Dr. Susan Crawford:

I thank the Deputy for the question, which is, of course, entirely unanswerable at this stage. My view is that we have to have a legislative commitment to change. We should stop talking about it and say we are going to implement the following changes in the legislation, outline them and on we go. One thing backed up by research is that if schools refuse to take autistic children, it means the buy-in is not there from the top down. That is where we need to pull back a step and start educating educators on what is important and what is real inclusion. We are good at firing out these words and we are very lofty as researchers and lecturers, going all over the world giving speeches about various subjects, but implementing change is very different, as in being the change. I have often heard lofty conversations, lectures and keynote speeches from people talking about inclusion, whereas their own departments are not always so inclusive. It has to be an inherent, philosophical sea change from the top down and the bottom up. I see locally that if it is put to ordinary people on the ground that they can come and learn about autism or about our way of understanding and being, they will say all they want is to be told. I have encountered this time and again.

The same is true of working from the top down to get teachers to buy in. Of course, it has to go back to initial teacher education. When I was at University College Cork, I conducted a study looking at initial teacher education and educators' ability, knowledge, skills and so on to accommodate students with disabilities in general or students who are autistic specifically, and they will scream about how they have no ability to do it properly. They get whistle-stop tours through the subject in undergraduate education, and it is similar in postgraduate education unless the person tries to go deep into the issue as Ms McSherry and I have done. Education is huge. We need to back in there, strip it back and ensure it will be part and parcel of any educational process that autism is clearly specified to be addressed.

We are talking of one in 60, at least. The Centres for Disease Control and Prevention in the United States speaks of about one in 54 of the population being autistic. I would say Ireland is not far behind that, in reality. It is about looking at it and saying that we will be the change we want to see, and starting in those areas such as education, health, and so on.

On the HSE, where would one begin? I really mean this. There is no joined-up thinking in the HSE. I brought that expertise over from the US around the whole area of catatonia of autism and I now have any number of neurologists contacting me asking how to go about getting something similar in other pockets of the country. The HSE should be doing that, not Susan Crawford as a parent. There is so much wrong. The HSE does not even look to know what is going on here local to us that we have set up and which they could be replicating around the country. There is no joined-up thinking in the HSE. There is a model of good practice here in the mid-west that has not spilled out around the country. That is just a working example of the total lack of joined-up thinking.

Deputy Tully asked if I believe the education setting is ideal for having multidisciplinary team input. It is a very definite time and day and there is scope there to plan and implement. The other side of it is that anything we implement must be joined together so that the occupational therapist is working with the teacher, and the physiotherapist and speech and language therapist are working with the psychologist and so on, so we are all singing from the same hymn sheet. If one is going off to a private therapist here and a private professional there and dipping pieces in, it is very hard to bring all of that together. If all of this expertise is coherently in one spot it makes all the difference. This is why, back in the day, our unit just took off. It had everything going for it just so seamlessly.

I cannot speak strongly enough about the importance of movement. If autistic children are learning movement skills from an early age it can be a lifesaver in terms of managing their behaviours and keeping them regulated. Movement breaks throughout the day can mean somebody is not coming home and attacking their parents or whatever is going on in many houses, as we know. The reality is that these types of measures need to be implemented and put in place in schools, and ingrained in the educators as well. Back in that time, two experts Dr. Rita Jordan and Professor David Sugden came into the unit to work with the staff. Ongoing workshops were the order of the day before any Croke Park hours or anything else. It was all part and parcel of what that whole process was. We knew a bigger picture had to be filled and we knew that the workshops and the continuing professional development had to be ongoing. There were all of those little steps that can be implemented.

As legislators, I say that members must hammer on the door and be the ones who actually draw up the change.