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Hello - Looking At Asd And Boxall Profile

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#1 gavweedy

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Posted 23 January 2014 - 09:54 PM

Hi all. i am a teacher at an SEBD school in Kent and having completed my Masters looking at assessment I am now moving on to a doctorate looking at a specific area. I am interested in the use (or not) of the Boxall Profile with pupils diagnosed with ASD BEFORE the use of profile. I am interested to look at how it might be used as a screening tool. The BP norm values are gathered from a neurotypical data set. "Normal" or "Typical" pupils if you like. I want to see if ASD pupils skew or change the results. Perhaps if there is a typical ASD profile for Boxall. 

If anyone can offer any insight to this , or personal experience. (I saw one post on here about use of BP to draw up an IEP). We are trialling its use in our school and we have a high percentage of pupils with ASD diagnoses ( hence my concern/interest)

I look forward to hearing from anybody about anything!!

Gavin


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#2 Kadenza

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Posted 24 January 2014 - 09:03 AM

I've ever come across Boxall, so can't help, I'm afraid. Hopefully others will have more insight.

#3 Mozzy

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Posted 24 January 2014 - 09:34 AM

Hi Gavin

 

Welcome to the forum.

 

I'm not a parent of a child with Autism, I am an adult with Autism and know very little about the Boxall Profile, but I am still hoping I can help you (a tiny bit).

 

Firstly a lot of parents on here have had children fail in a SEBD school or have had to fight to keep their child out of a SEBD school, they often do not feel this is the right place for their child. So, this might (but I am hoping not) the reason why no one else has responded to you yet.

 

I hope they consider that even thought they think SEBD schools in general are not right for students with Autism they will take the time to help you because there are a heck of a lot of ASD students in SEBD schools and your trying to help them which I think is admirable.

 

I have Googled the Boxall Profile and had a quick read, as I said I have no experience but I have become a trainer of Autism Awareness for social care professionals so will try and give you my initial thoughts on it.

 

Firstly a lot of children with Autism, especially the ones who are likely to end up in your school will be of average or good intelligence so will have spent many years learning to conform, you might think "yeah right" if they could conform they would not be here. What I mean by that is they can often "fake" skills by using another skill, have scripted language to bridge gaps in understanding and also fake the most simplist of things such as eye contact so for a grate many tasks they may seem to understand and even engage.

 

This all takes energy, I for myself describe it as almost like learning another language. You thinking what you want to say in your native English then translate it in yoour head to French for example. This is what I have to do daily. Someone says a simple, normal saying such as "right everyone lets get down to work". My Autistic brain has to pull this apart...

 

right - ok is that right as in left or right or is it being used to get my attention, mark the start of something using the wrong word which I have seen many times before and totally annoys me.

 

everyone - am I supposed to be here? Yes. So that everyone includes me today, I think!

 

lets get down - down as in onto the floor. Is that directed at me or only the kids sat on tables because they need to get down and I do not. So actually was I included in the earlier everyone or was that just directed at those sitting on tables...

 

work - hang on hang on I still have not figured out if I am included in the everyone. Do I need to work? What work is it? Are we just carrying on from yesterday? For how long? 

 

That example is pushing things to the extreme but it can really be like that for some. And the person can be concentrating so so hard to figure it out the teacher thinks they are focused on them or the work and it comes as a shock when they opt out! When in reality they are seriously stressed and not taking things in. So that can totally throw question 1 on your Boxall Profile (if I googled the right one).

 

Question 2 - taking care of things. Someone with Autism can take huge care of things but often the wrong things. They might care a massive amount about a tiny Dr Who figure they got free with something but show no care over a school computer - one has meaning to them and one is an item. With Autism can often come a lack of sympathy / empathy and this isn't just with people saying to an ASD child who brakes a computer "how would you feel if I broke you Dr Who figure" and trying to relate that to the computer is often hard if not impossible for them. You have asked them how they feel, they might be able to tell you if you broke their fugure they would be sad or angry etc etc but doesnt mean they will apply that to how you feel over the school computer.

 

A lot of children with Autism when having IQ tests produce a "spikey profile" meaning in some areas they can score above average and in others below with often huge differences in the scores. So they often do not fit into any test or profile for anything!

