AUTISTIC SPECTRUM DISORDER REFERENCE GROUP NOTE OF MEETING HELD 31 OCTOBER 2005 Present: Anne Aberdein Claire Brogan Caroline Brown John Cameron Aline-Wendy Dunlop Bette Francis Jane Hook Jane Neil-Maclachlan Stella MacDonald Tommy MacKay Jean MacLellan John McDonald Shona Pittillo Val Sellars Isobel Sutherland Dorothy Warren Apologies: Ken Aitken Jane Cantrell Paul Dickinson Carol Evans Ian Kerr Robert McKay Iain McClure Michael McCue Val Murray Shabnum Mustapha Frances Scott Charlene Tait Polly Wright Minutes of August meeting The minutes were accepted as an accurate record of the meeting. Matters Arising The group discussed concerns about the ability of the main group to maintain impetus since the disbanding of the diagnosis and training subgroups, and whether the group is now representative enough. It was agreed that if members are unable to make future meetings, individuals should aim to send an alternative person. It was agreed that a brief should be prepared of what the reference group is currently doing and looking at the next phase. Members will then consider at the next meeting if there is a need for subgroups (e.g. adult services and guides/planning). It was suggested that members of the reference group could chair the new sub groups instead of Bette and Jean who will continue to work in partnership with members. An LA education representative is needed. Dorothy/Jenny to analyse last 3 sets of minutes and summarise what the reference group is attempting to achieve for January meeting. Members to email Dorothy with thoughts on potential for two subgroups. Members to nominate colleague to attend in their place if unavailable to attend future meetings. Shona to contact Martin Vallely, COSLA for suggestions for education representative. Group Membership Anne Aberdein was welcomed to her first meeting. Information Sub Group Bette reported that the group had discussed growing concerns about persistent email correspondence giving people a negative message. It is hoped that the information event being planned by the subgroup will lead to a positive sharing of information across Scotland. The event will be held at Airth Castle on 28 February. The group agreed it is important that the Cross Party Group is acknowledged for its work to ensure the best for all people and is not avoided by parents because of perceived negative perceptions. PHIS 2 was handed to members for comment. The intention is to distribute it to attendees at the information event. Dorothy to email group draft programme for information event. Jean to seek views of Lewis MacDonald regarding a possible meeting with convenors of the CPG. The meeting would give everyone an opportunity to see how information could be better disseminated. Training Leaflet Bette apologised that the skeleton training leaflet is not yet ready. Jennifer Pickthall will join the team from 21 November and take work forward on the ASD front. Advocacy Bette was disappointed to report that the Advocacy Safeguards Agency has now been disbanded. The agency had identified positive work. NHS QIS, the Health Councils and the new team in the SE will take forward some of the ASA’s role, and this will be clarified in the Advocacy report. Health conference Bette reported that bookings are currently at 200 consisting mainly of professionals. Ken Aitken has been unable to attend the last two conference planning meeting due to illness but has given assurances that he will be at the next meeting on 5 November. It was agreed that the booking date should be extended to 12 November and subsidised places should be offered to encourage parents to attend. The Highland Medical Director has had to withdraw but Jean will chair. Lorene Ahmet, a parent and scientist from Action Against Autism was invited to speak as a carer but chose not to accept as she wished to present at the conference as a scientist at a level at which participants may have found difficult to engage with. A conference booklet will be handed to delegates with information on the speakers and where to get further information. Dorothy to amend conference flier regarding subsidised parent places and email John McDonald, NAS and other relevant organisations for forwarding onto parents Stella to investigate cost of minibus for Fife parents and contact Dorothy for approval. Respite Isabel reported that she is investigating shared care with Autism Alliance and NAS that do shared respite. The offer of some limited funding this year would enable an initial scoping of available respite but it is unlikely that a significant project could be developed without longer term resources. Care 21 will be published shortly and there may be opportunities to identify a piece of work that fits in with the recommendation. Isabel to prepare proposal for next meeting and to email group with current best practice. Training pilot evaluation Members were handed copies of an email from Iain McClure outlining the progress of the ASD assessment pilot, particularly regarding the 3Di development. Members agreed that £5,000 should be earmarked so that 3Di training can be offered to the participants. Tommy reported that he had been working with the team since June to see how evaluation can be worked into the design. The next stage is investigating if service delivery for assessment of ASD can be improved in rural/urban areas by establishing Tier 2 multi-disciplinary teams. Up to 40 participants (aged 0 to 18) in Argyll and Bute (rural) and East Renfrewshire (urban) will be sampled. 