An investigation into making mainstream sex and relationship education autism-friendly

By Sara Danson

 

Introduction

Considerable attention has been given to deciphering the unique social impairments associated with autism (Travis and Sigman, 1998; Volkmar et al., 1997). However, little is known about how these social deficits affect the individuals ability to understand sex and relationship education (SRE) in school, and whether a lack of understanding of this kind of education is a contributory factor in their social difficulties beyond their childhood years. This paper examines what may be missing from current SRE, and considers how this kind of education could be improved.

It is likely that many children with autism will not innately develop the social skills necessary to function successfully in society (Myles and Simpson, 2001). Social skill deficits associated with autism can affect the ability of an individual to initiate and maintain social relationships, and individuals with autism often struggle to create meaningful relationships throughout their lives (Attwood,2000; Seltzer et al., 2003). Understanding issues related to social interaction, relationships and sexuality may be difficult for individuals with autism without some intervention. Many individuals with autism are not cognitively impaired and are able to attend mainstream education (Emam and Farrell, 2009), yet mainstream schools may lack components that are able to guide these individuals throughout their social development. Attwood (2000) contends that schools do not pay enough attention to the development of social skills, which is necessary for the autistic population that attend mainstream education. Many schools incorporate relationship guidance into statutory sex education within the curriculum of science in secondary schools (Monk, 2001), and by this time it is likely that neurotypical (NT) children will have developed the social knowledge relevant to process this information. Individuals with autism may need some support to develop the same level of social knowledge as their NT peers (Schopler, 1997), and may not have the relevant understanding to process information about sex and relationships at this time.

Specific programmes have been designed in order to help individuals with autism develop social skills and their understanding of social rules (e.g. Beaumont and Sofronoff, 2008; Charlop-Christy and Daneshvar, 2003; Gray, 1998; Sofronoff et al., 2011). However, these practices are often carried out in specialised settings. This paper intends to investigate whether it is possible to improve mainstream education so that it addresses the needs of people with autism by including components that are recognised in the literature as being beneficial for these individuals, and currently incorporated into specialised programmes.

In order to understand what may benefit the autistic population in mainstream education, it is important to discuss the social skill deficits often associated with autism.

An overview of the social skill deficits associated with autism

Individuals with autism frequently show impairments in reciprocal social interactions and demonstrate a repertoire of limited behaviours and interests (APA, 2000). Bauminger (2002) suggests that individuals with autism have difficulties with reciprocal peer interaction and impairments in social cognition. This affects various social mechanisms such as the understanding of the perspectives of others, the interpretation of verbal and non-verbal communication, and the ability to predict the behaviours of others (Crick and Dodge, 1994).

Theorists have suggested that individuals with autism lack socio-emotional understanding (Bacon et al., 1998; Sigman and Ruskin, 1999), and social intelligence (Greenspan and Love, 1997). However, it can be argued that deficits in these areas may be affected by a lack of social experience (Bauminger and Kasari, 2000; Hobson, 1993; Wing, 1992).

Impairments associated with autism may be impediments to the development of satisfactory, age appropriate peer relationships. If an individual exhibits fewer social impairments, they are more likely to achieve friendships with their peers (Orsmond, Wyngaarden Krauss and Seltzer, 2004). Studies have shown that individuals with less verbal ability are likely to have fewer interactions with peers (Sigman and Ruskin, 1999; Stone and Caro-Martinez, 1990), and individuals with fewer stereotypical behaviours associated with autism will have more engagement in social activities and more acceptance from peers (Attwood, Frith and Hermelin, 1988; Lord and Hopkins, 1986).

Research indicates that children and adolescents with autism initiate fewer social interactions than their NT peers (Attwood, Frith and Hermelin, 1988; Hauck et al., 1995; Lord and Magill-Evans, 1995; Sigman and Ruskin, 1999) and spend less time in proximity with their peers (McGee, Feldman and Morrier, 1997). Peer interaction is low in frequency and poor in quality (Lord and Magill-Evans, 1995; Sigman and Ruskin, 1999). Children and adolescents with autism tend to have fewer friends and more experiences of bullying than their typically developing peers (Koning and Magill-Evans, 2001). These individuals will experience less potential for friendship and will be at a significant disadvantage in mainstream school environments.

