A core challenge that faces society in its push towards neuro-affirming care is that we need to disentangle what it means to be Autistic from Autistic trauma. The co-occurrence of post-traumatic stress (PTSD) in Autistics is approximately 10x more than the general population.
Sandhya offers concrete tools to help schools be a safe place for autistic students to attend.
My name is Sandhya Menon. My pronouns are she/her and I’m a developmental psychologist based in Melbourne, Australia. So before I start, I’d like to acknowledge that I’m coming to you and presenting this from the lands of the Wurundjeri people, lands that were unceded and I’d like to acknowledge that. I pay my deep respects to the Aboriginal Elders past and present and extend that respect to any Aboriginal and Torres Strait Islanders or indigenous people in their own lands here today.
So I thought I’d start with maybe a little bit about me rather than my losing information, which might very well happen. I’m working as a psychologist at the moment. I’m navigating client work but in around 2020, after learning a bit more about what it means to be affirming, discovering my own diagnosis I kind of started having an internal shift of where the real problems lie, right? So I didn’t know that five years ago the content that I’m talking about today and I don’t blame anyone who doesn’t know that ’cause I didn’t, right? My work is centred around changing environments to support the Autistic child because I’ve seen Autistic children in therapy for circumstances that were completely beyond their control. I’ve heard their stories and I know my own story and it simply hasn’t been fair. So, it’s with that perspective that I bring to this presentation around the systemic shift that we’re looking at making when we think about trauma and attachment in the education system. So I’m just gonna go, yes. So I’ll start with defining some of those terms.
So if you haven’t heard the terms attachment and trauma kind of thrown around, this is what that means, right? So attachment is really referring to the quality of bond that shapes our emotional and relational development. Attachment, early secure attachment in childhood leads to many positive outcomes such as better social relationships, better relationships with ourselves, better problem solving abilities, higher quality of life. Those with secure attachment believe that good things will happen to them and they trust the people they love which sounds really good.
But the important question to ask is how do we get there? So the relationship between the student and the caregiver and in this case we’re gonna talk about teachers, it needs to be stable, predictable, and calm. So if there is a change, the teachers should be alerting students to the change so that even the change becomes predictable. When they seek comfort from their teacher, it is important that their experiences are believed, validated, and they walk away regulated. So they feel comforted from that experience in having their feelings organised.
Now, so often the stories that come out of the clinic is that Autistic children’s experiences aren’t believed. Only their outward behaviour has been reprimanded but not so much what was going on underneath that caused that. So they don’t get believed when they hear little Johnny was sticking their tongue out and calling them names, and making them feel less than, and they don’t see all the coping of those small little things sort of internalise and internalise and then they’ve flipped. But the flipping is reprimanded and not so much all the other stories that have come before that when they’ve tried to do the right thing and tell a teacher, but instead get told to be more resilient or to develop coping strategies. It’s from these experiences that Autistic children learn to be quiet and not trust the adults to protect them because of the amount of distress they’re in is attributed to their neurotype and identity rather than the environment, and that’s quite disruptive to attachment. That’s why it’s important for us to be talking about this.
All right, so what is trauma? Trauma is really any experience that creates intense distress. It is a reflexive bottom-up response that’s not controlled. So let’s have a look at this graphic, okay? I really want us to separate upsetting topics which are just normal part of human behaviour from the big emotions that occur from trauma triggers where that emotion is amplified or sometimes it feels muffled, right? I know individuals who’ve been triggered report their event like it’s a vacuum. They have no recollection of what happened or how they got there, which kind of renders our usual antecedent behaviour charts kind of useless. Trauma occurs when the event outweighs our ability to cope. And when we are repeatedly exposed to that experience we call that complex trauma.
Now, what is really important for us to note here is that the event doesn’t actually have to be dangerous or to look dangerous to other people. Our bodies process both perceived and real threat as one and the same. And trauma is also really intensely personal, right? It’s not able to be easily observed. So the same event might be traumatic for one person, but not the other. And if we take COVID as an example, there were some people who perceived the shift to remote learning to be traumatic but there were some kids who thrived on homeschooling, right? So, when we have these repeated experiences of my arousal increasing, I perceive threat, I act out of my flight, flight, fawn systems and we continue to operate in that way it actually permanently impacts the way that we function and move in this world. So why am I talking about trauma for students, right? Trauma’s not something that we like to talk about with children. We like to believe that they have their childhood and they’re innocent or I like to believe that anyway. But thinking about trauma as it pertains to autism.
