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How can we make inter-agency work more effective ? Dr Mostafa Ewees (Senior educational psychologist, Stanford University ...
<ul><li>…   if you build your house on a busy highway you must expect many visitors …  Kanner ( quoted by  Bennett and Bil...
<ul><li>To establish some principles to guide effective work </li></ul><ul><li>To look at practical examples to illustrate...
<ul><li>my jobs and interests </li></ul><ul><li>some initial ideas  </li></ul><ul><li>-  what are we talking about ? </li>...
<ul><li>How to we achieve this ?  </li></ul><ul><li>Hearing the voices of people with autism … </li></ul><ul><li>What we n...
<ul><li>‘  I have difficulty finding out what other people are  feeling and thinking , its what people call mind reading. ...
<ul><li>Differences or difficulties ? ( Donna Williams,1996; Kenneth Hall, 1998) </li></ul><ul><li>‘ My world is not simpl...
<ul><li>link to ‘understanding autism’ </li></ul><ul><li>sources of information (and overload !) </li></ul><ul><li>know th...
<ul><li>Training and learning processes </li></ul><ul><li>-  collaboration and development </li></ul><ul><li>-  Autism-fri...
<ul><li>Differences can be noticed in the following :  </li></ul><ul><li>Ways of being with other people (social relations...
<ul><li>Solution- focused approaches  (eg. Ajmal and Rees, 2001)   </li></ul><ul><li>individual work </li></ul><ul><li>mee...
<ul><li>Solution- focused thinking </li></ul><ul><li>Helps people become aware of the effects of own actions, thoughts, be...
<ul><li>Scaling </li></ul><ul><li>Exceptions </li></ul><ul><li>Think  about the times when what is troubling you wasn’t ha...
<ul><li>Perspectives : autism and other learning and social profiles –  the importance of a sense of perspective ?   </li>...
<ul><li>DfEE  (Circular 10/99: Social Inclusion: Pupil Support) </li></ul><ul><li>lack of coordination of services to fami...
<ul><li>Behavioural (biological) basis  or </li></ul><ul><li>Not a pathological state  ( part of normal biological variati...
<ul><li>Autism affects:  thinking, feeling and understanding  but not same  for everyone </li></ul><ul><li>understanding o...
<ul><li>No one approach will meet the needs of all people with autism (Jordan and Jones, 1999) </li></ul><ul><li>Key consi...
<ul><li>Multi-disciplinary input  not  just at crisis points </li></ul><ul><li>Time is a crucial resource </li></ul><ul><l...
<ul><li>Easier said than done: multi-agency work is  a complex psycho – social process –  no wonder its tricky ! </li></ul...
The National Autistic Society, City Rd, London, ECIU ING, tel 0171 833 2299.  www.oneworld.org/autism.uk The NAS in Wales,...
The National Autistic Society , City Rd, London, ECIU ING, tel 0171 833 2299.  www.oneworld.org/autism.uk The NAS in Wales...
<ul><li>Williams, D. (1996)   Autism: and inside out approach . London: Jessica Kingsley. </li></ul><ul><li>This is one of...
