Scottish Strategy for Autism: evaluation

3. Findings: Delivery of the strategy’s recommendations and priorities

In this chapter we describe in more detail the content and development of the strategy and the activities undertaken to deliver its recommendations and priorities. This includes discussion of activities delivered by projects funded by three Scottish Government funding programmes.

Phase 1 of the strategy (2011)

The first iteration of The Scottish Strategy for Autism (2011) marked the beginning of a ten-year strategy which sought to improve care and support for autistic people. It was an ambitious strategy that outlined seven underpinning values, a series of time-defined goals and ten indicators for best practice in providing autism services. There were 26 specific recommendations, organised across six themes, intended to deliver against these goals.

There was a funding investment of £1.12 million to support the development of Local Authority Action Plans and the Autism Development Fund awarded £4,891,579.82 to 53 projects. This funded activity between 2011 and 2015 and enabled projects to support autistic people and their families/carers, and deliver elements of the strategy at a local and national level.

Table 3.1: Funding programmes 2011-21

	Total funding awarded	Number of projects	Lowest grant amount	Highest grant amount
Autism Development Fund 2011-15	£4,891,579.82	53	£5,000	£362,170
Autism Innovation and Development Fund 2015-18	£2,097,526.00	41	£4,300	£281,948
Understanding Autism Fund 2019-21	£435,801.00	9	£9,991	£72,601
TOTAL	£7,424,906.82	103

This section outlines the work delivered to fulfil the goals set out in the 2011 strategy using the 26 recommendations it outlined, listed under the six original themes.

Theme 1: Strategic leadership from the Scottish Government

Four recommendations around governance and support proposed that the governance group be reconvened to work collaboratively with COSLA, the NHS, and other public bodies to support local area implementation of the strategy. As part of this, the governance group was tasked with investigating the benefits of autism lead officers.

A governance group (the Autism Strategy Review Group) was set up to monitor progress of the strategy. Membership included autistic people, representatives from the third sector, government and professional experts.

Each local authority was given £35,000 to develop a local autism strategy, supported by a central autism hub – the organisation now known as Autism Network Scotland (ANS). Where autism lead officers were in place, they were invited to be part of a network facilitated by ANS.

Theme 2: Achieving best value services

Recommendations in this area related to research and evaluation. They included: evaluating the economic costs of autism; identifying gaps in research relating to autism services; assessing current outcomes for people with autism and their quality of life and; developing a ‘menu of interventions’ to identify the support available to autistic people, their families and carers.

Two pieces of work were commissioned to look at the services and support available to autistic people, their families and carers. The first was the Autism Mapping Project, completed in 2013. A partnership comprising the National Autistic Society Scotland, Autism Initiatives Scotland, Scottish Autism, the Convention of Scottish Local Authorities (COSLA), the Association of Directors of Social Work (ADSW) and the Scottish Government conducted research to explore what autism services were available across the country.

The Autism Mapping Project identified and located existing autism services across Scotland and provided each local area with an initial mapping of the services available in their authority. The project looked at what autistic people wanted in terms of services, what they felt worked well and identified priority areas for action that reflected local need. The report given to each local area was intended as a starting point for planning and improving future service delivery.

The second piece of work, which looked at interventions and support mechanisms, was also undertaken in 2013. The Menu of Interventions ('the Menu') – ‘a guide to interventions and supports for people on the autism spectrum’ aimed to help identify available advice and support and set out the referral and assessment process for all other services and interventions.

It provided information, drawn from a wide range of professionals, individuals and families of autistic people, regarding, ‘the challenges faced by autistic people across the lifespan and ability range’ and how these might be best addressed. This was intended to be a flexible approach allowing for the guidelines to be used both generally, across services and locations, but also as required by individuals.

The Autism Mapping Project, Menu of Interventions, support from ANS and government funding were intended to provide a starting point for the development of local strategic plans.

