for the year, so it was difficult to do. (Isobel, Mainstream School)
Environmental factors were also considered to be important determinants of the
balance between challenges and solutions, particularly relating to the learning, social
communication and well-being of pupils with autism. It was clear that many
mainstream schools had made provision for a quiet space for pupils to go at times
when they needed it. But in specialist schools there were also a number of additional
considerations regarding the environment to benefit the pupils with autism, e.g.
neutral classrooms to prevent sensory overload, arranging seating in the common
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room to encourage social interactions, visually supported learning and
resources/adaptive equipment for fine motor skill development.
A big focus for us is the environment … so the classrooms are small; they
have spaces where the students can work independently but spaces where
they can work collaboratively as a group. … Display is minimised, but it’s
kept very focused because we try to minimise the amount of visual stimulus in
the room that could distract or upset the students. So it’s very clearly defined
where there is a maths and literacy display in every classroom, but is one
specific area. (Nick, Specialist school)
Finally, heterogeneity of the characteristics presented in pupils with autism was
considered by some teachers to be a barrier to creative solutions and a challenge for
their day-to-day working lives. For example, one teacher felt that mainstream school
settings are not always suitable for pupils with high levels of anxiety, particularly
when their behaviour impacted on other pupils in the school:
I think, because, for the students who experience anxiety - a high degree of
anxiety - and then start to then display behaviours that impact on others, I
think that that's when we kind of, draw the line… like that girl with the
sensory pencil case. The final straw with her was, I mean she locked a
teacher in a room twice…and then in the canteen, she banged a door on a
member of staff, and hurt him - but it's, I think the students who have - whose
anxiety exhibits itself in behaviour we struggle to include them. (Beth,
Mainstream School)
In summary, themes 1 and 2 identified come key challenges facing teachers trying to
manage the needs of those with ASD and highlighted their use of a number of
creative solutions. Transcending these themes were a number of daily issues
emerging at the ‘chalk face’ of being a teacher, which influenced whether the
challenges or creative solutions were given greater prominence. Whilst educational
ideologies emphasising individual approaches, celebration of diversity, sufficient
staff expertise and training and conducive physical environments tip the balance in
favour of providing creative solutions, less individual approaches, workload
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pressures and heterogeneity of ASD characteristics lead to the magnitude of the
challenges outweighing their ability to provide solutions to facilitate achievement.
3.4 Discussion
This study explored the perspectives of teachers from mainstream and specialist
school settings regarding the policies and practices in their schools designed to meet
the needs of autistic pupils. It provided valuable insights into teachers’ experiences,
thoughts and beliefs, revealing the challenges for teachers supporting children with
autism, some of the creative solutions they implement to facilitate achievement and
the influence of particular ‘chalk face’ factors on the realisation of these solutions.
The first theme highlighted a number of challenges they face as teachers, including
addressing social communication difficulties, identifying learning needs and
recognising triggers for anxiety. Results supported previous research indicating the
need to support autistic pupils with their understanding of the concept of friendship
and perceived conflict. For example, Calder, Hill and Pellicano (2013) reported that
some children were confused about whether certain peers were friends or not and
described feeling lonely and left out of certain social groups. Other studies highlight
the difficulties they face developing reciprocal friendship (Bauminger et al., 2004;
Bauminger & Kasari, 2000; Dean et al., 2014; Sedgewick et al., 2016) and the
importance of teaching friendship skills and providing opportunities for pupils to
practice these skills (Brown, Odam, Lie & Zercher, 1999; Strain & Bovey, 2011;
Kohler & Strain, 1999).
The findings also support previous literature indicating that children with autism
don’t always interpret bullying situations accurately due to their lack of social
understanding (Feuerbacher, Moore and Gill, 2017), but that sometimes teachers
must address incidents where pupils are actually bullied for being different (Bejerot
& Mortberg, 2009; Chatzitheochari, Parson and Platt, 2014; NAS, 2003; 2006;
Symes and Humphrey, 2010; Wainscot et al., 2008) and indeed incidents where
pupils with autism may unintentionally cause harm to others (Humphrey, Hebron &
Oldfield, 2015).
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A second challenge identified by teachers in the present study was the importance of
identifying specific learning needs of pupils. Some teachers found that limitations to
conceptual understanding could be concealed by advanced use of language,
reflecting studies reporting an atypical language profile for children with ASD, in
which expressive language exceeds receptive language competency (Cohen &
Volkmar, 1997; Hudry et al., 2010). In addition, teachers reported how rigid thinking
prevented pupils from moving beyond their own special interests. While special
interests used in the curriculum sometimes allow pupils to manage their anxiety
(Klauber, 2005; Mintz, 2008), and have some engagement with what the class is
doing, overemphasis on them could lead to missed opportunities to challenge pupils
with ASD to learn and communicate in wider contexts. Achieving the correct balance
is therefore challenging for teachers, as described by teachers in this study.
Finally for Theme 1, a major challenge identified by teachers was the need to
recognise triggers for anxiety, both in response to environmental factors and to social
pressures. Anxiety is common for people with ASD (Bellini, 2004; Drahota, 2009;
Kim, Szatmari, Bryson, Steiner & Wilson, 2000) but research indicates that the
triggers can be different for those on the autistic spectrum compared to the NT
population, for example, difficulties predicting others’ behaviour and unanticipated
changes in the environment (Gillot et al., 2010; White et al., 2010). These can lead to
frustration, agitation and panic attacks and so impede their ability to cope day-to-day
(Gillott & Standen, 2007). In order to provide solutions that promote adaptive
behaviours, accurate identification of the triggers is therefore essential (Bellini, 2006;
Reaven et al., 2009) and another challenge for teachers.
Theme 2 reflected a number of creative solutions designed to facilitate achievement,
addressing various learning, social and mental health needs. First, a number of
practices were reported such as providing a clear structure to the day (e.g. visual
timetables), managing transitions, broadening interests and clear use of language.
These strategies are in line with suggestions in the literature regarding successful
approaches to helping pupils with autism (Anderson, 2007; Connor, 1999; Hodgdon,
2003; Leach & Duffy, 2009), for example priming (ensuring a child is comfortable
with a task before it is set) and visual cues to aid working memory have been found
to benefit pupils with ASD. Furthermore, the TEACCH (Treatment and Education of
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Autistic and Communication-Handicapped Children) method (Schopler, Mesibov &
Hearsey, 1995) provides four types of structure in the learning environment:
physical, sequential, task, and activity system and has been shown to effectively
support children with autism (Bodfish, 2004; Panerai et al., 2009; Probst & Leppert,
2008).
There were a number of creative solutions, particularly from specialist settings, to
monitor levels of anxiety (e.g. stress thermometers and calm boxes), something that
is crucial for the wellbeing of pupils with autism. Online survey results of a recent
inquiry by the All Party Parliamentary Group on Autism indicated that pupils are
often punished for what is seen as ‘poor behaviour’ when in fact the behaviour is a
direct result of anxiety from being in the school environment and that focusing on the
behaviour rather than the cause of the anxiety is setting the pupil up to fail (NAS,
2017). Strategies for correctly identifying and addressing anxiety related behaviour
are therefore essential in all schools.
In addition to teacher practices, Theme 2 identified a number of solutions designed to
facilitate social communication, e.g. through contact with peers and extra-curricular
opportunities. It is generally accepted that inclusion requires more than simply
placing students in mainstream environments and hoping they will integrate
(Armstrong, Armstrong and Spandaguou, 2011; Siperstein & Parker, 2008). Many
will misread social situations and act inappropriately (Hart and Whalon, 2011) and
these difficulties may impact negatively on their ability to form friendships (Locke et
al., 2013). Interventions to support their active social engagement with others are
therefore essential (Kasari et al., 2011; Stitchter et al., 2012). Encouragement of
contact with peers and the forming of clubs focusing on common interests are
strategies known to successfully influence social participation (Baker, Koegel and
Koegal, 1998; Koegel et al., 2012; Koegel et al., 2009; Koegel et al., 2013).
Teachers referred to clubs that were specifically focused on development of social
skills (often lunch-time clubs in mainstream settings, and more integrated throughout
the whole school day in specialist settings). While it is important to provide
interventions supporting social engagement with others (Lindsay, Proulx, Scott and
Thomson, 2014) a meta-analysis of 55 single subject design studies suggested that
school-based (child-focused) social skills interventions are minimally effective for
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children with ASD (Bellini, Peters, Benner and Hopf, 2007). Suggested reasons for
this were the de-contextualised settings and low generalizability to other settings and
peers. Instead interventions should be implemented in environments where social
interactions can occur naturally with access to NT peers (Koegel, Robinson and
Koegel, 2009). Interestingly none of the mainstream teachers referred specifically to
peer mediation techniques (i.e. the involvement of NT peers as role models for
children with social deficits). This technique is widely reported to be highly effective
in improving social skills (Chang & Locke, 2016; DiSalvo and Oswald, 2002; Harper
et al., 2008; Rogers, 2000; Smith et al., 2002; Mason et al., 2014; Pierce and
Schreibman, 1997) and enables generalisation to other settings (Koegel et al., 2012)
and over time (Kasari et al., 2012).
Teachers reported the option for pupils to join various clubs ranging from sports to
science fiction and computer games. These were seen as highly motivating and
enabled social interactions and the active participation of autistic pupils in school
activities. Indeed previous research indicates increases in appropriate interactions
between autistic and NT peers and improvements in verbal initiations when clubs are
based around the interests of students with autism (Baker et al., 1998; Koegel et al.,
2012)
The findings revealed a transcending theme describing the influence of various
factors at the ‘chalk face’ of the teachers’ day-to-day working lives that influenced
the prominence placed on the challenges or solutions. Whilst factors such as staff
training/expertise and resources will be more evident in specialist settings, other
factors such as educational ideology, teacher attitudes, and attention to the physical
environment varied widely. General policies and strategies such as time-out cards,
quiet spaces and diversity week are helpful, but it is vital that schools know their
students as individuals with unique needs rather than drawing assumptions about the
level and type of support required (Hebron, 2017). Environments should facilitate
socially inclusive opportunities (Roe, 2008) and shift away from the traditional
deficit approach towards addressing the barriers manifest in the external factors such
as school ethos and environment (Billington, 2006; Hebron, 2017).
While teachers in mainstream settings expressed a general desire to ensure the
successful inclusion of pupils with autism, sometimes other commitments prevented
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creative solutions being implemented and in line with previous research (Ruble,
Usher & McGrew, 2011) there was a definite sense that the heterogeneity of pupils’
autistic characteristics led to teachers perceiving the challenges to be too great for
them to be able to meet their needs. This is extremely detrimental for pupils with
autism and can result in exclusion when their individual needs are not being met
(Little, 2017). Case studies comprising interviews with students, teachers, peers and
Principals (Little, 2017) revealed that teachers who perceived that they held little
power or control provided fewer opportunities for social inclusion for their students.
Every child should be equally valued within the school culture (Dybvik, 2004) and
this means more than being present, but rather it is a concept based on access and
active participation for all students, whatever their needs (Swain et al., 2012).
Humphrey (2008) suggested a four-pronged definition of inclusion: that of presence
(of all pupils), participation, acceptance and achievement and described it as an on-
going process. Some teachers in this study provided excellent examples of school
communities that were committed to supporting inclusive practice in this way.
However, where challenges were perceived to be too great, their sense of efficacy
towards implementing creative solutions to the various challenges was undermined.
Methodological limitations
There are limitations of the present study to be considered. Geographically,
participants were all from Southeast England so might reflect some bias in terms of
the social economic status and ethnic origins of pupils in the schools. In addition, the
teachers interviewed were either members of senior management or special
educational needs coordinators who arguably possessed higher levels of
knowledge/expertise in the subject and therefore may not represent the full range of
thoughts and beliefs of regular teachers who don’t hold these roles.
Implications for practice
These findings have implications for the development of inclusive strategies. It is
clear that teachers face a number of challenges supporting children with autism, and
that in mainstream school settings this can be particularly demanding when
combined with pressures to meet the needs of large classes of pupils with a diverse
set of individual differences. Nevertheless, many of the creative solutions employed
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could be implemented more widely with minimal impact on resources or expertise
(e.g. appropriate use of timetables and visuals, managing transitions, anxiety
thermometers and clubs developed around their special interests). There is
nevertheless substantial scope for increased training of school staff concerning the
academic and social needs of pupils with autism.
Conclusion
In conclusion, the results from the present study illustrate how teachers face many
challenges supporting children with autism including addressing their social
communication difficulties, identifying learning needs and recognising triggers for
anxiety. The results also show that they implement creative solutions such as teacher
practices, contact with peers and extra-curricular opportunities, but their perceived
efficacy to implement these solutions is influenced by various factors occurring in
their day-to-day work. In particular, where schools treat pupils with autism as unique
individuals with specific needs, celebrate neurodiversity, provide appropriate training
for staff and make adjustments to the school environment, the challenges become
more manageable and the creative solutions can be realised. In contrast even when
teachers may wish to implement solutions, heavy workloads, other pressures and
perceived unsuitability of the setting for certain pupils makes this become less
feasible.
Findings from this study, together with those from Study 1 indicate the significant
impact of school ethos and peer relations on the success of inclusive school
placements, and hence quality of life, for children with autism in mainstream
schools. In order to explore further how school and peer group norms may be
impacting on their school experience, the focus of the next chapter switches to the
attitudes of neurotypical children in mainstream schools, that differ in terms of the
level of educational exposure to autism. In particular it will examine attitudes
towards peers with autism and towards the bullying of children with and without
autism.
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Chapter 4
Study 3: The effect of exposure on attitudes towards bullying and
autism in schools: A cohort study with a control group. Findings at
baseline.
Overview
The previous two empirical chapters have explored the experiences of children with
autism and their parents and teachers across mainstream and specialist school
settings. The results from these studies indicate the ways in which the school
structure can influence children’s experiences. This third study now focuses on
children without ASD and whether the school structure influences their attitudes and
behaviours to those children with autism.
4.1 Introduction
Chapter 1 discussed some of the challenges faced by children with autism, including
their greater exposure to victimisation and bullying (Bejerot & Mortberg, 2009;
Chatzitheochari et al., 2014; Humphrey and Symes, 2011; NAS, 2003; 2006; Symes
and Humphrey, 2010; Wainscot et al., 2008) and the factors contributing to this, such
as difficulties with social understanding (Garner & Hinton 2010; Wainscot et al.,
2008) and differences from the social norms (Horowitz et al., 2004; Mishna, 2003). It
also outlined how negative beliefs and stereotypes held by neurotypical individuals
in response to these factors can lead to prejudice and sometimes discrimination
towards those with autism. Humphrey and Symes’s (2011) ‘Reciprocal effects peer
interaction model’ provided a helpful explanation of how these prejudiced attitudes
can lead to bullying and social rejection and therefore increased isolation and
loneliness for children with autism.
Given the more extreme negative outcomes of bullying for children with autism,
such as damaged self-esteem and mental health difficulties (Reid and Batten, 2006;
Hebron and Humphrey, 2012; Bellini, 2004; Drahota, 2009; Kim, Szatmari, Bryson,
Steiner & Wilson, 2000) and higher rates of suicidal ideation and attempts than for
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typically developing children (Mayes et al., 2013; Rybczynski, Lipkin & Vasa,
2018), it is essential that research explores factors that influence neurotypical
attitudes and interventions to prevent bullying.
In Chapter 1.6, the influence of peers was explored through social domain theory
(Turiel, 2008), which explains social-moral reasoning and behavioural intentions in
relation to group identity. Killen and Rutland (2011) found that during early
adolescence, self-presentation (maintaining a positive image) is often more highly
valued than equality of treatment towards members of other groups (outgroups) due
to changes in social and moral reasoning at this age. In other words, whilst they have
more advanced understanding about morality, they may be more likely to give
priority to group functioning and social conventions, and be more willing to exclude
members of outgroups based on these factors in certain intergroup contexts.
Furthermore, they found that the school climate can influence the extent to which
peers hold inclusive or exclusive peer-group norms and these in turn can influence
reactions to bullying, moderate emotions and predict intended behaviours (Killen &
Rutland, 2011). Most research has focused on ethnic/racial bias, reporting that
children in heterogeneous schools and those with a shared common inclusive school
identity show less bias and towards outgroup members (Cameron et al., 2006; Killen,
Richardson et al., 2010; McGlothlin et al., 2005). However, Chang (2004) also
looked at school norms in the classroom and found that where high levels of
withdrawal are present in the classroom (i.e. children who are shy, quiet, submissive
and would rather be alone), this becomes an accepted norm, highlighting the
generalizability of findings across stigmatised groups.
Chapter 1.5 outlined a number of school-based programmes and interventions
designed to establish more inclusive social norms through increasing awareness and
acceptance and/or preventing bullying. The systematic reviews and meta-analyses of
whole school anti-bullying programmes reported mixed results, with many finding
little evidence of meaningful change (Baldry and Farrington’s, 2007; Ferguson et al.,
2007; Merrell, Gueldner, Ross and Isava, 2008; Smith et al., 2004).
Given the importance of incorporating an emphasis on peers and school
culture/climate into school-based interventions (Humphrey & Hebron, 2015), an
alternative intervention is to inform children about ASD with the goal of increasing
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acceptance of difference and diversity within the school context. However, studies
again showed mixed findings with some reporting improved knowledge and attitudes
after receiving descriptive and explanatory information (Campbell et al., 2004), but
failure to influence behavioural intentions (Staniland & Byrne, 2013) and other
research suggesting that information interventions are ineffective and even
detrimental to intergroup attitudes since they highlight stereotypic activities (Bigler,
1999).
It is not enough to focus on the deficits of a child with autism, but instead, the
general societal expectations about groups leading to prejudice and stereotypic
attitudes. For example, establishing an inclusive school ethos that celebrates diversity
and accepts difference (e.g. Morewood, Humphrey & Symes, 2011) can produce
school environments that Humphrey and Hebron (2015) refer to as ‘autism friendly’.
Morewood, Humphrey and Symes not only discuss the physical environment (e.g.
the slopes of the ceilings and open-plan layouts) but also the social environment,
such as giving safe and structured opportunities to interact with their peers (e.g.
through supported activities and clubs).
One such example of a model of inclusion that attempts to meet these goals is the
opening of purpose-designed and built specialist centres in three mainstream schools
in Surrey (NAS, 2015). The centres’ planning and design were consistent with
research on how physical environments can affect people with autism. Natural light,
ventilation, quiet areas and calm spaces to unwind were therefore integral to their
design. Pupils with ASD spend the majority of their lessons with their mainstream
peers, enabling them to benefit from the greater opportunities afforded them by being
a member of a mainstream school community. At the same time, the centres provide
specialist support from trained staff and a calm setting to which students with ASD
can retreat and/or develop their social or learning skills. Importantly, the schools also
implement personal, social & health education (PSHE) programmes about autism for
all pupils in the school, with the goal of further raising the salience of autism,
reducing uncertainty and encouraging a positive inclusive school culture.
The opening of these specialist centres offers a unique opportunity to explore the
impact of improved physical and social environments on changes in the attitudes of
children without autism towards their autistic peers. Whilst these schools don’t
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provide higher exposure in terms of numbers of pupils with autism, they do provide
higher exposure through making autism more ‘visible’ in the school and in terms of
increased awareness, understanding and attention given to autism and an inclusive
school approach. Furthermore exposure is increased through having students in the
classroom with greater support needs.
While many previous studies adopt the minimal groups paradigm (where social
groups are created in the laboratory and participants imagine being in a particular
group), this was a field study based on real school environments with established
group norms.
In addition to educational exposure, it is also important to explore the impact of
personal exposure (i.e. the amount of time a person spends with people with ASD)
on attitudes towards bullying and autism. Contact with members of other groups has
been found to challenge negative attitudes, reduce group norms that prohibit cross-
group friendship and facilitate the rejection of stereotypic expectations (Killen &
Rutland, 2011). Chapter 1.6 outlined how the Contact hypotheses (Allport, 1954)
states that prejudice is a consequence of unfamiliarity, resulting in negative
stereotypes and that contact can disconfirm the stereotypes and instil more positive
attitudes, beliefs and behaviours. Studies have found that across time, cross-group
friendships predict positive outgroup evaluations (Feddess et al., 2009) For example,
Maras & Brown (1996) found that contact with children with disabilities led to more
liking.
Aims
Given the worrying statistics surrounding bullying of autistic children, and in
particular the higher risks for adolescents, and those attending mainstream schools
(Hebron & Humphrey, 2013; Rowley et al., 2012), this study aimed to explore the
attitudes towards bullying and autism of neurotypical children in mainstream
secondary schools, with a focus on different targets of bullying (autistic and
neurotypical) and different bullying violations (verbal bullying and social exclusion)
to see if these attitudes, and those towards people with autism in general, varied
according to educational exposure (high: schools with purpose-built specialist centres
for autism vs. low: schools with no centre) and after follow-up (see Chapter 5),
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according to changes in personal exposure (decrease/no change/increase). The study
also aimed to explore the quality of attitudes of pupils towards bullying and autism.
Studies investigating children’s understanding of intergroup contexts mainly adopt
social domain theory, testing social-moral reasoning and behavioural intentions.
Intergroup emotion theory (Mackie, Devos & Smith, 1999) however also suggests
that group-based emotions can be associated with behavioural intentions. It is
therefore important to explore the quality of attitudes (beliefs, emotions and
behavioural intentions) for particular age groups since they may indicate differences
in processing of information and hence, inform types of interventions that are best
suited to children at particular stages of development.
This chapter presents the findings at baseline. As such, children in the study were
new to their schools, so had yet to be influenced by educational exposure to people
with autism. Differences by educational exposure were collected therefore to provide
the baseline data for the subsequent follow-up analysis (Chapter 5), and also to look
for any differences in attitudes by virtue of joining a school with or without a
specialist centre.
The specific aims of the baseline study were thus:
i. To explore the impact of educational exposure (i.e. being in a school
with/without a specialist centre), bullying violation and target of bullying
on judgements, emotions and intended behaviours towards bullying
ii. To explore the impact of educational exposure on attitudes to autism
iii. To explore the quality of attitudes of pupils towards bullying and autism.
4.2 Method
Design
The study had a factorial design, where the three between-subjects factors were i)
educational exposure (high: with specialist centre or low: without specialist centre);
ii) the target of bullying in a vignette (autistic (ASD) or neurotypical (NT)); iii) type
of violation in a vignette (verbal bullying or social exclusion). The dependent
variables were (a) judgement of the way the target was being treated, (b) emotions in
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response to the bullying scenario, (c) intended behaviours in response to the bullying
scenario and (d) cognitive attitudes towards people with autism.
Justification for Vignette Design
Vignettes are brief descriptions of a person/situation designed to stimulate key
features of a real world scenario and are often used to explore attitudes and
judgments in the social, behavioural and health sciences (Evans et al., 2015). One
dilemma facing researchers is whether to use experimental designs with high internal
validity but low external validity, or to maximize external validity at the expense of
control over the direction and nature of causality. Use of vignettes provides a way to
enhance experimental realism (external validity) and at the same time manipulate and
control independent variables (internal validity) (Aguinis, Bradley, 2014). In
particular, when used in surveys they allow for a broad range of variables to be
incorporated into the research design (Hughes and Huby, 2004). A second benefit is
that they have relatively low requirements in terms of time, personnel, funding and
other resources. Furthermore, they provide the ability to research hypothetical
scenarios addressing sensitive topics whilst avoiding ethical and practical problems
associated with other experimental methods (Evans et al., 2015; Alexander &
Becker, 1978; Ganong & Coleman, 2006; Gould, 1996; Hughes, 1998; Hughes &
Huby, 2004; Wallander, 2009).
Criticism of the vignette design usually relates to the extent to which responses
represent participants’ behaviour in the real world (Hughes & Huby, 2004; Gould,
1996). However, responses to vignettes are not intended to represent their behaviour
in the real world, but rather to provide predictors for such behaviour (Hughes, 1998;
Wallander, 2009; 2012). It cannot be guaranteed that hypothetical behaviour will
exactly reflect their actual behaviour, but evidence shows that the two correspond
(Lunza, 1990; Langley, Tritchler, Llewellyn-Thomas, & Till, 1991). Furthermore, a
meta-analysis of 111 studies (Murphy, Herr, Lockhart, & Maguire, 1986) showed
that vignette methodologies demonstrated little difference from observations of
actual behaviour. Other research showed that a concrete, detailed, hypothetical
vignette situation provides a better investigative vehicle than asking abstract
questions about attitudes and perceptions (Alexander & Becker, 1978).
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There are a number of recommendations regarding vignette content. These include
their length not being overly burdensome, having a story-like progression, a balance
of gender, neutral with respect to cultural and socio-economic factors, resembling
real people, being relatable, relevant and plausible to the participants, highlighting
key variables of interest and facilitating participant engagement and thinking (Evans
et al., 2015; Hughes & Huby, 2004). It has also been recommended (Hughes &
Huby; 2004) that scenarios are developed through drawing upon existing literature
and that they are scrutinized by a panel of experts for clarity, cultural neutrality and
validity.
Participants
Participants were recruited from six urban mainstream secondary schools in South
East England (three schools with specialist centres for autism and three schools
without centres) who agreed to participate. The schools with centres differed from
the schools without centres, in terms of the attention given to pupils with autism but
not in terms of numbers of autistic pupils. An ‘opt-out’ consent procedure was
employed, whereby parents were notified before the start of the study and could
revoke consent for the participation of their child. Pupils could also choose not to
participate on the day of testing. This resulted in the recruitment of 1050 pupils. Of
these, 64 provided no data so were removed from the dataset. 26 participants had a
diagnosis of ASD, so were also removed for the purposes of this analysis. The
sample therefore consisted of 960 participants (494 male; 466 female). The mean age
was 11.15 years (SD = 0.36 years). 788 participants (82.1 %) were white.
Procedure
Near the beginning of their school year, participants (Year 7 pupils, new to the
school) were asked to complete baseline measures of their attitudes and intended
behaviours in relation to bullying scenarios. The study was conducted in school
classrooms, with each class consisting of approximately 30 pupils and a teacher
always present. Pupils were informed that the researcher was interested in finding out
about their attitudes towards their peers and provided with information about what
they would be asked to do if they agreed to participate. Before the questionnaire was
completed, the researcher read aloud the instructions on the front of the questionnaire
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including what they should do if they don’t understanding something, how they
should answer questions and emphasizing that their answers would be anonymous.
