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Interview question design: policymakers

1. 政策背景和目标
1. Policy context and objectives

(1) Please briefly describe your responsibilities and scope of work in policy development.

My duties are to supervise the implementation of the Constitution, laws and regulations, the implementation of policies, initiatives and decisions, and the resolution and implementation of practical problems of immediate interest to the people through the form of opinions, criticisms and suggestions; to conduct investigations and researches on important issues in politics, economy, culture, social life and ecological environment, as well as on issues of general concern to the people. (c) Conducting research on important issues in politics, economics, culture, social life and the ecological environment, as well as on issues of general concern to the people, reflecting public sentiment and opinion, and submitting opinions and suggestions to governmental bodies in the form of research reports, proposals, suggestions or other forms.

(2) In your work, have you ever been involved in or responsible for the development of policies targeting vulnerable groups? What are the main objectives of these policies?

I have been involved in the development of policies aimed at supporting vulnerable groups. The objective of the policy on vulnerable groups is to provide stable and sustainable support to these groups, to help them improve their quality of life, to enable them to live as normally as possible under the influence of social forces as a whole, to enjoy the guarantees and services they deserve, to have a sense of accessibility and dignity, to enhance social cohesion, and to contribute to the harmonious development of society.

2. 政策标准和流程
2. Policy standards and processes

(1) What criteria and indicators do you refer to when developing policies for vulnerable groups?

The essential attributes of public policy determine that public policy must necessarily take social justice as its own value claim; therefore, the Government must pay attention to and solve the problems of vulnerable groups through public policy adjustments, so as to achieve an affluent and civilized society and to ensure social fairness and justice. It is necessary to establish the policy concept of supporting vulnerable groups in line with the requirements of the times, accelerate the establishment of a perfect social security and welfare system, and improve the implementation capacity of the policy. The two main principles for the protection of vulnerable groups in China's public policymaking are: to help protect the interests of vulnerable groups, and to help stimulate the potential of vulnerable groups.

(2) What is the process of policy development? Include stages from policy proposal to final adoption. Is there a specific evaluation mechanism to measure the potential impact and effectiveness of the policy during the policy development process?

Policy development is a multi-stage process involving multiple steps and considerations. The following is the basic process of policy development:

Problem identification and policy issue formulation. This includes identifying social problems, clarifying the need for policy development, and proposing policy issues.

Policy advice. Think tanks, expert groups or specialized institutions study and make recommendations on policy theories and programmes.

Policy agenda. Translating social problems into policy issues for systematic analysis, comparison, evaluation and justification.

Policy program design. Developing feasible policy options to address the problem, including objectives, instruments, budgets, etc.

Consultation and democratic participation. The views of all sectors of society are widely solicited to ensure the democratic and scientific nature of the policy.

Policy Decision Making. Leadership collectively evaluates and weighs the various options developed and selects the best option.

Policy publication and implementation. Formally publish the text of the policy  to publicize and explain the policy to all sectors of the community to ensure that the policy takes root.

Policy evaluation and adjustment. Evaluate the effectiveness of policies and make adjustments to policies and programs as necessary.

Resource input and organizational preparation. Ensure material security for policy implementation by setting up implementing agencies  and staffing them .

Supervision and rewards and penalties. Regulations are in place to ensure that the policy is fully and effectively implemented.

Each stage may involve detailed sub-steps and considerations to ensure that the policy is scientific, rational and feasible.

Policy evaluation is an important stage in the operation of public policy, and strengthening public policy evaluation is of great significance in testing the effectiveness of public policy and deciding on the survival or abolition of public policy. It is generally recognized that policy evaluation refers to the process of measuring and evaluating the efficiency, effectiveness and value of public policies on the basis of certain criteria, procedures and methods, and that its main purpose is to obtain relevant information on the implementation of public policies to serve as a basis for maintaining, adjusting, terminating and innovating the policies in question.

3. 对神经多样性的了解和支持
3. Understanding and support for neurodiversity

(1) Do you know anything about neurodiversity (e.g., autism, attention deficit hyperactivity disorder, etc.)?

The term "neurodiversity" is often used to describe people who think, behave or learn in ways that are outside the "typical" range. The majority of people, by contrast, are called "neurotypical". Just as "biodiversity" reflects the fact that all living things on earth are different, "neurodiversity" reflects the individual variability and richness of human cognitive and behavioral styles. At present, "neurodiversity" is more of an academic and behavioral concept, and has not yet appeared in official government documents.

