University of Birmingham Autism education in Greece at the beginning of the 21st century

This paper considers recent evidence on autism education in Greece in order to shed light on current developments and attitudes. Given the increase in relevant research in the country, a scoping review to identify topics that have been explored so far and propose areas for future research and implications for practice is timely and necessary. Peer- reviewed papers published between 2000 and 2019 were identified via electronic databases and their main themes were analysed. Themes related to autistic individual (i.e. the voice of autistic individuals and intervention studies), the family around them (i.e. the role of family and stigma), the role of teachers (i.e. teacher training and teacher stress levels) and the wider society (i.e. parent- teacher collaboration, the medical/deficit model of disability and inclusion) emerged from the review. The above themes are discussed in the light of the cultural characteristics of Greece and the recent economic crisis the country underwent as well as similar findings from other European countries.


Introduction
There are insufficient data on the exact number of people with autism in Greece (Stampoltzis et al., 2012). Pervasive Developmental Disorders (PDDs) used to be the most common way to refer to autism until a decade ago (Gena, 2009, cited in Makrygianni andReed, 2010). Nowadays terms such as autistic or Asperger traits, developmental disorders and the full diagnostic label Autism Spectrum Disorder are more widely used than autism possibly because οf the less negative connotation combined terms might carry.
Until early 2000s, autism was quite unknown among the general public. In 2002, Magiati et al. investigated Typically Developing (TD) children's understanding on different disabilities and found that none of their sample, aged between 8 and 11 years old, was familiar with autism. 70 out of the 79 children had never heard of autism, whereas the remining 9 of them thought that autism has to do with 'ear problems' (from the Greek word afti [αυτί] which means ear).
After the onset of the economic crisis in 2009, extensive budgetary cuts were applied to education, which as a result has been dismantled to a great extent (Kantzara, 2016). The field of Special Educational Needs and Disabilities (SEND) has been severely affected, as the vulnerable populations are the first to suffer from cuts in periods of crisis (Malli et al., 2018). Moreover, between 2008 and 2013 around 200.000 young well-educated Greeks left the country for employment reasons (Bank of Greece, 2016). This so-called 'brain drain' resulted in the country losing some competent professionals. Though there are no specific data on the actual jobs these people left behind, it is believed that the education sector was also affected.
Although there are studies showing that children with autism in Greece develop in very similar ways to that of autistic children in other European countries (e.g. Poppi et al., 2019, came to the above conclusion comparing Greece to the UK), country specific studies should be analysed in order to draw conclusions on how autism is perceived and for suggesting ideas for future research and relevant implications for practice. The aim of this paper, therefore, is to present and discuss literature on autism education in Greece in the last years addressing the need for more educational research on autism internationally (Graff et al., 2014). This paper will be beneficial first for researchers to get a clear view of areas that have already been researched but also and more importantly areas that warrant further exploration. Professionals will also benefit from this paper as there is currently a pressing need for more research-informed practice in the field of autism (Kossyvaki, 2017). A summary of the development of SEND and autism education in Greece and the national educational system will follow as this was considered necessary to set the scene for the review.

A brief note on the development of special and autism education in Greece
Inclusion was established for the first time in Greece in 1985 (Law 1566), and special classes were formed within mainstream schools to accommodate the needs of pupils with SEND (Syriopoulou-Delli, 2010). The first public school for autistic children was established in 2000 (Law 2817) and up until then children with autism used to attend special schools for children with intellectual disabilities (Hellenic Pedagogical Institute, 2000). The first national curriculum for children with autism was developed in 2003; this outlined academic objectives but also the need for teachers to address social, communication, play and independence skills (Ministry of Education).