The other main thread for this theme was research into the economic cost of autism. Although not delivered within the original timeframe, The Microsegmentation of the autism spectrum: research project, published in March 2018, provided a foundation for identifying ‘preventable’ costs of autism – those that would not be incurred if appropriate interventions and adaptations were provided to autistic individuals when required. It also:

• provided an accurate pooled prevalence estimate of 1.035% (103.5 per 10,000) for autistic people and applied the figures to Scotland to provide an accurate representation of the number of autistic people in each age group, by location and whether they also had intellectual disability;
• concluded that most figures around the proportion of people with autism and intellectual disability were too high and suggested a more accurate figure of 32.7%;
• looked at the economic cost of autism and concluded that the incremental annual cost to the national economy was £2.2 billion;
• proposed a model of segmentation of autism based on a matrix of eight segments looking at intellectual ability, symptom severity and additive risks; and
• linked segmentation and interventions to cost and proposed incremental saving amounts for each effective intervention.

Theme 3: Involving autistic people, their families and carers with decision making

These recommendations centred around increasing consultation and involvement with autistic people. They proposed that the governance group explore options to improve user and carer involvement in service planning, and that the Self-Directed Support Strategy Implementation Group ensured representation from the autism community.

Increasing engagement with autistic people was carried out in several different ways: through a scoping exercise to capture best practice, through facilitation by ANS and by enabling autistic people to participate in policy consultation.

In looking at how to increase engagement from autistic people, the governance group carried out a sample scope on what the NHS, local authorities and voluntary organisations were doing as a baseline for consultation good practice at the launch of the strategy. The governance group itself included representation from autistic people’s organisations.

A key part of the ANS role in helping local areas to develop their own strategies was to facilitate input from local steering groups including autistic people, their families and carers. Some local authorities chose to use part of their initial funding pot for establishing their strategy on consultation exercises with autistic communities.

Autistic people and their families commented on the proposed guidance and regulations for the Self-directed Support Act and policy development.

Furthermore, one-stop-shops were expected to report back about how they supported involvement from autistic people and the evaluation of the one-stop-shops identified effective involvement and engagement of autistic people in how their services were provided.

Theme 4: Improved cross-agency working

Recommendations included: developing good practice guidelines to support autistic people as they transition between services at different points in their lives; the governance group should contribute to a review of existing SIGN guidelines; a training sub-group to look at gaps in training provision; assessment of the impact of ANS.

ANS worked with the Scottish Government-funded Scottish Transitions Forum (part of ARC) to develop the Principles of Good Transitions Guide which details what support young people need for positive transitions. They introduced this to funded projects and worked with ANS to produce research and run transition events.

When the Scottish Strategy for Autism was launched in 2011, there were only SIGN guidelines for autistic children and young adults. The Autism Strategy Review Group was instrumental in developing SIGN guidelines around autism for adults, with Dr Ian McClure, a member of the group, going on to chair and co-author SIGN 145, which included guidelines on assessing and diagnosing autism for children and young people and for adults.

The early years of the strategy saw some work taking place to expand autism training. This started with the development of a four-tier model for classifying and standardising autism training in Scotland, continued with an overview of good practice in autism training and culminated in the publishing of a training plan. This looked at the training needs of practitioners, matched them to existing resources and identified any gaps in training provision.

Training for a wider audience was also considered, with Scottish Government-funded Open University and University of Strathclyde distance learning courses being offered to professionals and parents of autistic people to increase their understanding of autism.

The 2016 review of ANS identified the need for clarity in its remit and governance structure but highlighted the positive impact of its role in networking, sharing good practice, providing information and resources, and awareness-raising.

Theme 5: Improving diagnosis

These recommendations focused on steps that could be taken to improve guidance and training on diagnosis of autism, looking at how and by whom it is diagnosed, under what guidelines, how this information is shared and waiting times for diagnosis.

In the early years of the strategy, diagnosis and assessment of autism was guided by the PHIS Quality Diagnostic Standards for adults, which had a limited evidence base for interventions and the SIGN 98 (2007) guideline on children and young people with autism spectrum disorders. In recognition of the life-long nature of autism and its different manifestations in later life, this was superseded by SIGN 145 in 2016 (as referenced in the previous 18 theme) which provides guidance on diagnosis, assessment and interventions around autism for both children and adults.

Information about autism and how to diagnose it was shared with the Royal College of Physicians and Surgeons, included in the NES training framework and autism portal available to all healthcare professionals and became part of an eLearning course developed by ANS.

The Autism Achieve Alliance (AAA) was commissioned by the Scottish Government, to undertake research into waiting times for autism assessment. The results of this research were published in August 2014 and included a national action plan to address the causes of the delays and how to reduce them.

