John Bald: What has caused the explosion in the number of children diagnosed with autism?

John Bald is a former Ofsted inspector. He is Vice-President of the Conservative Education Society.

In 20 years of teaching and advisory work in a large education authority, I met two cases of autism. The first, in the East End, was a pupil who could not help unpredictable and unprovoked blurting out in class, in a way that made it impossible for me to teach. This was almost certainly Tourette’s syndrome, and it nearly broke me. The second was the child of highly-educated parents, who had no reading difficulties – his parents had asked me to work with one of his school friends – but who could not focus on anything outside his own immediate impulses. His parents had the means to try every available form of treatment and almost infinite patience. His father concluded that his brain was not “wired up” in the same way other people’s were. The parents did not give up.

We now have almost one-third of all children with education and health care plans identified as autistic, and a similar proportion of undiagnosed and untreated conditions in infant schools, where the need to pay for part of the cost of additional provision, with money the school does not have, is making impossible demands on reception class teachers and wrecking lives. At the same time, autism has come to be seen as part of a spectrum, rather than the absolute condition in the two cases above, a change in thinking that raises many further questions. The parents of children with special educational needs and disabilities (SEND) will, quite rightly, fight tooth and nail to do the best for their children. They argue that the autistic spectrum takes various forms, including suppression of anxiety in school that breaks out when the children return home, and that the condition itself went unrecognised in earlier times.

Both are true, up to a point. But do they explain what amounts to an explosion from isolated cases to hundreds of thousands of children each year, or is there more to it? I believe there is. In the early 1990s, the late Dr Sally Ward, working as a speech therapist in Manchester, thought was an epidemic of deafness, as children were failing to respond to their normal stimulus. She discovered that the problem was excessive exposure to television, which provided entertainment but did not require the children to respond. So, the bangs or noises, that visitors would use as an initial screening test for hearing, had become part of the children’s normal environment. The solution was personal intervention, typically involving visits from a speech therapist, to show parents better to engage with the children. Mobile phones make matters worse, and Sue Palmer’s prophetic Toxic Childhood is now reality.

Around the same time, one of my pupils began to show extreme behaviour when he started school, culminating in a serious attempt to burn down his home. Five years later, and after considerable public expenditure, a teacher in a private school tried out some tinted overlays and solved his reading and behaviour problems at a stroke. Children starting school have new demands placed on them both socially and in terms of learning. Reading requires them to focus closely on small details, and also to move their eyes. When the issue of light sensitivity was discovered by Helen Ellen around 1980, it was obscured by commercialism and by the term, “scotopic sensitivity syndrome,” which does not accurately describe the issue. Professors Arnold Wilkins, formerly of the Medical Research Council’s Applied Psychology Unit by Cambridge, and Bruce Evans, Of the Institute of Optometry, have done much to present the issue in a more acceptable form, and needs to be part of early assessment. The alternative leads to unnecessary and at times exorbitant cost.

The way the DfE and ministers have to make decisions as to the complexity. The DFE prefers to deal with organisations rather than individuals, for reasons best demonstrated by the scandals surrounding Covid. When I attempted to present evidence online sensitivity to a schools minister in the early 1990s, having just shown him how to save £28 million by disbanding a quango that had been taken over by leftists, he would not even look at it. Reliance on experienced Head Teachers to take over senior posts and advise was a useful safeguard, but they were not always up to speed with the areas that they were chosen to lead – as Sir Michael Wilshaw admitted when discussing his appointment as chief inspector. DfE officials are expected to know their field, but not in sufficient detail to examine primary evidence. They operate by synthesising the views of others. This makes it much harder for governments to take on board new evidence, particularly in the field of brain research, which for some, on both sides of the main political argument, represents inconvenient truth.

All areas of SEND are affected. I said in my last article that the current 12-year-old pupil, assessed as dyslexic, had been sent to a private school, at public expense.. The school by passing literacy problems by giving each pupil a laptop, and not teaching them to read at all. This reflects a view since the Warnock report of 1978, that we should help children to live with literacy problems rather than tackle them. The DfE binned my evidence on this to Sir James Rose, much to his annoyance, and has put my latest attempt to show them the work at the back of a long queue. The pupil in question, who could not read “the”, because he was convinced that he still had to sound out every word one letter at a time, read this paragraph, with just one error (hulking instead of hunting) yesterday:

“Giant squid are one of the most mysterious creatures in the natural world. As well as being one of the largest invertebrates (animals without backbones), they also have the biggest eyes of any animal, is 25 cm wide. These glaring spheres absorb the tiny amount of light found in the Midnight Zone, allowing them to spot bioluminescent prey or the looming bulk of a hunting sperm whale.”

The paradox is that he was able to learn to read and remember easily the most complex words in this paragraph while still having to work hard on shorter words, whether letters provide less information. A recent lesson was observed by a former Chairman of the Conservative Education Society, who described it, and the discussion with the pupil’s father, as “…heartwarming…remarkable.” I’m still happy to show the DfE and its advisers if they ever get to the end of their queue. More on autism next time.