Improving the Wellbeing of Autistic Girls at School

Originally published in Teaching Times 07.05.2024

By Dr Sue Sheppard, Educational Psychologist and Module Leader for Real Training’s postgraduate courses in autism
  

If you could model a learning environment that was intended to be an assault on the senses it might very much look like a typical school.

To a neurotypical person this might be difficult to comprehend – yet for a young autistic person, our schools can be the epitome of chaos. Hundreds of children shouting noisily, teachers raising their voices to be heard, bells going off, the constant echo of footsteps in corridors, people talking all at once in lessons, dense slides, bright lights, itchy uniforms, a bombardment of smells in the dining room.
  
It can take a lot of energy just to be there.
  
For autistic girls, however, this exhaustion is often multiplied due to their need for perfectionism and the pressures of masking as they strive to meet social expectations. The more we learn about their routines, including ruminating, the clearer it becomes that this can be at the detriment to positive wellbeing. Autistic girls have even been described as ‘little psychologists’ by some in the field, due to their tendency to over-analyse events and experiences.

Gender stereotypes have shifted over the last ten years or so and we now recognise the nuances of autism in girls. I’ve spent thirty years as an educational psychologist, developing a specialism in autism and in recent years have increasingly worked with young autistic girls. Many of these girls report feeling isolated, misunderstood, anxious and exhausted. There is a significant increase in those who find attendance challenging and many have been out of school for extended periods of time. These students may gain other labels, for example, anxiety or depression which become the focus and their wider needs can then be ignored. It has been suggested that up to 80% of autistic girls remain undiagnosed at the age of 18.

Much of what I have learned comes from listening carefully to autistic girls and women and their families. Here’s what I would advise teachers and leaders to focus on;

Provide meaningful ways to connect

Research is showing that a ‘sense of belonging is key’ for autistic girls who need to find a feeling of community just as much as their peers. Many autistic girls can struggle with this at school, however, some girls might be very sociable and talkative and others will be more shy and isolated. It is important to ensure autistic girls spend regular time with named key staff who can really get to know them and ‘empower’ them to share their views around what works well for them and what makes challenges worse.

In a recent video produced by the Donaldson Trust, Erin Davidson, a 17-year-old with autism explains that “the feeling of isolation at school was, well, crushing because I could be surrounded by people and still be entirely alone.”

Schools can help by setting up supportive lunchtime or drop-in groups for neurodiverse girls so they find peers they can relate to and perhaps even gain support from. Providing peer mentorship schemes or buddy schemes with empathetic neurotypical peers or trained wellbeing ambassadors can also be considered, with guidance from teachers or support staff.

Breaktimes can be problematic because they are unstructured. Providing activities where autistic girls can bond with a small group in shared activities such as art/craft, origami workshops, digital animation or film clubs, reduces the need for scripted small talk and allows them to talk about an interest with others who are equally passionate. It might bring added benefit of providing some much-needed sensory stimulation or opportunities for relaxation.

Recognising anxiety triggers and managing transitions

Emerging research suggests autistic girls may be more prone to anxiety than autistic boys. Before adaptations can be made, we need to identify the triggers for each individual. Often, for girls, this can be related to unexpected changes, a lack of control over transitions and a need for perfectionism. Classroom-based solutions might include; pre-warning of changes, sticking to ‘set’ seating patterns and allowing autistic individuals to leave the classroom five minutes earlier than their peers when it is quieter. At the same time, it is very important to ensure they do not find themselves ‘standing out’ even more. They may need more individual instructions to get started and visual supports and prompts, plus reassurance that they are on track.

Outside of the classroom, anxiety drop-in workshops can help equip girls with calming strategies, breathing techniques and ways to understand and avoid catastrophizing and negative thought patterns. One technique I often find works well in individual work is the ‘size of the problem’ method of viewing their concerns. Introducing the idea of a ‘stress bucket’ has also been effective as has teaching about ‘automatic negative thought patterns’ and using ‘laddering and rating scales’. Visual demonstrations of ideas are important and analogies often seem to help. Additional support from staff who have specialist skills and autism training will help each girl build up a personal ‘toolkit’ of strategies to understand and manage anxiety. It takes time, but is very important, as is the encouragement to trial ideas.

Reducing sensory overload in the classroom

Reducing sensory overload in the classroom; it is important to recognise that individual needs will be quite different here, so teachers should work closely with the young person to identify what helps, whether that’s allowing her to wear noise-cancelling headphones or providing a preferred seat at the front of the class or pulling down blinds etc. Some schools also provide the opportunity to use screens at workstations or a quiet zone. Individuals will differ and may experience hyper and hypo sensitivity to sensory input. I usually carry out sensory audits as part of my assessments. Take note, as well, that the dining hall can be hugely problematic and separate spaces for eating lunch may be needed.

Some girls will find the concept of pair work uncomfortable, others end up leaning on just one solitary friend. Teachers could steadily build up a small rotation of ‘trusted and preferred’ peers to increase the quality of social interaction and also help broaden the ideas that are discussed. Giving set roles in advance which draw on their strengths is useful, for example, appointing a girl who has skills in drawing as the illustrator. If the pace of lessons is a challenge, providing opportunities for remote or virtual work, such as collaboration via Google documents and allowing ‘time to process’ thoughts can also be beneficial.

Teaching self-compassion

Girls who gain a diagnosis can feel more understood, but this journey can take time. Building positive affirmations into the routine of school life and teaching self-compassion can help guard against this. Perfectionism and over-analysing are common traits in autistic girls, so teachers should work with students to set realistic goals and teach that failure can be a benefit to learning.