Since birth, Autistic individuals have been exposed to sensory and social pressures that might frequently overwhelm our ability to cope which may in itself present as complex trauma. Just the repetition of our inability to cope because of our sensory environment to start with and then social. So that makes understanding a trauma response crucial to understanding how an Autistic student who has at least five or six years of being exposed to this operates in the classroom. Next, we have difficulties interpreting the cues in our body and locating the source of discomfort, and understanding where that discomfort comes from. That, in itself, results in heightened general arousal levels. So interoception is really our attention to body cues and neuroception is our attention to threat. We have heightened sensitivity to threat. It comes from our neurobiological bases as the watchers where we are supposed to be hypervigilant to threat to keep everyone else safe but it is not quite adaptive in today’s environment where we don’t need to, we don’t need a hypervigilance anymore.
Now Autistic individuals experience the world through a sensory lens. So management, support of that sensory input is crucial, right? It’s important for us to feel regulated enough to learn. Now let’s talk about that social environment. The social interaction of our neurotype within environment. So moving around in our peer group we are at an increased risk of bullying and maltreatment but the simple fact that we are different, our want to seek belonging is human but it’s actually a human need that is often denied to Autistic students. Now, thinking about school-based interventions, I’m quite compassionate in this regard that school-based interventions have historically been well-meaning. They see Autistic students struggling at school so they try to implement strategies to help. However, the impact is quite different from the intention.
This has historically been born from the work of neurotypical autism experts who come from good intentions but have poor impacts because efforts haven’t been made to understand how and why we are different and to celebrate this difference rather than forcing us to act and communicate in ways that are congruent with our peers. That’s the whole hammering the square peg to fit the round hole type thing. So we’ve got a history of teaching autistic children to suppress their natural ways of being, which now we’re seeing a lot more in the research is coming out as being quite highly traumatic. And the Autistic population has a very high incidence of PTSD, right? I really like to take a moment to thank the Autistic people who do speak up and bring these issues to light because talking about trauma is not easy. And then we’ve got a sensory environment, right? So think about the unfriendliness of the classroom with our neurotype. Misunderstandings, misattributions of our behaviour leaves a lot of internalised shame. And this is really about the work that the environment needs to do in understanding ourselves.
And lastly, you’re thinking about trauma-informed approach in education. Looking at adverse childhood experiences studies, 61% of adults studied experienced one form of traumatic stress in childhood, and one in six reported that they had four more ACEs. So ACEs are adverse childhood experiences. It’s really important to know that that’s preventable. So being trauma informed means that changes impact so much more than just our autistic children but really a large proportion of our population. All right, so we’ll have a look at this graph. This is a graph that outlines polyvagal theory. I’m talking about the increased levels of arousal. So basically when humans feel safe their ventral vagal state, their nervous system support the homeostatic functions of health, growth, restoration. We can really, and this is kind of where we learn. And this is where attachment’s really important and our connection to others. We can only do this in our ventral vagal states.
Then we have the fight flight systems. So the activation of the dorsal vagal and the sympathetic nervous system, so fight or flight and freeze. And then you’ve got the deactivation. This is where those safe adults and having secure attachments really come into play. So this is how I see the link between attachment and trauma. Attachment playing an important role here. And in the deactivation setting, keeping a child regulated. And this is kind of the trauma states that we look at. And when we think about fight or flight, traditionally we thought of fight as the child is being aggressive, the child is throwing items. I understand this, but I’ve seen goals that say the goal is to stop the child throwing items. So we’re gonna teach them some rules without understanding the underlying meaning of, hang on, there’s been an increase in arousal, there’s been threat activated and we need to understand why the threat is happening, right? Similarly with functions of escape. A child is in flight mode. There is panic, fear, anxiety, worry that’s going on in the system. It’s important to understand why they find it hard to be in a certain place and implement, I guess, ideas for safety.
