Joint Committee on Autism díospóireacht

Autism Policy: Discussion (Resumed)

An Cathaoirleach

I welcome everyone to the meeting. Apologies have been received from Senator Ardagh.

Before we start our businesses, I will read out some formal notices. All those present in the room are asked to exercise personal responsibility to protect themselves and others from the risk of contracting Covid-19. I remind members of the constitutional requirement that members must be physically present within the confines of the place where Parliament has chosen to sit, namely, Leinster House, in order to participate in public meetings. I will not permit a member to participate where he or she is not adhering to this constitutional requirement. Therefore, any member who attempts to participate from outside the precincts will be asked to leave the meeting.

For the information of our witnesses, I wish to explain some limitations to parliamentary privilege and the practice of the Houses as regards references they may make to other persons in their evidence.

The evidence of witnesses physically present or who give evidence from within the parliamentary precincts is protected, pursuant to the Constitution by absolute privilege. They are reminded of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity by name or in any such way as to make him, her or it identifiable, or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity. Therefore, if their statements are potentially defamatory in respect of an identifiable person or entity, they will be directed to discontinue their remarks. It is imperative that they comply with any such direction.

I propose that the usual speaking arrangements will apply. Witnesses will make their opening statements for five minutes. This will be followed by questions from the members, with five minutes for each member, as per the speaking list that was circulated on Microsoft Teams. Our first session will run from now until 12.30 p.m. We will have a short break and resume for our second session. At the request of the Working Group of Committee Cathaoirligh, we will finish our meeting at 2 p.m.

I take this opportunity to raise a couple of other matters relevant to the committee. In November 2022, the committee published a report on the summer programme for 2023. Earlier in the month, we wrote to all special schools to inquire if they were taking part and, if not, why not. I encourage schools to answer if at all possible. We have a reply rate of roughly 50%. From my understanding and from speaking to the Department, there has been a significant increase in the number of special schools taking part in the programme. There is an increase of 50% on 2022, which is an additional 20 schools. We hoped it would have been higher. We thank those schools for coming forward to make sure we provide that programme, which is much needed by the children.

This committee has also called for the Houses of the Oireachtas to be transformed into an autism-friendly Parliament - one of the first in the world. Training courses have been organised, with our first session for Members just last Thursday. There are a number of online sessions organised, so I encourage everybody within the parliamentary community to attend over the coming months. I particularly thank Roisin Deery for her work on rolling this out in the Houses. I ask all members within their parties or party groupings to make sure all our Oireachtas Members and political staff undertake that training so we will achieve our goal that Leinster House will be an autism-friendly Parliament before the end of 2023.

The first item on the agenda is the minutes from our previous meetings. The question is that we approve the minutes of the meetings on 20 April, 25 April and 27 April 2023. Is that agreed? Agreed.

The second item on our agenda is the resumption of our consideration of autism policy. I welcome our first witness to the session, Mr. Adam Harris, founder and CEO of AsIAm. Our second session will take place at 12.30 p.m., where we will have representatives from the Irish Planning Institute and the National Disability Authority. Before we hear from the witnesses, I propose that we publish their opening statement and submissions on the committee’s website. Is that agreed? Agreed.

The remit of this committee is to consider matters relating to the services and support provided by the State for autistic people. The committee has considered a broad range of important topics concerning autistic children and adults alike. We are now reviewing the evidence provided by numerous people - representative bodies, State bodies, experts in various fields and other stakeholders. We are considering their recommendations to be included in our final report, which we plan to publish in the first week of June of this year.

Mr. Harris, founder and CEO of AsIAm, needs no introduction. We met him on 17 May 2022 – one year ago tomorrow. That was the first session where we met Mr. Harris. He provided us as members with training before we started into our work programme over the past 12 months. He addressed the public meeting on 12 July and our session in the Seanad Chamber on 2 March. He is core to the programme of Leinster House being transformed into autism-friendly building. I thank him for his support with that project, which had its first session here on Thursday. We heard very complimentary remarks from Oireachtas Members afterwards. We look forward to working with him and the team over the next number of months in achieving our goal before the end of 2023.

This is the 48th meeting of this committee and the 19th public session. We are looking forward to hearing Mr. Harris’s views on issues and how they can be addressed in the future. I ask him to highlight issues in any areas we have not covered. I call Mr. Harris to make his opening statement.

Mr. Adam Harris

I thank the committee for the invitation to appear before it once again and for the very extensive engagement we have had with it, both collectively and in terms of engagement with individual members, since its establishment last year. This committee has worked hard to put the voices of our community front and centre. We appreciate and warmly welcome the positive, solutions-focused approach.

In contributing to today’s session, AsIAm hopes to draw the committee’s attention to several key issues and priorities as members begin the challenging work of distilling the extensive insight they have garnered into tangible recommendations that will deliver real change on the ground for autistic people. As a starting point, perhaps it is useful for me to point to our recent Same Chance report, which was published to mark World Autism Month. The Same Chance report provides something of a state of the community report or insight into what life as an autistic person is like in Ireland today. It paints a stark picture. More than 1,603 autistic people are represented within the report and 90% of people do not think the Irish public understands enough about autism. Some 91% believe that being autistic is a barrier to being accepted by and making friends with others. Some 38% believe they have experienced discrimination in the past 12 months on the grounds of being autistic. Some 61% do not believe the education system is inclusive and 75% shared this view in respect of the health system. Some 61% have experienced barriers to accessing mental health services on the ground of being autistic and 68% are on waiting lists to access services. This is just a snapshot of an extensive report that is available on our website. Perhaps the most startling statistic in it is 86% of people who are autistic do not believe they have the same chance in Irish society. That is why the work of this committee is so important. It is about ensuring that autistic people have the same chance in every aspect of Irish society, no more or no less.

We accompanied this work with an attitudes to autism survey in which we polled a representative sample of 1,000 Irish adults. We see positive increases in awareness, for example, 80% of people are now aware of autism as a clinical diagnosis and more than half of the community now knows somebody who is autistic. Interestingly, 46% of people point to a family member, either in their immediate family or their wider family circle, who has an autism diagnosis. However, less than half have a good understanding of autism. The reality is that while people who know autistic people are more likely to point to positive attributes of being autistic, there are still worrying stereotypes within the community about autistic people. This is important to the ambition of this committee’s report. There is a very significant recognition of the barriers our community face, with 57% of the general public recognising that autistic people are treated negatively in a different way.

Having painted that backdrop, at this stage in the committee’s proceedings, it is the best use of members’ time for me to go straight into some specific perhaps guiding points around the drafting of the recommendations of the committee. The first is that implementation is key and only appropriate legislation will deliver it. A recurring theme and point of discussion throughout the committee's work has been the importance of implementation. Many members of our community can point to numerous policy initiatives over the years that were promising and that reflected community priorities but that sadly simply never became reality. They became reports gathering dust on shelves. I know that this committee is determined that this will not be allowed to happen this time around. The strongest tool to at least monitor implementation would be the passage of legislation along the lines of Malta’s autism empowerment Act from 2016. To be clear, the latter is not designed to address every issue facing the autistic community, nor is it designed to create a new schedule of rights for autistic people over and above what exists for other disabled people.

This legislation would simply require the State to publish an autism strategy at regular intervals, to involve autistic people in the process of drafting and monitoring the implementation of the strategy and to require the relevant Minister of the day to report on progress annually. We know it is not uncommon for the State to have overarching strategies for broad policy areas, with specific strategies or focuses where they are clearly required.

It is reassuring for us to see broad political support for a national autism strategy and the work of the Minister of State, Deputy Rabbitte, in the proposed forthcoming autism innovation strategy. However, we know it has faced significant opposition from Government Departments in the past and we are concerned that a general election could see this go right back to day one unless the initiative is protected by legislation. We also know there is strong support for this within the general public, with 75% of the Irish public answering "Yes" to the question “Ireland should have a law in place to ensure we have a National Autism Strategy”. Unsurprisingly, 96% of autistic people share these views.

We also would say it is important that the committee align its recommendations with the broader landscape of disability policy and planning, particularly in the sphere of autism. We are conscious that several important pieces of work are taking place, including the Government’s forthcoming autism innovation strategy and the HSE's autism programme board, which is based on the HSE review of autism services in 2017. It is important that the committee consider these two pieces of work in any recommendations it might make so as to avoid conflicting plans or a watering down of any solutions. Whatever recommendations are made, it is critical that they are rights-based, human rights-compliant, evidence-based and that they regulate the supports provided. In recent times we have seen and heard about some of the dangers that come from a lack of sufficient understanding of autism and the resourcing and regulating of practices which are supposed to support our community.

AsIAm welcomes the recommendation of the Oireachtas Committee on Disability Matters on behaviour-based approaches, which have caused much harm to many in our community. We would also point out the large number of so-called therapies and therapists that operate in the field of autism that are not regulated and which practices have no scientific basis. This poses a waste of resources for families at best and exposes autistic children and adults to significant risk of harm at worst. It is vitally important that we do not continue to take a charity approach to how supports are provided for autistic people and the summer programme is just one example of where we have a system that is voluntary, that is based on the goodwill of Departments and that is not about providing for people's rights. The summer programme is just one example of how that does not deliver and the significant impact that has as a result. We ask that the committee's recommendations place a strong emphasis on all supports for autistic people funded by the State being evidence-based and human rights-compliant.

