NDIA Accountability Project

Submission 79 — Ashton's Place — Inquiry into the Thriving Kids initiative

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ASHTON’S PLACE

Supporting children with Autism

Ashton’s Place

Supporting children with Autism
Liz Barclay
Director of Clinical Services
Ashton’s Place
redacted
01 October 2025

Committee Secretary

Health, Aged Care & Disability Department of the Senate

PO Box 6100

Parliament House

CANBERRA ACT 2600 AUSTRALIA

Dear Committee,

Submission to the House Standing Committee on Health, Aged Care & Disability

RE: Thriving Kids Initiative

I am writing on behalf Ashton’s Place, a charitable foundation dedicated to supporting young autistic children. I am the Clinical Director of the foundation, and a paediatric occupational therapist. I have 18 years of experience working with young children in the public (community health), private and not for profit sectors. I have an in-depth understanding of the early intervention, the early education and care sector, and the assets and barriers that families of autistic children face within these sectors.

Ashton’s Place is a registered NDIS provider. One of the key goals of our organisation is to support young children with autism to develop the emotional regulation, resilience, understanding of routines, self-help, play, social participation and independence skills that are needed to access the early childhood education and care setting. In many cases, the children that we support have been unsuccessful in accessing the early childhood and care setting, and have been excluded due to their high support needs and/or challenging behaviours.

As an organisation, we offer three key models of support:

  1. The Autism Connect Early (ACE) Programme - supporting young autistic children to develop the skills needed to participate meaningfully in the early childhood education and care setting, and prepare for a successful school transition.
  2. Educator capacity building in the form of mentoring and coaching.
  3. Traditional therapy in a clinic or home setting.

These evidence-based models have been developed to meet the unique educational needs of autistic children by emphasising regular access to high-quality early intervention, continuous parent education and skill-building, and generalisation of functional skills (mastered by the child) across all key settings (home, kindergarten, community). Importantly, families are able to access these early intervention supports through the NDIS. This not only creates opportunities for greater access to early intervention per se but also exposes children to the specialised approaches shown to be efficacious in the research on autism learning and education for autistic children with support needs that extend

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ASHTON’S PLACE

Supporting children with Autism

Ashton’s Place

Supporting children with Autism

across severity levels 1, 2 and 3. Because these models have been developed in line with research recommendations and evaluated for their effectiveness by researchers from the University of New England, I am confident in putting them forwards as robust and viable autism-specific approaches for the new Thriving Kids Initiative.

I am excited about exploring possible avenues for partnering with this new government initiative for maximising outstanding outcomes for children with autism, their families, educators, and service providers.

redacteding the time to consider this submission.

Liz Barclay Clinical Director Ashton’s Place

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Submission to the House Standing Committee on Health, Aged Care & Disability

Thriving Kids Initiative

Terms of Reference Addressed

A. Examine the effectiveness of current (and previous) programs and initiatives that identify children with developmental delay, autism or both, with mild to moderate support needs and support them and their families. This should focus on community and mainstream engagement, and include child and maternal health, primary care, allied health playgroups, early childhood education and care and school.

A. Effectiveness of programs and initiatives that identify children with developmental delay and autism—Family Experiences and Perspectives

  1. Current procedures for comprehensive developmental assessment are slow, disjointed, subjective and often unregulated terms of the people making diagnostic recommendations, particularly in regional areas.

  2. Limited pathways for diagnosis exist within the public health system, particularly in regional areas. Families often report waiting several years for confirmation of diagnosis, particularly in regional areas where access to an experienced and multidisciplinary assessment teams is limited. Without dedicated NDIS funding for diagnostic assessment, families without funds for private assessment are precluded from timely access to early support when early intervention has been shown to be the most impactful in relation to short-term and sustained benefits. This issue contributes to the socioeconomic divide and renders a proportion of children to disadvantage and poorer life outcomes.

B. Current programs and initiatives that support children and their families with autism and developmental delay—Family Experiences and Perspectives

  1. Families are pleading for their autistic children to receive access to specialised and child-focused supports that are recommended by experienced professionals. Importantly, generic support models (e.g., the child attending a playgroup) are not suited to the learning needs of autistic children and cause them to ‘fail’ in achieving important learning objectives. This, in turn, creates parental distress as they observe their child struggling without effective support.

  2. The NDIS has been significant in enabling families, particularly those who are already financially disadvantaged, to access direct support in terms of building their capacity to understand and assist their children.

  3. The current model of inclusion support extending across Early Childhood Development Programs (ECDP), class specific inclusion support, and allied health playgroups does not work for autistic children. There are several reasons for this situation which begin with long wait periods for early childhood education and care providers to have inclusion support applications confirmed through providers such as KU (this trend exists across numerous metropolitan and regional locations in Queensland, New South Wales and Victoria). If funding is made available, it is not individualised to the child, and incumbents are often lacking in the skills required to understand and support children with diverse learning needs – particularly in regional areas. This results in children with

complex support needs being supported in a 1:11 adult to child ratio and the risk of educational trauma due to children not receiving sufficient support.

  1. Undiagnosed children with complex and challenging behaviours are not able to access the support and/or individualised approach they need in the early childhood and care setting. This results in exclusion from care, impacting parental mental health and ability to participate in the workforce. It also impacts directly on worker retention in the early childhood and care and teaching workforce.

Conclusion: The current models of comprehensive diagnosis, assessment, and inclusion-based early childhood education are not working for children, families, and educators.