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working together with autism by Mostafa Ewees

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Transcript of "working together with autism by Mostafa Ewees"

  1. 1. How can we make inter-agency work more effective ? Dr Mostafa Ewees (Senior educational psychologist, Stanford University at California)
  2. 2. <ul><li>… if you build your house on a busy highway you must expect many visitors … Kanner ( quoted by Bennett and Billington, 2001)* </li></ul><ul><li>... 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) </li></ul>*Lloyd-Bennett, P and Billington, T.(2001) editorial, Educational and Child Psychology 18(2)
  3. 3. <ul><li>To establish some principles to guide effective work </li></ul><ul><li>To look at practical examples to illustrate these principles. </li></ul><ul><li>To consider the range of skills and perspectives needed </li></ul>
  4. 4. <ul><li>my jobs and interests </li></ul><ul><li>some initial ideas </li></ul><ul><li>- what are we talking about ? </li></ul><ul><li>- why ( are we talking about it ) ? </li></ul><ul><li>- how ( can we improve the situation) ? </li></ul><ul><li>Task : ‘Listening to Kenneth ‘* </li></ul><ul><li>1. strengths </li></ul><ul><li>2. challenges </li></ul><ul><li>3. what needs to </li></ul><ul><li>happen ? </li></ul><ul><li>* Extract from ‘ Different for a reason ’ BBC Radio 4 (23.9.01) </li></ul>
  5. 5. <ul><li>How to we achieve this ? </li></ul><ul><li>Hearing the voices of people with autism … </li></ul><ul><li>What we need to know can be learned from the people themselves …. </li></ul>
  6. 6. <ul><li>‘ 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 …’ </li></ul><ul><li>‘ 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 …’ </li></ul><ul><li>‘ 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…’ </li></ul><ul><li>‘ It’s really hard work to learn , it’s really difficult because no-one writes books about it. Everyone assumes it comes naturally to everyone…’ ( Chris, student, from ‘The Face’ Channel 4, 2001). </li></ul>
  7. 7. <ul><li>Differences or difficulties ? ( Donna Williams,1996; Kenneth Hall, 1998) </li></ul><ul><li>‘ My world is not simply a damaged version of yours …’ ( Jim Sinclair, 1992 ) </li></ul><ul><li>‘ these individuals are the experts on their autism and should be our future collaborators in our understanding of autism’ ( Peeters, 2000 ) </li></ul><ul><li>‘… 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 ) </li></ul><ul><li>‘… 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…’ </li></ul>
  8. 8. <ul><li>link to ‘understanding autism’ </li></ul><ul><li>sources of information (and overload !) </li></ul><ul><li>know the person first and foremost </li></ul><ul><li>reading, watching and thinking </li></ul><ul><li>( 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 ) </li></ul>
  9. 9. <ul><li>Training and learning processes </li></ul><ul><li>- collaboration and development </li></ul><ul><li>- Autism-friendly schools initiative, (Autism </li></ul><ul><li>Cymru, 2004 - and LEAs); identity card </li></ul><ul><li>initiative with the police service and others; </li></ul><ul><li>collaborative training processes in schools </li></ul><ul><li>(eg. Barrett, 2006) </li></ul>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
  10. 10. <ul><li>Differences can be noticed in the following : </li></ul><ul><li>Ways of being with other people (social relationships) </li></ul><ul><li>Ways of communicating and or speaking (social communication) </li></ul><ul><li>Fixed ways of thinking and doing things (social imagination) </li></ul><ul><li>These are known as the ‘triad of impairment’(Wing, 1996). </li></ul>
  11. 11. <ul><li>Solution- focused approaches (eg. Ajmal and Rees, 2001) </li></ul><ul><li>individual work </li></ul><ul><li>meetings </li></ul><ul><li>ways of hearing peoples’ stories and perspectives …. </li></ul><ul><li>‘ 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…’ </li></ul>
  12. 12. <ul><li>Solution- focused thinking </li></ul><ul><li>Helps people become aware of the effects of own actions, thoughts, behaviours on themselves and environment </li></ul><ul><li>Helps people consider own knowledge about the situation and consider own skills and opportunities to do something about it to resolve own difficulties. </li></ul><ul><li>Promotes self-reliance but needs to be facilitated. </li></ul><ul><li>Focus on the positive </li></ul><ul><li>What is going right ? </li></ul><ul><li>Look for exceptions ? </li></ul><ul><li>Scaling </li></ul><ul><li>Priorities for change not problems to be sorted </li></ul><ul><li>What would you see happening ? </li></ul><ul><li>Positive language leads to solutions </li></ul>
  13. 13. <ul><li>Scaling </li></ul><ul><li>Exceptions </li></ul><ul><li>Think about the times when what is troubling you wasn’t happening. What was happening then ? etc. </li></ul><ul><li>Miracle question </li></ul><ul><li>Imagine the issue has gone away. What is happening instead ? </li></ul>1 10 5 Last year/month today 1 5 10 6 months ?