To achieve an equitable Ireland for autistic people, two distinct ranges of actions are required. First, we need timely and effective autism-specific supports, such as access to assessment, therapies and educational services. Second, we need to autism-proof every aspect of Irish society, particularly all public services, to ensure autistic people have parity of access to supports such as healthcare, social protection, employment and housing. The committee will agree, from its many public hearings, that the strength of the autism community is the many incredible autistic and parent advocates and local groups who make it up. Without their service, much of the support families receive would simply not happen as it is only in place because of their tireless advocacy for, and often direct delivery of, such resources on the ground. Most of these groups operate on a shoestring and have little to no funding. We would like to see the committee address this and support the development of autistic-led groups across the country, while ensuring every area also has access to an autism parent support group. We urge the committee to ensure that autistic people and families are centrally involved in every aspect of implementation of a national autism strategy and that a mechanism is found to retain this forum in some shape or form to continue to provide a space and support for autistic people.

I want to leave the committee with the voices of some autistic people captured within our Same Chance report. When asked “What is one thing that you wish everyone knew about Autism”, one community member said: "I wish they knew how difficult simple tasks are, like going to the shops, finding a school place, participating in community activities like sports". Another said: "I wish everyone knew how hard I am trying every day to fit in, to be accepted, to have people like me and feel like I am valued as a member of the community. I feel people view a diagnosis, in particular an adult diagnosis of autism as ‘an excuse’ or ‘being lazy’."

When talking about the challenges to participation in the community, one community member said: "Securing a school place and the challenges we had to endure to get that place amounts to absolute discrimination. It was an appalling and upsetting process." Another said: "We were asked to take our daughter out of a Santa experience because of the noises she was making other parents were complaining. We are so used to her making these sounds as she does it when she is excited or happy so we were shocked when they asked us to remove her and too upset to say anything at the time."

When talking about the lack of access to supports, one community member said: "Well they are on the books but services are lacking due to staff shortages. Only half the quota of staff are available and there are over 400 children on the books and another 271 waiting. Unfortunately you have to shout loudest to be heard, puts a terrible strain on families..." Another said: "After 51 month wait - he has had a gross and fine motor assessment and handwriting assessment from CDNT nothing else to date."

Critically, the community is also clear that it does not have to be that way. When we asked “What is one thing others could do remove barriers in your day-to-day life” , one person said: "Be our friend or partner. Do not walk through us like we don’t exist. Stop treating us like we are invisible." Another said: "Just be nicer and kinder to everyone, even if you do not know if they are autistic or not. If everyone made some allowances and if I knew people were taking their time with me and not judging me it would relieve a lot of my anxieties."

I thank the committee for its engagement and I look forward to the discussion.

An Cathaoirleach

We will go the speaking list that was circulated on Microsoft Teams. There is a new member on the list, Deputy Carey, who has replaced Deputy Carroll MacNeill after she was appointed as a Minister of State. Deputy Carey has been ill since he was appointed to the committee so we want to wish him well. He has not been in Leinster House in recent months so I want to acknowledge Deputy Carey.

Deputy Pauline Tully

I wish Mr. Harris a good morning and thank him for his presentation. As always, he focuses us on what we should be doing, on what the issues are and on what is important as we come to preparing our report. I hope the committee, in its meetings over the year, has helped to create awareness, and more than that I hope it has given autistic people a chance to air their concerns and talk about the barriers in society they face. I have learned so much in the past year and I thank all the people who presented at the committee for that.

Mr. Harris is right in saying we need legislation because it is wrong that when a general election is called and a Government changes everything has to start from scratch again. The committee has worked well with cross-party support and I hope that whatever has been achieved, if it is not down in legislation it will be followed up by the next Government and I will give a commitment from my party that if that was the case we would do that.

Mr. Harris mentioned the autism innovation strategy that the Minister of State, Deputy Rabbitte is working on. He says: "it has faced significant opposition from Government Departments in the past". I ask Mr. Harris to expand on that because that would be concerning. I wonder if that is similar to something we have come across in the Committee on Disability Matters in that when you engage with a lot of Departments on what they do in disability they say there is one Department that deals with disability and they do not seem to understand that everybody has a responsibility. That is the case with autism as well.

I refer to the lack of regulation of psychology and applied behaviour analysis, ABA, as well. There was a good and informative discussion on this at the Committee on Disability Matters but until the autistic community supports this type of therapy or until it supports autistic people and is properly regulated, it does not have a place in society. I invite Mr. Harris to expand on that as well.

Mr. Adam Harris

On the opposition, I am not necessarily speaking to the autism innovation strategy but it is more about any effort that has been implemented over the past decade to try to get an autism strategy in place. We have been lucky to get the autism innovation strategy because we have had a significant commitment and push from the Minister of the day to get that. However, if you look back over recent years we had a Bill from the Labour Party in 2012, which was the first autism Bill. This was followed by former Senator James Reilly's Bill in the last Seanad, which was followed by a motion from Sinn Féin calling for an autism empowerment strategy and that passed unanimously in the Dáil. We have seen further efforts by the Rural Independent Group and the Labour Party since then. Every time this has come to the floor of a House of the Oireachtas it has had cross-party support and there has not been a single politician against it.

Yet, every time it actually comes to turning that political will into reality, it simply does not happen. That is concerning, because if there is a political consensus on something, based on the needs of the autism community, it should happen. If we want to understand the rationale for some of the opposition, I would probably look to two pieces. There can be a reluctance to take a disability-specific approach. However, we need to be very clear that we have a Disability Act and a national disability inclusion strategy, and lots of areas of public policy, we have broader strategies and we recognise the need to put specific lenses on issues. For example, we have Sláintecare, but there is still a national cancer strategy. We have an anti-racism strategy, but there are still specific strategies that focus on the Traveller and Roma communities. Sometimes there is a need to put a specific lens on a particular cohort of people, even perhaps for a period of time. The data that comes from the autism community and the fact that we are now looking at a community of people shows that there has been a shift. If we were having his discussion even last year, we would have been talking about 1.55% of the population; we are now talking about 3.38% of people, based on Department of Education data. There has been a significant shift in demographics. There has been a massive range of issues arising as a result of that. Quite simply, if the existing apparatus was working, we would not be asking for a specific strategy. We are asking for it because it clearly has not delivered for the scale of the challenges the community is facing. Closely linked to that, we would look at issues, for example, such as the reform of the EPSEN Act. It is really positive to see that review take place and to progress, but in the past there has been a sense that we do not need to implement legislation because we are doing it anyway. I think we know, in reality, that as long as we take a model that is grace and favour, people are left behind. Very often, it is those who face the greatest barriers. Too many of the supports for autistic people in Ireland are based on this charity model, instead of recognising that autistic people are rights holders. Those would probably be the two areas where we would see the most significant causes of opposition. That is why we think legislation is important.

On behaviour-based approaches, it is very clear that it is the overwhelming view of autistic adults who have experienced applied behaviour analysis, ABA, that it can be an extremely traumatising experience. There is also a recognition that the actual evidence base for ABA, for many autistic people, is extraordinarily questionable no matter what perspective one comes from. What I would say is that when we talk about the ABA industry, it is an incredibly well-funded industry. It is not surprising that as evidence moves on and the wishes of the community move on, there will be significant pushback. I would describe what we have seen to date as pushback. I do not see it as being particularly constructive. Taking the international ABA congress, which was held here last year, as an example, when the agenda includes a session which is basically about how to answer your critics, that shows me that we are really not talking about anything substantive. There is still a very paternalistic view within that sector that is problematic. What this fundamentally comes back to is the question of why we have therapies and why there are interventions for autism. The only sorts of supports we should be looking at for autistic people are ones that support an autistic person to be their best self in the community. Yes, it is important to gain an understanding into what other people think, but it is about enabling them to have the autonomy to make their own decisions and be fully involved in the community. It is very worrying that in our education and health systems, we still see overwhelmingly behaviour-based approaches. While there is much good in the recently published autism best practice guidelines from the Department of Education, we raised significant concerns prior to their publication that there is a whole pillar in them that is based around behaviour-based approaches. I am not sure that part of the reason for that is not that there is a tendency to want to give people who perhaps do not understand autism as well what they want, which is a way of addressing behaviour that they can see, as opposed to actually trying to give people who are working in our health and education systems a human rights-compliant understanding of what autism is.

An Cathaoirleach

Does Deputy Tully have any other questions?

Deputy Pauline Tully

Maybe afterwards.

An Cathaoirleach

I call Senator Wall.

Senator Mark Wall

I thank Mr. Harris for coming in. It is important to start with some statistics. This is our 48th meeting and our 19th public session, which shows the importance of what we are discussing today. To reference the AsIAm report for more, 86% of autistic people feel that they do not get the same chance, and 57% of the public recognise that autistic people are treated in a different way. That is what we have found in all of our public meetings. Everyone who has come in and advocated on behalf of autistic people in this country have been very loud and clear on what their demands are. As the Cathaoirleach said, Mr. Harris was in with us on 17 May last year. He has been very clear on his demands. I thank him for his advocacy for autistic people in Ireland. I have a few questions. The Cathaoirleach has outlined that the issues we are looking at with the summer programme. One of the issues I have discussed with the Cathaoirleach, that was mentioned at a meeting last Thursday, is the idea of trying to implement a plan ensure that there is a summer programme in every large town in this country. That needs a bit of impetus from the Department. I know that the Cathaoirleach has pushed on that, and he pushed on it again last week. We cannot have large towns where there is no summer programme provision. I ask Mr. Harris to comment on that and where it is going.

I listened to my local radio station, Kfm, on the way in today, and heard Mr. Harris mention Clane, which is looking to promote an autism-friendly town. We have mentioned that before. I think that should happen everywhere. The Cathaoirleach has outlined what is happening here in the Oireachtas in Leinster House, which is brilliant, but we need to push that and keep pushing it. I know that AsIAm is at the forefront of that work. I must mention what is being done in Clane and towns like Clonakilty that we have mentioned before.

