Referencing Styles : AGLC Unit 16 Autism Review Document By FUNKE AKINYOSADE HND Understanding how health and social care services and system support individuals and intervention strategies that support individual with specific need. Introduction: Autism is a lifelong developmental disability that affects how a person communicates or relates to other people. It also affects how they make sense of the world around them. Without the right support, it can have a profound and devastating, effect on individuals and families. It is a spectrum condition, which means that, while all people with autism share three main areas of difficulty, their condition will affect them in different ways. Some people with autism are able to live independent lives but others may need a lifetime of specialist support. 2.1 Analyse the care needs of Autism Spectrum Disability using the triad of impairments as a frame work. One of the best known form of autism is Asperger syndrome, this is a developmental condition affecting the way the brain processes information and how a person communicates and relates to others. People with the condition are often average or above average intelligence. They have fewer speech problems than people with other types of autism, but may find it difficult to understand and process language. According to (Garner 2009,pp42-43), says that recently it has been accepted that autism like SEN is mainly multi-factorial in cause and that such things as neurological impairments, biochemical abnormality and childhood illness are all implications in some way. Notoriously, the cause of autism has come under the spot light, with the claims of one researcher that autism is linked to MMR (measles mumps and rubella) vaccination in childhood. Such claims have largely been shown to be erroneous. People with Autistic Spectrum Disorders have difficulties in three main areas within their lives; this is referred to as the 'triad of impairments. People with ADS have difficulties in three main areas of their lives, communication, socialisation and inflexibility. Communication is something most of us take for granted. We learn to communicate from a very young age, learning from our parents how to interact with each other, which means if we say something to someone the other person is likely to respond. When we communicate with each other we used gesture such as body language, various moments by using our hands, legs, lips and eyes. However a person with autism spectrum disorder will not necessary notice these visual cues or understand their meanings and therefore not getting the full meaning of what or how something has been said. Tone of voice is also something which is misunderstood and people with an ASD have to be taught about tone of voice and what different tones mean. Socialisation is also something we learn to do at young age when we visit relatives and friends, start school and go to parties in both of these skills. However a child with autism spectrum disorder will not understand the way either of these works. for example a lack of interest in others, not paying attention, using inappropriate or strange social behaviour because they find it difficult to express feelings, needs or emotions. These problem can be very difficult for people with autism to fit in socialisation. Inflexibility of thought is something many of us have but we can be swayed with simple argument. For example at my work place someone else has sat on the chair I always like to seat on during tea break but I can reason with myself that is not life threatening to me if I don't seat there on that day. However person with autism could see it as one thing that upsets for the rest of her day. She will always use a particular seat and therefore she can’t have her morning breakfast because she doesn't have that seat. This then upset her ability to think as this incident took advantage of her and override her thought process. For someone to develop theory of mind, he has to be aware of his own emotion, desire and self-awareness. Communication can leads to pain, due to inability to communicate. Lack of choice of food and clothes prefer. Interaction care need, spiritual and sexual needs not met due to inability to communicate. Children with disability are at higher risk of experiencing abuse and neglect than other able children without disabilities. Winter Bourne view case study in institutional abuse for adults with learning disabilities and autism, august 2012. The case that went on challenge because of substantial failings by managers, commissioners, regulators and safeguarding agencies. The review found that many of the conditions under which the abuse occurred were present from 2008 including the restraint by untrained staff, a lack of professional input or patient advocacy and the limited ways staff work with patients. Professional standards and code of practice had no bearing on patient care as winter borne view became largely led by its biggest staff group, the unregulated support workers, despite the presence of a team of 13 learning disabilities nurses. Training was skewed towards restraint practices with nothing about working with patients. What is good is, the fact that staff have the opportunity to learn about people with autism spectrum disorder. Families can support better when they work alongside professionals. Makaton is a language programmed designed to provide a means of communication to individuals who cannot communicate efficiently by speaking. Working with autism people, I learn makaton sign language is used for children or adult with autism spectrum disorder alongside speech language. For example I can communicate with clients using this makaton sign such as, do you want to drink tea, use the toilet, and do you want biscuit, please and thank you. 2.2 The two current system