Autism Assessment and Diagnostic Service for Children and Young - - PowerPoint PPT Presentation

The Retreat: Scarborough and Ryedale CCG Autism Assessment and Diagnostic Service for Children and Young People

The team

We are a multidisciplinary team:

• Clinical psychologists
• Speech and Language Therapist
• Occupational Therapist
• Assistant Psychologists
• Child and Adolescent Psychiatrist for consultation

This is important as we are tasked with clarifying whether the difficulties a child and family are experiencing are really due to a neurodevelopmental condition such as ASD, or whether other issues

• ffer a better explanation:
• Social anxiety
• Learning difficulties
• Emotion regulation difficulties.

Partnership and choice

• Working together with Healios to enable the choice of a fit-

for-purpose, high quality online pathway

• Healios also provides a multidisciplinary team
• On referral, we will be offering families the choice of:-

– All online – All face-to-face – A mixture of online and face-to-face

• Wherever we can we will try to provide the type of service

the person chooses

What is Autism Spectrum Disorder (ASD)?

• Much more common than most people think – more than 1 in 100 in the

UK

• We see a peak of referral and diagnosis at school start, then again at

transition to high school and finally between 18-25 when people move into independent living

• It is a spectrum condition – all autistic people share certain core features,

but being autistic will affect them in different ways to varying degrees.

• More men than women appear to be affected, but we now understand

many more girls/women might be affected than we thought in the last 10- 20 years.

• Autism is a lifelong developmental condition, present from birth, even

though difficulties might not become fully apparent until later in childhood or adolescence.

What are the characteristics of ASD?

• Vary from one person to another, but in order for a diagnosis to be

made, a person will usually be assessed as having had the following, since early childhood – persistent difficulties with social communication and social interaction – restricted and repetitive patterns of behaviours, activities or interests, and sensory sensitivities They will have had these characteristics to the extent that they impact

• n every day functioning, socially, educationally, occupationally and
• ften to the detriment of the person’s mental health.

Referrals to the service

• Referrals can be made by GPs, school staff (SENCOs) and other

education, health and social care professionals

• Good quality referrals are the best way GPs and everybody involved

in looking after children can help maximise the use of a costly ASD assessment service.

• We want to avoid delays in referral - often this is what happens if

we have incomplete information and need to get back to referrer.

• We cannot accept referrals where information that an ASD

assessment there indicated is unclear.

What should referrers be looking for?

• If you see a child and parents/school are querying ASD, there are

FOUR areas that you should ask about, this will allow you to populate our referral form effectively:

• I. Social communication and interaction
• II. Repetitive behaviours and routine
• III. Highly-focussed interests
• IV. Sensory Sensitivities
• If in doubt, please give us a call, we are always happy to discuss

referrals

• Remember - only if you can give some indicators in all areas can we

accept a referral.

What are we looking for in relation to Social Communication and Interaction?

• Does the child have difficulties with

communicating? Lack of engagement in conversation; or at the other extreme, being highly verbal but ‘going on and on’ and not really making conversation a two-way interaction - including struggling to understand jokes and sarcasm, struggle with vagueness

• r abstract concepts, taking

expressions literal.

• Do they struggle to interpret or

show facial expressions (including lack of eye contact).

• Does the child have any friends?

Autistic people may find it hard to form friendships.

• Does the child have difficulty

'reading' other people - recognising or understanding

• thers' feelings and intentions -

and expressing their own emotions? This can make it very hard for them to navigate the social world. They may: – appear to be insensitive – seek out time alone when

• verloaded by other people

– not seek comfort from other people – appear to behave 'strangely'

• r in a way thought to be

socially inappropriate.

What are we looking for in relation to Repetitive Behaviour and Routines?

• Does a child struggle with change in

routines and transitions?

• Do they only cope with changes etc

when their parents prepare them and make lots of additional adjustments to help?

• Does the child show repetitive

motor behaviours (flapping hands, rocking or spinning in circles) or make repetitive vocalisations? These are not always easy to see.

• The world can seem a very

unpredictable and confusing place to autistic people, so they often prefer to have a daily routine so that they know what is going to happen every day.

• They may want to always travel the

same way to and from school or work, or eat exactly the same food for breakfast.

• The use of rules can also be
• important. It may be difficult for an

autistic person to take a different approach to something once they have been taught the 'right' way to do it.

• Autistic people may not be

comfortable with the idea of change, but may be able to cope better if they can prepare for changes in advance.

What are we looking for in relation to Highly Focused Interests and Sensory Sensitivity?

Sensory sensitivity

• Does the child have an unusual

response to sounds/lights/touch/ smells/taste?

• Autistic people may also

experience over- or under- sensitivity to sounds, touch, tastes, smells, light, colours, temperatures or pain.

• For example, they may find

certain background sounds, which other people ignore or block out, unbearably loud or

• distracting. This can cause anxiety
• r even physical pain. Or they

may be fascinated by lights or spinning objects. Highly focused interests

• Does a child become ‘obsessed’

with specific items or topics? Will this become their all- encompassing interest?

• Many autistic people have

intense and highly-focused interests, often from a fairly young age.

• These can change over time or be

lifelong, and can be anything from art or music, to trains or computers.

• An interest may sometimes be

unusual.

What are we commissioned to provide?

• To assess child/young person of school age as to whether they have

ASD.

• Our team will summarise findings in a report
• Report will be shared with referrer and GP with parental permission
• We will make some recommendations how child can be supported
• We will make recommendation for additional referral if we have

mental health concerns

• If more detailed sensory assessment is indicated, we will make

recommendation for this

• Our service is able to provide mental health support,

communication support, training for parents, sensory assessments - however this is not covered under the existing contract.

Questions?

Email scrccg.retreatautism@nhs.net Telephone 01904 426043