“The big wide world of school”: Supporting children on the autism spectrum to successfully transition to primary school: Perspectives from parents and early intervention professionals
Published Online: Aug 11, 2020
Page range: 91 - 100
DOI: https://doi.org/10.21307/sjcapp-2020-009
Keywords
© 2020 Nigel Chen et al., published by sciendo.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Commencing primary school is the first major educational transition in a child’s young life (1), and a critical period where appropriate supports can have a meaningful impact on short and long term academic, social and mental health outcomes (2-5). Whilst typically seen as a positive experience, educational transitions can present significant challenges for children, as well as their families and teachers (6). Transition to school is invariably accompanied by the loss of existing supports, coupled with the need to establish new supports and relationships with school teachers and peers (7-9). The experience of transitioning is often associated with increased anxiety, and uncertainty for both the child and their family (10).
While adapting to new environments and coping with uncertainty are difficult for all children, this time can be particularly challenging for families who have a child with a disability, such as Autism Spectrum Disorder (ASD) (1, 11). The complex nature of ASD can contribute to significant difficulties during the transition process, with autistic “Autistic” is used throughout this manuscript in accordance with preferences of the autistic community. Kenny L, Hattersley C, Molins B, Buckley C, Povey C, Pellicano E. Which terms should be used to describe autism? Perspectives from the UK autism community. Autism 2016;20(4):442-462. doi:10.1177/1362361315588200
Transition to school is defined as the transition of a child and their family to new service delivery models through a series of coordinated steps (16). The transition may be deemed successful, when children feel secure and comfortable, are eager to attend school, develop academic and social skills, attain higher levels of independence, participate actively with peers and teachers, and experience a sense of wellbeing, belonging and inclusion (7). Influencing the successful transition to school is school readiness, a broad concept encompassing the skills and abilities a child needs to be successful at school, as well as the schools readiness for the child and the family’s readiness for their child to make the transition to school (17, 18). One well-established contemporary definition describes school readiness as going beyond academic skills or child-related factors, taking a systems-focused perspective highlighting the mediating influence of external factors in preparing a child for school, contextualizing a child within the environment and emphasizing the importance of an active, rather than a passive role for the receiving teacher and school (19). This model also draws attention to the influence of more overarching factors, not directly related to an individual child, such as educational policies at the local and national level (19).
This multidimensional, or “interactionist” model is further developed by Britto (17) who argues that school readiness consists of two characteristics (transition and gaining competencies), on three dimensions (children’s readiness for school, schools’ readiness for children, and families’ and communities’ readiness for school). The interplay of these three dimensions work towards preparing for the upcoming challenges associated with the transition.
While research has begun to explore the issue of school readiness for autistic children, including the identification of barriers and protective factors (1, 2, 6, 10, 18, 20), this research is limited (10). The benefits of intervention in the early years preceding school entry is well established with findings supporting the role of early intervention (EI) in promoting school readiness, and later academic and social success (21). A growing number of autistic children also participate in EI programs leading up to school with the goal of preparing them for school life. While EI programs differ in regard to their theoretical underpinnings and operational frameworks many achieve positive outcomes for children (22, 23). Evidence supports the importance of tailored supports, both for the child and family, in facilitating positive transition outcomes (1, 2, 24).
Consistent with multi-dimensional or interactive models of school readiness and transition planning, is consideration of the influence of a range of personal and contextual factors on successful transition to school. Perceptions as to what constitutes a successful transition for an individual child likely differ between stakeholders. While parents and teachers share many of the same beliefs in regard to as what supports facilitate the transition process, there is evidence that they define success differently (25). For example, in a survey study, Dockett and Perry (25) found parents emphasized academic preparedness more than teachers, whilst teachers placed more emphasis on adjustment to the school environment. However, the authors noted that while differences were apparent in trends in responses between groups, context and individual circumstances made it difficult to define a single set of universal predictors for a successful transition to school for autistic children. This highlights the importance of consulting the various stakeholders actively involved in the transition process. For this reason, this study sought to understand the perspectives of parents and EI staff on school readiness and transitioning planning for autistic children.
An inductive qualitative (26) research design was employed, seeking the rich meanings, understandings and perspectives of parents and EI staff across Australia. Focus group methodology and interviews were utilized (27) aiming to obtain a broad understanding of the attitudes and perceptions of participants.
