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 offer 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 on every day functioning, socially, educationally, occupationally and often 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 • Does the child have difficulty communicating? Lack of 'reading' other people - engagement in conversation; or at recognising or understanding the other extreme, being highly others' feelings and intentions - verbal but ‘going on and on’ and and expressing their own not really making conversation a emotions? This can make it very two-way interaction - including hard for them to navigate the struggling to understand jokes and social world. They may: sarcasm, struggle with vagueness – appear to be insensitive or abstract concepts, taking – seek out time alone when expressions literal. overloaded by other people • Do they struggle to interpret or – not seek comfort from other show facial expressions (including people lack of eye contact). – appear to behave 'strangely' • Does the child have any friends? or in a way thought to be Autistic people may find it hard to socially inappropriate. form friendships.
What are we looking for in relation to Repetitive Behaviour and Routines? • Does a child struggle with change in • They may want to always travel the routines and transitions? same way to and from school or work, or eat exactly the same food • Do they only cope with changes etc for breakfast. when their parents prepare them and make lots of additional • The use of rules can also be adjustments to help? important. It may be difficult for an autistic person to take a different • Does the child show repetitive approach to something once they motor behaviours (flapping hands, have been taught the 'right' way to rocking or spinning in circles) or do it. make repetitive vocalisations? These are not always easy to see. • Autistic people may not be comfortable with the idea of • The world can seem a very change, but may be able to cope unpredictable and confusing place better if they can prepare for to autistic people, so they often changes in advance. prefer to have a daily routine so that they know what is going to happen every day.
What are we looking for in relation to Highly Focused Interests and Sensory Sensitivity? Sensory sensitivity Highly focused interests • Does the child have an unusual • Does a child become ‘obsessed’ response to sounds/lights/touch/ with specific items or topics? Will smells/taste? this become their all- encompassing interest? • Autistic people may also experience over- or under- • Many autistic people have sensitivity to sounds, touch, intense and highly-focused tastes, smells, light, colours, interests, often from a fairly temperatures or pain. young age. • For example, they may find • These can change over time or be certain background sounds, lifelong, and can be anything which other people ignore or from art or music, to trains or block out, unbearably loud or computers. distracting. This can cause anxiety • An interest may sometimes be or even physical pain. Or they unusual. may be fascinated by lights or spinning objects.
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
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