James Reilly (Dublin North, Fine Gael)

I thank Deputy Brian Hayes for bringing this motion before the House. Approximately 20 years ago I was a member of a health board and became involved in an educational sub-committee involving inspectors from the Department of Education and Science. At that time, the Department still refused to acknowledge there was such a thing as autism. Following numerous meetings with officials, they softened their position to accept there might be such a thing as autism but it did not require any particular educational approach.

Thankfully, we have come a long way since then. I accept that matters have improved greatly but I urge the Minister tonight to go the last leg of the journey that would allow children with autism access to the educational support they need, which is primarily one to one. This can be achieved through ABA and other mechanisms. I have no issue with the concept of an eclectic approach but I do take serious issue with the fact that the current eclectic approach as described by the Minister is not a one-to-one approach but a one to six with two special needs assistants, SNAs. The Minister has failed to convince this House about her approach.

I know from my own research that many SNAs have no specific training in autism and that even teachers who are involved in the classes are not what one could describe as experts in the teaching of children with autism. As other speakers pointed out, the co-author of the Government task force report on autism accused the Minister of following a grossly misguided policy on education for autistic children. She said that "international research for the past 40 years shows that up to half of children who engage in ABA as a primary method of preschool intervention go on to mainstream education without any additional supports". She further indicated that the Minister had not sufficiently educated herself on the various methods of educational intervention for children with autism and that she consistently made very basic errors when referring to applied behaviour analysis. She stated in regard to the Minister: "If she read anything about this approach and-or visited any classroom which follows this as its primary methodology it would be clear to her that this theoretical orientation is utilised to teach children not only basic learning behaviours required to learn but also language; speech — a prime component of early intensive behavioural intervention; self care; daily living and leisure skills; social communication and routine preschool teaching; and, for the older children, the national curriculum."

Dr. Honan said the task force report listed ABA as the first and most effective educational approach to dealing with autism. She also pointed out that both TEACCH and PECS are used in this system, according to each child's needs and that all other interventions that emerge in the field are closely evaluated and, where supported by scientific evidence, incorporated into the classroom.

It appears that many ABA tutors who have a four year degree in areas such as psychology are not regarded as being qualified in the eyes of the Department. ABA schools provide an eclectic approach. They use all modalities with the principle that they have highly trained skilled personnel available on a one-to-one basis for the children and the outcome after three years is nothing short of dramatic.

Even if the Minister did not have an ounce of humanity in her and if she had no sense of what was morally right, she would surely see the benefit from an economic perspective of having children assessed in a timely fashion. This is an issue for the Health Service Executive and the Minister for Health and Children. The delay in getting an assessment is somewhere between 18 months and two years. If these assessments were carried out at an early stage and appropriate educational facilities were made available, many of these children would be able to attend regular schools. While many children may require additional help through the special classes for autism in ordinary schools, we would all support the overall aim of integration. It is clear that this will not be possible in all cases but for a large number of children with autism this is the preferred route and this is what will give the child, the family, the State and the Exchequer the best outcome.

When I was a member of a health board more than ten years ago, I estimated the cost of "specialing" a patient. In psychiatry this is the term used to describe a situation where a patient is minded 24 hours a day. A dedicated nurse is provided one to one to prevent a patient from self-harming or harming others. The cost was £100,000 ten years ago. I do not know what that is in today's money. I do not know how many of those cases are in psychiatric institutions. I do not have any idea how much money it would cost but it would be a damn sight more than the €5 million to €6 million that it is reckoned is required to support the further 12 ABA schools it is proposed to establish. If the Minister has figures to the contrary perhaps she will share them with us.

Natural justice, humanity and fairness demand that ABA is made available to those for whom it is the most appropriate mode of treatment. Early assessment is essential. It is nonsense to have speech and language therapy for the education of young children solely under the remit of the Health Service Executive when clearly the Department of Education and Science should have access to it. I know of one school in Swords which has special needs assistants and teachers but it cannot get any speech and language or occupational or behavioural therapy.

As the Minister is aware, ABA operates for in excess of 240 days of the year because children with autism need far more intervention than the average child in terms of an educational input week in and week out. To operate according to the normal school year is counterproductive. We have reached a situation where we are to have 12 pilot ABA schools. Are we to wait another ten years for them in the way we have to wait for cervical screening?

Yvonne Ó Cuanacháin recently asked: "How do you fight the whole resources of the State when they are brought down to bear on you...when they decide to fight such a terrible and aggressive case?" I urge the Minister to think as a mother, to think of the devastation on getting the diagnosis. She should think of the darkness descending over her as her beautiful child's future disappears before her eyes. Think of what it is like to live in a house that is totally disrupted by this child and the destructive capacity of many of these children as they try to deal with the frustration caused by their disability. Then think of the hope that ABA represents, the thought that one's boy — it is usually a boy as three out of four with autism are boys — might after all have a shot at what we describe as normality, a chance of a normal education later in live, a chance to go university, to be independent. Then imagine what the Minister's current policy is doing in depriving parents of this opportunity. That is why parents risk all, even their houses, to give that chance to their child. I ask the Minister to restore hope, ease the pain of these families and spend what is, in the context of the €900 million, a measly €5 million to €6 million to secure the future of our children.

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