Autism in Denmark – an overview - with special focus on inclusion

By Birgitte Bjørn, parent and Autism advocate, researcher, author

Sparring with Director Torbjörn Andersson, The Foundation Samraadet and my son Nicolai
Østergaard Jensen

The large picture of the autism field in Denmark is, that the field have went through large changes
over the last 10 years, and is still doing it. Paradoxally, new large initiatives and well-researched
projects are taking off, while there is an increasing despecialization, increasing budget cuts and a
significant decrease in the amount of students and people receiving specialized help or education.

A high standard, quality and knowledge

Danes enjoy a high standard of living and Denmark ranks highly in numerous comparisons of
national performance, including education, healthcare, and protection of civil liberties, democracy
governance and human development.

There are 98 municipalities in Denmark. The level of service is different as the municipalities are
self-governing and set their own standards. Some municipalities are rich and some are not so rich
and it has an impact on the citizens living there. Actually some parents to an autistic child choose
to resettle in another municipality because of the low service level in their existing municipality.

More Facts about Denmark

Estimated population, Oct. 2014 5.655.750

Area 42.915.7 km2

Municipalities 98

Ordinary Schools, 2013 1.312

Special Schools, 2013 181

Pupils in Ordinary Schools, 2013 558.581

Pupils in Special Schools, 2013 9.060

Historically speaking, Denmark has been a leading country in the autism and disability field. The
standard, quality and available information in this field is and has been very high. It is a part of the
Danish welfare system, namely that these fields are funded through taxes. Danish taxes are high,
between 38% and 56% - depending on your income. On top of this there is the high custom on

of 25%.
The base knowledge of workers within this field is quite unique. Initiatives such as TEACH, ATLASS
and STUDIO 3 are prioritized highly due to their work focusing on the entire individual, rather than
simple symptom curing. These programs contain both structure, participation, autonomy, ”low
arousal” and stress reduction. The latest one has put extra focus on the significance of creating
wellbeing for the individual in question.

Due to the relatively small size of Denmark, spreading new information and knowledge becomes
easy, which benefits both employees and citizens.

Disability housing, communities, colleges and housing for the elderly

In Denmark there is being constructed, and have been constructed, specialized housing for the
disabled and elderly, as well as college like buildings where they citizens can support each other
and be around like-minded individuals. But budget cuts affect the quality of these construction
projects. A reduction in staff is one of the things that gets cut. And the ability to receive a free
”companion” to help with everyday activities are continuously down prioritized in Danish
municipals. In 18 out of 98 municipals the rights to this aid have altogether been removed. Some
autistic people are therefore left without any contact or options to go outside their institution.

However the Hinnerup Kollegie, have just finished work on the (presumably) first in the world,
construction tailor made for elderly citizens with autism.

Photography of Seniorhuset (photography printed with the permission of Aarhus Stifttidende)

Seniorhuset consists of 4 residences, all part of a developmental project, whose agenda is to
gather information and experience with elderly autists, and what can be done to help them.

Something very unique, but completely reasonable, is that the requests of the residents are being
heard. Among other things they have in unison picked the green paint for the walls, as well as a
kitchen window facing their common area. As one of the residents said: ”If you have an
apartment, you also have to have a kitchen window”.

Princess Marie greeting one of the residents in the new housing (photography printed with the
permission of Aarhus Stiftstidende)
Picture of the common area in the new housing. Do note the windows facing the common
grounds, ceiling windows, green plants and the mellow green wall colours. (photography printed
with the permission of Aarhus Stiftstidende)

The Psychiatry

The standard is once again high. There is a fixed limit for how a citizen should have to wait before
receiving a diagnosis, and are guaranteed treatment within 2 months. This guarantee is upheld
somewhat well.

But in Aarhus, Denmark’s second largest city - where I live, the psychiatry area is receiving budget
cuts. Construction of a new psychiatric hospital has begun, and accompanying is a demand for an
8% increase in efficiency. This means that from 2015 there will be made cuts in the specialized
help available to autistic children aged 0-7.

