Improving access to social care for adults with autism


When I get to see someone ... I don't always understand what they are asking me. I don't give complete answers to their questions and they don't press for additional information. I get upset and often cry, then I feel stupid and they think I'm overemotional or exaggerating my symptoms.

Adult with autism (7)

Offering an assessment to someone who has, or may have, autism is a proactive duty for local authorities/trusts. In the past, many adults with autism, particularly those with Asperger's Syndrome or high-functioning autism, did not have assessments (26), and often those assessments that were carried out were in areas offering limited training in how to assess people with autism (27).

Assessing the social care needs of someone with autism should be done by a person with sufficient training and experience, and the forms that they use need to be sufficiently well constructed to capture the sometimes subtle needs that people with autism can have.

People with autism can find assessments perplexing. While this in part relates to the nature of autism, many carers we spoke to also found assessment processes confusing (50), so the issue is one that services should address.
Assessing someone with autism can be difficult, because people with autism:

Preparing in advance and flexibility towards the person with autism may help the assessment process capture the right information. If you are conducting an assessment with someone with autism (28):

You might also want to ask yourself (28):

While some of these examples are of specific relevance to people with autism, others are simply good practice in any social work or social care assessment.

There are also a number of issues often connected to autism, which an assessor should consider (28):

Consider risk factors that may arise from people's obsessions, dietary problems, social isolation, self-neglect, running/absconding, mental health problems, inappropriate sexual behaviour, self-harm and other factors. Consider too if the person with autism is also a parent or carer, and if so, how their autism affects how they care for the other person.

It is important to consider the impact of autism when assessing under the Mental Capacity Act 2005 or the Mental Health Act 2007. For example, someone with autism may have good theoretical knowledge about an issue and appear to have capacity, but in fact are not able to retain or weigh up the information.

For more tips on communicating generally with people with autism, see the Making services accessible and acceptable - Frontline staff subsection.

* In Northern Ireland, the DHSSPS 'Circular HSC (ECCU) 1/2010: Care management, provision of care and charging guidance' applies (not FACS).

Further reading