The Scottish Strategy for Autism - Menu of Interventions

Interventions

Intervention, whether it be through Education, Social Work, Health or Voluntary Services, needs to follow on from appropriate assessment by a team with specialist knowledge and experience of ASD. Ideally, adults with ASD would have been diagnosed in childhood but, in reality, many have been missed and present in adulthood. They should have access to accurate diagnostic assessment carried out by qualified and experienced clinicians as a precursor to intervention.

Following diagnosis for children, current Scottish Early Years Policy outlined four principles of early intervention. These principles underpin the group's thinking around interventions for both children and adults.

• We want all to have the same outcomes and the same opportunities
• We identify those at risk of not achieving those outcomes and take steps to prevent that risk materialising
• Where the risk has materialised, we take effective action
• We work to help parents, families and communities to develop their own solutions, using accessible, high quality public services as required.

There are many forms of intervention and, as an initial guide when collecting examples of ASD interventions, the group took the definition as being "things people do that help". This was further refined to clinical, educational and social interventions. A distinction was made between interventions which are to lead to some form of change and supports which are to maintain skills when developed. However, the group was keen not to be too prescriptive and specific as much depends on the individual with ASD and their context. Some interventions are supports and vice versa so it was decided not to make artificial distinctions between the two terms.

Clinical intervention, usually provided by health services, requires that the client be assessed by a specialist ASD clinician who has the knowledge about their particular condition in the context of the ASD spectrum and all its co-existing conditions. This clinician has detailed knowledge of development across the lifespan and/or adult personality as well as family dynamics and lifestyle. They need to have the level of knowledge and therapeutic skill to be able to intervene at an appropriate level to effect behaviour change where required. Individuals and their families need to be able to quickly have access to the clinician when necessary.

An educational intervention is usually carried out by qualified education specialists such as teachers or educational psychologists but may be supported by other staff depending, as previously stated, on the individual and the context of the intervention. Social interventions, in their broadest sense, may be introduced and maintained by a range of potential providers and all may be supported by families and carers working together with the team involved. It is important to remember that people on the spectrum may be carers themselves. This has implications across the lifespan from maternity care to care of the elderly and all points in between.

Capacity and consent issues should be considered regarding the individual thought likely to benefit from the potential implementation of any intervention. There may be considerable overlap between types of intervention and multi agency collaboration may be required with a clear lead identified for each individual.