used for supporting an individual with autism spectrum for example advocacy. Advocacy in all its forms seeks to ensure that people, particularly those who are most vulnerable in society, are able to, (a) Have their voice heard on issues that are important to them. (b) Defend and safeguard their rights. (c)Have their views and wishes genuinely considered when decisions are being made about their lives. An advocate is someone who provides legal support when it is needed. An advocate might help to access information you need or go with you to meetings or interviews, in a supportive role. You may want your advocate to write letters on your behalf, or speak for you in situations where you don’t feel able to speak for yourself. Autism is a lifelong developmental disabilities that affects the way a person communicates and relates to people around them. Carers often play an important role in supporting people with autism spectrum disorder, but continuing reliance on their families may inhibit their dependence. This is why advocacy can be important by helping adults with ASD to have a greater degree of independence. They therefore need help to express their aspirations, interpret and process information regarding their rights and to request relevantly. TEACCH means treatment education of autism and related communication handicapped children. TEACCH clinical services include diagnostic evaluations, parent training and parent support groups, intervention groups, and individual counselling for higher functioning clients. Teacch developed the intervention approach called structured TEACCHing an array of teaching or treatment principles and strategies based on learning characteristics of individual with autism spectrum disorder, including strengths in visual information processing, and difficulties with social communication, attention and executive function. The goal of structured TEACCHing is to promote meaningful engagement inactivities, flexibility, independence, and self- efficacy. Structured teacching strategies into other evidence based practice. Children with autism learn better than visually than verbally. Visual cue direction makes it clearer to them. Structure, routine and distraction are three materials help many children with autism spectrum disorder to survive all problem they are facing. Individual with autism people they are all visual learners which means they understand written works much better than spoken language. A communication device often tells to make it simple. For example device like iPad that says I want something to eat, I want something to drink, and am done. This help in a way that the child is hungry using this device to communicate reduce challenging behaviour. Breaking down living skills into smaller steps makes it easier for a child with autism to perform. Academic skill must be broken down into small steps. A child might like to learn through identical pictures then she or he will learn through the object to match the pictures. The child might like to learn through categories or match written words. Motivation is the key elements to teaching autism children. The computer is a great learning tool for autism people, since the love consistent learning of the environment. 2.3 Evaluation services for autism in my work place institution, partnership, choice and therapies to support. Hackney day centre for learning disabilities was commitment to individuals with autism spectrum disorder and their families have been demonstrated through its tireless work of ensuring evidence based and best practice service delivery. The centre program and service are driven by person centre philosophy with emphasis on skill building using evidence based clinical practices and approaches that recognize the unique needs and strengths of an individuals with autism spectrum disorder. The centre helps you to grow and prove yourself. The centre provide you the help, so it up to individual choice to help themselves by participating in available activities. The centre is run by hackney council, help the service users to learn skills, awareness and to live happy productive lives as equal members of the society. Staffs are supportive and service user are happy. Client feel relaxed, interact with staff. The centre is where service users build their confidence back. Playing cards, going out on a trip every Friday such as bowling club, forest park, escorting client to hackney college for their poetry lesson, client attending music group sensory class in the college and many more play a big impact in their life. The inclusion policy in the UK means that children with special needs will not be educated alongside children without special needs with some support in mainstream schools. However in my south Thames College and other college all over England this is not always the best option and a more specialist provision is often needed. For example as adult being in a meeting where something has been said, but afraid to get up and give wrong answer, but a child with autism who already has low self-esteem it is even harder. Children with autism who has behaviour problem can attend behaviour management session to do their class work or talk. The professionals think they know more than the service users with autism spectrum disorder. In college the person that takes learners notes, learner don't have choice than to accept without complaining, even if they don't like that particular person to write their notes. Learners funding through student finance doesn't come on time due to late submission of application, learner might lack advocacy agencies that helps to take notes and learner might wanted to withdraw. Partnership with student and link officer availability is not there due to not enough staff in colleges. Support plan people get jealous and starts to get