Introduction
All requests for neurodevelopmental assessments should follow the pre-assessment pathway. This may result in a referral for Autism and/or ADHD being made along with the completion of a next steps form (if appropriate).
Form to provide information to inform whether a child or young person needs a diagnostic assessment in relation to Autism and/or Attention Deficit/Hyperactivity Disorder (ADHD). This form contains sections to be completed by a referrer (SENCO, health or social care practitioner, PFSA), parent and child or young person. Please download and save to your computer, and use this form in Word and not in your web browser.
If you would like support in completing this form, we would advise you to ask whoever you think is best placed to help. This might be someone at your child’s school (e.g. SENCo), or someone else who is working with you (e.g. PFSA, Social Worker or health practitioner).
All new requests for a neurodevelopmental assessment are initially triaged by a member of the Children and Young People Neurodevelopmental Partnership, clinical team.
Where there is additional complexity, triaging clinicians can request the information be reviewed by a member of the CYPNP clinical leadership team by placing them on the agenda for discussion at regular MDT Triage meetings.
In exceptional circumstances where there is significant complexity that requires additional information that is likely to be available through local authority systems (e.g. through Children’s Social Care and/or Education records) young people may subsequently be put forward for more in-depth consideration of their referral through discussion with interagency colleagues from across the local system in a regular Interagency MDT Triage meeting.
The assessment pathway for the child or young person will then depend on:
- Age –the pathway may vary depending on the age of the child or young person
- Location – the approach differs slightly for those in the East Mendip area
Neurodevelopmental Assessments for 5-17 year olds (school age)
Initial Appointment
online gathering background information and allocating a keyworker
- A first appointment with the child or young person’s parent carer is offered. In most cases, this appointment will be online via a video link.
- The purpose of this appointment is to gather background and contextual information relevant to the young person’s neurodiversity assessment (including a comprehensive developmental history).
- The young person is allocated a keyworker from the CYPNP team who will co-ordinate their assessment and be a point of contact.
Second Appointment
face-to-face with two members of the CYPNP team
- The child or young person and their parent carer are invited to a second appointment with two members of the CYPNP team. This appointment is face-to-face.
- This appointment starts with a discussion about the reasons an assessment is wanted and how it is hoped our work together will be helpful.
- Informed consent for the assessment is gained from the young person (wherever appropriate) and their parent carer.
- After this initial chat, wherever possible, the young person and their parent carer are seen separately.
Liaising with other services and practitioners
gathering information
- Our team will gather information from other people who have recently, or are currently, working with them.
- This might involve requesting an update in writing from a school practitioner (e.g. teacher or SENCo). We might also need to have a conversation with them.
Follow up appointments (as required)
gathering further information
- Further appointment(s) are offered to gather enough information to enable us to complete the assessment.
- What this involves is different for every young person.
- Follow up appointment(s) might involve specialist assessments of cognitive ability (thinking skills), language needs, or other possible areas of difference.
- This might involve consideration of co-occurring or alternative explanations for the young person’s areas of difference (e.g. medical/genetic needs, attachment, or the impact of difficult life events they may have encountered).
- We may need to observe the young person at their school and/or home.
Feedback, report, recommendations and follow up
discussing the outcome of the assessment
- A feedback appointment is offered to share and discuss the outcome of the assessment.
- A comprehensive report is written for the young person which will include a formulation (understanding) of their areas of difference, confirmation of any diagnosis given.
- Young person and parent carer are welcome to request a follow-up appointment to discuss the assessment further within three months of receiving the report.
- We will make some specific recommendations and signpost to any appropriate next steps.
East Mendip
The approach differs slightly for East Mendip. To access East Mendip pathway the child or young person will need to be registered with one of the GP practices below. A full list of practices can be found on the Next Steps Form.
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- Frome Medical Practice
- Beckington Family Practice
- Mendip country Practice
- Park medical practice
- Grove House Surgery
- Oakhill Surgery
Autism Assessments for 0-5 year olds (pre-school)
For children age 0 to 5 years not yet in school. For those aged 4 but in school please see the Neurodevelopmental Assessments for 5-17 year olds (school age) pathway
Where there is a concern about possible autism in a child aged 0 to 5, professionals (GP, health visitor, Speech and Language Therapy, Occupational Therapist) can refer directly to the team at Somerset Foundation Trust (SFT) (preferably by Advice and Guidance or otherwise by the Community Child Health (CCH) secretaries – CCHadmin@somersetFT.nhs.uk)
The referral should contain the relevant information required including developmental assessment, nursery reports as well as speech and language reports.
The individual being referred would be expected to have accessed the MAISEY (Multi-Agency Identification and Support in the Early Years) process, so a referral may come via a professional on the panel. You can find out more about the MAISEY process here.
In Somerset, the child and their family also have access to the Portage service. The work Portage Home Visitors do helps to act as a signpost support for parents who have children in Early Years and often feeds into Multi-Disciplinary Triage (MDT) discussions with health and education colleagues.
Portage Home Visitors attend all MAISEY meetings in Somerset. They will then support families with early-diagnosed Autism or those following the pathway by providing access to services including, home visits, stay-and-play groups and focus groups for children.
Neurodevelopmental Assessments for 18+ years (adults)
There are valid reasons to, and not to, access an assessment once concerns are identified. Some young people and families may not wish to pursue this as they do not wish to be labelled or are concerned about the potential stigma a diagnosis can bring.
It is important to understand that accessing an Autism and/or ADHD assessment can also have many potential benefits. For example; it can provide a framework for a young adult to better understand themselves, or for others to understand them (e.g. parents, teachers, health and social care practitioners). This can enable young adults to access support, for example in education and employment, including reasonable adjustments under the Equalities Act (2010). An autism and/or ADHD assessment and subsequent diagnosis can also act as a protective factor against areas of differences associated with neurodevelopmental conditions being misunderstood in adult mental health settings (e.g. as Borderline Personality Disorder)
Young adults who wish to access an assessment for either autism and/or ADHD can do so through the medical route with the Somerset Adult Autism Spectrum Service and/or the Somerset Adult ADHD Service.