Inclusivity for children with autism spectrum disorders: Parents' reflections of the school learning environment versus home learning during COVID-19.

Whilst attendance in mainstream school helps encourage inclusivity, these environments are recognised as being particularly challenging for young people with an autism spectrum disorder (ASD). The COVID-19 pandemic brought a novel transition as young people moved from school to home-learning. This study compared the experiences of parents of children with ASD and co-occurring health difficulties of school-learning environments with their home-learning environments during COVID-19 lockdown. An interpretative phenomenological analysis was conducted on semi-structured interviews from six parents of children (aged 8-15 years old) with ASD. Four superordinate themes were generated: Interactions between Health, ASD and Learning Environments; School Support and Managing Health Needs; Seeking Solutions; and Learning from COVID-19 Lockdown. The study highlighted the impact of ASD and co-occurring health difficulties on learning where parents found ways to provide positive home-learning environments which could be used and/or transferred back into school environments. These results hold real-world implications where educators could treat sensory and ASD friendly environments as standard and include genuine adjustments for children with ASD and additional needs. A flexible home-learning approach using parental knowledge around environmental adjustments that support learning, wellbeing and a sense of inclusion should be prioritised for children's overall development and wellbeing in these unprecedented times, and beyond.

Using human-centred design to develop innovative approaches to improve delivery of briefinterventions in primary care: The heal their project

Introduction: A priority action of the Healthy Ireland implementation plan is the Making Every Contact Count initiative (MECC) that aims to leverage the 30 million annualcontacts with the healthcare system by asking every healthworker to deliver brief interventions [1]. Benefits of briefinterventions are well established, but GPs and pharmacistsreport challenges implementing them in practice includinglimited training, time, and poor fit with existing practices [2].Aim: This government-funded Sláintecare project aimedto develop a novel method for brief interventions in pharmacy/GP settings using human-centred design.Methods: User research was carried out with twelve users,including patients (3), GPs (4), and pharmacists (5) to identify their needs and priorities. Participants were recruited viaemail using a purposive sampling approach and completedsemi-structured interviews with a design researcher. All participants invited agreed to participate. Next, a series of design sprints were completed with the research team. Designsprints allowed the team to integrate insights from user research with findings from a literature review/secondary research to understand pain points, identify stakeholder anduser goals, and develop a list of initial design specifications.This list was used to develop and iterate a series of prototype solutions. Prototype service blueprints and wireframes(simple, two-dimensional schematic illustrations of thedigital interface) were developed and tested with users before final versions were agreed.Results: Findings from the interviews and literature review indicated (1) the main barrier to adoption was time, (2)patients and pharmacists were very positive about brief interventions with GPs more hesitant, (3) an approach blendingtechnology with a consultation was preferred, and (4) havinga specific list of local supports was important. Prototyping and evaluation processes identified that a simple interfacewith a clear indication of progress were preferred.A blended intervention combining a tablet-based digitaltool and structured interaction was developed. The interface was designed to maximise use of patient and healthcareprofessional time, and mapped to the 5As approach (whichis underpinned by principles of motivational interviewing,shared-decision making, and readiness to change frameworks). The HealthEir digital tool enables patients to selfcomplete the Ask, Advise, and Assess phases of a briefintervention using a tablet device while waiting to see theirpharmacist/GP. The pharmacist or GP then review thepatient's responses, risk level, and importance confidenceand readiness scores. They complete the Assist and Arrangeelements during the consultation, supported by a directoryof local/national patient support services before printinginformation tickets for the patient to keep. The HealthEirintervention has been successfully rolled out at eight pilotpharmacy sites nationally, with a mix of urban/rural sites,and independent/chain pharmacies.Conclusions: Adopting an interdisciplinary approachbased on human-centred design principles led to the development of a blended brief intervention that has been successfully introduced in pilot sites across Ireland. While theimplementation has been smooth despite COVID-19 challenges, and initial feedback has been very positive, the impactcannot yet be fully evaluated as research is ongoing. Futurework will involve extending the intervention to include otherhealthcare professionals.