NHS Scotland

I wonder whom this site was meant for? www.nes.scot.nhs.uk/.../learning-resource-on-autism-spectrum-disorders.aspx   (I hope I transcribed this long winded URL correctly).

It links to http://asd.nes.scot.nhs.uk/  Trouble is the first chapter goes to five pages on the triad of Impairments. I blame NAS for this. The triad is a diagnostic tool not a definition of day to day life with the condition!  Then you look at the description of a young person with asperger syndrome: "difficulty in using speech for communicate wishes or needs" - clearly the report was written by an illiterate! Also read the case study "old child Harry" aged 10, and the many other case studies - are these helpful I wonder?

The advice on adults is more useful but lacks detail.

There's a section on stress: "the way in which patients with asd may display signs of stress and anxiety may not differ greatly from anyone else" is not a great start. They just explain standard stress indicators. So what is the point of writing a guide to helping autistic patients if this is the best they can come up with? But of course the Triad doesn't cover this, so it is hardly surprising.

On strategies for encouraging communication it says: "the impact of the triad of impairments, on the acquisition, use and understanding of language can be substantial in the patient with ASD".  The trouble is one minute they are describing a person with mild aspergers, the next it is someone with full severe autism - there seems to be no distinction. The training package is a hotch-potch of very badly written poorly understood derivative nonsense.

"The patient with an ASD who has good vocabulary and speech may still not use it to communicate"

Daily Life Skills: "children, and some adults, may present with particular problems in toileting, constipation and incontinence".

Females and ASD: this is actually better informed than most of the document - worth reading.

It is easy to understand lack of understanding amongst hospital staff with such poor and conflicting resources. I suspect they largely have the view, prevalent across the NHS, that they only treat severe cases, and treat milder cases as malingerers. That's how it comes over.

The contact is one Jane Cantrell, Programme Director, NMAHP, at 3rd Floor, Hanover Buildings, 66 Rose Street, Edinburgh EH2 2NN (NAS MODS am I allowed to post these details?) jane.cantrell@nes.scot.nhs.uk  I think if you've had the appalling treatment you describe, this is the person you need to take it up with, in the first instance.

But I persist in my opinion that the problem lies in using the triad of Impairments to define day to day living with autism. It should only be used as a diagnostioc tool to distinguish autism from other factors. It is grossly irresponsble to build patient support guidelines around the Triad.

Also why does Scotland always have to do things differently, just for the sake of it? Why not just use UK national guidelines. Re-inventing the wheel is more than likely to multiply misunderstandings.

I say that as a Scot, born and raised and educated there, just nowadays live south of the Border. There this notion "whaur's like us?" that leads particularly to not doing things the English way. But in trying to be different, all to often the outcome is wrong. And there are high-ups in Scotland just wont be told that they are totally in the wrong - its a Scottish hang-up not being able to control some idiots at the top.

I wonder whom this site was meant for? www.nes.scot.nhs.uk/.../learning-resource-on-autism-spectrum-disorders.aspx   (I hope I transcribed this long winded URL correctly).

It links to http://asd.nes.scot.nhs.uk/  Trouble is the first chapter goes to five pages on the triad of Impairments. I blame NAS for this. The triad is a diagnostic tool not a definition of day to day life with the condition!  Then you look at the description of a young person with asperger syndrome: "difficulty in using speech for communicate wishes or needs" - clearly the report was written by an illiterate! Also read the case study "old child Harry" aged 10, and the many other case studies - are these helpful I wonder?

The advice on adults is more useful but lacks detail.

There's a section on stress: "the way in which patients with asd may display signs of stress and anxiety may not differ greatly from anyone else" is not a great start. They just explain standard stress indicators. So what is the point of writing a guide to helping autistic patients if this is the best they can come up with? But of course the Triad doesn't cover this, so it is hardly surprising.

On strategies for encouraging communication it says: "the impact of the triad of impairments, on the acquisition, use and understanding of language can be substantial in the patient with ASD".  The trouble is one minute they are describing a person with mild aspergers, the next it is someone with full severe autism - there seems to be no distinction. The training package is a hotch-potch of very badly written poorly understood derivative nonsense.

"The patient with an ASD who has good vocabulary and speech may still not use it to communicate"

Daily Life Skills: "children, and some adults, may present with particular problems in toileting, constipation and incontinence".

Females and ASD: this is actually better informed than most of the document - worth reading.

It is easy to understand lack of understanding amongst hospital staff with such poor and conflicting resources. I suspect they largely have the view, prevalent across the NHS, that they only treat severe cases, and treat milder cases as malingerers. That's how it comes over.

The contact is one Jane Cantrell, Programme Director, NMAHP, at 3rd Floor, Hanover Buildings, 66 Rose Street, Edinburgh EH2 2NN (NAS MODS am I allowed to post these details?) jane.cantrell@nes.scot.nhs.uk  I think if you've had the appalling treatment you describe, this is the person you need to take it up with, in the first instance.

But I persist in my opinion that the problem lies in using the triad of Impairments to define day to day living with autism. It should only be used as a diagnostioc tool to distinguish autism from other factors. It is grossly irresponsble to build patient support guidelines around the Triad.

Also why does Scotland always have to do things differently, just for the sake of it? Why not just use UK national guidelines. Re-inventing the wheel is more than likely to multiply misunderstandings.

I say that as a Scot, born and raised and educated there, just nowadays live south of the Border. There this notion "whaur's like us?" that leads particularly to not doing things the English way. But in trying to be different, all to often the outcome is wrong. And there are high-ups in Scotland just wont be told that they are totally in the wrong - its a Scottish hang-up not being able to control some idiots at the top.