Developing digital approaches for adolescents and young adults with autism and learning disabilities: Tools to facilitate access and shared decision-making

Abstract

Aims:Digital living is now an integral part of many children and young people’s (CYP) everyday experience. Practitioners who work with them are increasingly focused on effectively deploying technology to help those with social, emotional and mental health (SEMH) needs. Throughout all aspects and phases of work, practitioners must adhere to legal and professional best practice standards in involving service users, person-centred working and in enhancing accessibility for all.Methods:Measures introduced to reduce the spread of Covid-19 triggered significant service delivery change in a specialist multi-disciplinary child and adolescent mental health service (CAMHS) team. The majority of assessment and intervention work moved to an online audio and web conferencing platform. A shared decision-making approach was developed to support service user understanding of online appointments and to giving informed consent, in line with the i-THRIVE Framework for system change (Wolpert et al., 2019). Three Guides were developed and distributed ahead of online appointments: written, easy-read and video.Findings:Data collected within a Quality Improvement (QI) framework indicated that the Guides supported practitioners to prepare service users, as well as themselves, for digital working. The Guides supported service access, collaborative decision-making and increased CYP autonomy. Their introduction also led to conversations about equity and cultural responsiveness, as well as serving as a model for the development of aids to support shared decision-making for autism diagnostic assessments.Limitations:This paper outlines the first phase of the QI project with a small participant sample and requires further engagement with service users to review the use of Guides and shared decision-making decision aids.Conclusions:Digital approaches present new possibilities and are rapidly changing service delivery across CAMHS. The importance of involving service users in shared decision-making when developing digital practices must be held in mind as part of this change process.