Theme 6: Improving access to the workplace

Recommended evaluating the impact of the supported employment framework for Scotland.

There were several areas of activity around improving access to the workplace in the formative years of the strategy. In a direct response to the objective outlined under theme six, a specially convened sub-group of the governance group submitted a response to the supported employment framework, outlining how it could best support autistic people to access employment opportunities.

More recommendations around employment were included in the ‘Summary Guide on Employment Policies and Initiatives’ in Scotland which was produced by Autism Initiatives. The guide provided a background to employment policies and initiatives in Scotland and was intended as a resource for local areas setting up supported employment initiatives.

Some of the local initiatives received funding to improve access to the workplace and these included Project SEARCH, Diversity works 4 me, Iwork4me, the Shirlie Project, Autism Rights Group Highland and the Richmond Fellowship.

Summary

The foundation phase of the strategy rationalised various strands of work into a coherent action plan to tackle the inequalities and disadvantages experienced by autistic people and those close to them. The early years, guided by the initial 26 recommendations, were ones of consolidation and preparation, creating frameworks for assessment, diagnosis and training, commissioning research and producing resources to help local authority partnerships translate a national strategy into local action.

The intentions of this phase provided a basis for the evolution and expansion of the strategy as it entered its next phase.

Phase 2: An outcomes approach from 2015-2021

In 2015, the Scottish Government and COSLA refreshed the strategy and reframed it into an outcomes-based approach with the intention that these new outcomes – healthier life, choice and control, independence and active citizenship - would help realise the strategy’s vision for autistic people and their families.

Once again, the strategy’s priorities were reinforced with funding through the Autism Innovation and Development Fund (2015-18), which distributed £2,097,526 to 41 projects, and the Understanding Autism Fund (2019-21), which disbursed £435,801 to nine projects. These funds were administered and managed by Inspiring Scotland, which also provided capacity-building support to projects throughout this period. Table 3.2 includes details of the amount of funding awarded and the number of projects that align with each of the four strategic outcomes.

Table 3.2: Autism Innovation Fund (2015-18) and Understanding Autism Fund (2019-21) ^[2]

Strategic outcome	Total funding awarded	Number of projects
Active citizenship	£1,740,433	31
Choice and control	£152,546	4
Healthy life	£502,310	9
Independence	£138,038	6
TOTAL	£2,533,327	50

Strategic outcome 1: A healthy life

Autistic people enjoy the highest attainable standard of living, health and family life and have timely access to diagnostic assessment and integrated support services.

This first outcome looks at diagnosis, post-diagnostic support, advocacy for autistic people and mental health policy and provision.

The focus of recommendations around diagnosis was to improve assessment and diagnostic services and increase capacity. For post-diagnostic support, sustaining the growth of one-stop-shops was established as a priority, alongside the development of a post-diagnostic support ‘toolbox’. Exploring what needed to be done to support parents, and the role of advocacy services were seen as crucial to helping autistic people enjoy high standards of living and family life, as was reviewing provision in the Mental Health (Care and Treatment) (Scotland) Act 2003.

Our analysis of the funding awarded to projects in 2015-21 shows that nine projects were most closely aligned with this strategic outcome. These projects accounted for a total of £502,310 across the two funding programmes. Some examples of funded projects are identified in the sections below.

Diagnosis

The Scottish Government created the National Autistic Improvement Team (NAIT), involving professionals from education, speech and language therapy, occupational therapy and psychiatry who provided practitioner-to-practitioner support around education and inclusive practice, assessment and diagnosis and employment. Their website shares information about who can diagnose autism and the process for doing so, clinical guidelines and neuro-developmental pathways.

Post-diagnostic support

The recommendations captured in ‘A Healthy Life’ recognised that diagnosis must be followed by appropriate support. A successful pilot of one-stop-shops was replicated in five different locations with funding from the strategy of approximately £2 million to support the roll out. One-stop-shops offer autistic individuals, their families and professionals information and advice about autism and local support services.

More recently, the Scottish Government funded a pilot National Post Diagnostic Support Programme. This service aims to support newly diagnosed people across Scotland to understand and embrace their identity as an autistic person. The service is delivered in partnership with national and local charities^[3] and focuses on ensuring that autistic children and adults, as well as their families, are empowered with the information and support that they need after a diagnosis, whilst also providing autism-led peer support. The pilot started in December 2020 and will run for six months. It will then be independently evaluated and the results of the review used to determine the direction of a national service.