Using an evidence-based approach to addressing key barriers:

A. New model for inclusion of autistic children Ashton’s Place has been piloting an approach to better support autistic children in early childhood education and care settings. The Autism Connect Early (ACE) Programme offers an individualised approach to meaningful participation (inclusion) in the childcare environment. Learning experiences linked to individual goals are developed by special needs teachers, occupational therapists, speech pathologists and behaviour practitioners. These experiences are delivered by a team of educators and therapy assistants under the guidance of therapists across a range of learning activities. Because the key aim of this programme is to build childrens’ capacity for inclusion and transition into mainstream schools, all children are supported to engage with their autistic and neurotypical peers, in experiences that are developmentally appropriate, motivating for, and meaningful to them.

The ACE Programme has been developed in collaboration with senior researchers from the Brain Behaviour Research Group at the University of New England and submitted to formal evaluations to examine its effectiveness in supporting autistic children with poor communication and complex needs. The research team has adopted a triangulated approach to evaluation by collecting data using multiple methods (e.g., standardised tests, observational scales, self-report scales) and monitoring the effects of participating (the child), experiencing/observing (the parent), and delivering (the educator) ACE Programme. The full evaluation process has involved in-depth and detailed analysis but for this submission simplified case studies that show ‘change’ are provided in appendices. Child changes are shown in relation to skill development in adaptive capacity, communication, fine motor, gross motor, play, self-regulation, and social emotional domains. Parent and educator changes are shown along the dimensions of confidence and satisfaction.

These evaluations show that the programme is effective in supporting children whose families have reported previous negative experiences and/or exclusion within previously-attended early childhood and care settings. Importantly, the ACE Programme has been of particular benefit for children identified as being ‘high needs’ on the five criteria of social engagement (low with all others), speaking capacity (absent to minimal), and isolated/restricted play patterns (high). These children experience delays in motor skill development and are highly prone to become overwhelmed in generic environments that do not support their sensory needs and tolerances. These children have not achieved the pre-requisite skills needed to succeed in standard early childhood learning environments and often require 1:1 support to feel safe and remain open to learning. The child is exposed to learning

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Supporting children with Autism

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Supporting children with Autism

experiences following a relationship building process that ensures educators understand and empathise with the child’s experiences (see Appendix A for child and parent case studies).

The ACE Programme is built on four key pillars, shown in the research, to be essential to promoting success for autistic children in the early education and care setting. Each of the pillars below represents a dimension along which systematic change is made.

  1. Educators
  2. Peers
  3. Environment
  4. The child

Meaningful Inclusion in the ACE

Reviewed research evidence using a neurodiversity lens

  • Inclusion happens ad hoc
  • There are gaps in our knowledge

Barriers to inclusion success

  • Expensive ‘resource heavy’
  • Specialised
  • Time consuming
  • School settings are not set up for it

Our challenge

  • Apply meaningful inclusion and monitor its effects …. How are we tracking?

B. Research Findings and ACE Pillars

  • PILLAR 1: Educators
  • PILLAR 2: Peers
  • PILLAR 4: ASD Child
  • PILLAR 3: Environment

The ACE Programme aims to help autistic children to participate in inclusive experiences that enhance their learning and relationships. Due to this, regular and positive exposure to typically-developing (TD) peers is essential. To ensure that peer-based interactions are successful (from the perspectives of autistic and TD children), peers are actively prepared to welcome autistic children in the classroom. This preparation centres on the autistic and TD childrens’ learning needs and can involve educating peers about autism and acceptance of diversity, specific skill-building (e.g., use of alternative and augmentative communication (AAC) technology), and social responses to sustain social interactions and build relationships with autistic children. Importantly, this preparation is delivered by educators who are trained in supporting and guiding TD peers in strategies for understanding and including their autistic classmates.

Some findings on inadequate preparation of peers:

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  • Increases the likelihood of autistic children being bullied, poor long-term outcomes for autistic children, and burnout of typically developing children (Humphrey & Hebron, 2015; Locke, Anderson, Frederick, & Kasari, 2018; Reiter & Vitani, 2007). This highlights that typically developing peers are also likely to suffer when support is inadequate.

  • Attempts at inclusion of autistic children in mainstream environments with no preparation can lead to negative peer perceptions and further isolation (Linimayr, Lindahl-Jacobsen, & Farias, 2023).

Some findings on effective preparation of peers:

  • Leads to increases in social skills for TD and ASD children, and the formation of friendships for ASD children, which can have a protective effect against bullying in later years (Cappadocia, Weiss, & Pepler, 2012; Locke et al., 2018; Mazurek & Kanne, 2010).

  • Educator training in how to prepare TD children for interactions with their autistic peers is significant to its success.

Specific Recommendations:

  1. Increase workforce capacity and skill set within the public health system (primary care, child development teams) to enable early identification of developmental delays and neurodevelopmental disorders. Establish a robust process for diagnostic assessment that is delivered in a timely manner.

  2. Increase developmental surveillance within the early childhood education and care setting. Specialist itinerant support teachers or allied health professionals, complete with autism - related training and hands-on experience should be employed to fulfil this role.

  3. Increase funding to ensure greater access to inclusion support in early childhood education and care. Children must receive support from workers with specific skills and training in understanding neurodiversity, building relationships, and a positive behaviour approach. This cannot be achieved in current workforce ratios.

  4. Consider a model such as the ACE Programme to support children in accessing individualised supports, that target their developmental goals, within their educational setting—the place where a substantial amount of their time is spent. The model should also encompass the education and skill development of neurotypical peer groups to understand, support and include their autistic peers.

C. Identify Gaps in Workforce Support and Training Required to Deliver Thriving Kids.

  1. Early childhood educators and teachers are not equipped with the skills and knowledge needed support autistic children, particularly those children who demonstrate challenging behaviours.

  1. Current early childhood regulations specify a 1:11 adult to child ratio. Many Kindergarten classes have between 5-10 children with additional support needs, who may often require 1:1 support.