The Greek educational system for pupils with autism
Nowadays, autistic pupils are likely to be offered one of the following educational provisions: (i) full-time mainstream education (i.e. autistic children attend the same class with their TD peers either without support or with additional 1:1 support by a special education teacher: special education teachers in Greece have either a bachelors' degree in special education or a bachelors' degree in education and a masters' or other postgraduate qualifications in special education, Hellenic Pedagogical Institute, 2008), (ii) inclusion classes operating within a mainstream school (i.e. autistic children attend some classes together with their TD peers and for some other core classes they are separated), (iii) generic special schools (i.e. these are primarily for children with intellectual disabilities), (iv) autism specific special schools and (v) home schooling (Giannopoulou et al., 2019;Papadopulou et al., 2017). The decision of offering students one of the above provisions depends on the existence and severity of additional intellectual disabilities and/or language difficulties. The majority of pupils with autism attend mainstream education or receive special education services (e.g. 1:1 support or inclusion classes) within mainstream schools (Stampoltzis et al., 2012).
According to the Hellenic Statistical Authority (2017) there were 430 special schools (primary and secondary) in Greece in the school year 2015/2016 and autism was the second most common SEND category in these schools after intellectual disabilities. More precisely, 29% of the pupils attending special schools for 2015/2016 were autistic (2900 autistic students on roll: 2258 males and 642 females). The number of autism specific schools is considerably smaller with 5 primary schools and 3 nurseries (Giannopoulou et al., 2019). The number of students with autism who attend mainstream education or the number of mainstream schools which cater for students with autism is not known. It is, however, reported that a number of children with autism do not access the appropriate educational provision (Loukisas and Papoudi, 2016) or do not receive any schooling (Kantzara, 2016). This is despite the fact that 9 years of schooling is now compulsory for all students including these with SEND (Hellenic Pedagogical Institute, 2008).
Most autistic children in Greece also attend costly interventions by specialists after school, either at home or at outpatient centres, to develop language, communication and social skills (Stampoltzis et al., 2012). This can be a financial burden for parents who often have to cover an amount of these costs themselves in addition to the costs covered by the Greek National Insurance Service (Loukisas and Papoudi, 2016).

Methodology
A review of the electronic databases EBSCO, PsycINFO and Google scholar was conducted in December 2019. Titles and abstracts of the papers were checked. The terms used for the search were 'autism', 'Pervasive Developmental Disorder', 'education', 'training', 'teaching', 'school' and 'Greece'. These terms were selected as they were thought to be the main terms which would provide outcomes on autism education in Greece. To paint a contemporary picture, the review was restricted to studies published in the 21st century (between 2000 and 2019). The search was also limited to this timeline as the author was particularly interested to collect information on recent developments following the establishment of the first public school for autistic children in Greece in 2000 and the publication of a couple of seminal studies showing lack of autism awareness in the country in the early 2000s (Magiati et al., 2002;Mavropoulou and Padeliadu, 2000). The inclusion criteria for studies to be add in the review apart from the fact that they had to be published between 2000 and 2019 were that these should: (i) consist of empirical data, (ii) have been through a peer review process before being published and (iii) be pertinent to education. After the identified outputs were analysed, their reference lists were also reviewed to check for papers which might build on the existing themes.

Results and discussion
Twenty-six papers were identified via the database searches which met the inclusion criteria and another 15 outputs were added to the list after the hand searches resulting in 42 outputs overall. Only 6 of these also included countries other than Greece (i.e. Gena et al., 2005;Gulberg et al., 2019;Guldberg et al., 2017;Nikolaraizi and De Reybekiel, 2001;Poppi, Jones and Botting, 2019;Wood and Milton, 2018) whereas the rest of the studies provided data exclusively about Greece. The outputs were published in 27 different journals with almost 50% of them (n = 19) having been published in 6 journals (see Table 1). Only two of these journals are specific to autism. Twenty-eight of the studies were published between 2010 and 2019 (7 outputs were published in 2019) whereas only 13 outputs were published between 2000 and 2009 showing an increase in publications as the years progressed (see Figure 1).
The studies identified for this literature review were grouped within the following four thematic categories: (i) the autistic individual, (ii) the family around them, (iii) the role of teachers and (iv) the wider society. Each category consisted of a number of pertinent subthemes. The studies identified for each category will now be presented and discussed in detail.  ' (p. 163). He also commented that he had been experiencing various difficulties at the university because staff had no knowledge about how to support him. He highlighted the importance of raising autism awareness among staff in educational establishments. The second participant, a young woman with autism, agreed on this point and further emphasised the need for more understanding and acceptance of autism in Greece. This finding disagrees with what happens in other countries in Europe where autism is now more established and autistic people lead ordinary lives and are involved in research and decisions made for them; for example, at the Autism-Europe Congress in 2016 four out of ten members of the scientific committee were autistic researchers (Bölte, 2017).

