Swansea University

Student Wellbeing Centre

Autistic Spectrum Questionnaire – Code B Students

Autistic Spectrum Advice & Support – The Student Wellbeing Centre

The Wellbeing Team at Swansea University employs two Autistic Spectrum Condition (ASC) Coordinators with a specific role to support students who wish to engage with us through their University journey. You could be a student who already has a known AS condition and are anxious about getting the right advice and support before you come to university. We cannot stress enough how important it is you develop links with us before you start – it makes your life and move to university so much easier having the support we can offer in place for you right from the start instead of waiting for things to wrong.

We do not replace NHS services who hold a statutory responsibility for providing health services such as your GP, community health team, psychiatrist etc. Our role is to support you to receive the right support to make your student experience a successful one. We can liaise with departments to ensure reasonable adjustments are made to your study programme. We provide a service that aims to ensure your services provide a continuation of any provision you may already have and provide support to you during your studies to access services wherever appropriate.

The Student Wellbeing Centre’s role is to enable and empower students with AS conditions to make positive decisions and choices for themselves. We aim to promote mental wellbeing and be a source of stable advice and support during your academic studies in addition to any other support you are receiving from services with statutory responsibility for managing your care.

We do this in a number of ways, through one to one work with the ASC coordinator, specialist mentoring, workshops, a library section and groups

Please look at our website for further details: http://www.swansea.ac.uk/wellbeing/mentalhealthadviceandsupport/

The main purpose of this form is:

·  To give you the opportunity to disclose in further detail the nature of your AS condition and to describe how you feel your needs impact on your academic and social experience at Swansea University

·  To enable the AS Support Service at the Wellbeing Centre to provide you timely and effective advice prior to your enrolment so to lessen your anxiety

·  To define reasonable adjustments that may need to be made in relation to your studies and where possible with your accommodation

·  To ensure, where necessary, relevant staff are aware of your requirements and are able to support you.

Personal Details/Course of Study

Student ID/UCAS/Direct Application no:
First name(s) / Family name/Surname
Date of birth / e-mail address
Home tel. / Mobile tel.
Correspondence address
Post Code/Zip Code
Country
Course title / Singleton campus / c
Full/Part time / Bay campus / c
Under/post Graduate / Month and year of entry on to course

Details about your specific needs

Nature of your condition/s:

What support do you currently receive from services you may have or have had in the past?

What support do you think you will need at university?

Examination and in class test requirements

If your mental health condition has given you special examination provisions, please provide evidence from your doctor or school/college where they have recognised you require the additional provision.

I have been recommended the following examination support (please tick):

Extra time (amount______) c

Use of a computer c

Rest breaks (10 minutes per hour) c

Access to a toilet c

Smaller room with other students with similar recommendations c

Separate room (you will have to provide specific evidence why this is the case) c

Other: Please stipulate over the page; c

Evidence submitted with questionnaire

If you have a diagnosis of AS, the University needs confirmation of this via a GP or other qualified medical practitioner letter. Without this evidence we cannot make arrangements for support or exam/class test requirements. Please indicate below which source of evidence you are submitting. Please scan your documents and email WITH your questionnaire as a PDF/JPEG or post them with your questionnaire to our postal address provided on the last page.

GP c

Educational Psychologists Report c

Psychiatrists Report c

Psychologists Report c

OT/Social Services Report c

Accommodation

We liaise with Residential Services to try and place you in suitable accommodation where possible. Please note you will still need to apply for accommodation when offered a place at the University via the online application system.

Do you require accommodation at University in halls of residence? YES/NO

Ensuite bathroom c Fridge to store medication c

A quiet room c Ground floor room c

Other c Please specify ______

In the event of a fire, are you able to evacuate the building independently? YES / NO

Please can you state how your condition impacts on you to make your request/s

Enrolment

If you require ‘fast track enrolment’ – a special pass is available from Student Support Services reception in the Keir Hardie Building during enrolment to collect

Induction & Ongoing Mental Health Support

UK Students

Do you manage an AS condition and you could do with regular support to help you settle in and help you maintain your wellbeing while you are at University? Support for AS conditions are provided by our team of specialist mentors, coordinated by Wellbeing’s AS Team.

Due to the way mentoring is funded, you have to apply for Disabled Students Allowance (DSA) via your relevant student funding body. DSA is a non means tested grant awarded by Student Finance to provide students who have long standing conditions of at least 6 months, even if well managed with academic support whilst in education. All is dependent on your level of need but it could provide:

·  Equipment allowance to pay for specialised equipment and software

·  Academic related support requirements such as note taking, study skills and specialist mentoring

·  General allowance to pay for costs incurred such as consumables, photocopying etc.