 

As an adult having seen and been in the social care system, none of their "standard" assessments fitted me. The mental health one because I was not generally depressed and only showed signs of depression for short spells following something major (a trigger) I was not therefore depressed, I was reactive. Because I didn't take pills, cut my arms, was not going to lie or steel and did not take drugs, drink alcohol I passed all those sections the only sections I showed "problems" in were the making / maintaining of friends, social interaction and interests section. Me repeating the same set of DVD's on a 5 day rotation basis was the biggest concern they had and that only pointed towards mild OCD in their eyes. I was clean, tidy and ate when offered food. Low need to them.

 

To the learning disability team I had grater needs but still messed up their testing system because my reading and writing are fine. My IQ is in the normal rage (but when all the sub-scores are looked at in some areas I scored over 140 and in others under 70). I can read a letter than comes through the post, I can follow a set of reasonably complex instructions (like draw a 5cm line from the middle of the page, turn the ruler to the left, draw another line of 5cm then....) Yet on adaptive functioning functioning (living and social skills) I scored rock bottom!

 

And to general care team in Social Services I again threw their assessment because my medical needs and memory etc are ok.

 

I hope you can what I am trying to say, that as much as every child will be different and score different so much in ASD can influence scores like this sometimes giving a false positive.That anger and frustration for someone with Autism can often stem from huge fear and anxiety which they do not know how to express.

 

I cannot help much more than that, I wish I could it is only through people in the job such as you do looking at things like this that ASD kids stand a chance in schools that maybe are not perfect for them.

 

And I do hope others come and give their first hand experiences. I know some have or have had children in ESBD schools. Good luck with what your doing :)


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#4 maximus prime

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Posted 24 January 2014 - 12:21 PM

Sorry I don't have any knowledge of the Boxall profile although I have Googled and it seems to lead to Nurture groups. My daughter's school have well established Nurture programmes that are considered very successful. They share the site with the Positive Play initiative and so share resources and get advice direct from there too.

Lucy had the opportunity to access Nurture group but to be honest the children in Nurture Group are the very children Lucy finds incredibly difficult to be alongside and given the choice avoids them like the plague.

She visited with her TA to see what she thought and decided she much preferred being in her class doing the same work as her friends. She would find it difficult if children were challenging, if it was noisy, if there weren't clear rules and routines and anything that she would consider chaotic (which is very mild disruption to you and me)

Sorry I can't help more.

#5 caci

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Posted 24 January 2014 - 01:08 PM

I haven't heard of the Boxall profile either, but like others have Googled it.

 

Having scanned through the questions, I can see how the answers for our son would vary greatly depending on when and where you took the "snapshot" of his abilities.

 

If a child feels comfortable with a situation, they can cope with things that on others days would be impossible.

 

As others will tell you, teachers often say "But you have done the same thing everyday for 3 weeks now, why can't you do it today ?" Our kids can't answer that, as there often is no direct reason, but a combination of many factors (most of which will appear very minor and insignificant to others)

 

Some thrive on strict boundaries and routines, whereas for others any "rules" cause problems, as the child needs to feel in control. Sometimes this varies from day to day too. Each child's abilities can also vary greatly from day to day.

 

 For our son, the idea of a Nurture group wouldn't work, as he wouldn't feel comfortable with what he would term as "baby-ing"



#6 Prosecco Queen

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Posted 24 January 2014 - 08:49 PM

I haven't hers of the Boxall profile either. I have an academically able son with challenging behaviour and fought hard to keep him out of an SEBD school. Happy to help in any way I can , just let me know.

#7 Jolly Roger

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Posted 26 January 2014 - 02:33 PM

The main problem with the Boxall Profile as an autism strategy is the fundamental one: Marjorie Boxall developed it to address issues experienced and presented by children who had suffered an absence of nurturing: neglect, attachment issues, other psychological conditions induced by experience.

Autism is none of these things. It is a neurological disability, not a psychological condition. The most effective interventions and strategies for autism are built on the known differences between psychological conditions caused by experience and developmental conditions caused by neural development.