The huge issue that still comes up is the assessment of need. What is AsIAm's position in relation to the importance of an assessment of need? I deal daily - as am sure colleagues here do - with parents who come into the office saying that they are being asked for an assessment of need. Every time we talk to the HSE, they say that it is not that important for clinicians, but it may be important for education. Where does AsIAm stand in relation to the importance of an assessment of need? Is more impetus needed to go to the private sector to ensure that those that most need them - and there is such a backlog at the moment - actually get them? The number one issue that I deal with in the office and in my dealings with people is the inability to get assessments of need, and the current waiting list.

Lastly, I want to raise the issue of adult diagnosis, which is something new, as Deputy Tully said. The last year has been a learning curve for me in relation to autistic people and their needs. One of the big issues that has come out of our discussions is the needs of autistic adults. We all hear about children's needs, which are so important, but there seem to be so many adults who also have particular needs. How does AsIAm deal with that particular cohort of people?

Mr. Adam Harris

To start with the summer programme, I think what we really have to get back to is a simple principle, which is that we need to get to a point in our thinking where we are saying that is simply cannot be allowed to happen that people do not have access to this programme. I recognise that there is a limit that can be done within the confines of the education system. Personally, I think that ultimately, we need to look at a different contract to try to get to a point where programme provision is mandatory. I realise that that is a more complex issue that we are not going solve solely within the autism sphere. I recognise that. If that is the case, the onus goes back on the State and we must ask what it is going to provide as an alternative. It is simply unconscionable that there are families today who are facing into the summer with absolute dread because they are really facing into a summer where there will be little to no support. The impact that that has on the individual and the family in terms of well-being, participation, finance and mental health, is very significant. We need to shift our thinking and get to a point of saying that it cannot be allowed to happen that someone would not have access to the programme. When we begin to think in that way, we will get a lot more creative and we will begin to think in a much more joined-up way around how we can remove some of these barriers.

The Senator mentioned Clane. We are delighted that it is one if the communities that is becoming autism-friendly. We are doing a launch event there on 31 May. We are working with approximately 20 communities across Ireland this year. What this is really about - and I think it is important to the work of the committee as well - is that there are very clear issues around Government policy and resourcing that need to be addressed, but a lot of the problems also come from society not understanding and accepting. We need to look at how we can shift attitudes. Part of that is reaching out into the community as well. With the initiative in Clane and in towns across the country, it is about small changes in terms of communication, predictability and the sensory environment that make a big difference for autistic people. For me, what I am interested in is the long-term impact. What would it be like to grow up in a town where, instead of people feeling from a very young age that there is something wrong with them, they are broken and they need to change, they grow up in a community that says it wants to meet them halfway? We would really like to see that rolled out further.

On the assessment of need process, fundamentally, AsIAm's position is that we urgently need to review the Disability Act. It is welcome that we are reviewing the EPSEN Act at the moment, but it does not really make sense to do that independently of reviewing the Disability Act. Ultimately, we would like to see a right to services established. If people had a right to services, that would give them confidence to look at how the assessment of need process works in and of itself. Linked to that, the HSE and others might say that people do not really need an assessment, but it is the only thing they are entitled to, so therefore it is absolutely critical.

Linked to that, we need to be careful in this discussion about the fact that while families want services, a good diagnosis will help direct those services. Sometimes, what gets lost in the bureaucracy of all this is how important a diagnosis is for understanding yourself and for having that understanding of how you fit into your family. That is why that High Court judgment has restored the ability to get an autism assessment through assessment of need. That was so important. Ultimately, though, the issue is that no matter what rights you give people, they only work if you have the clinicians to deliver those services. In the private sector, if you needed a certain skill set and you could not get it, you would then move land to ensure that you got the skills you need. Fundamentally, if we are seeing officials come over from Australia every year to take our occupational therapists, OTs, our speech and language therapists, SLTs, and our psychologists, we need to ask how we make a better proposition to keep people whose skills are critical.

I totally agree with the point about adults. The reality is that you are an autistic adult for a lot longer than you are a child. That often gets overlooked. In AsIAm we have an adult support and wellbeing programme. This year, we worked with approximately 1,000 adults across the country, providing a suite of supports. For every group we set up, we are operating 20 group aid support programmes for adults at present. It will be 30 by August. We could fill every group three times over. We need to see a lot more support and focus in that space. That is critical.

Deputy Joan Collins

I thank Mr. Harris for coming before the committee again. I have a few questions. Mr. Harris made a point about legislation along the lines of Malta’s Autism Empowerment Act 2016. Then, he proceeded to say that the "legislation would simply require the State to publish an autism strategy at regular intervals, to involve autistic people in the process of drafting". Is that exactly what Malta’s Autism Empowerment Act is? That would be very important. I refer to publishing an autism strategy at regular intervals.

The other questions are based on the assessment of needs, which Mr. Harris spoke about. We need the clinicians to deliver. What is crazy at the moment is that Australia is capturing our medical people and we are going to other countries, such as India, and are capturing their people and leaving them without the supports they need in their own country. It is a catch-22. How does Mr. Harris think we could hold onto our therapists who are coming through the system? I have been thinking about this a lot in relation to the State playing more of a role. It may be to do with paying for degrees for students to come into the system. On the basis of paying for their course, they would then give a commitment to stay in the country for ten years, eight years, six years or some period of time that would embed them in communities and clinics throughout the country. I know people want to travel because they gain a lot of experience when travelling and they can bring it back. An initiative like that could help to maintain people in the country for a period of time. What we are seeing in many of the clinics is that we cannot maintain them and we cannot recruit for them. Therefore, it is putting more pressure on the other staff who get demoralised and then they decide to leave as well. If we had a situation where we assured that all services were properly serviced, it would make a difference to people wanting to stay, because then they would have more of an ability to develop their own resources.

On the assessment of needs, I have raised the issue of principals or equivalents filling out the education needs on the assessment of needs. Is that still going on, or was that just a once-off thing because of the court case?

There is a serious situation whereby people are going to private psychologists who are not regulated. People are paying for private psychologists who are not recognised by the HSE or otherwise.

The other area I want Mr. Harris to expand on is the role of the community, which is very important. I know the hard work Margaret Lowndes, Helen Holmes and all those people and parents in Rathfarnham are doing to try to support their children. Should there be a national council of parents in the area of autism, or something like that, which could support these groups and give them a structure so they could work to advocate for autistic children? There could even be a disability national parents group that could be supported. I say this because they have a role to play. Our Lady of Hope School in Crumlin still does not have services for the children who most need them. It was opened on that basis and yet it still does not have the therapists, psychologists, etc., to work with the children. Could Mr. Harris assist us by outlining what we should do to ensure the services can be accessed by parents and children?

Mr. Adam Harris

I thank the Deputy. There are a few pieces there. The Autism Empowerment Act in Malta started its life in the Parliament there as the autism disorders Bill. When it was published, there was very extensive engagement with autistic adults which led to the shape of the Bill being changed significantly. The fundamentals of that Act are that it requires a strategy, which I think is for a three-year term. It requires the Minister of the day to report on it and it establishes a council that steers the implementation. That council must have a majority of autistic representatives on it. That is fundamentally what the Maltese legislation does, and it really is seen as best practice in the autism community globally.

In terms of the assessment of need and how we get more psychologists and other therapists to stay here, the Deputy has hit the nail on the head with many of the suggestions she has made. I am sure that if there was someone from a professional body here, they would have more to say than I would. However, what I would say as a starting point is that training more is critical. We know we are not training enough, so that is an obvious starting point. It will obviously take a number of years for us to benefit from training more. However, if we are going to train more, we need to look at the sort of infrastructure we can put in place to make sure that the people who benefit from those additional places can then contribute to the Irish healthcare system.

Career progression is a problem for many therapists. People can get entry level jobs but there are perhaps fewer opportunities to progress at the same pace as one would in other environments. More senior roles are an issue. Culture must be a huge challenge. We know the scale of the challenge for children's disability network teams, CDNTs, for example, from the perspective of families. I can only imagine how challenging it must be to work in that environment when you do not have a full team, when you are trying to support people and when you are very under-resourced and all the stress and strain that goes with that. It ultimately comes down to a matter of getting more people to stay and work within the system. Then, people would see it as a more desirable or more pleasant place to work. That is important.

We also need to look at private practice. This is a bit like Sláintecare, where consultants are tying themselves into the public system. There are many people working within the public system who are also doing private practice. Sometimes the lines can blur there as well. There has to be a clearer line - you are either in the public system or the private system. That is something we hear from families.

In terms of the education element of the assessment of need, which came in based on a recent judgment from the courts, we have massive concerns about the approach that sees a principal or someone in the school completing that element of the report. That is for a number of reasons. First, for us filling out a form based on existing paperwork already in the school cannot be seen as any kind of assessment. I am concerned that if a family inevitably challenges that element of the assessment, as they would be perfectly entitled to do, that would be struck down and we would end up seeing the Department of Education or the NCSE making the same mistake the Department of Health made, whereby if we try to cut corners around assessment of need we will end up with large numbers of people who will end up having to have their assessment redone. That, in turn, will only extend waiting lists.

Even if none of that was an issue, we are fundamentally concerned about the fact that principals have a role in allocating the resources in the school, in line with guidelines, to students in the school. Therefore, if you are asking the person to allocate the resources and to assess what a person's educational needs are, that is clearly a conflict for us. We think that places both principals and families in an unenviable position.

The private psychology piece is really worrying. The AsIAm position is that it is not enough to just protect subsets of psychologists. I know what is being looked at now are educational psychologists, clinical psychologists and counselling psychologists, starting with those terms. However, we will still have people then presenting themselves as a consulting psychologist or child psychologist to try to get around those rules. We have seen that happen in other jurisdictions. There needs to be very robust regulation.