Specialist mentoring is only funded through DSA and the website www.yourdsa.com is an excellent website to explain and guide you through the process.

Please do not delay in applying for DSA. We cannot put any support as described above in place without you taking the steps to apply. Yes it does mean filling out a form and attending an assessment but so many students tell us they wish they had applied in readiness to start university rather than not having bothered it is well worth being organised. If you are stuck and don’t know where to start, email us on and we will give you the guidance needed.

International Students

Disabled Students Allowance (DSA) is only for UK students.

If you have AS support needs, please provide us with medical evidence of your condition and the level of support you have required. Coming to the UK to study can be an exciting opportunity to build new skills and confidence but equally it can cause anxiety if you are unprepared for the level of support available to you here in the Swansea area perhaps in comparison to the level of care you have received in your home country.

It is really important you contact us as soon as possible if you are applying to come to Swansea University. We can give you realistic advice on what is on offer here so you can get a better idea of how you will manage your AS condition. Although DSA is not open to International Students, our AS Coordinators are accessible to you so have a point of contact in the University to discuss your needs and so you can also be kept informed of our other activities, workshops and support available. Please email us on and we can guide you through to the information you need.

Confidentiality and Consent

The University has a duty to ensure that you have a clear opportunity to disclose information relating to your disability and any specific requirements you may have, in a way which will not affect your treatment.

The Data Protection Act defines any written or electronically stored information about an individual’s disability as ‘sensitive personal data’. We therefore respect your right to privacy.

To make an effective response to your disclosure the Student Wellbeing Centre may need to communicate disclosed information to appropriate members of staff for example those involved in teaching, accommodation, libraries, etc.

If you wish the disclosed information to be kept confidential between yourself and the Student Wellbeing Centre then you accept that you cannot expect any adjustment as a result of your disability/specific need/medical condition, other than those that would normally be available through the University’s fulfilment of its ‘anticipatory duty’.

In exceptional circumstances the Student Wellbeing Centre may pass disclosed information to a third party (i.e. Fitness to practice) without consent where there is believed to be serious risk to the health and safety of yourself and/or others.

Information given within this form will be treated in accordance with the Data Protection Act (1998) and will be stored securely for 7 years and thereafter will be destroyed.

Randstad HR Solutions

Swansea University works in partnership with Randstad HR Solutions to provide all Disabled Students Allowance funded non-medical helper support including note taking, and mentoring..

To enable us to coordinate and provide your support, we need to share certain personal details about you and your support needs with Randstad HR Solutions. Randstad HR Solutions will not need information about your disability. Randstad HR Solutions will require details such as your full name, address, date of birth, funding confirmation and the type of support that has been recommended. We cannot provide this information to Randstad HR Solutions without your consent.

If you do not give consent to share the above details with Randstad HR Solutions it may not be possible for your support to be provided by Swansea University and you may have to consider alternative arrangements.

I understand that the information contained within this form and the documentary evidence I have provided may be passed to appropriate people outside Student Services in order that where necessary, reasonable adjustments can be considered and acted upon.

c I give consent for information to be shared with people on a need to know basis

c I give consent for information to be shared with my parents/next of kin

c I give consent for you to discuss my case with my funding body (Local Education Authority, Student Finance England etc.)

c I give consent for my personal details to be shared with Randstad HR Solutions

c I do not give consent for my information to be shared with anyone

If there is anyone who you do not want us to share your information with, please state below:

I am signing to certify that the information I have provided is accurate to the best of my knowledge, and that I will alert the University of any changes at any point from today forwards. I understand that the University will use the information to best evaluate the support that it can provide and that members of the Student Wellbeing Centre will be in touch to discuss any specific details

FULL NAME
SIGNATURE
DATE

Please print off your questionnaire, sign it and attach supporting evidence such as an Educational Psychologist report, medical report or needs assessment.

Please either send the report to the address below:

FAO ASC Caseworkers

Student Wellbeing Centre

Horton House

Swansea University

Singleton Park

Swansea, SA2 8PP

Alternatively, you can send this electronically to

Please note we will also require all supporting evidence scanned in a PDF format.

PLEASE NOTE: Without supporting evidence we cannot arrange your support.

Checklist

Have you completed the questionnaire fully? c

Have you indicated whether you have applied for DSA? c

Have you signed the form after printing it? c

Have you attached your supporting evidence? c

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