Posted on by Dr James Shea

Are autistic girls being overlooked?

Relatively recent research suggests that the ratio of autistic boys to girls is likely to be nearer three to one (Loomes et al, 2017), or even equal (Grey et al, 2021), however only one fifth of autistic girls are diagnosed before the age of 11 compared with over half of autistic boys (Belcher et al, 2022).

There are often challenges with girls being recognised as autistic which then means their needs are not recognised nor met and can lead to significant mental health issues in adolescence and into adulthood. 

While there will always be exceptions, it can be suggested that the diagnostic criteria for autism are based on a ‘male presentation’ of autism (caveats, naturally) and certainly a presentation that does not involve ‘camouflaging’ or ‘masking’. Loomes et al (2017) have identified that there is a diagnostic gender bias which means girls are less likely to receive clinical diagnosis.

Girls are more likely than boys to display camouflaging or masking behaviours although some boys will also mask.  They may demonstrate more desire to interact with others, may maintain some friendships and demonstrate more social, emotional and empathetic behaviours than boys, or may display behaviours perceived as shy or passive (Zakai-Mashiach, 2023).  Stereotypical views of autism may be of children who cannot make eye contact, who are isolated, who have unusual and fixed interests and communication skills that demonstrate a difference in use of tone and body language.  However, many girls observe and practice their social skills so they are appearing to interact like their peers, and their special interests may be age appropriate, so the intensity of these is not identified.  They may well be perfectionists and high achievers who appear to be doing well academically and socially.

The resources needed to camouflage in autistic people can result in a loss of identity, internal conflict, anxiety, depression and increased risk of suicidality (Belcher et al, 2022; Howe et al, 2023). Risk of suicide is seven times higher in autistic people than non-autistic people (Howe et al, 2023) and autistic females are more likely to die by suicide than autistic males, with camouflaging being an additional risk factor in suicidality (Cassidy et al, 2018).  They are also at higher risk of experiencing sexual violence (Hopkins et al, 2023).  Autistic girls are more likely to underachieve academically compared with their non-autistic peers, but are less likely to get support because they internalise their difficulties (Zakai-Mashiach, 2023). 

The complexities of adolescence can lead to mental health issues in non-diagnosed autistic girls, where if they are lucky, someone will consider the possibility of autism. Teachers need to be alert to the knowledge that camouflaging may mean that they have far more autistic pupils in their classes that they realise and the behaviours may look quite different in girls. Organisations such as the Autistic Girls Network (https://autisticgirlsnetwork.org/) are working hard to raise awareness of the needs of autistic girls and women and have lots of useful information on reasonable adjustments in school. Parents of autistic girls are more likely to report elevated levels of stress than parents of autistic boys (Hopkins et al, 2023), due to the mental health issues of their children, late diagnosis, needs not being met and the increased vulnerability of girls. This also has implications for how schools work in partnership with parents and enable them to feel supported.

Michelle Sogga is a Senior Tutor in Education (Early Years) and can be found on X at @msogga