I told you I was gonna lose my words a bit. All right, so another way that we can think about this is through the lens of neurobiology and how children learn. So over here we’re seeing Dr. Daniel Siegel’s hand model of the brain, which I really love as a way of, a nice way of talking about brain development. The brain is built sequentially. So first we have our brainstem responsible for survival areas. We have our emotional region, that’s our limbic region and we have our prefrontal cortex. Now, when a child is regulated that’s when the prefrontal cortex is connected to the emotional state and they’re able to learn, right? But with increased threat, so we kind of pair these two concepts together with increased threat, they are going to experience higher levels of arousal in which they purely act out of survival state, right? So prefrontal cortex, like the outer layer kind of goes but going from emotional and survival and that’s the fight or flight state. All right and really important to remember that threat, again, could be real or perceived. And from an autistic child’s perspective it could be bright lights and noise that are threats to our nervous system. All right, so we know that we need to be safe and secure and regulated. Chris did a marvellous job of touching on what it means to feel safety, which I love. So we know that we need safety and secureness and thinking about that Maslow’s hierarchy of needs in order for us to learn.
But studies show that educators perceive a false dichotomy between meeting students’ social and emotional learning needs versus meeting their academic needs. And I think in that there lies a shift that we need to make. So I think of what is effective instruction time? It’s not maximised instruction time. I’d like to think about effective instruction time because instruction time is likely to be ineffective or just unproductive if a student is hyperaroused and stressed and not feeling valued. So we move to engage instruction time, emotional engagement, and building time into the curriculum to nurture those relationships.
In Australia, we’ve got this like a programme that’s called Student Voice in Schools. And it’s a lovely initiative to ensure students have input into their education and has been a game changer for many to be able to feel safe enough to engage at school. And so we’re sitting with the way to meet their academic needs is to first meet their social and emotional learning needs.
And when we have that in place everything after that becomes a lot easier and much more natural, right? Children have their needs met, so they’re less disruptive. They’re better regulated so they learn more effectively, right? Research has shown that relationships with students are more effective in impacting classroom behaviour than punishment. And students report, no, teachers report that while these students show healthy internal growth, teachers too were less stressed and had greater job satisfaction. So having an attachment focus and seeing behaviour through a regulatory lens has ripple effects for experiencing education and as educators too.
All right, so we talk a lot about what it means to be safe, right? And I thought I might offer some ideas for how we build safe environments, right? So first we need to look at environmental safety. What does the environment look like? What are some of the sensory challenges that could be reduced? What’s some sensory accommodations might be in place? And is it structured and predictable? Okay, and I think we really need freedom to engage in our accommodations rather than seeing this as a privilege that can be taken away. And this comes back to our fundamental disability rights and access to inclusive education. I know I’ve lived through the era where fidget spinners were banned at schools because of their disruption and it was actually really more disruptive for my Autistic ADHD clients because the accommodation wasn’t replaced. Thinking about accessible education, I believe Lauren or Autienelle will talk more about this but I love the idea of the universal design for teaching and to teach the way that children learn.
Then we have the idea of relational safety and how we feel safe with others. And that’s teachers need to have the ability to hold emotions, to create inclusive practise, to see your true self, right? And that’s bypassing the neurotypical small talk and just let’s go engage with our spins (special interests). Did you know this fun animal fact, for example. I learned today that there’s a stink bird. Look it up, it’s pretty fun. Me and my friend exchange animal facts and love it. And that’s relational safety. All right, to validate and encourage, to just use humour, and to create that socially safe environment, right? And again, coming back to that attachment, I need to trust in you to protect me in my time of need. When I come to you I need to feel safe and I need to feel heard, and I trust that you’ll protect me.
And then coming back to the Autistic student having those regulation opportunities so I know what opportunities are available to me to regulate at school that are safe for me to access that aren’t contingent on me performing any behaviour. To have the ability to be unmasked and be accepted for that. And in order to do this we need to create those inclusive environments.
All right. So when we’re building attachment-aware, trauma-informed schools, there’s a pronged approach, right? There needs to be some top-down work. There needs to be some bottom-up work. So schools need to get behind this and make this a priority. Teachers alone can’t make the shift in their curriculum. There needs to be – at the very least – school, but district culture. So thinking about local and national curriculum, like get behind trauma-informed practise. We need to listen to people like Chris who goes out to schools for people to understand what Autistic culture is. Right. Yeah, so you know, how we process our senses. What are Autistic social skills and the way that we play? In order for us to respond to behaviour, first, we need to understand where’s the miscommunication falling. I’d really call for us to look at our practise on a policy level, particularly calling into account suspension policies. Too often I’ve seen students get suspended for having had a meltdown which is actually a trauma response and then get further punished for it. And to start with, we haven’t first examined the lack of supports from the school that led to the student exhibiting the stress response. Right, so there’s a bit of humility that needs to come into play there, and having strong collaborative systems with providers and families.