What we also think is a problem in Ireland, and perhaps this is something for the committee's recommendations, is that in the UK there are very clear national guidelines as to what constitutes an autism assessment. Therefore, if people are going privately, they know where they stand and what the report needs to say. In Ireland, we have a very confusing system whereby people are not told what needs to be in the report and then, when they get the report, they are told it is not good enough. We would like to see national guidelines because they would both protect families and improve practice across the board. The community piece around supporting community groups is very important. That is one of the things we would like to see. We welcome any opportunity for parent groups to be given a stronger voice and be consulted. Critically, what we would also like to see happen for parent groups is funding to be made available or some sort of national pot of money to which groups could apply to support their activities. I see what these groups are doing on the back of table quizzes and race nights, so I can only imagine the difference they could make in a very tangible way on the ground if they received even a small amount of support from the State.

Deputy Joan Collins

I thank Mr. Harris.

Senator Eileen Flynn

Mr. Harris will know that 38% of autistic people still experience discrimination and 61% are on waiting lists for access to services. That 61% really strikes me. It should never be the case that 61% of people are, in my opinion, denied access to mental health services. How is that happening in today's society? I brought up a few times at this committee the likes of Jigsaw not working with children who are autistic. That is blatant discrimination and should not be allowed to happen.

This committee launched a report a few months ago saying that every school in the country should have a summer programme. Some schools did not even do the surveys we sent around, which speaks volumes about our education system in the sense that it is not what you do but the way that you do it. They did not even have the decency to respond. I totally understand, however. I visited St. Catherine's Vocational School in Killybegs yesterday, which has an autism class. The young woman who received an award for all her great work was in the school for six years. That was the first time in my activism and in all the work I have done that I have seen a young woman go on to complete her leaving certificate examinations. It was so welcome. I know it does not apply to all schools but it happens in some schools. Those days where this does not apply should be far behind us. Again, that speaks volumes about our education system when it comes to inclusion of people with autism. That is something we must look at as a committee.

It is not really about blame. Sometimes for people who are different in society we tend to blame ourselves. I support the call and I also support the parent groups. They are critical. They are accessed in areas for people of the Travelling community for people of colour, black and brown people as well.

About the swing, I am passionate about it. I have done research on it. My local authority in Ardara in County Donegal advised me that there is actually a swing in Dungloe and services in Dungloe which is 30 km away from Ardara. Would that benefit autistic children?

Mr. Adam Harris

It certainly would. It is an example of something in a mainstream setting. Sometimes when we talk about autism, we only talk about education and health and forget that autistic people and people with other disabilities want to be able to enjoy the same activities as everyone else, including things like accessible playgrounds, communication boards on playgrounds, equipment and sensory gardens. We would like to see more of that because it enables people's participation. The brilliant thing about many of these resources is they are also beneficial to people who are not autistic. They create a space that works for everybody and that can drive inclusion in a meaningful way.

Deputy Marc Ó Cathasaigh

I thank Mr. Harris, personally, and AsIAm for the continuing valuable support they have given the committee. I will not presume to speak for others on the committee, but when I became a member, I was terrified to open my mouth because I was afraid to say the wrong thing. AsIAm's training and the confidence it gave us were invaluable in the sense that I felt I could engage with the issue and go out and talk to people without being terrified of putting my foot in my mouth. I thank Mr. Harris for that.

Regarding the recommendations Mr. Harris would like to see in the report, he has emphasised legislation, which is front and centre. This committee has done great work and great credit is due to the Chair on that, not least in bringing the voices of autistic people to the fore, including bringing people to the meeting we had in the Seanad Chamber, which was very powerful. If this committee is to have a meaningful legacy, it will be the legislation because that is not about this Government or the next one; it is about Governments into the future. That is where it becomes binding and meaningful. I would certainly like to see that recommendation in the report.

I am very struck by the discussion of structural discrimination. Going back to my being terrified when this committee started its work, we all see the world through our own eyes. Unless we get the input of that experience from other people, we cannot be expected to know. That awareness piece is very important to our understanding the challenges. Rather than an approach that aims at integration we need to look more at inclusion. Mr. Harris mentioned the behaviour-based guidelines from the Department of Education. In dealing with our own children or in dealing with children in school, as I used to do, we all know that behaviour comes from somewhere and is asking for something. If we are only managing the behaviour, we are failing to understand where the behaviour came from and what it is designed to achieve. It can be much more difficult in the case of an autistic child to understand where that behaviour came from. By trying to get that understanding we will really move to inclusion.

I was very struck by what Mr. Harris said about the autism-friendly communities. Waterford is trying to become the first autism-friendly city. Our built environments should not make anybody feel like the broken one - the phrase Mr. Harris used. We need to do more than just set up islands of safety. For example, people who work in libraries appeared before the committee and they spoke about establishing those kinds of islands of safety within our cities. However, we need to make all our built environment much more inclusive of neurodiverse people so that they can feel as though they can move around their own world independently. It comes down to people being able to see the world through those eyes, the increased legibility that Mr. Harris spoke about, the predictability, this sensory environment, making sure that things are not overpowering.

Later, representatives from the Irish planning institute will appear before the committee. In their submission they stated that at their recent CPD webinar on universal design and inclusive public spaces, they heard that public spaces do not meet the current requirements for neurodiverse people. If we are just setting up pockets where neurodiverse people feel safe and not allowing them free movement between them, we are missing a trick.

I reiterate my thanks. It has been a major learning experience for me. We certainly need to focus on that legacy piece. We need to continue to focus, as this committee has done, on raising awareness so that we are not blind to the structural discrimination and inequality that are built into our society. We need to ensure we have a universal design that allows people to participate to the greatest extent possible within their own society.

Mr. Adam Harris

I am delighted that the Deputy found the training useful. The Leinster House autism friendly project is about making the precincts of this building accessible. The by-product is that Deputies and Senators can benefit from the training, which hopefully will also inform policy formulation. What people do not know they do not know. It provides the opportunity to see the world through an autism lens, as opposed to thinking about autism when we are talking about autism. When we are talking about public transport, we need to consider how that relates to autistic people. When we are talking to education, we need to consider how that relates to autistic people. We need to proactively autism-proof if we want to be inclusive. Hopefully that is where the training can add some value.

The discussion of structural discrimination is really important. The discrimination experienced by many autistic people is different from that experienced by other minorities. Not many people get up out of bed in the morning and say, "I don't like autistic people, and as a result, I'm going to discriminate." It often comes from a lack of knowledge and a lack of respect, but also from a lack of a reference point. We discriminate without realising that we are discriminating in how we design the systems and the world we live in. Critical to this is the autistic voice. Looking at the history of autism, it is a pretty dark space. For most of the history of autism, things were done to autistic people instead of for autistic people. One of the really positive shifts we have seen over the past ten years is autistic people and their families being listened to increasingly. That highlights to me that if we want to end structural discrimination, we need to create more opportunities to support autistic people to play that leadership role and to be able to advocate. Advocating does not just mean coming to a forum like this; It means people being able to advocate for themselves about what they want for lunch. It means being able to decide where they want to work. It means being able to deal with issues, local and national. More needs to be done to support autistic voice. Compared with other countries - this also applies to disabled persons organisations - we are at a very early stage in building that movement and resourcing that movement.

More could be done in that regard.

It is great to see Waterford working towards becoming an autism-friendly city. It will be a very exciting project.

The point around safety is really important. In our survey, a significant proportion of people were not able to say they felt safe in their communities. The amazing thing about some of the measures for autistic people is that they are about being able to use facilities. It might be having access to a quiet space, for example, if people are feeling overwhelmed. It is not just about using a facility on a particular day; it is about people feeling confident and safe in knowing there are accommodations there and things will be okay if the world becomes overwhelming for them. That sense of safety is linked to judgment and attitude. It is also linked to the need for forward planning. One of the challenges around making our society autism-friendly from a design point of view is that it cannot be codified in the way other forms of accessibility can be codified. It is more about the need to create frameworks in which we think about design. Often, that did not happen in the past, which is where many of the problems emerge.

Deputy Ruairí Ó Murchú

I apologise for being late. I heard everything that was said in the meeting while I travelled in the car on my way here. To say I did more than hear it would be madness. I managed to take some notes when I was stopped at red lights.

I have spoken to Mr. Harris before about these issues. A huge amount of work has been done by members of the committee. Fair play to the Chairman, who has always given me the leniency for which I generally push. We have had repetition of discussion of certain issues, which has been positive. Mr. Harris has given a really good synopsis of all the points. We could probably deal with a lot of the issues if people were nicer and had good manners. I remember hearing a member of An Garda Síochána talking about traffic calming. He said if people had good manners, we would not need half of the measures. Unfortunately, it is not the situation that people will always show good manners. We need to look at legislation to set in train a process in law. Mr. Harris made a point about charities. If people need something as a right, we must be able to provide them with it. It cannot operate on the basis of whether providers choose to offer a service, which can lead to outliers, whether in a charity, school or whatever the particular set-up might be.

We have talked about the AON process. The workforce planning work needs to be done. We have all had interactions with the Minister, as I am sure has Mr. Harris. Even if we get this right from today, it will be four or five years down the line before we see an impact. A number of the occupational therapists and speech and language therapists who have spoken to the committee said there is no problem with reviewing the AON process. They asked that we also review the provision of therapies, what we can provide in the short term and what is the best means of getting access for people. We all know there are issues in schools. Some of that has been addressed insofar as we will see the provision of more autism units. We have spoken about bespoke approaches and being able to change things. We need to have free flow in schools in order that children can go from an autism unit back into mainstream or whatever suits the particular case.

