The majority of this information applies to the Norfolk, UK pathway and assessment process for a more general overview you can visit the National Autistic Society
It is important to get advice on where to begin. Many people fall at very basic hurdles i.e. being told by their GP that the child is too young for a diagnosis. There are a few tips to ensure you get the best possible start along the pathway to a diagnosis.
1st Tip – Consult your child or young person’s educational placement i.e. Nursey, primary, infant, junior, middle, high school etc – the reason being is part of the diagnosis hinges on your child or young person presenting with similar traits in two or more differing environments.
It is important that you consult with the SENCO as it might be that although your child or young person isn’t having a meltdown every day, their might be smaller signs of processing delay or inattentiveness that are going un-noticed.
2nd tip – Contact your GP and explain your concerns - ask to be referred to community paediatricians (Upton road for Norwich or Newberry centre for Gt Yarmouth might be mentioned)
3rd Tip – Keep a diary; keep a record of behaviours, patterns, traits
ASD Helping Hands ethos is that we support prior to a formal diagnosis, the only time we have declined to help a family was when there were two highly trained professionals involved stating no diagnosis. We are here to help you navigate the ASD pathway and other you advice and guidance along the way.
Keep in mind our youth groups and family groups are open to anyone who is on the journey towards a formal diagnosis. We can also offer advice regarding challenging behaviours and offer strategies which aren’t necessarily linked to a diagnosis.
Autism is a spectrum condition, meaning that it affects everybody differently and some may experience more difficulties than another with Autism.
There are many things that may appear to present as Autism but these could be attributed to a wide range of conditions such as ADHD (Attention Deficit Hyperactive Disorder), personality conditions or GAD (General Anxiety Disorder) among many others.
Autism affects three main areas:
Social communication is the use of language in social contexts. It encompasses social interaction, social cognition, pragmatics, and language processing.
Social interactions (such as sharing interests with other people), the use of non-verbal communication (such as making eye contact), and the development and maintenance of relationships (such as making friends).
Social Imagination or Rigidity and inflexible thought patterns
Social imagination allows us to understand and predict other people's behaviour, make sense of abstract ideas, and to imagine situations outside our immediate daily routine or experience.
Difficulties around sensory issues are now taking a much more prominent approach in the diagnosis of Autism always these aren't always considered.
Is it Autism?
Getting a Diagnosis?
The first people to notice difficulties will typically be the family members, but Teachers, health workers or early years providers may raise concerns about a child's development.
It is important for that child to visit their GP as soon as you suspect they may have a developmental condition. You may wish to take along with you a diary of difficulties, any reports you have from professionals regarding the child's developmental delays or missed milestones.
The GP may refer you immediately to a Peadtiratic team for assessment if they are unsure they may postpone the referral and conduct what they title as 'watchful waiting'.
(Watchful waiting (also watch and wait or WAW) is an approach to a medical problem in which time is allowed to pass before medical intervention or therapy is used.)
If a referral is refused it is important to keep track and note any difficulties that you see wiht times and dates, it may be worth completing an ABC chart.
If your GP doesn't believe your child's difficulties are related to the Autism Spectrum, ask them what they think it could be and could they refer your child to a mental health service or therapy to help with their difficulties.
What to expect at the assessment
In Norfolk, we have several Pathways that are used for an Autism Diagnosis. For a fully detailed view of the pathway please click here
The following standards will apply to every Autism Diagnostic Assessment:
•The assessment will always involve more than one discipline from the core team
•Details of parent/carers concerns
•Child /young person’s concerns
•Details of home & social care
•Education report from school A developmental history.
•Observation of the child in 2 different environments i.e. clinic/home, clinic/school (the school observation may be completed by a member of staff from the school/early years setting, but will be interpreted by the ASD Panel)
•Access to child psychiatry if appropriate.
•ASD specific tool can be used. This will be at the discretion of the panel ASD diagnostic assessments will be completed and families informed of the outcome as swiftly as clinically possible but within a maximum time frame of 24 months from a specialist request being made.
Possible outcomes of the ASD Assessment can include:
A diagnosis of ASD
A diagnosis of an alternative condition with referral to appropriate services
Diagnosis of ASD and a co-existing condition.
Further specific specialist assessment needed.
Where there is uncertainty regarding a diagnosis consideration needs to be given to whether to have a period of watchful waiting and/ or planned review.
The ASD panel will offer a forum to clinicians where this will assist in the diagnostic process.
ASD is not indicated signposting to the Healthy Child Programme and Local Offer
A second opinion may be considered:
•Where there is disagreement within the ASD team or with parents and young person that cannot be resolved. •Where there is a lack of progress /response to the care plan and interventions put in place.
It is important to note that if a child is currently under Tier 3 Mental health Services and they have concerns around Autism they can arrange an assessment themselves and this will be communicated to the ASD Coordinator.