Autism Denmark (Landsforeningen Autisme) has made the following statement on the affair:

”Early diagnosis is alpha and omega, when it comes to autism. It is therefore very important that
the correct diagnosis is given at an early age. Examining the children and diagnosing correctly
takes experience, thoroughness and specialized knowledge.”

Uncoordinated action
Considering previous initiatives as well as budget cuts, it is reasonable to conclude that the autism
field in Denmark lacks a larger unified plan or direction, and that there currently is a depressing
negative development happening in the specialized social field.

Watering down the specialized social area

In 2007 there was a structural reform in Denmark, where among other things the specialized social
field was handled individually from municipal from municipal, where earlier on there had been
regional standards. Following 2007, there is now 98 individual municipals in Denmark, and with
them huge variation in their available knowledge and the available services for disabled citizens.

In extension of this should be mentioned, that Denmark is rather unique, because the majority of
our offers and specialized aid for handicapped citizens are free due to funding through high taxes.
Elementary school is likewise free to attend.

Specialized elementary education is currently a subject of high political interest, due to the
increasing costs of it, and the want of politicians to bring down expenses by relocating funds from
specialized schools to regular ones. Therefore there now is an alarming focus on removing children
with special needs from a specialized school, and placing them in regular ones, as well as removing
the demands for specialized / tailored education.

What is described in the above paragraph is inclusion. It is roughly defined by the national
association of municipals as follows:

The placement of disabled children in local schools, so the pupil has the opportunity to learn the
same lessons as regular children, such as conforming to the structure and the norms of the
school.

Due to student transfers several specialized schools are getting shut down, and the highly
experienced and trained staff is left to seek jobs elsewhere.

Determined politicians are also quite adept at shedding negative light on diagnoses and slandering
them with wrong and harmful ’knowledge’. Because without a diagnose municipals aren’t
required to provide the same aid as they otherwise would have to. Because the needs of a person
is hard to know without anyone providing a solid diagnosis and accompanying plan of action.

Specialized education and segregation, 2012/2013

The amount of students receiving segregated education, that is education received in a separate
specialized environment in a normal school, has been dwindling steadily since 2010/2011

The goal of the government and the national association of municipals is that 96% of all students
should be included in the normal school education by 2015. That is to say, only 4% of all children
in normal schools should be receiving separate education, and this is regardless of their needs.
In 2012/2013 a total of 5,2% of children in municipal schools received segregated education.

Table 1. Students receiving specialized education in either segregated or inclusive offers anno
2010/2011-2012/2013

2010/2011 2011/2012 2012/2013

Students in Ordinary Schools  590.861  578.877  577.396

 - Segregated ones below

 1) Special Schools etc.  13.231  12.291  11.641

 2) Special Classes Ordinary Schools, etc.  20.745  18.970  18.323

 - Included ones below

 3) Ordinary Classes  32.950  36.536  856*

Pupils, receiving Special Education  66.926  67.797  30.820**

In Total

Note
* and **

Fald i samlet antal

specialundervisningselever skyldes
ændret specialundervisningsbegreb
I 2012/2013 blev specialundervisningsbegrebet
ændret, således at specialundervisning er 1) al
undervisning i specialskoler og
dagbehandlingstilbud, 2) al undervisning i
specialklasser og 3) undervisning i den almindelige
klasse, hvor eleven får støtte i mindst 9 timer om
ugen (inkluderet tilbud) (se også afsnittet Værd at
vide).

Elever, der modtager støtte i mindre end 9 timer, skal

have støtte som led i den almindelige undervisning.
Disse elever medregnes ikke længere som elever, der
får specialundervisning.
Med det ændrede specialundervisningsbegreb er der
kun godt 850 elever i 2012/13, der får
specialundervisning i inkluderede tilbud mod 37.000 i
år 2011/12. Det betyder, at de godt 850 elever, der
modtager specialundervisning i et inkluderet tilbud,
får støtte i mindst 9 timer om ugen.

