Joe O'Toole (Independent)

Where did we hear that before, "a lot done, more to do"? Senator Ormonde seems to be describing a different country from the one we are dealing with on the ground. The reality is that autism is not being dealt with in any real way. There is an extraordinary shortage of people at all levels. I agree with Senator Ormonde as regards the shortage of professionals. It is not just at the therapy end. Where are they? There is a shortage of educational psychologists. Those we have are running around the country testing. They do not have the opportunity or the time to plan programmes in consultation with the groups mentioned by Senator Ormonde and then to implement them. One is constantly being told about the number of people waiting for assessment. The real difficulty is what happens next. I know educational psychologists from Ireland who are working in the North or in the UK. The reason they will not work here is because of the total frustration of not being able to sit down with children who have problems and plan programmes that can be implemented and assessed. Their whole working life here is spent testing and testing, eventually getting reports out but without any subsequent follow-up.

Autism above all issues is extraordinarily complex. I have always failed in explaining autism to people, even to teachers who had not dealt with it themselves. It is important to talk to ordinary people about it. The autistic spectrum covers such a wide range that we really need people to have some clear understanding. People thinking or talking about autism should recognise that some autistic people have very high IQs. They are often very bright people with extraordinary creative drives. It is a condition, for want of a politically correct word, that is rooted in problems of social, emotional and communication skills.

In terms of communication, autistic people tend to interpret the absolute meaning of words. Whereas the average person might say, "I will kill you if you do that", an autistic child might well believe he or she is going to be killed. They cannot get out of that. The position is the same in terms of their social skills. The tactile sense is foreign to them. They are not emotional. They are not clingy. They do not like touching or hugging, in general terms. There is an emotional difference in the way they relate to people and places. If one takes the three areas of difficulty, emotional, social and communication, that is where the problem starts.

That might not be a huge problem in many cases, but what happens next is crucial. It is because of their different interpretation of words, their social and emotional responses, that they appear different. They recognise themselves to be different. They are distressed about this and it is from that level of distress that they will suddenly ask: "What am I doing wrong here?" Their interpretation of what they are doing wrong is also wrong. This just leads us into a riddle. It is a good idea to see autism as a type of see-through rubric cube because one can move in all sorts of directions within a shape, but at the same time one can hardly explain it to people. It is extremely difficult to understand.

Given its complexity, it ranges from what might be called mild to serious levels of autism. These are just my words; I am not sure precisely what they mean. Not all autistic children are the same. In fact, no two autistic children are the same. Then there are those with a high level of function with autism, normally referred as people with Asperger's syndrome. They need a different level of response.

One of the problems here is that a fully functional educational psychologist has to be a fully qualified teacher, with teaching experience over a number of years and must also be fully qualified as a psychologist, with experience in psychology for at least a couple of years. That entails a longer course than a surgeon's. I do not know whether people understand that is the calibre of person required. They should be able to go into schools and explain to pupils, teachers, parents or whatever what it is that is going on. To try to explain autism can be so difficult. The shortage of educational psychologists is a problem. Then there is a temptation to promote or allow people to become educational psychologists with a slightly lesser level of qualification than I have just outlined. They would be recognised, but they might not be fully trained teachers or psychologists. They might be fully trained teachers without a diploma in psychology or fully trained psychologists without teaching experience or qualifications. Any school will say that an educational psychologist must be someone who is a psychologist and a teacher who also specialises in education psychology. It is complex.

One looks at the autistic child and the level of response in social situations, the communication and emotional difficulties. One assesses how the child is interpreting "reality", the levels of distress and confusion and the behavioural difficulties as they arise and on that basis plans a programme. For that programme to be put in place, the teacher will need a high level of support at school level. When we talk in this House about more money for special education and psychology, forget about the broad vision: what we mean is a child with autism who needs support, very often one-to-one support involving one teacher and one pupil. If I said that on television or radio, people would say I was asking for the moon but there is no other way to do it. Along the Border there is considerable co-operation and a public representative from Northern Ireland told me that in Middleton in Armagh a full new autistic unit has been built but lies unused. That could cater for some of our problems as well as those of the South Eastern Education and Library Board in the North. We must encourage people to work together on both sides of the Border on that issue, particularly in the Border schools. Once an assessment is carried out, the psychologist should be anchored to remain in contact with the child instead of being sent off to do more assessments. The psychologist should meet the teacher, the principal teacher, maybe the parents and the support teachers in the school, to outline the programme for the child who has a particular difficulty in communication skills or in the emotional area. They can collaborate to help the child through the distress and confusion caused by the autism which is rooted in social, emotional and communication difficulties.

There is a shortage of all kinds of therapist, whether speech or occupational. We all know the work they do but until we must attend an occupational therapist ourselves or have a frozen shoulder and attend a physiotherapist, we do not understand how useful they are. Many people know someone who has had a serious stroke resulting in a loss of speech, or movement on one side of the body but who, with therapy over some months, can regain 90% of those powers. The same can be achieved for autism but because the problem is inside a child's head, it is not as obvious. That is why we must put these services in place.

I may stand up here and make a strong case for the national development plan, more roads and investment in railways, and the opening of the Sligo-Limerick line and so on but if I have to make a choice, I will. If someone tells us that the development of extra DART stations is being delayed in order to put the money into dealing with autism, I will support that and will give the Government fair dues for the decision. I can understand Senator Ulick Burke's point about the frustration at our level because we cannot see this happening. We must grasp this issue and do the business here because otherwise we are letting down the children and their families.

Several schools in east Clare, close to the Minister of State's Limerick constituency, have done good work to deal with autism in primary schools and have been quite successful. We all know the difficulties families who have a child with autism face in trying to find support and help; they will do anything for their child. In addition, they have another difficulty which sees their relatives, friends and neighbours involved in a constant series of fund-raising activities for some special school or unit which does not have money to provide the service. This is an extra tax on these people in the absence of Government resources and distribution of tax revenue. I urge the Minister of State to consider this.

I am pleased to have had the opportunity to address this issue. It is important that the Houses of the Oireachtas discuss such issues. The Minister of State needs to bang the table and ensure the Cabinet listens and makes money available for the services we want to achieve in this area.