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Dáil Éireann debate -
Thursday, 25 Nov 1999

Vol. 511 No. 5

Adjournment Debate. - Services for Children with Disabilities.

I thank the Ceann Comhairle for giving me the opportunity to raise this matter on the Adjournment. Asperger's syndrome is a developmental disorder related to autism where a person has subtle but serious handicapping impairments in his or her communications and social skills and pursues a narrow range of interests and routines in an intense, obsessional manner. To the man on the street, a person with Asperger's syndrome may just appear to be odd, eccentric or irritating. Their most notable characteristics are the absence of friends and their tendency to have obsessional interests, be it astronomy, cars or Star Trek.

Sufferers have a serious lifelong disability which may be expressed as poor communications and social skills, clumsiness and hypersensitivity. The person frequently becomes deeply frustrated and may get paranoiac, depressive and violent, particularly when misunderstood. The individual sufferers, while in the autistic spectrum of disability, vary in the degree of severity of the condition but share common problems, for example, severe unease with society. They are frequently very unhappy and have extra problems from their teens to their late 20s. Their families carry a massive support burden, coping with behaviour which can be abusive and disabling, particularly without the intervention that is needed.

There is no accurate research of this problem in Ireland, but national and international statistics put the incidence of Asperger's syndrome at one person in every 300. The occurrence is considered six times more common than classic autism and there is an estimated 10,000 sufferers in the State. Although it is more than 50 years since this condition was identified in Ireland, we – in particular, the mid-west region – lag behind other countries in treating it. There is poor diagnosis of the condition and, in some cases, it takes more than ten years to diagnose it. There is also poor education and training, there are not any specialised services to allow development and growth of sensitivity to the needs of the sufferers of the condition and there is not any residential or sheltered living facilities.

The mid west region, with its concentration of teacher training, university employment and medical services is well placed to become one of the most appropriate areas to provide quality service for these people. The priorities are early diagnosis of the condition; appropriate education and training services geared to the special needs, especially of teenagers and young adults; small sheltered housing facilities with independent living, possibly for young adults; specialist services including medical, psychiatric, psychological and neurological, particularly for the 16 to 30 age group, which has the highest incidence of suicide; support for parents and families by meaningful respite facilities; and affordable conferences to inform and evaluate the current state of knowledge of the condition.

Each area should adopt a co-ordinated approach to the services needed by those who suffer from Asperger's syndrome. Such an approach should be facilitiated by setting up a task force to deal with the disability, involving local authorities to provide social housing, teacher training colleges, universities, the Department of Education and Science and other interested parties. In particular, there is a need for better education at school and training at cen tral level to allow development and growth sensitive to the special needs of these people. Smallscale residential services or sheltered housing should be provided to allow these people a certain amount of independence, which most people want in their late teens. There is also a need for appropriate respite care, structured and closely monitored work placement opportunities to encourage moves towards independence and support should be provided by psychologists, psychotherapists, social workers and psychiatrists on an ongoing basis to assist the families of the sufferers of this condition.

The people with this disability have suffered a great injustice in that they have been neglected over the past 50 years. We now have the knowledge, the resources and the possiblity to begin to right this wrong. By doing so, we would greatly improve the quality of life of thousands of sufferers and their families, but is there the political will to do that?

Given that this condition is suffered mainly by children and young adults, I ask the Minister of State to ensure that the necessary resources will be made available to assist these people, bearing in mind that Asperger's syndrome was first identified in 1944. I implore the Minister of State and his Department to bring this neglected area to the fore and to assist the children and young adults suffering from this condition and their families.

I thank the Deputy for raising this important matter and I respond to him on behalf of my colleague, the Minister for Health and Children, Deputy Cowen. Asperger's Syndrome is a relatively new syndrome and it is not yet clear whether it is an entity on its own or whether it represents one end of the autistic spectrum. As with persons with autism, persons with Asperger's syndrome have great difficulty with social relationships. They are, however, not so obviously affected in terms of communication and behaviours as those with autism.

In terms of treatment, the most important factor is early recognition and referral to the child psychiatric services. These is no specific cure available, but early diagnosis can lead to the provision of support and guidance for the affected child and his or her family. Likewise schools and teachers need to be informed of the condition so that appropriate remedial measures can be instituted. The recent expansion in the child psychiatric services has ensured that the condition is becoming increasingly recognised. However, because of its relative rarity an exact prevalence figure for Ireland is not yet available.

Persons with Asperger's syndrome may reach adult life without the condition being diagnosed. They may then present with adjustment problems and need the help of psychiatric services. There is not general agreement as to whether they require a very specialised approach or whether they should be treated on an initial basis within the generic services. Group therapy has been advocated by one authority as the best approach. There is no specific treatment available. Again as with children, the most important factor is that the diagnosis be made and various supports be put in place.

The provision of health related support services to persons with Asperger's syndrome is a matter in the first instances for the health boards. Given the possible link with the autistic spectrum, in some health board regions support for this group is being developed through the services for persons with autism. In particular, where children of school going age are identified, health related support services are provided, in the main, on an out-reach basis, in the same manner as those available to children with autism.

My colleague, the Minister for Health and Children, was pleased to be in a position this year to allocate additional funding of £1.5 million in 1999, with a full year cost of £2.5 million in 2000, for the further development of health related support services for children with autism. This funding has been used to enhance early intervention, pre-school and out-reach services for children of school going age. This multi-disciplinary support includes speech and language therapy, psychological, occupational and physiotherapy services, nursing and social work support.

The provision of educational services for children with special needs, including those with Asperger's syndrome, is the responsibility of my colleague, the Minister for Education and Science. He has expanded the range of services and supports provided by his Department for this group.

The funding provided this year was part of an overall package of £12 million in 1999, with a full year cost of £18 million in 2000, allocated to services for persons with an intellectual disability and those with autism for the development of a range of residential, respite and day care services.

Since his appointment as Minister for Health and Children, and despite the many competing demands that are made on the resources available to his Department, Deputy Cowen has consistently identified as one of his priorities the provision of additional residential, respite and day care services for people with an intellectual disability and those with autism.

The evidence of that commitment is demonstrated clearly by the level of additional funding, £53 million up to the end of 1999, increasing to £59 million in 2000, which the Minister has made available for these services since his appointment.

The accelerated provision of further additional resources for these services remains one of the Minister's highest priorities and is being pursued by him in the context of the Estimates process for 2000 and the national development plan. I am confident that the Government's budgetary measures for the coming year will have due regard to the levels of need that have been identified.

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