Intervention studies
Intervention studies were a very prominent topic in this literature review. Gena and Kymissis (2001) found that setting individualised goals can be an effective way to address the communication difficulties of children with autism in inclusive Early Years settings. Gena (2006) used strategies from Applied Behavior Analysis (ABA) such as social reinforcement and prompting and found that these were effective in increasing the social interactions, both initiations and responses, of autistic children with TD peers at school. Mavropoulou et al. (2011) researched the impact of task organisation, a component of Treatment and Education of Autistic and related Communication handicapped Children (TEACCH), on the independent play of two children with autism and found that on-task behaviour, task accuracy and independence improved as a result of the intervention. Argyropoulou and Papoudi (2012) examined the effectiveness of intensive interaction during interactive play; the teacher of an inclusion class facilitated the play between a preschool boy with autism and a TD girl and the boy's social interaction, especially responses to his peer, improved. Makrygianni et al. (2018) compared the effectiveness of three community-based early intervention programmes for young children with autism (i.e. ABA, TEACCH and eclectic approaches) which were applied to the children 4-5 hours a day, 5 days a week for 9 months and found that ABA was the most effective in improving intellectual functioning. However, the study did not show statistically significant differences among the three programmes and this should be taken into consideration alongside the high cost of ABA. Mpella et al. (2019) explored the effects of theatrical play on the social skills of young children with autism and found that anxiety levels decreased for some participants whereas collaboration and forming friendships with peers improved as a result of participation in the programme.
8 Support for Learning • Volume 0 • Number 0 • 2021 © Two intervention studies on the use of technology were also identified. Volioti et al. (2016) asked special education teachers their views on an application teaching social skills to children with autism via social stories. The teachers responded for themselves but also on behalf of students with autism and reported that the application was easy to use and they also expressed high levels of satisfaction. Tsiopela and Jimoyiannis (2014) used technology to teach pre-vocational skills to older students with autism in a special vocational school. They found some positive effects from the implementation of a two-month web-based instructional intervention; more precisely, they reported that autistic students with various levels of autism severity acquired a number of pre-vocational skills such as carpentry, ceramics, tailoring and gardening after having attended a few personalised sessions of limited duration.
Few intervention studies, which were conducted at participants' homes or in the community, were also identified showing that autism interventions should go beyond the school setting. Gena et al. (2005) tried to modify the affective behaviour of one pre-school girl with autism at home using video modelling and in-vivo modelling. Both types of modelling took place during play activities and the results demonstrated that both video modelling and in-vivo modelling systematically increased appropriate affective responding for the participant. Mavropoulou (2007) led two pilot befriending schemes for children with autism for over 3 years. These schemes despite the benefits for the participants and their families also contributed to raising public awareness on autism. Gkogkos et al.
(2019) investigated the effectiveness of an ABA programme in helping an adolescent with autism improve his sexual behaviour and minimise his inappropriate behaviours. The sessions took place at the participant's home and at the Institute of Systematic Behavior Analysis as sexual education is not taught at schools in Greece.
To sum up, the reviewed studies showed that a number of interventions have been researched in the Greek context. This is in line with the findings on the views of parents of children with autism regarding the use of interventions in Europe (Salomone et al., 2016). Although the study did not involve Greece and focused on early intervention, it reported that behavioural interventions (e.g. ABA) were equally used across the 18 included in the study European countries and developmental/relationship-based interventions (e.g. Intensive Interaction) were more commonly used in Southern and Eastern Europe. The family around the autistic individual

The role of the family
There is limited research having involved parents of children with autism in Greece. Mothers often take on the role of the coordinator or co-therapist for their children by finding a school and selecting appropriate interventions for them as well as offering extra education at home (Loukisas and Papoudi, 2016). Makrygianni and Reed (2010) found that parental stress and the parents' ability to discipline their child were related to the child's developmental progress following intervention.
The value of extended family should also be highlighted here as not only parents but also grandparents and other relatives play an important role in raising a child in Greece (Markodimitraki et al., 2017). This is in line with Preece's et al. (2017) study on parental perspectives on parent training which found that other members of family should be trained in autism in Southeast Europe.

