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Sharing practice: practice to achieve integration of services
The Act promotes integrated working across agencies, in assessment, intervention, planning, provision and review. The following practice examples focus on work that individuals can do to facilitate integrated working as well as on effective systems and structures that can be put in place to support it.
Collaboration between health, education and leisure helps children with disabilities access out-of-school activities
Children with physical disabilities often struggle to access out-of-school activities and consequently miss out on opportunities for physical activity and social interaction. A collaboration between physiotherapists, occupational therapists and education and leisure resulted in the creation of several trampolining groups in local leisure centres. The project is part-funded by the NHS. The funding shortfall was made up from budgets held by local active school co-ordinators who also helped by booking the venue and a sports coach. The coaches' knowledge of trampolining skills combined with the therapists' knowledge of the children and their difficulties enabled these sessions to be very effective as well as fun for the children. The children were able to work on their therapy goals outwith a therapy/health environment by participating in a very normal activity in a local setting. It also demonstrated to leisure centre staff that children with a physical disability can still participate in active sessions. Several of the children went on to join regular trampolining sessions at the leisure centre. For further information email: katy.boocock@hpct.scot.nhs.
Collaboration between professionals to help ensure children are meaningfully involved in decision-making
This example, which focuses on one individual case study, demonstrates how collaboration by different professionals can ensure children are involved in decision-making about their learning needs. Professionals working with two pupils, both of whom had complex learning needs due to cerebral palsy, felt their use of ICT and augmentative and alternative communication ( AAC) should be explored further. They wanted to seek, and act on, the young people's views. The following steps were taken:
- A speech and language therapist trained teachers at the pupils' school to use 'Talking mats', a communication tool that uses pictures and symbols as the basis for communication.
- The teachers then trained the two pupils to use the tool.
- 'Talking mats' was used to ascertain the young people's views.
A discussion using the 'Talking mats' tool to ascertain the pupils' views was led by the speech and language therapist and recorded by the Assisted Technology Support Service for possible inclusion in a later meeting. This level of preparation meant that both pupils attended their meetings feeling empowered and confident that their views would be included and taken into account. The professionals involved believe that a more strategic approach is required at national level to the training of education providers in alternative methods of communication for children with communication difficulties. Visit www.talkingmats.com for more information on the 'Talking mats' technique.
Primary and secondary integrated schools' practitioner forums facilitate multi-agency working
An integrated schools' practitioner forum has been set up in Coatbridge involving health and social work representatives, secondary school staff, home-school partnership officers, police and the additional support needs support manager. The forum meets approximately every three months to share practice and information. Recent discussions have focused on transition groups run by social work, initiatives being run by community police and new ways of working by the school nurse. The area's additional support needs support manager has a coordinating role and places particular emphasis on joint working, supporting transitions, sharing information in order to reduce paperwork at meetings and developing joint training. A primary forum has now been established and an inaugural meeting held which focused on a reading initiative where parent support workers worked with parents to support a reading recovery programme. Area learning support staff attended the meeting along with primary head teachers, home link workers, social workers and a health representative. For further information email: roma.french@ea.n-lanark.sch.uk.
Interagency management plans for visually impaired children
CVISTA is an interagency group of professionals in Tayside working in a coordinated way to provide services for children with visual impairment and their families. There are three CVISTA teams - one in each of the local authority areas, which comprise professionals from health, education, the Forfarshire Society for the Blind, Guide Dogs for the Blind and Parent to Parent. They meet once each term to discuss, with parents' consent, the visual needs of individual pupils. The purpose of the meetings is to provide interagency management plans for each child who has a visual impairment, to regularly review and update these plans, and to look at the policy and practice of interagency team working. The CVISTA model enables the agencies providing services to children with a visual impairment to fulfil their duties under the Act. The interagency management plan informs the child's individualised educational programme or coordinated support plan and supports schools in their responsibility to ensure that the appropriate additional support is in place for individual children.
For more detailed information on CVISTA, a leaflet is available from the Angus Council website: www.angus.gov.uk. To obtain a sample interagency management plan, email ASLAct@scotland.gsi.gov.uk quoting ref: ISdoc5.pdf.
