Highland Council Psychological Service Practice Paper
Introduction
Background
Aims and Principles
Identification, Asessment and Intervention
Introduction
The purpose of this practice paper is to outline Highland Council Psychological Service’s approach to meeting the needs of children and young people with Autism Spectrum Conditions (ASC). It provides a background to Autism Spectrum Conditions, describes responsibilities of the Psychological Service and offers guidance on the roles and responsibilities of schools.
Autism Spectrum Condition (ASC) is a complex developmental disability affecting language and communication, social interaction, and flexibility of thought and behaviour. These areas, known as the ‘triad of impairments’ (Wing & Gould, 1979), can vary significantly between individuals and can affect children and young people across the range of intellectual abilities. Children and young people with ASC may also have accompanying sensory sensitivities, for example to touch, smell, noise, taste or visual stimuli. Despite the wide ranging differences, each individual with ASC has some level of difficulty in social interaction, social communication and imagination.
Although the prevalence of ASC in the UK is hard to establish, it was recently estimated to affect approximately 60 in every 10,000 children (Chakrabarti & Fombonne, 2005), with 420 children in Highland having a diagnosis of ASC in May 2005.
Children and young people with ASC vary widely in terms of additional support needs. Some may achieve very well and be able to access the full curriculum with limited additional support, others may require specific school based interventions and strategies to help them learn and develop.
Aims and Principles
All schools operate within the current legislative framework of the Education (Additional Support for Learning) (Scotland) Act 2004 which requires schools to meet the needs of all children.
The Act requires that:
• Schools should be in a position to help parents / carers and pupils with ASD understand their strengths and difficulties and support their learning
• Interventions are evidence based, that is, have a proven track record of success and allow ongoing evaluation
• Teachers should be able to use various strategies to help children / young people with ASC access the curriculum, for example, making sure that any difficulties encountered in literal and inferential comprehension are addressed
Identification, Assessment and Intervention
Early identification of additional support needs in relation to ASC is important so that assessment of the child’s needs, planning of educational provision and parental support can be facilitated. Where assessment over time may indicate an ASC, early intervention appropriate to a child’s needs should not depend on diagnosis. All children have an equal entitlement to access a broad and balanced curriculum, which involves effective teaching with support tailored to their needs, based on a cycle of assessment, intervention and review. In implementing this cycle, all schools should be able to identify children and young people with additional support needs.
The staged intervention process to identification, assessment and review, adopted by the authority, is rooted in sound educational practice – teachers plan teaching approaches based on assessment, implement those approaches and review the outcomes in terms of progress made by the child or young person. If the child / young person fails to make progress despite the school implementing a focused programme of support over time, schools may request the assistance of professionals outwith the school.
School provision should ensure that:
• There is regular and effective liaison between home and school promoting parental involvement and contribution from an early stage
• Differentiation of the curriculum meets the needs of pupils with ASC effectively
• Pupils are able to benefit from specific interventions detailed in their individualised plan if one is required. If an individualised plan is required, there are a number of booklets using the SPELL approach which are personalised to the child and which can provide an appropriate framework to record relevant information and to plan and present support.
• Teaching approaches enable effective and independent learning, for example, through
- visual and written support
- simplified language
- consideration of the physical learning environment
- maintenance of structure and routines needed by pupils with ASC
- attention to stress and anxiety reduction
- specific teaching programs for communication and social development, including independent living skills
• The possible benefits of appropriate information technology are explored and where practicable, access is secured for the child
• The pupil’s progress is recorded and documented over time
Highland Council Psychological Service is guided by ‘Autistic Spectrum Disorders: Guidance for Chartered Psychologists working with Children and Young People’ (BPS 2006) and also operates within the current legislative framework of the Education (Additional Support for Learning) (Scotland) Act 2004.