  2. There is a young and largely unregulated workforce of allied health practitioners working in the NDIS system. Often providers may be working with children and families with complex needs, but without the practical experience, clinical supervision or specialist training that is needed to work with this population. Completing an allied health degree does not give a graduate the specialist skills required to work in the early intervention space. It is not uncommon for a graduate therapist to be given a caseload of 50+ children, with monthly (if that) supervision with an online mentor. There is limited opportunity for in-person mentoring, or work shadowing for junior therapists, which is an essential part of skill development, particularly in the early intervention context.

  3. There are discrepancies in the quality of supports regional Australians can access in comparison to families living in metropolitan areas, with the former group of people experiencing substantial disadvantage.

  4. There are limited pathways for diagnosis within the health public system. Child development teams, particularly regionally, do not always have access to someone qualified to complete a diagnostic assessment. Families are forced to pay privately if they want their child to be comprehensively assessed but this option is not available to a large proportion of families.

Conclusion: Numerous and large gaps in staff knowledge/training, educational procedures, and limitations in service options do not provide a sufficient basis for delivery of the Thriving Kids Initiative. The initiative will fail without carefully planned and implemented remediation of these issues.

Using an evidence-based approach to address workforce limitations:

The first pillar for meaningful inclusion directly addresses the issue of low workforce readiness in supporting autistic children within existing contexts and frameworks. Effective training of educators is not only most likely to lead to effective support of autistic children, but also greater feelings of educator confidence, self-efficacy, and satisfaction (Emam & Farrell, 2009; Mackenzie, Cologon, & Fenech, 2016; Robertson, Chamberlain, & Kasari, 2003).

Despite increasing training opportunities, teachers persist in reporting that they feel inadequately trained for the challenge of addressing their autistic students’ specific needs. Particular concerns not only centre on poor knowledge and skills but low resources/administrative support and limited opportunities for collaboration These issues have been linked to teacher anxiety, isolation, and reduced work effectiveness (Jaffal, 2022).

Teacher attitudes towards inclusion of autistic children in mainstream schools is shown to impact their daily practice (e.g., use of autism-specific strategies). A review of 16 studies on educator attitudes to inclusion of autistic children revealed mixed results. Importantly, the factors that moderated (increased/decreased) attitudes included autism knowledge, experience. training and gender (Gomez-Mari et al., 2022).

ASHTON’S PLACE

Supporting children with Autism

Ashton’s Place

Supporting children with Autism

A National Autistic Society (2021) survey study found that only 26% of autistic children (11-16 year olds) felt happy at school and only 24% felt included. Also, 60% of teachers stated that they did not have the training they needed to teach students on the autism spectrum.

A South Australian study (Boshoff et al., 2025) assessed the experiences of 225 autistic students (aged 10-14 years) and found they did not receive adequate levels of support, acceptance, and understanding at school. Key factors included the need for increased assistance to ‘fit in’ and develop positive relationships with peers and educators, greater capacity for teachers to be ‘in tune’ with their student’s needs, and changes to the school environment to cater for sensory sensitivities.

There is strong consensus across studies that training and support of educators and teachers is a non-negotiable component of supporting autistic children in building capabilities across cognitive, communication, social, and other important domains. Due to this, educators who work in the ACE Programme participate in theoretical (i.e., online learning modules) and applied (i.e., application of new knowledge/skills to practical child-focused educational experiences) training. Once educators receive training in to increase knowledge in general autism issues, more in-depth training is delivered on specialised topics such as accommodating sensory preferences, enhancing emotion regulation, understanding an ‘autistic’ learning style, and creating proactive positive behaviour supports. Further, educators are supported by more senior staff, to apply their new learning to the particular issues they encounter with the children they support whilst in their daily practice. This continuous immersive model of training has been shown to assist educators in building positive attitudes, skills, and confidence towards supporting the children in their care (see Appendix B for educator case studies).

Specific Recommendations:

  1. If it is proposed that the delivery of supports for young autistic children will include existing supports such as Child & Maternal Health, Primary Care, allied health playgroups, early childhood education and care and schools, significant service re-design to increase the workforce capacity needs to be considered. This can only be achieved via significant funding dedicated to increasing workforce capacity with particular attention to allied health teams in community health, allied health support available for early childhood education and care centres and schools, and inclusion support in the early childhood sector. Workforce capacity must be sufficient for families to have regular and ongoing reviews with a consistent team of supports.

  2. Review the regulatory ratios in early childhood education and care, in contexts when children with diverse learning needs are being enrolled and adjust government funding to support increased staffing provisions. Consideration needs to be given to children with moderate developmental delay being allocated a provision of funding for inclusion support at minimum a 1:4 (child:adult) ratio, in line with their developmental abilities. Some children with very high support needs, including co-regulation, physical behaviours and/or absconding risks need funding provisions for accommodate 1:2 (child:adult) ratios.

  3. Implement effective workforce training and support in the early childhood and care and primary school sectors. Incumbents working in inclusion support positions require specific training, such as the completion of an autism in early childhood certification. Increased high quality training that includes in person modelling of support strategies and regular, ongoing mentoring, will reduce the intensity of the supports currently provided by early intervention therapists under the NDIS. Recommended modules include but are not limited to:

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  • Understanding neurodiversity
  • Understanding and accommodation sensory preferences
  • Positive behaviour support
  • Emotional Regulation
  • Multimodal communication supports
  • Autistic learning
  • Modifying the environment
  • Relationship based approaches
  • Extending play skills
  • Preparing for, and supporting transitions

  1. Increase access, in early childhood education and care settings, to therapeutic consultations delivered by occupational therapists, speech pathologists and positive behaviour support practitioners, to guide the planning of specific goal targeting experiences, update recommendations and problem solve challenges. Therapeutic consultations should be made available for all children with diagnosed neurodivergence and / or developmental delay and utilised at the transdisciplinary team’s discretion based on clinical need. A provision of funding for monthly reviews that include clinical review, parent, and educator capacity building is recommended at minimum in the early intervention years (0-7).