Local multi-agency forums - a 'bottom-up/top-down' model of integrated working
Local multi-agency forums of children's services practitioners including headteachers, deputy headteachers, health visitors, school nurses, therapists, and family support workers, have been operating in Midlothian for three years. They co-ordinate support for all children with additional support needs and build capacity within children's services. They provide local multi-agency support on the basis of need and are described by those involved as "a robust 'bottom-up/top-down' model of integrated working of children's services". Four integration managers manage two forums (0-12 years and over 12 years) for each local area, each of which meet every six weeks. The forums focus on providing practical support for children and their families through:
- Strengthening the staged system of multi-agency assessment and planning
- Promoting multi-agency training and joint working
- Allocating/commissioning support from a range of agencies and services
- Supporting an additional support needs resourcing strategy, which has been introduced for all schools based on a formula rather than an audit basis
- Strengthening transitional arrangements
- Increasing co-location at practitioner level
- Encouraging the reframing of services to provide responsive local units of operation eg support for learning teams, therapists, school nurses, family support workers, social workers
School improves communication between professionals and parents to achieve better outcomes for a child
The following example, which focuses on an individual case study, shows the steps being taken by a primary school to meet a pupil's additional support needs and maintain a positive relationship with his parents. The child has an attention disorder, which impacts on his behaviour and ability to form relationships both in and out of school. His parents were becoming increasingly concerned and requesting more and more tests and observations. The school was concerned that the relationship between the two parties would break down. Steps taken to maintain a positive relationship include:
- Informal weekly contact with the mother when she brings in medication for her child
- Paperwork, completed by the class teacher, to reassure the mother that her child's medication is being administered correctly and on time
- Good communication between the class teacher, additional support for learning auxiliary and headteacher to ensure the child's needs are met in class
- Regular review meetings are held within school to which all support providers are invited. The minutes of each meeting are shared with all involved with the child, including his parents
- Family sessions, set up by support providers, to take forward points raised at reviews
- The school has joined an advocacy service through Children in Scotland. Visit www.childreninscotland.org.uk/html/serv_adv.htm for further information on the service
- A daily diary is sent home with the child, including reminders about homework, notes on the work the child has done at school and notes on how the day has gone
Those involved have cited difficulty in finding time to write up the minutes of meetings and changes of staff, which makes information sharing difficult, as challenges that need to be addressed.
Professionals from across sectors collaborate to run a parent support group
A school in North Lanarkshire hosts a pre-two parent support group for parents of children who have been diagnosed with complex needs. The group is run with support from physiotherapists, speech and language therapists, a school doctor, school nurses, home visiting teachers, social work, and advocacy groups. The group meets once a week for two hours and there is also a fortnightly information meeting with creche facilities where parents can find out about additional support services and benefits such as those provided by voluntary organisations. The purpose of the group is to support families and children, identify appropriate support, help them come to terms with their child's disability, provide hope and raise expectations and provide peer support. For further information email: ronalogan@redburn.n-lanark.sch.uk.
'Local area co-ordinators' co-ordinate multi-agency support for children with additional support needs
Fife Council has employed two local area co-ordinators to support individuals with disabilities to live in supportive communities. Part of their role involves co-ordinating support for children with additional support needs.
If a family knows that their child will be moving schools, changing classes or have concerns regarding the issues surrounding the record of needs and co-ordinated support plan, they are encouraged to contact a local area coordinator as soon as possible and not wait until a crisis has developed. This gives the coordinator time to get to know the child and their family by meeting them informally and spending time listening to what they have to say as well as explaining clearly what their remit is. If the family is in agreement, the coordinator will make him/herself known to any other professionals, organisations or people involved with the family. This may be a neighbour, a family friend, a relative, people in a voluntary organisation, social worker, educational or clinical psychologist, school staff and others. One of the co-ordinators said she has found that families are often intimidated, uninformed and do not know who to call to discuss and resolve concerns. Yet their requests are usually practical, realistic and achievable with a little creative effort on the part of those involved. Co-ordinators can use their expertise to facilitate either an informal get-together of relevant people or a more formal meeting. It is their role to support the family, and any others involved, to achieve the most positive outcomes. This might involve providing support to other people or communities involved with the family to make these possible.
Further information on the role of local area coordination can be found in the publication 'Making Connections: Stories of Local Area Co-ordination in Scotland', published by the Scottish Consortium for Learning Disability. Email: administrator@scld.co.uk.
School inclusion team and integration team co-locate to develop new curriculum programme
The inclusion team and integration team at a secondary school in East Lothian have worked together to develop and deliver an enhanced curriculum programme for pupils with a wide range of additional support needs. Crucial to the programme's success was a change in space, which allowed both the inclusion team and integration team to be based in one room together.
The programme explores different ways of working with students in a school environment. Those involved said bringing together pupils with a wide range of needs, including low self-esteem, challenging behaviour, low attendance and autism, rather than creating "a bad boys club", has also been crucial to its success. The pupils attend different sessions in different groups of four or five dependent on their timetable thereby eliminating the stigma that is often associated with a single large group. The programme includes a number of health promotion courses, anger management, conflict resolution, and offers the opportunity to complete the Duke of Edinburgh Award. This year, its pilot year, 11 of the 17 pupils receiving the enhanced curriculum programme achieved the Duke of Edinburgh Bronze Award. For further information email: lgillies@dunbargrammar.elcschool.org.uk.