Parents and autism

The pilot National Post Diagnostic Support Programme will consider how best to support parents as part of its service, ensuring they get the information and support they need to help their child or children with an autism diagnosis and life as an autistic person.

ANS produced a summary report with recommendations on what needs to be done to better support parents and Scottish Government funding was used by Scottish Autism to run an advice line throughout the COVID-19 pandemic to support families.

Several local projects funded by the Autism Innovation and Development Fund supported parents and families. These included the following:

• Barnardo’s Intensive Behaviour Support Service aimed to improve parents’ ability to positively manage their child’s autism in Southeast Scotland.
• The Richmond Fellowship’s Scotland-wide Positive Pathways project offered training, support, and advice for family carers of autistic individuals aged 5-18 who have emotional and behavioural challenges.
• Perth Autism Support’s Partnership Family Support Project supported families with autistic children.
• The Tailor Ed Foundation offered home-based support in developing practical skills and strategies for autistic children and their families in Edinburgh.

Advocacy and autism

One of the outcomes of the strategy has been a new website which was set up to support organisations supporting autistic people to create websites and set up new advocacy services.

Another outcome has been the work by ANS, whose report into Autism and Advocacy led to the production of a policy and practice paper about autism-informed advocacy and a successful pilot on parental advocacy training, which will be rolled out nationally when funding is secured.

There are a few examples of projects funded by the Autism Innovation and Development Fund that focused on advocacy. Kindred, for instance, provided advocacy support to ten families with autistic young people in Fife, Edinburgh and the Lothians, and the Speak Out Advocacy project in South Lanarkshire offered a dedicated advocacy service for autistic people.

Mental health provision and law

An independent review team gathered evidence on how people with learning disability or autistic people experience the Mental Health (Care and Treatment) (Scotland) Act 2003 and their report, published in 2019, identified a set of legal and practical changes which could reduce or remove the discrimination that autistic people and people with intellectual disability have experienced under Scotland’s current Mental Health Act. The Scottish Government is considering how how these recommendations should be taken forward.

The Scottish Government also committed to exploring alternative solutions to out of area placements for people with complex care needs and autism. The Coming Home Report and the Mental Welfare Commission’s themed report identified the challenges faced by autistic people and the Scottish Government’s team is working with Social Work Scotland autism and learning disability sub-group to assist HSCPs to improve how autistic people’s needs are met and understood within all services and funding a post at Glasgow University to support work on complex needs.

Strategic outcome 2: Choice and control

Autistic people are treated with dignity and respect and services are able to identify their needs and are responsive to meet those needs.

The focus of this outcome was to raise the awareness of both the public and professionals about autism and what it means to be autistic, whether it be in school, the criminal justice system or in day-to-day life. Recommendations centred on achieving this through awareness-raising campaigns, training and education. This part of the strategy also set out objectives around autism and aging, recognising that autism affects a person throughout their lives.

A total of £152,546 of funding was awarded to four projects that aligned with this outcome between 2015 and 2021 through the Autism Innovation and Development Fund and Understanding Autism Fund. Some examples are provided below.

Raising awareness of autism

There was significant activity focused on raising awareness of autism among different groups in the community.

Whilst there is an acknowledged lack of understanding of autism across many areas of public and professional life, the criminal justice system was identified in the strategy as an area needing particular focus. Work with the Scottish Offenders with Learning Disabilities (SOLD) produced guides for support staff and defence solicitors on working with people with communication needs and developed training and awareness raising for advocacy workers and support staff to help them support autistic people who find themselves in the criminal justice system.

Women and girls, who are thought to be under-diagnosed^[4] were another area of focus and Scottish Women’s Autism Network (SWAN) was established to support autistic women by sharing advice and knowledge on autism and how it affects women. The Scottish Autism’s Women and Girls Right Click Programme, funded by the Autism Development and Innovation Fund was set up 2016. The online service provides information about addressing health and wellbeing challenges for women who live with the condition as well as their parents, carers and other professionals working in the field of autism.