Social difficulties often persist across the lifespan and many individuals with autism continue to have social difficulties in adulthood (Church, Alisanski and Amunallah, 2000; DeMyer, Hingtgen and Jackson, 1981; Seltzer et al., 2003). Adults with autism tend to have fewer friendships and are less likely to move away from home or get married (Howlin, 2000; Rumsey, Rapoport and Sceery, 1985; Szatmari et al., 1989). In a study in 2000, Howlin, Mawhood and Rutter discovered that around half of adults with autism were reported to have no particular friends with whom they had a reciprocal social relationship. These findings indicate a need for further consideration of what may have been missing from these individuals education in childhood and adolescence, which may have affected their ability to create positive social relationships.

To date, there has been relatively little research that considers the autistic perspective when developing social skills in mainstream school environments. In order to facilitate research in this area, it is important to investigate the prevalence of students with autism within mainstream schools.

Prevalence of autism in mainstream schools

It will be difficult to accurately confirm prevalence figures regarding autism within mainstream schools, as estimates often include varying data which may be the result of different methodologies such as case finding, sampling, and the use of different diagnostic definitions (Baron Cohen et al., 2009). However, recent studies suggest that approximately 1% of the population have autism (Baird et al., 2006; Baron Cohen et al., 2009). Over the past 10 years, there has been a considerable increase in the number of students with autism who are included in mainstream environments (Emam and Farrell, 2009) and recent figures suggest that around 70% of children with autism are educated in mainstream schools (DfE, 2012).

It is likely that current prevalence figures only account for those diagnosed with autism. Many of the children with autism in mainstream schools are likely to be on a register that confirms that they have special educational needs (SEN), and some studies that have attempted to calculate prevalence figures have screen only children in schools who require additional support in education and a formal diagnosis of autism (Baird et al., 2006). It is possible that in these instances, cases of autism were missed because the children were not recognised as requiring additional support. Also, there are likely to be many individuals with autism who do not have a formal diagnosis. Girls are less likely to be given a formal diagnosis than their male counterparts (Russell, Steer and Golding, 2010). Lower-functioning autism is more likely to be detected during school years (Baron-Cohen et al., 2009). Higher cognitive ability may disguise the pervasive nature of social impairments (Shery, 2000; Willey, 1999) and some children may go through school without being identified as having additional needs. The process of appointing relevant additional support is often dependent on psychologists (Glashan, MacKay and Grieve, 2004), so children without a formal diagnosis my not have access to the same support as those who are recognised as requiring additional support.

The National Autistic Society (NAS, 2003) recommended that interventions for autistic children should commence no later than six weeks after diagnosis. This suggests that individuals with autism who remain undiagnosed are at a disadvantage. Warnock (2010) argued that the needs of this population are more likely to be met in specialised institutions. She expressed concern that autistic individuals may experience inclusion in mainstream education as a painful kind of exclusion (p.35), and they are especially at risk of poor outcomes due to negative experiences in school.

There is relatively little research that investigates the impact of educational settings for individuals with autism (Jones, 2006). The assessment of outcomes for children with autism who are included in mainstream education significantly influence policy initiatives (DfES, 2003) yet despite this guidance, assessments seem to be poorly maintained (OFSTED, 2004) and follow-up studies are scarce (Barnard et al., 2000). Parents and professionals are in need of clear evidence on which to base decisions regarding educational placements (Dyson, Howes and Roberts, 2002).

Educational policies in the UK advocate the inclusion of students with SEN in mainstream schools, providing that they have access to additional support, and schools are required to make adjustments to enable students with SEN to be included in every area of school life (DfEE, 2001). If individuals with autism are included in mainstream education, it is intended that they will benefit from positive interactions with NT peers (Robertson, Chamberlain and Kasari, 2003). However, children with autism may require more than just inclusion to facilitate these interactions.

Continuing difficulty in adulthood within the autistic population identifies that there may be flaws in mainstream education, and highlights a need for a better understanding and insight into the unique social needs of this population, and for professionals to continue to learn how to use this insight to improve social skills training and relationship guidance. If education for children with autism includes significantly different approaches in specialised settings, and some (possibly many) children with autism require more than just inclusion in the mainstream to facilitate the interactions with their NT peers that may lead to improved peer learning, it is important to question whether these children are benefiting from inclusion in mainstream schools.

