Validated local practice details

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C4EO theme: Disability

The Early Communication and Autism Partnership (ECAP), Nottinghamshire

Themes this local practice example relates to:

  • Disability
  • General resources
  • Local area early intervention strategies

Priorities this local practice example relates to:

  • Improving the well-being of disabled children (up to the age of eight) and their families through increasing the quality and range of early interventions
  • Ensuring all disabled children and young people and their families receive services which are sufficiently differentiated to meet their diverse needs

Basic details

Organisation submitting example

Nottinghamshire County Council and Nottingham Regional Society for Adults and Children with Autism (NORSACA)

Local authority/local area:

Nottinghamshire Children’s and Young People’s Partnership

 

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The context and rationale

Background details to your example

We wanted to develop joint approaches to early intervention for young children with autistic spectrum disorder (ASD in order to achieve improved outcomes for children and their families. The partnership, initially a pilot in two areas of Nottinghamshire, was established at a time when there were increasing numbers of very young children being identified with autism, and concerns about the local authority’s capacity to meet the needs of this group of children and their families.

We aimed to:

• Provide prompt and integrated support.
• Increase parental confidence in their ability to understand and meet the needs of their children.
• Increase the confidence of staff in early years settings and schools to make appropriate and inclusive provision for children with ASD.
• Improve children’s educational progress.
• Ensure that as many children as possible would have their needs met successfully in their local communities.

The Nottinghamshire Local Authority (LA) Inclusion Support Service (ISS) Early Years team had, for many years, provided a successful early intervention programme for young children with complex additional needs. This programme involved home teaching and provision of advice, support and training for parents/carers and for staff in early years settings and schools. Evaluations from parents/carers and staff indicated that the most effective support was provided when agencies supporting the children and families worked in partnership with the parents/carers and with each other.

NORSACA’s Early Years Diagnostic Centre (now the Elizabeth Newson Centre) had undertaken a three-year action research project, developing the “Frameworks for Communication” approach - a diagnostic and intervention programme for very young children with autism. The outcomes of the project were published in the International Journal of Autism in 2002. Evaluation of the programme demonstrated significant progress in the children involved and high levels of satisfaction amongst the parents who felt empowered to work effectively with their own children.

A series of meetings between Nottinghamshire LA, NORSACA and local National Health Service (NHS) staff then took place to explore ways of enhancing and improving the co-ordination of services for pre-school children with autism, based on this specific approach, and also on the existing knowledge and experience of the ISS Early Years Team. This resulted in the setting up of the Early Communication and Autism Pilot.

 

The practice

Further details about the practice

The pilot programme provided a core service which consisted of:
• Initial assessment and a regularly updated individual programme.
• Weekly home visits lasting approximately two hours from a specialist member of the Early Communication and Autism Partnership (ECAP) team, who worked with the child using an interactive approach, and also helped the family to develop programmes and activities to carry out with their child on a daily basis.
• A series of eight to10 multi-agency parent workshops (once a week for approximately three hours each) led by members of the multi-agency team, where parents and carers learned together about how to improve communication with their child, shared their experiences with each other and benefited from mutual support.
• A series of booklets giving practical strategies, reinforced by advice offered in home visits and at the workshops.
• Support, training and advice to early years settings and schools, both before and after the children were admitted, to facilitate a successful transition and ensure that appropriate, inclusive educational provision was in place.

The pilot had an initial allocation of funding of £100,000 from central government (the Special Educational Needs (SEN) Small Programmes Fund). This enabled us to set up the project, provide some consultancy support, commission the external evaluation and meet some of the salary costs in the first year. In the second year, the LA funded two of the four specialist posts; the general Surestart Grant funded a third year; and the final year of the pilot was funded from the existing ISS Early Years budget by redeploying a member of staff to the programme.

The pilot initially operated in two areas in the south of the county, offering the core service to approximately 20 children with the most complex needs and their families.
In 2005, when the pilot became a partnership and was extended across the county, the additional five specialists were also redeployed from an existing LA Early Years Special Educational Needs Service. The staff received additional specialist training to support them in undertaking their new roles.

Other than staff salaries, the only other resource costs for ECAP are professionals’ time on the steering group and consultancy panels (provided free of charge by the services concerned), and a small amount of funding for ongoing consultancy advice for the specialist team. This is bought in from NORSACA, the voluntary organisation and specialist provider.