Mr. Harris referenced the issue of silos within the system. Children may fall under the care of the CDNT or under primary care. Some end up in a ridiculous situation whereby they need a service or a strategy to deal with anxiety, for example, but because they do not fit into a particular box, they cannot be seen. That is not good enough. I accept that we do not have all the people and all the locations in place to provide all the particular services. We need to have a real conversation about how we offer services and what we can offer in the short term, while also ensuring we have the workforce planning and the focus on throughput. Otherwise, there is no point in talking about these issues. A lot of people would not be overly concerned about not getting 37 hours out of the AON if they got sufficient support to cover what they need. As Mr. Harris said, children and their families need to understand exactly what they need to do and the trajectory of the process.

The idea of a plan for life is an important issue. We want a system that is more holistic. A number of witnesses who came before the committee spoke about different systems in America and elsewhere. In the case of a child aged 14 to 16, say, we should, as much as it is possible to do so, have a plan for meeting his or her needs, and that plan should move with people as they transition through life. It should cover every part of the system, from education right through to employment. There are decent pilot projects being run by Trinity College and others but the State services are not in action. We are talking about people's lives. We need to be able to provide a roadmap from cradle to grave. I accept it is easily said. It is a big part of what needs to be done.

There are also straightforward and simple things that can be done. Reasonable accommodation means people should be able to access regular services that are not autism-specific. Going back to employment, there are issues with the grants and how people can apply for them. Some people cannot get the grant or avail of assistive technology at a point at which they could learn to use it before going into employment. There is no holistic approach in that regard. With a bit of sense and flexibility, we could have something better and we could have a real conversation that goes beyond what we can and cannot provide at the moment. I am very taken with assistive technologies. However, we all know there will not be enough provision.

When dealing with psychologists, occupational therapists, speech and language therapists and so on, particular strategies are developed for individual children. My son Turlough had the odd appointment for speech and language therapy. His mother might go with him one week and I would go another week. We had to do it in the middle of all the other things that were going on and we probably did not take in enough. If there were further engagement, such as via telephone, for example, it would add a bit of reinforcement. The information could be shared with SNAs, teachers and all the others who play a part in the child's life. I am not saying those people should take over the roles of therapists but we need to find a better way to do all of this.

I have made my points in a completely disjointed way. I will not show Mr. Harris the notes I took. He would need a map to follow them. We are failing our citizens. There must be a system from cradle to grave. We can fix services and everything else but there needs to be a broader view. There are positives. We have seen what has been introduced here to make Leinster House a more autism-friendly place, although there still is a fair amount of work to be done. A lot more people are aware of autism and are willing to offer reasonable accommodations. Mr. Harris spoke about the bad-case scenario of people being put off by noise, stimming and whatever else. However, I have seen a hell of a lot more people who have come around to the idea of accommodating autism and who recognise what is involved. That might be because they know someone with autism, perhaps in their own family, or they have just become more aware of it generally. That awareness aspect is helpful.

As per usual, I have pontificated for a long time. If Mr. Harris can take questions out of what I said, I will be highly impressed. I will be even more impressed if he can answer them.

An Cathaoirleach

As per usual, the Deputy has left no time for a reply. However, I will allow Mr. Harris to do so.

Mr. Adam Harris

If we take a step back for a second, many of these issues, particularly in regard to the assessment of need process, come back to the question of trust. The systems that are there are not perfect but we know there are ways in which they could be improved or improvements could be explored. The problem, however, is that what we have, we must hold. Whether we are talking about the education system or healthcare, the reality is that the way in which supports have been provided, governed and withdrawn, with people having to battle to get them, means none of the systems have lent themselves to a position whereby people feel any sense of trust in them. That is what makes change so difficult. It would be extremely hard to say we should move away from the right to an assessment because there is nothing there to tell us we should trust the HSE in how it supports autistic people.

That is just a reality. Trust is hard won. We need to see much more significant effort to win that trust. I am concerned that every time there is a setback, such as when we did not get schools to open for people as early as we should have during the pandemic or when it comes to issues such as people's data and how they have been managed over the years, litigation strategies and so on, it really damages trust and sets us so far back. Sometimes we overlook the cultural aspect of this. It actually starts with how bureaucracy interacts with families day to day. Often it is not empathetic or supportive. That in and of itself does a great deal of damage to the ability of the system to operate well. One thing that is definitely true is the lack of joined-up thinking within the system. The HSE will tell us that the supports it delivers are needs-based, not assessment-based. However, in other words, for a child to get a school place he or she needs to have a specific recommendation in his or her report. Indeed, we are told that such paperwork is not necessary to get access to the social protection system, but we find in many instances it is necessary. In fact, we often find that what national policy says and implementation on the ground can vary hugely from postcode to postcode. That in and of itself is a significant challenge we face.

One question we can ask ourselves is whether we are using what we have as well as we could be. So often, even things that we know work are forever kept at pilot stage. If I was to point to one example, I would point to the Middletown Centre for Autism and the fantastic work it does. Services in the North are streets ahead of us in regard to how that resource is maximised. We, for some reason, are still far behind. That is just one example.

Training is at the heart of much of this. The Deputy mentioned autism-proofing. If we can just go to mental health for a second, I have been amazed when I interact with mental health professionals at just how low the level of knowledge is sometimes. We know there are people who need very bespoke mental health supports from a very experienced practitioner while others simply need reasonable accommodations, but the lack of training means people very quickly get into the space of “I cannot see autistic people”, not realising the diversity and individuality of what we are talking about. We need to look at a universal training programme. One good thing we have seen in the UK is the Oliver McGowan training programme where now all NHS staff, by law, have to have training in autism. That is very important because we know, for example, when people are critically ill, if those treating them do not know the differences around autism, that can lead to tragedies, as has happened, and that has led to the mandatory training. Also, over time, it will take the fear factor out and make people a little more open to being flexible in their thinking.

The final point is I completely agree on the employment piece. That links back to this sense of a lifelong plan. I would like to see a starting point where we even have education plans for everyone. We do not, let alone transition plans. A concern is, and it strikes me as extraordinary, that it seems the Department of Education funds supports and is facilitating inclusion for many autistic people in the education system, but after 14 years, if a person is not going to college, the assumption is he or she will go to a day service rather than being how he or she can get a job and participate in the community and how we can support him or her to do that. I hope I somehow answered-----

Deputy Ruairí Ó Murchú

I am fairly sure Mr. Harris answered. That was a lot more coherent than the questions he was asked. I imagine the Cathaoirleach will deal with this. In my garble, what I managed not to see until now is the issue of augmentative and alternative communication, AAC. Specifically we saw rapid prompting method, RPM, working with Fiacre Ryan, but at some level, we are not too worried. Whatever works for whatever kid. It gave me that notion of somebody who was hidden away and many people could have quite easily said there is nothing they could do. It can be imagined the absolute frustration that such a person would have had to deal with. Whatever about education, the other piece is in regard to therapies. Let us just put them where they work and are needed. An element of that is that it makes sense to have those therapies in school at times. However, I may have made too many points earlier.

An Cathaoirleach

I am conscious of the time.

Mr. Adam Harris

The AAC is so important. If we look to the progress being made around Irish Sign Language, this is no different in terms of a rights issue. It is about people being able to interact in the community with their preferred mode of communication. I know Fiacre. The amount of work he has done and the journey he has been on is incredible. For us, it is not so much about saying we should favour any one particular approach but rather making sure that whatever works for the person should be resourced. In regard to AAC, we see it as particularly problematic when people are given the equipment but those around them do not receive the training they need to use it. That is one example of a lack of joined-up thinking.

In regard to the NICE guidelines, the National Institute for Health and Care Excellence guidelines, there is a variation of them in Scotland based on the same principle. The NICE guidelines are actually widely used by many clinicians in Ireland because they are seen to be best practice but their use is by no means required. The HSE does not produce them. Our own Psychological Society of Ireland produced good best practice guidelines for children’s assessment last year but they are a voluntary code. They do not form the basis of what is needed in a report. They contribute to some of the confusion within the private sector in that a person might get a private assessment by an appropriately qualified clinician and get an extensive report, or that person might get a letter with a signature at the end of it. At the moment there is nothing in national policy that says which we should favour, and that is very worrying. It is leading to many of the challenges families are seeing on the ground and something of a cottage industry developing in places.

In regard to the CDNT, it could be argued that there is no model. There is a model on paper but it is simply not working on the ground in any meaningful way for families. It is a source of immense frustration for people. Our view is that the more that supports can be provided in context, the better. That is where we would like to see the further roll out of a school-based model. It is important to say that this is where there should be significant joined-up thinking. We know that, ultimately, it is Department of Education policy that we want to see these therapy teams regionally. They are going to be competing with the HSE for recruitment. We need to look at a much more integrated approach in that regard.

An Cathaoirleach

I have a few questions or points myself. In Mr. Harris's opening statement, he mentioned the HSE review of 2017 and the fact that recommendations were made in that. Here we are in 2023 and not all of those recommendations have been implemented. Will Mr. Harris give us a synopsis of where that is and the recommendations that were made at the time? Personally, I agree with him with regard to the Maltese legislation. That was my starting point back in 2020 on this journey looking to get legislation brought in and put in place to make changes. I strongly believe that is the way to go.

It is ridiculous. We are a First-World economy striding ahead on many issues European-wide, yet we are so far behind. We are looking to meet with Scottish Autism and have a meeting organised with the Scottish minister. They have actually now reviewed their ten-year strategy and are implementing changes based on what they see as having gone wrong and what has worked while we still have not produced our strategy ten years after our neighbours.