  2. Regulate services delivered by allied health professionals to ensure high quality of supports are provided. In addition to AHPRA requirements, therapists must demonstrate the applicability of their skills to the early intervention scope of practice.

  3. Develop the capacity of the regional workforce. The above recommended increase in governance and regulation may assist with this, as may incentives for experienced practitioners to move to regional areas.

  4. Increase access to state funded autism specific programmes within mainstream schools throughout Australia. Access to a schooling that is focused on the autistic learning style provides a setting that can appropriately support children who do not necessarily have an intellectual disability, but who require a different approach to learning that is not able to be supportive in the current schooling model.

D. Identify mechanisms that would allow a seamless transition through mainstream systems for all children with mild to moderate support needs.

  1. Implement a stage-based and cumulative approach to mastery of key pre-requisite skills to set a strong foundation for subsequent skill acquisition for autistic children. For example, in the year before Kindergarten (QLD), focus should be placed on developing self-help skills of toileting, eating, dressing, transitioning from place to place, and developing independent play skills. In the year before formal schooling increased focus needs to be placed on following group routines, developing attention, managing belongings, developing emotional regulation skills, and developing motor skills.

  2. Establish an integrated system for creating individualised child supports capable of being implemented and monitored within wider mainstream settings.

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  1. Develop a communication and information exchange system that spans across key workers, support organisations, and families so all key data are shared in a consistent manner.

Conclusion: The labels ‘mild’ to ‘moderate’ are not be taken to indicate lower or less intense support needs in the case of autistic children. The temptation to make existing and ineffective systems ‘fit’ children’s supports should be avoided and attention must be paid to building specialised systems that aid real change.

Using an evidence-based approach to establishing seamless transitions:

Pillar 4 of the ACE Programme focuses on the transition from one educational setting to the next. It encompasses preparation of the individual autistic child for inclusion within a mainstream environment, and the various factors supporting this transition. A review of the literature suggests that this can include the development of school-readiness skills, provision of ongoing intervention and support for the child, and coordinated efforts of parents, professionals, and educators at both ingoing and outgoing schools to create and follow a clear individualised plan for the child’s transition (Alonzi-Gold & Grajo, 2021; Fleury, Thompson, & Wong, 2014; Karanth & Chandhok, 2013; Larcombe, Joosten, Cordier, & Vaz, 2019; Marsh, Spagnol, Grove, & Eapen, 2017; Trembath & Starr, 2017).

Further review of the literature relating to strategies to enhance effective transition of autistic children into mainstream schools recommends:

  • Long-term (e.g., two years in a programme such as the ACE Programme) and targeted building of key ‘life’ skills needed by the child to be as self-regulated, independent, and successful (with new school activities, procedures) as possible. Mastered and emerging skills (plus strategies for initiating these) are included in a ‘transition package’ to support information sharing.

  • Prior to transitions, a stepwise, clear, and individualised transition plan needs to be developed which forms the written map for the process to be followed by stakeholders (e.g., what do we do in the existing setting, what do we do at home, what do we do in the receiving school?) (Forest, Horner, Lewis-Palmer, & Todd, 2004).

  • Opportunities are required for stakeholders (e.g., parents, new teachers) to form collaborative relationships early in the transition process (Forest et al., 2004). Positive parent-teacher communication can enable the school to apply familiar supports and self-management routines early to avoid challenges developing later on. (Fontil & Petrakos, 2015; Jellinek, Keller-Margulis, Mire, & Fan, 2023).

  • Each transition process needs to be built in phases — prior, during, follow up, with support/training delivered at each of these. Transitions are deemed to be successful, not when the child ‘enters’ the new school, but when they feel valued and safe in this new environment (Beamish, Bryer, & Klieve, 2014; Starr et al., 2014).

  • Barriers such as administration issues, lack of educator knowledge, and difficulty with relationships between school staff and families can limit the success of transition plans (Fontil,

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Gittens, Beaudoin, & Sladeczek, 2020). Additionally, limited resources for schools results in transition plans not meeting the desires of educators or current recommendations (Beamish et al., 2014).

Specific Recommendations:

  1. Consider an inclusion model based on the principle of gradual and meaningful participation, such as the Autism Connect Early (ACE) Programme in select early education centres in all local government districts. This will allow targeted early years supports, delivered by transdisciplinary teams that have the appropriate training. It is recommended that this model be made available for children with moderate to severe support needs.

  2. Consider piloting the ACE Programme model in the school system based on its success in the early childhood and care setting.

  3. Increase educator and teacher training, as noted in the recommendations in response to Identifying gaps in workforce support and training required to deliver thriving kids.

  4. Increase parent capacity building through regulated providers. This may include online trainings delivered in a hybrid model of LMS style training, group connection and individual mentoring - that are evidence based and accredited.

  5. Develop a system for implementation of time limited and goal-oriented standalone therapeutic supports delivered by experienced allied health professionals or specialist teachers to address key issues that are common in autistic children. These supports should be available for any child with diagnosed developmental delay or neurodiversity.

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Supporting children with Autism

Ashton’s Place

Supporting children with Autism

APPENDIX A:

Child and Parent Case Studies

Case Study 1

Case Study 1 (CS1) is a female with a diagnosis of Autism Spectrum Disorder—Severity Level 3. This child was non-speaking and experienced substantial difficulty with social engagement.