offended. It allows you to be confident of yourself. It also focus on culture, African we put it on state of denial. In my place of work with learning disabilities people, social interaction is the only way interacting with them, by saying good morning and give them cup of tea when requested due to weather condition. Later find out where they wanted to go for that particular day by showing them pictures of places through visual cues. In my place work which is a day centre, where client go out and make use of the community facilities. Also if they can't communicate with you and need your attention, the only way is to come close to you pull your hand so that you can follow them. 3.1 Self-help means to give assistance to (someone); make it easier for (someone) to do something. For example she helped me with my project. Training service users individually to help themselves with normal daily living. Also by escorting service user to local shop to get control of their own money through learning. What is mental capacity act: The Mental Capacity Act 2005 (MCA) is a framework that provide protection for people who cannot make decisions for themselves. It contains provision for assessing whether people have the mental capacity to make decisions, procedures for making decisions on behalf of people who lack mental capacity and safeguards. The underlying philosophy of the MCA is that any decision made, or action taken, on behalf of someone who lacks the capacity to make the decision or act for themselves must be made in their best interests. Guardianship means lacks of mental capacity to make a decision at the time it needs to be made because of mental impairments. It applies to some people who has learning disabilities, mental health problem, brain injury or illnesses such as dementia and may also include people with autism. The best team is multidisciplinary team work to get the best interest of the client when the client has no capacity to make their own decisions, e.g. deciding on a major operation, having an operation and be confined to a wheelchair. Biomedical is a very loose term that means different things to different people. Most people use the term to refer to a group of interventions which are design to stop or at least reduce the effect of biomedical problems such as gastrointestinal abnormalities, immune dysfunctions, detoxification abnormalities and nutritional deficiencies or imbalance, stated by (Cook 2014). Biomedical intervention believe that these biomedical problem act as triggers which cause or at lease exacerbate, many of the problems faced by people with autism. Biomedical treatments include – chelating therapy means pulling on heavy metal detoxification or B12 injection, glutamine injections which helps detoxification part ways actually works, and many more other treatments hat associated with biomedical treatments. Speech and Language therapy- According to (Garner 2009), states that many children experience special education needs, language and communication problems. The source of communication problem might linked to physiological issue. Speech and language therapy provides life-changing treatment, support and care for children and adults who have difficulties with communication, or with eating, drinking and swallowing. It is really important that we get the right approach to be able to work with autism spectrum disorder priory to behaviour, for example children would not want to participate in the task provide for them unless he or she needs prompting or the task to be completed. The more persuasion to continue will improve their profession. Later the therapy then advance from two phases to complete their sentences, later they used three sentences by repeating the words so that the client will not forget. They make sure there is improvement in both spoken and written language. 3.2 Evaluation of biomedical and speech and language therapy There is improvements through biomedical treatments for child with autism . The following are steps to help autism people. Sugar free diet is also a very effective biomedical treatments. Sugar free means avoiding juice, and soda, too much fruit, refined cards like chips, pretzels, cookies and crackers. The gluten free, casein free diet is the most effective diet and in the top five most effective biomedical treatment intervention. Gluten is found in wheat, oat, spelt, rye, barely and kola-nut, gluten rice, guinea, dairy product, cow milk, cheese, yogurt, butter, ice cream, goat milk products, casein free-rice milk, nut milk and potato milk. Autism children eats organic food because it helps their brain to function properly than processed package food. Addressing food sensitivities is top most beneficial biomedical treatments and mostly done through blood test. One of the greatest thing you can do with a child with autism is to help them feel better. Biochemical intervention really do help feel better if he or she will get more out of all the traditional therapies. The impact of the treatments has changed children life by getting involve in some of the things they can't do, but through this treatments they progress and do something new. Biochemical enables children with autism to be happy through treatments, and make huge difference. For example in case of Sam story a two and half years old boy diagnosed of autism. Sam was born bright and happy, was breast-fed, and received the best medical care available (including all the vaccinations he could possibly have). He talked, walked, loved, and played normally — that is, until after his measles, mumps, and rubella vaccination at 22 months. He received diphtheria, tetanus, whooping cough, measles, mumps and rubella, chicken pox, hepatitis A and B, influenza, pneumonia, haemophilic, and meningitis vaccines — all before he was 2 years old. Then something