Outline of Learning Disabilities
1. Summarise how learning disabilities can affect social and emotional development of children and young people (8 Marks)
Learning disabilities affects are varied, and what affects one person will not affect others with learning disabilities. Their issues are very specific to them. Learning disability doesn’t just affect the academic success; it also affects other areas such as social and emotional development.
Emotional intelligence/ development issues result in inappropriate responses, lack of empathy or ability to recognise others feelings. They may not know what to do or react in situations that comply with social norms. Their awareness of non-verbal cues may be limited, including understanding expressions, which may result in them not understanding what the other person means and produce frustration and anger. They may not be able to respond to feedback appropriately, and disclose information at inappropriate times or to the wrong people. If disclosing information to the wrong people this may result in exploitation, bullying or abuse. Many find it difficult to ‘recover’ from their early difficult experiences and result in issues later in life such as depression and anxiety. Emotional issues may also exacerbate learning disabilities.
Social wellbeing/ competence issues can result in difficulties in developing the skills needed for social interaction with others and identification of social cues. It can reduce the ability to communicate effectively and make and maintain friendships. It can also influence decision making which may not be appropriate the situation. Some of the skills needed to interact successfully can be taught to some people with disabilities, while for others this can never be learnt and result in further problems. Lack of social competence may lead to people becoming rejected and ridiculed by their peers, resulting in withdrawal, social isolation and self-confidence, self-worth and esteem issues, which may manifest as stress anxiety or depression. Negative experiences may result in trust issues which make forming relationships with others even more difficult As a result of not being accepted they may be more willing to conform to peer pressure in an attempt to be accepted. This can then lead them into getting into trouble and potential for them to be involved in ASB and disruptive behaviour
2. Explain the difference between a learning disability and a learning difficulty (6 Marks)
Learning difficulties - are specific learning disabilities that are not related to impairment of intelligence, but have specific problems processing certain information. An individual may often have more than one specific learning difficulty and other conditions may also be experienced alongside each other. They may have no other related problems and no relating social difficulties. Examples of learning difficulties are
Dyslexia - difficulty processing language, manifesting as problems with reading, writing and
spelling.
Dyspraxia - difficulty with fine and or gross motor skills, including coordination and manual
dexterity.
Dysgraphia - difficulty with handwriting, spelling and composition, including formulation of
letters, handwriting can be difficult or impossible to read
Dyscalculia - problems with maths, time, money, counting, adding up and other
Learning disabilities –usually begin early in life, unless the result of a brain injury. It is linked to an overall cognitive impairment. A child with a learning disability may have one or more learning difficulties and related social and emotional issues. The characteristics of a learning disability are a significantly reduced ability to understand new or complex information, or to learn new skills, reduced ability to function independently which affects development. IQ is one method of identifying a learning disability alongside social functioning and other factors such as social contexts. Social functions include communication, assessing risks, taking care of self, and being safe.
3. Discuss the three causes of general learning difficulties (3 Marks)
A learning difficulty is caused by the brain working differently to the norm. The three causes of general learning difficulties are
Heredity – Learning disabilities often run in the family. Genes are passed from the parents, e.g. Chromosome abnormalities such as Down’s syndrome or Turner syndrome or fragile X Problems during pregnancy and birth – it can result from anomalies in the developing brain,
or a result of illness or injury. This can include Mother’s illness during pregnancy, foetal exposure to alcohol or drugs, low birth weight, oxygen deprivation, or by premature or prolonged labour or a very premature birth
Something affecting the development of the brain after birth, or in early childhood.- this can be caused by head injuries, malnutrition, toxic exposure (such as heavy metals, radiation or pesticides), neglect, child abuse, lack of mental stimulation early in life or significant illness or injury affecting brain development.
The Definition of Autism
4. Outline three differences between autism and Asperger syndrome (6 Marks)
People with Asperger’s suffer from less severe symptoms than those with autism. Three differences between autism and Asperger syndrome are
Learning ability - People with Asperger’s do not on the whole experience language delays.