All right, so teachers, we heard from Ross Greene today which I loved regarding the CPS model and it’s a wonderful model that fits right into this work of children do well if they can. And then thinking about their role, teachers require training and support through scheduling and proactive stress management. I understand why behaviourism occurs in classrooms because they’re really easy to implement. It’s so much easier when everyone does the same thing. And it exists because we’re taking the short-term payoff in favour, no, we’re taking this short-term payoff, right, and just kind of dismissing that longitudinal perspective because we’re exhausted and have multiple demands placed on us, right? And acknowledge the limitation on this. I think we need to do more in supporting teachers to look at what do you need in order to help you make this shift, right? To strengthen our student voice and when we correct, first we need to connect with them. So I like the phrase connection before correction and to preserve their dignity while we’re correcting them. All right, so for students, all students need to believe and feel that they are valued members of their community, right? And this comes back to our experiences of felt safety.
In order for students to feel safe enough to speak up we need to first create the environment that reduces the arousal. We need to show them that the experiences matter and when they speak up, it is heard. We need to have diversity and inclusion leading the way in our curriculum, okay, because diversity and inclusion really benefits us all. Students learn to accept from a young age different minds and communication styles in play and learn the attitude of radical acceptance, and that sets up attitudes for life for when non-autistic students become employers and can contribute to hopefully changing the shocking unemployment and underemployment statistics for Autistics.
My son came home yesterday with a really cute anecdote. He has this girl in his class from China who’s still learning English and primary language is Mandarin. He used a sign with her when communicating. He said it was okay to use sign and English so that she could learn. And he corrected me. He said – and this is a child in grade one, by the way – he said learning English is very tiring for her. So instead he’s listening to the other bilingual speakers in the class and picking up some Mandarin words so that he could talk to her. And that’s what this is about. Other kids doing the work, so all the work isn’t on the one child. I’d love for us to see more of those kind of attitudes in classroom, that understanding of Autistic culture, understanding of Autistic communication, understanding of Autistic play so that every member can feel valued in the community.
Now, I’ve done a little bit of this work for you. I wrote a book called “The Brain Forest” to talk about neurodiversity in classrooms. It’s even got a section at the back on kind of classroom activities that we can set up to talk and then start the conversation on inclusion. So if you haven’t heard of it yet it’s worth a look into. So coming back, thinking about our role as adults, thinking about secure attachment, we are the hands that hold children. We have it in our power to prevent adverse childhood experiences and build those emotionally, socially, and sensory safe environment, right? So that we can slow down and hopefully stop for the next generation of Autistic children who grow up with internalised shame and feeling like they don’t belong. To support this generation of Autistic children in knowing they can advocate for their needs and have them met. And really my big goal is to know that they don’t have to advocate for their needs and still have it met. Really, simply be understood. It is something that is human to want and need but is an opportunity unavailable to many Autistic students. We can create inclusive environments that literally change the world and the outcomes for the next generation.
Alright, so hopefully at the end of this presentation we know about having a trauma-informed lens. We understand that children learn when they are regulated. We know to see dysregulation as threat activation rather than wilful behaviour. But where do we go from here? We need to act, right? We need to put those systems in place that echo in actions information. So I call on anyone watching for us to shift our language, right? Rather than being trauma-informed, I’d like for us to be trauma-responsive. Rather than being attachment-aware, let’s have an attachment focus, right? And this really calls for greater accountability to put this education into use to well and truly create safe environments for Autistic students and beyond. And really, a greater quality of education for all of us in our schools.
The Reframing Autism team would like to acknowledge the Traditional Owners of the lands on which we have the privilege to learn, work, and grow. Whilst we gather on many different parts of this Country, the RA team walk on the land of the Birpai, Awabakal, Wattamattagal, Whadjak, Amangu, Bunurong and Kaurna Yarta peoples.
We are committed to honouring the rich culture of the Aboriginal and Torres Strait Islander peoples of this Country, and the diversity and learning opportunities with which they provide us. We extend our gratitude and respect to all Aboriginal and Torres Strait Islander peoples, and to all Elders past, present, and emerging, for their wisdom, their resilience, and for helping this Country to heal.