Recently, this new concept has come to refer to people who "learn differently, think differently, and communicate differently", such as autism spectrum disorders (ASD), attention-deficit hyperactivity disorder (ADHD), specific learning disorders (SpLDs, which includes dyslexia, dyspraxia, dyscalculia, and dysgraphia), and Tourette Syndrome (TSS). dyspraxia, dyscalculia, dysgraphia, and dysgraphia), and TouretteSyndrome. It is worth noting that most of all neurodiversity covered contains the word disorder, to emphasize the impediments to neurodiverse people living in a society designed for the vast majority of neurotypical people (NTs for short). For example, the current public awareness of ADHD in children is still insufficient, and there are still many shortcomings and weaknesses in the children's mental health service system, especially the capacity of grassroots services cannot fully meet the demand for children's mental health services.

(2) What are the existing government policies or measures currently in place to support neurodiversity groups?

Special education has always been a livelihood undertaking to which the Chinese Government attaches great importance and concern. The report of the Eighteenth National Congress explicitly proposed support for special education; the Nineteenth National Congress proposed that special education should be provided well; the Fifth Plenary Session of the Nineteenth Central Committee proposed that the safeguard mechanism for special education should be improved; and the Twentieth National Congress further proposed that the development of special education should be strengthened in a mutually beneficial manner.

According to data from the National Health Commission, the prevalence of autism among children in China is 7 per thousand. There is a lack of effective drug treatment for childhood autism, and the main treatment pathway at present is rehabilitation training, with the optimal treatment period being before the age of 6. If scientific intervention is received before the age of 3, the symptoms and prognosis of the affected children can be improved to varying degrees. China provides a series of legal supports and policy guarantees for the autism spectrum disorder (ASD) community and their families. These support measures cover a wide range of areas, including diagnostic screening, rehabilitation assistance, education, employment, and livelihood protection, and the specific support measures may vary from region to region. Some regions are already conducting autism screening and assessment, and there are proposals to include autism screening in free newborn screening programs.

国家卫健委2021年印发《健康儿童行动提升计划(2021-2025年)》,明确提出加强儿童心理行为发育监测与评估,探索建立以儿童孤独症等发育异常为重点,在社区可初筛、县级能复筛、专业医疗机构诊断和康复的服务网络。推动妇幼保健机构、儿童医院、二级以上综合医院、精神专科医院开设儿童精神心理科或儿童心理保健门诊,加强儿童精神心理专科建设,促进儿童心理学科发展。教育部通过扩大孤独症儿童入学机会,持续提升孤独症儿童教育工作水平。中国残联通过加强残疾儿童康复救助。2022年出台《关于印发 0-6 岁儿童孤独症筛查干预服务规范(试行)的通知》,明确为0至6岁儿童提供孤独症筛查干预服务规范);6岁学龄之前的孤独症儿童,可以进行免费康复训练;6-18岁学龄孤独症儿童,可以去特殊教育学校进行义务教育。2024年1月出台《关于推进儿童医疗卫生服务高质量发展的意见》,明确要提高抑郁、焦虑、多动症、孤独症等心理行为问题和常见精神障碍的筛查识别和处置能力。
The National Health Commission: 2021 issued the Healthy Children Action Enhancement Plan (2021-2025), which explicitly proposes strengthening the monitoring and assessment of children's mental and behavioral development, and exploring the establishment of a service network focusing on developmental abnormalities such as autism in children, which can be initially screened at the community level, rescreened at the county level, and diagnosed and rehabilitated by specialized medical institutions. Maternal and child health-care institutions, children's hospitals, general hospitals above the second level, and psychiatric hospitals have been promoted to open child psychiatry and psychology departments or child mental health-care outpatient clinics, to strengthen the construction of child psychiatry and psychology specialties, and to promote the development of the discipline of child psychology. The Ministry of Education has continued to raise the level of education for autistic children by expanding opportunities for autistic children to enroll in school. The China Disabled Persons' Federation (CDPF) has strengthened rehabilitation and assistance for children with disabilities through. in 2022, it issued the Circular on the Issuance of Service Specifications for Autism Screening and Intervention for Children 0-6 Years of Age (for Trial Implementation), which specifies the service specifications for autism screening and intervention for children 0-6 years of age); autistic children before the age of 6 years of age at school age are eligible for free rehabilitation and training; and autistic children between the ages of 6-18 years of age at school age are eligible to go to special education schools for compulsory education.2024 The Opinions on Promoting the High-Quality Development of Children's Medical and Health Services was issued in January, specifying the need to improve the screening identification and disposition of depression, anxiety, ADHD, autism, and other psycho-behavioral problems and common mental disorders.2025 The Opinions on Promoting the High-Quality Development of Children's Medical and Health Services were also issued in January.