It shows how far behind we have been. It is important that both the committee's work and that strategy is right and that we do not miss anything within that.

Regarding supports for parents, Mr. Harris made the point that every child and young adult has a right to those supports but that they are ultimately not available or we are waiting for local charities and parents' groups that have been set up across the country. Unfortunately, there is not a geographical spread of those groups and there are glaring omissions where there are no supports. My local area is one of them and that is something that as a public representative I have to and will rectify.

I will not ask Mr. Harris to comment on it, but to unfund is quite striking. I made a comment to another organisation that was at the committee a number of weeks ago with significant multi-million euro assets and yet there are parents' groups striving to fundraise with bag packs etc. to give support and services to parents. We need to make sure we have a system throughout the country where there are no omissions with regard to supports for parents and children and that we fund it as a Government; that is the way forward.

The summer programme was mentioned by a number of members and it is particularly disappointing in my own region, the Shannonside region which is Longford, Westmeath, Cavan, Monaghan, Roscommon and Leitrim. We only have two schools in that entire region that will provide a programme of up to two weeks and in that case it is not for all of the school's students. Based on the numbers I put together only around 14% of the students of special schools in that entire region, which takes in six counties, will have accessibility to the summer programme this year which is extremely disappointing. However, overall, we have seen an increase of more than 20 other schools that have taken it on board so we need to get into a situation where if there are other organisations within a region that would be prepared to take on and put a programme in place, that is what we need to do. We need to make sure that access is there for as many students as possible.

I thank Mr. Harris for his work and his support to us as a committee. We still have a bit to go before we finalise our report. I thank Mr. Harris for his support with our Leinster House project and the training for us as Oireachtas Members. A number of our committee members have said that they themselves have been educated and that is our job and our role, to make sure more Oireachtas Members have a better knowledge of this area. Ultimately something I will look for is a monitoring committee within Leinster House to monitor the implementation of the recommendations the committee will make. That has to be the case because we do not want a situation where this report ends up with the Department. A lot of reports have been produced over the past ten or 12 years yet nothing has really been implemented. In my role as Chair and on behalf of the committee members that is something we do not want to happen and we will make sure it does not happen. We have waited for too long. Too many people have been let down, too many families have been let down and that has to change. That is a commitment I give in my role as chair of this committee and personally as an Oireachtas member.

Would Mr. Harris like to make any final comments?

Mr. Adam Harris

I thank the Chair. I will start with the HSE review he alluded to. That review made a number of recommendations. To summarise them broadly, it refers to the need for increased awareness, particularly within the healthcare sector, training, better awareness of the services, and information around autism. It also talks about the need to look at how autism assessments are working and particularly in that vein to look at how there can be less incoherence between mental heath, disability and primary care. In theory, a person should be able to access an assessment no matter what door they go through and there could be a tiered approach to that assessment depending on the person's presentation and needs. That is being piloted, I think, in three community healthcare organisations, CHOs, at the moment across the country. We will have to wait and see what the outcome of that review or pilot is. The awareness campaign will happen in the next 12 months or so. Covid-19 has naturally delayed some of that. It is really important that the recommendations of this committee are informed by and aligned with that work so we can make sure to have a joined-up approach and that we do not have conflicting recommendations at the end of the process.

In terms of the comment about community groups, that is so important because we see groups that do amazing work with very little. We have never seen more need. During the course of the Covid-19 pandemic, queries to AsIAm went up 300%. As a result of the time where it was next to impossible to fundraise we went out, did urgent appeals, and nearly doubled the size of our team. We felt we had an obligation and that if we did not do what was needed there and then that, simply, no one would do it. It is really incumbent on everyone in terms of the State and other organisations where there are resources to get those out into the field as quickly as possible. We are increasing the funding we raise and we increase the expenditure we have in the field year-on-year because there is such an urgent need and I really think that has to happen. The reality is there are plenty of organisations within the field who want to do that sort of work and who need that sort of funding so it is vital we all play our part as a result of that.

I commend the committee's work around the summer programme because it has put an important focus on things. The Chair is right that it is important we ultimately look at some sort of co-ordinating function. We have seen how the Department now has the power to compel schools to open an autism class. When we see a situation where schools perhaps are not participating in the summer programme but are leasing out their school for a summer camp I do not think that should be allowed to happen. Whether it is special educational needs organisers, SENOs, or some other entity there should be an ability to get buildings to put in place staff if schools will not do that themselves. We need to look at giving an agency the power to co-ordinate the summer programme in that manner. What is clear from this year is that the voluntary approach is not working and a much more robust system is needed to ensure participation and that families have the level of service they need.

Mr. Brendan Allen

I thank the Chair and committee members for offering us the opportunity to talk to them about autism and planning, buildings and public space. My name is Brendan Allen. I am a fellow of the institute and also one of its past presidents. I am accompanied by Ms Flanagan, who convenes our practice committee, and Dr. O’Leary, a senior planner with the institute.

The IPI was founded in 1975. We are the all-island professional body representing professional planners engaged in physical and environmental planning in Ireland.

The institute’s mission is to advance planning by serving, improving and promoting the planning profession for the benefit of the community and the common good. We represent more than 1,000 planners on the island of Ireland across the public and private sectors. Our members work in local authorities, An Bord Pleanála, central government, regional assemblies, academia, private practice, semi-State bodies, large developers, etc. The institute is also affiliated to the umbrella body, the European Council of Spatial Planners, has international links with the Planning Institute of Australia and the New Zealand Planning Institute, and is a member of the Global Planners Network. I will preface my contribution by saying that I just happen to be a planner who happens to have an autistic child, so I have a personal interest in some of these issues and notice these things from a planning perspective as well as a human one just by virtue of that.

Proper planning and sustainable development is the cornerstone of the Irish planning system. Pursuing sustainable development involves seeking positive improvements in the quality of the built, natural and historic environment, as well as in people’s quality of life. A key concern for planning and for people generally is placemaking, taking a multifaceted approach to the planning, design and management of public spaces. Placemaking seeks to achieve connections between people and the public places, their use and how they use it. We believe we can work with the various people involved in design to ensure autism-friendly spaces through this placemaking lens, on which planners play a unique role.

There is a key role for planners, architects, engineers and accessibility consultants in ensuring universal design at the project stage, but there also may be a role for incorporating neurodiversity at the strategic, plan-making, level. However, to facilitate consistency in decision-making, such policies should be evidence based and consistent to avoid a situation where some planning authorities may differ significantly in their requirements, leading to mixed outcomes. We have experienced that type of thing in the past. We want all local authorities to be operating from the same design guidance hymn sheet.

Currently, new planning legislation to replace the Planning and Development Act 2000 is being progressed through the Oireachtas. As we have made clear in our evidence to the Joint Committee on Housing, Local Government and Heritage as part of its pre-legislative scrutiny of the Bill and reflected in its report, better planning outcomes will require ensuring greater public participation in plan-making and empowering local people to shape their surroundings. We note that the principle of social cohesion underpins this new legislation, which should facilitate a greater awareness of the need for design to work for people with different sets of spatial needs.

We note that the forthcoming publication of draft sustainable and compact settlements guidelines for planning authorities for public consultation will see a focus on quality design and placemaking, and this committee may also wish to integrate its views into that consultation. There may also be a role for evidence based, autism-specific design guidelines to raise awareness among planners, architects, engineers and landscape architects of the need to deliver safe and accessible spaces for everyone, and indeed there may be scope for statutory ministerial guidelines following the passage of the new planning legislation.

Recently we held a continuing professional development, CPD, webinar on universal design and inclusive public spaces which was attended by more than 60 members. We heard that public spaces do not meet the current requirements for neurodiverse people. One of the speakers was a colleague of Mr. Harris from AsIAm. We heard how we need to look at how we can improve the experience of these spaces for autistic people, the need to raise awareness about urban design opportunities to reduce anxiety and less intense sensory experiences, create greater accessibility and reduce sensory load and the value of initiatives such as Dublin City University’s autism-friendly university design guide. The institute is happy to continue working to ensure we build the capacity of our members in this regard. However, it must also be acknowledged that there are very real resource constraints in the planning system at present and the overall quantum of planners in the public and private sectors must increase to deliver current roles and responsibilities. Only this will allow our members and other built environment professionals specialise further in urban design and neurodiversity issues. Creating obligations without adequate resources will risk raising expectations without necessarily improving outcomes.

The IPI’s education guidelines, which we use to accredit planning programmes in third-level institutions, require students to learn about access and additional needs, urban design, and about planning and health, social justice and diversity. It may be appropriate for future guidelines to place an additional focus on planning for neurodiversity.

We are happy to address any questions the committee members may have. Should the committee wish to engage further with the Irish Planning Institute on any aspect of today’s discussion, we would be happy to assist in any way possible.

Dr. Gerald Craddock

The National Disability Authority, NDA, thanks the Chair and the members of this committee for the opportunity to present on the topic of accessibility of the public realm for people with autism. I am joined by my colleague Ms Mary Tallant, senior standards and monitoring officer.

The NDA provides independent and evidence-informed advice to the Government on policy and practice relevant to the lives of disabled people, informed by engagement with relevant stakeholders, including disabled persons' organisations, DPOs, such as AsIAm, which was before the committee earlier, as well as persons with disabilities, older people and professional bodies. The centre for excellence in universal design at the NDA promotes the universal design of built and digital environments, services and systems.

It is important to note that a universal design approach also caters for the needs of people with autism and other neurodiverse conditions. We view autism as a different ability rather than a disability. This is an enabling approach, not only for the person with autism but also for practitioners in facilitating their full participation. Universal design is central in creating an environment that is accessible, understandable and usable by everyone and disadvantages nobody.