Questionnaires were paper-based, and completed under controlled conditions.
Each questionnaire included one of four different vignettes depicting a story about a
bullying incident. Participants were allocated quasi-randomly (i.e. in sequence
according to where they sat in the room) to one of four vignettes depicting a bullying
scenario. 150 pupils in high educational exposure schools (HEES) and 122 in low
educational exposure schools (LEES) received vignette 1: NT target subjected to
verbal bullying; 131 in HEES and 123 in LEES received vignette 2: NT target
subject to social exclusion; 127 in HEES and 105 in LEES received vignette 3:
autistic target subject to verbal bullying and 113 in HEES and 89 in LEES schools
received vignette 4: autistic target subject to social exclusion.
Whilst previous studies ask participants to imagine what the response of the victim or
perpetrator of bullying would be, in this study participants were asked to imagine
themselves watching the scene take place, i.e. as a bystander, since this is the most
likely role for the majority of school children (Salmivalli, 1996; 1999). Further,
focusing on bystander intentions also allows us to consider whether there are more
prosocial attitudes in schools where there may be less exclusionary norms (and even
less differentiation between ingroup and outgroup members), supporting Palmer et
al.’s (2015) findings of more prosocial bystander intentions when the victim is an
ingroup member. Characters within the vignettes were the same gender as the
participant. Participants were asked to complete the questionnaire carefully and
quietly, indicating their responses on five-point Likert scales and circling adjectives
(positive and/or negative) which they associated with people with autism using the
Adjectives Checklist (ACL) (Siperstein, 1980). Some pupils were assisted in vignette
and questionnaire reading, so as not to exclude those with reading difficulties.
Participants were given 20-30 minutes to complete the questionnaire. At the end,
participants were thanked and given the opportunity to ask any questions.
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Materials
Vignettes
Vignettes were developed in line with the recommendations above including length,
neutrality, relevance and relatability. The use of vignettes in previous studies was
drawn upon and drafts were then scrutinized by a primary and secondary supervisor
for their sense, clarity, cultural neutrality and validity. They were also asked to assess
the severity of bullying violations and use of stigmatized targets. Once finalized, the
vignettes were subjected to a pilot testing process, where 30 Year 6 pupils were
assigned one of the four vignettes and asked to complete the draft questionnaire. The
pupils were asked to indicate anything that was unclear and wording was amended
accordingly. Vignettes are shown in Appendix J.
Questionnaire
Participants completed the following:
i) Demographics: Pupils were asked to provide demographic information (gender,
age, whether they have a disability/special educational needs/autism/Asperger’s
Syndrome, ethnic background and how many people they know/friends/family
who have autism or Asperger’s Syndrome). They were also asked three
identifier questions enabling baseline and follow-up questionnaires to be
matched without the use of pupil names.
ii) Judgements, emotions and intended behaviours: These measures were
developed in line with similar previous studies (Jones et al., 2009; Swaim &
Morgan, 2001). These required pupils to indicate their agreement on five-point
Likert scales ranging from not at all to extremely or from definitely not to
definitely. The questionnaire is shown in Appendix J. The first set of eight items
related to judgements about what happened to the target, including 4 prosocial
judgements (e.g. ‘How much do you think what happened to Emily/Jack was
mean?’) and 4 antisocial judgements (e.g. ‘How much do you think what
happened to Emily/Jack was funny?’). The scale had good internal consistency
(α = .74). The next set of eight items related to their emotional response to the
incident, where pupils were asked, ‘How strongly do you think you would feel
the following emotions…?’ with 4 prosocial items (e.g. ‘angry’, ‘sad’) and 4
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antisocial items (e.g. ‘excited’, ‘satisfied’). The scale had good internal
consistency (α = .71). A further eight items concerned their intended behaviours
in response to the bullying scenario. Again there were 4 prosocial items (e.g.
‘How likely would you be to report it to a teacher?’, ‘How likely would you be
to smile at Emily/Jack to show support for her/him?’) and 4 antisocial items (e.g.
‘How likely would be to do nothing?’, ‘How likely would you be to laugh’). The
scale had good internal consistency (α = .72).
iii) Attitudes to autism: The Adjectives Checklist (ACL) (Siperstein, 1980) was used
to measure cognitive attitudes towards people with autism. This scale is
designed to mirror the behaviour of children in classroom settings where
children express their opinions or beliefs about a peer using common descriptors
such as ‘mean’ and ‘friendly’ etc. Participants were asked to think of a person
they know who has autism or Asperger’s Syndrome and to circle words from a
list of 34 adjectives (17 with positive valence, 17 with negative valence)
describing a peer’s affective feelings, physical appearance, academic behaviour
and social behaviour that they would use if they had to describe this person to
their classmates. They were told they could use as many or as few words as they
want. The ACL has good construct validity and Cronbach’s alpha reported to
range from .67 to .91. In this study, the Cronbach alpha coefficient was .87.
iv) Personal exposure to autism: Time spent with people they know to have autism
was measured on a Likert scale from ‘never’ to ‘very often’.
Data analysis
The data were analysed in the following ways:
i) To screen data for missing values and normality
ii) To describe participant demographics and to compare demographics for those in
HEES and LEES using t tests and χ2
iii) To explore the main effects of educational exposure, type of bullying and target
of bullying on judgements, emotions and intended behaviours using ANOVA
iv) To explore the main effect of educational exposure on cognitive attitudes to
autism using ANOVA
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4.3 Results
i) Data screening
Missing value analysis revealed no serious problems regarding patterns of missing
data with the exception of the item ‘How often to you spend time these days with
people that you know to have autism or Asperger’s Syndrome?’ For this item there
were 60 missing values (6.3%) out of a total of 960. As this was used as an IV in the
final analysis of change scores after follow-up (see Chapter 5), these participants
were excluded from this part of the analysis. For cases where 1 out of 4 prosocial or
1 out of 4 antisocial items was missing, the mean of the 3 supplied scores was
imputed. Preliminary checks were conducted to ensure that there was no violation of
assumptions of normality. None of the variables were skewed, but there were a
number of variables with positive kurtosis (Table 4.1). All except one variable (mean
prosocial judgements) showed homogeneity of variance. Alpha was set to .05.
Table 4.1
Skew and Kurtosis of Baseline Scores
Skew KurtosisHigh Educational Exposure Total Judgements -1.58 3.26
Total Emotions -0.80 0.47Total Intended Behaviours -1.09 1.65Total Attitude -0.15 0.28
Low Educational Exposure Total Judgements -1.53 3.05Total Emotions -1.00 1.49Total Intended Behaviours -1.21 2.15Total Attitude 0.00 -0.26
NT Target Total Judgements -1.43 2.63Total Emotions -0.20 1.08Total Intended Behaviours -1.32 2.64Total Attitude -0.04 -0.10
ASD Target Total Judgements -1.76 4.19Total Emotions -0.91 1.00Total Intended Behaviours -0.94 0.94Total Attitude -0.14 0.09
Verbal Violation Total Judgements -1.84 4.90Total Emotions -1.05 1.57Total Intended Behaviours -1.30 2.86Total Attitude -0.10 0.09
Social Exclusion Violation Total Judgements -1.35 2.19Total Emotions -0.75 0.53Total Intended Behaviours -1.04 1.21Total Attitude -0.08 -0.14
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ii) Differences in participant demographics by educational exposure
Comparisons of participant demographics by educational exposure revealed a
significant difference by ethnic background, with a higher percentage of white
participants in high educational exposure schools (HEES) (84.2%) than in low
educational exposure schools (LEES) (80.5%). Ethnic background was therefore
included as a factor. Comparisons also revealed a significant difference in number of
people they know with ASD. Participants from HEES knew more people with ASD.
(See Table 4.2.)
Table 4.2
Differences in Participant Demographics by Educational Exposure
Educational exposuret/chi squared pHigh Low
Gender M = 266 (51.1%)F = 255 (48.9%)
M = 228 (51.9%)F = 211 (48.1%)
χ 2 = 0.04 (1)
.84
Age x = 11.14sd = 0.34
x = 11.16sd = 0.37
t = -1.21(898.46)
.23
Disability/SENMissing = 3
Yes = 33 (6.3%)No = 436 (83.7%)Not sure/prefer not to say = 52 (9.9%)
Yes = 28 (6.4%)No = 345 (79.1%)Not sure/prefer not to say = 63 (14.5%)
χ 2 = 4.82 (3)
.19
Ethnic BackgroundMissing = 5
BME = 65 (12.5%)White = 437 (84.2%)Other = 17 (3.3%)
BME = 48 (11.0%)White = 351 (80.5%)Other = 37 (8.5%)
χ 2 = 12.23(2) <.001
No. of people you know with ASDMissing = 16
0 = 61 (11.8%)1 = 121 (23.4%)2 = 91 (17.6%)3 = 38 (7.4%)More than 3 = 60 (11.6%)Don’t know = 146 (28.2)
0 = 77 (18.0%)1 = 90 (21.1%)2 = 62 (14.5%)3 = 20 (4.7%)More than 3 = 38 (8.9%)Don’t know = 140 (32.8)
χ 2 = 14.11(5)
.02
No. of people in your family with ASDMissing = 11
0 = 438 (84.6%)1 = 60 (11.6%)2 = 13 (2.5%)3 or more = 7 (1.4%)
0 = 369 (85.6%)1 = 46 (10.7%)2 = 9 (2.1%)3 or more = 7 (1.6%)
χ 2 = 0.50(3) .92
No. of friends with ASDMissing = 8
0 = 224 (43.2%)1 = 106 (20.4%)2 = 39 (7.5%)3 = 7 (1.3%)More than 3 = 10 (1.9%)Don’t know = 133 (25.6%)
0 = 187 (43.2%)1 = 81 (18.7%)2 = 26 (6.0%)3 = 6 (1.4%)More than 3 = 4 (0.9%)Don’t know = 129 (29.8%)
χ 2 = 4.24 (5)
.51
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Time spent with people with ASDMissing = 60
Never = 163 (32.8%)Rarely = 131 (26.4%)Sometimes = 120 (24.1%)Often = 57 (11.5%)Very often = 26 (5.2%)
Never = 154 (38.2%)Rarely = 90 (22.3%)Sometimes = 88 (21.8%)Often = 53 (13.2%)Very often = 18 (4.5%)
χ 2 = 4.62 (4)
.33
iii) The impact of educational exposure on judgements, emotions and intended behaviours
To test the impact of educational exposure on judgements, emotions and intended
behaviours in relation to vignettes depicting different targets of bullying and different
violations, 2 (educational exposure: HEES vs. LEES) x 2 (target type: NT vs. ASD)
x 2 (violation type: verbal vs. social exclusion) ANOVAs were conducted separately
for each of the dependent variables. These were implemented as custom models
where ethnicity was included as an additional factor, but not included in any of the
interaction terms. The means, standard deviations and ANOVA results are presented
in Table 4.3.
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120
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Table 4.3
Descriptive Data and ANOVA Results for Responses to Vignettes by Educational Exposure
Educational exposureHEES (1)
N=521LEES (2)
N=439ASD Target
N=240NT Target
N=281ASD Target
N=194NT Target
N=245Main
Effect ofEducational Exposure
Main Effect of
Target Type
Main Effect ofViolation
Type
Educational exposure x
Target Type
Educational exposure x Violation
Type
Educational exposure x
Target Type x
Violation Type
Verbal BullyingN=127
Social Exclusion
N=113
Verbal BullyingN=150
Social Exclusion
N=131
Verbal BullyingN=105
Social Exclusion
N=89
Verbal BullyingN=122
Social Exclusion
N=123
Mean Prosocial Judgements
x= 4.48sd = 0.45
x= 4.32sd = 0.51
x= 4.36sd = 0.49
x= 4.16sd = 0.63
x= 4.41sd = 0.57
x= 4.17sd = 0.60
x= 4.33sd = 0.56
x= 4.17sd = 0.57
F = 2.56p = .11p
2 <.001
F = 6.03p = .01p
2 =.01
F = 23.34P < .001p
2 = .03
F = 2.12p = .15p
2 < .001
F = 0.08p = .79p
2 < .001
F = 0.39p = .68p
2 = .001
Mean Prosocial Emotions
x= 4.37sd = 0.41
x= 4.34sd = 0.47
x= 4.31sd = 0.48
x= 4.17sd = 0.48
x= 4.35sd = 0.48
x= 4.24sd = 0.55
x= 4.26sd = 0.54
x= 4.27sd = 0.43
F = 0.43p = .51p
2 < .001
F = 5.64p = .02p
2 = .01
F = 4.06p = .04p
2 = .004
F = 1.93p = .17p
2 = .002
F = 0.37p = .54p
2 <.001
F = 1.27p = .28p
2 =.003
Mean Prosocial Intended Behaviours
x= 4.24sd = 0.49
x= 4.23sd = 0.51
x= 4.25sd = 0.50
x= 4.14sd = 0.59
x= 4.27sd = 0.55
x= 4.12sd = 0.61
x= 4.18sd = 0.65
x= 4.20sd = 0.58
F = 0.47p = .50p
2 = .001
F = 0.50p = 0.48p
2 = .001
F = 2.88p = .09p
2 = .003
F = 0.11p = .74p
2 < .001
F = 0.00p = .98p
2 < .001
F = 1.65p = .19p
2 = .003
Results showed no main effect of educational exposure on judgements, emotions and
intended behaviours towards the vignette at baseline. Results did however reveal
significant main effects of target type on judgements and emotions, with higher
prosocial judgements in response to ASD targets (M = 4.35, SD = 0.54) than to NT
targets (M = 4.26, SD = 0.57) and higher prosocial emotions in response to ASD
targets (M = 4.33, SD = 0.47) than to NT targets (M = 4.25, SD = 0.49) indicating that
participants were more prosocial when the child being bullied had ASD compared to
the child without autism. Figure 4.1 illustrates the differences in prosocial judgements
and emotions by target type.
Judgements Emotions4.00
4.05
4.10
4.15
4.20
4.25
4.30
4.35
4.40
ASDNT
Mea
n Sc
ore
Note. * p < .05
Figure 4.1. Prosocial judgments and emotions by target type
Results also revealed significant main effects of violation type on judgements and
emotions, with higher prosocial judgements in response to verbal bullying (M = 4.39,
SD = 0.52) than to social exclusion (M = 4.20, SD = 0.58) and higher prosocial
emotions in response to verbal bullying (M = 4.32, SD = 0.48) than to social
exclusion (M = 4.25, SD = 0.48) indicating that participants were more prosocial in
response to verbal bullying compared to social exclusion. It should be noted however
that effect sizes were small. Figure 4.2 illustrates the differences in prosocial
judgements and emotions by violation type.
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Judgements Emotions4.00
4.05
4.10
4.15
4.20
4.25
4.30
4.35
4.40
4.45
Verbal BullyingSocial Exclusion
Mea
n Sc
ore
Note. ** p < .01; * p < .05;
Figure 4.2. Prosocial judgements and emotions by violation type
iv) The impact of educational exposure on cognitive attitudes toward autism
An ANOVA comparing cognitive attitudes towards people with autism according to
educational exposure was conducted, also as a custom model where ethnicity was
included as an additional factor, but not included in any interaction terms. This
showed a significant main effect of educational exposure, with higher positive
attitude scores from participants in high educational exposure schools than in low
educational exposure schools. However, the effect size is small, indicating that
educational exposure only accounts for a small percentage of the variance in attitude
scores. The means, standard deviations and main effects are presented in Table 4.4.
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Table 4.4
Descriptive Data and ANOVA Results for Cognitive Attitudes by Educational
Exposure
Educational exposure Main Effect ofEducational exposure
HighN=521 (54%)
LowN=439 (46%)
Positive attitudes towards autism
x= 22.60sd= 4.76
x= 21.95sd= 5.20
F = 4.35p = .04p
2 =.02
High School Exposure Low School Exposure20.0
20.5
21.0
21.5
22.0
22.5
23.0
Mea
n Sc
ore
Note. * p < .05
Figure 4.3. Cognitive attitudes towards autism by educational exposure
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4.4 Discussion
This baseline study, explored the attitudes of neurotypical children towards bullying
and towards people with autism according to educational exposure, different targets
of bullying and different bullying violations. It also explored the quality of attitudes
(i.e. judgements, emotions and intended behaviours) towards these variables.
Results showed no differences in judgements, emotions and intended behaviours
towards the vignette according to educational exposure at baseline. This is as
expected due to the timing of the data collection (i.e. the start of their first term in
their respective schools, before children had experienced educational exposure).
Regardless of educational exposure however, neurotypical children had greater
prosocial judgements and emotions towards ASD targets of bullying than NT targets.
This is partly supported by social domain theory (Turiel, 2008) in that participants
may have evaluated the bullying of ASD targets as more wrong than the bullying of
NT targets for moral reasons of fairness and equality.
Results also revealed greater prosocial judgements and emotions when the violation
was verbal bullying, rather than social exclusion. Killen and Rutland (2011) point out
that exclusion is not always classified as bullying since there are certain instances
where exclusion is legitimate (for group functioning) or a result of different
interpretations of the situation. This finding was also supported by Boulton et al.
(2002) who found that social exclusion was the category least likely to be defined as
bullying. Hence the more direct verbal bullying depicted in vignettes may be less
acceptable than social exclusion, which could be perceived as more ambiguous.
Social exclusion has been classed as indirect bullying (Olweus, 1993) and rates of
direct and indirect bullying have also been reported to differ in relation to age and
sex, with the most common form of bullying being verbal (Ahmed & Smith, 1994;
Boulton et al., 2002), but an increased amount of indirect bullying by girls in
secondary school. The findings from this study didn’t reveal any differences
according to sex, but the greater prevalence of verbal bullying among children may
influence perceptions of bullying and may account for the greater prosocial
judgements and emotions when the violation was verbal.
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Finally, results showed that children in HEESs had greater positive attitudes towards
people with autism. It is stressed that these attitudes represent data at baseline for the
purposes of comparing groups at follow up. They do nevertheless show a significant
difference even at baseline, which may be simply a result of their admission to a
school with a specialist centre, and the knowledge that their new school has an
inclusive normative climate (Morewood, Humphrey & Symes, 2011). Whilst the
difference was significant, the effect size was small, indicating that the educational
exposure only accounted for 1.7% of the variance in attitude scores.
In terms of quality of attitudes, significant differences were only found in children’s
judgements and emotions towards the vignettes, but not in their intended behaviours.
Participants indicated a greater increase in prosocial judgements (judging the scenario
to be mean, unfair, cruel and bullying) and/or decrease in antisocial judgements
(judging it to be exciting, deserved, normal and funny) and also a greater increase in
prosocial emotions (anger, pity, sadness and shame) and/or decrease in antisocial
emotions (pride, excitement, amusement and satisfaction) towards bullying of a child
with ASD and also towards verbal bullying. Despite this moral understanding
however, they showed no difference in behavioural intentions towards bullying of
ASD and NT targets, reflecting a possible societal understanding of rules that make
groups function smoothly (Killen & Rutland, 2011).
These findings have implications for anti-bullying programmes, which should focus
on group processing and issues relating to morality, intention to harm and different
forms of direct and indirect bullying. Further implications will be discussed in
response to follow up data in Chapter 5.
Conclusion
In summary, the results from baseline showed no difference in judgments, emotions
and intended behaviours according to educational exposure, but did find, irrespective
of educational exposure, that neurotypical children have more prosocial judgments
and emotions towards the bullying of a child with ASD (vs. an NT) and towards
verbal bullying (compared to social exclusion). Furthermore, children from schools
with a specialist centre reported more positive cognitive attitudes towards people with
autism than children in schools with no centre, though the effect was small and may
126
reflect the knowledge that they have recently joined a school with an inclusive
normative climate. Explanations for these findings drew on previous research
exploring moral reasoning and group functioning of people in this age group and
differences in perceptions of direct and indirect bullying.
The findings from this study provide the baseline for the follow-up study, which is
presented in the next chapter. This will present an analysis of the change in attitudes
after one academic year of educational exposure compared to a control group. In
addition, it will consider the influence of changes in personal exposure to autism, and
whether there are differences in the quality of attitudes expressed.
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Chapter 5
Study 4: The effect of exposure on attitudes towards bullying and
autism in schools. A cohort study with a control group. Findings at
follow-up
Overview
The previous chapter provided the baseline data for the cohort study and explored the
impact of educational exposure on neurotypical children’s attitudes to those with
autism. This next study includes the follow up data after one year and evaluates
changes in attitudes after educational exposure compared to a control group and also
after changes in personal exposure.
5.1 Introduction
Chapter 4 provided the main introduction to this study, which explored the effect of
educational exposure on attitudes towards bullying and autism in schools. It
considered the challenges facing children with ASD in school, particularly that of
bullying and the ‘double disadvantage’ (Humphrey & Hebron, 2015), i.e. a higher
prevalence and more severe outcomes for children with ASD. It also discussed the
mixed results of anti-bullying and information-based interventions and the possible
explanation for this being the heightened priority afforded to group functioning and
social conventions during early adolescence in certain intergroup contexts, which can
sometimes be at the expense of equality of treatment towards out-group members
(Killen & Rutland, 2011).
In line with recommendations by Humphrey and Hebron (2015) to incorporate
emphases on peers and school culture/climate into a comprehensive approach to
tackle bullying of children with ASD, this study took advantage of a model of
inclusion designed to enable pupils with ASD to have the benefits of being a member
of a mainstream school community while at the same time receiving specialist
support and a calm purpose-designed setting to retreat to and develop social/learning
skills. This model is being evaluated by the National Autistic Society, following the
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opening of the specialist centres in three mainstream secondary schools in Surrey in
2015. This particular study formed part of the evaluation, and aimed to explore the
attitudes of neurotypical (NT) children to bullying with a focus on different targets of
bullying (ASD and NT) and different bullying violations (verbal bullying and social
exclusion). It aimed to see if these attitudes, and those towards people with autism in
general varied according to educational exposure (high: schools with purpose-built
specialist centres for autism, and low: schools with no centre) and additionally after
follow-up, according to changes in personal exposure (decrease/no change/increase).
The study also aimed to explore the quality of attitudes of pupils towards bullying
and autism in light of differences reported in children’s understanding of intergroup
contexts, including cognitive skills/social-moral reasoning; the focus of social domain
theory (Killen & Rutland, 2011), and also emotion responses, explained by intergroup
emotion theory, suggesting that group-based emotions are associated with
behavioural intentions (Mackie, Devos & Smith, 1999). The study therefore
investigated the quality of attitudes (beliefs, emotions and behavioural intentions)
since they may indicate differences in processing of information and hence, inform
types of interventions that are best suited to children at particular stages of
development.
Results at baseline showed no differences in judgements, emotions and intended
behaviours according to educational exposure. This is as expected due to the timing
of the data collection (i.e. the start of their first term in their respective schools, before
children had experienced educational exposure). They did however indicate that NT
children had greater prosocial judgements and emotions towards ASD targets of
bullying than NT targets. They also revealed greater prosocial judgements and
emotions when the violation was verbal bullying, rather than social exclusion. These
findings were discussed in relation to social domain theory (e.g. evaluation of the
bullying of ASD targets to be more wrong than the bullying of NT targets for moral
reasons of fairness and equality), prevalence and perceptions of direct and indirect
bullying, and quality of attitudes (i.e. differences in judgements and emotions but not
in intended behaviours). Finally, baseline results showed that children in high
educational exposure schools (HEES) had greater positive cognitive attitudes towards
people with autism, although the effect size was small, and may simply reflect an
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understanding that the school into which they were admitted has an inclusive
normative climate by virtue of the existence of the specialist centre.
This chapter presents the findings at follow-up (i.e. after one year’s attendance in
their respective schools). While at baseline, any differences reported by educational
exposure (high vs. low) could be attributed to assumptions about the school climate,
data collected at follow-up (Time 2) reflects a degree of ‘educational exposure’
resulting in their immersion for one school year into the culture/climate of the school.
In addition, differences were also explored according to changes in ‘personal
exposure’ (i.e. the amount of time individuals spend with people with autism).
Aims
The specific aims for the follow-up study were therefore:
i) To explore the impact of educational exposure, bullying violation and target of
bullying on changes in judgements, emotions and intended behaviours towards
bullying
ii) To explore the impact of educational exposure on changes in cognitive attitudes
to autism
iii) To explore the impact of change in personal exposure, bullying violation and
target of bullying on changes in judgements, emotions and intended behaviours
towards bullying
iv) To explore the impact of personal exposure on changes in cognitive attitudes
towards autism
v) To explore the quality of attitudes of pupils towards bullying and autism.
In line with previous research suggesting that school climate can influence inclusive
or exclusive peer-group norms (Cameron et al., 2006; Chang, 2004; Gasser et al.,
2013; Killen & Rutland, 2011; Maras & Brown, 1996; Morewood, Humphrey &
Symes, 2011) this study tested the hypothesis that NT children in schools with high
educational exposure will show a greater increase in prosocial judgements, emotions
and intended behaviours towards vignettes depicting bullying scenarios (Hypothesis
1) and a greater increase in positive cognitive attitudes towards their peers with
autism (Hypothesis 2). Furthermore, since studies show that contact leads to more
liking of peers with disabilities (Maras & Brown, 1996), this study tested the
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hypothesis that an increase in personal exposure to autism will result in greater
increase in prosocial judgements, emotions and intended behaviours towards
vignettes depicting bullying of ASD targets (Hypothesis 3) and a greater increase in
positive cognitive attitudes towards their peers with autism (Hypothesis 4). There was
no a priori hypothesis for violation type, but this was included to explore possible
differences in response to verbal bullying and social exclusion according to
educational and personal exposure.
5.2 Method
Design
The study had a factorial design, where the four between-subjects factors were i)
educational exposure to people with autism (high or low), (ii) change in personal
exposure to autism (3 groups representing change from baseline to follow up:
decrease; no change; increase), iii) the target of bullying in a vignette (autistic (ASD)
or neurotypical (NT)); iv) type of violation in a vignette (verbal bullying or social
exclusion). The dependent variables were the degree of change over the course of one
school year in (a) judgement of the way the target was being treated, (b) emotions in
response to the bullying scenario, (c) intended behaviours in response to the bullying
scenario and (d) cognitive attitudes towards people with autism.