This paper aims to examine whether current SRE practices in the UK can be developed in order to be better understood by the autistic population in mainstream schools, and how current guidelines may be improved. The next section summarises current government guidelines on SRE in mainstream schools.

Current guidelines relating to sex and relationship education

Guidance with regards to social relationships has been incorporated into mainstream sex education since the Government issued new guidelines on SRE in 2000. Currently, there is a responsibility of all educational authorities and managements within each school to include relationship guidance alongside sex education (DfEE, 2000). However, since the release of these guidelines, there has been argument over whether there are inconsistencies in sex education within the UK, as methods of delivering these guidelines differ between schools (Blake, 2008; Buston and Wight, 2001: McLaughlin et al., 2007: Monk, 2001). Although the Education Act 1993 made sex education compulsory in secondary schools in England and Wales, the provision is determined by the management within the schools (DfEE, 2000). Minimal government guidance has led to a lack of consensus on how much SRE to deliver in British schools, what to include in its content, and the best way to deliver the material (McLaughlin et al., 2007). Inconsistency in the content and delivery of SRE is likely to make the quality of the delivery of these guidelines variable and subject to the personal views of the teaching and governing staff.

Due to rising rates of teenage pregnancies and sexually transmitted infections, guidelines dictate that secondary schools should provide more information and guidance regarding contraception (DfEE, 2000). However, there does not seem to be much recognition that these figures could be improved with more education regarding relationships. Although relationship guidance is included in the guidelines, this is often taught alongside sex education, and therefore included within the curriculum of science within secondary education (Monk, 2001). Relationship guidance seems to have a lower priority than learning about biological aspects such as anatomy, reproduction, contraception and risk of contracting diseases (DfEE, 2000). Guidelines suggest that individuals should be advised on how to navigate relationships, but there does not seem to be written support for how to improve social understanding in order for individuals to create healthy bases for the development of successful relationships.

There does not appear to be any government guidance that indicates that the specific needs of autistic children should be considered in the development of mainstream SRE programmes. The guidelines suggest incorporating the importance of stable and loving relationships (DfEE, 2000, Introduction, paragraph 9), but for individuals with autism, there is little direction for schools to help students achieve the social skills necessary to develop these relationships. Some children, especially those with autism, may be learning about the biological aspects of sex before they are able to understand these issues in a social context. It is important that they are given social guidance to support this information before it is introduced. With a greater number of individuals with autism being taught alongside NT students exploring their sexuality during adolescence, it is becoming increasingly important that children with autism develop adequate social understanding at an early stage.

There are many different interventions that have been recognised as being beneficial for children with autism that aid the development of their social skills. The next section discusses the importance of social skill training, and includes some examples of what may help these children through their social development.

Social skill training

It is important that all individuals, regardless of disability, receive the appropriate guidance in order to acquire the skills involved in developing a sexual identity, creating healthy social relationships, and ensuring a positive quality of life (Whitehouse and McCabe, 1997). In order to ensure that people have the best possible support through learning these skills, it is necessary that this support is offered at the appropriate time and at a level that they can understand (Gordon, 1971).

Myles and Simpson (2001) describe the development of social skills as being part of a hidden curriculum, which children with autism find difficult to access, but significantly influences their ability to make friends. Often, individuals with autism find social rules much more difficult to understand than those that can be written of generalised in other contexts, which often hinders the development of peer relationships (Emam and Farrell, 2009). Although individuals with autism may have more difficulty developing their social skills than their NT peers, Nichols, Moravcik and Tetenbaum (2008) contend that individuals with autism, regardless of their level of social impairment, are able to achieve the same social skills as NT people if they are offered the appropriate guidance at the right time.

Social skills training has been considered a priority in special education, as a result of many years of concern regarding the risk of individuals with autism exhibiting inappropriate behaviours in public (Tarnai 2006), and research in social skills training for the autistic population continues to address minimising risk of these behaviours (e.g. Charlop-Christy and Haymes, 1996; Griffiths, Quinsey and Hingsburger, 1989; Haracopos and Pederson, 1992; Ruble and Dalrymple, 1993; Tarnai 2006). Within specialised settings, education for individuals with autism has maintained a strong focus on developing social skills (HMIE, 2006). This suggests that people with autism in mainstream education are expected to develop the same skills without the same intervention. However, there may be many students in mainstream environments who could benefit from autism-specific social skills training but do not have access to the same support that is specifically designed for this population.