There is a lot of common content shared by Boxall and autism-specific interventions and therapies - but as any parent of an SEN child knows, the content of an intervention is only half the story: the oversight by the school, the long term intentions, the professionals' comprehension of the child's condition and basic question of whether the intervention is child-centred or dutifully following a ready made programme - all these matter and make a crucial difference to the child's life and prospects. Autistic needs require an autism-specific response - not a psychological one - even when the majority of the content is identical. The majority of fruit juice is water, but the tiny amount of cordial you add dictates the flavour.

When I hear of a child with autism being assessed with Boxall and placed in a generic (not autism specific) behavioural unit, I'm afraid my learned response is, "Oh no, not again!" I've seen it go pear shaped far, far too often.
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#8 Huwbert

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Posted 26 January 2014 - 04:25 PM

The main problem with the Boxall Profile as an autism strategy is the fundamental one: Marjorie Boxall developed it to address issues experienced and presented by children who had suffered an absence of nurturing: neglect, attachment issues, other psychological conditions induced by experience.

When I hear of a child with autism being assessed with Boxall and placed in a generic (not autism specific) behavioural unit, I'm afraid my learned response is, "Oh no, not again!" I've seen it go pear shaped far, far too often.

 

I think that's why Gavin is asking here JR - he says he is concerned, and is looking for evidence of skewing.

 

Sadly ( or maybe gladly ?!)  I don't know anything about Boxall or behaviour units, so can't help with the enquiry

HUW x



#9 Jolly Roger

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Posted 27 January 2014 - 08:02 AM

I think that's why Gavin is asking here JR - he says he is concerned, and is looking for evidence of skewing.


Yes - and my answer is that whether ASD kids skew the results is irrelevant when compared with how the use of Boxall undermines and even jeopardises the care and education of children with autism.
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#10 gavweedy

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Posted 27 January 2014 - 03:14 PM

wow! well i certainly stirred up a hornet's nest with that one! I will mull over some of the points here and reply in some detail soon. I am not advocating the widespread use of BP for ASD kids, I am wondering about how it might/ is being used for ASD pupils. 

so many thanks for bothering to come back to me at all and i really welcome ALL input......but you can be a little gentle i am a messenger not an evangelist for it!

gav


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#11 imperfect parent

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Posted 27 January 2014 - 05:45 PM

AS a parent who has had their parenting questioned while school and LA deny all difficulties my son was experiencing I struggled to write a response.  The issue isn't only whether the children have ASD, and how they can be supported, but how parents are treated.  Far from being poor parents we have in fact been excellent and yet it seems that we are disbelieved at best, and blamed at worst, for our children's struggles in school.

 

My youngest son had support similar to Boxall, but all this was mask the real underlying problems.  Also it was time limited, not needs led and lasted only for 6 weeks.  Too little , very late, and then nothing..


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#12 gavweedy

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Posted 28 January 2014 - 11:33 AM

well i think i might need to clarify my position here. I have been working in SEBD for 30 years and over that time have seen the change in the nature of the pupils coming into schools like ours. Whether we like it or not there are large percentages of SEBD schools with pupils who have a PRIOR diagnosis of ASD and I very much doubt this figure will be going down anytime soon. What we need is to empower teachers, particularly those long experienced ones in SEBD, to feel confident that they can deliver what is needed for ASD pupils rather than follow the way they have always dealt with particular behaviours.

I am not interested in the use of BP to point towards ASD for non-diagnosed pupils. I am simply interested in whether or not the BP has ANY potential for use with pupils with ASD (diagnosed). I hope that bit is clear. In current conversations with Marion Bennathan ( joint author of BP) I am fully aware of its limitations. However, given that it is designed to offer remediation for particular behaviours, i was simply wondering whether or not the same behaviours exhibited by ASD/SEBD(only) could be looked at in a similar way. Then looking making allowances for any types of responses which are behaviours common to ASD pupils as a distinct group. Therefore it would be necessary to see if there are "typical" ASD patterns to BP's. This is a very difficult area and the notion of screening is perhaps over-simplified. I know that some ASD kids have been given BP. My question is why? What did it show? Did the interventions put in place as a result yield any positive outcomes? 

