Special Educational Needs and Disability Act 2001
Special Educational Needs and Disability Act 2001 (c. 10), also known as SENDA, is an Act of the Parliament of the United Kingdom. It is intended as an adjunct to the Disability Discrimination Act 1995, which legislated to prevent the unfair treatment of individuals, in the provision of goods and services, unless justification could be proved. This legislation was deemed necessary as the previous Act did not encompass educational organisations. This was further replaced by the Disability Discrimination Act 2005.
The act required schools, colleges, universities, adult education providers, statutory youth services and local education authorities to make 'reasonable provisions' to ensure people with disabilities or special needs were provided with the same opportunities as those who were not disabled.
The Act stated that discrimination occurred when the educational establishment/body either fails to make reasonable adjustments to accommodate individuals with special needs or a disability, or when they give them less favourable treatment.
Disabilities
A disability is an umbrella term, covering impairments, activity limitations, and participation restrictions. Impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations.
Thus disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives. Disability is the interaction between individuals with a health condition (e.g. cerebral palsy, Down syndrome and depression) and personal and environmental factors (e.g. negative attitudes, inaccessible transportation and public buildings, and limited social supports).
Disability is extremely diverse. While some health conditions associated with disability result in poor health and extensive health care needs, others do not. However all people with disabilities have the same general health care needs as everyone else, and therefore need access to mainstream health care services.

Types of Childhood Disabilities and Other Special Needs
Autism
Attention-Deficit/Hyperactivity Disorder (AD/HD)
Cerebral Palsy
Deafness and Hearing Loss
Down syndrome
Epilepsy
Learning Disabilities
Intellectual Disability
Blindness/ Visual Impairment
Speech and Language Impairments
Traumatic Brain Injury
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Severe and/or Multiple Disabilities

Autism:
Autism is a developmental disorder affecting children from birth or the early months of life. It results in delay in, and deviance from, the normal patterns of development1. These occur in three areas of behaviour:
· Social relationships and interactions
· Language and communication.
· Activities and interests.
When problems occur in all these three spheres of development, and at a deeper level than the usual variations expected in ordinary children, the distinctive pattern of autism becomes evident. In the past there has been confusion over terminology, but experts now consider that children with the triad of impairments should come under the umbrella diagnosis of "autism spectrum disorders" 2,3, which should prompt further in-depth diagnosis. Gillberg2 suggests that the diagnosis of autism should specify additional features such as severity, cognitive level, clinical traits and associated medical conditions.
The incidence is hard to establish because of the problems of diagnosis but the National Autistic Society suggests a possible prevalence rate of almost 1 in 100 people in the UK for autistic spectrum disorders (91 per l0,000) 4.
Although autism is probably present from birth, or very soon after, its nature means that the specific disorders of developmental progression will not necessarily be apparent for many months or even years.
Relationships, communication and activities are immature in all young babies. It is only when they become more sophisticated that delays and deviations from the usual may be evident. Diagnosis is complicated by the variations found in the mental ability of children with autism. About two-thirds have additional learning difficulties and their unusual behaviour patterns may be ascribed to an overall developmental delay. Conversely, autism may be overlooked in children with average and above-average mental ability. Any odd behaviours or abnormalities in development, especially in very young children, may be dismissed as mild or transient.
Cause
The cause of autism remains unknown. The most likely hypothesis is damage to the brain, perhaps prenatally, though this has not been conclusively proved. The factors responsible may include:
· genetic or chromosomal abnormality
· viral agents
· metabolic disorders
· immune intolerance
· perinatal anoxia5.
These factors can result in other handicapping conditions, which explains why children with autism often have additional learning disabilities and some may have identified medical conditions such as fragile X syndrome, tuberous sclerosis and neurofibromatosis. However, this is not the full explanation as there are children who have damage to the brain as a result of these factors, but who do not have autism. There are also children diagnosed with autism in whom no cause is apparent, partly because the particular neurological impairment necessary for autism to occur has not yet been identified2. In a review, Gillberg noted overwhelming evidence that autism has biological roots but found no single consistent explanation.

Genetic factors were important in some cases, perinatal stress in others, while in certain cases autism could have been produced by a combination of genetic and environmentally-induced brain damage.
One model by Baron-Cohen and Bolton6 accounts for the uncertainty over the causes of autism by suggesting a final common pathway (Figure 1). This model shows how different causes, some of them unknown, can result in damage to areas of the brain responsible for the development of normal social function. communication and play.
Importance of early identification
As with any child with special needs, early identification is essential to allow interventions to be implemented. With autism, these need to be started before deviation and delay from the normal pattern of development has progressed too far. Children with autism often display a characteristic need for sameness and structure. Their resistance to change can impede treatments because inappropriate behaviours have to be curtailed as well as more appropriate behaviours introduced. Mays and Gillon suggest that early intervention can improve communication skills and reduce out-of-control behaviours. Beck Williams, a nurse therapist working with children with autism, believes it is an advantage to know the child from a very young age and that it is possible to intervene at the start of a new behaviour which has the potential to become self-mutilating or dangerous8.
Early recognition of the condition also allows families to receive advice and support to help them adjust and respond to the child's difficulties.
Diagnosis of autism is rare before the age of two years and is frequently much later. It requires comprehensive, specialist assessment, which means primary health care workers being alert to the features of the condition and making the appropriate referral. Attwood notes that autism can be diagnosed in children as young as 18 months but in practice this may be hard to achieve, partly because of the nature of the disorder and partly because of lack of knowledge. Unfortunately at present a considerable number of professionals involved with young children do not recognise autism, although it is hoped that this situation will improve and cases will be referred to specialists at younger ages for early intervention. Nurses and nursery nurses who work with babies and young children are in a prime position to recognise possible early signs that warrant investigation.

Key points Autism is an organic disorder affecting several areas of a child's development. Autism is present from birth, or very soon after, but the nature of the disorder can mean that diagnosis is delayed for months or years. Early intervention can improve long-term function and help the families. Babies with autism may display characteristic features of gaze, hearing, social development and play. Nurses working with babies and young children are in a prime position to recognise these characteristics and refer the family for specialised assessment. Learning disabilities may or may not be present in children with autism. Always listen to the parents. They often suspect something is wrong even though they may not be able to be precise.
Since about two-thirds of children with autism have other learning disabilities as well, community nurses working with children with learning disabilities may be the first professionals to suspect autism. In children without additional learning difficulties, the health visitor may be the one to recognise developmental delays or deviations from the norms. Community paediatric nurses may also be key health workers in families whose children have experienced pre- and postnatal difficulties that may be associated with autism.