With a new generation of teenagers with autism spectrum disorder (ASD) entering public high schools, there is even greater urgency to improve school support for these students. The prevalence of ASD has gone up 150 percent in the last five years (Baio et al., 2018). From our estimates, there are around 256,000 students with ASD in America's high schools, and that number will be increasing. Many of these students will be able to access the general education curriculum and be enrolled in diploma-granting programs, but they will need support in developing social relationships, independently functioning in complex high school settings, and transitioning into the community after high school. In addition, there will still be students with ASD who need significant academic supports provided in special education classes, hopefully with inclusive experiences happening during their days. All students with ASD, by law, deserve individualized programs that consist of scientifically validated practice.
One reason that it is especially important for high schools to provide an effective educational program for students with ASD is that historically, these students have struggled when transitioning to life after high school. Students with autism are less likely than those in any other disability group to be able to find and keep jobs or go on to community college or university programs. Also, they often continue to have difficulties making friends or being involved in social activities in the community. More often than other young adults, they tend to live at home with their parents.
Since we know what the post-high school results are, what can we do to change the design in high schools to produce better life outcomes for young adults with ASD?
Developing Independence and Confidence
When one mixes tumultuous high school settings, the roller coaster ride of adolescent developmental change, and the spectrum of autism, one gets a perfect storm of complexity. Complex problems resist single solutions, and comprehensive responses are required. As key personnel at the Center on Secondary Education for Students with Autism (CSESA), which is funded by the Institute of Education Sciences, we helped design a comprehensive treatment program for high school students with autism. The CSESA program focuses on the areas where high school students face the greatest challenges: social competence, reading comprehension, independence, and transition to community and work.
Getting Social
Students with ASD have great challenges in social competence, including limitations in social communication, social awareness, and social problem solving. If not addressed, these limitations can result in difficulty negotiating and compromising in groups, a lack of friendships, social isolation, and victimization by bullies. Social competence is also important for finding and maintaining employment after graduation.
There are many ways that schools can help teens with ASD develop social skills. Peer buddy programs and social skills groups such as Social Competence Intervention (Stichter, 2016) and Program for Evaluation and Enrichment of Relational Skills (PEERS) (Laugeson, 2013) have helped students with ASD improve their ability to engage in conversation, read the facial expressions of others, and arrange for "get togethers" outside of school. Peers are a natural source of support, and structured time together to foster social interaction at lunch or during an elective period can be beneficial to all students. In addition, activities that are fun yet require peer interaction, such as the games Hedbanz or Jenga, can provide a context for developing social competence and fostering friendships. Peers also can assist students with ASD with organizing tasks, following rules, or even acting as a tutor of content.
If typical peers are aware of effective strategies to foster social communication, they can help their classmates with ASD learn about the "hidden" social curriculum of adolescent peer culture. For example, it may not be obvious to a student with ASD that only seniors hang out in a particular part of campus, or that they can joke with a peer at recess, but it's not always appropriate to do that with the teacher before class. Peer networks also provide an opportunity for students to get to know their classmates with ASD beyond the characteristics that define their disability.
Ready to Read
Individuals with ASD often have challenges with understanding the meaning of texts (such as the main theme, key points, character motivation and perspectives, inferences, and responding to the "wh—" questions). These challenges will affect what they learn in most academic content areas.
At CSESA, we've developed two evidence-based approaches to address reading comprehension skills. The Alternative Achievement Literacy (AAL) program is designed for students with the most limited literacy skills (often students who also have intellectual disability and are enrolled in modified degree programs) (Browder et al., 2016). Students with ASD who read fluently (at the 3rd grade level or above) but are struggling with comprehension can try the Collaborative Strategic Reading program (Reutebuch et al., 2015).
When using either approach, it is important to identify age-appropriate, relevant, and interesting texts. Both start with a review of vocabulary that may be new or challenging for students with ASD (emotional content, pronouns, idioms). As its name suggests, the Collaborative Strategic Reading program is organized for pairs of classmates (a student with ASD and neurotypical peer) to read and review texts. After reading the text, the students ask each other to define words, to describe the main idea, or to predict what will happen in a story. Each is also encouraged to ask "wh—" questions about the text. As students get to know each other, they often make this into a game. One instructor used the peer-generated questions on a final quiz administered to the entire class.
When altering texts for AAL, teachers should make as few adaptions as necessary for the student to comprehend the meaning. Perhaps a required text such as Romeo and Juliet can be modified by removing some of the advanced vocabulary, and, if needed, adding pictures to represent the central characters or nouns such as sword, tongue, or villain. Following the reading of a few lines of text, teachers use as little prompting as necessary to assist the student. First teachers ask the student a question about the text. For some students, they may use a prompt board to provide a choice of pictures or words to narrow the possible answers. After the student responds correctly to a prompt, the teacher starts delaying the prompt to give the student a chance to independently respond to the question.
