If we look at the pupil with autism it may be surprising to see the variety and the extent of professionals involved within their support network. Therefore, when supporting a pupil with autism it may be appropriate to consider the multi-professional context that they and the family face. Who then, might be involved in the wider support network? What role can professionals as individuals fulfil for the pupils with autism and how can they work together? Some of the professionals they may come into contact with are listed below:
Autism Outreach Teacher – can provide education consultation and training on an outreach basis to schools supporting pupils with autism and they may also observe and assess the pupil prior to this.
Arts Therapist – (Music Therapist, Drama Therapist) can support the child to use art, drama or music as a medium to express or make sense of feelings, to be able to respond and relate to the therapist and others within the safety of the therapeutic relationship or to share and work on any issues that are challenging them, without using words. Governed by their own professional bodies, anyone including parents can refer to an arts therapist (as defined by the Scottish Government under the Allied Health Professionals banner).
Autism Networker – professionals, who have joined the Autism Network Scotland with the intention to share good practice, learn from each other and observe key principles of participation.
Befrienders – can provide an additional social support for the person plus they can informally provide short respite to the family. A befriender may be preferable for some children with autism who have difficulty socialising as the planned interaction is on a 1:1 basis, rather than a group context. This service can be provided by voluntary agencies or Social Work services, and often the befrienders are volunteer workers.
Behaviour support staff – can provide knowledge of behaviour management techniques to support the child in class and also how these might be adapted for the home.
CAMHs teams – Child and Adolescent Mental Health (including Clinical Psychologists, Child and Adolescent Psychiatrists, Nurse Therapists, Occupational Therapists, Mental Health Workers) – can work in partnership with Social Work, Education and Health teams to promote mental health awareness and good practice and provide consultation to these agencies. Can provide assessment and intervention for children and adolescents with mental health problems ranging from behavioural difficulties to severe, complex and persistent mental health disorders. Often Community Mental Health workers provide initial assessment and brief intervention for mental health problems, whilst multi-disciplinary CAMHs professionals will tend to work with more severe and complex cases.
Care Managers – the role of Care Managers is focused on meeting the needs and of supporting people in their own homes. In practice wider aims of community care or aspects of the care management process may apply. The majority of Care Managers in Scotland are Social Work trained.
Children’s Panel / Children’s Hearing – Children’s panels can occur if a child is experiencing difficulties in their life. This can arise if a pupil with autism has an extended period of time refusing to attend school (information gained from dialogue with legal professional). A Children's Panel may also occur when a child commits a crime and the case goes to the Procurator Fisca who may decide to send the case to a children’s Panel. Relevant individuals such as family members, Youth Worker, Social Worker or Teacher, may be involved, although numbers are kept to a minimum. A hearing into the incident will be heard by a Panel of three individuals, trained by the hearing system, and if the child admits the crime, a decision will be made as to how to proceed. This could lead to Social Work involvement, a child protection order, a supervision requirement, other requirements or there may be no further action. The outcome will be dependent on the crime - and in the case of children with autism links with other services and professionals may be important. If the child denies the crime it goes back to court as a children’s referral and the Sheriff will decide whether the child is guilty or not after hearing the evidence. A guilty verdict may result in the case getting sent back to the panel, who will make a decision about how to proceed. The children’s Reporter is responsible for ensuring that the Panel meetings follow the established legal procedures and rules. The child may be appointed a ‘Safeguarder’ to act in their interests following a children’s hearing.
Class Teacher – may be the first point of contact for parents or the child if they are experiencing difficulties with their education or school life.
Clinical Psychologist – is a mental health professional who aims to reduce psychological distress and enhance and promote psychological well being. They use psychological techniques and methods to enable clients to make positive changes in their lives. Clinical psychologists can work with any particular age group and some specialise in working with children and adolescents, including those who have difficulty with behaviour and or relationships with others.
Community Learning Disabilities Nursing Service – can help with: managing challenging behaviour, continence management, sleep management, promoting independent living skills, health promotion, sexual health education and more, including supporting parents and carers and collaborative working with, or referring to other agencies as appropriate. They can also support the transition to adult health services.
Counsellor - may work within a school, in a community based health team or with a voluntary agency. The person should not be sent to counselling, but request counselling. A counsellor sees a client in a private and confidential setting to explore any difficulties the client may be having, distress they may be experiencing or perhaps their dissatisfaction with life, or loss of a sense of direction and purpose (adapted from British Association of Counselling and Psychotherapy).
Dietician – a dietician provides advice, information and teaching on nutrition and diets. Referrals can be made by GPs and hospital consultants. They work with parents, professionals and the general public.
Early Years and Childcare Services – co-ordinated by Educational Psychology in some instances – meet regarding the needs of pre-school children with Additional Support Needs (ASN) to discuss appropriate placements. These are multi-agency from Health, Education and Social Work (for example Dundee City Council).
