Working together with autism
How can we make inter-agency work more
effective ?
Dr Mark Barrett
(Senior educational psychologist, Conwy LEA and University of
Sheffield)
some thoughts …
… if you build your house on a busy
highway you must expect many visitors
… Kanner (quoted by Bennett and Billington, 2001)*
... Like ‘peace’ and ‘love’ everyone agrees
multidisciplinary work is a good thing
but there is no agreement on what it
might look like … (paraphrasing Jordan, 2001)
*Lloyd-Bennett, P and Billington, T.(2001) editorial, Educational and Child Psychology 18(2)
Outcomes for the session
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To establish some principles to guide
effective work
To look at practical examples to
illustrate these principles.
To consider the range of skills and
perspectives needed
background
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my jobs and
interests
some initial ideas
- what are we
talking about ?
- why ( are we talking
about it ) ?
-
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Task : ‘Listening to
Kenneth ‘*
1. strengths
2. challenges
3. what needs to
happen ?
how ( can we improve
the situation) ?
* Extract from ‘Different for a
reason’ BBC Radio 4 (23.9.01)
Principle 1: understanding autism
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How to we achieve this ?
Hearing the voices of people with
autism …
What we need to know can be learned
from the people themselves ….
More views from ‘the inside
out’
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‘ I have difficulty finding out
what other people are feeling
and thinking, its what people
call mind reading. I also have
difficulty making expressions
and knowing what’s
appropriate, like what kind of
eye contact …’
‘When I ‘m In social situations I
usually feel very nervous or
anxious, especially if around
people I don’t know well …I
don’t know how to behave
at all, I have to pick up cues
from other people …’
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‘Some emotions are more
difficult than others: fear,
anger, surprise because it can
be very similar in the way
people express them –
especially if they are mild.There
are very small cues (clues)
between them …I’m not picking
up…’
‘It’s really hard work to learn,
it’s really difficult because noone writes books about it.
Everyone assumes it comes
naturally to everyone…’ (Chris,
student, from ‘The Face’
Channel 4, 2001).
A view from the ‘inside out’
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Differences or
difficulties ? (Donna
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Williams,1996; Kenneth Hall,
1998)
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‘My world is not simply a
damaged version of yours …’
(Jim Sinclair, 1992)
‘ these individuals are the
experts on their autism and
should be our future
collaborators in our
understanding of autism’
(Peeters, 2000)
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‘…in the playground I always
tried to find a quiet corner, in
the classroom I tried to find
a quiet corner to do nothing
at all (Kenneth Hall, 1996)
‘… the sound of the
children’s voices was like
dynamite in my ears …its
hard to know what’s
expected of me, I like it
when things are clearly
explained and there are
clear, fair rules…’
learning to work in the field 1
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link to ‘understanding autism’
sources of information (and overload !)
know the person first and foremost
reading, watching and thinking
(from ‘Rainman’ to ‘Snowcake’ and What’s eating
Gilbert Grape, from Curious incident of the dog etc
to ‘Somebody Somewhere’ and The Blue bottle
Mystery)
learning to work in the field 2
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Training and learning processes
- collaboration and development
- Autism-friendly schools initiative, (Autism
Cymru, 2004 - and LEAs); identity card
initiative with the police service and others;
collaborative training processes in schools
(eg. Barrett, 2006)
Barrett,M. (2006) ‘Like dynamite going off in my ears’. Using autobiographical accounts of autism
with teaching professionals. Educational Psychology in Practice, 22 (2) 95-110
What are the differences we
notice in ASD ?
Differences can be noticed in the following :
 Ways of being with other people (social
relationships)
 Ways of communicating and or speaking
(social communication)
 Fixed ways of thinking and doing things
(social imagination)
These are known as the ‘triad of
impairment’(Wing, 1996).
Principle 2 : Developing skills
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Solution- focused approaches (eg. Ajmal and
Rees, 2001)
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individual work
meetings
ways of hearing peoples’ stories and
perspectives ….
‘Our guard went up…’ never seen anything like it , ‘… told them the same thing a
thousand times…’ ,’we are still waiting for the diagnosis…’ … these are severe
impairments … ‘… differences not difficulties…’
For example : a solution focused approach
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Solution- focused thinking
Helps people become aware
of the effects of own actions,
thoughts, behaviours on
themselves and environment
Helps people consider own
knowledge about the
situation and consider own
skills and opportunities to do
something about it to resolve
own difficulties.
Promotes self-reliance but
needs to be facilitated.
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Focus on the positive
What is going right ?
Look for exceptions ?
Scaling
Priorities for change not
problems to be sorted
What would you see
happening ?
