A comparative analysis of the predominant educational services available for autistic children aged 0 to 11 in Malta and England

Abstract

Educational services for autistic children are shaped by interacting policy, funding, and professional arrangements, producing variability in provision across settings and systems. Such variability can lead to uneven access, inconsistent quality and divergent outcomes for children and families. Examining the models that underpin service design and delivery makes visible the assumptions guiding decision making, clarifies where practice supports or undermines inclusion and identifies system level improvements that can transfer across contexts. This dissertation presents a qualitative comparative analysis of predominant educational services for autistic children aged 0 to 11 in Malta and England and examines the disability models shaping how services are organised and delivered. The study takes the view that service pathways matter as much as diagnosis. Families encounter autism-related provision as a sequence of decisions, referrals, placements and supports that are shaped by governance, resourcing, professional roles and underlying assumptions about autism and inclusion. Situated within a critical realist paradigm, the research adopts a descriptive analytic comparative design to explore what services exist and how and why they take their current form in each context. Data was generated through Rich Pictures adapted from Soft Systems Methodology, semi-structured interviews with ten expert participants, four in Malta and six in England, working across education, health, social care, policy and non-governmental provision and documentary analysis of relevant policies, strategies and organisational materials. The dataset was analysed thematically, with ongoing refinement of the Rich Pictures. Findings suggest that both systems promote inclusive education, but they do so through different structures. England’s arrangements are more decentralised, with pathways shaped by local commissioning and varying across localities, contributing to uneven access and complex navigation. Malta’s pathways are more centralised, providing a clearer route to assessment and school-based support. However, capacity constraints and waiting times can delay access and increase reliance on public-social partnerships and private provision. Themes spanned assessment, intervention, mainstream support and placement, with mixed deficit and rights-based framings. The dissertation concludes by outlining implications for improving timeliness, coordination and equity of provision, particularly through stronger early years support, clearer navigation and more consistent inclusive practice across settings.