CHILD CHANGE Development of Skills:

  • Adaptive Capacity: Not Mastered 74, Mastered 53
  • Communication: Not Mastered 61, Mastered 97
  • Fine Motor: Not Mastered 31, Mastered 44
  • Gross Motor: Not Mastered 35, Mastered 51
  • Play: Not Mastered 33, Mastered 50
  • Self-Regulation: Not Mastered 30, Mastered 33
  • Social Emotional: Not Mastered 76, Mastered 75

The figure above shows the rate of mastery for each of the daily programme domains. Communication showed the highest rate of mastery at 61% which is particularly pleasing for this child who had minimal capacity to connect with others. Further analysis of the individual communication programs in Appendix 1 shows that the most commonly completed tasks were “Hands/Extends object to ask for help”, “Makes eye contact to obtain object” and “Uses PECS to request” and this shows that the child was successful in learning alternative (to speech) methods for having her needs met. Fine motor, gross motor and play programs also had a high mastery rate, which aligns with the increase in parent satisfaction scores for those areas. The moderate mastery rates for adaptive capacity, self-regulation and social emotional are consistent represent more complex skills that a child with ‘severe’ difficulties would require prolonged time to master.

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Supporting children with Autism

Ashton’s Place

Supporting children with Autism

PARENT CHANGE Confidence and Satisfaction: Parent Confidence

The Parent Confidence Scale (PCS) was completed at entry and exit by CS1’s Mother. The scale consisted of 11-items that asked parents to ‘rate the degree of confidence you feel in your ability to handle the situations presented below’ on a 100-point scale (0 = ‘not at all’, 50 = ‘moderately’, 100 = Perfectly). The 11 items of the PCS are shown below and higher scores equate to higher confidence.

  • Q1: Timepoint 1: 8, Timepoint 2: 7
  • Q2: Timepoint 1: 8, Timepoint 2: 7
  • Q3: Timepoint 1: 9, Timepoint 2: 5
  • Q4: Timepoint 1: 10, Timepoint 2: 5
  • Q5: Timepoint 1: 6, Timepoint 2: 7
  • Q6: Timepoint 1: 8, Timepoint 2: 7
  • Q7: Timepoint 1: 6, Timepoint 2: 8
  • Q8: Timepoint 1: 6, Timepoint 2: 10
  • Q9: Timepoint 1: 8, Timepoint 2: 7
  • Q10: Timepoint 1: 8, Timepoint 2: 9
  • Q11: Timepoint 1: 8, Timepoint 2: 9

This figure shows that the largest increases in confidence occurred for questions 8—11 (i.e., explaining autism to others, understanding the child’s sensory needs, helping the child regulate her emotions, supporting the child to make positive choices).

Parent Satisfaction

The Parent Satisfaction Scale (PSS) was completed at entry and exit by CS1’s Mother. This scale consisted of 10-items and asked parents to ‘rate the degree of satisfaction you feel regarding your child’s participation in the ACE Programme’ on a 9-point scale (1 = ‘not at all’, 9 = ‘very much so’). The 10 items of the PSS are shown below and higher scores equate to higher satisfaction.

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  • Q1: Timepoint 1: 1, Timepoint 2: 3
  • Q2: Timepoint 1: 1, Timepoint 2: 5
  • Q3: Timepoint 1: 3, Timepoint 2: 9
  • Q4: Timepoint 1: 1, Timepoint 2: 4
  • Q5: Timepoint 1: 1, Timepoint 2: 2
  • Q6: Timepoint 1: 1, Timepoint 2: 1
  • Q7: Timepoint 1: 1, Timepoint 2: 4
  • Q8: Timepoint 1: 9, Timepoint 2: 9
  • Q9: Timepoint 1: 9, Timepoint 2: 9
  • Q10: Timepoint 1: 9, Timepoint 2: 9

This figure shows that the largest positive improvement in parental satisfaction with gross motor skills, followed by fine motor skills, pretend play skills and early learning skills. The score for communication did not improve and remained at the lowest possible score which falls in line with this child’s greatest domain of impairment.

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Supporting children with Autism

Ashton’s Place

Supporting children with Autism

Case Study 2

Case Study 2 (CS2) is a male with a diagnosis of Autism Spectrum Disorder—Severity Level 3. His expressive and receptive communication skills are substantially delayed but he is considered to be socially motivated.

CHILD CHANGE Development of Skills

  • Adaptive Capacity: Not Mastered 19, Mastered 49
  • Communication: Not Mastered 38, Mastered 62
  • Fine Motor: Not Mastered 15, Mastered 33
  • Gross Motor: Not Mastered 28, Mastered 19
  • Play: Not Mastered 20, Mastered 44
  • Self-Regulation: Not Mastered 24, Mastered 29
  • Social Emotional: Not Mastered 25, Mastered 57

The figure above shows that the highest mastery rates were seen in communication, social-emotional development, adaptive capacity, and play. In addition to showing strong improvements in communication (an area of substantial dela), this child made gains in areas with a social-emotional component, and this is likely to be a reflection of the child’s capacity to be motivated using social stimuli and the educator’s efforts to expose the child to such stimuli during programme delivery.

PARENT CHANGE Confidence and Satisfaction: Parent Confidence

The Parent Confidence Scale (PCS) was completed at entry and exit by CS2’s Mother. The scale consisted of 11-tiems that asked parents to ‘rate the degree of confidence you feel in your ability to handle the situations presented below’ on a 100-point scale (0 = ‘not at all’, 50 = ‘moderately’, 100 = Perfectly). The 11 items of the PCS are shown below and higher scores equate to higher confidence.