changed. Vaccines may affect susceptible children through different mechanisms. In some it is overwhelming of an already taxed immune system with over 2 dozen vaccinations at a very young age, for some it is the thimerosal (ethyl mercury) used as a preservative until recently in most vaccines (although it is still present in most flu vaccines).He lost his language abilities and became detached. He was unable to relate in normal ways with his parents and other children. And he became withdrawn, and less interactive. These are all signs of autism. Having a roadmap, a new GPS system based on functional medicine and Ultra Wellness, makes this straightforward. You just take away what’s bothering the patient. Give his body what it is missing and needs to thrive (based on the individual’s biochemical uniqueness). Then the body does the rest. After following a gluten-free diet and treating his gut for 3 weeks, Sam showed dramatic and remarkable improvement. He’s getting back much of his language skills and showing much more connection and relatedness in his interactions. After 4 months, he was more focused, unstuck and verbal. After 10 months, his bowels were back to normal, he was verbally fluent, mainstreamed in school and he “lost” his diagnosis of autism. After 2 years all his abnormal tests were normal including the high metals, gut inflammation and damage to his mitochondria and free radicals. And more importantly, the child was totally normal. Not every child has such a dramatic recovery but many improve, and some improve dramatically using the approach of functional or systems medicine. Every child with behaviour problems, ADHD, or autism is unique — and each has to find his or her own path with a trained doctor. But the gates are open and the wide road of healing is in front of you. The time cost at my place of work having one to one with speech and language therapy during service users assessment. The role of therapy is to access the seriousness of these conditions and to advise teachers, parents and other professionals on how best to enable this people to communicate more effectively with others. How to work with individual to get their needs met is through concepts of pictures with autism. When a client ask to meet the physicians the first step is to seek the client consent or physicians refers the client, this is to help the physicians why they refer the client. After it is crucial to complete a full evaluation valve on client break down in details, follow their weakness and the areas that need to be work on and how to come out with correct lesson plan to care for the client through therapy programmed. It is very important to clinicians to maintain addition score on how the client does from the session to session, and as well discussed the result with the client and the finding to client, care giver, teachers and every other disciplinary member involve in client life. After the session ends the therapy will write a note on how the session works, and they would include measuring goal and progress to be able to track the client progress through the cost of the therapy programme. For instance, therapy know after a session the client require a moderate cue to produce as initial 80 percent accuracy, written that down and comparing session notes over the course of the therapy programmed, allowing clinician to evaluate and track the progress of client. The ultimate goal is to be able to carry over the tool taught in therapy programmed day to day activities outside the therapy office. As she or he jump from therapy progress into their daily activities. Also the tool that they learn from the therapy programmed can be used independently outside their daily life. 3.3 Discuss the potential impact of some emerging development (e.g. technology and legislation) on support for individual with autism spectrum disorder. Technology can be described as using mechanical and scientific methods to change a process. Medical technology can be used to refer to a procedure, equipment and process by which health and some form of social care is derived. Some technology changes such as, television cable, interactive, digital, satellite, telephone, fax, email, blog- twitter. New medical and surgical procedures (e.g. joint replacement), new drugs,CT canners. The impacts of this technology, Changes in the nature of work and how we work. Changes how time and space is experienced. Changes in pattern of equality/ inequality. Equipment get smaller / portable/easier to steal or be lost. Equipment storing information may have implication for confidentiality. Work may be redefined- cause conflict between generation e.g. some may not see helping a client with a toy as work. Global world means that law governing how we work are now made by unified government. The European Union such broad laws can help to unify and improve work practices. Gender role normally specified for certain jobs changes. Work changes in health and social care because of the advancement in health science more people can now be treated in the community e.g., community homes instead of relying on doctors and nurses. Technology allows goods and services to be sourced all over the world. Worker may lose service skills. Workers may have to learn new skills, doctors (staff) may have to be retrained to use new operating equipment. Loss of jobs and also creation of new jobs too. Constant communication 24 hours. Some equipment may be unaffordable by poorer section of society. Technology may become absolute quickly. An Assertive Technology assessment can become quite complex, therefore, if it is to truly meet the unique needs are neurologically-based. They potentially affect speech, gross and fine motor skills, sensory integration, socialization skills, self-regulatory functions, and cognitive abilities. As with