From Eye to Us: Prerequisites for and levels of participation in mainstream school of persons with Autism Spectrum Conditions

Publicerad:2013-01-21

Uppdaterad:2013-03-12

Specialpedagogen Marita Falkmer har forskat om det sociala samspelet hos elever i grundskolan med autismspektrumtillstånd, AST, samt upplevelsen av delaktighet.
– Om du har en elev med AST i din klass krävs det inte bara insikt i elevens situation, det krävs också kunskap om hur AST påverkar elevens sätt att tänka och förstå, säger Marita Falkmer.

Författare

Marita Falkmer

Handledare

Mats Granlund, Högskolan i Jönköping. Annette Joosten, School of Occupational Therapy & Social Work, Curtin University, Australia

Opponent

Sven Bölte, professor Karolinska Institutet

Disputerat vid

Högskolan i Jönköping

Disputationsdag

2013-01-23

Titel (eng)

From Eye to Us: Prerequisites for and levels of participation in mainstream school of persons with Autism Spectrum Conditions

Institution

Högskolan för lärande och kommunikation, HLK. CHILD

Abstrakt

Denna avhandling handlar om grundläggande förutsättningar för delaktighet i sociala samspel samt om observerad och upplevd delaktighet i svenska grundskolor hos elever med Autismspektrumtillstånd (AST), t.ex. autism eller Aspergers syndrom. AST kännetecknas av begränsningar inom tre områden: socialt samspel, kommunikation och föreställningsförmåga. Den nya svenska skollagen slår fast att elever med AST inte ska placeras i särskolan om de inte också har intellektuella funktionsnedsättningar. Detta har lett till att fler elever med AST får sin undervisning i grundskolan. Svensk skolpolicy har tydligt uttalat att målet för svenska grundskolor är att de ska vara inkluderande. En inkluderande skola ska vara anpassad så att den kan tillgodose alla elevers behov, både vad gäller möjlighet att uppnå kunskapsmålen och av att känna sig delaktiga och accepterade i skolmiljön. Trots detta är kunskapen om hur elever med AST själva upplever sin delaktighet i skolan begränsad. Det har dock visat sig att man inte alltid får samma resultat om man låter elever skatta sin egen delaktighet som vid observationer. Dessutom saknas samlad kunskap om vad föräldrar till barn med AST tycker är viktigt för att skolan ska fungera inkluderande.

Eftersom skolor är sociala miljöer krävs det sociala färdigheter, dels för att kunna vara delaktig i inlärningssituationer, dels för att kunna delta i aktiviteter utanför klassrummet. Att delta i positiva sociala samspel med klasskamrater är viktigt för att känna sig delaktig i sin skolmiljö. Eftersom AST medför svårigheter med socialt samspel och kommunikation riskerar dessa elever att känna sig mindre delaktiga än sina klasskamrater i grundskolan. Därför måste möjligheter att aktivt delta i skolmiljön erbjudas. Dessutom måste eleven ha vilja och förmåga att delta i de aktiviteter och samspel som erbjuds. Lärare har en viktig roll när det gäller hur delaktiga elever med AST upplever sig vara. Läraren bör därför ha god insikt i sina elevers situation, förmåga och intressen.

En grundläggande förmåga som möjliggör socialt samspel är att kunna känna igen och tolka ansikten. Redan spädbarn uppmärksammar ansikten och ögon. Ögon är extra viktiga för att känna igen människor samt för att uppfatta uttryck för känslor. Att inte uppmärksamma ögon kan därför vara en nackdel när man samspelar med andra människor. Personer med AST har ofta svårt att tolka ansikten och ansiktsuttryck, vilket anses vara en av orsakerna till deras svårigheter i sociala samspel. Det finns dock motstridiga uppgifter om hur vanligt det är med dessa svårigheter och hur personer med AST tittar på ansikten när de ska känna igen en person eller ett ansiktsuttryck. Personer med AST tittar troligen inte så mycket på ögonen utan fokuserar mer på munnen.

From Eye to Us: Prerequisites for and levels of participation in mainstream school of persons with Autism Spectrum Conditions

Children with Autism Spectrum Conditions (ASC) are included and thus expected to participate in mainstream schools. However, ASC are characterized by poor communication and difficulties in understanding social information; factors likely to have negative influences on participation. Hence, this thesis studied body functions hypothesized to affect social interaction and both perceived and observed participation of students with ASC in mainstream schools. Case-control studies were conducted to explore visual strategies used for face identification and required for recognition of facially expressed emotions in adults with ASC. Consistency of these visual strategies was tested in static and interactive dynamic conditions. A systematic review of the literature explored parents’ perceptions of factors contributing to inclusive school settings for their children with ASC. Questionnaires were used to investigate perceived participation in students with ASC and their classmates. Correlations between activities the students wanted to do and reported to participate in were identified. Teachers’ accuracy in rating their students with ASCs’ perception of participation was investigated. Furthermore, correlations between the accuracy of teachers’ ratings and the teachers’ self-reported professional experience, support and personal interest were examined. Correlations between teachers’ ratings and their reported classroom actions were also analysed.

The frequency and level of engagement in social interactions of students with ASC and their classmates were also observed. Correlations between observed frequencies and self-rated levels of social interactions were explored. The International Classification of Functioning, Disability and Health-Version for Children and Youth (ICF-CY) has been used as a structural framework, since ICF-CY enables complex information to be ordered and possible interactions between aspects in different components and factors to be identified. In regard to Body Functioning, difficulties identifying faces and recognizing basic facially expressed emotions in adults with ASC were established. The visual strategies displayed a high stability across stimuli conditions. Teachers’ knowledge about their students with ASC, in addition to their ability to implement ASCspecific teaching strategies, was emphasized as enhancing Environmental Factors for participation. Students with ASC reported less participation and fewer social interactions than their classmates, which could be interpreted as activity limitations and participation restrictions. However, in regard to some activities, they may have participated to the extent they wanted to. Compared with classmates, observations of students with ASC showed that they participated less frequently in social interactions, but were not less involved when they actually did. No correlations were found between perceived participation and observed social interactions in students with ASC. Teachers rated their students with ASCs’ perceived participation with good precision.

Their understanding of the students with ASCs’ perception correlated with activities to improve the attitudes of classmates and adaptation of tasks. No such correlations were found in regard to reported activities aimed at enhancing social relations. The ability to process faces is usually well established in adults. Poor face processing can impact social functioning and the difficulties in face processing found in adults with ASC are probably the result of developmental deviations during childhood. Therefore, monitoring and assessing face processing abilities in students with ASC is important, in order to tailor interventions that aim to enhance participation in the social environment of mainstream schools. Since participation is a complex construct, interventions need to be complex, as well. In order to facilitate positive peer relations, teachers need to provide Activities adapted to the interests and social abilities of the students with ASC, and in which students with and without ASC can experience positive interactions. This requires that teachers assess all aspects that can affect Participation, including Environmental Factors, and the student’s functioning in regard to Activities and Body Functions. To enhance social interactions, interventions must be planned based on these assessments. If needed, interventions may require teaching students with ASC visual strategies, in order to enhance face processing and thereby the ability to recognize faces and facially expressed emotions. Observations together with self-reported information regarding the students’ preferences and their involvement constitute a basis for the planning and evaluating of such interventions. To include self-determination aspects could allow for possible interventions to be tailored in line with the students’ perceived needs and their own wishes, rather than primarily meeting a standard set by a control group. However, good insight into the students’ perception of Participation may not be enough. In order to adapt teaching instructions, communication and activities teachers also need ASC specific knowledge.