The management and support of children and young people on the autism spectrum is a complex, multifaceted endeavor that requires a thorough understanding of evidence-based practices. The National Institute for Health and Care Excellence (NICE) Clinical Guideline 170 provides a comprehensive framework for practitioners to enhance their skills and deliver optimal care. This blog will distill key recommendations from the guideline to help practitioners improve their approach and encourage further research.
Key Recommendations for Practitioners
Access to Health and Social Care Services
Ensuring that all children and young people with autism have full access to health and social care services is fundamental. This includes mental health services, regardless of intellectual ability or coexisting diagnoses. Practitioners should advocate for and facilitate this access to ensure comprehensive care.
Training and Competence
Practitioners must receive ongoing training in autism awareness and management. This training should cover behavior that challenges, risk assessment, and communication strategies. Enhancing knowledge and competence in these areas will significantly improve the quality of care provided.
Adjusting the Environment
Adapting the social and physical environment is crucial for minimizing negative impacts on children with autism. This can include:
- Providing meaningful visual supports
- Adapting personal space
- Considering sensory sensitivities to lighting, noise, and colors
Processes of care should also be tailored to individual needs, such as scheduling appointments to minimize waiting times and providing single rooms for certain medical procedures.
Family and Carer Support
Families and carers should be offered assessments of their own needs, including personal, social, and emotional support. Practical support such as short breaks, emergency plans, and future care planning are also essential. Engaging families in the care process can lead to better outcomes for the child.
Psychosocial Interventions
Specific social-communication interventions tailored to the core features of autism should be considered. These interventions should be play-based and involve parents, carers, and teachers to enhance joint attention, engagement, and reciprocal communication. The strategies should be adjusted to the individual's developmental level and delivered by trained professionals.
Behavioral Challenges
Practitioners should assess and address factors that may increase the risk of challenging behavior, such as communication impairments, coexisting disorders, and environmental changes. If no trigger is identified, a psychosocial intervention should be the first line of treatment. Antipsychotic medication may be considered when other interventions are insufficient or cannot be delivered due to the severity of the behavior.
Life Skills Development
Support in developing coping strategies and skills to access community services, including public transport, employment, and leisure facilities, is vital for children and young people with autism. This helps them integrate more effectively into society.
Coexisting Problems
Addressing coexisting mental health or medical problems with appropriate interventions is crucial. Cognitive Behavioral Therapy (CBT) may be considered for children with autism and anxiety who have the verbal and cognitive ability to engage. Adaptations to the method of CBT delivery, such as using written and visual information, can enhance its effectiveness.
Sleep Problems
Detailed assessment and management of sleep problems should be provided, including the development of a sleep plan and the use of medication if necessary. Referral to a sleep specialist may be required for persistent issues.
Transition to Adult Services
Reassessment of young people with autism at around age 14 is necessary to verify the need for continuing treatment into adulthood. A comprehensive assessment, including coexisting conditions, should be conducted, and a formal multidisciplinary meeting may be beneficial to ensure continuity of care.
Conclusion
Implementing the recommendations from the NICE Clinical Guideline 170 can significantly enhance the skills of practitioners and improve outcomes for children and young people with autism. For a deeper understanding and to explore further research, practitioners are encouraged to read the original research paper.
To read the original research paper, please follow this link: Autism: the management and support of children and young people on the autism spectrum (NICE Clinical Guideline 170).