4 multi-agency teams, ideally including a medic, speech and language therapist and educational psychologist, will be trained on a 5 day course by members of current Tier 3 teams. This is scheduled for January 2006. Tommy outlined the strengths and weaknesses of the training (annex 1 refers). The group agreed that the project would bear interesting results if Tier 2 and Tier 3 correlated well. It was acknowledged that co-morbidity will create most problems. Interpretation is important and orientation on ADOS is worthwhile. John Cameron raised that it might be useful to adopt the same methodology to compare adults with autism with adults with Aspergers etc. Tommy to speak to Caroline Brown, John Cameron, Jane NeilMcLachlan and Iain McClure regarding evaluation of all 4 pilots. Tommy to discuss additional funding for evaluation of pilots with Bette. Exploring service delivery models John McDonald reported that one of the big issues is the lack of actual services on the ground. The challenge is how to meet demand. There is a need to support the whole life journey with variable complexity of life position and emergent need. It is therefore extremely difficult to get an average cost for care. Expectations in childhood may not be met in adulthood. There are design issues around the nature of services and services for people with ASD. Jean drew the group’s attention to parallels with the Kerr report in anticipating needs of an ageing population. The group discussed the problem of social workers working in isolation, putting together expensive packages for individuals and the notion of ‘one size fits all’. Members discussed problems with the single shared assessment and lack of knowledge by commissioners and social workers leading to unsuitable services. Emergent skills are not mentioned in assessments despite individuals with ASD continuing to develop throughout their lives given back up and support. It was agreed that there is a need to support adults with ASD in the family home. Long term needs should be addressed and it is important to be realistic about what the family can deal with. People with ASD have the right to lead their own lives and follow their own lifestyles. Capacity building is vital, both for individuals with ASD, their families and local teams. The focus of sub group work needs to ensure changes in services on the ground. Themes could be around policy into practice. Service commissioning is also the key to ensuring services fit for purpose. Members to email Dorothy with further thoughts. Policy colleagues in eCare to be invited to future meeting to discuss single shared assessment. Polly Wright to be invited to do presentation as planning and commissioning officer in a local authority. VA Bill Jean reported that the consultation had concluded end September and around 130 responses were received. A list of those unsuitable to work with vulnerable adults will now be drawn up. There are also possible related developments in a vetting and barring scheme following the Bichard response. The new system will probably be brought in by stages, starting with children and moving onto adults. Respondents are in favour of adult protection committees which are envisaged as smallish structures. It should be a duty in the Bill to share information and it will be for the lead agency to decide who carries out the investigation. This will be flexible. Bette is currently leading on the third area – people with learning disabilities who are compulsorily detained. No further legalisation is required but policies need looked at. The Bill may include other elements on direct payments changes, AWI and issues around ordinary residence. Bette to circulate membership of steering group around Reference group. Bette to flag up items of relevance to VA Bill to members at future meetings. Update on UK Autism Research Co-ordination Group Bette reported that she had attended a meeting of the DFeS group on 28 October. The group are attempting to pick up knowledge on research and agree a way forward. The remit is not yet finalised. Members of this group were not aware of the SIGN guidelines and were pushing for an ASD network and database which we already have in Scotland. There is good practice in Wales too. There is a lot of joining up to be done. A.O.B. The group agreed the next meeting should be rescheduled to 23 January to allow time for action to be taken on issues discussed. Date of future meetings Monday 23 January,10.00am to 4pm, COSLA, Rosebery House, Edinburgh Monday 27 February,10.00am to 4pm,St Andrews House, Edinburgh Scottish Executive December 2005