  14. 14. <ul><li>Perspectives : autism and other learning and social profiles – the importance of a sense of perspective ? </li></ul><ul><li>Consultations, procedures and assessment frameworks - making guidance a reality … </li></ul><ul><li>Assessment: multi-agency (WAG Consultation paper 2006) </li></ul>
  15. 15. <ul><li>DfEE (Circular 10/99: Social Inclusion: Pupil Support) </li></ul><ul><li>lack of coordination of services to families from agencies and disciplines </li></ul><ul><li>Autism straddles different disciplines </li></ul><ul><li>- for definitions, diagnosis, education and care a multi disciplinary approach helpful. </li></ul>
  16. 16. <ul><li>Behavioural (biological) basis or </li></ul><ul><li>Not a pathological state ( part of normal biological variation, with advantages and disadvantages – problems arise from social attitudes not disabilities ) </li></ul><ul><li>Way forward consider: </li></ul><ul><li>- autism as a range of developmental characteristics in </li></ul><ul><li>social understanding, communication and flexibility of </li></ul><ul><li>thinking and behaviour </li></ul><ul><li>issues are around levels of adaptive functioning </li></ul><ul><li>- this respects individuals but recognises major difficulties in </li></ul><ul><li>coping with the world. </li></ul>
  17. 17. <ul><li>Autism affects: thinking, feeling and understanding but not same for everyone </li></ul><ul><li>understanding of the world comes from the social process of joint construction of meaning (Vygotsky, 1962) </li></ul><ul><li>How do we share the issues arising from this for people with autism with fellow professionals ? </li></ul>
  18. 18. <ul><li>No one approach will meet the needs of all people with autism (Jordan and Jones, 1999) </li></ul><ul><li>Key considerations; </li></ul><ul><li>how does the child/young person learn best ? </li></ul><ul><li>What barriers exist n? </li></ul><ul><li>What support would mean a child would not fail in a local setting ? </li></ul><ul><li>What setting is the least restrictive way of meeting needs and providing education ? </li></ul>
  19. 19. <ul><li>Multi-disciplinary input not just at crisis points </li></ul><ul><li>Time is a crucial resource </li></ul><ul><li>Autism outreach teams: multi-agency </li></ul><ul><li>See Cumine, Leach et al. (1997,2000); Leicester City Council, Leicestershire County Council and Fosse Health Trust, </li></ul><ul><li>(1998) </li></ul>
  20. 20. <ul><li>Easier said than done: multi-agency work is a complex psycho – social process – no wonder its tricky ! </li></ul><ul><li>Unique challenges for autism ? – impact of anxiety … </li></ul><ul><li>Differing professional positions and perspectives (social worker, clinical psychologist, nurse, paediatrician, psychiatrist, police, speech and language therapist, occupational therapist, teacher, teaching assistant, headteacher) </li></ul><ul><li>Unique perspective of the child/young person </li></ul><ul><li>Unique position of parents/carers </li></ul>
  21. 21. 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
  22. 22. 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
  23. 23. <ul><li>Williams, D. (1996) Autism: and inside out approach . London: Jessica Kingsley. </li></ul><ul><li>This is one of several books by a woman who readily </li></ul><ul><li>acknowledges and describes her own autism . </li></ul><ul><li>Haddon, M. (2003) The curious incident of the dog in the night time . London: Johnathon Cape. </li></ul><ul><li>An acclaimed novel written from the point of view of a young person with an autism spectrum condition. </li></ul><ul><li>Cummine, V., Leach, J. and Stephenson, G. (2000) Autism in the Early Years, A Practical Guide. London: David Fulton . </li></ul><ul><li>As above (1998) Asperger Syndrome, A Practical Guide for Teachers. London: David Fulton. </li></ul><ul><li>Jordan, R. and Jones, G. (1999) Meeting the Needs of Children with Autism Spectrum Disorders . London: David Fulton. </li></ul>
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