any “spectrum” disorder, autistic children display a wide range of challenges and abilities and thus we cannot make global assertions about AT “for children with autism. an AT suggestion for a child with a specific academic challenge will have to be viewed through the filter of the child’s other issues, as well as their available support system and personal preferences. An AT assessment can become quite complex, therefore, if it is to truly meet the unique needs of an individual child. One of the things to keep in mind as you consider the possible benefits of a piece of AT equipment or software is that while certain aspects of the tool may help one problem, other elements may exacerbate a co-existing problem. For instance, a computer-based program that works with a child on developing appropriate social responses may include a response reward that involves flashing lights and a loud noise which may seriously disturb him. There are two purposes for technology supports: 1.) For Alternative and Augmentative Communication (AAC) and 2.) As a motivating teaching tool or strategy for increased independence. For this second purpose, technology can serve as a support for academics and literacy, social skills, vocational training, for leisure time pursuits, and daily living. Whatever type of technology you choose for a child, it is important that the technology is not introduce as a toy and then expect that the child will be able to use it later only as a tool or learning device. In many cases, if a child has become acclimated to using the iPad for fun, it is often extremely difficult to have it function as a dedicated communication device as well. What is very effective, however, is having your child use whatever games/apps are fun for them. A child with autism can enjoy iPad for example the device has lot of different things that a child with autism can make used of it, this encourage the child to use their hands such as finger to play piano on iPad. I pad change children life and encourage with different things on it. 4.1 The concept of challenging behaviour. According to Emerson, (1995, p4) defined challenging behaviour as abnormal behaviour of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, be placed in serious jeopardy or behaviour which is likely to seriously limited use of, or result in the denied access to ordinary community facilities. Person showing this behaviour is not a problem to be fixed or someone doing something wrong that the behaviour is a sign that something is not working. It shows that there are some needs being unfilled or a problem with communication. In essence there is something going wrong that needs to be addressed not that the person doing something wrong who needs to be stopped. Behaviour is poor educational needs, challenging behaviour is a construct, every behaviour is meaningful people behave in particular way because they want something. People behave the way they do because they want to escape. People with autism spectrum disorder have difficulties when they want to communicates. This may be in understanding what other people are saying or being able to express themselves. Improving communication may be helpful in reducing or stopping challenging behaviour. Communication problem in difficulties are the following, understanding skills being over estimated. Difficulties when given too much language to process. Difficulties due to hearing problem. Difficulties understanding abstract concepts (things that cannot be seen or touched), negative (e.g., not, don't) and time concepts (e.g., yesterday, this afternoon) communication sent a message to others. Difficulties in producing clear speech. Lack of words need to send a message. Using the right words but wrong other. For example a 3years old girl who was diagnose of autism, she was present with challenging behaviour, hate herself, no eye contact and none verbal as well. Because of many sensory issues, showing tantrum, shouting, screaming and heating people. She spent hours steaming being repetitious in her own world. Helping her to recover will required to learn who she was by copying her in her own world. Learning how to make her speak and make eye contact, she will gradually recover from autism. 4.2 Describe some potential impact of challenging behaviour on health and social care organisation. The health and social care field where help is needed to support in changing or adopting behaviour to enhance the quality of their lives. This will include, Prompting or encourage someone to seek advice from a health professional from the following disease such as cardiac vascular disorder, high blood pressure, stress and lack of exercise, excessive smoking and alcohol. Provide support and understanding especially when they are having difficulties it raises concern. Changing takes time, you cannot make them to change in your own reaction it can be frustrated. People behaviour makes us feel incompetence in hat mood, when feel that way our emotion taken over. Higher level of staff turnover because of their angry problem due to their emotion feeling. Nowadays is very clear violence in any form physical or emotion towards staff is not acceptable. Staff needs not to fall in the same pattern of response. For example, they might feel anxious or bored, or in pain. If you can recognise the early warning signs, you may be able to prevent behavioural outbursts. For example, if being in a large group of people makes the person you care for feel anxious and they become agitated, you could arrange for them to be in a smaller group or have one-to-one support. Many organisations with learning disabilities or dementia they have strategies for coping with challenging behaviour. Some of these organisations also provide opportunities for carers to connect with other people in a similar situation for example, through family linking schemes. 