Participants
Recruitment of participants is explained in Chapter 4. Of the 960 participants at
baseline, 185 did not provide data at follow-up (110 male; 75 female). The sample for
this analysis therefore consisted of 775 participants (384 male; 391 female). The
mean age was 11.15 years (SD = 0.36 years). 643 participants (83%) were white.
Procedure
The procedure was the same as that described in the baseline analysis (Ch.4), except
for the addition of a follow-up visit, when the same measures were taken again at the
end of the school year. Allocation of questionnaires to completers (participants who
completed both baseline and follow-up questionnaires) was: 120 pupils in high
educational exposure schools (HEES) and 98 in low educational exposure schools
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(LEES) received vignette 1: NT target subjected to verbal bullying; 106 in HEES and
96 in LEES received vignette 2: NT target subject to social exclusion; 107 in HEES
and 79 in LEES received vignette 3: autistic target subject to verbal bullying and 93
in HEES and 76 in LEES schools received vignette 4: autistic target subject to social
exclusion. At the end of the follow-up visit, participants were thanked, debriefed
about the research and given the opportunity to ask any questions.
Materials
Vignettes
Vignette development and piloting is described under ‘Materials’ in the Baseline
Analysis (Ch.4).
Questionnaire
The questionnaire was the same as that described under ‘Materials’ in the Baseline
Analysis, with the exception of the omission of three contact questions at follow-up:
‘How many people do you know that have autism?’, ‘How many people have autism
in your family?’ and ‘How many of your friends have autism?’.
Data analysis
The data were analysed in the following ways:
i) To screen data for missing values and normality
ii) To describe participant demographics and to compare demographics for those in
HEES and LEES and also for those at baseline and those at follow up in terms of
completers and non-completers using t tests and χ2
iii) To explore the main effects of educational exposure, type of bullying and target
of bullying on changes in judgements, emotions and intended behaviours and of
educational exposure on attitudes to bullying and autism using ANOVA
iv) To explore the main effects of personal exposure to autism, type of bullying and
target of bullying on changes in judgements, emotions and intended behaviours
and of personal exposure on attitudes towards bullying and autism using
ANOVA
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For this study, it was decided to compare change scores rather than conduct
ANCOVAs partialling out the Time 1 scores. It is recognised that these methods can
lead to different conclusions (Lord, 1967). However, Wright (2006) explains that
when we are interested in the amount of gain in either of the conditions, the change
score approach is preferred. Further research comparing these methods concludes that
ANCOVA should be used in randomised studies, but that in non-randomised studies
of pre-existing groups (such as the present study), ANOVA of change scores is less
biased than ANCOVA (Van Breukelen, 2006).
5.3 Results
i) Data screening
Missing value analysis revealed no serious problems regarding patterns of missing
data with the exception of the item ‘How often to you spend time these days with
people that you know to have autism or Asperger’s Syndrome?’ For this item there
were 85 missing values (11%) out of a total of 775. As this was used as an IV, these
participants were excluded from this part of the analysis, and account for differences
in degrees of freedom. Little’s MCAR test confirmed that data were missing
completely at random in relation to age, gender, ethnicity, educational exposure,
number of people they know/friends/in family with ASD. For cases where 1 out of 4
prosocial or 1 out of 4 antisocial items was missing, the mean of the 3 supplied scores
was imputed. Otherwise, pairwise deletion of missing data was implemented.
Preliminary checks were conducted to ensure that there was no violation of
assumptions of normality. None of the variables were skewed, but there were a
number of variables with positive kurtosis (Table 5.1). All except one variable
(change in judgement by personal exposure) showed homogeneity of variance. Alpha
was set to .05.
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Table 5.1
Skew and Kurtosis of Change Scores
Skew KurtosisHigh Educational Exposure Total Judgements 0.64 3.34
Total Emotions -0.19 2.22Total Intended Behaviours 0.18 3.59Total Cognitive Attitude 0.24 1.13
Low Educational Exposure Total Judgements 0.22 2.76Total Emotions -0.29 3.08Total Intended Behaviours 0.37 3.79Total Cognitive Attitude 0.01 1.35
NT Target Total Judgements -0.15 2.07Total Emotions -0.56 2.65Total Intended Behaviours 0.26 4.52Total Cognitive Attitude 0.23 0.69
ASD Target Total Judgements 1.14 4.09Total Emotions 0.30 2.29Total Intended Behaviours 0.28 2.52Total Cognitive Attitude 0.01 1.35
Verbal Violation Total Judgements 0.31 2.59Total Emotions -0.09 1.46Total Intended Behaviours 0.30 4.03Total Cognitive Attitude 0.26 1.37
Social Exclusion Violation Total Judgements 0.43 2.53Total Emotions -0.32 2.88Total Intended Behaviours 0.27 3.23Total Cognitive Attitude -0.12 0.96
Personal Exposure 1 (Decrease) Total Judgements 0.12 5.51Total Emotions -0.74 3.96Total Intended Behaviours -0.59 1.02Total Cognitive Attitude -0.13 -0.55
Personal Exposure 2 (No Change) Total Judgements 0.52 1.91Total Emotions -0.30 1.92Total Intended Behaviours 0.22 4.25Total Cognitive Attitude 0.02 1.42
Personal Exposure 3 (Increase) Total Judgements 0.49 2.26Total Emotions 0.42 2.11Total Intended Behaviours 0.65 2.65Total Cognitive Attitude -0.05 0.05
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ii) Differences in participant demographics
Comparison of participant demographics by educational exposure
Comparisons of participant demographics by educational exposure revealed a
significant difference by ethnic background, with a higher percentage of white
participants in high educational exposure schools (HEES) (85.1%) than in low
educational exposure schools (LEES) (81.1%). Ethnic background was therefore
included as a factor. Comparisons were also measured regarding the number of hours
of Personal/Social/Health Education (PSHE) pupils received in a year relating to
autism/special educational needs & disabilities/difference & diversity. A Mann-
Whitney U test showed a significant difference, with HEES providing more hours of
PSHE in one year (median = 4) than LEES (median = 3).
Table 5.2
Differences in Participant Demographics by Educational Exposure
Educational exposure t/chi squared/ Mann-Whitney U
pHigh Exposure Low Exposure
Gender M = 215 (50.5%)F = 211 (49.5%)
M = 169 (48.4%)F = 180 (51.6%)
χ 2 = 0.24 (1) 0.62
Age at baseline x = 11.14sd = 0.35
x = 11.16sd = 0.37
t = -.80(771) 0.43
Disability/SENMissing = 2
Yes = 25 (5.9%)No = 362 (85.0%)Not sure/prefer not to say = 39 (9.2%)
Yes = 23 (6.6%)No = 278 (80.1%)Not sure/prefer not to say = 46 (13.3%)
χ 2 = 3.65 (2) 0.16
Ethnic BackgroundMissing = 4
BME = 53 (12.5%)White = 361 (85.1%)Other = 10 (2.4%)
BME = 39 (11.2%)White = 279 (80.4%)Other = 29 (8.4%)
χ 2 = 14.35 (2) .001
Change in time spent with people with ASD1
Missing = 85
+3 or more = 15 (3.9%)+2 = 36 (9.4%)+1 = 71 (18.4%)0 = 166 (43.1%)-1 = 77 (20.0%)-2 or less = 20 (5.2%)
+3 or more = 19 (6.2%)+2 = 30 (9.8%)+1 = 55 (18.0%)0 = 132 (43.3%)-1 = 48 (15.7%)-2 or less = 21 (6.9%)
χ 2 = 4.46 (5) 0.49
Number of hours of autism/SEND/ difference/ diversity PSHE in a year
N = 426Mean rank = 409.64Median = 4
N = 349Mean rank = 361.59Median = 3
U = 65120Z = -3.02
.003
1 Whilst there was no difference in time spent with people with ASD according to educational exposure, participants in both HEES and LEES showed increases in percentages from T1 to T2 in the categories ‘very often’, ‘often’ and ‘sometimes’ and decreases in percentages for ‘rarely’ and ‘never’, although these were not significant.
135
Comparison of participant demographics of completers & non-completers
Comparisons of participant demographics of completers (those who completed
baseline and follow-up questionnaires) and non-completers (baseline questionnaires
only) revealed a significant difference by gender, with more boys dropping out
(59.5% of non-completers) than girls (40.5% of non-completers) compared with an
even split of male and female completers. Gender was also therefore included as a
factor.
Table 5.3
Differences in Participant Demographics of Completers and Non-Completers
Completed vs. non-completers t/chi squared pCompleters Non-completers
Gender M = 384 (49.5%)F = 391 (50.5%)
M = 110 (59.5%)F = 75 (40.5%)
χ 2 = 5.48 (1) .02
Age x = 11.15sd = 0.36
x = 11.15sd = 0.36
t = -.11 (955) 0.91
Disability/SENMissing = 3
Yes = 48 (6.2%)No = 640 (82.8%)Not sure/prefer not to say = 85 (11.0%)
Yes = 13 (7.1%)No = 141 (76.6%)Not sure/prefer not to say = 30 (16.3%)
χ 2 = 4.35 (2) .11
Ethnic BackgroundMissing = 5
BME = 92 (11.9%)White = 640 (83.0%)Other = 39 (5.1%)
BME = 21 (11.4%)White = 148 (80.4%)Other = 15 (8.2%)
χ 2 = 2.67 (2).26
How often do you spend time with people with ASD at T1Missing = 60
Never = 260 (36.0%)Rarely = 172 (23.8%)Sometimes = 169 (23.4%)Often = 91 (12.6%)Very often = 31 (4.3%)
Never = 57 (32.2%)Rarely = 49 (27.7%)Sometimes = 39 (22.0%)Often = 19 (10.7%)Very often = 13 (7.3%)
χ 2 = 4.68 (4) 0.32
iii) The impact of educational exposure
a) Judgements, emotions and intended behaviours
To test the hypothesis that high educational exposure over the course of the year
would lead to a greater increase in prosocial judgements, emotions and intended
behaviours in relation to vignettes depicting bullying (Hypothesis 1) and also to
explore responses to different targets and violations, 2 (educational exposure: high vs.
low) x 2 (target type: NT vs. ASD) x 2 (violation type: verbal vs. social exclusion)
ANOVAs were conducted separately for each of the dependent variables. Given the
136
significant main effect of personal exposure (reported below), this was included as a
factor to keep this variable constant when we explored differences by educational
exposure. ANOVAs were implemented as custom models where gender and ethnicity
were included as additional factors, but not included in any of the interaction terms.
The means, standard deviations and ANOVA results are presented in Table 5.4.
Consistent with Hypothesis 1, results revealed a significant main effect of educational
exposure on change in emotions (Figure 5.1). These results indicate that participants
with low educational exposure to autism showed a decrease in prosocial emotions
towards bullying in comparison to participants with high educational exposure who
showed an increase. In order to explore further the differences in prosocial emotions
between Time 1 and Time 2 for participants in high and low educational exposure
schools, paired samples t tests were conducted separately for HEES and LEES. For
HEES this showed an increase in mean scores from Time 1 (M = 4.29, SD = 0.47), to
Time 2 (M = 4.31, SD = 0.47), but the difference was not significant, (t (402) = -1.05,
p = .30). For LEESs this showed a decrease in mean scores from Time 1 (M = 4.31,
SD = 0.51), to Time 2 (M = 4.28, SD = 0.53), but again the difference was not
significant, (t (339) = 1.22, p = .22).
Results also showed a three-way interaction of educational exposure x target x
violation (Figure 5.2), indicating that while verbal bullying produced similar changes
in prosocial emotions between ASD and NT targets, social exclusion presented a
different picture, whereby participants in LEES showed a decrease in prosocial
emotions towards NTs subject to social exclusion, but an increase in prosocial
emotions towards social exclusion when the target was autistic (matching participants
from HEES).
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120
138 Table 5.4
Descriptive Data and ANOVA Results for Change in Responses to Vignettes by Educational Exposure (Raw Data)
Educational exposureHigh (1)
N=426 (55%)Low (2)
N=349 (45%)
Main Effect of
Educational exposure
Main Effect of
Target Type
Main Effect of
Violation Type
Educational exposure x
Target Type
Educational exposure x Violation
Type
Educational exposure x
Target Type x Violation
Type
ASD TargetN=200
NT TargetN=226
ASD TargetN=155
NT TargetN=194
Verbal BullyingN=107
Social Exclusion
N=93
Verbal BullyingN=120
Social Exclusion
N=106
Verbal Bullying
N=79
Social Exclusion
N=76
Verbal Bullying
N=98
Social Exclusion
N=96Change in judgment
x= 0.00sd = 0.54
x= 0.04sd = 0.65
x= 0.01sd = 0.47
x= 0.02sd = 0.66
x= 0.00sd = 0.51
x= 0.16sd = 0.69
x= 0.01sd = 0.55
x= -0.10sd = 0.73
F = 0.01p = .94p
2 = .000
F = 1.55p = .21p
2 =.002
F = 0.42P = .52p
2 = .001
F = 1.14p = .29p
2 = .002
F = 0.001p = .97p
2 = .00
F = 1.83p = .16p
2 = .01
Change in emotions
x= 0.02sd = 0.38
x= 0.02sd = 0.53
x= 0.01sd = 0.50
x= 0.05sd = 0.54
x= -0.10sd = 0.46
x= 0.07sd = 0.52
x= -0.03sd = 0.43
x= -0.15sd = 0.60
F = 5.47p = .02p
2 = .01
F = 0.40p = .53p
2 = .001
F = 0.38p = .54p
2 = .001
F = 0.88p = .35p
2 = .001
F = 0.00p = .99p
2 =.000
F = 3.20p = .04p
2 =.01
Change in intended behaviour
x= -0.01sd = 0.52
x= -0.10sd = 0.60
x= -0.034sd = 0.60
x= -0.13sd = 0.55
x= -0.10sd = 0.43
x= -0.05sd = 0.66
x= -0.05sd = 0.46
x= -0.13sd = 0.67
F = 0.29p = .59p
2 = .00
F = 1.23p = 0.27p
2 = .002
F = 0.55p = .46p
2 = .001
F = 0.13p = .72p
2 = .000
F = 1.63p = .20p
2 = .003
F = 1.59p = .21p
2 = .01
High Low
-0.08
-0.06
-0.04
-0.02
0.00
0.02
0.04
0.06
0.08
Educational Exposure
Mea
n C
hang
e Sc
ore
(mar
gina
l mea
ns)
Note. * p < .05
Figure 5.1. Change in prosocial emotions towards bullying by educational exposure
-0.20
-0.15
-0.10
-0.05
0.00
0.05
0.10
0.15
0.20
High Low
Neurotypical Targets
Educational Exposure
-0.15
-0.10
-0.05
0.00
0.05
0.10
0.15
0.20
HighLow
ASD Targets
Verbal BullyingSocial Exclusion
Educational Exposure
Figure 5.2 Change in prosocial emotions towards bullying by educational exposure
(three-way interaction)
To explore this significant interaction further, 2-way target x violation ANOVAs
were conducted for each level of educational exposure (low and high). This revealed
a significant interaction for low exposure schools of target x violation, F(1,286) =
139
6.145, p = .014, p2 = .021, indicating that in low exposure schools, verbal bullying
resulted in a greater decrease in prosocial emotions for ASD targets (M = -0.12, SD =
0.61) than for NT targets (M = -.03, SD = 0.65), but the opposite effect was true for
social exclusion, which resulted in a decrease in prosocial emotions for NT targets (M
= -0.15, SD = 0.61), but an increase for ASD targets (M = 0.06, SD = 0.59) (Figure
5.3).
ASD NT-0.20
-0.15
-0.10
-0.05
0.00
0.05
0.10
Verbal Bullying
Social Exclusion
Figure 5.3 Change in prosocial emotions with low educational exposure
b) Cognitive attitudes to autism
To test the hypothesis that high educational exposure over the course of the year
would lead to a greater increase in positive cognitive attitudes towards people with
autism (Hypothesis 2), an ANOVA was conducted, also as a custom model where
personal exposure was controlled for and gender and ethnicity were included as
additional factors, but not included in any interaction terms. This showed no
significant effect. The means and standard deviations are presented in Table 5.5.
140
Table 5.5
Descriptive Data and ANOVA Results for Change in Cognitive Attitudes to Autism by
Educational Exposure
Educational Exposure
Main Effect of Educational exposure
HighN=426 (55%)
LowN=349 (45%)
Change in cognitive attitudes
x= 0.73sd= 4.95
x= 0.60sd= 5.64
F = 0.00p = .97p
2 = .00
iv) The impact of change in personal exposure
ANOVAs were conducted to measure change in attitudes according to their change in
personal exposure to people with autism. A median split was used to categorise pupils
as either having low exposure (below the median) or high exposure (above the
median) at baseline, and again at follow up. This resulted in three categories of
personal exposure:
1. Pupils with high exposure at baseline and low exposure at follow-up
(decrease);
2. Pupils with high exposure at baseline and high exposure at follow-up or low
exposure at baseline and low exposure at follow-up, i.e. no change in
exposure from baseline to follow-up (no change);
3. Pupils with low exposure at baseline and but high exposure at follow-up
(increase).
a) Judgements, emotions and intended behaviours
To test the hypothesis that an increase in personal exposure to autism would lead to a
greater increase in prosocial judgements, emotions and intended behaviours in
relation to vignettes depicting bullying of targets with ASD (Hypothesis 3) and also
to explore responses to different violations, 3 (personal exposure: decrease; no
change; increase) x 2 (target type: NT vs. ASD) x 2 (violation type: verbal bullying
vs. social exclusion) ANOVAs were conducted separately for each of the dependent
variables. These were implemented as custom models where gender and ethnicity
were included as additional factors, but not included in any of the interaction terms.
141
The means, standard deviations and ANOVA results are presented in Table 5.6.
Results revealed a significant main effect of change in personal exposure for change
in judgements, but this had a small effect size. However, due to lack of homogeneity
of variance for this variable, and unequal sample sizes, a Kruskal-Wallis test was
conducted and this showed no significant difference in change of judgements
according to change in personal exposure.
142
120
143
Table 5.6
Descriptive Data and ANOVA Results for Change in Responses to Vignettes by Change in Personal Exposure Raw Data)
Personal ExposureBaseline: High
Follow-up: Low(Deccrease)
N=78
Baseline: Low/Follow-up: Lowand
Baseline: High/Follow-up: High(No Change)
N=488
Baseline: LowFollow-up: High
(Increase)N=124
Main Effect of
Personal Exposure
Main Effect ofTarget Type
Main Effect ofViolation
Type
Personal Exposure x Target
Type
Personal Exposure
x Violation
Type
Personal Exposure x Target Type x
Violation Type
ASD TargetN =35
NT TargetN=43
ASD TargetN =229
NT TargetN=259
ASD TargetN =49
NT TargetN=75
Verbal Bullying
N=15
Social Exclusion
N=20
Verbal Bullying
N=19
Social Exclusion
N=24
Verbal Bullying N=122
Social Exclusio
nN=107
Verbal Bullying N=138
Social Exclusion
N=121
Verbal Bullying
N=25
Social Exclusion
N=24
Verbal Bullying
N=39
Social Exclusion
N=36
Change in judgment(violates Levene’s)
x= -0.26sd = 0.60
x= 0.04sd = 0.83
x= -0.07sd = 0.38
x= -0.30sd = 0.94
x= 0.05sd = 0.53
x= 0.07sd = 0.61
x= 0.05sd = 0.49
x= -0.00sd = 0.67
x= -0.06sd = 0.43
x= 0.26sd = 0.76
x= -0.07sd = 0.62
x= 0.04sd = 0.56
F = 3.19p = .04p
2 = .01
Kruskal-Wallis Test:χ 2 (2,n=660) = 4.12, p = .13
F = 1.32p = .25p
2 =.002
F = 1.28p = .26p
2 =.002
F = 0.19p = .83p
2 =.001
F = 1.423p = .24p
2 =.004
F = 1.71p = .16p
2 =.01
Change in emotions
x= -0.14sd = 0.43
x= 0.06sd = 0.59
x= 0.10sd = 0.38
x= -0.18sd = 0.74
x= 0.00sd = 0.42
x= 0.02sd = 0.49
x= -0.02sd = 0.43
x= -0.03sd = 0.54
x= -0.13sd = 0.41
x= 0.13sd = 0.65
x= -0.01sd = 0.63
x= -0.01sd = 0.58
F = 0.12p = .89p
2 =.00
F = 0.04p = .85p
2 = .00
F = 0.19p = .66p
2 =.00
F = 0.11p = .90p
2 = .00
F = 0.66p = .52p
2 =.002
F = 2.03p = .11p
2 =.01Change in intended behaviour
x= -0.09sd = 0.54
x= -0.14sd = 0.57
x= -0.12sd = 0.48
x= -0.11sd = 0.71
x= -0.01sd = 0.47
x= -0.07sd = 0.58
x= -0.04sd = 0.56
x= -0.16sd = 0.52
x= -0.20sd = 0.55
x= 0.23sd = 0.83
x= -0.01sd = 0.50
x= -0.06sd = 0.79
F = 0.74p = .48Np2 = .002
F = 0.34p = .56p
2 =.001
F = 0.13p = .72p
2 = .00
F = 0.05p = .95p
2 =.00
F = 2.42p = .09p
2 =.01
F = 1.84p = .14p
2 = .01
b) Cognitive attitudes to autism
To test the hypothesis that an increase in personal exposure to autism would lead to a
greater increase in positive cognitive attitudes towards people with autism
(Hypothesis 4), an ANOVA comparing change in cognitive attitudes towards people
with autism according to change in personal exposure was conducted, also as a
custom model where gender and ethnicity were included as additional factors, but not
included in any interaction terms. Consistent with the hypothesis, this revealed a
significant effect of change in personal exposure, F(2,653) = 7.771, p < .001, p2
= .023. Post-hoc comparisons indicated that the mean score for the ‘Increase’ group
(M = 2.042, SD = 5.851) was significantly higher than the mean score for the
‘Decrease’ group (M = -0.932, SD = 4.421), p < .001.The mean score for the
‘Increase’ group was also significantly higher than the mean score for ‘no change’
group (M = 0.586, SD = 5.164), p = .019. This indicates that pupils who increased
their personal exposure to people with ASD had more positive cognitive attitudes
towards them than pupils who decreased their personal exposure and also pupils with
no change in personal exposure.
Decrease No change Increase
-1.5
-1.0
-0.5
0.0
0.5
1.0
1.5
2.0
2.5
Decrease
No changeIncrease
Change in Personal Exposure
Mea
n Ch
ange
Sco
re (r
aw m
eans
)
Note. * p < .05
Figure 5.4. Change in cognitive attitudes towards people with autism according to
change in personal exposure
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5.4 Discussion
This study investigated the attitudes of neurotypical children towards bullying and
towards people with autism according to educational exposure, personal exposure,
different targets of bullying and different bullying violations. It also explored the
quality of attitudes (i.e. judgements, emotions and intended behaviours) towards
these variables. The opening of purpose-designed and built specialist centres in three
mainstream schools in Surrey provided a unique opportunity to examine neurotypical
pupils’ evaluations of direct and indirect bullying towards people with ASD in
mainstream school settings with contrasting physical and social environments.
In line with the first hypothesis, results showed that pupils in HEES showed a greater
increase in prosocial emotions towards hypothetical bullying scenarios. Second, an
interaction showed that for participants in LEES, while there was a decrease in
prosocial emotions towards social exclusion when the target was NT, they reported
an increase in prosocial emotions when the target was autistic (matching participants
from HEES). Whilst hypotheses 3 and 4 could not be supported, data suggested
support for hypothesis 4 - that pupils who increase their personal exposure to people
with autism showed a greater increase in positive cognitive attitudes towards them
than pupils with no change or a decrease in personal exposure. Finally, results
highlighted a difference in the quality of attitudes revealed in the findings for
personal exposure compared to educational exposure. While personal exposure led to
greater changes in cognitive attitudes, educational exposure led to differences in
emotional responses to stigmatised peers more generally. These findings are
explained below.
Pupils with high educational exposure showed an increase in prosocial emotions
towards hypothetical bullying scenarios. There are many changes in social and moral
reasoning of children in this age-group. For example, they have a developing
understanding about morality, but may also prioritise group functioning and social
conventions in certain contexts (Killen & Rutland, 2011). Self-presentation is
important, but they are also able to control their explicit prejudice (Abrams et al.,
2009; Rutland, 2004; Rutland et al., 2005). Social Identity Development Theory
(Nesdale, 2004; 2007; 2008) suggests various phases of development in relation to 1.
strength of identity with a group; 2. the extent the outgroup is perceived as a threat;
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and 3. the extent prejudice is considered a norm. These factors can be influenced by
the school climate, i.e. schools that emphasise moral responsibility and a sense of
community can influence inclusive and exclusive peer group norms (Colby &
Kohlberg, 1987; Killen & Rutland, 2011). Chang (2004) studied social norms in the
classroom and found that they can affect behaviour. For example, if high levels of
withdrawal displayed by certain peers are an accepted norm, this is more accepted by
peers. The finding from the present study might therefore be explained by the
increased emphasis placed on establishing an inclusive culture and adjusting social
norms in HEES, leading to a greater sense of community and heightened prosocial
emotional reactions to bullying, irrespective of the violation or target.
The second finding showed that that for participants in LEES, while there was a
decrease in prosocial emotions in response to verbal bullying (for both targets) and in
response to social exclusion when the target was NT, interestingly they reported an
increase in prosocial emotions when the target was autistic (matching participants
from HEES). Verbal bullying is reported to be the most common form of bullying
(Ahmed & Smith, 1994; Bjorkqvist et al., 1992; Boulton et al., 2002) so a possible
explanation for the decrease in prosocial emotions for verbal bullying in LEES is that
it is accepted as a social norm in these schools, and hence more likely to be tolerated
in order to preserve group functioning and social conventions. In contrast, while
previous research suggests that social exclusion is least likely to be perceived as
bullying (Boulton, et al., 2002) it may be the case that perceptions are different when
the target has disabilities/SEN. Social exclusion of a peer with ASD may raise more
moral considerations for NT children, regardless of educational exposure. Further
research is needed to investigate this hypothesis further.