Most NT people become aware of the social rules regarding developing relationships, but people with autism may have difficulty learning how to interpret social cues, understand responses from others, and follow other rules that govern social interactions that NT people learn as they grow up, through the indirect learning from frequent peer interaction. (Attwood, 1998; Jones, 2006). Myles and Simpson (2001) contend that social skills training and interpretation of social situations should be an integral part of the education of children with autism. With guidance that improves social skills, it is possible that individuals with autism will be able to benefit from an increase in the quality and quantity of social interactions and these children will then have more access to the same indirect learning as their NT peers.

Certain methods have proven useful in social skills training for the autistic population. Although longitudinal research in this area seems to be scarce, and the long-term success of these interventions may be difficult to measure with any accuracy, it is possible that they are able to improve the skills necessary for children to develop social networks in school that provide positive influences for a considerable period throughout their transition into adulthood. As a result, children with autism may have a more positive experience of school, and have greater access to the peer interactions that provide an important source of indirect learning of social skills (Bandura, 1977).

Various strategies have been developed that concentrate on teaching adolescents with autism the social skills necessary to achieve healthy relationships and positive social integration in preparation for adulthood. With certain interventions designed to teach social skills to the autistic population, it is possible to increase their social confidence and knowledge about all aspects relating to relationships and sexuality (Attwood, 2008). Data from social skill interventions designed for individuals with autism may provide important information that could improve mainstream SRE programmes. The next section discusses some of the main approaches of social skill training for this population, and considers other aspects that may improve the individual experiences of people with autism in mainstream environments.

Social Stories

Gray (1998) developed the use of Social Stories to teach children with autism to interact with their peers. Social Stories originated from collaborating with children with autism, and have been successful in teaching social cues and adaptive behaviours to this population (Barry and Burlew, 2004; Reynhout and Carter, 2006; Swaggart et al., 1995), and this strategy has often been used within various teaching programmes (Gray, 1998).

Social Stories describe social situations in a format that has been shown to be easily understood by individuals with autism (Reynhout and Carter, 2006). It is the general understanding that many individuals with autism have strengths in visual processing (Dettmer et al., 2000). Visual supports used in Social Story techniques have been able to enhance understanding of different social situations, and increase social understanding in children with autism (Gray, 1998).

Social Stories can be used to explain various social situations that are often experienced by children with autism, by considering the perspective of each child in the social situations (Gray, 1995). The perspective of the child for whom the story was created is adopted and maintained throughout the duration of the narrative. Stories can be easily individualised for different perspectives according to the specific needs and abilities of each student (Gray and Garand, 1993).

This strategy is derived from the concept that individuals with autism perceive their environment differently to NT people. If this is the case, then it will be important to consider different perspectives in the education of this population, especially when teaching the rules that govern social interactions. For individuals with autism, Social Stories may be helpful in their understanding of social rules, as they are able to provide more explanation for the reasons behind societal expectations (Ivey, Heflin and Alberto, 2004). Throughout the programme, the students comprehension of different social contexts is monitored during these sessions, and this has been useful in discovering how each individual perceives a social situation and assessing whether the student has adequate understanding of target behaviours before they are practised in a real-life setting (Gray, 1998). Potential areas of concern are identified and these can be addressed by adapting the Social Story and the approach of this intervention (Gray and Garland, 1993).

Social Stories have been effective in improving appropriate play and increasing positive social behaviours (Barry and Burlew, 2004; Ivey, Heflin and Alberto, 2004), increasing frequency of positive communication between peers (Theimann and Goldstein, 2001), improving the quality of interactions (Swaggart et al., 1995), and reducing inappropriate or aggressive behaviours (Adams et al., 2004; Lorimer et al., 2002).

