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Examples of good practice in autism service delivery
Richard Ibbotson – National Director Scotland
Catherine Steedman – Deputy Director Scotland
1. Development of a personalised communication tool
2. Support to an individual with co-morbid mental health issues
3. Providing a One Stop Shop service in a rural area (Highlands)
What is good practice in
autism service delivery ?
Autism Initiatives’ 5 point star – a
framework for understanding autism
5 principles of good practice:
We need a shared understanding of the person with autism
and a partnership approach that demonstrates that we have
power with not power over the person with autism, to
develop a range of personalised approaches.
We use these personalised approaches to support the person
with autism to develop strategies from/through which they
acquire and use the skills they need which in turn supports
them to become an independent and valued citizen.
18,132
Steven
COSPA
18,557
 Autism
 Learning Difficulties
 Anxiety
 ‘Complex needs’
How these affected Steven
 Limited choice making
 No control over daily life
 No control over major life decisions
 Negative reputation
Difficulties
 Communication challenges
 Complex family involvement
 Inconsistent expectations
 Poor understanding of motivations ‘ what makes Steven tick’
What we did – the good practice
 Fundamental review of communication
 Development of a communication system that works for him (key ring picture
system)
 Focus on what makes Steven feel safe – what does he understand about his
environment and the people around him
 Move away from a behavioural focus
 Fill life with positive and successful experiences
What we did – the good practice
18,132
James
COSPA
18,557
 Aspergers syndrome
 Anxiety disorder
 Obsessive compulsive disorder
How these affected James
 He rarely went out
 Echolalia increased
 Quality of communication decreased
 Extremely poor quality of life
 Increased likelihood of severe mental illness
 Unhappiness
Difficulties
 No family involvement
 Other people’s expectations
 James’ expectations
 He needed to engage with psychiatry and health professionals
What we did – the good practice
 Key was a named worker, who co-ordinated communications and took the pressure away
from James
 Person-centred working and planning
 Trust, predictability, honesty, power-with
 Used his preferred communication - visual aids, notes, knocking signals, through doors,
social stories and emails.
 Adapted our communication to support James to have choices and express his opinions
 Liaising with all health and social work professionals
 Time to build resilience
 A ‘safety net’
 Staff profiles sent before meetings
 Telephone appointments
 Shared understanding of remit with other agencies
 Meetings at his house, meetings at the GP surgery
Highlands One Stop Shop: rural support
The One Stop Shop
 A One Stop Shop, not because it is one place you go to, but because we can provide
everything you need in a flexible, person-centred way
 We provide the widest range of services to autistic people, their families and professionals
working for autistic people
 Individual level – workshops to learn from others, social opportunities, counselling-type
service, pre diagnostic and post diagnostic work, preventative services
 Community level – training, education, advice, weaved throughout local autism strategies
in the areas we work
 Edinburgh, Perth and Highlands
Rural support – capacity building
 Analysing the statistics
 Feedback from our evaluations
 Skye, Caithness, Lochaber drop-ins
 Working with schools – Fort William
 Late diagnosis group – at a distance
Bringing the OSS to the rural area
 Local focus groups – what is wanted
 Mapping – what’s already around
 Getting the environment right
Monthly meet-ups
 Drop in - table tennis, gaming, scrabble, cards, playing with others
 1:1 during the drop-in times
 1:1’s in and around the area
 Very flexible – meet someone on the way there and someone on the way back!
Take people to the drop-in venue
 Meet with employers and other agencies while there
 Unexpected outcome – parent support group
 Skye - 19
 Caithness – 20
 Lochaber - 11
Working in and with schools
 Two school teachers working in Fort William – pre and post diagnostic work
 Visit schools, training support teachers, helping the autistic children to define autism
 Post diagnostic work – they had nothing
 Head in Kinlochleven – great! Wants to help, recognises she and her team need to know
more
 Replication – Dingwall next
Distance learning: late diagnosis work
 Autism Strategy Development funding
 Remote Late Diagnosis group
 10-week Late Diagnosis group to rural areas
 Sensory integration; relationships; employment; education; childhood; mental health;
lifestyle; communication; the brain
 Isle of Lewis
What next
 Wider areas
 Increased use of IT
 But … we need funding to continue!