The Scottish Strategy for Autism - Menu of Interventions

Background

There is a proliferation of "interventions" for people on the autism spectrum. An initial trawl by the group identified several hundred. However, the evidence base in support of most of these interventions is scant. The SIGN guideline 98 published in 2007 relates only to those under 18. The NICE guidelines for adults with ASD published in 2012 provides useful information but emphasises that the evidence base identified to underpin their recommendations is limited and frequent recourse was made to the literature relating to children or to those with Learning Disabilities.

The group drawing up this guideline is not, therefore, in a position to make evidence based recommendations. However, it is clear that many people are working effectively with people on the spectrum and their families. Much work of practical use is going on throughout the country that is not necessarily formally evidenced by research studies.

There is a need to evaluate this work with an emphasis on practice into theory rather than the other way about. The Scottish Autism Strategy requires that a menu of interventions be drawn up so the group, comprising specialist clinicians, educationalists, researchers, autism practitioners and carers took a pragmatic view and decided that, rather than look at existing interventions, they would look at the nature of the autism itself and the challenges it poses for many. This would then enable them to identify interventions to address these challenges.

The difficulties and challenges common to people on the spectrum were discerned following lengthy consultation and are as follows:

• Understanding the implications of an autism spectrum diagnosis
• Development of effective means of communication
• Development of social communication
• Developing and maintaining relationships
• Social isolation for individual with autism
• Social isolation for family
• Learning to learn skills
• Predicting and managing change
• Behaviour and emotional regulation protecting wellbeing
• Restricted and repetitive interests and behaviours
• Motivation issues
• Sensory issues
• Daily living skills
• Co-existing conditions (e.g. epilepsy, anxiety etc).

It is hoped that identifying ways of addressing these issues provides a practical framework for interventions and supports where required.