Myles and Simpson (2001) describe Social Stories as a technique that may be able to provide access to a curriculum of social understanding that the individual with autism may not yet have been able to access. This has been able to provide guidance in how to respond in social situations, and has helped individuals develop self-awareness. Tarnai and Wolfe (2008) suggest the use of

Social Stories when teaching children with autism about issues relating to sex and sexuality, as it may offer help to students regarding potential problematic situations or help them prepare for future stages of sexual development.

Treatment and Education of Autistic and related Communication Handicapped Children (TEACCH)

TEACCH was developed as a programme for children with autism, which included all areas of education, including social skills. This was intended to address the need for an educational tool that could be helpful for individuals with autism of all ages and levels of functioning (Olley, 1986). TEACCH incorporates structured teaching techniques, which regulate the material the child uses, how long the child uses this material, and how the child interacts with this material (Schopler et al., 1971). The structured teaching techniques involved in this programme help children with autism throughout their development by organising their environment, and providing meaningful visual information to support learning (Mesibov, 1997; Schopler, Mesibov and Hearsey, 1995).

TEACCH is based on the concept that individuals with autism share a pattern of neuropsychological deficits and strengths (Mesibov and Shea, 2010). The structured teaching techniques incorporated into TEACCH interventions can be individualised for each student, taking into account the deficits and strengths that are specific to them.

One of the main principles of TEACCH is that parents have active involvement in the educational process, from the initial assessments of individual needs to the subsequent practices that are influenced by these assessments (Olley, 1986). Marcus et al. (1978) were able to show that structured teaching techniques similar to those implemented in TEACCH programmes could be easily transferred into the childs home environment so parents were able to continue promoting positive behaviours at home. Although the level of involvement of the parents differ between each family (Schopler and Olley, 1982), it is likely that the child will benefit more from TEACCH the more actively the parents are involved (Schopler et al., 1984). Comparisons of observations in school and at home will inform practices regarding the specific needs of each individual (Olley, 1986).

Implementation of the TEACCH programme has been able to assist children with autism with non-verbal communication skills (Ozonoff and Cathcart, 1998), and has been shown to have a positive impact on social behaviour (Clements and Zarkowska, 2000; Jordan and Jones, 1999; Jordan and Powell, 1998; Powell and Jordan, 1997). Coupled with a high level of parental contribution, structured teaching techniques have been shown to increase frequency of social interaction, and incidences of appropriate behaviours in play and communication (Short, 1984). In addition, Ozonoff and Cathcart (1998) argue that implementation of TEACCH services in the education of children with autism may help them function more independently as adults.

Mesibov (1982) used the TEACCH programme to outline a developmental approach to teaching sex education, by matching the programme to the child by taking account of the childs existing social skills. The notion of this programme being used in SRE was developed under the assumption that all individuals with autism require assistance with this kind of education at some point in their lives, but the amount of assistance will vary between individuals and needs to be specified for each person. Once the individual has reached optimum understanding of the social skills necessary to understand the concepts involved in sex education, they are able to move onto the next level, and they are introduced to more advanced concepts in this area. Schopler (1997) created a sex education programme with different levels that can apply to autistic students based on their cognitive functioning. This programme aims to focus on the person with autism and their individual needs, and requires making appropriate adaptations between the tuition of each child in order to meet these needs, and building on their existing skills.

Many theorists have argued that, contrary to the original beliefs that TEACCH is a programme intended to be used in autism-specific contexts, it is possible that the techniques implemented in this programme can supplement current mainstream education and benefit all students, including those with autism who are included in these environments (Mesibov and Howley, 2003). TEACCH may also benefit NT peers by promoting recognition of autism, which may help facilitate healthier partnerships between these populations (Ijichi and Ijichi, 2006).

Teacher and peer training

Difficulties relating to certain characteristics associated with autism have been found to affect the students relationship with their peers and teachers (Barnard et al., 2000; Emam and Farrell, 2009). Successful inclusion for individuals with autism, where they can experience positive social interactions, can be achieved if there is a better understanding of autism among professionals and peers (Dugan, Kamps and Leonard, 1995; Kamps et al., 1994).

