The Scottish Strategy for Autism - Menu of Interventions
Guide to Interventions and Supports for People on the Autism Spectrum
Appendix 3:
Worked example of a young person on the Autism Spectrum
Joe Beattie is an 11 year old boy who lives in village just outside a small city in Scotland. He lives with his family and attends a small village school. Joe's behaviour has always been a bit different from the other children. He has always struggled to make and maintain friendships; does not pay attention in class; dislikes noise and, often needs to leave the class. Differences in his behaviour have become more apparent since entering the older P4-7 class in the village school and there has been a dramatic increase in more 'challenging' behaviours. There is now a lot of concern regarding his current school placement and transition to high school.
Joe was not previously known to health services but did have Additional Support Needs Meetings annually at school. Recently, due to the escalation in challenging behaviour, he has been discussed at the Senior Integrated Team (SIT) Meeting by the Complex Needs Co-ordination. The complex needs co-ordinator and ASD Outreach Teacher, who both work within the Local Authority Department of Education were able to talk to colleagues from Child and Adolescent Mental Health and Social Work at the SIT meeting as both also attend this group every 6-8 weeks to discuss kids who appear to be struggling at school because of mental health and/ or developmental difficulties. The SIT meeting agreed that he would benefit from a developmental assessment. His family agreed and his GP referred for an urgent diagnostic assessment at which he was found to have a dual diagnosis of ASD and ADHD. Meaning that in addition to a developmental social communication impairment, which fulfilled criteria for a diagnosis of ASD, he also had a generalised attention difficult in keeping with a diagnosis of ADHD - ADD subtype. The menu of interventions was used to clarify his requirements and identify what services were currently available and which need to be developed in the area.
| ASD CHALLENGE |
WHAT NEEDS TO HAPPEN? |
WHO SHOULD DO IT? |
AVAILABILITY |
OUTCOMES |
| 1. Understanding the implications of an autism diagnosis |
Joe, his parents and extended family would be invited to attend New Pathways Post Diagnosis Group - Joe may also benefit from |
NHS and/ or Voluntary Sector NHS CAMHS Core Worker |
Yes Yes |
1,4, 5, 6 |
| 2. Development of effective means of communication |
Assessment of language comprehension to ascertain whether he needs further specific input. |
NHS Community (school-based) Speech and Language Therapist |
Yes |
2, 4, 5, 6 |
| 3. Social communication |
Specific work on practical aspects of social communication informed by socialSMARTS profile - to improve consistency of social skills, develop further social skills/ or social strategies and inform 'good fit' environments. Opportunities for informal social communication practice in small group setting |
NHS Speech and Language Therapist Specialist ASD provider: Perth Autism Support Group/ Spectrum Club |
Yes - needs ongoing funding Yes |
2, 4, 5, 6 |
| 4. Developing and maintaining relationships |
Individual sessions to develop understanding of relationships. Informal peer mentoring group Buddy Systems |
NHS CAMHS/ Specific ASD Resource/ Specialist ASD provider Education |
Yes - but limited Yes - but ongoing funding required To be commissioned |
4, 5, 6 |
| 5. Social isolation for individual with autism |
Informal social communication practice in small group setting. |
Specialist ASD provider: Perth Autism Support Group/Spectrum Club |
Yes - both require ongoing funding |
2, 4, 5, 6 |
| 6. Social isolation for family |
Family support and social activities. |
Perth Autism One-Stop-Shop/Perth Autism Support Group. |
Yes - both require ongoing funding |
|
| 7. Learning to learn skills |
Assessment of cognitive abilities to ascertain whether he needs further specific input |
NHS CAMHS Specific Worker: Clinical Psychologist |
Yes |
1, 3, 4, 7, 8 |
| 8. Predicting and managing change |
Specific work on planning and managing what needs to be done on a practical basis in day to day life including preparation for appointments and meetings |
Voluntary sector specialist provider: Perth Autism Support and/ or Parent to Parent |
Yes |
4, 5 |
| 9. Behaviour and emotional regulation protecting wellbeing |
socialSMARTS (Profile, Skills/ Strategies and Accommodations) Model Trainings - delivering workshops to professionals in health, education and social work -to improve/ develop emotion regulation skills/ strategies and help with understanding how his behaviours may be seen by others and the implications. Ongoing support. Registration for Autism Alert card. |
NHS Clinical Psychologist and/ or ASD outreach teachers/ schools and/ or SW and or Voluntary Sector: Perth Autism Support Group/ Parent to Parent. Voluntary sector specialist provider: Perth Autism Support/ Parent to Parent |
Yes - being rolled out Yes - rolled out over the past year Health and Education Funded - ongoing funding required Yes |
4, 5, 6 |
| 10. Restricted and repetitive interests and behaviours |
SMART Observation by care provider/NHS CAMHS MH Service/Specialist ASD Resource for assessment if required. |
Specialist Care provider/ CAMHS MH Service with Specialist ASD Resource |
Yes - rolling out |
8 |
| 11. Motivation issues |
SMART Observation by care provider/NHS CAMHS MH Service/Specialist ASD Resource for assessment if required. |
Specialist Care provider/ CAMHS MH Service with Specialist ASD Resource. |
Yes - rolling out |
1, 4 |
| 12. Sensory issues |
Sensory Assessment to determine the purpose for Joe and intervention e.g. sensory diet |
NHS OT - limited resource |
Yes - but increased capacity required |
8 |
| 13. Daily living skills |
Detailed assessment of Joe`s self care skills. Detailed assessment of suitability of Educational Placement Specific work on daily living skills |
CAMHS MH Service with Specialist ASD Resource and/ or OT Local Authority Complex Needs Group -Senior Integrated Team involvement, ASD Outreach teachers and school. Placement Panel and Specialist Educational Bases SW Locality Team and/ or SW Transitions Group |
Yes Yes - but underfunded Yes - needs to be more accessible |
1, 3, 4, 7, 8 |
| 14. Co existing conditions-examples |
CAMHS/ GP to assess Joe`s mental, developmental and physical health when and if necessary with the help of the Specialist ASD Resource when needed. Joe`s diagnosis to be flagged on NHS data systems so that his requirements are understood in the event of emergency admissions |
CAMHS MH Service/GP MIDIS clinical data system |
Yes Yes - rolling out |
5, 8, |
There are fewer gaps but many funding issues are highlighted when mapping ASD services in this locality with need.
Contact
Email: Alison Taylor
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