Some people with Autism may never speak ever. However, children with Asperger’s speech patterns may be unusual, with lack inflection, or may be formal, monotone, they may not understand the subtleties of language e.g. humour, or understand the give-and-take nature of a conversation.
Cognitive ability - Some diagnosed with autism also have learning difficulties, and may have
below than average IQ. Most people with Asperger’s possess average to above-average intelligence. a person with Asperger’s doesn’t have a significant cognitive delay
Those with ASD have characteristics that stop them from behaving according to socially
accepted norms. Autistic people are seen as aloof and uninterested in making friends and forming relationships. Those with Asperger’s may have social issues but appear to want to fit in, but do not have the skills to achieve this, resulting in social awkwardness, lack of empathy and non-existent appropriate non-verbal communication skills .
5. Describe the three different conditions within the autistic spectrum (3 Marks)
Asperger’s - the mildest form of autism, they are usually obsessively interested in a single
Autism - Those with autism have more severe impairments involving social and language
functioning, as well as repetitive behaviours. Often, they have learning difficulties and seizures.
Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS) those diagnosed
with this condition share some traits of autism or Asperger’s. Most have milder symptoms than those with autism, but they do not share the language skills and above-average intelligence associated with Asperger’s.
6. Explain five social interaction limitations of a young person with ASD (5 Marks)
Difficulties with social interaction include
Non-verbal communication – Non-verbal communication takes up around 70-80% of overall
communication. There are deficiencies in the use of non-verbal cues and behaviours, e.g. eye contact, posture, personal body space, and gestures to control social interaction. This manifests as both inability to use non-verbal communication or read it from others, which can result in miscommunication. Lack of eye contact means that they miss out on many important meaning cues, but even with eye contact they may not understand the subtleties of communication such as humour, or read the true meaning from expressions or tonality of voice. Miscommunication or lack of understanding could result in frustration, outbursts and other challenging behaviours
Peer relationships –they may find it difficult to develop and maintain appropriate
relationships, resulting in them becoming loners. Some may enjoy this but for others this may result in frustration and depression as they don’t have friends. It may also make them feel uncomfortable in the presence of peers, making school time difficult, and disengaging in learning
Difficulties with social communication – delays in language development may mean that
learning and communication with others is problematic.
Deficits in the ability to initiate or sustain a conversation–the ability to start a conversation
is key to developing relationships. Because of this ASD children are disadvantaged socially even if they want to make friends.
Repetitive use of language or idiosyncratic language -Some with ASD repeat words or
phrases or repeat what someone else has just said or use inappropriate language. This can be frustrating for the listener and impede social interaction, and shows lack of understanding.
Inflexibility- flexibility is useful in school and in the wider world. Although a school day is
structured in the form of lessons, there can be many changes throughout the day, and layout may change. For an ASD person this may be very unsettling and cause disruption.
Causes of Autism
7. List the genetic & environmental causes of autism (6 Marks)
The exact cause of autism is not known, but research has pointed to several possible factors, including genetics and environmental factors. These include
certain health conditions associated with higher rates of ASD these include: Fragile X syndrome, Tuberous sclerosis, Rett syndrome, Neurofibromatosis, Muscular dystrophy, Down’s syndrome, Cerebral , Infantile spasms ( a type of epilepsy), intellectual disability (about half of those diagnosed with autism have an IQ below 70).
prenatal exposure to the chemicals thalidomide and valproic acid, pollution or pesticides, exposure to alcohol or medications such as sodium valproate
Specific problems with the development of the brain and nervous system. Studies have found abnormalities in several regions of the brain, which suggest that autism results from a disruption of early pre-natal brain development. Later, when the brains of children without autism get bigger and better organised, autistic children's brains grow more slowly.
Factors associated with the mother including advanced parental age at time of conception, obesity or diabetes, maternal nutrition, infection during pregnancy and prematurity.
Any birth difficulty leading to oxygen deprivation to the brain
8. Provide a brief overview of how autism is diagnosed in adults and children (8 Marks)
Diagnosis in children
Diagnosing autism spectrum disorder (ASD) can be difficult, since there is no medical test, like a blood test, to diagnose the disorders. Doctors look at the child’s behaviour and development to make a diagnosis.
ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable.However, many children do not receive a final diagnosis until much older. Early recognition, treatment and management is crucial to assisting a child develop, so a child be seen and assessed within 3 months of an initial referral. They are assessed by each professional separately, by a multi-disciplinary team (clinical psychologist, paediatrician and speech and language therapist) using diagnostic tools
The key people who will notice differences are parents, so professionals must respond appropriately to parental concern. There is a specific pathway to diagnosis prescribed by NICE (National Institute of Clinical Excellence). Diagnosis must rule out other possible causes for behaviour. Detection is through observing social interaction and reciprocal communication behaviour. They look at
spoken language responding to others interacting with others
eye contact, pointing and other gestures ideas and imagination
unusual or restricted interests and/or rigid and repetitive behaviours
Assessments include structured assessment tools in the form of questions to both the child and parents. These toolkits assess communication, social interaction, and attention. Alongside these toolkits observation, developmental history, medical history and other factors associated with increased are assessed – to ensure a complete picture is achieved before diagnosis is made.
required. Care plans can then be put into place with specifically individually tailored support required, including adaptations, treatment and management strategies.
Diagnosis in adults
Assessment in adulthood may be as a result of previous misdiagnosis or other reasons. As with children professionals will assess if there are any other causes for their behaviour apart from ASD. NICE has a set of guidelines for assessing for autism, laying out the specific diagnosis pathway.
Assessment is recommended if an adult presents with one or more of the following
“persistent social interaction problems persistent social communication problems
rigid and repetitive behaviours, resistance to change and/or restricted interests difficulties in obtaining or sustaining employment or education
problems with starting and sustaining social relationships
contact at any time in his or her life with mental health or learning disability services
a history of a neurodevelopmental condition (such as learning disability or ADHD) or mental disorder.”
If they do present with any of the above then an Autistic Spectrum Quotient – 10 (AQ-10) is administered, unless they have a moderate to severe learning disability as it could give an inaccurate result. If a person scores highly in the AQ-10 then the person can be referred for a specialist diagnostic assessment. This assessment focusses on the person’s attention to detail, attention switching, communication, imagination and social. They should be fully involved in the assessment, and significant others asked to input into the assessment.
A comprehensive assessment covers: core characteristics of autism especially those present in childhood and continued into adulthood, developmental history, behavioural issues, how they function in different environments, mental, neurodevelopmental or physical disorders, hypo- or hyper-sensory sensitivity and attention to detail. They will also observe the person in social situations. Alongside this specific screening tools can be used, which are similar to the 1s used for children.
Once a person is diagnosed a care plan should be drawn up, based on their specific needs, this can include psychosocial interventions, supported employment programmes and medication. This should include a risk management plan. Risk management is important as those with ASD can be vulnerable to harm caused by others or themselves, this includes neglect, exploitation and abuse and self-harm. So where appropriate a risk management plan should be used. Alongside this a crisis management plan should be drawn up identifying triggers, reactions to the triggers, how their condition effects them during crisis, and management techniques for this.
Four times as many boys as girls are diagnosed with ASD. Females diagnosed with autism tend to be more severely affected than males. Girls with autism show more irritability and externalizing behaviours than boys.
Evidence suggests that females have a degree of protection against autism; it takes more autism risk genes to tip girls’ brain development onto the autism spectrum than it does for boys. The female protect effect may result from sex chromosomes. Girls have two matched Xs, but, a mutation on a boy’s X or Y chromosome may prove more harmful because he lacks that matched copy. More mutations are required to produce autism in females.
Researchers suggest autistic characteristics in girls depend on intelligence. Girls with an IQ less than 70 have greater social communication impairments than boys. But those with IQs above 70 tend to have fewer restricted interests. These differences may make it difficult to recognize the signs of autism in girls. But restricted interests among girls may just be more socially appropriate e.g. a girl with autism might give facts about a pop star whereas a boy might talk about a train timetables, or girls may collect makeup rather than coins, so less noticeable.
