Autism, towards a new integrated programme: personalized courses and assistance for all ages

There are no unique standards to effectively treat autism spectrum disorders, but personalized life and care plans. If autism diagnoses grow, then it is necessary to identify integrated paths involving families, social and health services, multidisciplinary professionals.

With this objective, the Emilia-Romagna Regional Council is preparing to approve the Integrated Regional Program for Autism 2023-2027 (PRIA) in the coming weeks, the result of a two-year joint effort involving family associations, the offices of Health, Welfare and Schools of the Region, the Health Trusts, the Regional School Office and local authorities. By listening to the requests of the Associations and examining the data and resources available, we have arrived at a shared Program which introduces several innovations compared to the past. Today the presentation of the PRIA in the Assembly Commission.

The resources for the two-year period 2022-2023 amount to 6.4 million euros from regional health funds, to which approximately 4.5 million euros have been added for 2022 alone, provided for by the Ministry of Health with law 134/2015 and a further 7, 5 million provided by the Ministry of Disabilities with the Fund for the inclusion of people with disabilities: overall it is therefore more than 18 million euros.

They will be invested in training, early interception of disorders in children, definition of multidisciplinary teams that integrate both health and social assessments for the preparation of personalized life and care projects for adults.

All to deal with a phenomenon that is also growing rapidly in Emilia-Romagna: only considering users suffering from autism spectrum disorders followed by the Child and Adolescent Neuropsychiatry service, in ten years the number has grown by 244.9% , going from 1,584 assisted in 2011 to 5,464 in 2021.

“This plan is the result of a long process that has brought families, health professionals, the world of schools and associations, the Region and local authorities around the same table – comment the Councilors for Health, Welfare and School Policies Raffaele Donini, Igor Taruffi and Paola Salomoni -. The growth of diagnoses demonstrates the relevance of this phenomenon, which however must be interpreted and treated not only from a purely health point of view, but also taking into consideration the social, cultural, economic variables of people affected by autism spectrum disorders, to arrive to define personalized life plans”.

“The regional autism project is finally renewed and this openness to services for adults is appreciated – underlines Marialba Corona, president of Angsa Emilia-Romagna (Angsa Bologna, Angsa Parma, Angsa Piacenza, Angsa Ravenna, Fondazione dalla Terra alla Luna Ferrara, Aut Aut Modena, Autism Faenza and Imola Autism) -. Equally important, for the childhood age, is having kept some points such as the 4 hours of direct treatment for early childhood, obtaining supervision in the school environment carried out by behavior analysts also in the other age groups. Now our job will be to monitor its implementation, with particular attention to the provision of care allowances for minors and adults, with respect to which the Region has ensured its commitment”.

At Barca a space dedicated to autistic children

The innovations introduced by the Program

The involvement of different actors through provincial working tables represents a fundamental novelty for this Programme. Another important aspect concerns the adoption in each Company of a specific Diagnostic Therapeutic Assistance Path (PDTA) which clearly identifies objectives, available resources, treatment times.

Furthermore, at an organizational level, the establishment of a regional technical group for monitoring and verifying the implementation of the plan is envisaged, with the participation of the associations.

For minors, an essential point is the investment in specific training at the provincial level for support teachers and educational assistance personnel, with supervision at the schools for each individual case. The PRIA program then underlines the importance of intercepting forms of autism early, through a specific project that will involve the staff of nurseries, kindergartens and paediatricians of free choice.

For adults, the key point concerns the definition of the process of taking charge, which must be contextually defined by the health, social and health services, by the reference social services under the supervision of the mental health departments of the Health Trusts. This is because, for example, even people with mild or medium autism, if they are in a situation of social fragility, may need support (housing, occupational and socially related) to participate in the life of a community: decisive from this point of view having regard to the role of local authorities which can ensure these services through additional resources provided for in the area plan.

At the local level, the Program provides for the definition of multidisciplinary reference teams that have health and social skills, connected with the Mental Health Centers and the Primary Care Department: these teams are involved in planning the network of social and health services and in the implementation of programs of qualification, training and supervision of services dedicated to people affected by autism spectrum disorders. In the event of serious or very serious disabilities, the professionals of the Multidisciplinary Evaluation Units (doctors, paediatricians, social workers) also participate in these teams.

The teams define the life plan of each user and the pathways for accessing care articulated within the company areas. They do not operate in isolation, but integrate their interventions with other services, such as those envisaged for targeted placement for people with disabilities and for the social and work inclusion of people who find themselves in conditions of fragility and vulnerability, also exploring hypotheses alternative and innovative accompaniment and assistance at work.

Autism, towards a new integrated programme: personalized courses and assistance for all ages