The third finding showed that pupils who increased their personal exposure to people
with autism showed more positive cognitive attitudes towards them. Accepting that
NT and ASD pupils are often perceived as representing different groups, this finding
can be explained by the contact hypothesis (Allport, 1954), which states that contact
between groups can disconfirm stereotypes and instil more positive attitudes, beliefs
and behaviours. Much research based on the contact hypothesis focuses on ethnic
groups, and reports less bias against different ethnic groups following high quality
cross-group friendship (Aboud, Mendelson & Purdy, 2003; Feddes et al., 2009).
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Fewer studies have explored the effects of contact with children with disabilities, but
from the limited studies, again findings indicate that contact leads to more liking of
and peers with disabilities and condemnation of their exclusion (Maras & Brown,
1996; Gasser et al., 2013). In contrast to many cross-sectional or correlational studies
where contact is reported at one time point, this study was longitudinal, collecting
responses at two time points (compared with a control group). Participants weren’t
randomised to HEES and LEES so there is a possibility other factors may contribute
to attitudes. But since changes in personal contact occurred prior to data collection at
follow up, there may be a tentative causal link between personal exposure and
subsequent attitudes.
Finally, results highlighted a difference in the quality of attitudes revealed in the
findings for personal exposure compared to educational exposure, whereby personal
exposure led to greater changes in cognitive attitudes whilst educational exposure led
to differences in emotional responses to stigmatised peers more generally. For
personal exposure, not only were there significant differences in cognitive attitudes
towards people with autism, but also in judgements towards the vignette (p = .04)
although this wasn’t reported since it violated the assumption of homogeneity of
variance. It does however point to a possible pattern in differences in the more
cognitive attitudes in response to personal exposure.
In contrast, for educational exposure, differences were found in emotion response,
supporting the findings of Gasser, Malti and Buholzer (2013) that moral emotions
indicate a greater likelihood to include children with disabilities than moral
judgements. The presence of significant differences in emotional responses and
absence of differences according to their judgements and intended behaviours points
to the possibility that children in HEES feel that bullying is not fair, and respond to
this in an emotional sense, but may not show increased prosocial cognitive responses
due to the importance of protecting their group and its social conventions. Rutland
and Killen (2011) explain how emotions are helpful but not vital to moral
understanding, reflecting Piaget’s (1932) view that moral emotions should not be the
basis of moral understanding, but instead, judgement and rationality. Indeed very
little research examines the emotions attributed to participants in bullying/excluding
scenarios. One such study by Malti, Killen & Gasser (2011) asked 12 and 15 year old
147
Swiss and non-Swiss adolescents to judge exclusion based on nationality and found
that Swiss participants (the ingroup) attributed fewer positive emotions to excluders.
The findings in the current study showed how participants similarly attributed
emotions to themselves as hypothetical bystanders (as members of the ingroup) and
for participants in HEES indicated a greater increase in prosocial emotions (anger,
pity, sadness and shame) and/or decrease in antisocial emotions (pride, excitement,
amusement and satisfaction) in response to the bullying of stigmatised people more
generally (the outgroup) irrespective of target type. These findings support Killen
and Rutland’s (2011) contextual perspective, which asserts that children evaluate
exclusion differently dependent on the context. They also highlight the importance of
encouraging both personal and educational exposure. Whilst it may be social norms
and group expectations within schools with high educational exposure that affect
prosocial emotions in response to bullying, personal contact is vital for positive
cognitive attitudes, and in support of Pettigrew (1998) simply attending a ‘mixed
school’ is not enough.
In summary, the results of this study found that i) children in schools with high
educational exposure to people with autism show increased prosocial emotions in
response to bullying, irrespective of the target or violation, ii) children in schools
with low educational exposure to people with autism generally report a decrease in
prosocial emotions with the exception of the social exclusion of ASD targets, where
they reported an increase matching those in HEES and; iii) positive cognitive
attitudes towards people with autism increase with personal contact. Explanations for
these findings drew on previous research exploring intergroup relations, contact
hypothesis and social identity development theory.
Implications for practice
These findings may have implications for education authorities in their consideration
of the physical and social school climates that not only meet the needs of children
with ASD, but also establish an inclusive normative climate, and sense of community
that may intensify NT children’s emotional reactions to bullying. They may also
have implications for schools with low educational exposure to autism for tackling
bullying. Schools with low educational exposure showed decreases in prosocial
emotions over the course of year 7, particularly for verbal bullying, indicating that
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they became more tolerant of this form of bullying. Anti-bullying programmes could
focus on both the moral and social conventional responses to direct and indirect
forms of bullying emphasising both cognitive and emotional factors of respective
roles in bullying scenarios. Furthermore, while thorough consideration of the
physical and social school climate is important, contact-based interventions are also
vital for improvements to attitudes towards people with ASD. Positive contact can
disconfirm stereotypes and increase liking between peers, as shown in the present
study, and in Study 5 (Ch.6), which used positive contact through group music
making to improve intergroup relations between NT and ASD peers.
Methodological limitations
This study had certain limitations. Given that the centres in the high educational
exposure schools had only recently opened, there is a possibility that an inclusive
school ethos had not yet been established to the extent to which more significant
differences could be measured compared to control schools. Unfortunately long-term
durability of these findings couldn’t be tested, due to the constraints of this study.
Further data collection, for example, when the participants reach Year 10, may
provide a better indication of this. A further possible limitation relates to multiple
comparisons associated with a three-way ANOVA. Whilst ANOVA adjusts for the
number of levels within a factor, it makes no such adjustment for the numbers of
factors and interaction in the design. There is a greater chance of a significant result
with more factors/interactions. Some advocate that alpha levels should therefore be
adjusted to account of multiple comparisons (Cramer, 2016). Others however believe
this to cause greater problems since doing so increases the potential for Type 2 errors
(Perneger, 1998). In particular Perneger advises against Bonferroni corrections when
assessing evidence about specific hypotheses. Alpha levels were therefore
maintained at .05.
Conclusion
In conclusion, research shows that children with autism experience higher prevalence
and more severe outcomes of bullying such as increased isolation and loneliness,
mental health difficulties and higher rates of suicidal ideation and attempts. Anti-
bullying interventions report mixed results, and while fidelity may be a factor it is
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suggested that this could also be due to heightened priority given to group
functioning and social conventions during early adolescence (Killen & Rutland,
2011). Nevertheless, studies show that schools with an inclusive normative climate
can reduce intergroup bias and that a comprehensive approach is needed to tackle
bullying of children with ASD. The present study therefore focused on attitudes of
NT peers and the school culture/climate, comparing the impact of high and low
levels of educational and personal exposure to people with autism on their attitudes.
Findings showed that that whilst personal exposure facilitated a greater increase in
positive cognitive attitudes towards people with autism, educational exposure
facilitated a greater increase in prosocial emotional responses to bullying of a more
abstract group of stigmatised people. The model of inclusion that enables higher
educational exposure to peers with autism provides NTs with increased awareness
and understanding of autism and may therefore have provided an inclusive normative
climate that is more accepting of difference and hence less tolerant of bullying.
Nevertheless, the findings also show that contact-based interventions are vital for
improvements to cognitive attitudes towards people with ASD. These results
highlight the importance of exposure at both educational and personal levels, and has
implications for models of inclusion and school interventions designed to instil
greater understanding and acceptance of stigmatised groups, and autism in particular.
A longitudinal research design is proposed, which explores whether pupils in schools
with high educational exposure to autism further increase their prosocial attitudes
through the establishment of a normative climate over time, and whether quality of
attitudes may also change with age.
The significant findings relating to personal exposure in this study indicate the
importance of contact-based interventions for improving attitudes towards children
with autism. The next chapter therefore presents a pilot trial evaluating the impact of
a contact-based intervention using group music-making on the prosocial attitudes of
neurotypical children towards their peers with autism.
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Chapter 6
Study 5: The impact of a school-based musical contact intervention
on prosocial attitudes, emotions and behaviours: A pilot trial with
autistic and neurotypical children
Overview
This thesis to date has explored the experiences of girls with autism, their parents
and teachers and illustrates that contact with those with autism may help to change
the attitudes of neurotypical children. This final study used a trial design to explore
the impact of contact through music on the attitudes, emotions and behaviours of
neurotypical children.
6.1 Introduction
The purpose of this final study was to explore further the attitudes towards autistic
children of neurotypical (NT) peers and how these might be influenced by
contextual factors such as their level of contact with people with autism. As
discussed in previous chapters, research indicates that the school climate can have a
great effect on the prevention of bullying (Kärnä et al., 2011; Ttofi & Farrington,
2011) and peer relationships are a key part of inclusion for pupils with special
educational needs (Ochs et al., 2001). However, social outcomes for pupils with
autism are often negative, which may be partly attributable to group identity and the
influence of self-presentation (maintaining a positive image) on attitudes during
early adolescence (Killen & Rutland, 2011).
One core component of inclusion is positive contact. The findings reported in
Chapter 5 indicate the importance of exposure at both educational and personal
levels, with personal exposure facilitating a greater increase in positive cognitive
attitudes towards people with autism. This reflects intergroup contact theory, which
states that, under appropriate conditions (equal status between groups, common
goals, intergroup cooperation, support from authorities and personal interaction)
151
intergroup contact is one of the most effective ways to reduce prejudice between
majority and minority members (Allport, 1954). Through communicating they are
able to understand each other’s points of view, and consequently, their prejudice
diminishes. As a result, members of groups can ‘reconceptualise’ their group
categories, and increase the ability to take the perspective of, and empathise with,
members of the outgroup.
One potential method of increasing contact in schools is through music lessons as
this enables the children to interact and learn with each other in a more relaxed and
less direct way than other classroom lessons. The advantages of using music to
increase positive contact between children with and without autism are manifold.
First, there are many benefits of music for children with autism, including
processing of affect (Allen et al, 2009a; Allen et al., 2009b; Heaton et al., 1999) and
encouraging interaction (Ockelford, 2013). In particular, a qualitative study of
adults with ASD found that people with autism experience emotional arousal from
listening to music, but may have difficulties verbalizing their emotional states when
they listen to music. Furthermore, results showed that music was used to increase
their sense of belonging and manage depression.
Second, music is known to facilitate social cohesion (Dunbar, 2012; Tarr, Launay
& Dunbar, 2014), although the capacity for group music making to improve social
skills is dependent on the promotion of positive interaction. Therefore when music-
making involves interaction, studies reveal positive social outcomes such as
increases in cooperative behaviour (Kirschner and Tomasello, 2010; Overy, 2012).
However music lessons with minimal contact show no such improvement
(Goldstein & Winner, 2012; Rose, Jones Bartoli & Heaton, 2017). Consequently
studies designed specifically to promote positive interactions through group music-
making have found increases in empathy (Rabinowitch, Cross & Burnard, 2013),
helping and cooperation (Gerry, Unrau & Trainor, 2012). However, these studies
lacked ecological validity since they were conducted in laboratory settings. In
response to this, Schellenberg et al. (2015) used the more naturalistic school setting
to investigate the effect of music making on social and emotional skills. This study
investigated if group music training could be associated with prosocial skills.
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Children, aged 8 and 9, received 10 months of music lessons that were specifically
designed to promote cooperation and positive interactions. Outcome measures
included vocabulary, emotion comprehension, sympathy and prosocial skills, tested
at the beginning and end of the training period. Results showed a greater increase in
sympathy and prosocial behaviour in comparison with a control group, but only for
pupils who had poor social skills at the beginning of the study. While Schellenberg
et al.’s study tested the impact of the music programme, the present study used a
music programme not only for its known facilitation of social cohesion, but also as
the vehicle for providing positive contact between neurotypical and autistic
children. Further, the present study focused specifically on prosocial attitudes,
emotions and behaviours (including additional areas not measured in the previous
study such as tendency to bully and tendency to be a victim). Finally the present
study explored the impact of contact through the music programme on both ingroup
(NT) and outgroup (ASD) members.
Aims
The primary aim of the present study was therefore to measure the impact of music-
based contact on prosocial attitudes, emotions and behaviours of neurotypical
pupils. As such, and in line with previous research suggesting that contact leads to
more liking of peers with disabilities and condemnation of their exclusion (Maras &
Brown, 1996; Gasser et al., 2013), it tested the hypothesis that NT children in the
contact condition will show a greater increase in prosocial attitudes and in prosocial
judgements, emotions and intended behaviours towards vignettes depicting social
exclusion of an autistic peer than NT children in the no-contact condition. In
addition, the secondary aim was to compare prosocial attitudes, emotions and
behaviours of pupils with autism before and after a music-based intervention,
although it is recognised that numbers are small for this analysis. This was a pilot
study as it was small scale and randomisation was not feasible, but it provides some
preliminary insights into the impact of contact through music.
153
6.2 Method
Design
This was an intervention study design using quantitative methods to obtain self-
reported measures. All children took part in music groups and for the primary aim
the study compared independent samples, where the between-participants factor
was NT children’s contact with autistic peers during a music-based intervention
(contact vs. no-contact). The dependent variables were the degree of change over
the course of the intervention in participants’ prosocial attitudes, emotions and
behaviours (scales outlined below). For the secondary aim, a within-participants
analysis was conducted for the differences between baseline and follow-up scores
of the pupils with autism, of their prosocial attitudes, emotions and behaviours
(scales outlined below).
Participants
Participants were children in Years 5 and 6, recruited from one mainstream primary
school in Surrey. An ‘opt-out’ consent procedure was employed for parental
consent and children could also choose not to participate on the day of testing. This
resulted in the recruitment of 65 pupils: 55 NT pupils aged 10-11 and 10 pupils
with special educational needs, aged 9-11, eight with a diagnosis of an autism
spectrum disorder (ASD), verified by the school SENCo. The pupils without a
diagnosis of ASD had autistic characteristics. Nine attended the school’s specialist
resource centre (SRC) for children with special educational needs. Some pupils had
additional characteristics. These are shown in Figure 6.1. All were considered by
the SENCo to be suitable participants for the intervention. Of the original sample,
six NT pupils and five ASD pupils provided no data at the end of the intervention
(Time 2) so these were removed from the dataset. Of the five ASD pupils with no
data at Time 2, three still attended the whole programme. The NT sample therefore
consisted of 49 participants (20 male; 29 female). The mean age at Time 2 was
10.37 years (SD = 0.49 years). 42 participants (85.7 %) were white. The ASD
sample consisted of 5 participants (all white males aged 10 at Time 2).
154
Class 1a: Contact
NT children: n = 12Boys = 5Girls = 7
ASD children: n = 5Boys = 5Girls = 0
1. ASD, ADHD2. ASD3. Global delay, Speech
& language delay4. ASD5. ASD, PDA, ADHD
Class 1b: Contact
NT children: n = 12Boys = 5Girls = 7
ASD children: n = 5Boys = 5Girls = 0
1. ASD, Cerebral palsy, Anxiety
2. ASD, ADHD, Selective mute, Anxiety
3. ADHD, Growth hormone deficiency, Social communication disorder, Speech and language delay
4. ASD, BESD5. ASD, ADHD
Class 2: No contact
NT children: n = 25Boys = 10Girls = 15
Figure 6.1. Attendance for each group (contact vs. no contact)
Procedure
At the beginning of their school year (Time 1), all children were asked to complete
baseline measures described below. The study was conducted in two school
classrooms with a teacher always present. Pupils were informed that the researcher
was interested in finding out about their attitudes towards themselves and their
peers and provided with information about what they would be asked to do if they
agreed to participate. Before the questionnaire was completed, the researcher read
aloud the instructions on the front of the questionnaire including what they should
do if they don’t understanding something, how they should answer questions and
emphasizing that their answers would be anonymous. Questionnaires were the same
for all NT participants, except for questions relating to the vignette, in which the
characters’ gender matched to the participant. ASD participants were not given the
vignette or questions relating to it. Questionnaires were paper-based, and completed
under controlled conditions. The children with autism completed questionnaires
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separately with one-to-one help from teaching staff. NT participants were given
approximately 30 minutes to complete the questionnaire.
NT participants belonged to two previously established form groups called ‘Class
1’ (n=24; contact) and ‘Class 2’ (n=25; no-contact) for the purposes of this study.
Class 1 was selected as the contact group since it contained one of the ASD pupils
(the remainder joining them from the SRC). Class 1, together with the children with
ASD were split into two groups (1a and 1b) (with half the ASD children in each
group), providing a ratio of 1:2/3 ASD:NT pupils in the contact group. They
received 11 weekly singing classes – 35 minutes in length – that were specifically
designed to help children develop their social skills, musical engagement and
communication between singers. In general ASD pupils were able to participate
fully. Teaching assistants were present, but enabled them to participate
independently, only intervening on occasions when a pupil required additional
support, e.g. to leave the room for periods if they were feeling anxious, or if they
were finding an activity particularly challenging. On occasion behavioural
challenges emerged, e.g. a minor conflict causing one ASD pupil to be moved from
one contact group to the other contact group. Two of the ASD pupils dropped out
near the beginning of the programme (causing minimal impact on the group
dynamic), resulting in a ratio of 1:3 ASD:NT pupils in the contact group. Class 2
also received the singing classes, but without any children with ASD present. All
children completed the same measures again at the end of the three-month
intervention period (Time 2).
The effect of the intervention on prosocial attitudes, emotions and behaviours of NT
pupils in the contact group was compared to those of the no-contact group. In
addition, the differences in scores of ASD pupils between Time 1 and Time 2 were
considered.
Questionnaire
Participants completed the following:
Demographics: Pupils were asked to provide demographic information (gender, age
and ethnic background). They were also asked three identifier questions enabling
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baseline and follow-up questionnaires to be matched without the use of pupil
names.
Scales
i. Prosocial behaviour was measured using the 10 items from the Social
Behaviour Questionnaire (Tremblay et al., 1991), modified for self-report
(rather than teacher-report). Items assessed helping, sharing, kindness and
conflict resolution (e.g. ‘If I saw someone who had been hurt, I tried to help
them’; ‘I invited other children to join in my game’, etc.). Participants
reported on a five-point scale (1 = not at all like me; 5 = extremely like me).
Scores were averages of the 10 ratings. The scale had a good internal
consistency, with Cronbach’s alpha coefficient of .81 (T1) and .81 (T2)
ii. Sympathy was measured using the seven-item Child-Report Sympathy
Scale (Eisenberg et al., 1996), modified so that children made responses on
a five-point scale instead of a three-point scale (1 = not at all like me; 5 =
extremely like me). Scores were averages of the seven ratings. The scale
had good internal consistency, with Cronbach’s alpha coefficient of .88 (T1)
and .83 (T2).
iii. Tendency to be a victim was measured using the victim scale (five items)
from the Bullying Prevalence Questionnaire (Rigby & Slee, 1993). The
scale included items such as ‘I got called names on purpose’ and responses
were given on a four-point scale (1 = never; 2 = once in a while; 3 = pretty
often; 4 = very often). The victim scale had a Cronbach’s alpha .86 at T1
and .88 at T2.
iv. Tendency to bully was measured using the bully scale (six items) from the
Bullying Prevalence Questionnaire (Rigby & Slee, 1993). The scale
included items such as ‘I enjoyed upsetting wimps, someone I could easily
beat’ and responses were given on a four-point scale (1 = never; 2 = once in
a while; 3 = pretty often; 4 = very often). The bullying scale had low
internal consistency. Even after removing two negatively correlating items
(‘I liked to make others scared of me’ and ‘I liked to get into a fight with
someone I could easily beat’) the Cronbach alpha coefficients were still only
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.50 at T1 and .60 at T2. However, previous studies report Cronbach’s alphas
of .75 and .78.
Vignette
NT pupils were asked to read a vignette. The vignette drew on previous studies and
drafts were scrutinized for sense, clarity, cultural neutrality and validity. The
vignette depicted a child with autism being socially excluded - since social
exclusion is a common outcome for children with autism due to their social
difficulties and their peer group’s lack of awareness/reduced acceptance of
difference (Humphrey & Symes, 2011). Once finalized, the vignette was subjected
to a pilot testing process and amended accordingly. [See Appendix R for the
vignette.]
Scales in response to vignette
Developed, in line with similar previous studies (Studies 3 & 4 of this thesis; Jones,
et al., 2009; Swaim & Morgan, 2001) (NT participants only)
v. Judgements towards treatment of a target of bullying with ASD: Pupils
indicated their agreement on five-point Likert scales ranging from ‘not at
all’ to ‘extremely’. The set of eight items related to judgements of the
treatment of the target of bullying in a vignette, including 4 prosocial
judgements (e.g. ‘How much do you think what happened to Emily/Jack was
mean?’) and 4 antisocial judgements (e.g. ‘How much do you think what
happened to Emily/Jack was funny?’). Cronbach’s alpha coefficients
were .69 (T1) and .75 (T2)
vi. Emotions in response to the bullying of a target with ASD: Pupils indicated
their agreement on five-point Likert scales ranging from ‘not at all’ to
‘extremely’. The set of eight items related to their emotional response to the
incident, where pupils were asked, ‘How strongly do you think you would
feel the following emotions…?’ with 4 prosocial items (e.g. ‘angry’, ‘sad’)
and 4 antisocial items (e.g. ‘excited’, ‘satisfied’). Cronbach’s alpha
coefficients were .66 (T1) and .71 (T2).
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vii. Intended behaviours in response to the bullying of a target with ASD: Pupils
indicated their agreement on five-point Likert scales ranging from
‘definitely not’ to ‘definitely’. The set of eight items concerned their
intended behaviours in response to the bullying scenario. Again there were 4
prosocial items (e.g. ‘How likely would you be to report it to a teacher?’,
‘How likely would you be to smile at Emily/Jack to show support for
her/him?’) and 4 antisocial items (e.g. ‘How likely would you be to do
nothing?’, ‘How likely would you be to laugh’). The scale had low internal
consistency. After removing two negatively correlating items (‘Apologise to
Emily/Jack’ and ‘Encourage Amy/William to keep ignoring him’) the
Cronbach alpha coefficients were .70 (T1) and .71 (T2).
viii. Open format questions : At T2 only, participants were also given 4 open-
format questions about the intervention, asking what they liked best, what
they didn’t like, how well their group worked together and if there is
anything else they want to say.
[See Appendix R for the full questionnaire.]
Music Programme
A feasibility study was conducted, consisting of in-depth interviews with two music
teachers from mainstream primary schools, exploring current practices for teaching
music, methods of including children with autism in music lessons and the
manageability and fitness for purpose of the proposed music programme. In
accordance with the findings, an 11-week music programme was designed and
implemented by an external consultant, experienced in the delivery of singing
courses for children. The programme specifications were as follows:
Suitable for implementation in classrooms with up to 30 children
Age appropriate and inclusive of all ability levels
Every session to include opportunities for pair/group work and for
groupings to allow all NT children to work with ASD children at
various points throughout the term
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Enable pupils within each class to work on a project together (e.g.
write a song) across the course of the term
Take into consideration the individual needs of children with ASD to
help them feel engaged in the sessions
As far as possible, provide a positive experience for all
A short interview with the music consultant at the end of intervention provided
further information about its design and implementation. Care and attention had
been given to the needs of the children with autism, to ensure that all activities were
inclusive, and that a clear structure was provided at the beginning of each session
(i.e. warm ups - song-writing - singing games). To achieve the objective of ensuring
interaction between NT and ASD pupils, she paired children up for clapping games,
provided opportunities for all children to be ‘leaders’ for warm ups and enabled
group work for song-writing activities. She reported that pupils were very
enthusiastic, and became quite immersed in writing Christmas-themed songs (e.g.
about husky rides and advent calendars), with all children contributing to the words
and melodies. Some children were so inspired that they wrote their own songs out
of school and brought them in to be used in sessions. Others used the singing games
in the playground, inviting larger groups of pupils to join them.
A couple of problems were reported: discipline was not always controlled, and the
behaviour of a number of pupils (usually NTs) disrupted the positive experience for
the rest of the class. The music consultant felt there was a difference in level of
maturity between the boys and girls, with the girls generally more mature.
Recommendations for future were to keep class sizes the same and larger like Class
2 (since Class 2 had more confidence due to having more singers to a part), and to
only include pupils of the same year group (the first group included Y5 ASD
pupils) since this may have affected social interactions. Overall the consultant felt
it was a genuinely positive experience for most, and noticed a number of incidences
when NT pupils showed real compassion and consideration for the children with
ASD.
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Data analysis
The data were analysed in the following ways:
i.) To screen data for missing values and normality
ii.) To compare NT participant demographics for those in contact and no-
contact groups using t tests and χ2
iii.) To explore the effect of contact on NT participants’ changes in prosocial
behaviour, sympathy, tendency to bully/be victimized and attitudes towards
the vignette using t-tests/Mann-Whitney U tests
iv.) To explore the degree of change for those with ASD in their prosocial
behaviour, sympathy and tendency to bully/be victimized using Wilcoxon
signed ranks tests
v.) To consider open-format questions, comparing answers of those in contact
and no-contact groups
6.3 Results
i) Data screening
Missing value analysis revealed no problems regarding patterns of missing data.
For cases where one item was missing within a subscale, the mode of the supplied
scores was imputed. Preliminary checks were conducted to ensure that there was no
violation of assumptions of normality. Four of the variables were skewed (tendency
to be a victim; tendency to be a bully; judgements; emotions) and there were a
number of variables with positive kurtosis. Table 6.1 shows skew and kurtosis
values of change scores. All except one variable (tendency to bully) showed
homogeneity of variance. Mann-Whitney U/Wilcoxon signed ranks tests were
conducted for scales that violated assumptions of normality. Alpha was set to .05.
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Table 6.1
Skew and Kurtosis Values of Change Scores
Skew KurtosisExperimental Group Total Prosocial Behaviour 0.99 0.83
Total Sympathy 0.49 -0.75Total Tendency to be a Victim -3.10 3.05Total Tendency to be a Bully -3.42 4.07Total Judgements -5.09 8.76Total Emotions 3.92 4.44Total Intended Behaviours -0.06 -0.58
Control Group Total Prosocial Behaviour 1.83 1.28Total Sympathy 0.48 -0.24Total Tendency to be a Victim 1.35 2.52Total Tendency to be a Bully 4.57 8.72Total Judgements 1.40 0.32Total Emotions -1.83 2.95Total Intended Behaviours -1.92 3.41
ii) Differences in NT participant demographics by group
Comparisons of participant demographics by group revealed no significant
differences by gender, age at T2 or ethnic background (see table 6.2).
