Dean Anthony Da Conceicao, Autism Adviser at the National Autistic Society, offers some advice for teachers on what to do if they suspect a child they teach may be autistic. Dean discusses various issues from potential signs of autism, how to broach the subject with parents, the diagnostic process and strategies to support autistic children with or without a formal diagnosis.

Signs that a pupil may be autistic can be harder to see in some children than others. If you feel a pupil may be on the autistic spectrum but is undiagnosed, broaching the subject of getting a formal diagnostic assessment sensitively can feel challenging. We have some tips that you may find useful if you have any concerns.

If you suspect a child may be autistic

It may be useful to speak with the school and their specific lead for special educational needs/ additional support needs about your concerns, this maybe the Special Educational Needs Coordinator (SENCO) in England, Wales and Northern Ireland, or the Learning Support Teacher in Scotland. 

If a parent/carer approaches you with concerns

• It is really important that you don’t dismiss the parent’s claims, even if you don’t agree with their concerns. You may feel you haven’t seen any evidence at school of the child having difficulties but it doesn’t always necessarily mean that they may not be on the autistic spectrum.
• It is very common for autistic children to present differently at school than they do at home.
• As autism is a spectrum condition, being autistic will affect individuals in different ways.
• Observe the child throughout the day, keeping a behaviour diary of any signs that may indicate the need for a formal diagnosis.
• Behaviours and anxieties have a purpose. Keeping a diary can be helpful in identifying the function of certain behaviours and offers some clarity to an individual’s strengths and needs.

What should you be looking for?

• Not drawing other people’s attention to objects or events. For example, not pointing at a toy or a book, or at something that is happening nearby (a child may eventually do this, but later than expected).
• Carrying out activities in a repetitive way. For example always playing the same game in the same way, or repeatedly lining toys up in a particular order.
• Resistance to changes with routine or doing things differently.
• Behaviour such as biting, pinching, kicking, pica (putting inedible items in the mouth), or self-injurious behaviour.
• Challenges with social interaction or communicating with peers / classmates.
• Do they show any repetitive or obsessional behaviour? For example, repeating the same word (echolalia) or phrase, physically moving/tapping, lining objects up or ordering items?
• Looking withdrawn within lessons – a pupil may be holding in a lot of anxiety throughout the school day and then displaying that anxiety through challenging behaviour when they get home.
• Playing on their own, or playing with their peers but in an unusual way. For example, a child may have a strong desire to always win games or prefer a consistent outcome to every play scenario. They may also wish to follow rules and display challenging behaviour if those rules are broken.
• Showing inappropriate behaviours to other children or staff members.

It is important to be aware that some children may be able to mask certain difficulties which may indicate the need for a diagnosis - for example autism may present differently in females.

Autistic women and girls may be better at masking their difficulties in order to fit in with their peers and have a more even profile of social skills in general. Some examples of the way in which autism can be presented differently with females include:

• Masking difficulties
• Interacting socially more often
• Being subject to greater social expectations
• Having more active imaginations
• Engaging in pretend play more often
• Having interests which are similar to other girls

A child that is able to mask their autism may have the same underlying needs as other autistic children. The only way to find out if a child is autistic is for a formal diagnostic assessment to be carried out.

Broaching the subject of diagnosis

If you suspect a child in your class may be autistic, you may want to speak to the child’s parent/s or carers about your concerns. Deciding who the most suitable person to raise concerns with is a good way to begin broaching the subject. A parent or carer may be more responsive talking to some people than others.

Choosing the right time can also help. For example, arranging a meeting specifically to discuss this subject rather than including it within a general progress meeting. This should help make parents/carers feel as though their concerns are being listened to, as well as support everyone’s involvement and focus on the topic.

Having information, articles and facts prepared can also be helpful. This could also help with anxieties someone may have and answer some questions that may arise in the conversation.

Being aware of language and pace can also be useful. Using clear and concise sentences can be helpful for some people.

Talking is not the only way of broaching the subject. It may be worthwhile considering whether you could write a letter or an e-mail. This can give you some time to plan what you want to say and also give them some time and space to process the information. Someone may feel confused if they have not heard of autism before. Reading through information together can help with feelings of frustrating, denial and even relief.

In some cases, you will be able to guess the kind of reaction you will get. It is important to not dwell on negatives; give the person some positive information about autism. For example, a possible benefit of having a formal diagnosis of autism means a child may have access to accurate support. Identifying the strengths and needs of an individual and implementing the correct support means there is no reason why an individual cannot lead a successful and fulfilling life.

Getting a formal diagnostic assessment of autism

The following is a brief overview of how a parent can access a formal diagnostic assessment for their child:

• Book an appointment with their child’s GP if they wish to go through the NHS, or contact a private diagnostic service directly if they wish to speed up the process by going privately. Details of diagnostic services around the UK can be found on our Directory.
• Talk to the GP about the behaviours that make them suspect their child may be autistic. It is important for the parent to feel as though their concerns are being listened to. Making a list or compiling a file with information from our website can be useful to ensure that each point is discussed in detail.
• Request that the GP refers their child to an autism diagnostic service that can carry out a formal diagnostic assessment.

It is not uncommon for some GPs to request observations or feedback from schools before making a referral. Behaviour diaries can be useful with providing information that can be passed onto the GP.

Supporting a child with or without a formal diagnosis

If someone has a diagnosis of autism, accurate and early intervention is key to get them the support that they need.

Even before a child is diagnosed, there is still a lot of support that you can put in place. Our website is a good starting point which goes through some general strategies that may be useful. 

It is important to identify and tailor support strategies to meet an individual’s needs as what may work for one pupil, may not for another. Some autistic children, when asked how they are, may respond with predicable phrases such as, “I’m fine, thanks”, even when they are not feeling ok. It is important to identify an individual’s preferred method of communication and support them by altering communicative approaches to suit their unique autistic profile.

There are also other websites which offer some strategies and resources that could be helpful:

• Autism practice - education newsletter
• TES Online community
• Autism Education Trust

If a pupil appears to be achieving well academically, they may still need extra emotional and social support. Each UK nation has their own code of practice offering advice to professionals on identifying, assessing and providing for special educational or additional support needs:

• Supporting children's learning code of practice (2010) (Scotland)
• Special educational needs  and disability code of practice: 0 to 25 years (2015) (England)
• Special Educational Needs Code of Practice for Wales (2004)
• Code of practice on the identification and assessment of special educational needs (1998) (Northern Ireland)

Raising awareness within schools

We believe that autistic people should be understood, supported and appreciated by all members of our community. Anyone can help by raising autism awareness, whether by leading a fundraising event, a small assembly within a school or by using educational resources.

There are many ways of introducing autism to others. Our ‘What is Autism?’ webpage is a great place to start.

Raising awareness within the classroom, families, friends or professionals can make a difference for an autistic person to feel safe and supported by everyone in the community.

Further information

If you would like some more information on what you can do to help raise autism awareness, feel free to contact our Supporter Care Team:

• via e-mail at: supportercare@nas.org.uk
• by telephone: 0808 800 1050 (free from most landlines and most mobile networks).

You can also find out more about what help and support is available.