This study was undertaken across Australia, including Western Australia, New South Wales, South Australia, Queensland, and Tasmania. Schooling in Australia varies across states, however, consists of 13 years of education, including primary school, secondary school and senior secondary school. Compulsory schooling (primary to secondary) begins at approximately five to six years of age (28). Prior to engaging in school, children can attend kindergarten or preparatory school, or day-care.
Autism Specific Early Learning and Care Centres (ASELCCs) are accredited long day-care centres, providing early intervention and parental support for autistic children up to six years of age. The therapeutic services provided by ASELCCs draw primarily from behaviour-based interventions, such as
A total of 45 EI professionals and 18 parents of autistic children participated in this study. Both EI and parent participant groups were recruited via ASELCCs across Western Australia, New South Wales, South Australia, Queensland, and Tasmania.
Parents of children were provided with information regarding the present study, and were invited to participate if their child was transitioning out of an ASELCC in Term 4, 2017, to commence school at the start of 2018. Parent participants were primarily female (n = 15). The parent group collectively included 24 autistic children who were predominantly male (n = 16).
EI staff were offered the opportunity to volunteer for this project if they held professional experience with transitioning autistic children to school from an EI setting. EI staff were informed that participation was not a requirement of their employment. EI staff were primarily female (n = 42). There was some overlap in roles for EI staff (i.e. staff members holding multiple roles). EI staff included trained teachers or educators (n = 14), early learning providers (n = 7), health professionals such as occupational therapists (n = 9), speech pathologists (n = 5), physiotherapist (n = 1), social workers (n = 1), behaviour analysists (n = 1), program managers, team leaders and coordinators (n = 8), and administrative staff (n = 2). EI staff experience working with autistic children ranged from 0.25 to 39 years, with the median experience being four years.
A total of five focus groups and four interviews were conducted with EI staff while two focus groups and nine interviews were conducted with parents. Focus groups for EI staff and parents were, on average, 59.2 and 82.5 minutes long, respectively. Interviews were on average 32.3 minutes for EI staff and 32.8 minutes for parents. Parents and EI staff who were unable to attend focus groups were offered the opportunity to participate in an interview.
Qualitative focus group and interview responses were transcribed and exported into NVIVO (30) to be organized using inductive thematic analysis (31). In accordance with the process outlined by Braun and Clarke’s six phrase process (31), the research team first familiarized themselves with the transcripts and data. Initial codes were then generated by selecting and highlighting (32) relevant sections of text from the focus group transcripts. Initial codes were allocated to the text that described the journey of the child, the experience of the parents and relationship between the school, ASELCC EI provider and therapy providers. These initial codes were then collated into emerging potential themes. Based on a review of the emerging themes, main-themes and sub-themes were then defined and named. Following this process, all content was re-coded according to the sub-themes and main themes. Trustworthiness was ensured by addressing the four aspects of credibility, transferability, confirmability and dependability (32). To reduce the potential for researcher bias in interpreting qualitative responses, three research members independently coded qualitative responses. The research team met frequently to discuss the coding process with disagreement resolved via discussion. An audit trial of the thematic analysis process was also maintained in accordance with guidelines provided by (33). This included maintaining a record of the raw data and process notes, as well as documenting each stage of code and theme generation. The research team included managers of ASELCC centres, facilitating member checking and ensuring that the results accurately reflected the perceptions of the participants.
Thematic analysis resulted in 19 sub-themes falling under four main themes including 1) building the child; 2) building the parents; 3) building the school and 4) connecting the system (Figure 1). Here, “building” was coined to refer to development via a combination of supports and empowerment.
FIGURE 1.