Table 6.2
Differences in Participant Demographics by Group (NT children)
Group
t/chi squared p
Contact(with ASD pupils)(N = 24)
No contact(without ASD pupils)(N = 25)
Gender M = 10 (41.7%)F = 14 (58.3%)
M = 10 (40.0%)F = 15 (60.0%)
χ 2 = 0.00(1)
1.00
Age at Time 2 x = 10.33sd = 0.48
x = 10.40sd = 0.50
t = -0.48(47)
.64
Ethnic Background
BME = 2 (8.3%)White = 20 (83.3%)Other = 2 (8.3%)
BME = 3 (12.0%)White = 22 (88%)Other = 0 (0%)
χ 2 = 2.28(2)
.32
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iii) The effect of contact on change scores for NT participants
The impact of contact is shown in Table 6.3.
Table 6.3
Descriptive Data and t-test/Mann-Whitney U Results for Change Scores by Group
(NT children)
Scale Contact(with ASD pupils)N= 24
No contact (without ASD pupils)N= 25
t-test Mann-Whitney U
i. Prosocial behaviour x= 0.27sd = 0.55
x= 0.14sd = 0. 48
t (47) = .89p = .38p
2 = .02ii. Sympathy x= 0.12
sd = 0.53x= 0.25sd = 0. 72
t (47) = -.70p = .49p
2 = .01iii. Tendency to be a
victimx= -0.38sd = 0.66Md = -0.20
x= 0.13sd = 0. 66Md = 0.00
t (46) = -2.63p = .01p
2 = .13
U = 166Z = -2.56p = .01r = .37
iv. Tendency to be a bully x= -0.06sd = 0.18Md = 0.00
x= -0.01sd = 0.14Md = 0.00
t (46) = -1.11p = .27p
2 = .03
U = 260Z = -.76p = .45r = .11
v. Judgements (vignette) x= -0.11sd = 0.55Md = 0.00
x= 0.10sd = 0.51Md = -0.06
t (45) = -1.39p = .17p
2 = .04
U = 255Z = -.45p = .65r = .07
vi. Emotions (vignette) x= 0.19sd = 0.29Md = 0.00
x= -0.05sd = 0.52Md = -0.13
t (46) = 1.97p = .06p
2 = .08
U = 191.5Z = -2.02p = .04r = .29
vii. Intended behaviours (vignette)
x= 0.02sd = 0.48Md = 0.00
x= -0.11sd = 0.60Md = -0.17
t (46) = .84p = .41p
2 = .02
U = 271.5Z = -.35p = .73r = .05
Bold denotes significant difference between groups
Independent samples t-tests/Mann-Whitney U tests revealed no significant
differences in the change scores of participants in contact and no-contact groups for
prosocial behaviour, sympathy, tendency to be a bully, judgements towards the
vignette and intended behaviours towards the vignette. However, an independent
samples t-test revealed a significant difference in the change in tendency to be a
163
victim scores of participants in the contact group compared to those in the no-
contact group. The effect size was large. Since the data violated assumptions of
normality, a Mann-Whitney U test was also conducted, which also revealed a
significant difference between contact group and no-contact group. The effect size
was medium. Participants in the contact group therefore showed a larger decrease in
tendency to be a victim than participants in the no-contact group. Furthermore, in
support of the study’s hypothesis, an independent samples t-test also revealed a
greater change in emotions scores of participants in the experimental group
compared to those in the control group, which was approaching significance with a
medium effect size. Since the data violated assumptions of normality, a Mann-
Whitney U test was also conducted, which revealed a significant difference
between contact group and no-contact group, indicating that participants in the
contact group showed a greater increase in prosocial emotions in response to the
vignette than participants in the no-contact group. The effect size was medium.
Figures 6.2 and 6.3 present graphs of the mean scores at Time 1 and Time 2 for
each of the variables that revealed significant differences between contact and no
contact groups.
Contact No Contact0.0
0.5
1.0
1.5
2.0
2.5Time 1Time 2
Mea
n te
nden
cy to
be
a vi
ctim
scor
e
Note. * p < .05 (significant impact of condition on change score)
Figure 6.2. Mean scores at Time 1 and Time 2 for tendency to be a victim
164
Contact No Contact4.25
4.30
4.35
4.40
4.45
4.50
4.55
4.60 Time 1Time 2
Mea
n pr
osoc
ial e
mot
ion
scor
e
Note. * p < .05 (significant impact of condition on change score)
Figure 6.3. Mean scores at Time 1 and Time 2 for prosocial emotions
iv) Effect of intervention on scores of pupils with autism
Changes for those with autism are shown in Table 6.4.
Table 6.4
Descriptive Data and Wilcoxon Signed Rank Test Results for Differences in Scores
Between Time 1 and Time 2 in Children with Autism
Scale Time 1N= 5
Time 2N= 5
Wilcoxon signed rank test
i. Prosocial Behaviour x= 3.4sd = 0.5Md = 3.5
x= 3.52sd = 0. 97Md =3.70
z = -.14p = .89r = .04
ii. Sympathy x= 3.4sd = 0.9Md =3.71
x= 3.66sd = 0. 92Md =3.43
z = -.41p = .69r = .13
iii. Tendency to be a victim x= 2.4sd = 0.68Md = 2.60
x= 1.96sd = 0. 75Md = 1.80
z = -.18p = .07r = .58
iv. Tendency to be a bully x= 1.23sd = 0.56Md = 1.00
x= 1.27sd = 0.35Md = 1.17
z = -.38p = .71r = .12
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There were only five participants in this sample, and for pragmatic reasons it was
not possible to compare their data with a control group of autistic pupils who
received the intervention with no contact with NTs. Nevertheless it is still
interesting to consider differences in their scores between Time 1 and Time 2. The
table above indicates little variation in scores from Time 1 to Time 2, with the
exception of scale 3 (Tendency to be a victim). Whilst the Wilcoxon signed rank
test p value was only approaching significance, the small sample size represents a
greater probability of a type II error and there was a very large effect size, reflecting
a decrease in mean scores of 19.7% from T1 to T2. It should be emphasised that,
without a control group, we cannot assume that the intervention caused the decrease
in autistic participants’ tendency to be a victim. There are other factors that may
have also influenced the decrease in scores. It is interesting, nevertheless, to
observe this decrease over the course of the intervention.
v) Open-format questions
Responses from NT children to the open-format questions were mainly very
positive. There was little difference in responses from contact group and no-contact
group participants. Many participants expressed positive responses to the
intervention, e.g.:
The music lessons involved fun singing games that carried into the
playground. (Experimental Group participant)
I liked making up songs and playing funny games like 'Here comes Sally'. I
also liked how we were able to express ourselves and say our ideas.
(Experimental Group participant)
It was very fun and it made everyone smile and happy. (Control Group
participant)
I liked that we always had fun and we could relax and be ourselves. The
lessons were great and Mrs Smith [pseudonym] was very kind. We had lots
of fun and we didn't want it to end. (Control Group participant)
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Elements they didn’t like so much included the warm-ups and the misbehaviour of
some of the children, which affected their enjoyment. Many reported a general
improvement, however, in how well their group worked together over the course of
the term:
At the start it was a bit hard, but over the weeks we got to know each other
and cooperated better. (Experimental Group participant)
I think that our group worked well together and we made friends with other
people. (Experimental Group participant)
I think it changed a lot because at the start we didn't know how to work
together but at the end we got more used to it. (Experimental Group
participant)
I was happy with my group and I noticed everyone got more confident with
their singing and performing to each other. (Experimental Group
participant)
At first we all weren't very good at working as a team and after we were all
playing the games in the playground with other classes. (Control Group
participant)
We worked well as a team and some people really changed their behaviour
in class. (Control Group participant)
Overall, participants reported high levels of enjoyment and group-bonding, and a
desire to continue the course in the future.
6.4 Discussion
The present study was a pilot trial evaluating the impact of a one-term music-based
intervention with autistic children on the prosocial attitudes, emotions and
behaviours of their neurotypical peers. It further compared the attitudes of pupils
with autism before and after the intervention.
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Results showed that although the intervention had no impact on prosocial
behaviour, sympathy, tendency to bully and judgements/intended behaviours in
response to social exclusion, a significant increase in prosocial emotions was found
for children exposed to peers with autism, compared to those not exposed, in
response to a hypothetical bullying scenario depicting a child with autism being
excluded. In addition they showed a significant decrease in tendency to be a victim.
One possible explanation for the absence of differences in change scores for the
first four measures is that they are not specific to autistic children, but rather they
represent general non-group-specific measures of prosociality, sympathy and
tendency to be a victim/bully. A second is that the school ethos is already very
prosocial - reflected by the high scores at T1 – so differences from T1 to T2 and
also between contact and no-contact groups would be minimal. It could furthermore
be explained from a social-cognitive developmental perspective emphasizing
changes in social and moral reasoning found in children around this age. In middle
childhood, while children frequently use social-conventional reasoning, they often
prioritise moral reasoning when faced with intergroup aggression (Palmer, Rutland
& Cameron, 2015; Killen & Rutland, 2011), so this may have lessened the
differences between contact and no-contact groups since it may be that the majority
(regardless of contact) were morally inclined to reject social exclusion of out-group
members. Killen and Rutland (2011) found that older children coordinate both
social conventional and moral reasoning, but may be more likely to give priority to
group functioning and social conventions in certain intergroup contexts. It would be
interesting therefore to test older children to see if there is a greater effect between
contact and no-contact groups.
The studies cited above adopt social domain theory, testing social-moral reasoning
and behavioural intentions rather than emotions. Indeed, Killen and Rutland (2011)
suggest that children’s understanding of intergroup contexts is through their use of
cognitive skills and social-moral reasoning. Conversely, research drawing on
intergroup emotion theory (Mackie, Devos & Smith, 1999) has found that group-
based emotions can be associated with behavioural intentions for younger children
(aged 10/11) and that the level of emotion in response to bullying scenarios is
168
moderated by how strongly children identify with their group (Jones et al., 2009).
In the present study there was a significant increase in prosocial emotions, but not
in the measures testing more cognitive beliefs and judgements mentioned above. It
is conjectured that the result might therefore reflect social-developmental factors
relating to differences in the processing of emotions compared with the more
cognitive beliefs, judgements and behavioural intentions.
In partial support of the study’s hypothesis, participants in the contact group
indicated a greater increase in prosocial emotions (anger, pity, sadness and shame)
and/or decrease in antisocial emotions (pride, excitement, amusement and
satisfaction) in response to the vignette than those in the no-contact group. The
finding can be explored through consideration of the way music itself can instil
prosocial emotions. While the focus was on positive contact, the musical experience
itself could also have resulted in interpersonal ‘synchrony’, described as the
temporal coordination of biological events, social behaviours or affective states
(Kirschner, Tomasello, 2009; Wiltermuth & Heath, 2009). The synchronisation of
pulse and pitches in music leading to synchronous motor movements (such as
dancing and singing) has been found to weaken boundaries between the individual
and the group, leading to feelings of collective cohesion and increases in
cooperative behaviours (Anshel & Kippler, 1988; Judd & Pooley, 2014). Music
making is inherently social and an ideal vehicle for the development of synchrony
between participants and hence prosocial development. This is consistent with the
increase in prosocial emotions and also appears to be evidenced by responses to the
open-format questions. However these studies do not place an emphasis on
intergroup relations in improving attitudes towards out-group members. This will
be considered below.
Participants in this study imagined themselves watching the bullying scene depicted
in a vignette, not dissimilar to the role of bystander in a real bullying scenario.
Previous research has shown that prosocial bystander intentions are mediated by in-
group identification. For example, Palmer, Rutland and Cameron (2015) found that
children are more likely to support a victim if the victim is from their own group. In
the present study, it is possible that participants in the contact group showed a
169
greater increase in prosocial emotions in response to an autistic victim of bullying
since they associated the victim in the vignette with autistic peers in their own
group. In social psychology literature, this is defined as ‘recategorisation’, i.e.
members of different groups recategorise themselves as members of the same group
(Gaertner & Dovidio, 2000).
Intergroup contact has been shown to promote positive attitudes (Allport, 1954) and
reduce discrimination between groups. In this study, Allport’s optimal conditions
were met (i.e. equal status, common goals, opportunities for cross-group friendship
and general sanctioning of the goals of integration from the authorities). There is
much research indicating that contact between children of different groups reduces
prejudice (Feddes et al., 2009; Rutland et al., 2005). The greater increase in
prosocial emotions of the contact group in this study suggest that intergroup contact
may have promoted congruent intergroup attitudes and could therefore reduce the
potential for discrimination.
A further finding was that the contact group showed a decrease in the tendency to
be a victim (compared to a small increase by those in the no-contact group). This
could be as a result of lower levels of victimisation in the contact group, e.g. due to
the strengthening of social bonds between members and a reduction of uncertainty
associated with intergroup conflict (Hogg, 2000, 2012). It might also be attributed
to an increase in resilience, since positive relationships have been found to be
important criteria for resilience to victimisation (Flaspohler et al., 2009; Freitas et
al., 2017).
Of interest is the decrease in victimisation for the pupils with autism (a decrease of
19.7% from T1 to T2). While this was only approaching significance, it was a very
small sample, and hence a greater probability of a type II error. If positive contact
can reduce tendency to be a victim, it could prevent a number of negative outcomes
associated with victimisation, e.g. anxiety, depression, low self-esteem and physical
complaints (Smith, Lorenzo, Cowie, Naylor & Chauhan, 2004) and depression later
in life (Ttofi, Farrington, Lösel & Loeber, 2011). Having friends can protect
against the risk of victimisation (Hodges, Malone & Perry, 1997; Kochenderfer &
Ladd, 1997; Naylor & Cowie, 1999; Smith et al., 2004) and this is even more
170
crucial for improving social outcomes for children with autism. A study by Smith et
al. (2004) compared friendships, behavioural characteristics, victimisation
experiences and coping strategies of pupils who had identified themselves as
victims or non-victims two years earlier. Participants who reported being victims at
the start, but had ‘escaped’ being a victim 2 years on reported that they had tried to
have more or different friends. Indeed, the existence of peer-support systems in
schools creates a positive ethos and has been found to be an effective way for
victims to establish friendship networks (Naylor and Cowie, 1999).
It is acknowledged however that peer-support systems and friendship networks may
be more challenging to achieve when the victims are children with autism.
Humphrey and Symes (2011) explained the underlying mechanism causing the
increased risk of victimisation for children with autism in their reciprocal effects
peer interaction model. This explains how the impairments characteristic of
children with autism (e.g. difficulties in social understanding and lack of social
skills) combined with the characteristics of neurotypical children (e.g. lack of
awareness/understanding of autism, low acceptance of difference and atypical
behaviour) lead to reduced quality and frequency of peer interactions, limited social
networks and ultimately greater vulnerability to victimisation. They stressed that
having peers who are committed to developing positive relationships is crucial for
improving social outcomes for students with autism, and that sensitively handled
approaches for raising awareness and understanding of autism would help to
increase acceptance of difference. They recommend a ‘two-pronged’ approach
targeting both included students with autism and their peers. The intervention used
in this study represents a possible sensitive approach targeting both groups of
students that could be developed for future use.
In summary, the results of this study found that prosocial emotions towards the
social exclusion of a child with autism can be improved for neurotypical children
through positive music-based contact. Furthermore their tendency to be a victim
decreases. Explanations for these findings drew on previous research exploring
intergroup relations, the use of music for social cohesion and the importance of
friendship to reduce victimization.
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Implications for practice
These findings may have implications for tackling social exclusion for children
with autism in junior schools. For example, anti-bullying programmes could focus
on emotional elements of bullying/social exclusion and the best ways to act on
these emotions. In secondary schools, where older children might accept social
exclusion to protect group functioning (Rutland & Killen, 2011), anti-bullying
interventions should also focus on group processes and issues relating to morality
and intention to harm. Furthermore, contact-based interventions such as this
provide a way for those feeling victimised to experience positive social interactions
and make more/different friends (key for the reduction of victimisation). The use of
music is ideal for such an intervention since, through interpersonal synchrony, it
bonds individuals together and increases a sense of cohesion. Schools might
consider adopting such an approach for tackling bullying/social exclusion of pupils
who have autism/other special educational needs. Given that increasing numbers of
children with autism are included in mainstream educational settings, this presents
an ideal opportunity for them to develop social skills, but also for neurotypical
children to become more accepting of children who are ‘different’.
Methodological limitations
This study had certain limitations. The long-term durability of these findings
couldn’t be tested, due to the constraints of this study. It should also be emphasised
that the present study functioned as a pilot trial with only two groups and no
random assignment. Hence, future research might develop the intervention for use
with matched samples across schools, over a longer time period and with
randomised allocation of pupils to experimental and control groups. It would also
be interesting to test adolescents, (in light of findings by Killen and Rutland (2011)
that older children justify group functioning over fairness) to explore whether
positive music-based contact enables re-categorisation, increasing the differences in
prosocial attitudes between contact and no-contact groups.
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Conclusion
In conclusion, research shows that intergroup relations can be improved and
bullying behaviours reduced through positive contact enabling the establishment of
peer relationships. This is important for children with autism, for whom social
exclusion is common due to factors relating both to their social difficulties and also
to lack of understanding/low acceptance of difference by their peers.
Psychologically, social exclusion can have significant detrimental effects, such as
increased isolation and loneliness, difficulties establishing trusting relationships and
low self-esteem. This present study found that positive contact through group
music-making facilitated a greater increase in prosocial emotional responses to
social exclusion of a child with autism. Furthermore, results indicated that it helped
children to feel less victimised. Interventions such as this can meet curriculum
music targets, and at the same time provide opportunities for social inequalities to
be reduced and the negative outcomes these have on the achievement and wellbeing
of children with autism.
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Chapter 7
Discussion
7.1 Overview
Research relating to inclusion, peer-relationships and bullying illustrates an
association between the social challenges faced by children with autism and
stigmatisation, vulnerability to peer rejection and bullying in school. The serious
long-term outcomes of these kinds of victimisation include anxiety, depression, low
self-esteem and school avoidance. Coupled with the higher bullying prevalence
rates for children with autism they necessitate the need to address the impact of
inclusion on children with autism, and in particular, the factors that may be
influencing the attitudes of their neurotypical peers.
While we know that children with autism face a number of social challenges and
are at significantly greater risk of peer rejection and bullying, less is known about
the lived experiences of young people with autism, particularly girls, or how
teachers meet their needs in different types of school settings. Additionally, whilst
it is known that the attitudes and behaviour of neurotypical children can be
influenced by the school setting, research investigating the impact of different
levels of educational and personal exposure on attitudes of neurotypical children
towards autism is scarce. The empirical studies conducted for this thesis therefore
aimed to address these gaps.
Specifically, the thesis aimed to (1) explore the experiences of learning, friendship
and bullying of adolescent girls with autism and those of their parents, comparing
accounts of those in mainstream compared to special school settings; (2) explore
the wider contextual issues facing teachers of pupils with autism in mainstream and
special school settings; (3) examine differences in neurotypical children’s attitudes
towards bullying and autism according to educational and personal exposure to
autism, and; (4) evaluate the impact of a contact-based intervention using group
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music-making on the prosocial attitudes of neurotypical children towards their
peers with autism.
This final chapter presents a summary of findings from each of the empirical
studies, outlines the key themes and their relationship to existing literature (the
Synthesis), discusses implications for theory and practice, and highlights the
methodological limitations associated with these studies with recommendations for
future research.
7.2 Summary of findings
Study 1 used a qualitative design to explore experiences of learning, friendships and
bullying of girls with autism. Semi-structured interviews were conducted with 11
girls with autism, aged 12 – 18 years, and one parent of each girl. Thematic analysis
identified key themes relating to motivation to have friends, challenges for girls
with autism and the notion that many girls tend to mask their autism, which had
both positive and negative consequences. Overall, the girls were motivated to have
friends, albeit with a different perception of friendship, but often encountered social
difficulties and were sometimes targeted for bullying. Girls in mainstream settings
reported higher levels of school absenteeism and an increased tendency to mask
their autism. Furthermore, while bullying was reported in both setting types, the
intentionality of a transgression was often uncertain in special school settings,
leading to an overall conclusion that placement in mainstream may be linked to
greater absenteeism, a tendency to mask, and vulnerability to bullying.
Study 2 again used a qualitative design to explore the experiences and attitudes of
teachers in mainstream and special school settings relating to autism-specific
policies and practices in their schools. Semi-structured interviews were conducted
with 12 teachers – six from a mainstream setting and six from a special school
setting. Thematic analysis identified three key themes. First teachers face a number
of challenges supporting children with autism, such as addressing social
communication difficulties, identifying learning needs and recognising triggers for
anxiety. Second, they adopt various creative solutions to address these challenges
and facilitate achievement, implementing strategies to facilitate their learning,
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social communication and mental health. Finally, transcending these themes was
the notion that certain factors ‘at the chalk face’ control the balance between
challenges and solutions. Whilst staff training and resources may be more apparent
in special schools settings, a number of factors such as educational ideology,
teacher attitudes and attention to the physical environment needn’t vary as widely
as they were reported to between school types. Workload pressures/other
commitments and heterogeneity of autistic characteristics were often to blame by
teachers in mainstream schools, perpetuating the belief that the challenges are too
great and undermining their sense of efficacy towards implementing creative
solutions.
Study 3 employed a longitudinal quantitative design to investigate differences in
attitudes of neurotypical children (aged 11-12) in schools with high educational
exposure (i.e. schools with specialist centres for pupils with autism) compared to
those in schools with low educational exposure (i.e. schools with no specialist
centre). Survey data from 960 participants provided baseline measures of attitudes
towards bullying scenarios and towards their peers with autism. In response to
vignettes depicting bullying scenarios about which they were asked to imagine
themselves as a bystander, results indicated no difference in judgments, emotions or
intended behaviours according to educational exposure. Irrespective of educational
exposure, however, neurotypical children had more prosocial judgments and
emotions towards the bullying of a child with ASD (compared to a neurotypical
child) and towards verbal bullying (compared to social exclusion). Furthermore,
children from schools with a specialist centre reported more positive attitudes
towards people with autism than children in schools with no centre. Being new to
their respective schools, this result was at odds with that expected at baseline, and
could conceivably be due to the knowledge that they joined a school with an
inclusive normative climate by virtue of having a specialist centre for children with
autism.
Study 4 presented the follow-up data from Study 3, evaluating changes in attitudes
of neurotypical children (N = 775) towards bullying scenarios and towards their
peers with autism. In addition to comparing the impact of different levels of
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educational exposure to autism, changes in personal exposure were also
investigated. First, findings showed that educational exposure facilitated a greater
increase in prosocial emotional responses (e.g. anger, sympathy, sadness and
shame) and/or decrease in antisocial emotions (pride, excitement, amusement and
satisfaction) to bullying of stigmatised people in general (i.e. irrespective of target
or violation). Second, an interaction showed that for participants in low educational
exposure schools, while there was a decrease in prosocial emotions towards social
exclusion when the target was NT, they reported an increase in prosocial emotions
when the target was autistic (matching participants from high educational exposure
schools). Third, findings revealed that increased personal exposure facilitated a
greater increase in positive cognitive attitudes towards people with autism. Finally,
results highlighted a difference in quality of attitudes. While personal exposure led
to greater changes in cognitive attitudes, educational exposure led to differences in
emotional responses to stigmatised peers more generally.
Finally, in response to the significant effect of personal exposure in Study 4,
together with previous research showing the benefits of music for facilitating social
cohesion, Study 5 used an experimental design to evaluate changes to prosocial
attitudes of younger children (aged 9-11) who either had contact or no contact with
autistic peers during an eleven-week music programme designed to increase social
interaction. Changes in those with autism were also assessed. Survey data from 49
NT participants provided change scores in measures of prosocial behaviour,
sympathy, tendency to be a victim/bully and prosocial judgements, emotions and
intended behaviours in response to a vignette depicting social exclusion of a child
with autism. Results showed that the intervention had no impact on prosocial
behaviour, sympathy, tendency to bully and judgements/intended behaviours in
response to social exclusion. They did reveal however that participants in the
contact group showed a greater increase in prosocial emotional responses (e.g.
anger, pity, sadness and shame) and/or decrease in antisocial emotions (pride,
excitement, amusement and satisfaction) in response to the vignette. Participants in
the contact group also showed a greater decrease in tendency to be a victim than
those in the no-contact group. Furthermore, participants with autism also showed a
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19.7% decrease in victimisation, although this was while only approaching
significance.
In summary, the empirical studies of this thesis indicate that girls with autism report
school absenteeism, bullying and a tendency to mask their autism, particularly those
in mainstream schools. They also indicate that teachers in mainstream schools are
prevented from implementing creative solutions for pupils with autism partly due to
factors beyond their control such as work pressures and the wide range of needs,
but also due to other more controllable factors such as educational ideology, teacher
attitudes and attention to physical environment. Further, the results show that
educational exposure to children with autism facilitates a greater increase in
prosocial emotional responses of neurotypical children to bullying in general, while
personal exposure facilitates more positive cognitive attitudes towards people with
autism, and through music-based contact, supports greater prosocial emotional
responses to social exclusion of peers with autism.
7.3 Synthesis
This thesis explored the impact of inclusion on children with autism, including the
attitudes of their neurotypical peers, in order to gain a deeper understanding of
factors that may be influencing vulnerability to peer rejection and bullying of
children with autism. Two interrelating themes emerge from the findings of the five
empirical studies relating to the influence of the peer group and the school context.
These will now be discussed.