Source: Denmark’s Ministry of Statistics and the Ministry of Education.

Inclusion requires an investment

In order for inclusion to be successfully accomplished, there has to be an investment in specialized

education for staff, new ways to share and implement new knowledge as well as cross-field
cooperation and policies, specialized materials, tailored environments and so forth. And the
funding for this has to be present in order to support the project. But there is a distinct lack of
quality in the current inclusion process, according to Autism Denmark and the Danish ADHD-
association.

Budget cuts are made for the local schools, and the student with autism becomes the victim. It can
be illustrated with the following diagram:
The consequence of including the student with autism

In a specialized school the student would be in a tailored environment, and taught both regular
school courses such as math, history and English, as well as receiving training in social skills. All of
this would be done by experienced and specially educated teachers and educators. Said student
would now be included in a larger classroom with 25-30 students, and taught by teachers with
limited or no knowledge of developmental disabilities. Teachers who may not have had specialized
courses in understanding and dealing with autism, og teachers who may not be very motivated for
receiving a special needs student, in addition to their normal class.

A regular class usually contains:

2-3 students with developmental disabilities

2-3 students with learning problems

4 students who don’t speak Danish as their first language

2 students with social problems

The inclusion of special needs students have simply made to great demands of the staff. Several
teachers have already asked said students to remain home from school trips, workplace visits and
theme weeks. The staff simply can’t handle if the student should react negatively on a new
situation. The staff lacks knowledge and by extension the tools to solve situations like that.

A recent study concludes more than 17 % of the Danish students in regular school are not satisfied
with the school.

The students with autism becomes the victim

Autism Denmark receive an increasing number of messages from frustrated parents, telling the
same stories of stressed and restless children who are refusing to go to school, due to the negative
experiences associated with it. But even worse is that the parents also tell of threats by the
municipals to remove their school-avoiding children from the home.

The situation is now actually worse than what is described by Baroness Mary Warnock – the
woman behind the idea of inclusion, who herself have rejected the notion and have been left to
question the effects of inclusion of autistic students in regular schools.
Read what Mary Warnock in 2010 said about the special needs an autistic child has, and how
those are met in large schools with rigid administration, and most of all how these behaviors are
hurtful to the child in question, leaving them feeling left out and odd.

http://www.telegraph.co.uk/education/educationnews/8009504/Baroness-Mary-Warnock-The-
cynical-betrayal-of-my-special-needs-children.html

Summary

Despite the rise of singular projects like Seniorhuset, the quality and amount of available offers for
the disabled and autistic have been falling steadily through the last 10 years in Denmark.

These decreases of quality must of course also be seen in the light of a worsening international as
well as national economy.

Politicians have meanwhile been very adept at making diagnoses a dirty word. Again because
without a diagnosis the municipal don’t have anywhere near the same responsibility to help the
person in question, since a course of action can be hard to determine without knowing what is
wrong. This way the municipals save money.

The process of including evermore students with autism in the regular school hasn’t gone
according to plan, and there is a clear lack of quality with regards to the help for the students,
according to Autism Denmark and the Danish ADHD-Association. A recent study concludes more
than 17 % of the Danish students in regular schools are not satisfied with the school.

May I cite: ”Governments must recognize that, even if inclusion is an ideal for society in general,
it may not always be an ideal for school”, Mary Warnock.

While it is possible that municipals will save money short term with various miscellaneous cuts,
the cost will be too great for the individual with autism, who often isn’t able to commune their
discontent. But long term the society will definitely also pay the price, when these autists aren´t
given proper support through education and end up on welfare support, with stress, depression or
worse.

The institutionalized autist won’t have a very fulfilling life either when staff and aid is constantly
removed due to budget cuts.

This is a very sad development to face, well-knowing that the Denmark has such a high standard of
knowledge in the disability and autism field.