Situation of Social Work Services with Autistic Children at Vinh Phuc Social Work Center

: The research aims to describe the current status of social work services for autistic children, thereby making recommendations to improve the quality of social work services. The research paper was conducted on 36 autistic children’s relatives who are using social work services. The results showed that 44.32% of the autistic children’s relatives rated social work services Good to Very good and 55.4% rated Average.


INTRODUCTION
It is the pressures of modern life today that social problems begin to arise such as issues related to morality and lifestyle; economic problems; physical and mental health problems; environmental problems, natural disasters, epidemics, etc. The degree of the problems can be measured in many different ways according to the actual circumstances, but the development is extremely complex and unpredictable due to many reasons. It is the negative effects of society that increasingly affect people's health both physically and mentally. People began to appear strange diseases called diseases of the modern era, including: cancer, depression, multiple personality disorders... But among those diseases, the most popular is existence of autism syndrome. This is probably a disease that has caused many families extreme life depression and despair. Autistic people cannot afford to take care of themselves, the treatment process is difficult and long, requiring long-term financial capacity to protect the health of autistic people. In Vietnam, there are no statistics or epidemiological surveys on autism, but according to experts, the number of children with autism detected tends to increase faster compared to other children diseases.
In 2015, The National Children's hospital had 2,114 autistic children while in 2014, this number was 1,847. That means after only 1 year, the number of autistic children that were detected and treated at the hospital has nearly doubled. Research on disability model in children of the Department of Rehabilitation of the National Children's Hospital in the period 2010 -2015 shows that the number of children diagnosed and treated with autism was increasing; the number of autistic children coming to the hospital in 2015 was 50 times higher than in 2010; The number of children with autism receiving treatment in 2015 was 33 times higher than in 2010. [2] There have been many theories explaining the causes of autism, and the actual behavior of that children has been gradually observed and described. Since then, many therapeutic and educational methods have been born that contribute to improving the quality of life of autistic children. In 1944, Austrian Psychiatrist -Han Asperger  used the term Autism when describing social problems among the group of boys he worked with. According to him, children's language developed normally, but the way of expressing and pronouncing many tones was not suitable for the situation; There were disturbances in the use of personal pronouns. Children still had social contacts but tend to prefer being alone. The most special disorder was the cumbersome and complicated way of reasoning, which does not adapt to conditions and circumstances. These children had special interests in engineering and mathematics and had an extraordinary ability to remember [1], people take his name for this syndrome as Asperger.
In the 70s and 80s of The Twentieth century, people began to consider the concept of the Autism spectrum. In the book "The Autism Phenomenon", Lorna Wing (1978) found signs of autism disorder related to the character "Juniper brother". According to her assessment, this person has signs of autism such as: do not want to communicate, contact; indifferent to people around, preferring boring, repetitive activities; do not understand and respond to the feelings of others. Although it is not certain whether Juniter has autism or not, Lorna Wing's description shows some of the symptoms that we often see in children with autism [1]. Therefore, we continue research on the status of social work services with autistic children at the social work center of Vinh Phuc province to exploit service quality for autistic children here include: the advantages and limitations that need to be strengthened and overcome, solutions to improve the quality of social work services at the center.

OBJECTS AND RESEARCH METHODS
* Study design is a cross-sectional descriptive study.
-Family members of children who come for medical examination and treatment at social work centers of Vinh Phuc province should satisfy: -Aged 18 years and older -Agree to participate in the study after being introduced to the study.
-Can make important decision for autistic children (nurturer, authorized person) * Sample size and sample selection The study was carried out on 36 family members of 36 autistic children.

The time when autistic children were diagnosed at Vinh Phuc Social Work Center
After meeting and conducting a survey of 36 parents of autistic children at the social work center of Vinh Phuc province, they can see the current status of the age at which autistic children are diagnosed at the center. Specifically, the situation update is in Figure 2.1 as follows: (Survey data of 36 autistic children's relatives) The survey shows that 44.32% of autistic children at the center are detected early before 2 years old; 27.7% of autistic children at the center were detected after 3 years old; 16.62% of autistic children at the center were detected before 3 years old; 11.08% of autistic children at the center were detected before 1 year old. Thus, looking at the chart, it can be seen that it is relatively early for families to identify and recognize the early signs of autism in children at Vinh Phuc social work center. Most children are diagnosed with Autism before the age of 2 and a small number of children are detected very early before the age of 1. Now, the information technology is extremely popular, so it is easier for parents to find out and access to know the causes of their children's abnormal expressions at different stages. Most of the time before the age of 2, children can have many obvious signs for parents to know for sure that their child has autism. Before age of 1, children are still too young and will be difficult to be detected early. However, with current scientific measures, if parents have any doubts about their child's autism before the age of 1, they can completely learn and test it. Due to the prevalence of autistic syndrome today, along with the parents' care and concern for their children, the medical information technology approach makes it easier to help autistic children at the Vinh Phuc social work Center, they has been detected and intervened early, which is extremely good for autistic children according to scientific publications. Table 2.1 below are specific statistics on the cognitive performance of parents having a child with autism at Vinh Phuc social work center. When parents give birth to children, they always give their children all their love and they always want the best for their children... The fact that children have health problems at an early age certainly affects the psychology of parents a lot. Researching the psychological influence of parents to better understand their needs as a service provider is extremely important and necessary. Here are the specific research data:

(Survey data of 36 autistic children's relatives)
Looking at survey data 2.1, it can be seen that: there are many signs of parental instability when knowing that their child has autism. In which, up to 80.33% of parents feel shocked and cannot believe that their child has autism; 100% of parents, after learning that their child has autism, expressed concern about the child's upbringing and future; 83.1% of parents are extremely disappointed/depressed when they learn that their children will never be normal again; 72.02% of parents started regretting (if only they could do something to get their child back to normal) and began to accept having an autistic child; 63.71% of parents blame themselves, spouses, nurturers for rifts and conflicts in the family. Most of these psychological conditions happen to parents when they learn their child has autism.
However, a few parents, due to their knowledge and skills about this disease, are more optimistic and have more positive expressions, ready to accompany their children to overcome the disease. In the interview with Ms. T.T.T.H -a mother of autistic children at the Vinh Phuc Social Work Center said: "When he was one and a half years old, I saw that he didn't react much when I tried to start a conversation with him, I started to get worried because most children at that time could have many expressions like smile, practice speaking, good body reflexes with eyes, mouth, ... but my child has not yet. About two months later, I decided to take him to check and found out that he had signs of autism. My family and I are extremely shocked, I couldn't believe it and I didn't want to believe that my child was like this. I hugged my baby and cried, everyone in the family was also extremely worried and bewildered. Depressed/disappointed to know that the child will never be normal again 83.1% 16.62% 5 Expressed concern about the child's upbringing and future 100% 0% 6 Accept having an autistic child 72.02% 27.7%

Overall quality assessment of activities in social work services with autistic children at the Vinh Phuc Social Work Center province
When the parents let their children to be intervened at the Vinh Phuc Social Work Center, they will let their children participate in service activities at the Center. At the same time, parents will also be able to participate in service support activities and monitor how their child's healthy changes positively. Directly participating in activities and evaluating performance help parents feel more clearly about the quality of services, making a more accurate and objective assessment, more comprehensive. In addition, experiencing the service will help parents feel more secure and make practical contributions to improve the quality of the service. Below are the numbers of parents' evaluation of the quality of social work services for autistic children at Vinh Phuc Social Work Center as follows:

(Survey data of 36 autistic children's relatives)
Through the survey, the results in chart 2.7 can be seen that: 55.4% of parents have an average assessment of the quality of social work services with autistic children at the Social Work Center; 38.78% of parents' evaluations are at a good level and a small number of parents rate them at a very good quality level. And through the survey, there is no assessment of bad or very bad quality. Social work activities for autistic children at the Social Work Center of Vinh Phuc province are generally organized in a clear and organized scale, specifically planned, and inspected before the activities. The official action combined with scientific and modern working methods, a team of extremely responsible social workers, However, there are still many inadequacies affecting the quality of service activities at the Center such as the unreasonable allocation of teachers, the large number of autistic children, the lack of personnel with in-depth expertise in health care. special education, working experience of staff is still lacking, etc., so the quality of service has not really met the desired effect. Those limitations will be somewhat improved in the coming time when the Center has a more reasonable coordination of activities, carefully considers the operation plans to suit the actual conditions but still ensures the safety. The quality of the service helps autistic children at the Center have a better working environment, improve their condition over time, and parents also have more confidence and peace of mind when letting their children use the service at the Center.

CONCLUSION
The social work center of Vinh Phuc province needs to ensure the conditions of facilities, supplement human resources with qualified and professional qualifications, work experience, spirit and responsibility at work to ensure basic conditions to support autistic children. The center needs to allocate personnel more evenly and reasonably. Invest and manage more in social work activities for children with Autism to ensure the level and quality of activities.
The Center needs to adjust the support policy for social workers so that it is reasonable to protect the legitimate interests of employees who can focus on working, balance the workload, avoid putting pressure on employees.
Families of autistic children need to actively update their knowledge, skills, and information on caring and raising autistic children. At the same time, parents must regularly participate in training classes organized by the Center exclusively for parents to improve their child care skills and knowledge. Actively and actively participate in activities to support children with autism at the Center to coordinate with the Center to conduct intervention and therapy for children. In addition, families need to balance their time and have a more open view of autism, so they should regularly spend time with their children and other relationships. Families need to be vulnerable and share each other to help the child, accept the child and find a cure for the child, accompany the child to fight the illness, avoid hurting the child and lose faith and negative thoughts. positive about children.