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Supporting children with Autism

  • Q1: Timepoint 1: 8, Timepoint 2: 9
  • Q2: Timepoint 1: 9, Timepoint 2: 9
  • Q3: Timepoint 1: 3, Timepoint 2: 8
  • Q4: Timepoint 1: 7, Timepoint 2: 8
  • Q5: Timepoint 1: 7, Timepoint 2: 10
  • Q6: Timepoint 1: 8, Timepoint 2: 10
  • Q7: Timepoint 1: 5, Timepoint 2: 6
  • Q8: Timepoint 1: 9, Timepoint 2: 10
  • Q9: Timepoint 1: 3, Timepoint 2: 10
  • Q10: Timepoint 1: 7, Timepoint 2: 10
  • Q11: Timepoint 1: 8, Timepoint 2: 9

This figure shows an overall trend for increased confidence across all items of the scale with the largest change occurring for item 3 (i.e., responding to negative comments from the public) and item 9 (i.e., understanding their child’s sensory preferences). The self-reported increase in item 3 is likely to reflect this parent’s capacity to advocate for her child under challenging circumstances.

Parent Satisfaction

The Parent Satisfaction Scale (PSS) was completed at entry and exit by CS2’s Mother. This scale consisted of 10-items and asked parents to ‘rate the degree of satisfaction you feel regarding your child’s participation in the ACE Programme’ on a 9-point scale (1 = ‘not at all’, 9 = ‘very much so’). The 10 items of the PSS are shown below, and higher scores equate to higher satisfaction.

  • Q1: Timepoint 1: 1, Timepoint 2: 1
  • Q2: Timepoint 1: 4, Timepoint 2: 4
  • Q3: Timepoint 1: 8, Timepoint 2: 9
  • Q4: Timepoint 1: 1, Timepoint 2: 1
  • Q5: Timepoint 1: 2, Timepoint 2: 1
  • Q6: Timepoint 1: 1, Timepoint 2: 0
  • Q7: Timepoint 1: 1, Timepoint 2: 0
  • Q8: Timepoint 1: 8, Timepoint 2: 9
  • Q9: Timepoint 1: 8, Timepoint 2: 9
  • Q10: Timepoint 1: 8, Timepoint 2: 9

The figure above shows that parent satisfaction remained stable over time with higher satisfaction reported for gross motor development. In contrast, lower satisfaction was noted

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for play, independence, and communication. This is in contrast with the actual skill gains the child made in the programme.

Case Study 3

Case Study 3 (CS3) is a male with a diagnosis of Autism Spectrum Disorder—Severity Level 3. He experienced significant delay in spoken language and receptive communication. The capacity for social engagement varied in relation to level of self-regulation.

CHILD CHANGE Development of Skills

  • Adaptive Capacity: Not Mastered 26, Mastered 84
  • Communication: Not Mastered 65, Mastered 103
  • Fine Motor: Not Mastered 16, Mastered 73
  • Gross Motor: Not Mastered 42, Mastered 53
  • Play: Not Mastered 8, Mastered 90
  • Self-Regulation: Not Mastered 11, Mastered 73
  • Social Emotional: Not Mastered 28, Mastered 99

The figure above shows substantially high rates of mastery for important areas of development, including play (92%), self-regulation (87%) and fine motor (82%). Communication mastery was moderate (61%) with an emphasis on requesting and receptive compliance (e.g., pointing to request, 2-step familiar instructions, using a person’s name to gain attention, 2 - 4 word AAC requests.

PARENT CHANGE Confidence and Satisfaction: Parent Confidence

The Parent Confidence Scale (PCS) was completed at entry and exit by CS3’s Mother. The scale consisted of 11-tiems that asked parents to ‘rate the degree of confidence you feel in your ability to handle the situations presented below’ on a 100-point scale (0 = ‘not at all’, 50 = ‘moderately’, 100 = Perfectly). The 11 items of the PCS are shown below, and higher scores equate to higher confidence.

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  • Q1: Timepoint 1: 2, Timepoint 2: 9
  • Q2: Timepoint 1: 2, Timepoint 2: 9
  • Q3: Timepoint 1: 2, Timepoint 2: 7
  • Q4: Timepoint 1: 2, Timepoint 2: 8
  • Q5: Timepoint 1: 2, Timepoint 2: 9
  • Q6: Timepoint 1: 2, Timepoint 2: 9
  • Q7: Timepoint 1: 3, Timepoint 2: 10
  • Q8: Timepoint 1: 1, Timepoint 2: 8
  • Q9: Timepoint 1: 4, Timepoint 2: 10
  • Q10: Timepoint 1: 3, Timepoint 2: 9
  • Q11: Timepoint 1: 5, Timepoint 2: 9

The figure above shows a significant increase in all items with the largest being 7 points (i.e., confidence in understanding the child’s sensory preferences). The lowest increase was seen in item 3 which relates to the parent’s confidence responding to negative comments regarding their child’s behaviour.

Parent Satisfaction

The Parent Satisfaction Scale (PSS) was completed at entry and exit by CS3’s Mother. This scale consisted of 10-items and asked parents to ‘rate the degree of satisfaction you feel regarding your child’s participation in the ACE Programme’ on a 9-point scale (1 = ‘not at all’, 9 = ‘very much so’). The 10 items of the PSS are shown below, and higher scores equate to higher satisfaction.