70 families who have a child under the age of 8 with Autistic Spectrum Disorder (ASD) benefited from the initiative at a cost of £375,862 in the 2009/10 financial year.

 

Evidence and evaluation - making a difference to children, young people and families

Evidencing your practice has made a difference to children, young people and families

The core service is now available to approximately 70 children and their families, with elements of the programme being offered to many more, dependent upon individual needs and circumstances.

Following an external evaluation by Sheffield Hallam University (see below), a decision was taken to establish ECAP as a county-wide service from September 2005 - approximately three years after the initial pilot. ECAP then became the Early Communication and Autism Partnership rather than Pilot.

On the basis of the results of an external evaluation (see below), the pilot has been extended across the county, so that children and their families can continue to benefit more widely from the practice.

An interesting development from the partnership between the LA and NORSACA, forged through the ECAP programme, has been the establishment of the Park Hall Autism Resource Centre, a resource that is shared and co-funded by NORSACA and the LA. This provides a team and administration base for autism specialists (including ECAP staff) in both organisations, and a training and resource centre for parents and professionals.

 

Sustaining and replicating your practice

Helping others to replicate your practice

An external evaluation of the ECAP pilot was undertaken by Sheffield Hallam University in 2004. This provided the evidence of success required to support the continuation of and extension of the approach across the county. (A copy of the report can be provided on request to C4EO.)

Inclusion rates for this group of children have improved since the commencement of the pilot. Around 95 per cent of children accessing the support have been successfully included in mainstream Foundation Stage provision. We consider this to be a significant achievement since these are children with the most complex needs.

The children’s progress is measured on a regular basis by the specialist worker. Again, we have seen some successful outcomes, particularly in the key areas of communication and social interaction. More detailed information on the most recent outcomes can be found in the ECAP Annual Report (2008). (A copy can be provided on request to C4EO.)

The families of the children participating in the pilot were consulted in the external evaluation and are also sent a questionnaire at the end of each year, asking them to comment on a number of aspects of the support they receive. In 2008-09, 100 per cent of the parents who responded judged the service to be good or better, and there were many very positive comments on the quality of the support they received and their increased confidence as a result of the intervention. Some of these comments are captured in the ECAP annual report (2008) referred to above.

The views of managers and practitioners from all the partner agencies, as well as specialists from the team, and staff from the early years settings and schools that some of the children attended, were sought and reported on in the external evaluation. Again, the feedback was, and continues to be, overwhelmingly positive.

Hot tips for others:

The following are key success factors to ensure the intervention works well:

• A multi- agency steering group with genuine commitment and a willingness to work in partnership from all members.
• Specialist staff to deliver a high-intensity intervention package, with access to an expert consultant and specialist providers in the area.
• Regular case reviews to ensure that provision remains appropriate.
• Flexibility from all involved to adapt to changing needs and circumstances.
• Clear criteria for involvement, and readily available and accessible publicity and information about the programme, especially for referring agencies.


The involvement of NORSACA, a highly regarded and trusted voluntary organisation, as a key partner, gave us additional credibility with professionals and parents alike.

The fact that this was, initially, a time-limited pilot enabled us to take risks and helped us to persuade more reluctant colleagues to engage, because if the approach did not work or had any undesirable outcomes, it would not be continued.

Special attention should be paid to maintaining momentum and ensuring that newly appointed professionals, at all levels, are aware of the programme’s aims and objectives; the referral process; and the successful outcomes already achieved, to ensure ongoing support and engagement.

The practice could be transferable to other contexts, although other authorities may not be in a position to engage so readily and/or successfully with a local, highly-regarded voluntary sector organisation that is also a specialist provider of services to children and adults with autism and their families.

The fact that LA and NHS boundaries were not co-terminous led to patchy sign up in some areas when the approach was extended across the county (for example, different levels of engagement from some speech and language therapists or paediatricians).

Initially we had some difficulty in obtaining consistent support and involvement from colleagues in social care, although this has improved since the establishment of Children and Young People’s Services in the county.

We also found that demand quickly outstripped supply and we have had to make our criteria for support clearer and more widely known. We have also needed to redesign our referral form to elicit the kind of information needed to identify whether a child/ family meets our criteria for support. We have adapted the approach to provide elements of the support where the full core service may not be appropriate for some reason. This includes time-limited input; consultancy and advice to generic support workers/ parents/ early years settings and schools; parent workshops and the provision of literature to parents/carers.


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