4.3 Analyse intervention strategies for dealing with challenging behaviour. Cognitive behaviour therapy can help to change how you think ('Cognitive') and what you do ('Behaviour'). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now. One example could be someone who, after making a mistake, thinks "I'm useless and can't do anything right." This impacts negatively on mood, making the person feel depressed; the problem may be worsened if the individual reacts by avoiding activities. As a result, a successful experience becomes more unlikely, which reinforces the original thought of being "useless." In therapy, the latter example could be identified as a self-fulfilling prophecy or "problem cycle," and the efforts of the therapist and client would be directed at working together to change this. This is done by addressing the way the client thinks in response to similar situations and by developing more flexible thought patterns, along with reducing the avoidance of activities. If, as a result, the client escapes the negative thought pattern, the feelings of may be relieved. The client may then become more active, succeed more often, and further reduce feelings of depression. According to (Dr J.Reaven) state that cognitive behaviour therapy can be delivered in a variety of ways: individual, family, group, or even family and group. The advantage of group cognitive behaviour therapy is that individuals with autism spectrum disorder learn that others are struggling with the same issues, and they begin to overcome them together. Friendships and social support gained through this process may be healing in themselves. Advantage of family cognitive behaviour therapy is that it involves parents, educating them about their child’s challenges and teaching them to encourage use of cognitive behaviour therapy techniques when real life situations confront their child. This can make them feel more hopeful and confident in their ability to contribute to positive change in their child’s life. Researchers have found that one issue that can be particularly tough for parents of children with autism spectrum disorder is how much to shield or protect them from potentially negative experiences. The children often have a history of emotional and behavioural challenges and of real and painful failures in the world. Parents are reluctant to expose their child to any more failure, and may unwittingly limit exposure to experiences that are necessary to help the child become more independent and less anxious. Visual support such as photo, symbols, written list or physical objects can really help people with autism. Visual supports like egg timers can help some people with autism to understand abstract concepts like time, plan what they need to do and when in order to complete a task. For example you can try using calendar, so that the person will know how many days before Christmas. Using social stories could be helpful, these are short stories with pictures that describe different situations and activities that people with autism will know what to expect. If we create right environment for them to flourish, then we are getting amazing people to do amazing things for health and social care settings. It’s not just the money issue, or more about being the same as everyone else having the same opportunities. The support that people with autism syndrome or aspergers syndrome really need is regard to their social skills. This is very important for government department because in looking at autism it raised a range of issues that actually get to the heart of how modern public services are delivered. Supporting through building a rapport and relationship to individual client. Some people with autism have daily time table so that they know what is going to happen. However, Person centred planning is a process for continual listening and learning, focussing on what is important to someone now and in the future, and acting upon this in alliance with their family and friends. The need for routine and sameness can extend beyond this, you might see people dependence on routines can increase during times of change, especially at my place of work. At the day centre when staff realised it is nearly home time and putting their coat on, client behaviour change because is time to go home. Although communication plays a big part in person lives diagnostic of autism spectrum disorder for them to be able to express what they want. Difficulties with communication affect most people unable to explain themselves in terms of their needs. Biomedical intervention and speech and language therapy plays a big part too in their life. Biomedical helps when it comes to medication and food nutrients in this area and improve life. Speech and language therapy helps when it comes to communication by drawing and using pictures clues. Nowadays the impact of technology in health and social care setting has make lot easier and brings back better quality of life. Working with learning disabilities people has broaden my knowledge of understanding on how they behave and communicate by using sign language. Reference Autism Education Trust, (AET) what is autism. Available at: Available at: http://www.autismeducationtrust.org.uk>about AET. BRITISH INSTITUTE OF LEARNING DISBILITIES. Available at: http://www.bild.org.uk/Easysiteweb/Gatewaylink.aspx. Biomedical treatment for autism success by Larry D Cook, (2014). Healthy life style author, film maker and coach. Available at: http://www.biomedicaltreatmentsforautism.com. Community Care Inspiring Excellence in Social Care. Winter Bourne view, “a case study in institutional abuse. Available at: http://www.community.co.uk/.../winterbourns-view-a-case-study-in-institution. 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