  • Q1: Timepoint 1: 3, Timepoint 2: 7
  • Q2: Timepoint 1: 3, Timepoint 2: 8
  • Q3: Timepoint 1: 7, Timepoint 2: 8
  • Q4: Timepoint 1: 2, Timepoint 2: 8
  • Q5: Timepoint 1: 2, Timepoint 2: 8
  • Q6: Timepoint 1: 2, Timepoint 2: 8
  • Q7: Timepoint 1: 6, Timepoint 2: 8
  • Q8: Timepoint 1: 3, Timepoint 2: 9
  • Q9: Timepoint 1: 7, Timepoint 2: 9
  • Q10: Timepoint 1: 2, Timepoint 2: 9

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The figure above shows that this parent reported an increase in satisfaction across all items of the scale. The largest positive improvement was in knowing what a psychologist/positive behaviour support practitioner does. The score that remained the lowest was parent satisfaction with their child’s ability to engage socially.

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APPENDIX B:

Educator Case Studies

Case Study 1

Educator Confidence Scale

Case Study 1 (CS1) completed the Educator Confidence Scale (ECS) in term 3, 2024 and term 1, 2025. Their overall score at timepoint 1 was 111/140 which increased to 121/140 by timepoint 2. The ECS consists of 14 items which are rated on 100-point scale (0 = ‘not at all’, 50 = ‘moderately’, 100 = Perfectly). The 14 items of the ECS are shown below and higher scores equate to higher confidence.

  • Q1: Timepoint 1: 10, Timepoint 2: 10
  • Q2: Timepoint 1: 7, Timepoint 2: 10
  • Q3: Timepoint 1: 9, Timepoint 2: 10
  • Q4: Timepoint 1: 5, Timepoint 2: 10
  • Q5: Timepoint 1: 9, Timepoint 2: 10
  • Q6: Timepoint 1: 9, Timepoint 2: 10
  • Q7: Timepoint 1: 6, Timepoint 2: 10
  • Q8: Timepoint 1: 9, Timepoint 2: 10
  • Q9: Timepoint 1: 0, Timepoint 2: 5
  • Q10: Timepoint 1: 5, Timepoint 2: 9
  • Q11: Timepoint 1: 5, Timepoint 2: 5
  • Q12: Timepoint 1: 10, Timepoint 2: 10
  • Q13: Timepoint 1: 10, Timepoint 2: 10
  • Q14: Timepoint 1: 9, Timepoint 2: 10

The largest increases were seen in questions 7, 9 and 10. This demonstrates a substantial increase in how confident the educator reported feeling in relation to identifying the early signals that may indicate a child is becoming anxious or dysregulated, supporting parents to apply strategies they use in the ACE Programme to help their child at home, and recording data relating to a child’s participation and progress towards their individual goals. The largest decrease in confidence was in advocating for the educational and social-emotional needs of autistic children within the wider childcare programme.

Educator Self-Efficacy and Satisfaction Scale

The first 8 items of the Educator Self-Efficacy and Satisfaction Scale measure staff satisfaction with the workplace and their skills/abilities. A high score on these items indicates greater satisfaction. Questions 9 to 14 measure how challenging the staff member finds certain elements of the work. Lower scores on these items demonstrates less impediments and higher perceived efficacy. CS1 completed the scale in term 3, 2024 and term 1, 2025. The ESES consists of 14-items rated on a 10-point scale.

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  • Q1: Timepoint 1: 9, Timepoint 2: 9
  • Q2: Timepoint 1: 9, Timepoint 2: 9
  • Q3: Timepoint 1: 9, Timepoint 2: 9
  • Q4: Timepoint 1: 9, Timepoint 2: 9
  • Q5: Timepoint 1: 9, Timepoint 2: 9
  • Q6: Timepoint 1: 9, Timepoint 2: 9
  • Q7: Timepoint 1: 9, Timepoint 2: 9
  • Q8: Timepoint 1: 9, Timepoint 2: 9
  • Q9: Timepoint 1: 0, Timepoint 2: 0
  • Q10: Timepoint 1: 0, Timepoint 2: 0
  • Q11: Timepoint 1: 0, Timepoint 2: 0
  • Q12: Timepoint 1: 0, Timepoint 2: 0
  • Q13: Timepoint 1: 2, Timepoint 2: 0
  • Q14: Timepoint 1: 2, Timepoint 2: 0

As shown in the figure above, the maximum satisfaction score was given for items 1 to 8 at both timepoints which indicates that a satisfaction level remained at its maximum. For items 9 to 14, CS1 showed a slight increase in feeling challenged when supporting children who are dysregulated or exhibiting challenging behaviours and implementing therapist-recommended strategies across the day.

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Case Study 2

Educator Confidence Scale Case Study 2 (CS2) completed the Educator Confidence Scale in term 3, 2023 and term 1, 2025. The ECS consists of 14 items which are rated on 100-point scale (0 = ‘not at all’, 50 = ‘moderately’, 100 = Perfectly). The 14 items of the ECS are shown below and higher scores equate to higher confidence.

  • Q1: Timepoint 1: 7, Timepoint 2: 9
  • Q2: Timepoint 1: 7, Timepoint 2: 9
  • Q3: Timepoint 1: 6, Timepoint 2: 9
  • Q4: Timepoint 1: 10, Timepoint 2: 9
  • Q5: Timepoint 1: 7, Timepoint 2: 9
  • Q6: Timepoint 1: 6, Timepoint 2: 9
  • Q7: Timepoint 1: 6, Timepoint 2: 8
  • Q8: Timepoint 1: 6, Timepoint 2: 8
  • Q9: Timepoint 1: 8, Timepoint 2: 9
  • Q10: Timepoint 1: 5, Timepoint 2: 9
  • Q11: Timepoint 1: 5, Timepoint 2: 9
  • Q12: Timepoint 1: 8, Timepoint 2: 9
  • Q13: Timepoint 1: 7, Timepoint 2: 9
  • Q14: Timepoint 1: 7, Timepoint 2: 9

The figure above shows that only one item decreased over this period which showed a reduction in confidence advocating for the educational and social-emotional needs of autistic children within the wider childcare program. The largest increase in confidence was shown in recording data relating to a child’s participation and progress towards their individual goals and in identifying and accessing resources from within the childcare centre to deliver optimal learning and individualised supports for a child.

