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unpublished) are fully identified as such within the work and attributed to their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.

iii

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

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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

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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

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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.

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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.

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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

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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

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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.

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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

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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).

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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

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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.

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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)

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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

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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.)

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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

121

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

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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.

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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

148

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

149

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)

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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

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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 a.h.cook@surrey.ac.uk. 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 a.h.cook@surrey.ac.uk, 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: a.h.cook@surrey.ac.uk)Supervisors: Prof Jane Ogden, Department of Psychology, University of Surrey (e-mail: j.ogden@surrey.ac.uk) or Dr Naomi Winstone, Department of Psychology, University of Surrey (email: n.winstone@surrey.ac.uk)

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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

243

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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 a.h.cook@surrey.ac.uk, 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: a.h.cook@surrey.ac.uk)Supervisors: Prof Jane Ogden, Department of Psychology, University of Surrey (e-mail: j.ogden@surrey.ac.uk) or Dr Naomi Winstone, Department of Psychology, University of Surrey (email: n.winstone@surrey.ac.uk)

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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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a.h.cook@surrey.ac.uk, 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: a.h.cook@surrey.ac.uk)Supervisors: Prof Jane Ogden, Department of Psychology, University of Surrey (e-mail: j.ogden@surrey.ac.uk) or Dr Naomi Winstone, Department of Psychology, University of Surrey (email: n.winstone@surrey.ac.uk)

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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:a.h.cook@surrey.ac.uk

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:a.h.cook@surrey.ac.ukMany 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 a.h.cook@surrey.ac.uk, 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: a.h.cook@surrey.ac.uk)Supervisors: Prof Jane Ogden, Department of Psychology, University of Surrey (e-mail: j.ogden@surrey.ac.uk) or Dr Naomi Winstone, Department of Psychology, University of Surrey (email: n.winstone@surrey.ac.uk)

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:a.h.cook@surrey.ac.uk

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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