Referral criteria to Community Paediatric Service for children and young people with developmental concerns including concerns about possible Autism Spectrum Disorder
There is no direct referral for Autism Spectrum Disorder (ASD) assessment in Tower Hamlets. All children and young people (CYP) with developmental concerns who have social and communication difficulties possibly indicative of ASD have to be initially referred to Speech and Language Therapy( SLT) and Community Paediatric Service (CPS) via the Single Point of Access (SPA) referral form.
You may find it helpful to add a text to AccurX signposting patients to Early Help Hub e.g.
Please contact the Early Help Hub for more information and support;
https://www.towerhamlets.gov.uk/lgnl/health__social_care/children_and_family_care/Early_Help/Early_Help_Hub.aspx
Or call them on 020 7364 5006
Who to refer
Referrals can be made by health and education professionals working in Tower Hamlets. For an appropriate assessment of CYP where primary concern is possible ASD, we need as much information as possible from the CYP’s previous contacts. This will allow us to understand if further assessment for ASD is indicated or not. For under 30 months old we need completed M-CHAT and nursery observations form and for older CYP SCQ and school/nursery observations. (forms attached). Observed change over time assist greatly in the diagnostic assessments, copies of 6 monthly reviews, response to intervention and IEP reviews should be included and may be requested.
Having been assessed by the CPS as likely to have diagnosis of ASD, the CYP will be placed on the waiting list for Autism Diagnostic assessment.
We would see CYP with developmental concerns from 0 to 19 years.
If insufficient evidence is submitted, or if the submitted evidence does not meet our referral criteria, the referral will be rejected. The referrer and the CYP’s parents will be informed if the referral has been rejected.
Referral for children in educational settings: to be accepted CYP are likely to have a high level of need, of at least at ‘SEN Support’ level, with an individual educational plan (IEP) in place. Submitted evidence will need to illustrate the nature and severity of difficulties, indicating a high level of support has been put in place, including clear features of ASD if this is a concern. The difficulties will need to be seen in more than one environment.
To summarise, in order to support the assessment, the referral will need to include:
A copy of the CYP’s IEP, indicating the nature and level of needs, and additional provision put in place
Completed school/nursery observation questionnaire
At least one additional assessment report from a professional independent of the CYP’s school or nursery, indicating likelihood of ASD e.g. Speech and Language Therapy, Occupational Therapy, Educational Psychology, Behavioural Support Team
Completed ASD Screening Questionnaire (M-CHAT or SCQ)
Referral from Primary Care or other professionals: If the above information is not available the GP/professional is advised to request that the CYP’s school or nursery consider whether the referral is required and coordinate the referral.
For the child to be considered for further ASD assessment internally there should be evidence of significant impact including:
Severe speech and language delay: no words by 30 months of age, no phrased speech by 36 months i.e. 2 word combinations
Severely impaired or disordered communication functioning e.g. echolalia, lack of reciprocal conversation skills, self-directed in choice of activities and not able to engage in nursery/school routines without frequent adult support
Severe peer relationship difficulties e.g. not interacting with other children, aggression towards other children, not forming friendships
Stereotyped / repetitive behaviour, leading to dysfunctional behaviour or severe anxiety
Such difficulties will need to be seen in more than one environment.
Community Paediatric Service can only accept referrals if the main concerns are learning or developmental problems. Referrals for CYP with predominantly emotional and behavioural concerns for whom referrer may be concerned about ASD should be made to the Child and Adolescent Mental Health Service (CAMHS) who will triage and assess appropriately.
Additional notes
Click on Attachment for full guidelines including Summary flow chart.