Stigma
In Greece, autism is often perceived as a personal tragedy or misfortune and parents of children with autism are likely to feel helpless, stigmatised and marginalised (Padeliadu, 2007). Papageorgiou and Kalyva (2010) explored the self-reported needs of parents of autistic children and found that almost 1/3 of the parents in their sample had experienced rejection, while some other parents identified lack of understanding from their environments. One third of the parents had not disclose to people from their work environment that they have a child with autism, mainly because they were afraid of stigmatisation or that this would affect their promotion chances. More precisely, fathers seemed to withhold more than mothers from their work colleagues that they have an autistic child. The same study (Papageorgiou and Kalyva, 2010) found that parents of girls reported more understanding and acceptance from both their family and their work environment. This is probably because in the Greek society expectations of males are still in some cases higher than expectations of females (e.g. males are often the ones to sustain financially the family and continue the family name) (Kataki, 1984). In a recent study (Loukisas and Papoudi, 2016) mothers of children with autism reported having experienced covert or overt rejection and their child being stigmatised as 'abnormal'. The extent of stigmatisation of the individuals with autism in the Greek society is also illustrated in Giannopoulou et al.'s (2019) study which reported that a number of teachers believe that other pupils should not know about the presence of an autistic child in their classroom in order to avoid the latter's stigmatisation.
© From the author's personal experience, it is not uncommon for parents to keep the autism diagnosis of their child secret from school or deliberately delay getting their child diagnosed if the latter copes fairly well at school to avoid singling them out. The pressing need to improve public awareness on autism as a way to fighting the associated stigma comes as a conclusion in Veroni's (2019) study. In this study, around half the parents of children with autism in the sample indicated that they had experienced bias against them. The above findings are in total agreement with findings from Southeast Europe according to which families of children with autism experience stigma (Daniels et al., 2017).

Teacher training
A number of teachers in Greece feel that there is need for more specialised training in different SEND categories (e.g. intellectual disabilities, autism) in order for them to address appropriately the actual needs of the specific populations (Kalyva, 2010, cited in Spada, 2014. The need for disability specific training also emerges from the findings of two studies showing that there are numerous teachers' misconceptions as far as autism is concerned. An early study investigating Greek teachers' views on autism reported that even special education teachers lacked the necessary knowledge of the core characteristics of the condition and held out-dated and incorrect views about the causes of autism (Mavropoulou and Padeliadu, 2000); for example, teachers reported that autism has psychogenic origins (i.e. refrigerator mothers) and psychotherapy might be an effective intervention for this population. Even nowadays, there are studies showing that teachers still tend to hold several misconceptions about autism. For example, Giannopoulou et al. (2019) found that Greek teachers are likely to believe that: (i) autism is an emotional disorder, (ii) children with autism are not interested in creating relationships with others, (iii) most children with autism have special talents, (iv) all children with autism have some sort of learning difficulties, and (v) their prognosis is poor even if early intervention is provided. The same study reported that regarding the causes of autism, teachers are likely to: (i) believe that autism does not run in families and (ii) attribute autism to lack of maternal affection. Compared to the Greek situation, teachers' knowledge of autism seems to be of better standards at certain parts of Europe. In the UK, for example, teachers appear to have a basic understanding of autism but fill ill prepared regarding appropriate teaching strategies (Ravet, 2018).

Teacher stress levels
Overall, Greek studies report moderate levels of job stress for special education teachers. More precisely, Lazuras (2006) showed that organisational aspects of their work, poor supervision and weak bonds among colleagues were likely to cause stress among them. In a similar vein, Platsidou and Agaliotis (2008) found that the most stressful factors for special education teachers were student assessments as well as collaboration with experts, parents and colleagues. Teaching children with autism, however, was found to pose considerable stress even to special education teachers (Kokkinos and Davazoglou, 2009). On the whole, professionals with prior training in autism report significantly less stress when working with autistic children compared to those who had none (Guldberg et al., 2017).
The economic crisis of 2009 might have impacted the teacher stress levels. The numbers of teachers decreased considerably between 2010-2014 (8.5% decrease for primary education teachers and 27% decrease for secondary education teachers) (Katsikas, 2015 and OLME, 2014, both cited in Kantzara, 2016). Additionally, during the same period Greek teachers' salaries, which were lower than the salaries of their colleagues in the 27 countries of the EU, underwent severe cuts (Fryktoria 2012, cited in Kantzara, 2016). Yet, there are no available data on whether the number of teachers working with SEND pupils has been affected and the extent to which salary cuts impacted on their stress levels.
'Teachers' stress levels might also be affected by job security, which has seen a number of changes in the last years in Greece. Until mid-1990s, mainstream and special needs teachers were appointed in public schools after graduating from the university to permanent jobs. However, after mid 1990s teachers could not get a permanent job in special education (National Printing Office, 2019;e-nomothesia, 2010). Therefore, many special needs teachers used to work as supply staff on annual contracts and had to move schools often on annual basis. This situation changed during the school year 2020-2021 when a number of special needs teachers were permanently appointed.'