Independence and Behavior
Even the most academically competent student with ASD may struggle with the need for routine, a lack of organizational skills, intolerance of change, sensitivity to sensory stimuli, and anxiety. If unaddressed, these issues may surface as tantrums or meltdowns and can interfere with learning activities.
There are strategies educators can use to address a student's social-emotional needs and prevent the more challenging and interfering behaviors from happening. These include outlining the student's schedule, providing a structure to class sessions, using visual supports to supplement oral instructions, and making adaptations for sensory needs, such as allowing a student to wear a hat in rooms with florescent lights or earphones that interfere with distracting sounds during independent work or exam times. Regardless of the level of support needed by a student with ASD, increasing the use of self-management strategies to boost independence can be beneficial.
When challenging behaviors do arise, the Individuals with Disabilities Education Improvement Act requires that a functional assessment be completed for any student with an identified disability, to determine why the behavior is occurring. Frequently it is the role of the school psychologist to complete these assessments. A well-designed follow-up plan will include evidence-based strategies to reduce the challenging behavior along with strategies to develop or increase the use of an alternative skill or replacement behavior. For example, a functional assessment may show that a student often has a meltdown right before transitioning to lunch. The teacher may develop a picture schedule (visual support) of steps in that transition so the student can examine each step of the schedule right before the transition happens and better predict this change. Once strategies are selected, it is important to provide training to all staff so that everyone uses a consistent approach.
Preparing for Life After High School
Students with ASD often face their biggest challenge when they transition out of school into a job or higher education. They may not have the skills to work independently at the local supermarket, or they may not have the self-organizational skills to navigate around a college campus and follow a class schedule, despite having the academic skills to be successful. Because of the challenges related to these transitions and the lack of adequate support these students often receive when in high school, schools should offer specialized training to students with ASD to put them in a better place for future employment or postsecondary education. The CSESA transition program features several strategies that can assist teachers in this important preparation.
A first step in transition preparation is to identify the sources of support that may exist in the community and even in the high school. Many educators have found CSESA's Community and School Resource Mapping module a useful tool for locating and accessing vocational, recreational, and social support group transition services in the local community.
For all students with disabilities, federal law requires that school personnel establish an individualized transition plan by the time the student is 16 years old. Establishing the plan earlier, however, when students enter high school or are 14 years old, is a much better option. An earlier transition point allows the teachers, family members, and students (if capable) to begin establishing the goals for life after high school and plan the high school experiences that prepare the student to meet those goals. For example, in those early high school years, students may be given the opportunities for career or work exploration (working in a coffee shop or discovering what computer scientists do) that may help them or their caregivers identify reasonable goals for life after the transition. By the age of 16, students are already well into their high school curriculum plans and valuable opportunities may be missed.
It is important to prepare students for direct involvement in both their IEP and transition planning process as much as is feasible. CSESA staff have identified three evidence-based curricula (Self-Advocacy Strategy, Self-Directed IEP, Whose Future is it Anyway?) from which teachers can choose to provide just such preparation.
Having students with ASD involved in early planning and giving them choices about the future can, for many, instill a sense of self-determination, which is a worthy goal for all adolescents. But, for many teenagers with ASD, this does not happen. In fact, as they grow older, these students often become more dependent on their caregivers, which can limit their success when they leave school.
For young adults with ASD and other disabilities, we know that the best predictor of a student's future job success is their work experience during high school (Carter, Austin, &am Trainor, 2012; Lee & Carter, 2012). Drawing from the work of our colleague David Test and the National Technical Assistance Center on Transition, CSESA staff created sets of lessons and activities that focus on career exploration, job shadowing, work sampling, service learning, internships, paid employment, apprenticeships, and mentoring. Using these resources, high school teachers can select the types of instruction appropriate for individual students. Such preparation requires assessment and careful planning.
Their Best Hope
At an international conference on autism research, Peter Mundy, a noted developmental psychologist and autism researcher, once said that public schools may be the best hope for children and youth with ASD. If so, high school may be the last best hope for these students. Services do exist for young adults with autism after they leave school, but rarely is there the intensity or consistency that is possible through the public school system. The CSESA program was designed to maximize this high school experience and has many freely available resources professionals can use in their work with students with autism. Such work does have the potential for positively affecting the lives of adolescents as they leave schools and become young adult members of our society.
Authors' Note: Preparation of this paper was supported by Grant No. R324C120006 from the Institute of Education Sciences, U. S. Department of Education. Opinions expressed are not necessarily those of the funding agency. Thanks also to the CSESA research team working across seven universities, which includes the additional CSESA Key Investigators: Kara Hume, Leann Smith Dawalt, Bonnie Kramer, Jessica Steinbrenner, Kate Szidon, and Christopher Brum.