Another funded awareness-raising project, delivered by Autism Initiatives, involved autistic people producing a visual image of what life is like for them. The images created were then displayed through various medium to enhance understanding of autism among the wider community.

In the latter part of the 10-year strategy, a 2020 campaign was launched to raise public awareness of autism. The Different Minds campaign aimed to dispel some of the myths around autism and build empathy and support for autistic individuals through a more nuanced understanding. Development of Phase 2 of the campaign is due to begin in 2021.

In a more practical drive to raise awareness of autism and to help enable people to identify as autistic, ANS developed a webpage to highlight all autism alert card schemes in Scotland and provided a template to develop your own.

Finally, the Scottish Government team discussed the National Autism Awards proposed in the strategy with autistic people’s organisations and, on their advice, took the decision not to pursue this recommendation.

Training

There has been a host of activity to help increase knowledge about autism and train professionals. Since 2013/14 the Scottish Government has provided £671,000 to NHS Education Scotland (NES) to support autism training resources. Further investment for 2021/2022 will include an Allied Health Professional joining the NES team and provision of additional diagnostic training opportunities.

Work has continued to build on the training framework that was developed early in the strategy. There are three elements to the NES approach - the training framework, which shows practitioners the knowledge and skills they need to have; the NES training plan which details what training is available to acquire the skills and knowledge outlined in the framework; and an autism team who provide training, consultation, support, and resources.

Progress has also been made in training people outwith the NHS. The Care Inspectorate delivered training on autism to care inspectors (with ANS), developed an autism action plan and appointed an autism champion

More recently, specific training in diagnostic assessments has been progressed. A national scoping exercise in 2019 identified significant gaps in diagnostic assessment training across Scotland. In response, Developmental Diagnostic Dimensional Interview (3Di); Autism Diagnostic Observation Schedule (ADOS); and Diagnostic Interview for Social and Communication Disorders (DISCO) came together to train clinicians to identify and screen, perform structured diagnostic services and undertake complex assessments.

Education

Work is ongoing to raise awareness of autism and the needs of autistic learners both in teacher training and in schools.

The publication of the Not included, not engaged, not involved report on the experiences of autistic children missing school, was followed by a roundtable discussion, chaired by the Deputy First Minister, with key autism stakeholders to discuss and agree next steps. This led to the establishment of an Autism in Schools Short-Life Working Group in 2019 with an action plan that focused on driving improvement in education from the initial Teacher Education (ITE) programmes, wider sharing of inclusive pedagogical work and quality practice to continued support for ongoing professional practice and development.

NAIT have produced Initial Teacher Education Autism Course Materials: ‘We were expecting you!’ developed in recognition of the needs of autistic learners and those with related support needs.

For those already teaching, Education Scotland launched a refreshed Autism Toolbox in partnership with the Scottish Government and the Autism in Schools Working Group. The Toolbox is a free online resource developed to support the inclusion of autistic learners in Scottish nurseries and schools.

Other developments to raise awareness of autism in education include:

• An autism module for Post Graduate Diploma in Education designed by ANS;
• A commitment from the General Teaching Council Scotland (GTCS) to revise the framework for ITE and professional standards documents to ensure specific reference is made to autism;
• A sub-group of the autism governance group and GTCS co-created Meeting the Needs of Autistic Learners: a professional guide for teachers, published in November 2020;
• The Open University continued to offer free autism modules to professionals and parents of autistic people.

Autism and ageing

Support and services for autistic adults and older people is another area that has been repeatedly highlighted as one that needs to be addressed. The 2019 report by ANS, Autism and Ageing highlighted several areas of concern for the autistic community including social isolation, lack of service provision for older people and poor access to accurate and accessible information. The findings from this report formed the basis of an autism and ageing pilot in three local authority areas which ran from October 2020 to March 2021. One of the key aims was to increase knowledge and understanding among HSCP staff working with older people.

Strategic outcome 3: Independence

Autistic people are able to live independently in the community with equal access to all aspects of society. Services have the capacity and awareness to ensure that people are met with recognition and understanding.

This outcome included elements that support autistic people to live independently focused on increasing the number of autism friendly places in Scotland, enabling active travel and making sure autistic individuals have access to suitable housing.

Six projects aimed at supporting independence were awarded £138,038 in funding between 2015 and 2021 from the Autism Innovation and Development Fund and the Understanding Autism Fund. Some examples are provided below.