Our public realm is still not designed to be fully inclusive and welcoming for disabled people, including those with autism and their families in key areas such as transport, public spaces, buildings as well as key life domains such as education and employment. We know from our work that disabled people regularly encounter issues such as poorly designed public spaces and buildings through a lack of awareness and planning; the lack of adjustability of lighting, acoustics, temperature and ventilation; a lack of clear and easy to use signage; the lack of poor pre-visit information about the accessibility of buildings; a lack of quiet spaces for people who get sensory overload; and a lack of training of staff to build disability awareness and competence in the organisation.

We advise the committee of the importance of its consideration and inclusion of the following in its deliberations and in its report. A universal design approach is a central element in designing more inclusive services and buildings that enable autistic persons to fulfil their potential. Educational institutions should design their campuses to be more inclusive and the content of the curriculums and assessment processes should be designed to cater for the diversity of students and staff who are now part of all educational organisations. This will also ensure graduates are educated and knowledgeable about how to design more inclusive buildings, services and products into the future. It should reference key documents that can support professionals today in designing and delivering more inclusive solutions and important national accessibility monitoring functions that provide, and will provide, valuable data going forward on measuring how inclusive public services, buildings and digital services are for disabled people, including persons with autism. It should highlight the development of a new national standard on universal design of dwellings which will ensure key issues, some of which I have already mentioned, are included to improve the lives of persons with autism and neurodiverse conditions.

There are a number of key publications the NDA has produced that might be important for this committee.

The centre is developing a new code of practice and accessible public buildings for the purpose of informing public bodies of their obligations relating to the accessibility of public buildings. This draft document is currently undergoing public consultation and will be submitted to the Minister for approval before the end of the year.

The NDA has also updated the existing code of practice on accessible public services and information to include specific references to autism. This updated code of practice is awaiting approval from the Minister. The NDA has the responsibility to monitor its codes of practice and publish its findings. We will be publishing our first report on access officers later this year.

On an annual basis, the NDA monitors the accessibility of public websites and mobile apps as well as the percentage of disabled people employed in the public sector. The resulting data is published and available to the public.

The NDA is developing a national standard on universal design dwellings in collaboration with the National Standards Authority of Ireland, NSAI, to be completed in 2024. The centre has produced a series of ten booklets called "Building for Everyone: A Universal Design Approach". Booklet 9 specifically focuses on more inclusive planning. This booklet is aimed at planning professionals and provides guidance on how to deliver, promote and achieve universal design within the planning system. It highlights the importance of a collaborative approach to planning.

We have also published research on shared spaces in the Irish context. The report found that most stakeholders supported the general aims of shared space but expressed concerns about safety. There was broad consensus that Ireland needs a set of national shared space design guidelines, directed by the principles of universal design. It would be important for local authorities to review the findings and begin addressing the recommendations through indepth stakeholder engagement with disable persons organisations, DPOs, and persons with disabilities, including people with autism.

On education, we are working closely with the Higher Education Authority, HEA, on the delivery of the Programme for Access to Higher Education, PATH, 4 programme. This is a fund provided by the HEA to build capacity in third level institutions to incorporate universal design as a core part of the built digital environment as well as teaching and learning. The centre launched a new elearning continuing professional development, CPD, module last year aimed at professionals involved in the design and procurement of buildings but open to anyone interested in universal design in the built environment. The module provides participants with a case study of a universally designed public building, bringing them through the design, highlighting accessible features and presenting the real life benefits from interviews and users.

Finally, the NDA is also currently updating its existing elearning training module on disability awareness aimed at public sector staff. I thank members and am open to questions on any of the above.

Deputy Pauline Tully

I thank the witnesses for their presentations. Even though I have dealt with planners for years in the local authorities, I am not completely sure what qualifications planners have. Has there been a change of focus in the qualification to take into account issues of accessibility for disabled and autistic people? I am sure there are many planners who are also autistic. It brings to mind an architect who gave evidence at the Joint Committee on Disability Matters. She said she had been an architect for a number of years before acquiring a disability through an accident. This made her realise that what she had been designing previously was not at all suitable for disabled people. The Part M guidelines only look for a minimum standard where it is recognised that buildings are wheelchair visitable rather than liveable. Hopefully, they will be reviewed under the new legislation. Is there more of an awareness and a focus on ensuring that universal design principles are applied to building and public spaces within planning?

How serious is the issue of the shortage of planners? I was talking to a senior planner in my local area. He told me that they advertised a senior planner position recently and got no applications whatsoever. Twenty years ago they may have got 20 people looking for the position. With the issues with an Bord Pleanála and in the middle of a housing crisis, the last thing we need is to be held up on those issues because of a lack of personnel.

Mr. Brendan Allen

I have been working in planning for 25 years or thereabouts. In my education there was a awareness of it. Generally speaking, it was around the more physical, or seen, disabilities. From travelling abroad and from reading publications from the UK and the United States, I have noticed a higher awareness of the unseen disabilities. This would particularly apply to the design of major infrastructure or public building projects. For example, in the UK, when they designed the new Tottenham Hotspur stadium in White Hart Lane, they built in a sensory space. For somebody who might find it difficult to deal with a crowd of 50,000 people or whatever, they become fully inclusive through that model. That is becoming more and more common. I cannot speak on what kind of education architects get but from the planners' perspective we are dealing with a zoom out space, public realm and public spaces and that type of thing. There is an increasing awareness about things like finishes, visuals and signage to make it easier for people with autism to navigate. People with autism need predictability when moving around spaces. In order to increase awareness of this issue, we had the participation of Mr. Stuart Neilson, a director of AsIAm, in our CPD. Originally the CPD was set out to deal more with universal access, often associated with physical disabilities. To gain an insight into the issue of unseen disabilities, we asked Mr. Neilson to participate.

Dr. Seán O'Leary

We accredit planning schools in UCD, TU Dublin and UCC. The courses of study available are a four year undergraduate programme or a masters degree. These courses are accredited every five years against education guidelines. The last education guidelines we set were in 2019 so they will be reviewed shortly. The courses have an emphasis on access and additional needs. There are a number of core elements that every qualified planner needs to have on graduation and then there are also optional elements. We will be looking at these optional elements. That reflects some of the issues that the committee has raised. There are also additional considerations like developments in climate action and marine spatial planning. There is a whole range of things so those guidelines need to be kept alive. One becomes a full member of the institute if one has two years satisfactory post-qualification experience. One graduates as a graduate member and then one becomes a full or a corporate member after two years.

Regarding the resources issue, research from the County and City Management Association, CCMA, states that in planning departments in local authorities, with the current legislation rather than the Bill going through at the moment, there is a shortage of 541 people in the planning system. That includes planners in local authorities and also administrators and other people with relevant urban design qualifications.

We are concerned that the current Bill is looking for a whole new skill set in areas like urban design which are not necessarily in the country in terms of planners and other built environment professionals. The pipeline issue is relevant to this conversation as well. Across the three accredited programmes, 70 to 75 planners graduate every year.

They go in to An Bord Pleanála, local authorities, private practice, semi-State bodies, climate action, renewables and a whole range of areas. Many of them are international students going back to other jurisdictions. We are alive to the need to increase the skills of planners and make sure their awareness and understanding of this increases while also having to deliver other things across a limited number of credits, keep them in the system and make sure they are applying the skills in the system. That is something else we are working to do.

Deputy Pauline Tully

Are we losing them to other countries like we are in so many professions?

Dr. Seán O'Leary

There is a shortage of planners across the English-speaking world. For example, states in Australia have been contacting us looking to recruit planners from here. We are not alone in that.

Deputy Pauline Tully

The National Disability Authority indicated that it provides independent and evidence-informed advice to Government. Is this advice accepted, or is there an improved acceptance from Departments? I ask that because I often find, with some Departments, that they almost say disability is an issue for the Minister and Department it falls under whereas it is not. It is across the board. Every Department and public body has a responsibility. Is the NDA finding an improved acceptance of responsibility to change things?

Dr. Gerald Craddock

I thank the Deputy for the question. In general, yes. It comes back to education and organisations like AsIAm and others creating awareness of the issues. We come in with independent advice to present evidence that we have looked at international best practice and advise what should be pursued or advanced through legislation or new regulation. One of the issues brought up in the previous question was Part M. We have been talking to the Department of Housing, Local Government and Heritage about revising Part M because it is about visitable housing.

One area we have been heavily involved in over the past 18 months is Changing Places toilets being added to the revised Part M. We are developing national guidance to align with that new regulation regarding Changing Places toilets. The other area is working with the National Standards Authority of Ireland on universal design dwellings for homes and apartments. That is to advance the thinking and understanding about better designed homes that we would see informing the revision of Part M. The Department of Housing, Local Government and Heritage is sitting on that working group, with which we had another meeting yesterday afternoon. It is actively involved in that working group.

If we are talking about the built environment, the answer is, "Yes." We are working with professional bodies like the Royal Institute of the Architects of Ireland. Our next-door neighbours are Engineers Ireland. In the past couple of weeks we have sat, with our fellow attendees at this committee, on programmatic reviews on engineers and what is happening on engineering courses. We have now been able to look at the accreditation for chartered engineers. Universal design is now a key requirement for a chartered engineer. Over the next couple of months, we will be developing further criteria with Engineers Ireland and what that means for student attributes.

Deputy Pauline Tully

I know Dr. Craddock said his organisation monitors the percentage of disabled people employed in the public sector. Does that include autistic people or is there any kind of indication? I think 85% of autistic people are either underemployed or unemployed. Does Dr. Craddock have figures on that?