Theme 1: Influence of the peer group
Research has shown that whilst autistic children may have fewer friends and shorter
durations of friendship, they also have a social desire for relationships (Bauminger
& Kasari, 2000) and often show similarities with typically developing children in
terms of the types of activities they like to engage in (Bauminger & Kasari, 2000;
Kuo et al., 2013). Findings from Study 1 support these findings, showing that while
they may have perceptions of friendship that are different to those of their
neurotypical peers, girls with autism show a general motivation to have friends, but
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often continue to be excluded, bullied and at risk of social isolation. In response to
this, girls in mainstream schools attempted to mask their autism by imitating their
neurotypical peers or hiding their diagnosis, reflecting findings by Attwood (2006)
and Dean et al. (2016). There are arguments for and against concealment; some
arguing that deemphasising a disability lowers its salience, leading to less bias
(Brewer & Miller, 1984; Mara & Brown, 2000). Others argue that full disclosure of
a diagnosis leads to more consistent social support in the classroom and the
playground (Hewstone & Brown, 1986) and that giving autism a ‘greater dialogic
space in the school curriculum may enhance the perspective taking skills and
nurture creative potentialities for all children’ (Ochs et al., 2001, p. 416). Despite
the problems associated with masking such as internalisation and late diagnosis,
Study 1 found that it also sometimes provided girls with superficial social
competence. While the corresponding interviews with boys from a previous study
by Cook et al. (2016) found little evidence of masking, their active attempts to
disregard or avoid bullies were among the protective factors ameliorating the risk of
bullying. Together, these findings indicate the ways in which adolescents with
autism are adapting their behaviour to fit in, and meet the expectations of their
neurotypical peer group in mainstream settings.
This tendency to mask or adjust behaviours to avoid bullying is at odds with the
goal of inclusion to achieve social justice and the promotion of an inclusive ethos in
schools, where neurodiversity is accepted and supported by the whole school
community. In response, Studies 3, 4 and 5 looked at an alternative research focus –
that of the attitudes of neurotypical peers, and aspects of these that might be
influencing vulnerability to peer rejection and bullying of children with autism.
Humphrey and Symes’s (2011) ‘Reciprocal effects peer interaction model’
provided a helpful explanation of how prejudiced attitudes can lead to bullying,
social rejection and increased isolation and loneliness for children with autism. In
particular it proposes that problems of social cognition are only part of the problem
and that lack of understanding by the peer group can lead to reduced acceptance
and hence increased bullying and rejection. Although findings of Study 3 (at
baseline) indicated that children generally have more prosocial attitudes towards
bullying of a child with ASD, it was only through increased personal contact that
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improvements were found in the general cognitive attitudes towards children with
autism for 11-12 year old NTs (Study 4). Given the value placed on self-
presentation during early adolescence causing children to give higher priority to
group functioning and social conventions over equality of treatment towards
outgroup members (explained by Social Domain theory (Turiel, 2006))
interventions that re-categorise ingroup and outgroup dimensions and challenge
stereotypic attitudes are vital.
Study 5 therefore adopted intergroup contact theory (Allport, 1954), which states
that prejudice is a consequence of unfamiliarity, and that positive intergroup contact
instils more positive attitudes and behaviours and facilitates rejection of negative
stereotypes. Study 5 reflected earlier studies showing that contact with children
with disabilities leads to more liking and condemnation of exclusion (Maras &
Brown, 1996; Gasser et al., 2013) and also that increasing knowledge and practical
skills for interacting with disabled classmates results in more positive intentions to
interact with them (Roberts & Smith, 1999). For participants who received the
music intervention with high contact with autistic peers, their increase in prosocial
emotional responses to the social exclusion of a child with autism suggests that they
associate the victim in the vignette with the autistic peers in their own group. This
reflects work on the effect of ingroup identification on prosocial bystander
intentions (Palmer et al., 2015) and indicates a process of ‘recategorisation’,
whereby members of different groups recategorise themselves as members of the
same group (Gaertner & Dovidio, 2000).
In summary, the influence of peers can drive autistic children to adapt their
behaviour to meet neurotypical expectations. Instead, the goal of inclusion is to
promote, accept and support neurodiversity. Rather than viewing autism as a
disorder with associated stigmas, neurotypical children can be helped to understand
human variability as normal. These studies indicate that an effective approach to
achieve this is through encouraging intergroup contact, enabling recategorisation of
group identities and subsequent improvement in attitudes.
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Theme 2: Influence of school context
A second influence, weaving a thread through this thesis, is that of the school
context. While some children with a diagnosis of autism attend special schools, the
majority (73%) are placed in mainstream settings (DfE, 2015). Teachers agree that
inclusion is important for reasons of social justice (Artiles, Harris-Murri and
Rostenberg, 2006; Little, 2017; Polat, 2011), but often face challenges meeting the
diverse needs of a range of pupils due to lack of training (Robertson et al., 2003).
This can lead to beliefs that inclusion in mainstream settings is not suitable for all
kinds of disabilities, particularly social and emotional behaviour disorders
(Avarmidis & Norwich, 2002; Carlberg & Kavale, 1980). In contrast, special
schools offer expertise, resources and environments to meet the needs of children
with ASD/SENs (Frederickson et al., 2010). However some argue that comparable
provision is feasible across both setting types with adequate staff training
(Frederickson et al., 2010). This was certainly apparent in Study 2, which
highlighted a number of limitations in teachers’ ability to meet the needs of children
with autism, particularly in mainstream settings. Whilst factors such as staff
training/expertise and resources are more evident in specialist settings, other factors
such as educational ideology, teacher attitudes, and attention to the physical
environment varied widely. It is argued that, with appropriate training and
resources, mainstream schools are capable of meeting individual needs of children
with autism, while at the same time, providing an inclusive ethos that celebrates
neurodiversity. The alternative is an environment which accentuates autistic
children’s sense of being different and perpetuates poor friendship quality and
social network status (Kasari, Locke, Gulsrud, & Rotheram-Fuller, 2011; Locke,
Ishijima, Kasari, & London, 2010; Willimas et al., 2017).
Schools can be helped to take advantage of these findings through taking steps
towards achieving an inclusive school climate that not only addresses the needs of
individuals with autism, but also promotes a school community that accepts and
embraces diversity. In line with earlier studies associating an inclusive school
climate with positive moral identity and acceptance of difference (Chentsova-
Dutton & Tsai, 2010; Riekie, Aldridge and Afari, 2017), Studies 3 and 4
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specifically explored the effect of improved physical and social environments in
mainstream settings on changes in attitudes of children without autism. Through
focusing on providing an autism-friendly environment, coupled with increased
salience of autism, the heightened educational exposure facilitated a greater
increase in prosocial emotional responses to bullying of stigmatised people (i.e.
irrespective of target or violation). It is argued that this salience allowed
neurotypical children to attribute autistic characteristics to factors beyond their
control, instilling feelings of sympathy rather than contempt, as explained by the
stereotype content model (Fiske, 2007). It may also have enabled them to
understand the reasons for the behaviours of their autistic peers. Furthermore, by
addressing the concept of difference and diversity within the school ethos, high
exposure schools encouraged inclusive attitudes that may have led to the increase in
prosocial emotional responses to bullying more generally, reflecting the findings of
McGuire et al. (2015), that inclusive school norms encourage more positive
intergroup attitudes, even when peer groups may have a norm of exclusion.
In summary the school context can impact both the experiences of children with
autism, and also the attitudes of neurotypical children towards difference, diversity
and in particular their emotional responses to bullying.
Summary of themes
The influence of peers can therefore drive autistic children to adapt their
behaviours, and neurotypical children to exclude in order to protect group
functioning, generating negative outcomes such as internalisation, peer rejection
and bullying. Equally the influence of the school context can accentuate the
stigmatisation of autistic children without adequate attention to the physical and
social environment. Addressing both these influences through encouraging
intergroup contact and providing an inclusive school ethos can nevertheless lead to
the improvement of neurotypical attitudes towards autism, bullying and social
exclusion.
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7.4 Implications for theory
This thesis has several implications for theory. First, it draws on theories of social
cognition that explain the way categorisation of people in outgroups can lead to
generalisations (i.e. stereotypes), particularly when we are unfamiliar with the
category. Stereotypes of autism may arise due to unfamiliarity and the inability of
neurotypical children to fit various autistic characteristics into pre-existing
schemas. Related to this, studies show that members of ingroups strive to enhance
their own group status and differentiate themselves as far as possible from members
of other groups, particularly when there is uncertainty. This is the basis of social
identity theory, and is one explanation for adverse intergroup behaviour towards
children with autism due to the need to increase self-esteem and reduce uncertainty,
particularly when combined with exclusive peer group norms, as could be present
in schools with less inclusive social norms.
Social identity theory does not, however, differentiate the justifications of social
transgressions made by children based on the societal domain (social conventions,
customs and group function) and the moral domain (fairness, justice, welfare and
rights of others). As such this thesis examined whether social domain theory
(Turiel, 2006) could be applied to a stigmatised group that is hitherto under-
explored: children with autism. Where children (particularly in the age group
investigated for this thesis) strongly identify with their ingroup (in this context,
NTs), social domain theory suggests that decisions to exclude members of the
outgroup (i.e. ASD peers) may be justified as legitimate in order to protect group
functioning (i.e. social conventional judgements), even when they understand moral
implications. Whilst strength of identification with the ingroup (NTs) was not
directly measured in Studies 3 and 4, it was posited that the proactive efforts of the
high educational exposure schools to establish an inclusive school norm may lessen
pupil identification with the ingroup leading them to regard bullying/social
exclusion as less legitimate based on social conventional judgements. As a natural
experiment, measures in Study 3/4 did not reflect the minimal group paradigm
adopted in previous studies testing the social domain theory. Findings did, however,
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indicate that children in high educational exposure schools showed increased
prosocial emotional responses to bullying (regardless of target and violation),
inferring that moral transgressions such as verbal bullying and social exclusion
were viewed as less legitimate than is the case for children from low educational
exposure schools. Interestingly however, even the children in low educational
exposure schools reported an increase in prosocial emotions to social exclusion
when the target was autistic, indicating that while verbal bullying is tolerated more
than in high educational exposure schools, social exclusion of a peer with ASD may
raise more moral considerations for NT children, regardless of educational
exposure. In these studies it was only possible to conjecture the application of
social domain theory due to the chosen methodology. Further research using more
controlled experimental methods to investigate this hypothesis further would be of
great value in the context of NT and ASD groups – for example through explicitly
testing strength of identification and justifications for particular transgressions
against peers with autism (social vs. moral).
Given the predominantly emotional quality of attitudinal differences reported, these
studies also have implications for intergroup emotion theory (Mackie, Devos &
Smith, 1999). While social domain theory focuses on cognitive reasoning of
intergroup contexts, intergroup emotion theory suggests that membership of a group
can influence emotions and these are also associated with behavioural intentions.
However very little research examines the emotions attributed to participants in
bullying scenarios. Both Studies 4 and 5 revealed a significant increase in prosocial
emotions in response to bullying vignettes. Previous studies adopting intergroup
emotion theory found that group emotions can predict behaviour. For example,
collective guilt motivates people to take action to rectify a transgression
(Branscombe and Doosje, 2004; Brown et al., 2008), whilst collective shame
motivates them to avoid the event. Future studies could explore whether particular
prosocial emotions predict intended behaviours in response to the vignettes adopted
for Studies 3, 4 and 5. While these studies revealed a significant increase in
prosocial emotions, they showed no such increase in the measures testing more
cognitive beliefs and judgements. Given the similar pattern of quality of attitudes in
these studies, it was conjectured that social-developmental factors might be
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influencing the processing of emotions compared with the more cognitive beliefs,
judgements and behavioural intentions. While Rutland and Killen (2011) explain
how emotions are helpful but not vital to moral understanding, findings from this
thesis suggest a need for experimental research to explore these differences,
combining the two theories in a developmental context.
Finally there are implications for intergroup contact theory, which proposes that
prejudice against outgroup members arises from lack of knowledge or familiarity,
and under appropriate conditions is one of the most effective ways to reduce
prejudice between majority and minority members (Allport, 1954). Increased
personal contact in Study 4 and high contact with autistic peers in Study 5 led to
greater increases in positive cognitive attitudes and prosocial emotional responses
to social exclusion respectively. These findings reflect those of Maras and Brown
(1996) that contact with children with disabilities led to significantly more liking
than the control group (no-contact) and indicate a process of ‘reconceptualising’
their group categories and increasing their ability to take the perspective of, and
empathize with their autistic peers. Not only this, but findings from Studies 4 and 5
reflect those of Cameron and Rutland (2006) who found that placing salience on the
category of disability during intergroup contact positively influenced children’s
outgroup attitudes. Intergroup contact theory was therefore found to provide a
promising method of improving intergroup relations between autistic and non-
autistic children. Through increasing knowledge and familiarity, they can be
encouraged to understand each others’ points of view and redefine group
categories, leading to diminished anxiety, challenged stereotypes, and reduced
prejudice.
Overall, the findings necessitate consideration of more than one theoretical
framework when exploring attitudes towards autistic peers, and stigmatised groups
more generally. While Social domain theory provides detailed understanding of the
cognitive reasoning attributed to moral transgressions in intergroup contexts,
Intergroup emotion theory sheds light on group-based emotions and how these are
associated with behavioural intentions and Intergroup contact theory increases the
likelihood of empathising with and reducing prejudice towards other groups. In
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these studies, personal exposure led to greater changes in cognitive attitudes
towards peers with autism and a stronger emotional response to social exclusion of
children with autism whilst educational exposure led to differences in emotional
responses to stigmatised peers more generally. This points to the need to consider
all three theories in research that explores attitudes towards autistic peers, and
indeed stigmatised groups in general.
7.5 Implications for practice
This thesis raises a number of implications for successful inclusive educational
practice, related to improving awareness and understanding of autism and
acceptance of neurodiversity by teachers and neurotypical children and
consequently, increasing quality of life for children with autism in mainstream
schools. Findings from Study 4 revealed that autism-friendly physical and social
environments in mainstream schools facilitate prosocial emotional responses to
bullying of stigmatised people. Education authorities should consider this model of
inclusion as a means not only to facilitate the needs of children with autism, but
also to establish an inclusive normative climate leading to improved general
responses to moral transgressions against stigmatised groups. There are also
implications for mainstream schools in light of the findings from Study 2
highlighting the widening gap between inclusive and special school settings
regarding educational ideology, teacher attitudes, and attention to the physical
environment. Staff training and decreased work pressure is necessary in order to
provide teachers with the tools to: 1. support the wide-ranging needs of autistic
pupils individually rather than in a generalised approach; 2. address environmental
factors that cause barriers to inclusion, affecting the social, academic and mental
health outcomes for children with autism and; 3. promote an inclusive school ethos
through helping all children understand that everybody is different and that
neurodiversity is beneficial to society.
Findings also have implications for the interventions schools implement to promote
peer interaction, increase autism-awareness and prevent bullying. Study 1 showed
that for girls with autism, mainstream settings were associated with school
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absenteeism, bullying and an increased tendency to mask their autism in order to fit
in. Interventions to improve peer interactions should recognise the differences in
friendship perceptions and provide opportunities to share company through joint
activities/similar interests, enabling them to feel comfortable in social situations and
reduce the need to mask their autism. Studies 3 and 4 highlighted the differences in
quality of attitudes, indicating that educational exposure may affect emotional
responses to bullying, while personal exposure affects cognitive attitudes towards
autism. Explanations for lower prosocial responses in low exposure schools based
on social domain theory reinforce the need for anti-bullying programmes to focus
both on moral and social conventional responses to bullying, especially in
secondary schools, where older children might accept social exclusion to protect
group functioning (Rutland & Killen, 2011). Furthermore, findings from high
exposure schools reinforcing intergroup emotion theory indicate a need to focus not
only on cognitive factors (i.e. judgements, beliefs and intended behaviours) but also
on emotional factors relating to different roles in bullying scenarios.
Finally, the findings from Studies 4 and 5 indicate that contact-based interventions
are vital for improvements to cognitive attitudes towards peers with ASD in
secondary mainstream schools and to tackle social exclusion for children with
autism in primary mainstream schools. In particular opportunities should be
identified to increase personal contact in carefully considered social settings
between autistic and neurotypical children in secondary schools. Furthermore,
positive intergroup contact through group music making should be considered both
in primary and secondary school settings, not only to reduce victimisation but also
to increase a sense of cohesion between individuals, helping to disconfirm
stereotypes and increase positive attitudes between peers.
Overall, the findings demonstrate that while thorough consideration of the physical
and social school climate is important, positive interpersonal and intergroup contact
is also fundamental to the improvement of neurotypical attitudes. It is important
therefore that schools address both educational and personal exposure in their
endeavours to develop inclusive school and peer group norms.
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7.6 Methodological limitations and future research
As is the case in any research, there are various limitations to be considered. First,
geographically, participants were all from Southeast England for practical purposes,
which may reflect some bias in terms of socio-economic status and ethnic origins in
all studies. Second, participants for the qualitative studies represent sub-sets of their
respective populations. For example, due to Study 1 being interview-based,
participants required a degree of communication that may have led do the
underrepresentation of girls with poorer communication skills in the sample.
Similarly teachers interviewed in Study 2 were either members of senior
management or special educational needs coordinators who arguably possessed
higher levels of knowledge/expertise in the subject and therefore may not represent
the full range of thoughts and beliefs of regular teachers who don’t hold these roles.
Third, due to time constraints, the long-term durability of these findings couldn’t be
tested.
Future studies might therefore extend research by (1) interviewing a wider sample
of participants to explore experiences from children with varying levels of autistic
characteristics, for example using participatory research models (e.g. MacLeod et
al., 2013) or activity-oriented interview methods as a means to encourage openness
in children less able to respond to the interview setting (e.g. Winstone et al., 2014);
(2) exploring the perspectives of regular teachers regarding their implementation of
solutions and how this may be effected by their attitudes and educational ideology;
(3) develop the music-based intervention for use with matched samples across
schools and with randomisation of participants to experimental and control groups,
and implemented over a longer time period; (4) explore whether positive music-
based contact influences attitudes of older (secondary school-aged) children in light
of findings by Killen and Rutland (2011) that older children justify group
functioning over fairness. In addition, research should address recommendations
discussed above (in ‘Implications for theory’) to explore justifications given for
moral transgressions towards peers with autism and to integrate emotion based
findings with cognitive attitudes/behavioural intentions.
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7.7 Conclusion
In conclusion, this thesis contributes to the existing literature addressing inclusion,
peer-relationships and bullying of children with autism by investigating experiences
and attitudes in contrasting school settings to obtain a deeper understanding of
factors that may be influencing vulnerability to peer rejection and bullying of
children with autism.
A multi-informant approach provided a broad range of perspectives. Findings from
girls with autism and their parents indicated that placement in mainstream schools
may be linked to absenteeism, a tendency to mask autistic characteristics and
vulnerability to bullying. From teachers’ perspectives, inclusion may also pose
challenges due to workload pressures and heterogeneity of autistic traits, which
undermine their sense of efficacy towards implementing creative solutions to meet
the needs or pupils with autism. Findings from neurotypical children indicated that
personal exposure leads to increased positive attitudes towards peers with autism,
while educational exposure (i.e. through attending a school with an autism-friendly
physical and social environment) leads to increased prosocial emotional responses
to bullying of stigmatised peers in general. Finally, contact between neurotypical
and autistic children through group music-making increases prosocial emotional
responses to social exclusion of peers with autism and may also facilitate a decrease
in victimisation of children with autism, suggesting an increased sense of social
cohesion. These findings have practical implications for inclusive school settings,
providing potential solutions for improving awareness and understanding of autism
and acceptance of neurodiversity by the whole school community. There is a known
tendency for older children to prioritise self-presentation and accept transgressions
towards outgroup members to protect group functioning. Consequently an approach
that combines educational exposure within inclusive school climates, and personal
exposure through structured intergroup opportunities, is vital to improve bystander
responses to bullying and attitudes towards autism, and ultimately increase quality
of life for children with autism in mainstream schools.
189
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Appendices
Appendix A – Study 1 Letter to Parents/Carers and Information Sheets
Guildford, Surrey, GU2 7XH, UKTelephone +44 (0)1483 300800
Facsimile +44 (0)1483 300803 www.surrey.ac.uk
January 2016
Dear Parents/Caregivers
Re: Research study on the experiences of learning and friendships of girls with an autistic spectrum disorder
I am a PhD student in Psychology at the University of Surrey, conducting interviews as part of a research study about inclusion and the experiences of secondary school aged pupils with ASD, and the beliefs of their parents/caregivers and teachers regarding their learning and friendships.
As a parent/caregiver of a child with ASD, you and your daughter are in an ideal position to provide valuable first hand information from your own perspectives. Therefore, I am writing to invite you and your daughter to take part in the project. The interviews take around 30 minutes and I would like to interview you both separately about your experiences and beliefs regarding her learning and friendships. Your responses to the questions will be anonymous. There is no compensation for participating in this study. However, your participation will be a valuable addition to this research and findings could lead to greater public understanding of the experiences of children and young people with ASD.
The enclosed Information Sheet explains more fully what is involved. If you are willing to participate, your interviews can be arranged at a time and place that suits you. To arrange your interviews, please contact me at [email protected]. If you have any questions on concerns, please do contact me.
Many thanks and kind regards
Yours sincerely
Anna Cook MSc (Interviewer)PhD Psychology Student
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Guildford, Surrey, GU2 7XH, UKTelephone +44 (0)1483 300800
Facsimile +44 (0)1483 300803 www.surrey.ac.uk
Participant Information Sheet
(Pupil and parent/caregiver participants)
The experiences of learning and friendships of girls with an autism spectrum disorder (ASD)
IntroductionMy name is Anna Cook. I am a PhD Psychology student at the University of Surrey working on a project about inclusion and the experiences of secondary school age pupils with ASD, and the beliefs of their parents/caregivers and teachers regarding their learning and friendships. This research is funded by Qube Learning, who will also help to publicise the findings. I invite you and one of your parents/caregivers to take part in my project. Before you decide it is important for you to understand why the research is being done and what it will involve. Please take time to read the information carefully and discuss it with others if you wish. Ask me if there is anything that is not clear or if you would like more information. Take time to decide whether or not you wish to take part.
Thank you for reading this.
What is the purpose of the study?The purpose is to explore experiences of learning and friendships in girls with ASD and those of their parents/caregivers and teachers.
Why have I been invited to take part in the study?You have been asked to take part because you are a girl between the age of 11 and 17 with an autistic spectrum disorder/condition, and I would like to hear about your experiences at school, or you are the parent/caregiver of a girl between the age of 11 and 17 with ASD, and I would like to hear about your beliefs about how your daughter manages her learning and friendships.
Do I have to take part?No, you do not have to participate. It is up to you to decide whether or not to take part. If you do decide to take part you will be given this information sheet to keep, and you will be asked to sign a form agreeing to take part. If you decide to take part you can still change your mind and withdraw at any time and without giving a reason. A decision to withdraw at any time, or a decision not to take part, will not affect you in any way. If you
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decide to withdraw, you may choose to have any recording and/or transcript of your interview erased up until the point of analysis (June/July 2016).
What do I have to do?You will be asked to take part in an interview, lasting about 30-minutes, about your experiences of learning and friendships. The interview will be carried out by me (Anna Cook), and I will ask you about your experiences of learning in your school, how you form and maintain friendships and whether other pupils have ever treated you unfairly. I will also ask your permission to allow me to interview your parent/carer giver about your learning, friendships, any incidences of bullying.
With your permission, the interview will be recorded so that it can be listened to at a later date by the researcher.
What are the possible benefits and risks of taking part?
There is no direct benefit to you if you take part in this study, but you may be pleased to have the opportunity to discuss your experiences with somebody not from school and might benefit from talking about your experiences. In addition, your participation will be a valuable addition to research, which could lead to greater public understanding of the experiences of young people with ASD. I will be happy to discuss findings with you/your parent/caregiver(s) after I have finished my project.
Due care will be taken to ensure you are not placed under any risk during the interview. However, if you feel uncomfortable about any of the questions asked, you can ask to move to the next question, or for the interview to pause and/or stop altogether. Appropriate support will be provided for you, should you require it.
Will information about me be kept anonymous?
Yes. All information that is collected about you during the course of the research will be anonymised so that those reading reports from the research will not know who has contributed to it. After the interview, the recording will be transcribed (typed-up). You will be given a pseudonym (a pretend name) so that you will not be identifiable from the transcript (typed version). In addition all other names mentioned will also be given pseudonyms, and school names removed. Personal data will be handled in accordance with the Data Protection Act 1998. Research data will be kept for a minimum of 10 years in line with university policy. Transcripts may be used in future research with your consent. This will be sought with a separate consent form to be signed by you.This study has been reviewed and received a favourable ethical opinion from the University of Surrey Ethics Committee.
What happens at the end of the research?Results will be written up to contribute towards my PhD, and may be published in an academic journal and/or presented at a conference. You can request a summary of the results by contacting me after October 2016.
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What if there is a problem?Any complaint or concern about any aspect of the way you have been dealt with during the course of the study will be addressed; please contact Anna Cook (Principal Investigator) at [email protected], or Professor Jane Ogden (Supervisor and Director of the PhD Programme) on 01483 686929. Alternatively you may contact Prof. Moore (Head of School - Psychology) on 01483 686933.
Who should I contact for further information?Principal Investigator: Anna Cook (email: [email protected])Supervisors: Prof Jane Ogden, Department of Psychology, University of Surrey (e-mail: [email protected]) or Dr Naomi Winstone, Department of Psychology, University of Surrey (email: [email protected])
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Appendix B – Study 1 Consent Forms
Guildford, Surrey, GU2 7XH, UKTelephone +44 (0)1483 300800
Facsimile +44 (0)1483 300803 www.surrey.ac.uk
Pupil Consent Form
The experiences of learning and friendships of girls with an autism spectrum disorder (ASD)
I the undersigned voluntarily agree to take part in the study named above. ☐
I have read and understood the Information Sheet provided (version 3, 15.12.15). I have been given a full explanation by the interviewer of the nature, purpose, location and likely duration of the study, and of what I will be expected to do. I have been given the opportunity to ask questions on all aspects of the study and have understood the advice and information given as a result.
☐
I agree to the interview being recorded. ☐
I understand that all personal data relating to volunteers is held and processed in the strictest confidence, and in accordance with the Data Protection Act (1998). I agree that I will not seek to restrict the use of the results of the study on the understanding that my anonymity is preserved.
☐
I confirm that I agree for my parent/caregiver to be interviewed about my experiences at school. ☐
I understand that I am free to withdraw from the study at any time without needing to justify my decision and without prejudice.
☐
I agree for my transcript to be used in further research with my consent. ☐
I confirm that I have read and understood the above and freely consent to participating in this study. I have been given adequate time to consider my participation and agree to comply with the instructions and restrictions of the study.
☐
Name of volunteer............................................................................................... (BLOCK CAPITALS)
Signed................................................................................................................. Date..................................