Results of thematic analysis. Headings indicate primary themes; bullet points indicate sub-themes
The theme of building the child was built upon four sub-themes, 1) coping with change and developing routine, 2) developing a child’s independence, 3) managing a child’s anxiety and meltdowns and 4) understanding the child as an individual. These sub-themes were seen as key in supporting a successful transition to school for autistic children. School readiness for autistic children was clearly defined as going beyond literacy and numeracy skills. For parents and EI staff, school readiness included being independent in self-care and daily routines, and having sufficient emotional and social skills to cope with setbacks or changes in routine. These skills were important in enabling autistic children to effectively engage in and transition to school:
EI staff identified school readiness in the area of independence as developing self-care skills such as toileting, washing hands and carrying their bags, ideally prior to the transition to school. Independence in communication, inclusive of augmentative and alternative communication (AAC) when required, was also considered important in supporting the children’s opportunity to learn and engage:
Preparing children to cope with change and the new demands of the school environment were seen as critical by both parents and EI staff, who perceived the school environment as vastly different from the children’s present environments, such as preschool. Children reportedly needed time to adjust to the new demands of the classroom environment, with elements such as classroom noise and the increased number of peers identified as potential sources of stress. Supporting children to cope with the future changes and differences in routine and structure were particularly important to consider, with parents raising that changes in daily routine were likely to be particularly disruptive and distressing to their children. It was recognised that while school classrooms were structured, they were less structured than the children’s current environments:
According to EI staff, school environments would likely challenge autistic children in regard to sensory load, emotion regulation and managing anxiety, hindering the children’s successful transition to school. EI staff saw themselves as playing a key role in building resilience in autistic children, working with them to develop techniques and skills to manage these stressors. Developing appropriate emotional coping strategies was a prerequisite for both school readiness and ensuring successful transition, with building a child’s ability to self-regulate and manage their anxiety and emotions important in ensuring that they were equipped to cope with changes and engage in school. EI staff and parents focussed on providing autistic children with the necessary skills to recognize their emotions and strategies to manage and cope, including a ‘toolbox’ of sensory toys and other resources, enabling children to regulate their emotions independently in the school environment.
Important in the process of building a child’s capacities in anticipation of their upcoming transition to school, was understanding and recognizing that each child was unique. While EI staff reported that
Building the parents related to references that supported developing parental capacity to support their child. The theme comprised of four sub-themes including 1) parents being actively involved in advocating for their child, 2) providing structures and connecting parents to services, 3) supporting parents to manage anxiety and challenges and 4) upskilling parents to support their child. EI staff reported that it was essential to build a collaborative partnership with the parents and carers of the transitioning children, a partnership fundamental to supporting families through this process. Good relationships with parents enabled better communication, which in turn supported EI staff:
EI staff saw supporting parents and carers during the transition period as an essential part of their role. Several of the EI respondents noted that the transition to school was often a stressful time, not only for the child, but for the whole family. They considered themselves an important source of psychosocial and emotional support for parents, helping to feel like they were not left on their own once school started:
EI staff highlighted that in transitioning to school parents were key advocates in ensuring that their child’s needs were met by the receiving school, a factor significantly influencing their success in the school environment. EI staff also acknowledged the challenges of advocating for autistic children, expressing that this was a difficult space for parents to navigate with their involvement not always welcomed by schools, and accommodations rarely made. EI staff sought greater transparency as to what a school could potentially offer and the available accommodations:
Building the receiving school was associated with the capacity of the receiving school to accommodate and engage with the child, their family and EI staff prior to, during, and following the transition to school as one of the most significant factors influencing transition success. The theme was built using four sub-themes including 1) within school communication considerations, 2) mainstream versus special school, 3) the school environment, classroom supports and lack thereof and 4) receiving school knowledge of ASD were identified as important to building the receiving school.
Building the receiving school’s understanding of ASD was important to a child’s success in transitioning to school. Both parents and EI staff reported that teachers who had previous experience working with autistic children, or who had an understanding of ASD, were better able to understand and support autistic children in the classroom and ensure that they were engaged, participating and learning. As part of this, teachers with experience with ASD must support and educate other teachers
The classroom routine and structure, as well as the environment and teaching methods, significantly impacted children’s engagement and learning. Respondents reported that receiving schools played an important role in ensuring that the structure of the school environment facilitated learning and engagement for autistic children. In particular, parents often reported that their children had difficulty with a lack of structure, uncertainty in activities, transitioning between tasks and self-regulation. Successful transitions to school were facilitated by teachers implementing strategies in collaboration with parents and EI staff:
Though teachers providing support within the school was essential for success, respondents reported that while teachers may be receptive to implementing strategies, they may lack the resources, time and support. This meant that teachers often implemented strategies which were not individualised to each unique child.