Fujian Province: attaches great importance to the screening and rescue work for children with autism, strives to strengthen the care services for children with autism, promotes the construction of the screening and intervention service system for children with autism with multiple initiatives, and incorporates the screening and education for children with autism into the "Program for the Development of Children in Fujian Province (2021-2030)".2023 With the consent of the provincial government, the provincial Department of Civil Affairs, in conjunction with the Provincial Health Commission, the Provincial Federation of Disabled Persons, and other thirteen departments, has issued the "Fujian Province Several Measures for Strengthening Care Services for Children with Autism", which put forward 20 measures to strengthen care services for children with autism in six aspects, including improving the whole chain of services of screening, diagnosis, treatment, intervention and rehabilitation, promoting the guarantee of integrated education, constructing a social integration support system, strengthening the management of rehabilitation service institutions, accelerating the construction of talent teams, and strengthening the guarantee of the organization. 2023, the Provincial Health Commission formulated and issued the "Standardized Screening and Intervention of Autism Screening in Maternal and Child Health Care Institutions in Fujian Province". Standardized Outpatient Construction Standards for Autism Screening and Intervention in Institutions (for Trial Implementation), and the provincial finance invested 13 million yuan to support 13 county-level maternal and child healthcare institutions to carry out the standardized construction of autism outpatient clinics.

Shanghai: In March 2024, the Guiding Opinions on Strengthening Care Services for Children with Autism in the City were issued. It proposes that by the end of 2027, Shanghai will have established a sound system of care services for autistic children along the entire chain of screening, assessment, diagnosis and treatment, intervention and care, and puts forward 16 specific initiatives in five areas.

(3) What do you see as the main shortcomings in the current support system?

1. The full-cycle autism care and support system is not yet perfect. The rehabilitation and education services of the current system are dominated by patients aged 0-6 years, and it is difficult for patients aged 6 years or older to enjoy integrated education in compulsory education institutions, or to find market-oriented service institutions for older-age autistic patients. In China, the proportion of older autistic persons who are socially integrated and employed is less than 5 per cent, and the vast majority of older autistic persons are forced to rely on their families for life, with no socialized solutions to choose from when their parents grow old or pass away, which has become the "ultimate anxiety" for families of autistic persons.

2. The autism rehabilitation and education industry lacks unified standards. China's autism rehabilitation and education industry has no unified national standards, and there are only a small number of local standards and group standards, all of which are recommended rather than mandatory. Incomplete standards for service institutions, qualifications, intervention methods, service quality, and other aspects of the industry are unable to effectively promote the provision of high-level standardized services by industry institutions; the industry is characterized by a wide range of good and bad standards; the shortcomings of the practitioner workforce are prominent; the turnover of specialized personnel is high; the service model and intervention methods lack scientific guidance; and the effects of interventions are not as satisfactory as they could have been.

3. Lack of systematic planning for the construction of autism care systems. At present, most regions in China have not yet introduced special planning for the construction of autism care and support systems, and most of the regions that have introduced relevant policies have only focused on care services for autistic children, lacking a scientifically meticulous, systematic, comprehensive, and long-term planning layout for the construction of a full-cycle care and support system for autistic persons.

4. 政策通过的可能性
4. Likelihood of policy adoption

(1) What do you see as the main challenges in promoting new policies (e.g. support policies for neurodiverse creative talent)?

The main challenge is:

① How to improve the construction of a care and support system for neurodiverse groups. Expanding the coverage of policy-based financial subsidies and promoting policy entitlement.

② How to crack the employment challenges of neurodiverse groups, strengthen their vocational literacy and skills training, and enhance the development of special jobs and employment opportunities. According to a 2015 study by Drexel University in the United States, only 58% of young people with autism in the U.S. can get a job after high school, of which 80% are temporary. As a matter of fact, how to help adults with autism to be self-reliant is still a topic to be faced squarely by the international community together.

(iii) How to strengthen planning traction and formulate a nationwide special plan for the construction of a care and support system. On the basis of the existing foundation, long-term development goals are planned, the policy framework is enriched, and the roadmap for the development of the industry is refined.

(2) What is the level of government acceptance of the new policy? What are some of the factors that could affect the adoption of the policy? To what extent do you think public and stakeholder input plays a role in the policy development process?

Within the existing Chinese administrative framework, policies and initiatives in any area are formulated by government departments with administrative functions in that area, in accordance with laws and administrative regulations, decisions and orders, and within the scope of their authority, and are implemented once they have been introduced in accordance with the standardized procedures, so there is no question of acceptance or whether they have been adopted.

Governments at all levels under the leadership of the Communist Party of China (CPC) adhere to the principle of being people-centered and serving the people wholeheartedly, adhere to and develop people's democracy throughout the entire process, always maintain close contact with the people, and actively listen to the people's opinions and suggestions. Public participation and the collection of opinions play an important role in China's policymaking, as policymakers are able to make reference to the relevant opinions and suggestions and formulate policies that are more in line with reality and the needs of society, and that improve feasibility and effectiveness of implementation.

5. 未来展望
5. Future prospects

(1) What international experiences or success stories do you think can be drawn upon to improve our existing policies?

