Mainstream post-primary

Background

M is an intelligent adolescent autistic girl. She attends a specialist autism class in a mainstream secondary school. M is non-speaking, however, can understand spoken language.

M enjoys school, however, being in a large post-primary school can be an overwhelming experience. Making transitions from the classroom can be an especially anxiety provoking activity for M. M often displays involuntary motor mannerisms and behaviours of concern when anxiety levels are increased. This was evident across the home and school setting.

Triggers

Triggers that contributed to increased anxiety levels included some of the following:

  • Being misunderstood by the neurotypical community 
  • Not attending mainstream classes due to overwhelming sensory experiences
  • Increased noise levels outside the classroom
  • Being unable to clarify or question a person’s motives or intentions in a conversation
  • Setting high academic standards for oneself 
  • Exhaustion at home after long periods of time in school

During episodes of involuntary motor mannerisms, M experienced challenges in communicating with her parents and school team. This resulted in her being unable to answer questions, clarify confusions and/or protest as needed. Furthermore, lack of movement as a result of transition challenges often led to a build-up of energy that was released through unintentional behaviours of concern within the classroom.

Strategies

Reports from M and her family, alongside observations and OT assessment, indicated that movement and proprioceptive input had a regulatory influence for M, helping her to effectively regulate her emotions.  Physical activity and ‘heavy work’ activities provided this movement and proprioceptive input.

Walking and trampolining are activities M enjoys, therefore, increased access to these outdoor activities were initially established in the home setting, with a view to generalising to school. 

M accessed the trampoline as and when was needed at home regardless of the weather, and subsequently anxiety reduction was evident. 

Options to listen to online lessons and music while trampolining were provided, as these are particularly enjoyable activities her M. Verbal instructions to use the trampoline were avoided by adults as M typically did not respond, rather, she was encouraged through gradual exposure and consistent schedule routines and/or by referring to it casually at home.

An outdoor family fitness programme for M and her parents was introduced and led by M’s younger sibling. Exercises within the programme targeted goals in M’s Occupational Therapy programme and supported regulation and energy release. The inclusion of all family members was motivating for M and interrupted anxious thought ruminations. M enjoyed watching her parents and sibling engage in exercises and a competition was established between them which was extremely motivating for her.

M’s parents ensured there was routine access to outdoor activities such as cycling and wheelbarrow pushing in the garden. Through consistent routine these activities became predictable, therefore, M was more likely to participate. 

Once established at home, the school team introduced physical activities using similar teaching approaches. M was introduced to the trampoline at school through gradual exposure and transitions were supported by frequent walks nearby its location. After a week, M used the trampoline independently at school which allowed for significant energy release throughout the school day. 

Structured walks were scheduled and provided in school on demand, and the curriculum was accessed during some walks by listening to lessons being played on a portable device. 

Summary

M required adult support to safely release energy throughout her day. The above activities contributed significantly to M’s ability to attend school, access learning and build connections with her family.

The case study above provides evidence that learning and play can occur interchangeably and challenges the assumption that learning must take place in the classroom setting.

Outdoor play for teenagers can present in the form of group fitness activities. This should be considered as a strategy when working with this age group.

Supporting autistic people to release energy and regulate through playful outdoor activities can prevent energy release presenting in unintentional behaviours of concern.