There is currently no requirement for teachers to undertake any training in autism (Batten et al., 2006). However, Jordan (2005) argues that the role of the teacher is a significant driver in the transformation of mainstream schools into autism-friendly environments. A childs relationship with their teacher can significantly influence their educational experiences and can affect the childs progress through school (Birch and Ladd, 1998; Pianta, 2006). If teachers do not have adequate support and training, this is likely to affect their relationship with the children (Batten, 2005; Glashan, Mackay and Grieve, 2004). In one study, only 22% of teachers had received specific autism training (Barnard et al., 2002), and some studies found that teaching assistants (TAs) had little or no understanding of autism (Glashan, MacKay and Grieve, 2004).

Children with autism may exhibit challenging behaviours in the classroom (Howlin, 1998), and teachers tend to have more successful relationships with children with fewer behavioural difficulties (Birch and Ladd, 1998; Pianta, 2006; Pianta and Steinberg, 1992). Evidence suggests that the personal beliefs of the teacher affect their attitude within the classroom, which can influence the students self-esteem and achievements (Ashton and Webb, 1986; Tschannen-Moran, Woolfolk Hoy, and Hoy, 1998).

Not all students with autism in mainstream schools will have a statement of SEN, or require additional staffing (Jones, 2006). However, when students with SEN have additional help from a TA, it is possible that these TAs may adopt primary responsibility for the included student, thus reducing interaction between the child and their general teacher (Marks, Schrader and Levine, 1999) and therefore interfere with the development of the student-teacher relationship. The relationship a student has with their teacher can affect their social status (Robertson, Chamberlain and Kasari, 2003), and this can affect their relationship with their peers (Pianta, Steinberg and Rollins, 1995).

Research has shown that many of the successful interventions for individuals with autism in mainstream environments involve actively teaching NT peers about autism and encouraging them to interact with children who seem to exhibit social difficulties (Chan et al., 2009; McConnell, 2002; Rogers, 2000). Peer training techniques are able to help children with autism integrate into mainstream settings (Kalyva and Avramidis, 2005) and increase duration and frequency of peer interactions (Gonzalez-Lopez and Kamps, 1997; Morrison et al., 2001).

Early tuition of social skills

Individuals who are able to successfully navigate social interactions in primary school are able to use this social knowledge as they grow up and are more likely to profit from continued development of social understanding (Hamre and Pianta, 2001; Rogers, 1996). Children who develop greater social understanding at a young age are less likely to have behavioural problems. Such children are also more likely to achieve a higher academic performance in secondary school (Entwisle and Hayduk, 1988; Lynch and Cicchetti, 1997; Pianta, Steinberg and Rollins, 1995).

Incorporated into the Children Act 2004, was an initiative called Every Child Matters: a new approach to help the well-being of children up to the age of 19, regardless of their background or circumstances (Hallam, 2009). An idea that arose from the Every Child Matters initiative was one that described five social and emotional aspects of learning (SEAL): self-awareness, managing feelings, motivation, empathy, and social skills. SEAL promotes the social and emotional skills that are thought to be the basis of positive behaviours and emotional well-being (DfES, 2005) and is incorporated into the tuition of children during various stages and levels of learning. It is currently utilised in over 80% of primary schools (Humphrey et al., 2008).

There are three elements to the delivery of SEAL (Humphrey et al., 2008): the first centres on the development of the school, and intends to create a climate in which the social-emotional skills can be effectively encouraged; the second involves the interventions for children who are thought to require additional support to develop social skills; and the third involves one-to-one interventions with those who are believed to not be benefiting from the first two elements of SEAL.

The SEAL programme focuses on developing social skills and promoting positive social behaviour. Implementation of this programme in a NT context has been able to increase childrens communication skills, social and emotional understanding, and confidence in peer interaction (Humphrey et al., 2008), and has had a positive impact on student-teacher relationships (Hallam, 2009). In addition, reports show that SEAL can help children achieve positive outcomes in mental health and educational success (Weare and Gray, 2003).

Although this programme has been shown to have a positive effect on social skill development, there appears to be relatively little research that determines its influence in the social development of children with autism.

As previously mentioned, studies have shown that a relatively small number of teachers and TAs in mainstream environments are appropriately trained to work with children with autism. Evidence has shown that children learn better when their teachers and TAs have a good understanding of the needs of each individual and are appropriately trained to meet those needs (Downs, Downs and Rau, 2008). Also, effectiveness of interventions has been shown to be affected by the level of training of the professionals involved in implementing them (McGee and Morrier, 2005). This is likely to be the same for teaching social skills using the SEAL programme. If teachers are not appropriately trained to work with children with autism within their class, this may affect the success of the SEAL programme.

