This is something I’m struggling with a lot.

Our rules say that we have to treat children as being entitled to have their confidence kept – although there are exemptions and we warn children and young people that everything is confidential unless its something that may cause them harm, or someone else may be at risk etc. More problematic for me, is the idea that chilsren and young people can decide for themselves if they want treatment. This makes sense for youngsters in their mid-teens – there is the modification of the Gillick Ruling where   Lord Scarman says As a matter of parental law, the parental right to
determine whether or not their minor child below the age of sixteen will have
medical treatment terminates if and when the child achieves sufficient
understanding and intelligence to understand fully what is proposed.”
But how does it work for the adolescent with ASD who can not see beyond his immmediate needs and wants? I was at a Conference on Transitions for young autistic people – what was available? and met with several parents. One mum was worried because her 16 year old will no longer leave hisbedroom, which make sthe whole notion of Transition fairly academic.In that case, the thinking was probably quite simply: if he is not willing to leave his bedroom, then he is not able to determine the best action for him.

Of more concern is probably the more doubtful case: the girl who seems very able, does well at school but refuses to take her exams, Or the boy who refuses to see the psychologist because it is perfectly usual for him to talk to everyone by text message, or even the young person who denies they need help but refuses ever to wash or wash their hair? I suppose it might be said that a young person has the right to make those decisions…. but whatever happens then impinges on the parent. The unwashed boy will be rejected, and the parent can imagine and will bear the consequences. The texting person may communicate well enough in the short-term, but what then?

Transitions is a time of change. People on the spectrum dont like change – how much should be down to them?