I'm a clinical psychologist working in community learning disability team
in London. Hearing about this sort of situation is depressing. Despite
vaious government outpourings services are not becoming more 'person
centred'. In fact the fracturing and disaggregration of services in a
mixed economy of care means that there is less flexibility; various
automonous services just set their own rules and disabled people have to
try and fit them.
I've also seen how difficult it is for young people like Cathy to
negotiate the complex world of 'adult services' when they are moved on
from childrens services where education, health and social care are more
joined up.
However, a more practical answer to your query is that your friend will
probrably need to access an assessment through her local learning
disability team. My experience chimes with Larry that psychiatrists are
usually the ones who pronounce on autism issues, as autism is seen as an
psychiatric/developmental disorder and defined in psychiatric diagnostic
tomes such as DSM and ICD10. They might just use 'clinical judgement',
piecing information together from background information and someone's
current presentation, or they might use a diagnostic tool, such as the ADI
or DISCO. The reports by psychiatrists I've read vary a lot in
thoroughness and sensitivity. A clinical psychologist is more likely to
be asked to do an assessment of current abilities and support needs, maybe
including an IQ test. A learning disability social worker would then work
out what sort of support this young woman would need, and should find ways
to fund it. This is separate from DLA and could be arranged through
direct payments which means that Cathy and her family would receive the
money to pay someone they choose to help her, for instance with travel or
with her studies.
Another route might be to go to the GP and ask for a specialist assessment
from a reputable psychiatrist (Pat Howlin in London for instance) or the
National Autistic Society diagnostic service. Though sorting out the
funding for this can be complicated.
40 miles does seem a really long journey for anyone to do frequently.
Maybe an social worker, advocate or service broker can help Cathy and her
family look at different options.
Good luck, I'd be happy to do some more thinking about this with you if
you want to contact me off-list.
Deborah
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