East Cheshire neurodevelopmental pathway
Autism assessment age 0-4
| Question | Answer |
| What forms need to be filled out at the initial stages – is there a checklist to ensure everything which is needed for the referral to be accepted is completed? |
Referrals for the pre school development clinic are sent by email to the 0-4 Autism Spectrum Condition (ASC) Clinical Co-ordinator from a Paediatrician Once a referral for the autism pathway is received the patient is placed on a waiting list. A holding letter is sent with a leaflet outlining support available If the information in the referral shows that the child meets the criteria for assessment the parent will be sent confirmation that they have been placed on the pathway. The following is then sent to parents:
It’s important to remember to send all the requested information back to avoid any delays. Professionals involved with the child are then sent a Professional Concerns Questionnaire. |
| Where do the forms go? | When forms are returned they are saved securely to the child’s medical records |
| Who will the child/young person see at each stage of the diagnostic process and where? |
The child is seen by a Paediatrician at the pre-school development appointment, either at Macclesfield Hospital or at Pavilion House. From the information gathered at the pre-school development appointment an autism diagnosis decision may be made. If an autism diagnosis decision requires further information, the child may be called for an in person assessment (ADOS) with an ASC assessor, which takes place at Pavilion House in Macclesfield. |
| What tests will be done? | We assess using DSM V criteria based on the professional questionnaire results and sometimes ADOS assessments. The team rarely visit the child to observe them within an external setting (eg a nursery). |
| What reasonable adjustments can be done if my child has, for example, PDA and would struggle to attend a ‘normal’ appointment |
We always assess children via DSM V initially which involves the collation of information from a variety of sources, who routinely see the child. Therefore, our assessment at this point is primarily a paper exercise. If a child is deemed unsuitable for an ADOS we will offer to see the child in their own setting. (I.e. Nursery or school). If you tell us what works best for your child we will do our best to help. |
| What is the MDT (sometimes referred to as the ‘panel’) and when are they involved? |
Our Multi-Disciplinary Team (MDT) consists of a Consultant Paediatrician, an ASC trained assessor from Speech and Language and Occupational Therapy and a clinical co-ordinator. Members from the Health Visiting team and the Early Years team also attend on a rolling basis. We hold an in-person MDT every month, where unclear cases are discussed We hold a virtual MDT every two months, where clear cases are discussed |
| What happens at the point of diagnosis and how are people supported (whether or not a diagnosis is made) |
Whether a child or young person receives a diagnosis or not, we make sure you have the information you need. An initial feedback call is made to the parents, by the Clinical Co-ordinator, to deliver the diagnosis decision. The assessment report is discussed and it is emailed and sent in the post to the parent. For those receiving an autism diagnosis they are signposted to local and national services, plus any other relevant sources of support. A post diagnostic support pack is sent in the post for those who have received an ASD diagnosis. For those who do not receive an autism diagnosis, they are signposted to the Cheshire East Sensory Processing website and any other relevant sources of support. An In person feedback appointment is also offered to discuss the assessment process in more detail with the Clinical Co-ordinator and an ASC assessor. |
| What’s the difference between ASC and ADHD in this process (at what point would the practitioners decide whether they are looking at an ASC diagnostic, an ADHD diagnostic or both)? |
The 0-4 ASD Diagnostic pathway does not assess for ADHD as this is for children age 6+. If there are traits of ADHD uncovered during assessment for autism this is discussed at the MDT meeting and then a recommendation is made to refer for assessment of ADHD at Age 6 via Cheshire and Wirral Partnership NHS Trust. |