CAMHS works to raise its profile among teaching staff
The Child and Adolescent Mental Health Service ( CAMHS) in East Glasgow held a series of information sessions for teaching staff following introduction of the Act. Its aim was to improve teachers' knowledge of their work, the system, and the referral process. The service also developed a new referral form, specifically for use by schools. The work was arranged through liaison teachers in the area's learning communities and a survey revealed that 20 out of 28 school representatives were unaware of the existence of their local CAMHS. These information sessions were extremely useful in terms of networking and promoting the local CAMHS service. For further information email: Helen.cupchunas@yorkhill.scot.nhs.uk.
Guidance to raise awareness of speech and language therapy among teaching staff
A document has been jointly produced by Glasgow City Council and NHS Greater Glasgow to provide information on speech and language therapy services to mainstream educational establishments. The intention is to promote a shared understanding of the role and remit of the therapist, how education staff can access advice and how and when to refer, in order to promote effective working relationships. The document, Working Together with Speech and Language Therapy Service, will be amended as changes occur. As at January 2007, the guidance is in draft form. Email: Irene.Grant@glasgow.gov.uk for further information.
Wallet-sized guide to improve social workers' knowledge of the Act
Concern that social work professionals lacked understanding of their role in the context of the Additional Support for Learning Act and of its implications was raised at a meeting reviewing the HMIE report on the implementation of the Act. This led the additional support for learning working group in Moray, a multi-agency forum, to decide to provide every social worker with clearer guidance in an accessible format. As at January 2007, a diary-sized pamphlet has been devised and circulated to the social work team leaders. A wallet-sized guide to the Act is being devised as a tool for all social workers in spring 2007, following feedback from the pamphlet. A similar process has been developed for colleagues in Housing. Its success will be closely monitored. To obtain a copy of this pamphlet, email ASLAct@scotland.gsi.gov.uk quoting ref ISdoc2.pdf.
Co-ordinated support plan reporting system designed for use by all agencies
A co-ordinated support plan ( CSP) officer set out to create a simple reporting system that could be used by schools and all other agencies when completing CSPs for pupils. Using previously opened records of need as a source for commonly used terms (including factors, educational objectives, additional support required and persons providing additional support), return forms were produced by the CSP officer. The forms were shown to health professionals and social workers for consideration, comment and ideas for additional inclusions. Involving allied professionals in the process was appreciated and well received. Both agencies have been involved in refining the menu of terms used. While the exercise was designed for CSP reporting, this simple format for reporting is being considered to cover all cases where support is planned for children and young people with additional support needs.
Multi-agency social communication group supports pupils with social, emotional and behavioural difficulties during transition
A speech and language therapist and behaviour support teacher set up a multi-agency social communication group to help pupils with social, emotional and behavioural difficulties in a small rural primary school increase their skills and to support their transition to S1. The group ran over 12 weeks in the primary school. Strategies to support the pupils' emotional state and resilience were devised after seeking advice from a primary mental health worker. A home-link worker also participated in later sessions. A further group run by the behaviour support teacher and home link worker then followed in the secondary school.
Successful outcomes reported included:
- Increased awareness among the pupils involved of what to expect at secondary school, issues related to making friendships, and of social communication skills, eg turn taking, understanding facial expressions and linking these to emotions
- Increased awareness among staff at the secondary school of the pupils' needs
- Ongoing assessment, which resulted in referral and subsequent diagnosis of Asperger's Syndrome for two pupils
The team is now working on developing a pre and post evaluation tool. They stress that establishing dedicated collaboration time at all stages, eg planning, running, then reviewing the group, involvement of the local school staff, and establishing links with the curriculum is crucial to the success of this initiative. For further information email: Liz@lduthie.freeserve.co.uk or eilidh.ros@nhs.net
Independent case workers facilitate multi-agency working to improve outcomes for looked-after children and young people
This example demonstrates how an external agency can promote multi-agency working across professions to achieve better outcomes for looked-after young people. SWIIS Foster Care Scotland said it now recognises how difficult it was to achieve a seamless transition for looked-after young people who transfer to a new local authority area. SWIIS case workers have found that simple steps to improve communication between the two authorities can significantly improve the process of transition. Contact is made first with the education officers in both the home and receiving authority to gather information regarding previous schooling, placement schooling and to obtain contact details for those involved with the young person. A meeting is arranged, which brings together the headteachers, deputy headteachers and other relevant education personnel from both the home and receiving authorities. It is also attended by the young person's educational psychologist from their home authority and their SWIIS case worker. One particular transition case brought professionals together from Renfrewshire and Falkirk. Not all young people attend this meeting because of the complexity of their needs but they are always consulted before and afterwards. The SWIIS case worker continues to support the young person once the transition has been made. Visit www.swiisfostercare.com/scotland/default.asp for further information.
Multi-agency post-school planning group produce guidance for school leavers
A post-school planning group was established by Fife Council's education service comprising representatives from across different agencies and council departments, to produce guidance on arrangements for school leavers who have additional support needs. Its purpose was to establish the role of each agency in the transition process. The published guidance was launched in January 2006. To obtain a copy of this guidance, email ASLAct@scotland.gsi.gov.uk quoting ref: ISdoc1.pdf.
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