In the presence of (parent/guardian)................................................................... (BLOCK CAPITALS)
Signed................................................................................................................. Date...................................
Name of researcher/person taking consent........................................................ (BLOCK CAPITALS)
Signed................................................................................................................. Date...................................
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Guildford, Surrey, GU2 7XH, UKTelephone +44 (0)1483 300800
Facsimile +44 (0)1483 300803 www.surrey.ac.uk
Parent/Caregiver Consent to Child’s Participation
The experiences of learning and friendships of girls with an autism spectrum disorder (ASD)
I the undersigned agree for my child to take part in the study named above. ☐
I have read and understood the Information Sheet provided (version 3, 15.12.15). I have been given a full explanation by the interviewer of the nature, purpose, location and likely duration of the study, and of what my child will be expected to do. I have been given the opportunity to ask questions on all aspects of the study and have understood the advice and information given as a result.
☐
I agree to the interview being recorded. ☐
I understand that all personal data relating to volunteers is held and processed in the strictest confidence, and in accordance with the Data Protection Act (1998). I agree that I will not seek to restrict the use of the results of the study on the understanding that my child’s anonymity is preserved.
☐
I understand that my child is free to withdraw from the study at any time without needing to justify his/her decision and without prejudice.
☐
I agree for my child’s transcript to be used in further research with their consent. ☐
I confirm that I have read and understood the above and freely consent to my child participating in this study. I have been given adequate time to consider their participation and agree for them to comply with the instructions and restrictions of the study.
☐
Name of parent/guardian....................................................................................(BLOCK CAPITALS)
Signed................................................................................................................. Date..................................
Name of child volunteer……………....................................................................(BLOCK CAPITALS)
Name of researcher/person taking consent........................................................ (BLOCK CAPITALS)
Signed................................................................................................................. Date...................................
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Guildford, Surrey, GU2 7XH, UKTelephone +44 (0)1483 300800
Facsimile +44 (0)1483 300803 www.surrey.ac.uk
Parent/Caregiver/Teacher Consent Form
The experiences of learning and friendships of pupils with an autism spectrum disorder (ASD)
I the undersigned voluntarily agree to take part in the study named above. ☐
I have read and understood the Information Sheet provided (version 3, 15.12.15). I have been given a full explanation by the interviewer of the nature, purpose, location and likely duration of the study, and of what I will be expected to do. I have been given the opportunity to ask questions on all aspects of the study and have understood the advice and information given as a result.
☐
I agree to the interview being recorded. ☐
I understand that all personal data relating to volunteers is held and processed in the strictest confidence, and in accordance with the Data Protection Act (1998). I agree that I will not seek to restrict the use of the results of the study on the understanding that my anonymity is preserved.
☐
I understand that I am free to withdraw from the study at any time without needing to justify my decision and without prejudice.
☐
I agree for my transcript to be used in further research with my consent. ☐
I confirm that I have read and understood the above and freely consent to participating in this study. I have been given adequate time to consider my participation and agree to comply with the instructions and restrictions of the study.
☐
Name of volunteer............................................................................................... (BLOCK CAPITALS)
Signed................................................................................................................. Date..................................
Name of researcher/person taking consent........................................................ (BLOCK CAPITALS)
Signed................................................................................................................. Date..................................
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Appendix C – Study 1 Interview Schedules
Pupil interview
My research explores learning and friendships of young people with an autistic
spectrum disorder. I’m going to ask you some questions about these areas, and ask
that you be as honest and open as you can. If you don’t understand a question,
please ask me to clarify.
Demographic questions
To begin, I’d like to get some basic information about you so that I can show those
who read my research report that I managed to obtain the views of a cross-section
of people. The information that you give will never be used to identify you in any
way because all information collected will be anonymised. However, if you don’t
want to answer some of the questions, please don’t feel that you have to.
a. Were you born in the UK? If not where you were born?b. With which of the following groups do you most identify yourself?
Asian or Asian-British Black/African/Caribbean/Black British White British Mixed race Other
1. Your experience of learning in schooli. How long have you been at this school?
ii. Do you like it?iii. Can you tell me a bit about the lessons you like most and/or lessons
you think you are good at?iv. (If pupil mentions a particular subject they like) So what is it about
[subject] that you like and why do you think you are good at it?v. Are there any lessons you don’t like and/or think you are not very
good at, and if so, can you tell me why you don’t like them?vi. What do you think of your teachers?
vii. Does a teaching assistant help you in any of your lessons, and if so, in what way do they help with your learning?
viii. (Mainstream pupils) Do you have any lessons away from the rest of the class? If so how do you feel about this?
2. Your experience of forming and maintaining friendships
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i. Please can you tell me how you feel you get on with people at school?ii. Is there any one in particular that you like?
iii. If yes: What it is about [friend’s name] that you like? What do you do with them? What is it that you think they like about you? Can you tell me about the time when you started being friends with
[friend’s name], i.e., how you came to be friends in the first place? Do you have any friends who you meet outside of school, and if so
what kind of activities do you do together? Do you expect the friends you mentioned will still be your friends
next week/month/year, and if so, why do you think that is?iv. If no:
Do you have any friends outside of school, and if so….(as above)v. Are there any friends that you had in the past who you don’t see any
more? If so, what happened?3. Your thoughts about whether you have been treated unfairly by fellow
school pupilsi. Have any pupils at school ever done or said something you didn’t
like? If so, please can you tell me a bit about what happened?ii. [If they answered yes…] Why do you think those pupils treated you
that way?iii. How did it make you feel?iv. Who helped to sort out the problem, and did that problem get sorted
out?4. Your overall preferences
i. In an ideal school, what would people be like?
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Parent/Caregiver interview
I am conducting a study on the experiences of learning, friendships and bullying in
young people with ASD and those of their parents/caregivers. This study will
provide information regarding your own perceptions and the perceptions of your
daughter. This information will provide me with understanding and direction for
developing a programme in schools to address the need for more information on
ASD, and the problem of bullying among peers.
Demographic questions
To begin, I’d like to get some basic information about you so that I can show those
who read my research report that I managed to obtain the views of a cross-section
of people. The information that you give will never be used to identify you in any
way because all information collected will be anonymised. However, if you don’t
want to answer some of the questions, please don’t feel that you have to.
a. Were you born in the UK? If not where you were born?b. How old are you? 20-30, 30-40, 40-50, 50+c. With which of the following groups do you most identify yourself?
Asian or Asian-British Black/African/Caribbean/Black British White British Mixed race Other
d. What is your highest educational qualification?e. What is your current occupation (or if no longer working, your last occupation)?
1. Your beliefs about how pupils with ASD manage learning at schooli. Can you tell me a bit about your daughter’s special needs, how recently
she was diagnosed/issued with a statement? ii. What kind of setting/provision she may have received before diagnosis,
and what kind of provision she is receiving now?iii. How well does [pupil’s name] do in his lessons in general?iv. Does she have any subjects she particularly likes, and if so, why do you
think that is?v. What are his/her particular strengths and weaknesses?
vi. Do his teachers ever talk about any issues regarding his learning? If so, can you tell me the kinds of things they talked to you about?
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vii. Does [pupil’s name] need any additional support from a teaching assistant, and if so, what kind of support does she receive?
2. Your beliefs about how pupils with ASD manage friendships at schooli. Who well do you think your daughter gets on with other people?
(leave open)ii. Can you tell me a bit about [pupil’s name]’s friendships at school?
iii. Is she friends with other pupils with ASD and/or neuro-typical pupils, and what are the differences in the friendships?
iv. Can you talk a little about how [pupil’s name] forms friendships.v. Can she maintain friendships over time, and if so what are the factors
that enable them to be maintained? vi. Do you play a particular role in your daughter’s friendships (e.g. to
structure, establish or maintain his friendships)?
3. Your beliefs about [pupil’ name]’s experiences of bullyingi. I’d like to ask if your daughter has experienced any incidences of
bullying, that you know of - Has your daughter ever talked to you about being bullied at school, and if so, can you tell me about these incidences?
ii. How was this dealt with at school, and how did you feel about that?iii. What was your initial reaction to hearing that your daughter had been
bullied?iv. Do you think this incident/incidences affected [pupil’s name]? If so,
how (short term/longer term effects)? v. Can you tell me about any anti-bullying initiatives the school has
adopted?
4. Your beliefs about whether the level of inclusion exacerbates or protects from bullying
i. What led to your choice of school for your daughter and why? (academic/social) – and mainstream/special
ii. What is your view about bullying in general? How problematic do you think it is for children with ASD?
iii. Do you think there is more bullying in mainstream or special schools?iv. In an ideal world how would you like the school to be run, and what
would the children be like?
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Appendix D – Study 1 and 2 University Ethics Committee Approval
242
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Appendix E – Study 2 Information Sheet
Guildford, Surrey, GU2 7XH, UKTelephone +44 (0)1483 300800
Facsimile +44 (0)1483 300803 www.surrey.ac.uk
Participant Information Sheet
(Teacher participants)
The experiences of learning and friendships of girls with an autism spectrum disorder (ASD)
IntroductionMy name is Anna Cook. I am a PhD Psychology student at the University of Surrey working on a project about inclusion and the experiences of secondary school age pupils with ASD, and the beliefs of their parents/caregivers and teachers regarding learning and friendships and the policies and practices of the school. This research is funded by Qube Learning, who will also help to disseminate the findings. I invite you to take part in my project. Before you decide it is important for you to understand why the research is being done and what it will involve. Please take time to read the information and discuss it with others if you wish. Ask me if there is anything that is not clear or if you would like more information. Take time to decide whether or not you wish to take part.
Thank you for reading this.
What is the purpose of the study?The purpose is to explore experiences of learning and friendships in pupils with ASD and those of their parents/caregivers and teachers.
Why have I been invited to take part in the study?You have been asked to take part because you are a member of staff at a school attended by pupils between the age of 11 and 17 with an autistic spectrum disorder/condition – and I would like to hear about your experiences and beliefs about the policies and practices of the school regarding pupils with ASD and also how well pupils with ASD manage their learning and friendships.
Do I have to take part?No, you do not have to participate. It is up to you to decide whether or not to take part. If you do decide to take part you will be given this information sheet, and you will be asked to sign a consent form. If you decide to take part you can still change your mind and
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withdraw at any time and without giving a reason. A decision to withdraw at any time, or a decision not to take part, will not affect you in any way. If you decide to withdraw, you may choose to have any recording and/or transcript of your interview erased up until the point of analysis (June/July 2016).
What do I have to do?You will be asked to take part in an interview, lasting about 30-minutes, about the school’s policies and practices regarding ASD and also the learning and friendships of pupils with ASD at the school. The interview will be carried out by me (Anna Cook) and, with your permission, the interview will be recorded so that it can be listened to at a later date by me.
What are the possible benefits and risks of taking part?
There is no direct benefit to you if you take part in this study, but you may be pleased to have the opportunity to discuss your beliefs and experiences with a neutral third party and might benefit from talking about your experiences. In addition, your participation will be a valuable addition to research, which could lead to greater public understanding of the experiences of young people with ASD. I will be happy to discuss findings with you after I have finished my project.
Due care will be taken to ensure you are not placed under any risk during the interview. However, if you experience any discomfort relating the questions asked, you can ask to move to the next question, or for the interview to pause and/or stop altogether.
Will information about me be kept anonymous?
Yes. All information that is collected about you during the course of the research will be anonymised so that those reading reports from the research will not know who has contributed to it. After the interview, the recording will be transcribed. You will be given a pseudonym so that you will not be identifiable from the transcript. In addition all other names mentioned will also be given pseudonyms, and school names removed so they will not be identifiable in any publications. Personal data will be handled in accordance with the Data Protection Act 1998. Research data will be kept for a minimum of 10 years in line with university policy. Transcripts may be used in future research with your consent. This will be sought with a separate consent form to be signed by you.This study has been reviewed and received a favourable ethical opinion from the University of Surrey Ethics Committee.Transcripts may be used in future research with your consent. This will be sought with a separate consent form to be signed by you.
What happens at the end of the research?Results will be written up to contribute towards my PhD, and may be published in an academic journal and/or presented at a conference. You can request a summary of the results by contacting me after October 2016.
What if there is a problem?
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Any complaint or concern about any aspect of the way you have been dealt with during the course of the study will be addressed; please contact Anna Cook (Principal Investigator) at [email protected], or Professor Jane Ogden (Supervisor and Director of the PhD Programme) on 01483 686929. Alternatively you may contact Prof. Moore (Head of School – Psychology) on 01483 686933.
Who should I contact for further information?Principal Investigator: Anna Cook (email: [email protected])Supervisors: Prof Jane Ogden, Department of Psychology, University of Surrey (e-mail: [email protected]) or Dr Naomi Winstone, Department of Psychology, University of Surrey (email: [email protected])
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Appendix F – Study 2 Consent Form
Guildford, Surrey, GU2 7XH, UKTelephone +44 (0)1483 300800
Facsimile +44 (0)1483 300803 www.surrey.ac.uk
Parent/Caregiver/Teacher Consent Form
The experiences of learning and friendships of pupils with an autism spectrum disorder (ASD)
I the undersigned voluntarily agree to take part in the study named above. ☐
I have read and understood the Information Sheet provided (version 3, 15.12.15). I have been given a full explanation by the interviewer of the nature, purpose, location and likely duration of the study, and of what I will be expected to do. I have been given the opportunity to ask questions on all aspects of the study and have understood the advice and information given as a result.
☐
I agree to the interview being recorded. ☐
I understand that all personal data relating to volunteers is held and processed in the strictest confidence, and in accordance with the Data Protection Act (1998). I agree that I will not seek to restrict the use of the results of the study on the understanding that my anonymity is preserved.
☐
I understand that I am free to withdraw from the study at any time without needing to justify my decision and without prejudice.
☐
I agree for my transcript to be used in further research with my consent. ☐
I confirm that I have read and understood the above and freely consent to participating in this study. I have been given adequate time to consider my participation and agree to comply with the instructions and restrictions of the study.
☐
Name of volunteer............................................................................................... (BLOCK CAPITALS)
Signed................................................................................................................. Date...................................
Name of researcher/person taking consent........................................................ (BLOCK CAPITALS)
Signed................................................................................................................. Date....................................
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Appendix G – Study 2 Interview Schedule
Teacher interview
I am conducting a study on the experiences of learning, friendships and bullying in young
people with ASD and those of their parents/caregivers and teachers. This information will
provide me with understanding and direction for developing an intervention for schools to
address the need for more information on ASD, and the problem of bullying among peers.
Demographic questions
To begin, I’d like to get some basic information about you so that I can show those who
read my research report that I managed to obtain the views of a cross-section of people.
The information that you give will never be used to identify you in any way because all
information collected will be anonymised. However, if you don’t want to answer some of
the questions, please don’t feel that you have to.
a. Were you born in the UK? If not where you were born?b. How old are you? 20-30, 30-40, 40-50, 50+c. With which of the following groups do you most identify yourself?a. Asian or Asian-Britishb. Black/African/Caribbean/Black Britishc. White Britishd. Mixed racee. Other d. What is your highest educational qualification?e. What is your current position in the school?
1. Your beliefs about how well the school provides for pupils with ASDa. How many pupils are there with ASD in this school?b. Are all staff trained in autism? c. Please can you give some examples of strategies adopted by the school to help
pupils with ASD?d. What additional services are provided for pupils with ASD (SaLT, OT etc)?e. Mainstream only: How are the pupils with ASD integrated into mainstream
classes?f. Mainstream only: How well would you say inclusion is working in your school?
2. Your beliefs about how the school handles problems of bullyinga. How does the school deal with problems of bullying, specifically of pupils with
ASD?b. Can you tell me about any anti-bullying initiatives adopted by the school?
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c. What is your view about bullying in general? How problematic do you think it is for children with ASD?
d. Do you think there is more bullying of pupils with ASD in mainstream schools than there is in special schools? Why do you think this might be?
3. Your beliefs about how pupils with ASD manage learning at schooli. Can you tell me a bit about the needs of the pupils with ASD in general at this
school?ii. How well do pupils with ASD to in lessons in general?
4. Your beliefs about how pupils with ASD manage friendships at schooli. How well do you think pupils with ASD get on with other people at school?
ii. Do pupils with ASD maintain friendships over time, and if so what are the factors that enable them to be maintained?
iii. Do the staff play a particular role in facilitating friendships (e.g. to structure, establish or maintain friendships for pupils with ASD)?
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Appendix H – Study 3 & 4 Information Sheet
Participant Information Sheet
Attitudes of young people towards their peers
IntroductionMy name is Anna Cook. I am a PhD Psychology student at the University of Surrey working on a project about the attitudes of pupils in Year 7 towards their peers.
This research is funded by Qube Learning, and will be conducted in partnership with the National Autistic Society as part of a larger project evaluating ways to support students with autism. I invite you to take part in my project. Before you decide it is important for you to understand why the research is being done and what it will involve. Please take time to read the information carefully and discuss it with others if you wish. Ask me if there is anything that is not clear or if you would like more information. Take time to decide whether or not you wish to take part.
Thank you for reading this.
What is the purpose of the study?The purpose is to explore attitudes of pupils towards their peers in particular school situations.
Why have I been invited to take part in the study?You have been asked to take part because you are a pupil in year 7 and I would like to hear about your attitudes towards your peers.
Do I have to take part?No, you do not have to participate. It is up to you to decide whether or not to take part. If you do decide to take part you will be given this information sheet to keep, and you will be asked to sign a form agreeing to take part. If you decide to take part you can still change your mind and stop answering the questionnaire at any point, without giving a reason. Once you have handed in the questionnaire you cannot withdraw, however, because nobody will know which is yours. A decision to withdraw, or a decision not to take part, will not affect your academic progression or any subsequent application to the University of Surrey.
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What do I have to do?You will be asked to complete a questionnaire near the beginning of your school year. This will take place at school in a classroom or hall where you will be asked to work quietly and to answer questions as honestly as you can. A research assistant will be present in the room, together with a member of school staff. The questionnaire will take about 30 minutes and will include questions about you (e.g. your age and ethnic background) and about your attitudes towards a short story describing a made-up situation between students at school. You will be provided with assistance if you don’t understand any of the questions. You will then be asked to complete the same questionnaire again at the end of your school year.
What are the possible benefits and risks of taking part?
There is no direct benefit to you if you take part in this study, but your participation will be a valuable addition to research, which could lead to greater public understanding of pupil attitudes. I will be happy to provide a summary to the school of the research findings, after I have finished my project.
Due care will be taken to ensure you are not placed under any risk during the survey. However, if you feel uncomfortable about any of the questions asked, you can move to the next question, or to stop altogether. Appropriate support will be provided for you, should you require it.
Will information about me be kept anonymous?
Yes. All data collected during the course of the research will be anonymised so that those reading reports from the research will not know who has contributed to it. Personal data will be handled in accordance with the Data Protection Act 1998. Research data will be kept for a minimum of 10 years in line with university policy. Research data may be used in future research with your consent. This will be sought with a separate consent form to be signed by you.This study has been reviewed and received a favourable ethical opinion from the University of Surrey Ethics Committee.
What happens at the end of the research?Results will be written up to contribute towards my PhD, and may be published in an academic journal and/or presented at a conference. You can request a summary of the results by contacting me after October 2018.
What if there is a problem?Any complaint or concern about any aspect of the way you have been dealt with during the course of the study will be addressed; please contact [insert school contact details] at your school, or you may contact Anna Cook (Principal Investigator) direct at
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[email protected], or Professor Jane Ogden (Supervisor and Director of the PhD Programme) on 01483 686929. Alternatively you may contact Prof. Moore (Head of School - Psychology) on 01483 686933.
Who should I contact for further information?Principal Investigator: Anna Cook (email: [email protected])Supervisors: Prof Jane Ogden, Department of Psychology, University of Surrey (e-mail: [email protected]) or Dr Naomi Winstone, Department of Psychology, University of Surrey (email: [email protected])
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Appendix I – Study 3 & 4 Consent Forms
[LETTER TO PARENTS OF PUPILS AT CONTROL SCHOOLS]
September 2016
Dear Parents/Caregivers
Re: Research study on the attitudes of young people towards their peers
I am a PhD student in Psychology at the University of Surrey, conducting surveys as part of a research study about the attitudes of Year 7 pupils towards their peers. Permission to conduct this research has been granted by the Head Teacher of the school attended by your child in Year 7.
As a parent/caregiver of a child in Year 7, I am writing to invite your child to take part in the project. The survey will be in the form of a questionnaire and will take around 30 minutes during their school day (i.e. during tutor time, assembly or PSHE), once at the start of Year 7 and again at the end of the school year. Their responses to the questions will be anonymous. There is no compensation for participating in this study. However, their participation will be a valuable addition to this research and findings could lead to greater understanding of pupil attitudes at the start of their secondary school phase.
The enclosed Information Sheet explains more fully what is involved and should be read with your child if you agree that they may participate. If you are willing to allow your child to participate, you do not need to take any action. However, if you do not wish your child to take part, please inform your school secretary either by returning the slip below to [SCHOOL ADDRESS] or by email at [INSERT EMAIL ADDRESS] by [DATE].
If you would like further information, please do not hesitate to contact me (the researcher) at:[email protected]
Many thanks and kind regards
Yours sincerely
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Anna Cook MSc PhD Psychology Student
Research study on the attitudes of young people towards their peers I do not want my child to take part in the above research study.
Name of child_____________________________________
Name of parent____________________________________
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[LETTER TO PARENTS OF PUPILS AT CULLUM CENTRE SCHOOLS]
September 2016
Dear Parents/Caregivers
Re: Research study on the attitudes of young people towards their peers
I am a PhD student in Psychology at the University of Surrey, conducting surveys as part of a research study about inclusion and the attitudes of Year 7 pupils towards their peers in light of the introduction of the Cullum Centre at their school. Permission to conduct this research has been granted by the Head Teacher of the school attended by your child in Year 7.
As a parent/caregiver of a child in Year 7, I am writing to invite your child to take part in the project. The survey will be in the form of a questionnaire and will take around 30 minutes during their school day (i.e. during tutor time, assembly or PSHE), once at the start of Year 7 and again at the end of the school year. Their responses to the questions will be anonymous. There is no compensation for participating in this study. However, their participation will be a valuable addition to this research and findings could lead to greater understanding of pupil attitudes at in relation to the inclusive school approach adopted by their school.
The enclosed Information Sheet explains more fully what is involved and should be read with your child if you agree that they may participate. If you are willing to allow your child to participate, you do not need to take any action. However, if you do not wish your child to take part, please inform your school secretary either by returning the slip below to [SCHOOL ADDRESS] or by email at [INSERT EMAIL ADDRESS] by [DATE].
If you would like further information, please do not hesitate to contact me (the researcher) at:[email protected] thanks and kind regards
Yours sincerely
Anna Cook MSc PhD Psychology Student
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Research study on the attitudes of young people towards their peers I do not want my child to take part in the above research study.
Name of child_____________________________________
Name of parent____________________________________
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Pupil Consent Form
Research study on the attitudes of young people towards their peers
I voluntarily agree to take part in the study named above. ☐I have read and understood the Information Sheet provided (version 2, 02/08/16). I have been given a full explanation of the study, and of what I will be expected to do. I have been given the opportunity to ask questions on all aspects of the study and have understood the advice and information given as a result.
☐
I understand that all personal data about me is held and processed in the strictest confidence, and in accordance with the Data Protection Act (1998). I agree that I will not stop you from using the results of the study on the understanding that they are anonymous.
☐
I understand that I can stop answering the questionnaire at any point, without needing to explain my decision and without any consequences, but that once I have handed it in I cannot withdraw since nobody would know which questionnaire is mine.
☐
I agree for my answers to be used in further research with my consent. ☐I confirm that I have read and understood the above and freely consent to participating in this study. I have been given enough time to consider my participation and agree to follow the instructions of the study.
☐
Name of volunteer............................................................................................... (BLOCK CAPITALS)
Signed................................................................................................................. Date...................................
Name of researcher/person taking consent........................................................ (BLOCK CAPITALS)
Signed................................................................................................................. Date...................................
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Appendix J – Study 3 & 4 Questionnaire
3B
Attitudes of young people towards their peers
Thank you for agreeing to take part in this study. I would like to ask you some questions about your attitudes below.
What if you don’t understand the questions or words?
If there is a question or word you don’t understand, make sure you ask a teacher or researcher to explain what it means.
Will anyone know they are my answers?
Your answers in this survey are private. This means that your name is not on the form, and a member of staff will only know they are your answers if they help you fill in the form. If you don’t want to answer the question, just miss it out and move to the next one.
How do I answer the questions?
Don’t try to give the answer that you think you should give – we want to know how you really think and act. So please be as honest as possible. For each question, choose only ONE answer by marking an “X” in the box that fits your answer best. For example, if you saw the question:
How much do you think chocolate is…
Not at all Slightly Moderately Very Extremely
…Delicious?
☐ ☐ ☐ ☐ ☐You could choose “Not at all” if you do not like chocolate at all.You could choose “Extremely” if you think chocolate is extremely delicious.If you are somewhere in between, choose “Slightly”, “Moderately” or “Very”.
If you make a mistake, just scribble it out and put the “X” in your chosen box.
REMEMBER
Don’t put your name on the questionnaire. If you don’t want to answer a question, just skip it.
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The survey will take about 15 minutes – just take your time and ask for help if you don’t understand a question.
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About you…
1. Are you
Male ☐ Female ☐
2. My age is
11 years ☐ 12 years ☐
3. Do you have a disability or special educational needs (such as autism, ADHD, dyslexia or dyspraxia)?
Yes ☐No ☐Not sure ☐Prefer not to say ☐
4. Which one of these best describes youPLEASE TICK ONE BOX ONLY
Asian ☐Black ☐Mixed-race ☐White ☐Any other ethnic background ☐Don’t know ☐Prefer not to say ☐
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What is your house number (or house name)?
House Number or Name…………………………………
What is the first number in your date of birth?
First number of your date of birth………………………… (e.g. for 22 June, write the number 22)
What is the name of your first pet? (If you have never had a pet, put “None”)
First pet’s name…………………………………………………
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About your attitudes towards a story…
Please read the following story carefully and try to imagine yourself as somebody watching the scene taking place. You will then be asked to answer some questions about the story.