In relation to understanding of friendship and the quality of social relationships, boy’s score lower than girls, consistent with the general sense that girls have better social skills. This is consistent with those with and without ASD. Some research has shown that females with autism were similar to the typically developing males. This may mean this maybe the result of why more boys are diagnosed than girls. Instead of evaluating on an absolute scale, we need sex-specific assessment tools or compare girls scores with those of unaffected girls of the same age.
Other differences include
Girls with Asperger’s are better at masking and coping with symptoms. Boys are more susceptible to organic damage
Autistic girls have different brain activity in responses to social cues Girls carry more mutations.
Girls with more mild forms of autism maintain eye contact for longer than girls severely impaired. This is the opposite for boys.
Explaining Autistic Behaviour
10. Explain what constitutes as "challenging behaviour" (6 Marks)
behaviour leads to a desired outcome, it may be repeated again and again, as it is a way they see they can control things around them. It can be manifested in the following ways
Self-injury e.g. head-banging, scratching, pulling, picking, grinding teeth and eating things that aren't food.
Aggressive e.g. biting and scratching, hitting, pinching, grabbing, throwing, verbal abuse. Stereotyped e.g. repetitive movements/ speech/ manipulation of objects and rocking. Non-person directed e.g. damage to property, stealing, incontinence, lack of awareness of
danger and withdrawal.
Disruptive e.g. screaming and spitting and inappropriate sexual behaviour Other behaviours e.g., smearing, stripping off and running away
11. Define the characteristics of autism through children's behaviour (10 Marks)
Characteristics of autism vary significantly and dependent on the severity. The NICE Guidelines for Diagnosis give the following characteristics as indicators of ASD
Spoken language
o Preschool age (0-5 years) - delayed speech development (fewer than ten words by the age of 2 ) or not speaking at all, they may use non-speech vocalisations eg grunts, intonation may be flat or odd, repeating words or phrases and a tendency to refer to themselves with their name rather than I and preferring to communicate using single words, despite being able to speak in sentences
o School age(5-19 years) - they may use spoken language in unusual ways, preferring to avoid using spoken language may have limited use of words, monotone, and repetitive speech, speaking in pre-learned phrases, talking at rather than to others, prefer only to talk about topics which they are interested in, and may be seen as rude or inappropriate.
Responding to others
o Preschool (0-5 years)- gives either no or delayed response to their name being called, may not respond or have reduced responses to facial expressions, reacting negatively when asked to do something by someone else, and may not accept cuddles.
o School age (5-19 years) - they may also show difficulties in understand other people’s intentions or requests and misunderstand sarcasm or metaphor due to literalism
Interacting with others
o Preschool (0-5 years) - not aware of personal space, little interest in interacting with others, preferring to play alone, rarely using gestures / facial expressions when communicating, avoiding eye contact, aloof manner, lack of sharing of interests with others, not initiate play, not imitate others, not enjoying situations that most children their age like e.g. birthday parties, detached from feelings of others and uses adult as a means to get wanted object, without interacting with adult as a person
o Secondary school (11-19 years) - in addition problem with losing at games/ turn-taking/ rule changes, reduced understanding of friendship and social isolation.
Unusual or restricted interest and/or rigid and repetitive behaviours
o Preschool (0-5 years) - repetitive movements such as flapping their hands, rocking back and forth or flicking their fingers or play in a repetitive way e.g. lining blocks up in order of size or colour, rather than using them to build , preferring familiar routine, getting extremely upset if there are changes to their normal routine, over or under reaction to textures/sounds/smells strong like or dislike of certain foods, over-focus on certain interests and insisting on following their own agendas.
o Primary school (5-11 years) - they may believe that everyone should always stick to the rules, more orientated towards objects than people, dislike of change may lead to aggression or anxiety.
o Secondary school (11-19 years) - may have a preference for highly specific hobbies and interests, adhering to the rules can result in regular arguments, emotional distress caused by change, and repetitive behaviours may negatively affect daily activities.
