What is ASD?
Autism Spectrum Disorder (ASD) is also sometimes called Autistic Spectrum Condition (ASC). It is a lifelong neurodevelopmental disorder that affect how a person communicates with and related to other people.
Individuals with ASD vary a great deal and it can affect both children and adults. It is described as a “persistent” or ongoing condition that affects how people communicate and interact with the world. Individuals with ASD can struggle to interpret verbal and non-verbal language and can find it hard to navigate the social world.
They often have repetitive and restrictive behaviour, highly focused interests, and sensory issues. The ICD 11 is commonly used to diagnose ASD in the UK and defines the impairments as follows:
- Persistent difficulties in the ability to initiate and sustain reciprocal social interaction.This makes it hard to understand and express emotion, language, and non-verbal cues.
- A range of restricted, repetitive, and inflexible patterns of behaviour and interests. The person may also develop an overwhelming interest in a topic, follow inflexible routines, make repetitive body movements, or have sensory sensitivity (i.e. be either under- or over- sensitive to sights, sounds and smells)
Current ASD Pathway:
If there are concerns about a child’s social communication skills, their school should complete a referral following the behaviour pathway.
All referrals for an autism assessment now require the following completed paperwork:
- Multiagency Consent and Referral Form (to be completed by school)
- Current Concerns form- (to be completed by school)
- ASD Pathway Information Agreement Consent Form (to be completed by parents)
- AQ-10 Screening questionnaire (to be completed by parents)
- Any relevant professional reports and information on the child’s cognitive ability and their progress within school (e.g. SEND Pupil Profile)
If a young person is home educated, the referral should be made by their GP and parents will then be contacted by the Autism Coordinator to gather additional information.
ASD Triage Process
Once a referral has been received it will be graded by one of our consultant community paediatricians and, if necessary, be brought for discussion at one of our Multiagency Autism triage meetings. This meeting will be attended by representatives from Community Paediatrics, CAMHS, and Speech and Language Therapy. Parents and referrers will receive a letter informing them if the referral has been accepted and, if so, what kind of appointment will be offered.
It is important to note that we are a diagnostic pathway, and we triage referrals with a view to being able to give an ASD diagnosis. Unfortunately our pathway does not currently offer direct intervention for families but we commission post diagnostic support through CHAPS and SPACE. We signpost our families to support available locally via our ASD Post Diagnosis Pack.
Joint ASD Assessment Process:
The Joint Assessment process tends to be the pathway for school age children. The pathway varies in preschool children and a ASD diagnosis can sometime be given in general clinics via a different process.
The Joint Assessment will be carried out by a community paediatrician/specialist nurse and either a specialist speech and language therapist or member of our psychology team. The session will include:
- ADOS / Play Based Assessment
An assessment of your child’s interaction, communication and play skills using a range of toys and activities. This will be completed by either a specialist speech and language therapist or member of our psychology team.
A history will be completed by the community paediatrician /specialist nurse at the same time, asking you questions about your concerns, your child’s development and his/her social communication skills and interests.
After the assessment, you will be asked to wait in the waiting area for 15 minutes to enable the team to discuss their findings.
- You will then come back to the room to receive initial feedback and be given an opportunity to ask any questions you may have.
The Joint Assessment process usually takes 1.5-2 hours overall but there will be opportunities for the child to take breaks during the session.
Please note you may not receive a diagnostic decision on the day as the team may feel that additional information/ observation is needed before coming to a diagnostic conclusion. In this case the team may suggest one of several next steps including,
- A school observation by a member of the community paediatric team.
- A referral to Speech and Language either for a formal language assessment or a school observation to assess both language and social communication skills.
- A discussion of your child’s assessment at our monthly ASD Pathway Meeting. This is a multiagency discussion involving the sharing of information between agencies to help the clinicians come to a decision in trickier cases.
- An ADHD assessment if attention and hyperactivity has been observed during the ASD assessment.
- A referral to CAMHS for advice on anxiety management.
- A watch and wait approach to give us chance to monitor your child’s social communication skills and development over time.
The waiting list for our ASD assessment varies. Whilst awaiting ASD assessment, you are entitled to access support from Cheshire Autism Practical Support (ChAPS) on 0344 850 8607, who offer a wide range of services to parent carers and children and young people locally. Helpful information and resources are also available from the National Autistic Society (NAS) website www.autism.org.uk For further information about ASD. Any additional educational support should be needs based and this can be discussed with your child’s school without the need for a formal diagnosis as described in the Children s’ and Families Act 2014.
Additional advice on special educational support can be accessed via the Cheshire West and Chester Information and Advisory service (email@example.com). All services for children and young people with any special educational needs provided by the local authority, health or voluntary sector should also be found on the local offer website. ( Special Educational Needs and Disability (SEND) Local Offer | Live Well Cheshire West (cheshirewestandchester.gov.uk)