“Jack is a boy in your year group. You don’t know him well, but have been told that he has autism – a brain condition that causes him to have difficulties communicating with other people and to get anxious and even angry when things change unexpectedly or when there is lots of noise. One day, William – another boy from your form group – calls him a ‘freak’. This is not the first time it’s happened. On a previous occasion nasty things had been posted about Jack on social media. Jack tries to ignore it, but goes to sit on his own looking sad.”
Now, please answer the following questions:
1. How much do you think what happened to Jack was…
(Please give one “X” for every line)
Not at all
Slightly Moderately Very Extremely
…mean? ☐ ☐ ☐ ☐ ☐…exciting? ☐ ☐ ☐ ☐ ☐…deserved (i.e. Jack deserved it)? ☐ ☐ ☐ ☐ ☐…unfair? ☐ ☐ ☐ ☐ ☐…normal? ☐ ☐ ☐ ☐ ☐…funny? ☐ ☐ ☐ ☐ ☐…cruel? ☐ ☐ ☐ ☐ ☐…bullying? ☐ ☐ ☐ ☐ ☐
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2. If you watched this happen to Jack, how strongly do you think you would feel the following emotions? (Please give one “X” for every line)
Not at all
Slightly Moderately Very Extremely
Proud ☐ ☐ ☐ ☐ ☐Angry ☐ ☐ ☐ ☐ ☐Sorry for Jack ☐ ☐ ☐ ☐ ☐Excited ☐ ☐ ☐ ☐ ☐Sad ☐ ☐ ☐ ☐ ☐Amused ☐ ☐ ☐ ☐ ☐Satisfied ☐ ☐ ☐ ☐ ☐Ashamed of what William did ☐ ☐ ☐ ☐ ☐
3. How likely would you be to do the following? (Please give one “X” for every line)
Definitely Not
Probably Not
Possibly Probably Definitely
Report it to a teacher ☐ ☐ ☐ ☐ ☐Apologise to Jack ☐ ☐ ☐ ☐ ☐Do nothing ☐ ☐ ☐ ☐ ☐Laugh ☐ ☐ ☐ ☐ ☐Offer to hang out with Jack
☐ ☐ ☐ ☐ ☐Join in with William ☐ ☐ ☐ ☐ ☐Smile at Jack to show support for him
☐ ☐ ☐ ☐ ☐Encourage William to do more
☐ ☐ ☐ ☐ ☐About people you know with autism…
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Autism is a brain condition that causes people to have certain difficulties making sense of the world, and particularly communicating with other people and adjusting to changes.
1. Do you have a diagnosis of Autism or Asperger’s Syndrome?
Yes ☐No ☐Not sure ☐Prefer not to say ☐
2. How many people do you know that have autism or Asperger’s Syndrome?
Don’t know 0 1 2 3 More than 3
☐ ☐ ☐ ☐ ☐ ☐
3. How many people have autism or Asperger’s Syndrome in your family (including your extended family)?
Don’t know 0 1 2 3 More than 3
☐ ☐ ☐ ☐ ☐ ☐
4. How many of your friends have autism or Asperger’s Syndrome?
Don’t know 0 1 2 3 More than 3
☐ ☐ ☐ ☐ ☐ ☐
5. How often do you spend time these days with people that you know to have autism or Asperger’s Syndrome?
Never Rarely Sometimes Often Very Often
☐ ☐ ☐ ☐ ☐
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Think of a person you know who has autism or Asperger’s Syndrome. (If you don’t know anybody who has autism or Asperger’s Syndrome then try to imagine what this person would be like).
If you had to describe this person to your classmates, what kinds of words would you use?
Below is a list of words to help you. Circle the words you would like to use. You can use as many or as few words as you want.
Here is the list:
Healthy
Neat
Careful
Slow
Lonely
Glad
Sloppy
Pretty
Stupid
Clever
Cruel
Careless
Alert
Proud
Dishonest
Alright
Weak
Smart
Crazy
Bright
Unhappy
Greedy
Bored
Mean
Cheerful
Helpful
Ugly
Honest
Dumb
Happy
Ashamed
Friendly
Kind
Sad
Thank you for completing this questionnaire
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Vignette Types
(Target Group A: Typically Developing Target)
Emily/Jack is a girl/boy in your year group. You don’t know her/him well, but know that she/he is self-conscious about her/his weight. One day…
Violation 1: you hear Amy/William - another girl/boy from your form group - call her/him ‘freak’. This is not the first time it’s happened. On a previous occasion nasty things had been posted about Emily/Jack on social media. Emily/Jack tries to ignore the remark, but goes to sit on her/his own looking sad.
Violation 2: Emily/Jack walks up to you and some friends from your form and asks if she/he can join in your conversation. Amy/William - one of the girls/boys in your group says “no, we’re having a private conversation” and then turns her/his back on Emily/Jack to indicate that she/he should leave. This is not the first time it’s happened.
(Target Group B: Target with Autism)
Emily/Jack is a girl/boy in your year group. You don’t know her/him well, but have been told that she/he has autism – a brain condition that causes her/him to have difficulties communicating with other people and to get anxious and even angry when things change unexpectedly or when there is lots of noise. One day…
Violation 1: you hear Amy/William - another girl/boy from your form group - call her/him ‘freak’. This is not the first time it’s happened. On a previous occasion nasty things had been posted about Emily/Jack on social media. Emily/Jack tries to ignore the remark, but goes to sit on her/his own looking sad.
Violation 2: Emily/Jack walks up to you and some friends from your form and asks if she/he can join in your conversation. Amy/William - one of the girls/boys in your group says “no, we’re having a private conversation” and then turns her/his back on Emily/Jack to indicate that she/he should leave. This is not the first time it’s happened.
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Appendix K – Study 3 & 4 PSHE Survey Consent Form
Teacher Consent Form
Research study on the attitudes of young people towards their peers
I voluntarily agree to take part in the study named above. ☐I have read and understood the letter providing information about the survey (dated May 2017). I have been given a full explanation of the study, and of what I will be expected to do. I have been given the opportunity to ask questions on all aspects of the study and have understood the advice and information given as a result.
☐
I understand that all personal data about me is held and processed in the strictest confidence, and in accordance with the Data Protection Act (1998).
☐I understand that, after the survey has been completed, it will be combined with surveys from other schools and will not then be possible to identify my individual survey responses.
☐
I understand that I can stop answering the survey at any point, without needing to explain my decision and without any consequences.
☐I understand that my un-attributable answers may be used in further research. ☐I confirm that I have read and understood the above and freely consent to participating in this study. I have been given enough time to consider my participation and agree to follow the instructions of the study.
☐
Name of volunteer............................................................................................... (BLOCK CAPITALS)
Signed................................................................................................................. Date...................................
Name of researcher/person taking consent........................................................ (BLOCK CAPITALS)
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Signed................................................................................................................. Date....................................
Appendix L – Study 3 & 4 PSHE Survey
Over the past academic year, how many hours have ALL the children in Year 7 been exposed to the following?
None ½ hour
1 hour
2 hours 2 – 4 hours
5 or more hours
1. Films/videos specifically about autism
2. Films/videos about special educational needs & disability (SEND) in general or difference/diversity
3. Classroom discussion specifically about autism
4. Classroom discussion about SEND in general or difference/diversity
5. Work in small groups specifically about autism
6. Work in small groups about SEND in general or difference/diversity
7. Role-play sessions specifically about autism
8. Role-play sessions about SEND in general or difference/diversity
9. Teacher-led talk/lesson specifically about autism
10. Teacher-led talk/lesson about SEND in general or difference/diversity
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11. Whole year assemblies specifically about autism
12. Whole year assemblies about SEND in general or difference/diversity
13. Visiting speakers giving personal accounts of autism (role-models)
14. Visiting speakers giving personal accounts of SEND in general/difference/diversity (role models)
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Appendix M – Study 3 & 4 University Ethics Committee Approval
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Appendix N – Study 4 Debriefing
Debriefing (explanation of the study you took part in)
Thank you for contributing to our research, which measured the attitudes of students in Year 7 towards bullying in school.
You were either asked about your attitudes towards bullying of somebody with autism, or of somebody without autism. Many children with special educational needs experience bullying, so we wanted to explore the factors that might cause this.
We collected data from over 1000 Year 7 students from 6 schools. We hope that we might find some differences between your attitudes at the beginning of the year compared to the end of the year and also according to whether or not your school has a special centre for those with autism.
We predict that people with greater exposure to people with autism will have more positive attitudes about them. This could indicate greater understanding and acceptance of their differences and potentially improve the quality of the lives of young people with autism.
Thank you for taking part in the valuable research. We look forward to sharing the findings with you.
Anna Cook (and her team of research assistants from the University of Surrey).
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Appendix O – Study 5 Feasibility Study Interview Schedule
Effectiveness of a music intervention in primary schools: feasibility study
Current practice for teaching music in years 5/6
- National Curriculum requirements – how do you meet them?- Schemes of work/lesson plans – how do you use lesson times?- What kinds of themes/genres/areas to you introduce in years 5/6?- Timetabling of music on the curriculum- Teacher expertise – music specialists/non-specialists?- How do you assess progress in music?- Resources (instruments, A/V) and spaces- Extra-curricular music groups
Current methods of including ASD children in music lessons?
- Number of pupils with ASD in school?- Inclusion or separate classes?- Levels of ability/engagement with the curriculum of pupils with ASD?- Pairings/groupings?- How do you meet the needs of all children – are there - special strategies adopted in music for ASD children
Requirements for an intervention?
- Does the proposed intervention meet needs of the national curriculum?- Is it manageable within the timetable?- Can it be carried out with the available school resources?- What level of support would you require (training DVD, lesson plans, audio lessons)?- Would the senior leadership teams be supportive?
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Appendix P – Study Five Information Sheets
Information Sheet for Parents/Caregivers
Music and Attitudes Study
IntroductionMy name is Anna Cook. I am a PhD Psychology student at the University of Surrey working on a project about music and the attitudes of pupils towards themselves and their peers.
This research is funded by Qube Learning (a vocational training provider), and will be conducted in partnership with Surrey Arts (a division of Surrey County Council aimed to increase participation in the arts). I would like to invite your child to take part in my project. Before you decide if you are willing to give permission for your child to participate, it is important for you to understand why the research is being done and what it will involve. Please take time to read the information carefully and discuss it with others if you wish. Ask me if there is anything that is not clear or if you would like more information. Take time to decide whether or not you would like your child to take part.
Thank you for reading this.
What is the purpose of the study?The purpose is to explore attitudes of pupils towards their peers, and about themselves at the beginning and end of a school term, during which they will receive a singing course delivered by Surrey Arts.
Why has your child been invited to take part in the study?Your child has been asked to take part because they are a pupil in year 5 or 6 and I would like to hear about their attitudes towards their peers and about themselves before and after the singing course.
Does your child have to take part?No, they do not have to participate in the study. It is up to you to decide whether or not to give permission and it is also up to them whether or not to answer the questions in the questionnaire. However, all pupils in Year 6, and some in Year 5, will be expected to participate in the singing course, as this will be delivered during normal music lesson times. If you do decide to give permission for them to take part in the study you will be given this
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information sheet to keep, and no other further action will be required. Your child will be given their own information sheet to read. If they decide to take part they can still change their mind and withdraw from the study at any time (i.e. not complete the questionnaire) without giving a reason. However, once they have handed in a questionnaire the data cannot be withdrawn, because nobody will know which is theirs. A decision to withdraw, or a decision not to take part, will not affect their academic progression or any subsequent application to the University of Surrey.
What will your child have to do?They will be asked to give their consent to participate and to complete a questionnaire near the beginning of the school year. This will take place at school in a classroom where they will be asked to work quietly and to answer questions as honestly as they can. The researcher (Anna Cook) will be present in the room, together with a member of school staff. The questionnaire will take about 30 minutes and will include questions about them (e.g. their age and background) and about their attitudes towards their peers and also themselves. They will be provided with assistance if they don’t understand any of the questions. They will then be asked to complete the same questionnaire again at the end of the school term, after 11 weeks of class singing lessons from Surrey Arts.
What are the possible benefits and risks of taking part?
In addition to being given the opportunity to receive exciting class singing lessons from a highly skilled professional musician, your child’s participation will be a valuable addition to research, which could lead to greater public understanding of pupil attitudes. I will be happy to provide a summary to the school of the research findings, after I have finished my project.
The questionnaire will take place in a normal classroom and the pupils will not be exposed to any additional risk. The questionnaire will ask about their attitudes towards themselves and others, and in the unlikely event that they feel uncomfortable, their normal teacher will be present to help them
Will information about your child be kept anonymous?
Yes. All data collected during the course of the research will be anonymised so that those reading reports from the research will not know who has contributed to it. Personal data will be handled in accordance with the Data Protection Act 1998. Research data will be kept for a minimum of 10 years in line with university policy. Research data may be used in future research with their consent. This will be sought with a separate consent form to be signed by you and your child.
What happens at the end of the research?Results will be written up to contribute towards my research, and may be published and/or presented at a conference. You can request a summary of the results by contacting your school.
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What if there is a problem?Any complaint or concern about any aspect of the way you have been dealt with during the course of the study will be addressed; please contact [insert school contact details] at your school, or you may contact Anna Cook (Principal Investigator) direct at [email protected], or Professor Jane Ogden (Supervisor and Director of the PhD Programme) on 01483 686929. Alternatively you may contact Prof. Moore (Head of School - Psychology) on 01483 686933.
Who should I contact for further information?Principal Investigator: Anna Cook (email: [email protected])Supervisors: Prof Jane Ogden, Department of Psychology, University of Surrey (e-mail: [email protected]) or Dr Naomi Winstone, Department of Psychology, University of Surrey (email: [email protected])
This study has been reviewed and received a favourable ethical opinion from the University of Surrey Ethics Committee.
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Participant Information Sheet for Pupils
Music and Attitudes Study
Introduction: My name is Anna Cook. I am a student at the University of Surrey. I invite you to take part in my project. This sheet tells you why the research is being done and what it will involve. Please read the information carefully and discuss it with others if you wish. If anything is not clear, your parent/caregiver can contact me for more information. Take time to decide whether or not you wish to take part.
What is the purpose of the study? The purpose is to find out about what pupils think about themselves and other pupils in their school before and after a special music course delivered during music lessons.
Why have I been invited to take part in the study? You have been asked to take part because you are a pupil in year 5 or 6 and I would like to know what you think about yourself and also what you think about your peers before and after the music course.
Do I have to take part? No, you do not have to participate in the study. It is up to you to decide whether or not to answer the questions in the questionnaire. However, all pupils in Year 6, and some in Year 5, will be expected to participate in the music course, as this will take place during normal music lesson times. If you do decide to take part in the study, you will be asked to sign a form agreeing to take part. If you decide to take part you can still change your mind and stop answering the questionnaire at any point, without giving a reason. Once you have handed in the questionnaire you cannot withdraw, however, because nobody will know which was yours.
What do I have to do? You will be asked to complete a questionnaire near the beginning of your school year. This will take place at school in a classroom where you will be asked to work quietly and to answer questions as honestly as you can. The questionnaire will take about 30 minutes and will include questions about you (e.g. your age and background) and about your thoughts about your peers and also yourself. You will be provided with help if you don’t understand any of the questions. You will then be asked to complete the same questionnaire again at the end of your school term, after 11 weeks of the class music lessons.
What are the good things about taking part? In addition to being given exciting new class-music lessons, your responses will be a valuable addition to research.
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What if I don’t feel comfortable about taking part? If you feel uncomfortable about any of the questions asked, you can move to the next question, or stop altogether. You can also ask your teacher to help you if you wish.
Will people know the answers on my questionnaire are mine? No. All data collected during the course of the research will be anonymised (i.e. nobody will know it is yours).
What happens at the end of the research? Results will be written up to contribute towards my research, and may be published and/or presented at a conference.
What if there is a problem? Any complaint or concern about any aspect during the course of the study will be addressed; please contact your school.
Thank you for reading this.
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Appendix Q – Study 5 Consent Forms
July 2017
Dear Parents/Caregivers
Re: Research study on the attitudes of young people towards themselves and their peers
I am a PhD student in Psychology at the University of Surrey, conducting surveys as part of a research study about the attitudes of Year 5/6 pupils towards themselves and their peers. Permission to conduct this research has been granted by the Head Teacher of Eastwick Junior School.
As a parent/caregiver of a child in Year 5/6, I am writing to invite your child to take part in the project. The survey will be in the form of a questionnaire asking about their attitudes towards themselves and their peers. This will take around 30 minutes during their school day, once at the start of the Autumn term and again at the end of term. Throughout the course of the term they will receive a specialist class-singing curriculum delivered by a professional singing tutor provided by Surrey Arts. Your child’s responses to the questions will be anonymous. There is no compensation for participating in this study. However, their participation will be a valuable addition to this research and findings could lead to greater understanding of pupil attitudes near the end of the junior school phase.
The enclosed Information Sheet explains more fully what is involved. In addition I enclose a separate Information Sheet for pupils and would be grateful if you could read this with your child if you agree that they may participate. If you are willing to allow your child to participate, you do not need to take any action. However, if you do not wish your child to take part, please inform your school secretary either by returning the slip below to Eastwick Junior School office or by email at [INSERT EMAIL ADDRESS] by [DATE].
If you would like further information, please do not hesitate to contact me (the researcher) at:[email protected]
Many thanks and kind regards
Yours sincerely
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Anna Cook MSc PhD Psychology Student
Research study on the attitudes of young people towards themselves and their peers I do not want my child to take part in the above research study.
Name of child_____________________________________
Name of parent____________________________________
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Pupil Consent Form
Research study on the attitudes of young people towards themselves and their schoolmates
I voluntarily agree to take part in the study named above. ☐I have read and understood the Information Sheet provided (version 3). I have been given a full explanation of the study, and of what I will be expected to do. I have been given the opportunity to ask questions on all aspects of the study and have understood the advice and information given as a result.
☐
I understand that all information about me is held and processed in the strictest confidence and that all my responses are anonymous (nobody will know they are mine).
☐
I understand that I can stop answering the questionnaire at any point, without needing to explain my decision but that once I have handed it in I cannot withdraw since nobody would know which questionnaire is mine.
☐
I consent for my answers to be used in further research. ☐I confirm that I have read and understood the above and freely consent to participating in this study. I have been given enough time to consider my participation and agree to follow the instructions of the study.
☐
Name of volunteer...............................................................................................(BLOCK CAPITALS)
Date......................................................
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Appendix R – Study 5 Questionnaire
Attitudes of children towards their peers
Thank you for agreeing to take part in this study. I would like to ask you some questions about your attitudes below.
What if you don’t understand the questions or words?
If there is a question or word you don’t understand, make sure you ask a teacher or researcher to explain what it means.
Will anyone know they are my answers?
Your answers in this survey are private. This means that your name is not on the form, and a member of staff will only know they are your answers if they help you fill in the form. If you don’t want to answer the question, just miss it out and move to the next one.
REMEMBER
Don’t put your name on the questionnaire If you don’t want to answer a question, just skip it The survey will take about 30 minutes – just take your time and ask for help if you don’t
understand a question
About you…
1. Are you
Male Female
2. My age is
9 years 10 years 11 years
3. Which one of these best describes youPLEASE TICK ONE BOX ONLY
Asian ☐Black ☐Mixed ☐
B
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White ☐Any other ethnic background ☐Don’t know ☐Prefer not to say ☐
What is your house number (or house name) [from your address not your telephone number]?
House Number or Name……………………………………………
What is the first number in your date of birth?
First number of your date of birth…………………………….(e.g. for 22 June, write the number 22)
What name did you give your first pet? (If you have never had a put, put “None”)
First pet’s name………………………………………………………..
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Now think back to what you were like last term. Then read the sentences below and indicate how much each one sounds like you when you were at school last term. To do this tick one of the answers for each statement. There are no right or wrong answers:
Not at all like
me
Slightly like me
Moderately like me
Very much
like me
Extremely like me
1. If there was an argument between children, I would try to stop it.
☐ ☐ ☐ ☐ ☐
2. I invited other children to join in my game.
☐ ☐ ☐ ☐ ☐3. If I saw someone who has been
hurt, I tried to help them.☐ ☐ ☐ ☐ ☐
4. If another child had dropped something, I helped to pick it up.
☐ ☐ ☐ ☐ ☐
5. I took the opportunity to praise the work of other children.
☐ ☐ ☐ ☐ ☐6. I showed sympathy for
someone who had made a mistake.
☐ ☐ ☐ ☐ ☐
7. I offered to help other children who were having difficulty with a task in class.
☐ ☐ ☐ ☐ ☐
8. I helped other children who were feeling sick.
☐ ☐ ☐ ☐ ☐9. I would comfort a child who was
crying or upset.☐ ☐ ☐ ☐ ☐
10. I volunteered to help clear up a mess someone else had made.
☐ ☐ ☐ ☐ ☐11. I felt sorry for other kids who
didn’t have toys and clothes.☐ ☐ ☐ ☐ ☐
12. When I saw someone being picked on, I felt sorry for them.
☐ ☐ ☐ ☐ ☐13. I felt sorry for people who didn’t
have the things that I had.☐ ☐ ☐ ☐ ☐
14. When I saw another child who was hurt or upset, I felt sorry for them.
☐ ☐ ☐ ☐ ☐
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15. I often felt sorry for other children who were sad or in trouble.
☐ ☐ ☐ ☐ ☐
16. I felt sorry for other children who were being teased or picked on.
☐ ☐ ☐ ☐ ☐
17. I felt sorry for another kid who had made a mistake.
☐ ☐ ☐ ☐ ☐
Show how often the following statements were true for you when you were at school last term. To do this tick one of the answers for each statement.
Never Once in a while
Pretty Often
Very Often
1. I got called names by others ☐ ☐ ☐ ☐2. I gave soft kids a hard time ☐ ☐ ☐ ☐3. I got picked on by others ☐ ☐ ☐ ☐4. I was part of a group that goes around
teasing others☐ ☐ ☐ ☐
5. I liked to make others scared of me ☐ ☐ ☐ ☐6. Others left me out of things on purpose ☐ ☐ ☐ ☐7. I liked to show others that I’m the boss ☐ ☐ ☐ ☐8. I enjoyed upsetting wimps, someone I
could easily beat☐ ☐ ☐ ☐
9. I liked to get into a fight with someone I could easily beat
☐ ☐ ☐ ☐10. Others made fun of me ☐ ☐ ☐ ☐11. I got hit and pushed around by others ☐ ☐ ☐ ☐
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Read each of the following sentences carefully and show how strongly you agree or disagree with it. To do this tick one of the answers under each statement.
Agree Unsure Disagree
1. Kids who get picked on a lot usually deserve it ☐ ☐ ☐2. A bully is really a coward. ☐ ☐ ☐3. Kids should not complain about being bullied. ☐ ☐ ☐4. It’s funny to see kids get upset when they are teased. ☐ ☐ ☐5. Kids who hurt others weaker than themselves should be
told off.☐ ☐ ☐
6. Soft kids make me sick. ☐ ☐ ☐7. You should not pick on someone who is weaker than
you.☐ ☐ ☐
8. Nobody likes a wimp ☐ ☐ ☐9. It makes me angry when a kid is picked on without
reason.☐ ☐ ☐
10. I like it when someone sticks up for kids who are being bullied.
☐ ☐ ☐
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About your attitudes towards a story…
Please read the following story carefully and try to imagine yourself as somebody watching the scene taking place. You will then be asked to answer some questions about the story.
“Jack is a boy in your year group. You don’t know him well, but have been told that he has autism – a brain condition that causes him to have difficulties communicating with other people and to get anxious and even angry when things change unexpectedly or when there is lots of noise. One day, Jack walks up to you and some friends from your form and asks if he can join in your conversation. William – one of the boys in your group – ignores him and turns his back on Jack to indicate that he should leave. This is not the first time it’s happened.”
Now, please answer the following questions:
(Please give one tick for every line)
1. How much do you think what happened to Jack was…
Not at all Slightly Moderately Very Extremely
…mean? ☐ ☐ ☐ ☐ ☐…exciting? ☐ ☐ ☐ ☐ ☐…deserved (i.e. Jack deserved it)?
☐ ☐ ☐ ☐ ☐…unfair? ☐ ☐ ☐ ☐ ☐…normal? (i.e. just an ordinary event?)
☐ ☐ ☐ ☐ ☐…funny? ☐ ☐ ☐ ☐ ☐…cruel? ☐ ☐ ☐ ☐ ☐…bullying? ☐ ☐ ☐ ☐ ☐
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2. If you watched this happen to Jack, how strongly do you think you would feel the following emotions? (Please give one tick for every line)
Not at all
Slightly Moderately Very Extremely
Proud ☐ ☐ ☐ ☐ ☐Angry ☐ ☐ ☐ ☐ ☐Sorry for Jack ☐ ☐ ☐ ☐ ☐Excited ☐ ☐ ☐ ☐ ☐Sad ☐ ☐ ☐ ☐ ☐Amused (i.e. it would make you laugh)
☐ ☐ ☐ ☐ ☐Satisfied (i.e. content) ☐ ☐ ☐ ☐ ☐Ashamed of what William did ☐ ☐ ☐ ☐ ☐
3. How likely would you be to do the following? (Please give one tick for every line)
Definitely Not
Probably Not
Possibly Probably Definitely
Report it to a teacher ☐ ☐ ☐ ☐ ☐Apologise to Jack (on behalf of William)
☐ ☐ ☐ ☐ ☐Do nothing ☐ ☐ ☐ ☐ ☐Laugh ☐ ☐ ☐ ☐ ☐Offer to hang out with Jack ☐ ☐ ☐ ☐ ☐Join in with William ☐ ☐ ☐ ☐ ☐Smile at Jack to show support for him
☐ ☐ ☐ ☐ ☐Encourage William to keep ignoring him
☐ ☐ ☐ ☐ ☐
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[T2 Only]
Your music lessons
This term you had 11 music lessons with Mrs Askew. Please think about these lessons and answer the questions below.
What did you like best about the music lessons?
What didn’t you like as much?
How well do you feel your group worked together, and did this change over the term?
If there is anything else you want to say about the music lessons, please write it here…
Thank you for completing this questionnaire
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Appendix S – Study 5 University Ethics Committee Approval
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