Autism friendly places and communities

ANS have supported a number of organisations in their drive to become more autism friendly through provision of resources and training.

Three of the nine projects currently funded are focused on improving access to the community for autistic individuals through increasing understanding of autism among the non-autistic community.

• Perth Autism Support, for example, is working with Asda and other retailers to deliver training to staff on autism awareness in Perth, Aberdeen, Angus and Highland. It is also providing resources for managers on how to best support autistic employees.
• Project Ability is working with Glasgow Life to produce videos, created by autistic people, to describe their experiences of autism during lockdown and of visiting Glasgow Life venues. The aim of the project is to enhance understanding of autism among Glasgow Life staff and improve their facilities for autistic people.
• Autism Atlas is delivering autism awareness training, drama presentations and question and answer sessions in communities and organisations including Police Scotland, supermarkets and the Crown Prosecution Service across the central belt and Dundee. The sessions are led by autistic individuals and aim to enhance understanding of autism among members of the community.

Autism-friendly travel

Assistance with travel supports autistic people to be independent and most of these services are shaped and delivered at a local level. Contributors to this report agreed that there had been positive changes. At a national level, the blue badge scheme was extended to include carers of autistic people.

Autism-friendly housing

Appropriate accommodation for autistic people to live independently is an area that needs significant development. Progress has been made both strategically and practically in moving towards supporting the availability of autism-friendly housing through research and pilot projects.

Two reports, one from the Scottish Government – ‘Housing to 2040’ – and one from ANS – ‘Housing and Homelessness’ – acknowledge the need for adapted housing and include recommendations on how this can be achieved. Pilot projects, like the one in East Ayrshire, was funded to deliver autism training to all housing managers and officers.

Strategic outcome 4: Active citizenship

People with autism are able to participate in all aspects of community and society by successfully transitioning from school into meaningful educational or employment opportunities. This looks at obtaining and maintaining employment, social security arrangements, transitions planning and reduction of social isolation.

In this final section we outline some of the work designed to promote active citizenship among autistic people, including support to transition from school into educational or employment opportunities, other types of employment support and activities designed to address social isolation and enhance community involvement among autistic people.

Activities like this, particularly those supporting autistic people to move towards employment and to combat social isolation through participation in community activities, were a key focus of the Autism Innovation and Development Fund, and the Understanding Autism Fund. Thirty-one of the funded projects were most closely aligned with this outcome and they shared £1,740,433 in funding.

Employment

Strategic support, practical advice and resources and funding have contributed to addressing the barriers to employment and helping local areas deliver employment support to autistic people who want to enter or stay in the job market.

Supporting autistic people to enter or sustain employment

National agencies like Fair Start Scotland (FSS), the national employment support initiative, help people facing multiple barriers into work by offering tailored one-to-one help and advice. People looking for work are matched with an adviser who will advise on the best places to look for work, how to apply and how to work with an employer should adaptions be necessary to continue employment. Although there is no data specific to autism, latest statistics from FSS note they have supported 904 people with a ‘developmental disorder’ in which they include autism and ADHD.

There are several local projects funded by the Autism Innovation and Development Fund which aimed to improve the ability of autistic people to move into employment. For example:

• SWAN received funding to deliver employment-related mentoring support for autistic people in several local authority areas including Fife, Highland and Borders,
• Clydesdale Community Initiatives supported autistic people to develop new skills to enhance their employability; and
• TCV Scotland’s Discovering Nature Programme, delivered in partnership with Scottish Autism, provided outdoor-based science training workshops for autistic adults.

Work with employers to develop inclusive work environments and support autistic employees

Two strategic overviews^[5] have contributed to the resources available to organisations and local authority partnerships looking into employment support. This is reinforced with practical discussion through the ANS-facilitated Autism and Employability Group, which also addresses issues and identifies appropriate employment support.

Skills Development Scotland is another national organisation broadening opportunities for autistic people. Although many of its initiatives have a wider definition of ‘disabled’ or under-represented, the measures in place can support autistic people into work. Their Apprenticeship Equality Action Plan (EAP) sets out the approach to working with partners to ensure individuals from a diverse range of backgrounds, including autistic people and those with learning difficulties, can access work-based learning opportunities and achieve equal outcomes. This has been followed up with autism training for potential employers.