Education Officer – may become involved if child is refusing to attend school.
Educational Psychologist – SIGN Guidelines (2007) advocate educational representation on multi-agency assessment teams and Educational Psychologists (EPs) may adopt this role, although there are different service models in different authorities. EPs may offer consultation and assessment around matters relating to education and/or home and community life e.g. by providing insight about child development and/or offering advice about managing and supporting behaviour and communication intentions. There may be training opportunities for the EP in schools and beyond. Some direct intervention may occur, and research projects may also be undertaken.
Guidance Teacher – ten standards as outlined by 2004 review of guidance services. In summary, the guidance teacher aims to be an individual that: the child can come to in confidence, can liaise between external agencies and the child/school, can help the child with transition and planning for the future, and can help children understand choices and make informed decisions. A major role of the guidance teacher is to ensure that when a pupil raises a problem, action is taken to help them.
Head Teacher – responsible for whole school policy and approaches. Often a point of contact if concerns have been raised with a class teacher and these have either not been resolved or require further action. The Head Teacher is often the Link Person for services such as Educational Psychology.
Health Visitors and School Nurses – should be consulted about health issues in the first instance. Links with Social Work, Education, Health and Voluntary sector workers.
Local Area Co-ordinator – the role of the Local Area Co-ordinator varies from authority to authority, with some taking only adults, some only children, some not working for people with Asperger’s Syndrome, and some taking these cases on. The function of the LAC is not to be a case manager or to co-ordinate services, but to use knowledge of local groups and services to be able to link children with learning disabilities and their families to the services that they need.
Mental Health Worker – see CAMHs team.
– aims through working with the child, parents and carers, to assess and develop the child’s social and practical skills to enable them to function in their daily life. (Not just physical, but social and psychological also. Occupational Therapists can be based in hospitals or community based multi-disciplinary teams (CAMHs or Learning Disabilities integrated teams) and also within schools, as outlined by the Scottish Government’s information on Allied Health Professions
Parents – the majority of professional services indicate that they require parental permission for referrals and most list working with parents as one of their key functions. The Family Law (Scotland) Act 2006 and the Scottish Schools (Parental Involvement) Act 2006 lay out rights and responsibilities for parents of all children including those with ASN.
Parent Liaison Officer – can be contacted if parents have raised concerns with Class Teachers and Support for Learning Teachers/or Head Teachers and feel that these concerns are still an issue.
Peers – either in an informal capacity as social support or to model appropriate behaviour or in a formal capacity as a buddy, reading partner, with a circle of friends or another way that the school uses peers as support.
Play Therapist – can help children understand their feelings and upsetting events that they haven’t had the chance to sort out properly. Rather than having to explain what is troubling them, as adult therapy usually expects, children use play to communicate at their own level and at their own pace, without feeling interrogated or threatened.
Respite Workers - generally provide for short break services for carers and the people they care for, with a focus on the right break at the right time and in the right place.
School Nurse – intended as the first point of contact for parents, educators and pupils for all matters related to health. Ways this is done: Questionnaires to all pupils when they start school and prior to the transition to secondary to pick up health problems; educating staff about specific health problems and promoting good health; providing advice to individual pupils upon request; health promotion activities including sexual health and building confidence; vaccinating children; giving advice on issues such as bedwetting and in some cases knowledge of parental support groups.
Siblings – can provide a similar supporting role as listed for peers, or they may take on a more informal ‘advocacy’ role.
Social Workers – Social Work services may become involved if a child has a need relating to their home or community life that is going unmet. Social Workers, usually from children and families teams, can work either directly with the child to assess their need and arrange appropriate support or can work with parents to increase their ability to care for their child. In best practice adult social work are invited to, or made aware of, transition planning meetings for any young person aged 14 and over who might require social work support in adulthood
Speech and language therapist
Speech and Language Therapists (SLTs) are generally concerned with the development of speech and communication as well as eating, drinking and swallowing skills. SLTs are frequently involved in supporting children and young people with communication difficulties who are being assessed for or who have a diagnosis of ASD. SLT's may also be involved in working with adults with communication disorders in a range of settings.
SLT support may involve direct intervention, e.g. supporting the development of language skills, introducing supports for verbal and nonverbal communication (e.g. through the use of visual supports, signing systems and implementation of AAC - alternative and augmentative communication). Support may also include indirect support for education staff and parents in implementing communication strategies with the child or young person through information sharing, consultation and training.
Support assistants / Auxiliary - can help with issues like getting around school, focusing on class work, supporting organisation. Usually main support at less structured times - breaks and lunch.
Youth Workers – provided from a number of sources, including youth centres or clubs. Can organise leisure and play activities, but also work with children who are experiencing problems. Very broad term encompassing those who volunteer, such as Scout leaders, to those who work for Councils and Youth Centres. The general aims of youth workers are to promote well-being and to support the social and personal development of young people and teach responsibility and participation in the community.