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Professionals & practice

Pupils with autism in lessons

Who is it for? For teachers, school support workers and other educational professionals who teach or accompany pupils with autism.

In brief

Pupils with autism are very different from one another. There is no method that suits everyone. The German S3 guideline of 2021, however, named principles for everyday interaction (not specifically for lessons) that can suit many people with autism. These included concrete, direct language, clear structures and predictability (for example with visual aids), as constant caregivers as possible, consideration of physical distance and avoiding strong sensory stimuli. [1, Rec. 3] For nursery and school, it also named training for teachers, individual support without lowering the subject requirements, and a written support plan or reasonable adjustments. [1, Rec. 109] Added to this are options under school law such as reasonable adjustments and good cooperation with parents.

This English translation was produced with AI assistance and has not yet been independently reviewed.

Status of the guideline: This article relies substantially on the German S3 guideline on the therapy of autism spectrum disorders from 2021. According to the overview of the DGKJP, its validity expired on 23.03.2026. [2] This means it is formally no longer regarded as a current guideline. The principles reproduced here do not automatically become wrong, but they are currently not backed by a valid guideline. We will revise the article as soon as a new version is available.

Principles for lessons

What the 2021 guideline named for nursery and school. In a consensus-based recommendation (strong consensus), the guideline stated: [1, Rec. 109, Ch. C.10.2]

  • Teachers should receive training or comprehensive information about autism and about dealing with people with autism. This includes, among other things, features and course, frequent co-occurring conditions, the importance of transitions (for example to secondary school), the children’s and adolescents’ own experience and the effects on the family.
  • Support should be designed individually; its necessity should be reviewed and adapted over time. The aim is to compensate for disadvantages caused by the condition without reducing the subject requirements.
  • As examples, it named simplified work instructions, worksheets and task wording as well as reasonable adjustments tailored to the individual, such as extended working time, an individually designed workspace, a low-stimulus separate room where needed, and hearing protection.
  • A support plan or reasonable adjustments tailored to the needs should be formulated in writing with professionals, implemented in a binding way and reviewed regularly.

What the guideline named for everyday interaction. Pupils with autism are very different from one another. In a further consensus-based recommendation, the guideline named principles for everyday interaction (not specifically for lessons): concrete, direct communication, structuring of the environment and routines (for example with visual means, predictability and consistency of people), maintaining physical distance and avoiding strong sensory stimuli. Under- and over-demand should also be avoided. [1, Rec. 3]

The following points are a transfer to lessons by the editorial team. The details (blackboard, cover lessons, seating and the like) are not individually backed by evidence:

  • Language: Word tasks and expectations concretely, unambiguously and directly. Irony, hints and unspoken rules can be misunderstood.
  • Structure: Make the lesson sequence, work steps and time frame visible, for example on the board or on a plan.
  • Predictability: Announce changes such as cover lessons, room changes or trips as early as possible.
  • Consistency: fixed contact people and seats.
  • Stimuli: Reduce noise, glaring light and crowding, create places to withdraw.
  • Distance: Do not assume touch and physical closeness.
  • Fit: Avoid under- and over-demand. Cognitive and social abilities can be very differently pronounced.

Typical stumbling blocks in everyday school life

Experience from practice, not backed by a source: situations with little structure and many stimuli are often difficult:

  • breaks, canteen, corridors, changing rooms,
  • group work without clear roles,
  • cover lessons and trips,
  • oral participation under time pressure.

On school avoidance: in a parent survey of 486 pupils with autism (mean age 11 years), 43 % missed more than a tenth of school days in the survey month; pupils at mainstream schools missed more often. [6] See School avoidance.

When it becomes too much

Overload can show as meltdown (overload reaction) or shutdown (withdrawal, going silent). Triggers are often stimuli, social situations, changes or unmet basic needs. [7] A British NHS trust recommends discussing the person’s needs when they are calm and agreeing a plan for dealing with meltdown or shutdown in this way, and creating a calm, safe place in the situation. [7] Such a plan can include, for example, a signal, a place to withdraw and a contact person (suggestion from the editorial team). See Crises and challenging situations.

  • Reasonable adjustments: adapting examination conditions with the same requirements, for example extra time. The rules are state law, in Bavaria for example section 33 BaySchO (status of the provision: 07.10.2026). [3] Reasonable adjustments concern the assessment of performance; application and procedure are regulated separately by the school regulations. See Reasonable adjustments at school.
  • School support worker: depending on the individual case, a benefit of youth welfare or of integration assistance. [4; 5] The 2021 guideline recommended using school support individually, aimed at achieving clearly defined goals and for a limited period, reviewing the need regularly, always promoting the child’s independence and training school support workers in dealing with autism. [1, Rec. 109] According to the guideline, therapeutic interventions should not be taken over by educators or teachers. [1, Ch. C.10.2] See School support workers: role, tasks, limits.
  • Cooperation with parents and, where appropriate, therapists, see Cooperating with families.

Note: This is not legal advice. For questions in an individual case, the school head, the school supervisory authority or legal advice can help.

What do we know – what is still open?

2021 guideline (expired)

  • The principles named rest on consensus-based recommendations of the S3 guideline (clinical consensus points, strong consensus), not on effectiveness studies in lessons. For Germany, the guideline regarded school-based programmes from other countries (for example from the USA) as not transferable; for many of them there is no evidence in Germany. [1, Rec. 3, Rec. 109, Ch. C.10.2]

One study (parent report)

  • School avoidance has been frequently reported in a parent survey, especially at mainstream schools. This is a single cross-sectional survey from Great Britain; the parents were reached through social media and an autism organisation, among other routes. [6]

Open

  • Which school measures demonstrably improve participation: guideline chapter C.10.2 evaluated only five papers (one meta-analysis, one systematic review, two experimental studies, one online survey), which it itself described as to be viewed critically (small samples, large differences in design). [1, Ch. C.10.2] For Germany we have not evaluated further studies.

Sources and literature

  1. DGKJP, DGPPN et al. S3-Leitlinie Autismus-Spektrum-Störungen, Teil 2: Therapie. AWMF 028-047, 2021 (Empf. 3, Empf. 109, Kap. C.10.2). – Guideline (in German); validity expired on 23 March 2026 according to the DGKJP overview
  2. DGKJP: Aktuelle Leitlinien (Übersicht mit AWMF-Registernummer und Gültigkeitsdatum). https://www.dgkjp.de/wissen/aktuelle-leitlinien/ – Professional society (website in German)
  3. § 33 BaySchO – Nachteilsausgleich (Beispiel Bayern), Text gilt ab 01.08.2026. – State law (in German)
  4. § 35a SGB VIII – Eingliederungshilfe für Kinder und Jugendliche mit seelischer Behinderung oder drohender seelischer Behinderung. https://www.gesetze-im-internet.de/sgb_8/__35a.html – Statute (German federal law, in German)
  5. § 112 SGB IX – Leistungen zur Teilhabe an Bildung. https://www.gesetze-im-internet.de/sgb_9_2018/__112.html – Statute (German federal law, in German)
  6. Totsika V, et al. Types and correlates of school non-attendance in students with autism spectrum disorders. Autism 2020;24(7):1639–1649. https://doi.org/10.1177/1362361320916967 – Study
  7. Leicestershire Partnership NHS Trust, Autism Space: Understanding autistic meltdowns and shutdowns (Seite zuletzt geändert 28.04.2025). https://leicspart.nhs.uk/autism-space/health-and-lifestyle/meltdowns-and-shutdowns – Health service (NHS)

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