Do you know enough about the role of Speech and Language Therapy in tackling Exploitation and Abuse?

Today is #CEDay 21 and this article aims to raise awareness of the role that social understanding difficulties plays in child exploitation and abuse of autistic children with average to high IQ. 

In the UK around 1 in 100 children are diagnosed with Autism Spectrum Disorder (ASD)[i].  Autism is becoming a more common topic of discussion amongst safeguarding practitioners, but there are lots of myths and misconceptions and misleading terminology which can cause confusion for neurotypical workers in their interactions with autistic children. For example, many still think that there is a scale of autism so a person can be “more autistic” than another. It was this misconception that led to the term autism spectrum which better reflects the unique pattern rather than a sliding scale of difficulty from one extreme to another.  The term “high functioning” autism used by some professionals (which refers to ASD1 or a pattern of difficulties formerly Asperger Syndrome) is one label with which many people within the autistic community really struggle.

 

This is because high functioning suggests a level of capacity and functionality that is often simply not the case. There can be unreasonable expectations of a child’s abilities and assumptions made about their understanding based on this label.  A child with ASD1 is not impaired cognitively (in that they usually have average to high IQ’s), but it does not necessarily mean that they are operating at a higher level of functionality in terms of their social understanding. Usually, these children have significant difficulties in their social understanding, and differences in their ability to predict the behaviour of others known as “theory of mind” and it is these differences that can lead them to be more vulnerable, more susceptible to coercion and at significant risk of exploitation.

 

In layman’s terms theory of mind means being able to put yourself in someone else’s shoes, to be able to predict what someone might be thinking or what they will do next. Not having that ability can increase the risks of exploitation because a young person would not sense stranger danger or risks.   Research tells us “Children with autism cannot predict or explain human behavior within a psychological causal model that refers to constructs such as intention, desire or belief… the social world remains complex and hard to negotiate because they have difficulty understanding the reasons for other people’s actions, which may seem highly unpredictable and uninterpretable.[ii]

 

Other children with a presentation of pathological demand avoidance (PDA) and ASD are more complex to support because in addition to lacking theory of mind they also have an anxiety-based need for complete autonomy over every aspect of their lives and can exhibit extremes of behaviour, including sexually inappropriate and risk taking behaviours.

We know that some children with autism have Educational Health Care Plans (EHCP’s) but many do not.  This blog post is not about the NHS assessment or SEND funding crisis that results in thousands of children diagnosed or not being left without the vital support they need. It is about safeguarding and understanding what happens during the time it takes to achieve an assessment, (3.5 years is the average time it takes for a child to achieve an assessment for diagnosis in the UK[iii]). The longer a child remains without a plan or diagnosis the longer the gaps in their theory of mind and social understanding are ignored. This can often lead to children becoming exploited due to a hidden vulnerability.

 

Early diagnosis and intervention enhances the quality of life and education for an autistic child but it can also safeguard them from exploitation. Having an autism diagnosis in early life can ensure a child has access to specialist support to identify their difficulties and address them. It can help parents and families to understand what they need to know and learn so that they can better support their child. Typical parenting strategies and educational approaches do not work for autistic children. A diagnosis can unlock essential support, understanding and acceptance of behaviours at home and in the school setting. Ensuring autistic children have access to the right help to develop their social understanding is paramount.

 

We know that more and more predators are preying on vulnerable autistic children and young people. We know that online abuse is at an all-time high and we know that autistic children and young people are more socially isolated than their neurotypical peers. So, what can we do as parents and practitioners caring for autistic children and young people? We can start by looking at behaviour through an autistic lens, by paying better attention to children and understanding that autism is not a sliding scale of impairment based on cognitive levels. Just because a child can recite an encyclopaedia does not mean that they can predict how a situation may unfold, or understand risks of social interactions, including online friendships.

 

If we promote early diagnosis this will lead to understanding of needs and differences. Only when we understand autism in all its presentations and identify individual needs and difficulties can we understand what makes a child vulnerable to exploitation, it is only then that we are likely to know how we can safely educate autistic children.  What works for one will not work for all.

 

The NWG is committed to promoting awareness of exploitation and of the increased risks for neurodiverse children.  Please visit our events page for upcoming dates for webinars on this topic.

[i] Autism spectrum disorder (bma.org.uk)

[ii] (PDF) A Psychological Approach to Understanding the Social and Language Impairments in Autism (researchgate.net)

[iii] The National Autistic Society 2021 – WAAW_Quiz_20210304.pdf (thirdlight.com)