Dr. Gerald Craddock

Not at the moment. However, in 2019 we carried out a review of the monitoring and Part 5. We are looking for more disaggregated data to come back from public bodies. In the autumn we will be looking at revising the questionnaire that goes out to public bodies. We are always a year behind in the data we publish. For 2025 we should have more disaggregated data, which will be not only on the types of people with disabilities working in the public sector but also at what level they are within the public sector. Again, we have seen people come in at a base level who then do not progress through the organisation. That is another key element we have got from the feedback - looking at where they are in the organisation and if they have progressed in the previous 18 months or two years.

Deputy Marc Ó Cathasaigh

I thank both organisations for their presentations. I am fascinated by the idea of urban design and how it shapes our interaction with our public spaces in a way that we often do not even realise. That is the case both with the places we decide to dwell and spend time and the places we walk through quickly. I have a basic parameter. I have a six-year-old and he is a bit of a live wire. I often judge the quality of my public realm by how tightly I have to hang on to him. Waterford city centre is one of the few urban environments where I can let go of my child's hand and not worry about it.

Coming at it from a neurotypical perspective, a lot of our urban design is not even designed around maximising my experience within that environment. It is about exploiting my tolerances within that environment. It is about what I can put up with as a neurotypical person in terms of visual and auditory clutter. It relies on the fact that I can screen out many of those inputs, be it noise or visual clutter, and still operate within that environment. I do not think it is designed to maximise my experience of the environment. I feel strongly that universal design, not just in private areas, but applied across our public realm, will not only improve the experience of neurodivergent people or those with a physical disability but also will improve the experience of everybody within that environment. I am a strong believer in it.

My first question is a basic one. Are the witnesses talking to each other enough? Are they talking one to another? Are they making sure that the type of research being done in the NDA is transferring into what our planners are putting in? I think they spoke about incorporating neurodiversity at a strategic plan-making level. Is the NDA's work informing the Irish Planning Institute's work well enough? I was always conscious of it as a teacher. I emerged in 2005, and that could have been the last time I upgraded my teaching skills had I chosen to do that. We are all the products of our education. Is the Irish Planning Institute's CPD taking account of the work being done by the NDA? Is the communication there in the way it should be?

Mr. Brendan Allen

The broad answer is "Yes". It is an ongoing type. We clearly would not just be engaging with the NDA. We would bring in other people, as I did for our own particular CPD recently. It is when we get down to designing spaces that we see the granular detail of what the NDA is producing in terms of standards and guidelines, etc. It is at that level we frequently find ourselves engaging with the granular stuff. The making of a development plan will generally be a broad, strategic type level of planning. There are aspects of different participation models that could be brought in and which we could develop further at the plan-making stage, like involving neurodiverse people at the public participation process. As the Deputy has probably seen over the years, pre-Covid the making of development plans involved town hall meetings or this, that and the other.

Deputy Marc Ó Cathasaigh

Mr. Allen will know Arnstein's Ladder of Participation as well as any of us. There is public participation and there is real public participation. I think something that has been made very clear in this committee is the importance of the autistic voice.

A town hall meeting, for example, may not be the place where that voice is heard. I am sorry for interrupting Mr. Allen.

On predictability, and I am not suggesting we go back to these things, aspects of the Covid restrictions functioned very well. An autistic person does not know what 2 m is, as is the case for many people. However, when lines are put on the ground that indicate 2m and where the standing space is, that is the type of predictability that is being talked about. Good things came out of the pandemic. I am guessing we will probably have some research that will pick up on some of those Covid measures that worked, from a sensory-type perspective.

Deputy Marc Ó Cathasaigh

The NDA stated: "There was broad consensus that Ireland needs a set of national shared space design guidelines directed by Universal Design principles." Are we close to getting that? Is any work under way that would move us into that space? Is that something that needs statutory underpinning? I am aware Mr. Allen said that we need to be consistent across our urban spaces if we want a true universal design that neurodiverse people could navigate. Are we a million miles away from that or is any work happening in that direction?

Dr. Gerald Craddock

We are working closely with the National Transport Authority, NTA. For example, we were in Fairview just last week to look at active travel from Clontarf to the city centre. In short, there is confusion about what is shared space. It is a significant issue not only for people who are autistic but those who are blind or visually impaired. What has happened over the past couple of years, particularly in the UK, has given shared space a very bad name. For example, shared space was put on the top of an off-ramp on a motorway at Coventry. People were coming off the off-ramp at 60 km/h to 70 km/h, whereas our recommendation is for somewhere between 20 km/h and 25 km/h in order to create a shared space that includes motorised transport. The biggest issue we are seeing at present is the segregation of, or shared space between, cyclists and pedestrians. That is quite a contested area currently.

The County and City Management Association, CCMA, research found it was 541 in local authorities, which is planners and allied staff such as administrators and so on.

That is before accounting for the number the forthcoming legislation could require. The staff in question are separate from those required by An Bord Pleanála, private practice, regional assemblies and anyone else who might need planners.

An Cathaoirleach

The 70 to 75 graduates include international students. In most cases, they will not practise in this country.

Dr. Seán O'Leary

Some of them will practise here and some will leave and practise elsewhere.

An Cathaoirleach

What is happening with regard to third-level places? Are we increasing the number of courses at third level so as to have more qualified people? What is in place as of today?

Dr. Seán O'Leary

Dr. Gerald Craddock

It is up on our website. I can send the link. We published the report just before Christmas. We have to report every three years to the commission but we produce a yearly report.

We will be holding our board meeting on Thursday and Friday this week, so we should have our second report released, all going well, in the next two weeks.

We had all the local authorities and all the third level colleges in a hierarchy or "lowerarchy", if there is such a word. The phone started to ring rapidly. They wanted to move up the pecking order. We have seen quite an improvement in the accessibility of websites and mobile applications. It is getting that information out and also publish or be damned. Getting the information into the public domain that a website is not up to scratch has created quite a momentum among public bodies. Some of the work we do includes compiling the annual report on the percentage of people with disabilities, overseeing the implementation of the Irish Sign Language Act, which is a new job we got from the Government, and dealing with heritage sites. There is quite a bit of work, so we are seeing how we can bring this together so we can give a composite picture of where an organisation is across a number of sectors. Revision of the Disability Act would help, if we could get more specifics into the Disability Act regarding our monitoring functions as things have moved on quite considerably since 2005 when the Act was written.

An Cathaoirleach

I fully concur about that being reviewed. It is something that has come through this committee in the past 12 months across a number of areas. It possibly should have been done concurrent with the EPSEN Act. It needs to be reviewed. Creating the hierarchy or lowerarchy is important, as Dr. Craddock said. Nothing focuses the mind of an organisation at the bottom more than trying to get back up.

Dr. Gerald Craddock

Especially your next door neighbour.

An Cathaoirleach

That is the way to go.

Mr. Brendan Allen

I will add from my experience, going back the point about training, there will be standards and so on. One of the points the Cathaoirleach made was about training, especially around Leinster House. From an experience perspective, bringing an autistic person through Dublin Airport should, in theory, be a horrible sensory experience because there are bing-bongs, X-ray machines and so forth. However, from my personal experience, the staff are extraordinarily well trained. When a child wears a badge that says "important flyer", it could mean anything, but the staff are immediately able to zone in and they know what to do. I do not ask them. They just know. They have been trained. This is from, for example, the Ryanair check-in desk person to the security guard, to people working in shops. It shows it can be done if we operate off a good model. The airport is processing 30 million people a year. It is all about training and people's constant upskilling of knowledge in that area, but it can be done. I do not know how hard it is or how long it takes, but I guess the staff has to keep updating, upskilling and training. That is only my personal experience.

An Cathaoirleach

I concur with Mr. Allen about Dublin Airport. I probably had a fear as a parent heading abroad with our young lad, but we found it to be a great experience to be quite honest. We knew the safety net was there, that staff were trained and that if there was an issue, it would be dealt with. That is a lot of it. I fully concur with that.

The IPI report mentioned Dublin City University, DCU, representatives from which appeared before the committee to discuss its autism-friendly university guide. We recognise that as good or best practice with regard to rolling it out across all universities.

I am conscious of time. I committed to finishing the meeting by 2 p.m. to allow other meetings to take place. I thank the witnesses sincerely for coming before the committee today to give their advice and share their expertise in their fields. If there is any evidence they feel might be beneficial to us, such as the report when it is ready, I ask them to please send it to the clerk. The committee will be reporting to both Houses on 1 June 2023. I thank the witnesses for their comments and evidence. It will be beneficial to us as we finalise our report to ensure the built environment is there for all in the years ahead and especially for those on the autism spectrum for whom this committee is advocating.

The joint committee adjourned at 1.59 p.m until 12 noon on Thursday, 18 May 2023.

Joint Committee on Autism díospóireacht - Tuesday, 16 May 2023

Autism Policy: Discussion (Resumed)

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Adam Harris

Mr. Brendan Allen

Dr. Gerald Craddock

Mr. Brendan Allen

Dr. Seán O'Leary

Dr. Seán O'Leary

Dr. Gerald Craddock

Dr. Gerald Craddock

Mr. Brendan Allen

Mr. Brendan Allen

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Mr. Brendan Allen

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Mr. Brendan Allen

Mr. Brendan Allen

Mr. Brendan Allen

Dr. Seán O'Leary

Dr. Seán O'Leary

Dr. Seán O'Leary

Dr. Seán O'Leary

Mr. Brendan Allen

Ms Mary Tallant

Dr. Gerald Craddock

Dr. Gerald Craddock

Dr. Gerald Craddock

Mr. Brendan Allen

Mr. Brendan Allen

Mr. Brendan Allen

Mr. Brendan Allen

Joint Committee on Autism díospóireacht -
Tuesday, 16 May 2023