Educator Self-Efficacy and Satisfaction Scale

The first 8 items of the Educator Self-Efficacy and Satisfaction Scale measure staff satisfaction with the workplace and their skills/abilities. A high score on these items indicates greater satisfaction. Questions 9 to 14 measure how challenging the staff member finds certain elements of the work. Lower scores on these items demonstrates less impediments and higher perceived efficacy. Case Study 2 (CS2) completed the Educator Confidence Scale in term 3, 2023 and term 1, 2025. The ESES consists of 14-items rated on a 10-point scale.

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  • Q1: Timepoint 1: 8, Timepoint 2: 8
  • Q2: Timepoint 1: 8, Timepoint 2: 8
  • Q3: Timepoint 1: 9, Timepoint 2: 9
  • Q4: Timepoint 1: 8, Timepoint 2: 8
  • Q5: Timepoint 1: 7, Timepoint 2: 8
  • Q6: Timepoint 1: 6, Timepoint 2: 8
  • Q7: Timepoint 1: 7, Timepoint 2: 8
  • Q8: Timepoint 1: 6, Timepoint 2: 8
  • Q9: Timepoint 1: 2, Timepoint 2: 1
  • Q10: Timepoint 1: 2, Timepoint 2: 1
  • Q11: Timepoint 1: 2, Timepoint 2: 0
  • Q12: Timepoint 1: 2, Timepoint 2: 1
  • Q13: Timepoint 1: 2, Timepoint 2: 1
  • Q14: Timepoint 1: 2, Timepoint 2: 1

The figure above shows significant increases in how satisfied CS2 felt with their skills to adapt their approach based on a child’s individual learning needs and how much they can you do to engage children who prefer to play independently. All the scores for question 9 to 14 decreased, with a significant reduction in how frequently CS2 felt challenged by the communication between the team and management within the workplace.

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Case Study 3

Educator Confidence Scale Case Study 3 (CS3) completed the Educator Confidence Scale in term 3, 2023 and term 3, 2024. The ECS consists of 14 items which are rated on 100-point scale (0 = ‘not at all’, 50 = ‘moderately’, 100 = Perfectly). The 14 items of the ECS are shown below and higher scores equate to higher confidence.

  • Q1: Timepoint 1: 10, Timepoint 2: 10
  • Q2: Timepoint 1: 9, Timepoint 2: 10
  • Q3: Timepoint 1: 9, Timepoint 2: 10
  • Q4: Timepoint 1: 9, Timepoint 2: 10
  • Q5: Timepoint 1: 9, Timepoint 2: 9
  • Q6: Timepoint 1: 9, Timepoint 2: 9
  • Q7: Timepoint 1: 10, Timepoint 2: 10
  • Q8: Timepoint 1: 10, Timepoint 2: 10
  • Q9: Timepoint 1: 7, Timepoint 2: 9
  • Q10: Timepoint 1: 10, Timepoint 2: 10
  • Q11: Timepoint 1: 10, Timepoint 2: 10
  • Q12: Timepoint 1: 8, Timepoint 2: 10
  • Q13: Timepoint 1: 10, Timepoint 2: 10
  • Q14: Timepoint 1: 10, Timepoint 2: 10

The figure above shows that the scores for all items remained either the same or increased over the 12-month period, and this suggests an overall rise in confidence. The largest increases were seen in items 9 and 12 which demonstrates increased confidence in supporting parents to apply strategies you use in the ACE Programme to support their child at home and their understanding of how sensory processing impacts engagement, activity regulation and behaviour.

Educator Self-Efficacy and Satisfaction Scale

The first 8 items of the Educator Self-Efficacy and Satisfaction Scale measure staff satisfaction with the workplace and their skills/abilities. A high score on these items indicates greater satisfaction. Questions 9 to 14 measure how challenging the staff member finds certain elements of the work. Lower scores on these items demonstrates less impediments and higher perceived efficacy. Case Study 3 (CS3) completed the Educator Confidence Scale in term 3, 2023 and term 3, 2024. The ESES consists of 14-items rated on a 10-point scale.

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  • Q1: Timepoint 1: 8, Timepoint 2: 9
  • Q2: Timepoint 1: 9, Timepoint 2: 9
  • Q3: Timepoint 1: 9, Timepoint 2: 9
  • Q4: Timepoint 1: 8, Timepoint 2: 9
  • Q5: Timepoint 1: 8, Timepoint 2: 9
  • Q6: Timepoint 1: 8, Timepoint 2: 9
  • Q7: Timepoint 1: 8, Timepoint 2: 9
  • Q8: Timepoint 1: 7, Timepoint 2: 9
  • Q9: Timepoint 1: 3, Timepoint 2: 1
  • Q10: Timepoint 1: 3, Timepoint 2: 1
  • Q11: Timepoint 1: 1, Timepoint 2: 0
  • Q12: Timepoint 1: 1, Timepoint 2: 0
  • Q13: Timepoint 1: 3, Timepoint 2: 0
  • Q14: Timepoint 1: 3, Timepoint 2: 0

As shown in the figure above, CS3’s satisfaction increased to the maximum score for all questions between timepoint 1 and timepoint 2. There was also a significant drop in how challenged CS3 felt by the items 9 to 14. The largest change was seen in how challenged or overwhelmed CS3 feels when supporting children who are dysregulated or exhibiting challenging behaviours and how much of a personal challenge CS3 finds it to implement therapist-recommended strategies.

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