Eye contact, pointing, and other gestures
o (0-19 years) - All may exhibit reduced or no use of gestures and facial expressions to communicate, lack of eye contact, rarely point to or show an object to share interest and poor attention span
Ideas and imagination
o Preschool (0-5 years) - v little variety in pretend play, little or no imagination and obsessive interest in certain toys or objects whilst ignoring other things
o School age (5-19 years) little flexible imaginative play or creativity, lack of understanding of social etiquette and hierarchies and not develop age-appropriate peer relationships.
Additional factors
o School age (5-19 years) - includes poor social or fine and gross motor skills, while certain areas are advanced, social and emotional development may be more immature than other areas of development, naivety, trusting people excessively, Low muscle tone, does not react to pain, sleeping problems, difficulties toilet training, eats or chews on unusual things, Puts objects to nose to smell them, removes clothes often, frequent diarrhoea/ upset stomach/ constipation, a lack of common sense and less independent and delayed sexual development
The Theory of Mind is ability to predict behaviour based on the idea that other people have different intentions, desires, needs, and knowledge from us and possess different mental states. In essence it is the ability to mind-read. Development begins in this area at about 5 months old, with peak development at the age of 4. For most this is an automatic process and involves reading body language. However, for people with ASD this is a difficult or even impossible thing to do. Deficits in the theory of the mind indicate underdeveloped social and communication skills that define ASD. Deficits for those with ASD often continue to be absent throughout their lifespan and they are likely to feel overwhelmed in social situations and may prefer to retreat from others. They are not able to interpret meaning or guide their behaviour in light of non-verbal cues. This is because they cannot read emotions and many do not look at people in the face. By not understanding other people think differently, many may have problems relating socially and communicating. Due to a lack of understanding they may appear to be self-centred, or uncaring, resulting in them being bullied or excluded. Meaning making and keeping friends can be difficult. If they are unable to pick up the intentions of others, or understand deception they are at risk of abuse.
The theory of mind is recognised as an explanatory cause for a large majority of deficits seen in Autism Spectrum Disorders. Research has focused on preschool children as this is when there is rapid development. Children learn to understand actions do not always reflect true inner feelings, and people can have a variety of feelings at one time. Individuals with ASD often struggle with this idea, restricting the ability to communicate with others. One major area of research in this area is around false beliefs. False-belief describes holding a belief which conflicts with reality. Tests can assess the ability to attribute a false belief to another person. The test involves 2 people one has an object that they put down and then leave, the other person then moves it somewhere else. The first person returns and they are asked where the first person will look for the object. Almost all children without ASD over the age of 4 years can pass the task. However, only about 20% of ASD children are able to pass this task (85% of children with Down’s Syndrome passed the test), most say they will look for it where the second person put it.
Specific behavioural deficits seen in autism are impaired social functioning, impaired communication and lack of imaginative play and inability to imagine an object as something else. This triad of impairments characterizes the whole spectrum of autistic disorders. This could be explained by a single cognitive deficit i.e. an inability to cognitively represent mental states or theory of mind.
Communication and Language
13. Define the term "Receptive Language" (4 Marks)
Receptive language is the ability to understand or comprehend words and language heard or read. Receptive language is important for successful communication. Children need to understand spoken language before they can use language effectively. Receptive language disorder means difficulties with understanding what is said and usually begin before the age of four. They may find it challenging to follow instructions and may not respond appropriately to questions and requests. Difficulties in understanding may also lead to attention and listening difficulties and/or behavioural issues. There is no standard set of symptoms. However, symptoms may include:
Inability to understand complicated sentences or remember strings of sounds that make up a sentence.
inability to follow verbal instructions parroting words, questions or phrases
Language skills below the expected level for their age. Gives unusual answers to questions.
Poor attention
Hearing issues including Auditory Processing as this will impede development Inability to plan and sequence
problems distinguishing between similar speech sounds poor vision so can’t pick up on visual cues
inability to understand language in a number of contexts
The cause of receptive language disorder is thought to be a result of genetic susceptibility, exposure to language, and general developmental and cognitive ability issues. Treatment options include speech–language therapy, one-on-one/ group therapy, providing information to facilitate language growth and special education classes.
