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Department of Health

Think autism: updating the 2010 adult autism strategy

4. “I want the everyday services that I come into contact with to know how to make reasonable adjustments to include me and accept me as I am. I want the staff who work in them to be aware and accepting of autism.”

For many people with autism, mainstream public services can be hard to access.  Some of this is due to a lack of understanding of autism among staff but this is not the only factor. Many people with autism are hypersensitive to light and noise; they can have significant difficulties with communication and can struggle with the formats, language or instructions in forms or standard letters. Yet people with autism have a right to access mainstream services just like anyone else. This is, at its heart, about equal rights. Under the Equality Act 2010, all public sector organisations are required to make reasonable adjustments to services to ensure they are accessible to disabled people, including to people with autism.

Adults with autism should be able to benefit fully from mainstream public services to live independently and healthily, including access to appropriate housing to meet individual needs. Without reasonable adjustments many services can be inaccessible for adults with autism. Reasonable adjustments can include:

  • premises – taking account of hypersensitivities and providing quiet or lower-light areas;
  • processes – scheduling appointments at less busy times, allocating extra time to adults with autism and being flexible about communication methods, for example, less reliance on telephone-based services;
  • communications – avoiding ambiguous questions, not pressurising adults with autism in conversation and being aware of sensitivity to touch; ensuring essential documents and forms are available in accessible formats, in particular, easy read versions and formats that take account of sensory issues in their choice of colours;
  • planning and preparation – offering opportunities for adults with autism to visit settings in advance to familiarise themselves with what to expect, for example visiting a court prior to giving evidence or an optician’s prior to an eye test.

Since 2010, a number of guides have been published on making reasonable adjustments, including making GP practices and mental health services accessible. Some are listed under useful resources.

Reasonable adjustments may also include using new technology to help  increase and maintain independence.  This includes equipment to help people who have problems with speaking, hearing, sight, moving about, getting out and about, socialising, memory, cognition (thought processes and understanding) and daily living activities such as dressing and preparing meals. All service providers have an Equality Act duty to make reasonable adjustments and should think about technological enablers as part of this. Providers of specific specialist services to people with autism should be exploring the use of assistive technologies with the people they support to help develop their confidence, sense of achievement and independence. We would encourage applications for the Autism Innovative Fund which include innovative uses of technology.

One of the things many people find both frustrating and distressing is having to tell their story and explain what adjustments make a difference to them over and over again. Autism Passports are a simple adjustment which allow people to carry with them information about themselves. They can play a very important role in enabling a person to share with services what adjustments they need. DH will work with Baroness Angela Browning, NAS and others to look at how to promote Autism Passports and will report to the Autism Programme Board by the end of 2014/15. (Action 10)

Claiming social security benefits

DWP is ensuring that reasonable adjustments are made to the process for claiming social security benefits for people with autism.  The claims process for Personal Independence Payments (PIP) has been developed through extensive engagement with disabled people and disability organisations and has been designed to reflect their views. DWP recognise that for some individuals, for example, those with conditions like autism, attending a consultation in an unfamiliar place could cause anxiety.  So, when attending a face-to-face consultation, people can bring a relative, friend or a professional who supports them to help manage any anxiety they may feel and who can provide additional information and explanations about the person’s difficulties. Key staff involved in making assessments for benefits should also receive training to ensure they understand the needs of people with autism. DWP also keeps the process for claiming Employment and Support Allowance under constant review to ensure it is as fair and effective as possible. The most recent independent review, conducted by Dr Paul Litchfield, made a number of recommendations about simplifying the claims process and improving the forms and letters used.  When making changes to policy or processes that are likely to have a particular impact upon disabled people, a full equality analysis is undertaken.  DWP will, in addition, continue to ensure that reasonable adjustments are made to the benefits processes so that they are accessible to people with autism.

Education settings

Adjustments in education settings, such as providing quiet or low-light areas, can benefit people with autism.  The Disabled Student Allowance supports people with autism with the academic aspects of university life. This includes funding a note-taker for lectures, electronic equipment and software, social skills training, travel training, and 1:1 support.

As well as making reasonable adjustments, to the physical environment, service providers should look at providing awareness training for all frontline staff to enable them to make reasonable adjustments to their services and behaviour. This will increase the accessibility of mainstream services for people with autism, and lead to better understanding of the condition.  We recommend high quality and autism awareness training should be included within general equality and diversity training programmes across all public services.

Equality and diversity training

DH will lead the way by ensuring that its equality and diversity training includes autism. Many people with autism feel that training should focus less on the theory of autism and more on giving staff an insight into how autism can affect people, drawing directly on the experiences and input of adults with autism and their families.  This would better enable staff to understand the potential behaviours of adults with autism in different settings. Good quality autism awareness training is developed and delivered in partnership with people with autism themselves.

We will aim that, by the end of 2014, staff in all Directorates in DH have had access to training on autism and will also work with DH’s arm’s length bodies on including autism in their equality and diversity training. (Action 11) We will ensure that guidance and e-learning products developed as a result of the autism strategy are publicised across other Government Departments. (Action 12)