Parent-teacher collaboration
Research, legislation and policy have addressed to a certain extent the parentteacher collaboration. Syriopoulou-Delli et al. (2016) found that 100% of the parents and 96% of the teachers in their sample consider the parent-teacher collaboration to be of significant importance. However, parents do not seem satisfied © with the collaboration with teachers and believe that they do not receive enough information on their child's education or guidance from teachers on how to support their children (Mavropalias et al., 2019). The importance of collaboration between teachers and parents of autistic children has been recognised in the national curriculum for students with autism (Ministry of Education, 2003). Additionally, Law 3699 states that parents have the right to participate in the children's education and collaborate with the relevant services (Hellenic Pedagogical Institute, 2008).
Lacey has written widely about the great significance of parent-professional partnerships particularly in the field of special needs (e.g. Lacey, 2013). Although she wrote about the UK, she identified some practical difficulties for this partnership to work which echo the findings of this review for Greece.

The medical/deficit model of disability
The medical/deficit model of disability did come up in a couple of studies in this review, not as the main research topic though. It is common practice in Greece to adopt the medical model in order to understand autism and teach autistic individuals (Guldberg et al., 2019). According to the medical model the deficits lie within the autistic individuals who have to be adapted or 'treated'; the environment of the school and the broader society is set and inflexible and, therefore, unlike to change in order to accommodate their needs (Rieser and Mason, 1990). Professionals such as child psychiatrists, psychologists and other therapists (e.g. speech and language therapists and occupational therapists) often adopt the position of experts to secure power (Foucault, 1980, cited in Hodge andRunswick-Cole, 2008) and the medical and professionalised discourses are valued above others such as that of autistic individuals or their parents (Hodge and Runswick-Cole, 2008). A significant percentage of teachers often accept the perceived expertise of 'others' and place the responsibility of selecting educational interventions for children with autism on special education teachers or even medical doctors (Guldberg et al., 2017;Syriopoulou-Delli et al., 2012). The medical model of disability is still quite prominent in many countries in Southeast Europe where sessions with psychiatrists and speech and language therapists are the main services children with autism have access to (Daniels et al., 2017;Salomone et al., 2016).

Inclusion
A considerable number of studies exploring autism education in Greece focus on inclusion. Many educationalists feel that inclusion is only partially applied or it is applied in a disorganised manner (Guldberg et al., 2017). According to Pappas et al. (2018) spatial integration and not inclusion is applied in Greek schools. There is an interesting paradox when it comes to inclusion in Greece; on one hand, there are studies showing that teachers consider inclusion essential in order to minimise the impact of stigma on children with SEND and their families but at the same time many teachers are of the opinion that pupils with autism might get better and more appropriate education in special schools (Giannopoulou et al., 2019;Pappas et al., 2018;Zoniou-Sideri and Vlachou, 2006).
Attitudes towards inclusion have been widely researched. Avramidis and Kalyva (2007) explored the attitudes of primary teachers working in mainstream schools towards inclusion and found that despite overall positive attitudes, teachers felt ill-prepared at the prospect of including children with autism. It did come as no surprise that teachers with SEND experience were more positive towards inclusion than those who lacked such experience. Similarly, Fyssa et al. (2014) found that although Greek teachers are in theory in favour of inclusion, factors such as the child's type of disability, their functionality and their ability to adapt 'to the demands of a largely unchanged classroom environment' (p. 233) were crucial for the success or failure of inclusion. Teachers seem to be more cautious for some types of disabilities including autism (Avramidis and Kalyva, 2007;Pappas et al., 2018). Syriopoulou-Delli et al. (2012) found that the majority of the Greek teachers in their sample thought that children with autism are the most difficult group of students to teach and the hardest to manage their behaviour. Also, they reported that special schools seem more appropriate for them as they should receive education on social skills rather than following a curriculum focusing on academic skills. Additionally, teachers in Greece tend to believe that the class teacher is not responsible for the education of children with autism when the latter attend mainstream schools (Guldberg et al., 2017).
Parents also express serious concerns regarding the effectiveness of inclusion practices at school (Mavropalias et al., 2019). Although parents of TD children seem to recognise more benefits than drawbacks from the participation of their children in inclusion programmes, they also appear concerned when children with SEND have severe behaviour problems or severe intellectual disabilities; in these cases, they are afraid that their TD child will imitate inappropriate behaviours or show delays in their academic attainments (Tafa and Manolitsis, 2003). The author would like to add here a shocking experience she had from interviewing parents of children with autism attending a mainstream school with 1:1 support. In this school in Athens, the capital of Greece, parents of TD children were at war with parents of children with SEND and the school's senior leadership team The attitudes of TD peers are of significant importance, and they have been researched only to a certain extent. Nikolaraizi and De Reybekiel (2001) found that while Greek children had positive attitudes towards children with SEND, these were 'at a superficial level, reflecting mostly social and emotional concern, and not a willingness to interact with these children ' (p. 167). Mavropoulou and Sideridis (2014) found that peers' positive attitudes towards inclusion can improve. More precisely, they investigated TD peers' attitudes towards partially included autistic classmates and concluded that at the end of their contact experience the former had greater knowledge of autism and more positive attitudes towards their autistic peers than children who did not have this kind of contact. The findings on attitudes towards inclusion in the Greek context bear many similarities to equivalent findings in other parts of Europe. For example, in the UK where inclusion is perceived as a 'societal right' (Lessner Listiakova and Preece, 2020, p. 180) and the openness of teachers to teach this cohort is affected by the latter's level of difficulties (Humphrey and Symes, 2013). Additionally, peer relationships play a key part in the successful inclusion of pupils with autism at school and the wider society (Humphrey and Symes, 2013).