Since 2008, the United Nations General Assembly has designated April 2 every year as the World Autism Awareness Day to raise awareness of autism and to call on people from all walks of life to pay attention to the autism community. The cause of autism is not yet fully understood, and scholars from many countries generally agree that autism is a neuropsychological developmental disorder caused by high-risk factors in genetically susceptible individuals. This year's United Nations World Autism Awareness Day specifically calls for "a major shift" away from "curing or changing the narrative of people with autism to one that focuses on acceptance, support and inclusion of people with autism, and advocates for their inclusion. instead focusing on acceptance, support and inclusion of people with autism and advocating for their rights". In his message, Guterres said the international community needed to do more to promote inclusive education, equal employment opportunities and create an environment of respect for everyone.

CST,全称是孤独症谱系障碍及发育迟缓儿童家庭“照顾者康复技能培训”(Caregiver Skills Training)项目,2015年由世界卫生组织、美国公益组织《自闭症之声》、联合国儿童基金会共同发起,旨在通过专业人员对社区卫生保健人员等半专业人员进行培训,再由他们组成的引导师队伍进入患儿家庭培训,从而让父母掌握为患儿提供干预的关键技能。这一项目已在全球30多个国家开展临床研究和预实验,2550个孤独症家庭受益。
CST, or Caregiver Skills Training for Families of Children with Autism Spectrum Disorders and Developmental Delays, was launched in 2015 by the World Health Organization (WHO), Autism Speaks, and UNICEF, with the aim of providing parents with key skills to provide interventions for their children through the training of community health care workers and other semi-professionals by professionals. Professionals train semi-professionals, such as community health care workers, who then form teams of facilitators who go into the homes of affected children to train them in the key skills needed to provide interventions for their children. The program has been clinically studied and pre-tested in more than 30 countries around the world, benefiting 2,550 families with autism.

The Zelkova Countryside, a lifelong care facility for autistic people in Japan, may be a model of care for adult autistic people that can be used as a model. "Zelkova consists of a rehabilitation center, a welfare factory, and a family-style home for autistic people, and is subsidized by the government. Older autistic people can earn their own living by completing simple handicrafts with the help of the staff, and pay for their old-age care with the money they earn from the sale of their handicrafts.

(2) In the future, what measures do you think the government should take to better support and include neurodiverse groups, especially in the creative industries?

In the United States, about 50,000 people from the neurodiversity group enter adulthood each year, and thus there is a big issue of how to help them to live independently and be self-supporting. The number of adults from this group who are employable is still very small, and efforts need to be continued.

The Government should strongly support employment programs for the neurodiverse group to provide them with a relatively stable and predictable work environment in which they can become contributing and as independent as possible. Directly allow people in this group to earn income for their labor based on the practice of meaningful work, and at the same time allow people in this group to have the opportunity to touch and bond with regular people in their work. It allows for a greater sense of self-identity in the employment process, and at the same time raises public awareness of the person's abilities and potential for development. A small number of people from this group are gifted in certain areas and have abilities that exceed those of ordinary people, so they should be given reasonable training and strong support so that they can become competitive employers.

6. Summary

What are your suggestions or expectations for this project? Would you be willing to continue to provide support and guidance as the project moves forward in the future?

A welcome change in recent years is that more and more voices are calling for attention to be paid to neurodiverse groups such as autism, not just to autism as a disorder, but more attention should be paid to people with autism spectrum disorders, especially adults with autism spectrum disorders, and this has become a social consensus to a certain extent. Social security and rehabilitation assistance are also being gradually improved. Of the several important aspects of rehabilitation, education, employment, resettlement and social security, the main resources and efforts are now focused on rescue rehabilitation for persons aged 0-6, and integrated education is in its infancy, while employment and resettlement are quite weak, and the contradiction between the real needs and the supply of social services is quite prominent. If rehabilitation and education are disconnected from employment, older persons recognizing this group will be idle at home, with nothing to do, and the effects of their rehabilitation and education will diminish and their functional impairment will worsen, bringing greater obstacles to themselves and their families.

According to the United Nations' prediction, 80% of adults with autism are currently unemployed, and the situation may be even worse in China. According to the "Blue Book on the Needs of Autistic Families in China", the employment rate of adults with autism is less than 10%, 55.5% of parents lack confidence in their children's future employment to a certain extent, 69.3% of parents believe that job training for older autistic people has not been given the attention it deserves, and 72.7% of parents are worried about their children's future after they leave this world. At present, there is no relevant support policy in China to help adults with autism to find employment, and they generally face difficulties in employment after graduating from rehabilitation institutions or special education schools. The future of autistic children after they grow up is not only a knot in the minds of autistic parents, but also an issue that the whole society should pay attention to together.

Suggestion: This project can propose substantive and effective coping strategies in terms of systems, training, and business support in the context of supported employment for diverse neurological individuals, such as those with autism. I am willing to continue to provide support and guidance in the future progress of the project?