REPORT OF: HEAD OF SCHOOL SUPPORT SERVICES
TO: SCRUTINY COMMITTEE, EDUCATION AND COMMUNITY SERVICES
DATE: 14TH FEBRUARY, 2002
RE: PROVISION FOR CHILDREN WITH AN AUTISTIC SPECTRUM DISORDER (AUTISM) IN CARMARTHENSHIRE
Autistic Spectrum Disorder is a low incidence disorder but one which encompasses a relatively wide continuum of severity, ranging from mild (Aspergers Syndrome) to severe (Classic Autism). It describes individuals who have a set of features in common which affect their ability to
- understand and use non-verbal and verbal communication
- interpret the social behaviour of those around them
- interact in a meaningful way with other people
- think and behave flexibly according to the situation - they do not understand
what others are thinking or that they are thinking
- process the senses leading to hyper-sensitivity or hypo-sensitivity.
Autism is characterised in individuals by speech and languages difficulties, social isolation and rigidity, inflexibility of thought processes resulting in a resistance to change and obsessive and ritualistic behaviour. In its severest form Autism represents virtually a complete inability to form any relationships or act in a cogent social manner. It is important to note, however, that individuals with Autism range from those with Severe Learning Difficulties to those with classic Autism to those with average or above average ability. There is also a sub-group within the autistic spectrum called Aspergers Syndrome - it is used to describe those individuals with Autism who are of average ability and have good spoken language even though the ability to use it for communication is affected. Individuals with Aspergers Syndrome are likely to be clumsy, socially naïve and have obsessive interests. They can also exhibit extremely challenging and complex behaviours and are prone to periods of clinical depression.
The incidence of Autism in the UK has been rising steadily from 4 in 10,000 in the 1960s to its current level of 91 in 10,000. The varying IQs of these 91 demonstrate the range of ability and the type of provision needed to cater for those on the Autistic Spectrum.
IQ less than 70 - 20 in 10,000 (children in special schools)
IQ more than 70 - 71 in 10,000 (those likely to be in mainstream)
Although well below the national average at roughly 39 in 10,000 the incidence of Autism within Carmarthenshire schools has also been rising steadily - particularly in the past two years. The current figures are as follows:
School population 26,840
Statemented children 1,230
Autistic children 40
Aspergers Syndrome children 65
When parents, health visitors, preschool staff or teachers suspect that a child has Autism they refer the child to the Health Trust/Educational Psychology Service. A range of tests are undertaken by Doctors, Paediatricians, Educational Psychologists and S & L Therapists. The Paediatrician makes a formal diagnosis. In Carmarthenshire paediatricians and parents may request a second opinion from Professor Frazer at a Specialist Autistic Clinic in Cardiff.
Following a diagnosis by the Health Trust the LEA undertakes a Statutory Assessment of the child's special educational needs. ASD/Autism/Aspergers Syndrome will be written on the child's Statement of SENs.
In the majority of cases a child diagnosed as severely Autistic or a child with Autism and additional Severe Learning Difficulties will be admitted to one of the LEA's specifically designated Autistic Units. There are currently three English medium primary units at Pwll CP, Llanelli, Myrddin CP, Carmarthen and Ammanford and one English medium secondary unit, Garreg Llwyd at Gwendraeth Comprehensive. Welsh medium provision where the incidence is low at primary level is provided at the Speech and Language Unit in Nantgaredig and at secondary level in a specially resourced classroom at Ysgol Maesyryrfa. Each unit is resourced for up to 6 pupils (1 Teacher and 2-3 LSAs to 6 pupils). The children are offered small classes, high levels of support, regular Speech and Language Therapy and/or Occupational Therapy and opportunities for integration in mainstream classes where appropriate. With time pupils may move permanently to a mainstream school. Children with Aspergers Syndrome are generally placed in the LEA's mainstream schools. Appropriate levels of support are allocated to these children on a case by case basis through the LEA's resource panel.
The LEA also employs a Specialist Teacher for Autism who advises teaching and support staff in mainstream schools on appropriate teaching methods, strategies and programmes to facilitate the inclusion of these children.
Admission to Unit at 3 ½ or where an early diagnosis (0-4 years) has not been made pupils may be placed in one of the county's O&A Units before admission to an Autistic Unit.
Aspergers Syndrome SLD/Autistic SLD/Autistic Autistic pupils
(English medium) (Welsh medium) with complex/
Placement of pupils Placement of pupils Placement of Out of county
in mainstream with in appropriate pupils in placements in
appropriate support or Primary or Secondary specifically highly
in a Speech and Unit. Resourced resourced specialised
Language Unit. provision for 6 classrooms Autistic
pupils per unit Schools
LEAs Primary and Primary Units Primary Level
Secondary Schools Pwll Autistic Unit Nantgaredig Speech
Myrddin Autistic and Language Unit
LEAs schools are supported Ammanford Autistic Secondary Level
by EP Service and Unit Resource base
Specialist Teacher for Secondary Unit classroom at
Autism Garreg Llwyd at Maesyryrfa
Most Autistic pupils will remain in full-time education until their 19th birthday. Links with Special Needs post-school providers (FE/Social Services) established.
Early Intervention Team - Consultation with and involvement of parents of Autistic children is important to build up parent's confidence and trust - the LEA is currently financing two places on an Early Bird Autistic training course training professionals who in turn train parents and pre-school teachers on early intervention strategies and programmes to modify Autistic tendencies in pre-school children.
1) Autistic Network - On-going training opportunities for Unit Staff through full and half day INSETS.
2) Training course for LSAs including a module on Autism.
3) Provision of funding for Post-graduate course of study and qualification in Autism for appropriate staff.
1) Need for creation of stricter guidelines for admission to Units - currently units admit pupils with SLD and Autistic features. In future some pupils would be better provided for in SLD placements freeing up Autistic places for those diagnosed solely as Autistic.
2) The majority of Carmarthenshire's Aspergers Syndrome children are successfully integrated within mainstream schools. However as the number of Aspergers children being identified is increasing within the county the number of these pupils who present with additional complex and challenging behaviours is also increasing. These pupils are difficult to accommodate within the mainstream especially at secondary level. In terms of ability, however, they are not suited to the Autistic Units (being of significantly higher academic ability). A number of children are now being placed in out of county school placements in schools catering specifically for Aspergers Syndrome (the cost of such out-of-county placements is between £50,000-£70,000 pa) Consideration should be given to whether it would be more cost effective to provide a resource based classroom to cater for these pupils within the county (a second classroom in Garreg Llwyd could be considered).
3) Creation of Autistic Register to monitor LEA's statistics in relation to Autism.
4) Creation of Steering Group to plan long-term strategic policy for Autism (More secondary places / Division of Primary Units into Infant/Junior for rationalisation of resources etc).