Conclusions, directions for future research and recommendations for practice
As evidenced in this literature review, there are some similarities but also several differences regarding autism education in Greece compared to the rest of Europe. Several main conclusions with directions for future research are summarised below. The section concludes with a number of recommendations for policy makers and practitioners.
As far as autistic individuals are concerned, this review showed that they currently have limited involvement in decisions that concern their education and life, let alone participation in research. Regarding their education, strategies relating to ABA and TEACCH seem to have a prominent role. Since the reviewed studies failed to show statistically significant differences of these strategies, they should be seen with caution especially when they entail high cost (i.e. ABA). Additionally, the effectiveness of interventions implemented at private outpatient centres where autistic children receive a lot of their education should be researched. Furthermore, the effectiveness of interventions implemented at home does not seem to have been researched enough.
Family in its extensive form seems to play an important role in the education of children with autism in Greece. Mothers are usually more involved in the life of their autistic child and fathers feel more reluctant to share their child's diagnosis.
Grandparents and other family members are often of great help in raising a child in Greece. Further research on the impact of the nuclear but also the extended family on the education of children with autism is needed.
Teachers seem unclear about the extent of their responsibility to teach autistic children especially in mainstream schools. Many of them hold a number of misconceptions about autism and voice that they need more training. Teaching children with autism is likely to increase the teachers' stress levels but appropriate training has been found to reduce stress. Research needs to explore practical ways on how teachers can be supported via various types of training and possibly onsite coaching to teach children with autism.
There is definitely need for more understanding and acceptance of autism in Greece. The general public and more specifically teachers, TD peers and their parents are all, in theory, in favour of treating autistic individuals equally but this is not happening in practice and children with autism are often placed in specialist provision when there is no need for this. Withholding the diagnosis from the child or the school professionals for fear of stigmatising the autistic child is a practice many families follow and shows the amount of work the Greek society has to put in place in order to change the thoughts and feelings of the general public regarding autism. Future research should explore how positive attitudes towards autism can develop in the Greek school and society.
Finally, the long-term implications of the economic crisis on the education of children with autism should be investigated. Anecdotal evidence suggests that there has been a significant impact. It is about time, 10 years after the onset of the crisis, its impact on SEND and autism education was officially measured. It would have been an omission not to mention in this paper that, given the first results on the impact of the COVID-19 pandemic on the economies of European countries (Battistini and Stoevsky, 2020) and the well-being of disabled people (Office for National Statistics, 2020), future research should explore the impact of the pandemic on autism education in Greece.
© Based on the above conclusions, clear recommendations for policy makers and practitioners can be provided. Policy makers should raise autism awareness so that the associated stigma for children with autism and their families is eliminated. Leaving behind the medical/deficit model and adapting social models of disability (Haegele and Samuel, 2016) is likely to further promote understanding and acceptance. Also, developing appropriate training programmes for in service teachers and other professionals as well as including autism in the material taught at University undergraduate courses in relevant disciplines (e.g. education, psychology, speech and language therapy, occupational therapy) is of crucial importance. Additionally, policy makers should involve people with autism in research both as active research participants but also as co-researchers following the example of other European countries (e.g. Wood and Milton, 2018). Practitioners, first and foremost, should ensure that the voice of pupils with autism is heard. They should also apply evidence-based interventions and strategies. For this reason, they should be trained in a number of autism specific interventions and then select the interventions or elements of these which work with each individual child. Practitioners should work in close collaboration with parents and the extended family when appropriate. Last but not least, there also needs to be collaboration among all professionals who work with each child.