Utilizing a strengths-based approach was important to work with autistic children. Receiving schools who recognized and fostered a child’s strengths and interests at school assisted in facilitating the child’s learning and comfort at school. While incorporating a child’s interests and strengths were important in facilitating a successful transition to school, parents noted that leveraging these were challenged by a lack of flexibility in teaching styles limiting the application of this approach in the classroom and school system.
Responses indicated that the transition process was often perceived to be more challenging when transitioning to a mainstream school. In contrast, non-mainstream schools were perceived to more likely to use a strengths-based approach, have a better understanding of autism, and to provide a more suitable classroom routine.
The theme connecting the system was linked to references associated with communication integration and transition. Sub-themes including 1) early transition planning, handover and time to adjust; 2) communication and collaboration between stakeholders; 3) neurodiversity and culture of acceptance; 4) EI role as ‘greenhouse’ to support growth; 5) utilizing a strengths-based approach; 6) EI staff supporting the receiving school and 7) cultural and linguistically diverse (CALD) considerations formed this theme. For parents, being able to talk with teachers and discuss strategies, enabling their child to more successfully integrate into the school environment, ensuring that their child’s needs were met, supported transition:
Respondents however often reported poor communication and collaboration between the parents, the EI staff and the receiving school. This often led to difficulty in the transition planning process and ensuring a smooth transition to school.
Communication within the receiving school was a challenge during the transition period, with parents expressing that transferring information was confusing, particularly when it was being sent to various contact points within and outside the school. A lack of consistency in teacher boundaries, changing expectations and different approaches contributed to the confusion of autistic children. Mainstream and non-mainstream schools adopted different approaches to transition, influencing the experiences of autistic children and their families, with some parents holding the belief that the understanding and support available in non-mainstream settings facilitated the transition process:
Findings of this study highlight the importance of considering key ingredients in developing school readiness and transitioning autistic children to school. A holistic, interactionist approach considering the influence of both personal and contextual factors aligns with both the findings of this study and key concepts of school readiness and transition planning (17, 19).
School readiness and preparing autistic children for the transition to school was considered by both parents and EI staff as going beyond academic skills, to include developing social skills, language, play, and self-care skills. These skills were fundamental considerations in supporting a child's independence, their ability to build relationships with others, and engage within the school environment. Importantly, the environment surrounding the child, including their teachers, EI staff and parents must also be prepared in order to facilitate a successful transition. These findings are similar to that of a previous smaller-scale West Australian based study which found that in addition to a child’s skills, their teachers, education assistants and peers also influence transition experiences (34).
Key stakeholders noted that EI staff played a crucial role in developing an autistic child’s skills and working towards school readiness. Central to transition planning was acknowledgement that each child is an individual with their own strengths and challenges. Employing a strengths-based approach was also important in fostering successful transitions. Strengths-based approaches, focus on harnessing a child’s unique skills, abilities and strengths, promoting learning rather than focusing solely on deficits, or what a child cannot do (35, 36). Strength’s based approaches require tailoring as a child moves through the transition process into school and are heavily reliant on effective communication and collaboration between stakeholders.
It is important to acknowledge the importance, expertise, and roles of all key stakeholders in supporting the development of school readiness and transition planning for children with disabilities (5). Findings of this study suggest that this may be particularly important for autistic children, and in fact it was noted that without input from all stakeholders, autistic children were at risk of poor transition outcomes. Difficulties collaborating and communicating between key stakeholders has been identified by the Organisation for Economic Co-operation and Development (OECD) as a challenge to successful transitions to school for children (5). Reports of poor collaboration and communication between stakeholders emerged within the current study, along with evidence suggesting that the impact of poor collaboration may be particularly damaging to the transition experience of children with disabilities, such as ASD. Findings of this study suggest that EI staff are particularly well placed to facilitate a successful transition in a coordinated capacity, preparing the child, family and receiving teacher for the specific needs of the child.
