working together with autism by Mostafa Ewees
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working together with autism by Mostafa Ewees working together with autism by Mostafa Ewees Presentation Transcript

  • How can we make inter-agency work more effective ? Dr Mostafa Ewees (Senior educational psychologist, Stanford University at California)
    • … 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)
    • 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
    • my jobs and interests
    • some initial ideas
    • - what are we talking about ?
    • - why ( are we talking about it ) ?
    • - how ( can we improve the situation) ?
    • Task : ‘Listening to Kenneth ‘*
    • 1. strengths
    • 2. challenges
    • 3. what needs to
    • happen ?
    • * Extract from ‘ Different for a reason ’ BBC Radio 4 (23.9.01)
    • How to we achieve this ?
    • Hearing the voices of people with autism …
    • What we need to know can be learned from the people themselves ….
    • ‘ 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 …’
    • ‘ 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 no-one writes books about it. Everyone assumes it comes naturally to everyone…’ ( Chris, student, from ‘The Face’ Channel 4, 2001).
    • Differences or difficulties ? ( Donna Williams,1996; Kenneth Hall, 1998)
    • ‘ 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 )
    • ‘… 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…’
    • 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 )
    • 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
    • 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).
    • Solution- focused approaches (eg. Ajmal and Rees, 2001)
    • 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…’
    • 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.
    • 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
    • Scaling
    • Exceptions
    • Think about the times when what is troubling you wasn’t happening. What was happening then ? etc.
    • Miracle question
    • Imagine the issue has gone away. What is happening instead ?
    1 10 5 Last year/month today 1 5 10 6 months ?
    • Perspectives : autism and other learning and social profiles – the importance of a sense of perspective ?
    • Consultations, procedures and assessment frameworks - making guidance a reality …
    • Assessment: multi-agency (WAG Consultation paper 2006)
    • 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.
    • 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
    • issues are around levels of adaptive functioning
    • - this respects individuals but recognises major difficulties in
    • coping with the world.
    • 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 ?
    • 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 ?
    • 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)
    • Easier said than done: multi-agency work is a complex psycho – social process – no wonder its tricky !
    • 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)
    • Unique perspective of the child/young person
    • Unique position of parents/carers
  • 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
  • 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
    • 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.