The Psychological Service can:
• Offer advice and consultation to staff working with pupils with ASC
• Devise and contribute to training for schools and others working with children and young people with ASC
• Contribute to Highland Council’s strategy for meeting the needs of children and young people with an ASC
• Contribute to the 'Getting it Right for Every Child' initiative, which aims to support, facilitate and promote lasting improvements that will enable all children and young people to fulfil their potential
• Liaise with other appropriate agencies, e.g. the Autism Outreach Education Service, in supporting children and young people with an ASC
• Offer advice on particular interventions and strategies for learning
• Provide casework support for children and young people with complex needs, including liaising with other appropriate agencies, e.g. health and social work services
• Contribute to identification and assessment of children and young people thought to have an ASC, including assessment of the learning environment
• Operate within a local multi-agency diagnostic framework
Assessment, diagnosis and the role of the educational psychologist
Within Highland, diagnosis of an ASC is ultimately the responsibility of the relevant health professionals and is not made by Highland Council Psychological Service. However, the diagnosis is not made in isolation and information should be drawn from a wider multi-agency team including parents/carers, speech and language therapists, teachers and educational psychologists. Therefore, information from psychological assessment may contribute to a multi-agency assessment. Once all the information from the multi-agency assessment is available, it is usual for the local ASC diagnostic team to consider whether a diagnosis is appropriate.
The National Autism Plan for Children (NAS, 2003) promotes multi-disciplinary assessment and recommends that it includes developmental history, family involvement and observation across different settings. Multi-agency contribution in the assessment process is also recommended by the Scottish Intercollegiate Guidelines Network, as it may ‘identify different aspects of ASD and aid accurate diagnosis’ (Assessment, diagnosis and clinical interventions for children and young people with autism spectrum disorders, SIGN 2007).
Psychologists undertaking any detailed assessment will make use of the most recent professional guidelines available to them on appropriate assessment – currently the ASPEP and Scottish Division of Educational Psychology guidance document, ‘Educational Psychology Assessment in Scotland’ (2005).
Psychological assessment will:
• Ideally be conducted over time and in relation to different contexts
• Be formative in nature, e.g. used to adapt teaching and learning to meet individual needs
• Involve parents / carers as essential contributors to the process
• Consider the young person’s strengths and difficulties and generate a number of hypotheses that consider the range of issues
• Incorporate the child’s understanding of his/her world
• Consider the role that social and emotional responses, including the child’s self- perception and self-esteem, may be playing
• Draw, where appropriate, on views of other professionals.
• Be reported back formally in writing to the pupil, parents, school staff, and other relevant professionals where appropriate.
Psychological assessment is based on the child or young person in context and is part of the ongoing cycle of planning, action and review carried out jointly with schools, parents, children and other professionals. It supports measures to promote the general wellbeing and progress in education of the children and young people concerned and informs future teaching and learning (Educational Psychology Assessment in Scotland, 2005).
This practice paper should be read in conjunction with the Highland Council Education Culture and Sport, ‘Policy and Strategy for the Education of Pupils with Autistic Spectrum Disorders’, and the Scottish Division of Educational Psychology guidance document, ‘Educational Psychology Assessment in Scotland’ (2005).
References:
Association of Scottish Principal Educational Psychologists (ASPEP), British Psychological Society, Scottish Division of Educational Psychologists (BPS:SDEP) 2005, Professional Development Programme for Educational Psychologists in Scotland: Educational Psychology Assessment in Scotland, Glasgow
Chakrabarti, S. and Fombonne, E. (2005), Pervasive Developmental Disorders in pre-school children: Confirmation of high prevalence. American Journal of Psychiatry, 162(6), 1133-1141
National Initiative for Autism: Screening and Assessment (2003) National Autism Plan for Children (NAPC), (the NIASA guidelines), London: the National Autistic Society
Scottish Executive (2004) Education (Additional Support for Learning) (Scotland) Act 2004 Scottish Executive, Edinburgh
Scottish Intercollegiate Guidelines Network (July 2007) Assessment, diagnosis and clinical interventions for children and young people with autism spectrum disorders, NHS Scotland
The British Psychological Society Position Paper (October, 2006) Autistic Spectrum Disorders: Guidance for Chartered Psychologists working with Children and Young People
Wing, L. and Gould, J. (1979) Severe impairments of social interaction and associated abnormalities in children: Epidemiology and classification, Journal of Autism and Developmental Disorders, 9 11-29