  • Anderson, P. (2023) ‘Autism tied to higher rates of self-harm, suicide’ Available at:  https://www.medscape.com/viewarticle/995275?form=fpf  [Accessed 1/2/24]
  • Belcher, H., Morein-Zamir, S., Mandy, W., and Ford, R. (2022) ‘Camoflaging Intent, First Impressions, and Age of ASC Diagnosis in Autistic Men and Women’, Journal of Autism and Developmental Disorders, 52, pp. 3413-3426. https://doi.org/10.1007/s10803-021-05221-3
  • Cassidy, S., Bradley, L., Shaw, R. and Baron-Cohen, S. (2018) ‘Risk markers for suicidality in autistic adults’, Molecular Autism, 9 (42) https://doi.org/10.1186/s13229-018-0226-4
  • Craddock, E. (2024): Raising the voices of AuDHD women and girls: exploring the co-occurring conditions of autism and ADHD, Disability & Society, https://doi.org/10.1080/09687599.2023.2299342  
  • Gray, L., Bownas, E., Hicks, L., Hutcheson-Galbraith, E., and Harrison, S. (2021) ‘Towards a better understanding of girls on the Autism spectrum: educational support and parental perspectives’, Educational Psychology in Practice, 37 (1) pp. 74-93. https://doi.org/10.1080/02667363.2020.1863188
  • Hopkins, N., Iles, J. and Satherley, R. (2023) ‘The Experience of Raising Girls with Autism Spectrum Disorder: A Systematic Review of Qualitiative Research Studies’, Review Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s40489-023-00419-w
  • Howe, S., Hull, L., Sedgewick, F., Hannon, B. and McMorris, C. (2023) ‘Understanding camouflaging and identity in autistic children and adolescents using photo-elicitation’, Research in Autism Spectrum Disorders 108
  • Loomes, R., Hull, L., Palmear, W. and Locke, M. (2017) ‘What is the Male-to-Female ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis’, Journal of the American Academy of Child and Adolescent Pyschiatry, 56 (6) pp. 466-474.  Available at: https://www.sciencedirect.com/science/article/abs/pii/S0890856717301521?via%3Dihub [Accessed 26/1/24]
  • Maenner, M. et al (2021) Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years.  Available at: https://www.cdc.gov/mmwr/volumes/70/ss/ss7011a1.htm?s_cid=ss7011a1_w  [Accessed 26/1/24]
  • Milton, D. (2012) ‘On the ontological status of autism: the ‘double empathy problem’, Disability and Society, 27 (6), pp. 883-887.
  • Mitchell, P., Sheppard, S. and Cassidy, S. (2021) ‘Autism and the double empathy problem: Implications for development and mental health’, British Journal of Developmental Psychology, 39 pp. 1-18
  • Zakai-Mashiach, M. (2023) “I Was Like a Bird Without Wings”: Autistic Women’s Retrospective Experiences in General Schools’, Journal of Autism and Developmental Disorders, 53 pp. 4258-4270. https://doi.org/10.1007/s10803-022-05717-6

Useful online resources

Autistic Girls Network (also on Facebook and Twitter) https://www.youtube.com/@AutisticGirlsNetwork

Posted on by Dr James Shea

Working memory: could it be that it’s just poor resolution rather than 4-7 items?

We’ve all had the lecture. You can only hold so many items in your working memory because there are only so many slots. It’s in the Core Content Framework (CCF) for trainee teachers. It’s in the Early Careers Framework for recently qualified teachers. And it’s in all the NPQs. If I undertake sequence of colour, number, or items of information tests on you then, after between four and seven items, depending on context, you cannot remember the sequence accurately. Here is what it says in the CCF:

And so we break down instructions into small ‘chunks’. We think about capacity all the time and use it for instructional coaching. Granularity is key. But that idea of working memory having a limit, having only so many slots, is not the only idea in psychology. There is another theory which has just as much validity as the fixed idea. An idea that suggested we could be using many more items than 4-7 in teaching and it would still work. Welcome to the world of low resolution memories…

One competing idea is that the limit on capacity is based on resource rather than a fixed number of slots. It’s nothing new – it’s been around as long as the ‘slots’ idea and instead of slots, it says that working memory is a fluid pool of resources. In other words, you can remember a few things with precision, but that when you overload working memory the result isn’t a total failure to remember additional items, but a degradation in the quality of the memory of all eight items. It’s like pouring your working memory into 8 jars instead of 7. It’s spread around more thinly. The more items, the more pixelated (to use a modern term) the memory. If you want sharp resolution, then keep the number lower, if the outline is important and you’ll be adding resolution over time then the detail isn’t so important at the start. For example, an important part of kinesiology is knowing all 206 bones in the human body. But you still start with the skeleton of all 206. You will probably then divide the skeleton up into groups of more than 4-7 bones. You add detail as you go down so that magnitudinally, the memory can zoom out and in as it is needed. In many ways, it makes good sense to start with a very poor pixelated skeleton memory and then build detail up, rather than start with small detail of 4-7 items. Having the ‘whole’ in your memory, no matter how grainy, can work well when adding detail later on and being able to construct the fine detail into the whole picture.