Six of the nine projects funded by the Understanding Autism Fund focus on increasing awareness and understanding among employers of the benefits of employing autistic individuals. Over 60 employers across Scotland are participating in these projects, which include the following:

• IntoWork’s initiative to work with employers in Edinburgh and the Lothians to improve their understanding of autism.
• The Usual Place, which is engaged with businesses in Dumfries & Galloway through seminars to challenge misconceptions and negative attitudes towards autism.
• Values Into Action, Scotland’s Modern Apprenticeship pilot, which worked with local partners to secure Modern Apprenticeships for more than 20 autistic young people.
• Enable Scotland is working with employers across the country to improve recruitment and retention of autistic people, supported by an autistic people’s forum.

Transitions

The strategy acknowledged the importance of effective transitions between key stages in life, to support positive outcomes for autistic people. Much of the work completed under this priority has been in partnership with the Association for Real Change Scotland (ARC Scotland) or delivered through local projects. This has included:

• Funding ARC Scotland’s Scottish Transitions Forum (STF), a national network committed to improving the experience of children and young adults (14 to 25 years) with additional support needs as they make the transition to young adult life.
• Supporting the development and promotion of the Principles of Good Transitions 3 and an Autism Transitions supplement. The supplement was produced in partnership with ANS after consultation with autism communities. The supplement identifies key practice considerations, tools, and resources to help ensure autistic people and their families have access to appropriate transition planning.
• Trialling Principles into Practice, a training-based course based on Principles of Good Transitions 3, in ten local authority areas in Scotland.

At a local level, Autism Innovation and Development funding focused on supporting autistic people making the transition from school to education or employment. Some examples included:

• Central Advocacy Partners provided independent advocacy for autistic young people aged 14-25 in Forth Valley to support them through their transition from school.
• The Shirlie Project’s Bigger Picture programme supported autistic young people and their families in Highland to make the transition from education to life after school.
• The Thistle Foundation’s InterAct project in Edinburgh and Midlothian worked with young people with additional support needs including autism, their schools, families, and communities to support the transition from school to adulthood. This included developing traineeships and other opportunities for young people, as well as establishing opportunities for peer support.

Social security

Social Security Scotland, the new social security system is committed to treating people who access the services with dignity and respect and treat everyone equally. Its charter outlines an approach to inclusive communication, with an Inclusive Communication Stakeholders Group of which Scottish Autism is a member, and it is hoped that this new service will result in an improved experience for autistic people and their family members/carers when accessing the benefit system.

Social isolation

When autistic people are active citizens, they can be socially engaged, participate within their local community, and feel a sense of belonging.

Before the COVID-19 pandemic, isolation and loneliness was experienced my many autistic people and it is likely that this has been exacerbated with the restrictions and reduced access to services.

In recognition of the challenges resulting from the pandemic, £450,000 was provided to autism and learning disability support organisations to help support vulnerable people at risk of social isolation.

A few examples of projects delivered under the Autism Innovation and Development Fund 2015-18 that aimed to address social isolation are listed below:

• Project Ability provided weekly classes in Glasgow which included opportunities for social activities.
• The Royal Conservatoire of Scotland (in collaboration with the National Theatre of Scotland, National Autistic Society and NHS Greater Glasgow and Clyde) delivered a project to address and challenge barriers that autistic children, young people, and adults face accessing drama and theatre.
• The Watermill Foundation supported the first all-abilities cycle track in Scotland (the Highland Cycle Ability Centre) to enable autistic people to take part in social activities, as well as enhancing their self-esteem, confidence and overall health and wellbeing.

The National Post-Diagnostic Support pilot will also address social connection and isolation and put in place support for autistic people to engage across their communities.

Summary of delivery of the strategy’s recommendations and priorities

The ten-year strategy was ambitious and multi-layered to address the broad and wide-reaching outcomes and priorities that it contained. Delivery of the strategy required commitment and implementation at a local and national level, and partnership working across several sectors and services to deliver the vision and bring about change.

Most of the commitments in the strategy have been actioned to some extent, some have gained more traction than others and some still need much more focus and investment for real progress to be realised.

In the next chapter we explore the impact of these activities and deliverables within the strategy.