Discussion

Understanding issues related to social interaction, relationships and sexuality may be difficult for children with autism without some intervention over and above the statutory requirement for SRE. These children have the same rights as NT people to accurate information and comprehensive education that guides them into fulfilling social lives and healthy sexual relationships in adulthood.

Jones and Frederickson (2010) argue that treating all school children equally may not be the best approach in mainstream education. It can be argued that curricular structure in mainstream schools is designed for typically developing children and may not be appropriate for everyone (MacKay, 2002). This paper suggests that current guidelines should take into account that individuals with autism in mainstream education may benefit from social skill training before SRE. The fact that people with autism still encounter social difficulties in adulthood suggests that there is still a great deal of work to do through research studies and observations in education in order to determine how to improve the social integration of children. If children experience more and better interactions, they will have more opportunities to develop the social skills and social confidence in interacting with their peers that can create positive social relationships in adulthood. If there is social skills training within primary curricula, this may help ensure that the autistic population receive adequate guidance in the complexities of social interaction at the optimum time to assist them to achieve positive social networks through school and fulfilling social lives in adulthood. However, it is important to ensure that generic primary level social skills training is designed and delivered appropriately for the autistic population.

When SRE is introduced, it is important that all individuals are able to understand and process this information successfully. SRE in mainstream schools is based on typically developing levels of understanding and social maturity. SRE for the autistic population needs to be related to their level of understanding and social maturity (Schopler, 1997). It is possible that current sex and relationship education guidelines can be improved by examining the approaches undertaken by autism-specific educational strategies relating to SRE.

Due to the increase in the inclusion of students with autism in mainstream education, professionals feel a sense of urgency to ensure that children with autism have access to the most effective intervention (Jones, 2006). Teachers are under considerable pressure to ensure that the inclusion of these children brings maximum benefit to the children themselves, and their NT peers (Emam and Farrell, 2009). It is important that teachers understand that children with autism may need additional support through school, and this may involve allowing extra time to process new information (Happ, 1999; Lawson, 2001), or teaching skills that they would not normally teach (Jones, 2006).

Schools can benefit from raising awareness of autism. The provision of support and the views of the teachers are significant predictors on whether the inclusion of a pupil with SEN is likely to be successful (Balshaw and Farrell, 2002). Many children with autism with a statement of SEN due to behavioural problems, but no formal diagnosis of autism, will have distinct needs that are different from NT children with behavioural problems (Happ, 1999). With appropriate training for educational staff, the children with autism within mainstream environments will benefit from the fact that professionals involved in their care have a sufficient understanding of their perspective. Teachers with a thorough understanding of autism are more likely to successfully guide their students integration and encourage their interaction with NT peers.

With interventions in place that educate NT peers about autism, it is possible to encourage more frequent and better quality interactions during school time and beyond the class environment. Peer-mediated strategies have been shown to be successful in increasing social interactions, and with a better understanding of the perspectives of children with autism, their NT peers may have a greater willingness to discount the social impairments often associated with autism (Jones and Frederickson, 2010).

Parents should be aware of their influence in the education of their children. As previously mentioned, the more the parents are involved, the more likely the child will benefit from continued social skill development at home. Also, with healthy partnerships between the parents and the professionals involved in the childs education it will be easier to assess individual developmental levels, which may be able to guide further educational approaches.

Often, people with autism lack the opportunities to practise social skills. With recognition of this lack of experience, it is not necessarily complicated to address. With interventions throughout primary and secondary education that concentrate on increasing the frequency and quality of social interactions, partnered with social skills training to increase social understanding, these individuals are able to learn important skills necessary to have positive social experiences throughout their life. Social skills training strengthens the resources of individuals with autism, and provides the kind of support needed for the individual to integrate into social worlds. This integration will not only increase the quality of life of individuals with autism, but it will also benefit society if there is a greater understanding and acceptance of autism in the community and a greater opportunity for individuals with autism to achieve their full potential as citizens.

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