Positive language leads
to solutions
Sample tasks
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Scaling
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today
1
5
1
5
6 months ?
Think about the times when
what is troubling you wasn’t
happening. What was
happening then ? etc.
10
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Last year/month
10
Exceptions
Miracle question
Imagine the issue has gone
away. What is happening
instead ?
Principle 3: sharing
information
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Perspectives : autism and other learning
and social profiles – the importance of a
sense of perspective ?
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Consultations, procedures and
assessment frameworks - making
guidance a reality …
Assessment: multi-agency (WAG
Consultation paper 2006)
Principle 4: Look to the
research (eg Jordan, 2001)
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DfEE (Circular 10/99: Social Inclusion: Pupil Support)
lack of coordination of services to families from
agencies and disciplines
Autism straddles different disciplines
- for definitions, diagnosis, education and care a
multi disciplinary approach helpful.
multidisciplinary definitions of autism
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Behavioural (biological) basis or
Not a pathological state (part of normal biological variation, with
advantages and disadvantages – problems arise from social attitudes not disabilities)
Way forward consider:
- autism as a range of developmental characteristics in
social understanding, communication and flexibility of
thinking and behaviour
-
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issues are around levels of adaptive functioning
- this respects individuals but recognises major difficulties in
coping with the world.
Multi-disciplinary work
and
education
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Autism affects: thinking, feeling and
understanding but not same for everyone
understanding of the world comes from the social
process of joint construction of meaning (Vygotsky,
1962)
How do we share the issues arising from this for
people with autism with fellow professionals ?
cont.. provision
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No one approach will meet the needs of all
people with autism (Jordan and Jones, 1999)
Key considerations;
how does the child/young person learn best ?
What barriers exist n?
What support would mean a child would not fail in a local
setting ?
What setting is the least restrictive way of meeting needs and
providing education ?
cont… classrooms
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Multi-disciplinary input not just at crisis
points
Time is a crucial resource
Autism outreach teams: multi-agency
See Cumine, Leach et al. (1997,2000);
Leicester City Council, Leicestershire
County Council and Fosse Health Trust,
(1998)
Final thoughts
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Easier said than done: multi-agency work is
a complex psycho – social process – no wonder
its tricky !
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Unique challenges for autism ? – impact of
anxiety …
Differing professional positions and
perspectives (social worker, clinical psychologist, nurse,
paediatrician, psychiatrist, police, speech and language therapist,
occupational therapist, teacher, teaching assistant, headteacher)
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Unique perspective of the child/young person
Unique position of parents/carers
References
The National Autistic Society, City Rd, London, ECIU ING, tel
0171 833 2299. www.oneworld.org/autism.uk
The NAS in Wales, William Knox House, suite C1, Britannic
Way, Llandarcy, Neath, West Glamorgan, SA 10 6EL, Tel: 01792
8159 815915
Autism Cymru, 6, Great Darkgate, St, Aberystystwyth, SY23 1
DE Tel: o1970 625256 www.awares.org
There are also many books on autism and the autistic spectrum.
The following are among a growing number of accessible
books.
Hall. K.(1998) Asperger Syndrome, the Universe and
Everything. London: Doubleday
References
The National Autistic Society, City Rd, London, ECIU ING, tel
0171 833 2299. www.oneworld.org/autism.uk
The NAS in Wales, William Knox House, suite C1, Britannic
Way, Llandarcy, Neath, West Glamorgan, SA 10 6EL, Tel: 01792
8159 815915
Autism Cymru, 6, Great Darkgate, St, Aberystystwyth, SY23 1
DE Tel: o1970 625256 www.awares.org
Ajmal,Y and Rees, I (eds)(2001) Solutions in Schools.
London:BT Press:
Jordan, R.(2001) Multidisciplinary work for children with autism,
Educational and Child Psychology, 18(2)
There are also many books on autism and the autistic spectrum. The
following are among a growing number of accessible books.
Hall. K.(1998) Asperger Syndrome, the Universe and
Everything. London: Doubleday
References (cont.)
Williams, D. (1996) Autism: and inside out approach. London:
Jessica Kingsley.
This is one of several books by a woman who readily
acknowledges and describes her own autism.
Haddon, M. (2003) The curious incident of the dog in the night
time. London: Johnathon Cape.
An acclaimed novel written from the point of view of a young
person with an autism spectrum condition.
Cummine, V., Leach, J. and Stephenson, G. (2000) Autism in
the Early Years, A Practical Guide. London: David Fulton.
As above (1998) Asperger Syndrome, A Practical Guide for
Teachers. London: David Fulton.
Jordan, R. and Jones, G. (1999) Meeting the Needs of Children
with Autism Spectrum Disorders. London: David Fulton.