Several people have asked me recently if I could
share my take on what - from a developmental perspective - should go in an
Education, Health and Care Plan (EHCP) for a young person with autism.
First off, I would say that the developmental gaps
or core difficulties of autism are best addressed under the sections on
‘communication and interaction' and ‘social, emotional and mental health’.
Exact needs will depend on the autism profile of
the individual young person of course, but since the difficulties at the heart
of autism are usually more or less the same (otherwise the young person
wouldn't have a diagnosis of autism), the needs (Section B of the Plan) are
likely to look something like this:
Needs: Communication and interaction
Number
|
Need
|
1
|
Student
has difficulty making and maintaining friends
|
2
|
Student
is often rigid in his thinking and behaviour and has great difficulty
managing uncertainty and change
|
3
|
Student
is unable to take on board the different perspectives of others in order to
help to decide what to do in situations of uncertainty and/or to
problem-solve challenges
|
4
|
Student
does not read the non-verbal communication of others or use trusted adults as
a point of reference
|
5
|
Student
does not have the social competence to take part in reciprocal social
interaction
|
Needs: Social, emotional and mental health
Number
|
Need
|
6
|
Student
has severe difficulties with emotional regulation
|
7
|
Student
has difficulty staying within limits and accepting boundaries of adults
|
8
|
Student
can become easily distressed and agitated
|
9
|
Student
is unable to keep himself safe
|
10
|
Student
has great difficulty sleeping and is often awake in the middle of the night
|
So if those are the needs, then the outcomes
(section E) might look something like:
Outcomes: Communication and interaction
Number
|
Outcome
|
1
|
Student
will make progress towards mastery of the developmental milestones that lead
to competence in relationships
|
2
|
Student
will start to be able to manage gradually more complex
challenges/uncertainties, becoming more flexible and adaptive
|
3
|
Student
will work towards mastery of simple perspective-taking
|
4
|
Student
will make progress towards mastery of both reading and using the 5 channels
on non-verbal communication as well as mastery of social referencing
|
5
|
Student
will learn how to co-regulate (interact reciprocally) during social
interactions
|
Outcomes: Social, emotional and mental health
Number
|
Outcome
|
6
|
Student
will start to be able to take part in increasingly more complex cycles of regulation-challenge-regulation
|
7
|
Student
will be more able to accept limits and boundaries from trusted adults
|
8
|
Student
will be able to employ strategies that enable him to better handle his
periods of distress and agitation
|
9
|
Student
will be better able to understand the intentions of other people in order to
keep himself safe
|
10
|
Student
will be better able to settle himself if he wakes up in the night
|
……and then the provision (section F) to meet the
need (and lead to the outcomes) might look something like:
Support needed
|
Who delivers
|
Frequency
|
Review
|
Assessment
of student’s complex autism and anxiety
|
xxx
specialist service
|
Within
1 month of funding being agreed
|
Quarterly
against agreed outcomes
|
An integrated programme of:
|
|||
a)
Psychodynamic therapy
|
xxx
specialist service in conjunction with local CAMHS
|
Weekly
|
Quarterly
against agreed outcomes
|
b)
Relationship
Development
Intervention (RDI) in the educational setting
|
Teacher/TA
on a 1-1 basis, supervised by external RDI Consultant
|
Daily
for 1 hour
|
Quarterly
against developmental objectives assigned
|
c)
An RDI programme in the home
|
Parents,
supervised by external RDI Consultant
|
Twice
weekly each parent for 30 mins
|
Quarterly
against developmental objectives assigned
|
Bear in mind this is not the whole EHC Plan. I
have not addressed anything to do with young person’s views and strengths or
their cognition and learning. The sections on health and social care are
not addressed here either as I am simply focusing on the developmental aspects
but I would add that some of the mental health related needs could also be
flagged up in the ‘health’ section and some of the needs around developing
friendship competence, mastering perspective-taking, emotional regulation and
staying within limits could also arguably appear in the ‘social care’ section
as these would all be essential for the young person to be able to access
appropriate leisure opportunities in the community setting.
So what I have done here is to make addressing
social communication gaps (the ‘needs’ described in numbers 1-9 inclusive
above) crucial to the young person’s ability to access the curriculum and then
to show that RDI is the provision required to meet needs 1-9 inclusive.
I feel
like I’ve come full circle here. Regular readers of my blog might
remember this post from back in 2011 when I wrote:
‘In the education sector, even the most up to date
inclusion tools funded by government advocate compensating for or working
around the difficulties that pupils on the autism spectrum present with. There
is no mention of helping pupils develop flexible, adaptive thinking to help
them better access both the academic curriculum and the hidden social
curriculum.’
What I have described in the EHCP above in the
‘needs’, ‘outcomes’ and ‘provision’ will help pupils to develop flexible,
adaptive thinking and better access both the academic and hidden social
curriculum.
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