Where else might this begin to make sense in teaching? Well, certainly in English. One of the first things you do before teaching an extended text is to teach students the plot. If you are teaching pupils The Merchant of Venice then you teach students about the pairs of characters, the love interests, the racism, the basic plot around the borrowing of 300 ducats by Bassanio, through his friend Antonio, to pretend to be rich in order to woo Portia (Bassanio really doesn’t come out well in this play), the cross dressing and even the idea that Portia is played by a man who cross dresses back into a man to play the young lawyer. It’s a fiendish plot and one of Shakespeare’s more simple plays! But we absolutely teach the plot first using name tags, bags of gold and solid drama pedagogy. And all those items are not only more than four to seven items but the pupils won’t remember much of it…in great detail. However, as we go through the play and its key scenes, so we will add detail and so that grand plot will come together just like the skeleton with the 206 bones. Once that has happened, then our pupil can zoom in and out of the play examining themes, character evolution and key quotations at ease as they consider the play through the lens of a question. They can recall the large plot of more than 4-7 items and also add detail to each subsection of the plot. This idea is reinforced by one the earlier ideas about resolution rather than slots from this paper by Frick (1988) which found the parsing of knowledge (separating knowledge into items) did not happen as the knowledge entered working memory, but at the point of recall, something he calls the ‘process of recovery’.

Working memory is a finite resource. But rather than see it as restricted to 4-7 parsed slots, begin to see that depending on context and the pupil’s individual strength of working memory, resolution is that which is affected rather than number of items. And then, even further, start to think about delivering something that won’t be recalled immediately in fine detail. Deliver a whole worked example in its entirety first and then go through each section of the worked example in detail.

One issue for us all is why the CCF eschews this contrasting idea of resolution from its literature review. You can still overload working memory, but you are only overloading its ability to create memories with fine resolution. And then Frick would say the parsing happens on the recall, not on the initial learning so there’s further debate there.

There is clearly a place for lower resolution memories in teaching in terms of bigger and more complex sets of data. By adopting the idea of resolution you begin to work with magnitudinal ideas. You can move along the magnitudinal spectrum and allow pupils to zoom in and out of schemata seeing both overarching and complex pictures whilst they are also able to focus and recall fine parsed detail. It’s an important refinement to the idea of working memory and cognitive load and we have to, as teachers, consider how that affects the way we approach our teaching.

Copyright © Dr James Shea and Dr Gareth Bates 2023

Twitter:

Dr James Shea https://twitter.com/englishspecial

Dr Gareth Bates https://twitter.com/smashEDITT

Posted on by Dr James Shea · 1 Comment

Internal School Avoidance- how pupils avoid paying attention

Photo by SHVETS production on Pexels.com

In the classroom, a pupil uses attentional control to learn. They suppress their other thoughts and instead focus wholly on the thing being taught. Well, that’s the idea. Unless they don’t. And we’ve all been there. Sitting up, listening, tracking the speaker, nodding and wholly zoned out. We are as guilty as any other when it comes to not offering attentional control from time to time.

There are a variety of reasons pupils do this. Sometimes they are quite open about why they are doing it. ‘I’m tired.’, ‘It’s boring’, ‘I already know this’, ‘It’s too hard’ and ‘It’s too hot’ are all things pupils say to us. Sometimes they are discreet about it. They are are slow to get ready, slow to write, only answer questions in simple terms, make little effort in their spoken or written work. They are not paying attentional control. They can do it habitually in every lesson, or only in some lessons and indeed sometimes only for one teacher. There is a ceiling to how much behaviourist approaches to learning can improve this situation. But an issue it is. Because every educator you know will say they see this lack of attentional control on a regular basis from pre-school to post grad. And I want to personally honest here. I’ve been in meetings and talks where I am sitting up, listening, tracking the speaker, nodding and I’m actually away with the fairies. Sometimes my thoughts just go off on tangents. Sometimes I have other things on my mind. I’ve written before about anxiety and the way this affects our working memory and capacity to provide attentional control. If it affects us as adults it most certainly affects children. I have to be clear. I’m not focused on children who are trying hard to provide attentional control despite challenges. Those who have anxiety or other needs which are impairing their attentional control are not the subject of this blog. It is the many who could, but don’t. They waste time, they work slowly, they participate less than they could and they don’t focus their executive function on the learning happening.