Teachers are critical to a successful school transition for all children, however, similar to previous studies, a lack of communication and inconsistency in approaches were identified as significant barriers to transition (4, 18). In a large survey study of parents and teachers, teachers reported having greater concern overall for the transition of autistic children than children with other developmental disabilities, however, despite this higher level of concern, teachers were not found to dedicate any additional resources to autistic children beyond those dedicated to children with other developmental disabilities (6). Even in cases where parents and teachers were highly involved in transition planning and preparation, the practices employed by both groups were often generalised and not individualised (6), with a need for more individualised approaches being required to support the successful transition to school (18). Similar to these previous studies, teachers were reported to have difficulty implementing individualised and effective strategies, with time demands and inadequate resourcing and support identified as potential barriers. Responses from this study suggest that additional resources allocated to teachers may better enable them to support students with disabilities, such as ASD, in their classrooms. While receiving schools have a responsibility to work with EI staff and parents in preparing an autistic child for the classroom. These limitations in the availability of resources may limit their ability to collaborate with EI staff and parents. Future research may benefit from exploring the most effective means of allocating resources to support teachers.
Findings of this study highlight the role that EI staff play in not only developing the school readiness of autistic children, but in educating receiving teachers on ASD and how to establish an inclusive classroom. Developing teachers understanding of the common difficulties autistic children experience such as over-stimulation, anxiety, distress over unexpected change, and understanding how to implement relevant supports (e.g. AAC, social stories), supports better transition outcomes. Interventions for teachers must take into account the potential for limited resourcing and time to ensure that they are feasible to implement. For example, the Schedules, Tools, and Activities for Transitions (STAT) program to support transitions for autistic children in the classroom provides special consideration of how this intervention could be employed in under-resourced schools (37).
Parents are key in the transition process and their involvement contributes to successful transition outcomes (38). In this study, parents played a pivotal role as intermediaries between the early intervention team and the school, with this role coming more readily to some parents than to others. This intermediary role may likely be particularly challenging for parents from culturally and linguistically diverse backgrounds who may face additional stressors, such as language and communication barriers, and differing cultural perspectives as to what constitutes a “good” outcome (10, 18). Further, parents who are also autistic or in the broader autism phenotype may also experience difficulties advocating for their child. Parents understanding what to expect in the transition process removes the fear of the unknown, and reduces their anxiety and stress (39), with findings of the current study showing that while parents were key to ensuring a successful transition for their child, they also required assistance and support from EI staff and schools throughout this process.
While the present findings identify several key factors imperative for supporting the transition to school, it is noted that the perspectives of school professionals, that is, professionals who receive autistic children as part of transition, were not collected, which is noted as a limitation of the present study. Given that the perspectives of school professionals may further inform a better transition to school, future research may benefit from seeking to recruit an additional sample of school professionals. It should also be noted that this study was undertaken in an Australian context, including EI staff and parents from ASELCCs across Australia, therefore different results may be seen in different educational or EI contexts. As part of their participation in the ASELCCs, each child had received an autism diagnosis prior to commencing school and have had access to EI. It is possible that experience of transitioning to school may vary for families who differ on these considerations. For instance, children who present with certain challenging behaviours in a school setting may be responded to differently depending on whether they do or do not have a known autism diagnosis. Future research may seek to explore the perspectives and experiences of families with autistic children who were not diagnosed until well after commencing school. It was also not possible to empirically determine whether the reported challenges to school transition were specific to autism, or a general concern for families. While the present study primarily sought to obtain the perspectives of families with autistic children, future research may seek to directly compare and contrast the challenges faced by families with and without autistic children. Similarly, it is also possible that individual differences in the profiles of autistic children, such as their constellation of strengths and difficulties across developmental domains, may affect the challenges experienced by families. Future research may benefit from exploring how these individual difference factors may moderate school transition outcomes. Due to ethical restrictions, a profile of the children was not able to be reported in the current study. Information including the child’s gender, age, intellectual and adaptive functioning, as well as the parents educational and socio-economic backgrounds may assist to better understand the experiences of these families and how they can be better supported.
Findings indicate a number of factors associated with building the child, building the parents, building the receiving school and connecting the system, which facilitate the transition to school for autistic children. This study highlights the need for clear, collaborative and ongoing communication between parents, teachers and EI staff in supporting autistic children during the transition to school. EI staff are recommended to provide support to families and receiving teachers, to develop knowledge and understanding of ASD. Using a strength based approach, harnessing a child’s skills and individualizing the transition process are essential for success.