14. Explain how specialists categorise difficulties with expressive language (5 Marks)
Expressive language disorder occur when an individual has difficulty conveying or expressing information in speech, writing, sign language or gesture. They have the same ability to understand words but cannot put them into sentences. It is generally a childhood disorder and there are 2 types: Developmental – there is no known cause, and begins during the period of learning to talk and Acquired - caused through brain damage and can occur at any age, symptoms are dependent on what part of the brain is damaged. Specialists categorise symptoms in the following ways
Content i.e. weakness in interpreting sense or meaning of phrases or sentences. They will
have a very limited vocabulary, have difficulty with abstract concepts and encounter persistent problems with word-finding including retelling a story or relaying information in an organised or cohesive way, recalling the appropriate word to use a n d difficulty communicating thoughts, needs, or wants at the same level as their peers.
Use i.e. using language which is out of context or inappropriate to the situation also known
as semantic-pragmatic disorder. This can involve inability to identify and prompts and cues in a conversation, using language inappropriately in a variety of settings with different people and unable to come to the point or talking in circles. It also involves the inability to start or hold a conversation and not observing general rules of communicating with others
Form i.e. the content of sentences leading to issues with phonology, word forms and
grammar. Issues include; putting sentences together incoherently; using incorrect grammar and using poor or incomplete sentence structure; using non-specific vocabulary such as ‘this’ or ‘thing’ and inappropriate expression of things.
15. Provide an example of the strengths and weaknesses of the speech, language and communication skills of a young person with ASD (6 Marks)
Strengths
Those with ASD have positive contributions they can make to various fields. Let’s just take science for example. Below are traits that could actually benefit science, and actually advance scientific knowledge. 3 famous scientists attributed to have ASD have contributed to significant scientific advancements. These were
Albert Einstein. Einstein had difficulty with social interactions, had tactile sensitivity, was
very intelligent yet found his language difficult at times, and had difficulty learning in school. Einstein was very different and it was his difference that made him develop ideas that made him famous.
Sir Isaac NewtonNewton’s work on universal gravitation and the laws of motion dominated
scientific thinking for the next 300 years. He was very quiet and not very good at ‘small talk’, or typical day to day conversations. He was extraordinarily focused on his work and had a hard time breaking away.
Charles Darwin he was a solitary child and as an adult, avoided interaction with people as
much as he could. Darwin collected many things and was very intrigued by chemistry and gadgets.
Others includeJohn Couch Adams, known as England's greatest mathematical astronomer
with the exception of Newton. David BellamyEnglish botanist, Robert Boyle, chemist,
physicist, alchemist, inventor, one of the founders of modern chemistry, known for his
formulation of Boyle's Law, Marie Curie chemist and physicist, pioneer of research on
radioactivity, Francis Galtonrelated the statistical concept of correlation, and also coined the
term “nature versus nurture”,Irene Joliot-Curie co-discovered artificial radioactivity,
daughter of Marie and Pierre Curie, Charles Richter created the Richter Magnitude Scale to
quantify earthquakes and John B. Watson founder of behaviourism
So it can be seen that Autism can be beneficial to scientific research and advancement, in that they are very focussed and attentive to detail that others may miss, different perception of situations and sensory experiences and may perceive errors that are not apparent to others, giving considerable attention to detail. Their priority is problem solving rather than social interaction.
They have a focused desire to maintain order and accuracy with an avid perseverance in gathering and cataloguing information on a topic of interest persistence of thought. This attention to detail means that they can see things that others miss and will continue with a theory past what those without ASD would purse. Their unique concrete thought enables logical processes to be mapped. Their ability to recall information accurately means that errors are less likely to occur. Their determination to seek the truth can result in new ways of thinking often lead to discoveries that consequently discard their outdated predecessors offering original, often unique perspective in problem solving. So young people with ASD could possibly be the next Einstein.
Weaknesses
result of difficulties in communication the ASD person is more likely to simplify communication or withdraw from it at all, resulting in them becoming even more isolated.