Recognising and developing strengths; providing an outlet to work on and highlight strengths is essential. Take the lead from the individual and identify areas she enjoys e.g; drama, art, music, literature, baking, any sports, forest school skills, design and construction etc. Personally, I have seen girls who’ve been put in charge of social enterprise initiatives linked to their interests, such as catering for school events, really thriving in secondary school. We should celebrate areas where they do excel e.g. specific subjects, strong memories for facts, and good vocabularies. Often autistic girls have rich imagination and creativity and are strong with logical systems.

Regular rest and restore opportunities

For the majority of autistic girls masking and/or sensory overload is exhausting and they need opportunities to ‘recharge’. This could be a time-out system from class, quiet zones for break times and access to a ‘safe-haven’. They need ways to access safe spaces in school where there are named adults they can turn to. Reduced timetables at GCSE level can also facilitate positive learning outcomes.

While, in my experience, later arrival times can sometimes add unnecessary pressure about being treated ‘differently’ and ‘standing out’, slightly earlier departure times and/or relaxing or solitary activities before it is time to leave school can, and should, be offered. This provides the young person with an opportunity to decompress, get away from the sensory overload of school and travel home at a quieter time of day.

Working very closely with parents

Autistic girls need opportunities to unmask. They may hold it together during the school day but then release frustration or anxieties when they get home. Having open lines of communication with parents is essential, often school professionals will think that a young pupil is coping fine, but parents will have a very different view. In her highly informative video about spotting the signs of autism, Immie Swain describes how she would “keep it together at school but then when I got home everything would go wrong.” Schools need to know this whole picture and listen to parents. Alleviating pressures at school can make life at home easier. Sleep issues are also common and will further impact learning if not identified and supported.
  

Specific PSHE advice

I don’t like referring to autistic people as vulnerable learners, because it’s often our artificially created “neurotypical” environment that renders them that way. Autistic girls may be very adept learners, however, they can struggle to be flexible in rapidly changing social situations. Their lack of natural ability to pick up on social cues can make them more likely to be vulnerable to exploitation and bullying and in some cases victims of sexual assault. Teaching them how to stay safe will be important.

Schools might consider getting special-trained staff to teach sex-ed to autistic girls who often don’t discover intimacy until much later or indeed prefer not to have physical intimacy. They may also need more support when it comes to things like self-care and diet. Eating disorders can be present and need specialist support but eating issues may also relate to sensory factors or routines relating to calorie counting and specific diets. Schools need to be mindful and seek advice when it’s required.

Alternative female role models; some autistic girls might initially try to copy the most popular girl in the school or influencer on social media, but usually end up finding their own style. Highlighting positive neurodiverse role models in lessons can help them broaden their idea of what it is to be successful. There is a greater likelihood that autistic girls will not conform to gender norms and they may have a more unique understanding of interpersonal relationships.
   

Access to animals and nature

Time spent with animals and in nature can help alleviate anxiety, as well as helping with social interaction. Autistic girls often love their pets and are drawn to animals and report finding them more predictable than people. Whereas boys with autism may be more fixated on mechanical things, girls tend to have special bonds relating to animals and build positive relationships in this way. Schools that have a ‘school dog’ or links with horse riding centres or local farms have utilised such programmes with success.

Using alternative sports as an outlet for confidence-building

Sport can be another way for autistic girls to tap into a community as well as generally releasing endorphins. If your pupil finds team sports challenging, then offering her engaging solo activities such as fitness suites, wall climbing, swimming, and trampolining might also serve a similar purpose. Athletics is often popular. Sometimes, the most compassionate thing to do is just to let her sit out some PE activities (especially team-based ones).

Final thoughts

Autism has been vastly under-diagnosed in women and many education professionals are only now just beginning to learn how to spot the signs in the current generation of young girls – some of whom go to incredible lengths to camouflage their ASD.

Although some autistic girls may be quiet and not seek the attention of the group, this does not always mean they are ok. As they go through school and ‘informal rules’ around female social lives become more complex, the effort required to blend in will become more intense. It can feel isolating and anxiety-provoking if you want to keep talking about horses or manga characters, but your peers have moved on to other things.

It is vital, therefore, that individual needs are clearly identified and the right one-to-one support is put in place. This means not just making adaptations for multi-sensory needs within the classroom, but considering wellbeing and self-confidence in a broader context that will promote a ‘sense of belonging’, as well as increasing confidence and happiness. Sarah Hendrix, an autism advocate, speaker and assessor, has created a great video exploring how to do this.

Some of this requires a shift in mindset. Rather than simply trying to coach girls about how to fit in and improve their social skills – we should also be enabling them to find those moments of meaningful connection where they can genuinely be themselves. We also need to listen with care to identify solutions to any presenting challenges and we will need to be creative and highly flexible.

In a recent survey, conducted by the National Autistic Society only 14% of secondary teachers said they received more than half a day’s training on autism. Given the nuances of how ASD presents, particularly in girls, it is difficult to see how this can be sufficient. We need a whole school approach to build an autism-friendly school with good levels of training for all staff and an ‘autism champion’ who takes the lead.

Auditing autism provision in your setting should be a priority, both to celebrate what you are doing well, but also to identify an action plan for enhancing provision for this group.

Dr Sue Sheppard is a practicing educational psychologist. She is also Real Group’s specialist EP for autism and module leader for Real Training’s postgraduate courses in autism. She has been a consultant to the Lorna Wing Centre for Autism (part of the National Autistic Society) since 1996 and is embedded in the internationally recognised DISCO diagnostic training team. 

After starting her early career as a specialist teacher, Sue worked as an EP for numerous London boroughs. She has been instrumental in setting up provision for children with ASD across early years, primary and secondary. She continues to work in schools and with families and undertakes specialist psychological assessments of autistic children and young people.