The whole of my research is based on the notion that the majority of pupils in SEBD schools have some form of attachment issues (whether they are in one because of them is a moot point). Now whether that is a result or outcome of ASD is important because the BP is very good for use with SEBD kids. I just really want to gather thoughts about people's experience not so much whether they think it is a good/bad idea.

That discussion will happen later I hope. 

Please continue to add any thoughts but if you have direct experience, particularly if your child has been or is in a nurture group (as defined by Nurture Groups Network (http://www.nurturegr...ure-groups.html).

Many many thanks

Gavin


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#13 Jolly Roger

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Posted 29 January 2014 - 06:22 PM

I am simply interested in whether or not the BP has ANY potential for use with pupils with ASD (diagnosed). I hope that bit is clear.

Yes, that's clear.

My experience isn't as extensive as yours - just ten years teaching in a specialist autism unit. However, it informs my simple answer to your question: no.

If you have apupil who has autism and attachment issues, then that is a different matter. But I am pretty firm in this point: for ten years as an education professional and thirteen years as an advocate for parents of children with autism, one thing has been consistent and not diminshed an iota: local authorities and professionals have repeatedly placed children with autism in non-autism specialist units and subjected them to non-autism-specialist interventions because "they get fabulous results. The result is almost always significant psychological harm to the child.


The whole of my research is based on the notion that the majority of pupils in SEBD schools have some form of attachment issues (whether they are in one because of them is a moot point). Now whether that is a result or outcome of ASD is important because the BP is very good for use with SEBD kids.

This is a very interesting point - but I would want to spend more time and effort researching the fundamental before going on to investigate using Boxall.

An massive proportion of children with autism suffer from mental health problems - and they are frequently misdiagnosed as attachment issues (my theory is that this is because of two factors: 1. The diagnosis is made by people with no training or experience in autism and are simply failing to penetrate the communication barrier, resulting in a failure to comprehend the issue, and 2. Like so many professionals in the field, they have defaulted to their own baseline because that's where they are most comfortable.)

There is a very common saying among parents of children with autism: every problem looks like a nail when your only tool is a hammer.

The vast majority of mental health issues presented by children with autism are not attachment issues; they are anxiety based issues. This is because children with autism are not neglected or lacking nurturing experiences - but because they unable to decipher and decode the world around them, and as a result are confused and terrified. Those who can manage some of this are have difficulties interacting, and as result are frustrated and thwarted in everything that they attempt. Still more suffer sensory overload, which is a terrifying experience.

All of the most effective autism interventions are designed to manage sensory inputs, simplify and give structure to verbal and non-verbal communication, create an understandable order and pattern to experiences, and make the world less confusing and more predictable. So as you can see, it isn't the absence of nurturing experiences that causes issues for children with autism, but rather the inability to access those experiences.

If, after you have developed a personalised intervention for a child with autism and they have made progress, and then you have discovered that they have an attachment issue, then, I am sure, Boxall would be quite appropriate.

#14 gavweedy

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Posted 30 January 2014 - 02:32 PM

I am finding it difficult not to try and defend myself here and that is not really where I want to go with this! Just for the record I was a teacher in a NAS school as well. Anyhow, I think we are singing from the same page here as I too am concerned about insufficient differentiation between psychological and physiological driven behaviours and subsequent assessment for intervention. Nevertheless, I KNOW that this goes on so I want to know if people are using Boxall for it too. Whether right or wrong. I am going to be meeting with Dr Laura Cockburn (Specialist EP for NAS) as she feels there could be mileage in this research and lies within the realm of the work currently done by Coventry CAMHS ( there is an interesting paper "Clinical observations of the differences between children on the autistic spectrum and those with attachment problems: the Coventry Grid" (Good Autism Practice 26.10.10). Please feel free to give me your opinions but maybe we can move away from whether we believe it to be right or wrong. Because clearly, using a BP with an ASD child and then working by rote from the intervention manual is not an appropriate way to go. However, could all of the good work that has gone into BP and Beyond BP be adapted in some way? Maybe the answer is NO! 

Many thanks 

Gav





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