Approaches to Autism
16. Describe the concept of a "person centred approach" (2 Marks)
A person centred approach keeps the needs of the individual central, and tailors the health care, facilities, opportunities and any other needs to their individual circumstance. So does not adopt a one size fits all approach. It is a social support model that has been advocated by the government white paper Valuing People Now (2009). As such, this approach is regarded as the best practice to use for people with autism and learning difficulties.
It centres around the notion that everyone has the same rights and choices, should be treated with dignity and respect, and given the same chances as everyone else, including the right to take responsibility. This extends to their families too. It helps all parties involved, from the individual to those providing the support (whether professionally or family) in a holistic approach.
17. Identify the reasons for using a person centred plan (5 Marks)
A person centred plan is a document outlines all the services, support and actions required and agreed by the person whom care will be delivered to.
This needs to be agreed to ensure that the person can live life to the fullest they are able to
and as much as possible, how they would like to live it.
It takes into account all individuals involved in care, lets the individual and family to be
valued which in turn will raise self-confidence and esteem, so quality of life will be improved.
Regular reviews of need. Areas of need are varied, they can include social, medical,
education, communication, and even exercise. They will differ depending on the individual. They may also change over time. So to ensure that the best possible care is given this needs to be reviewed regularly. Plans should build on the strengths and work on weaknesses where possible.
By getting all people to input into the plan it gets the person’s life experience to be recorded
more holistically, so that support can be tailored accordingly to include likes and dislikes, areas of difficulty and reactions to medication.
Goal setting gives the person something to work towards. It must be SMART, this way
milestones can be tracked, gives the person motivation, which in turn will increase performance.
Action plans break down goals into achievable chunks, to maintain momentum.
Risk management involves identifying risks assessing the likelihood of the risk occurring,
18. Define the term "Social Inclusion" (1 Marks)
Social inclusion gives certain rights to everyone. This includes ensuring everyone’s basic needs are met in the form of access to employment, adequate housing, essential material goods and services, health care, education and training, etc. On a practical level this means working with communities to tackle and avoid circumstances that lead to social exclusion, such as poverty, unemployment or low income, housing problems and becoming housebound and isolated due to illness.
Practical Suggestions When Working with Autism
19. Provide two suggestions for creating a safe environment for individuals with ASD (2 Marks)
A calm and structured environment will assist. This means adapting the rooms and its contents so they are calm and clearly show what activity should be carried out in it. items could be labelled so they can use it will non or minimal support. Hazardous substances must be locked away. Thick carpet will reduce noise, double glazing will also reduce outside noise, and walls can be painted in a calm colour.
Alongside this an effective way to create a safe environment is well structured and supportive. This may not need any physical alteration; instead it requires a routine and strategies to support a person with autism. The National Autistic Society (NAS) advocate the SPELL environment
Structure - giving structure to daily life can reduce the anxiety of not knowing. sudden changes to daily routine should be avoided to minimise anxiety
Positive -use positive viewpoint and reinforcement especially when given opportunities to try new activities in a supportive environment. Give realistic goals to develop self-esteem and confidence.
Empathy - to put oneself in someone else’s shoes and we need to understand the autistic world. This will help to understand how to help overcome difficulties.
Low arousal -By limiting disruption, noise, etc. they are more likely to learn and work effectively. Calm speaking and slower movements can help reduce anxiety also.
Links -open communication is important as it reduces misunderstandings and promotes consistency
20. Describe two visual strategies used to support individuals with ASD (2 Marks)
People with an ASD are visual learners, so presenting information in a visual way can help to encourage and support communication, language development and ability to process information, promote independence, build confidence and raise self-esteem. 2 strategies are
Timetabling allows control and a degree of independence. It can referred to for reassurance as to what they are supposed to be doing and what the rules are and knowing what to expect.
Creating lists prior to going shopping to help complete errands independently
Non-verbal communication can be used to express needs in the following ways
Gestures– this can include shrugging shoulders and pointing between two objects to indicate
preference.
touching an object to convey interest
Exaggeration of facial expressions. Exaggerating can allow them to notice the communication
more, and will be more likely to use it
Sign language but this involves abstract signals which may not be easy to grasp initially. Pictures can used to communicate wants and needs, such as a drink, food, or activity.