A child not paying attention, avoids offering the attentional control required to make learning happen effectively. That avoidance can be space physical (a pre-school child might not want to move from one zone to the carpet zone), it can be subtle physical avoidance (a child might make getting ready to work take so long that the “Do Now” activity time has finished before they started) or it can be mental avoidance (they sit quietly, look at the teacher, track, nod, but make no effort to focus on the actual learning). One of these three things happen in pretty much every lesson I’ve ever observed. It’s incredibly common. However, I want to focus on attentional control avoidance because this countermands everything we are doing as teachers.

Using Baddeley’s model of working memory, the central executive brings together the visuospatial sketchpad and the phonological loop to form memories. However, this happens at a variety of levels. Imagine I am walking down the street thinking to myself. I don’t pay that much attention to the environment around me or the familiar route I am taking. However, I then get to a point where the road is closed blocking my normal route. I then need to find an alternative route in order to continue, it is the central executive that enables me to do this as it ‘switches’ attentional control. Pupils are doing similar things in lessons. They can glide through activities and teacher talk on autopilot – seemingly there, but not paying the level of attention required for strong learning.

We’ve all heard about the new focus on internal truancy. First there was external truancy where pupils skipped schools in unauthorised absences. Then we noticed they were dawdling between lessons, going to the toilets a lot – internal truancy, so we’ve cracked down on that and had numerous debates about locking toilets. But there is a swathe of pupils habitually and frequently not paying attention that are flying under the radar. They use classic avoidance strategies to appear compliant whilst keeping their learning minimised through not paying attention. It is a form of truancy that is so subtle, but it has a similar impact on lost learning. Why are we not cracking down on this as much as external or internal truancy? Because it’s really hard to force someone to pay attention if they don’t want to. It’s why a good teaching assistant is so helpful in a classroom. They can get through to the passive child and help them start to pay attention again. If they pay attention for the child that is not so good as a teaching assistant should not be doing the teaching. But they can intervene to help the child pay attention again.

Photo by World Sikh Organization of Canada on Pexels.com

And are there answers? Well, yes.

I’ve written before about episodic curiosity. When a pupil wants to learn in your subject they apply maximum attentional control to every aspect of learning in your lesson. It absolutely supercharges their progress. You could take the same child and move them to a different teacher or school and they would still be making awesome progress due to that level of attentional control. I recall a pupil bumping along at sub 4 for all of Year 10 and at the end of the academic year they told me they wanted to be a solicitor and asked what English grade they’d need to make this dream happen (needless to say, my answer was a shock to them). What happened next astonished me. They started paying attentional control to every aspect of every English lesson. They asked for and completed extra work. In the exam they scored an 8. I can’t take credit for that learning. But it taught me about the power of having a pupil motivated to learn in my subject. It taught me about epistemic curiosity and how important that is. When I really want to learn something, I really pay attention and the same is true for pupils!

We seem to be focused on cleaning up the cognitive landscape to remove extraneous load. We are using knowledge of studies from psychology to make remembering easier. We are very focused, rightly so, on behaviour. And then we watch child after child, in lesson after lesson, not pay attentional control. And we, as teachers, see it very often. There is a ceiling to CLT in lessons and a ceiling to behaviourist approaches. Those ceilings are that a child can simply withdraw or mute their attentional control. They might as well have 60 days a year off school instead, because that is the impact on the learning of some of those with the most reduced attentional control. There are lots of answers already out there and each pupil is unique and their personal solution might be complex. But until we start focusing on this area, then we are consigning a huge amount of learning hours to the dustbin of internal school avoidance.