The Scottish Strategy for Autism - Menu of Interventions

Guide to Interventions and Supports for People on the Autism Spectrum


Appendix 1

Worked example for children with autism in a local authority area

This example is designed to show how the framework could be used to map services within a local authority, for a particular age group. As an example, descriptions of the type of service providers have been used rather than specific names of services.

ASD CHALLENGE

Strategy Strategy Guidance

Service/provider

(bold if available immediately)

Referral path

Desired outcomes

1. Understanding the implications of an autism diagnosis

Post diagnostic discussion (s) and individualised counselling

The provision of good quality education and information packs for individuals, families/carers along with appropriate verbal discussion at time of need. Use of visual props if needed. Signposting to useful websites and forums.

Specialist diagnosis clinic, CAMHS

Specialist voluntary sector services

Follow on from diagnosis

Self-refer

Individual and family develop an understanding of their autism

Individual and family know where to receive further help and support i.e. where to go next

2. Development of effective means of communication

Individualised language therapy assessment. Updated as required. Symbolised communication systems, sign systems, verbal behaviour methods as required on an individual basis. Internet etiquette and supervision.

Pre-school specialist service

Speech and Language Therapy

Specialist voluntary sector service

Diagnosing service

Information not currently known

Self-refer

Individual can express their needs, wants...

3. Social Communication

Targeted social communication programmes delivered either individually or in group setting as required and appropriate to the individual to include internet etiquette and promotion of online safety.

Speech and Language Therapy
(in school)

Speech and Language Therapy
(social groups)

Educational placement

Specialist voluntary sector service (youth clubs)

Information not currently known

Information not currently known

Information not currently known

Self-refer

The individual develops social skills which improve their relationships.

4. Developing and maintaining relationships

Work to assess understanding of relationships and promote skills to develop relationships including sexuality issues and intimate relationships. Access to social groups, friendship circles etc.

Speech and Language Therapy
(in school)

Educational placement

Speech and Language Therapy
(social groups)

Specialist voluntary sector service
(social clubs)

Information not currently known

Information not currently known

Information not currently known

Self-refer

The individual develops social skills which improve their relationships.

5. Social isolation for individual with autism

Accessible social groups and opportunities, support in the community. Befrienders. Respect the need to be alone at times. Acceptance by families that friendships can take many forms.

Specialist voluntary sector service (youth clubs)

Specialist voluntary sector service (play centre)

Some clubs at community leisure centres

Some scout groups

Some brownie groups

Self-refer

Self- refer

No referral necessary

No referral necessary

No referral necessary

The individual can access social opportunities.

6. Social isolation for family

Family/ Partner/ Carer support, opportunity for respite. Access to Autism friendly environments.

Respite

Voucher system via specialist voluntary sector organisation

Local authority day time respite

Local authority overnight respite

Parent support

Various specialist voluntary sector services

Sibling groups

Specialist voluntary sector service

Autism friendly environments

Specialist voluntary sector play facility

Local play centre offering autism friendly sessions

Some cinema screenings

Social work assessment

Social work assessment

Social work assessment

Self-refer

Self-refer

No referral necessary

No referral necessary

No referral necessary

The family of the individual with autism can access social opportunities.

7. Learning to learn skills

A functional assessment of the person's cognitive abilities and learning style leading to a planned programme both directly with the individual and indirectly with the family, carer etc. Formal psychometric testing may be conducted if appropriate to inform intervention.

Pre-school specialist service

Educational placement including input from Educational Psychology

Diagnosing service

Information not currently known

Individual had skills to access and benefit from an educational setting

8. Predicting and managing change

Timely individual direct work with individuals to teach methods where required. Family/carer /employer guidance/education in these methods.

Visual supports; timetables, timers, text alerts, choice boards to be used as appropriate.

Pre-school specialist service

Educational placement

Specialist education support service (in school)

Community LD Nursing (at home)

Specialist voluntary sector service

Diagnosing service

Information not currently known

Parent or school

Information not currently known

Self-refer

The individual can cope with transitions with minimal distress

9. Behaviour and emotional regulation

Knowledge development in understanding behaviour in the context of ASD. Individual work with the individual on assessing behaviour, recognising triggers and developing and managing the implementation of strategies to help. Behaviour support plans, cognitive interventions, psychotherapy or counselling as required. Work with the individual's family/carers, criminal justice, social work, Police as appropriate. Autism Alert card possession.

CAMHS

Specialist education support service (in school)

Specialist voluntary sector service

GP

Parent or school

Information not currently known

Everyone relevant to an individual knows how to support that person to behave appropriately and manage their emotions.

10. Restricted and repetitive interests and behaviours

Assessment and positive day to day management on an individualised basis. Treatment by Mental Health clinician for OCD if required.

CAMHS

Educational placement

GP

Information not currently known

Any negative impact of restricted and repetitive interests/behaviours is minimised.

11. Motivation issues

Structured programmes as appropriate to the individual linking to the other core challenges as required. Career guidance, employer/HE/FE support.

CAMHS

Educational placement

Specialist voluntary sector service

GP

Information not currently known

Self-refer

Unconventional motivations contributing to an ASD challenge are addressed.

12. Sensory issues

Assessment of sensory difficulties. Identify strategies and implement.

Environmental adaptation on an individual basis with individual control working towards reducing the impact.

Occupational Therapy

Educational placement

Information not currently known

Information not currently known

The individual can experience social and learning opportunities without distress or discomfort due to sensory difficulties.

13. Daily living skills

Assessment of core life skills. Specific individual programmes to teach and maintain these skills where needed. Involvement of families/carers in assessment and implementation of new learning.

Education for families/employers/ care providers/housing dept re practical needs.

Occupational Therapy

Educational placement

Community LD nursing

Specialist voluntary sector services

Information not currently known

Information not currently known

Information not currently known

Self-refer

The individual learns and demonstrates the skills they need to function as independently as possible within day to day life.

14. Co existing conditions

Eg: epilepsy, dyspraxia, dyslexia, ADHD, ADD, sensory impairment, anxiety, sleep disorder, addiction, anger management, depression, self harm, psychosis, personality disorder, OCD, disordered eating patterns etc.

These require assessment and treatment/management by appropriate specialist clinician. Joint working is crucial across specialities with a clear case co-ordinating lead identified.

Appropriate specialist clinician

Case
co-ordinating lead identified

Will depend on the specialism

Via GIRFEC

An individual's needs that don't directly relate to ASD are addressed appropriately.

Services appear to be available to address each of the challenges, provided by a mix of health, education, social work and voluntary sector services. Closer analysis of referral criteria would however be required to be sure that services exist across the age range and intellectual ability and that these services are available across environments e.g. both home and school.

It would seem that referral paths aren't always clear with many instances where is has been hard to find the information required.

Few services appear to be immediately available which may indicate that whilst the services exist they currently don't have sufficient capacity to meet demand.

Finally, further work would be required to ensure that the services available are indeed generating the desired outcomes for individuals and their families.

Contact

Email: Alison Taylor

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