Ethical, Legal and Organisational Issues
22. Outline the organisational issues required to meet the needs of autistic people using health services (10 Marks)
The organisational issues, based on a person centred approach, required to meet the needs of autistic people using health services, to prevent barriers to access are:
Each person should have equal access to all appropriate health services needed to provide their care to reduce the injustices that have been previously experienced by people with ASD There should be sufficient support for the person to enable access to these services – including where appropriate a brokerage service or advocates to act as their champions, especially if there are communication issues. Barriers to access need to be overcome, and adaptations made including ensuring appropriate signage, information is given in the most appropriate format, and if needing to visit hospital that they can visit first to reduce anxiety Disability awareness should be built in to staff training. This will improve the competency so
they respond appropriately to the needs of adults with autism. Specific training should be given appropriate to the services offered. The knowledge base of professionals needs to be adequate to ensure that issues are detected early or prevented to reduce costs and provide the best service for the client. It also prevents negligence cases and discrimination issues and ensures professionals have the most up to date information so they can deliver the best quality of support. This training should also be offered to non-professional carers for the same reasons
That those with more complex or special needs should have access to specialist health services – this means that they can access the services specifically required for them. No 1 person is the same, and they may need specialist support. So access to this means that the person can have a better quality of life, and live it to the fullest. And outreach support may enable them to remain in mainstream society. Without this they may not be able to cope and breakdown occurs, which will then cost more money.
That individualised and personalised planning should be developed and implemented. Without appropriate timely support more issues may arise including mental/ physical health deterioration which could result in the need for high-cost acute services. The right support at the right time can improve quality of life, outcomes and give value for money.
That all agencies should link with service users and carers in a coordinated way, to ensure that social, educational and health needs are fully and comprehensively addressed. As per Transforming Social Care (2006) and Choice and control, all service users have the option to choose the type of care they require. All are given a specific personalisation budget to buy in the services they wish to have. This means that the service user has a care package that they want. However this does sometimes cause issues, as they may spend their budget on other things and neglect the core basic services they require, which could then have a detrimental effect on the quality of life. For example if they require carers to wash and feed them daily and the budget is spent entirely on recreational activities, their quality of life will diminish and may result in health issues, such as malnutrition. In these instances advice and guidance and maybe a brokerage service may be required.
23. Give four examples of discrimination and barriers to learning that an individual with learning difficulties may experience (8 Marks)
People with ASD should not be discriminated against, as laid down in the Equalities Act (2010). In the past, people with ASD were seen as less important, sometimes this still occurs. This can often lead to the neglect which is a form of abuse and deceptive discrimination. Examples of discrimination and barriers to learning include
A barrier to learning would be presenting material in ways that they find difficult to process,
and not including visual materials, or using purely abstract concepts that they cannot understand, or producing materials in a format that is not helpful to their condition, such as fancy writing or black on a white background for dyslexic people.
Being labelled thick – and assuming that it is not possible for them to do it so do it for them.
This does not enable learning or development, and labelling can result in the self- fulfilling prophecy
Not making reasonable adjustments i.e. in schools or the workplace to cater for their specific
needs. I have fought for my son at school for 5 years to get read write software for his dyslexia. The head teacher said he had to write as he would have to in the workplace and that they were discriminating against him by not giving him equal opportunities to achieve.
Not getting insurance as this is a pre-existing condition even though legislation says they
should not be prevented from getting it for this reason
24. Outline avenues for support and helpful resources for parents of children with autism (3 Marks)
Autism specific training programmes – to enable the development of life skills such as
Diagnosis and assessment services for complex needs. Once these needs have been
identified specific plans can be put into place to address these needs
Outreach support – to help those living on their own in the community maintain their place,
or to those living with families. Both are there to provide support and advice to bot the individual and the carers to prevent any form of breakdowns
Counselling where appropriate and attendance to complementary therapies such as CBT, to
minimise the negative effects
Support groups for both the individual and carers so they don’t feel alone, and to get peer
advice, and to prevent social idolisation and related mental health conditions
