Milton Keynes Community Paediatric Service
Referral, Assessment and Diagnostic Pathway for Autism Spectrum Disorder (ASD) in School Aged Children
Introduction
The neurodevelopmental disorders are a group of conditions with onset in the developmental period. The disorders are characterised with deficits that produce impairments of personal, social, academic, or occupational functioning (DSM-5 2013). The disorders range from specific deficits in learning, poor control of executive functions to global impairments of social skills or intelligence. Autism Spectrum Disorder (ASD) is one of the neurodevelopmental disorders. The neurodevelopmental disorders frequently co-exist. ASD for example frequently coexists with other neurodevelopmental disorders such as intellectual disability, Attention deficit Hyperactivity Disorder (ADHD), specific learning difficulties or communication disorders such as language disorder, speech sound disorder, social communication disorder (DSM -5 2013).
Autism Spectrum Disorder (ASD) is a behaviourally defined group of disorders, which is heterogeneous in both cause and presentation. Compartir
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)provides the standardised diagnostic criteria for ASD.
Milton Keynes Community Paediatric Team
Milton Keynes Community Paediatric team consists of consultant community paediatricians and clinical psychologists with expertise in autism spectrum disorder assessment. All the members of the team have received additional training in the use of recognised diagnostic tools such as 3 DI and Autism Diagnostic observation tool (ADOS). Milton Keynes Community Paediatric team is contracted to offer a diagnostic assessment to children up to the age of 16years.
The team offers a multidisciplinary diagnostic assessment in compliance with the NICE Guidance 128, the National Autism Plan (2003) and the NICE Quality Standard 51 (2014).
Referral process and Diagnostic Pathway
We accept referrals only from NHS health professionals. NHS Health professionals are expected to have an understanding of autism spectrum disorder and ensure the ‘FACT Plus’ screening assessment has been done by the school and intervention already in place to support the child’s identified needs before referral for diagnosis with the community paediatric team.
Once the referral is accepted, questionnaires to gather information from parents and school are sent to the family. The medical and social communication questionnaire are designed to provide holistic information on the child’s developmental history, medical history including prenatal, neonatal and family history, and past and current health conditions. The following questionnaires sent to home and to school
An appointment is offered within the 18weeks of receiving the referral.
The FACT Plus was developed by a multiprofessional team from Milton Keynes Council and CNWL Milton Keynes NHS Trust. It is a profiling tool used to identify children with additional needs in speech and language, communication and social interaction. It is expected that school age children would have a ‘First Access Communication Tool (FACT) Plus’ profiling; with the child’s difficulties meeting the threshold of level 3 or above on all four areas on the FACT Plus descriptors for, ‘Social Communication’, ‘Social Interaction’, ‘Flexibility of Thought’ and ‘Sensory’ areas.
Assessment period
The multidisciplinary assessment is done sequentially first with the paediatrician and then either by the clinical psychologist or the speech and language therapist depending on the needs of the child.
From first appointment to feedback appointment our aspiration is that the whole process should be completed by 30weeks, consistent with NAP guideline. Advice on intervention and support is however included in the initial clinic report to avoid any delay in meeting the needs of the child.
COMMUNITY PAEDIATRICS - REFERRAL GUIDANCE
Community Paediatrics is a Secondary Specialist Service and mainly accepts referrals from NHS Health Professional (e.g. GP, Health Visitor, School Nurse, Speech and Language Therapist, Consultant, CAMHS ), by referral letter (and not by choose and book system), which should clearly state the reason for the referral and/or the problem to be addressed.
§ Children aged 0-16 years of age or up to 18 years, if the child is in a Special Needs Schools
§ Registered with Milton Keynes GP (special arrangements for Hanslope and Aspland’s patients if the child is attending Milton Keynes school or is a Milton Keynes resident)
ASD/SCD assessments - before making a referral
§ The referral should clearly indicate a description of the child’s difficulties in more than one setting in the following areas: social interaction / social communication / rigid, repetitive or obsessive patterns of behaviours / interests
§ It is expected that school age children would have had the involvement of the Specialist Teaching Team and a ‘First Access Communication Tool (FACT) Plus’ profiling; with the child’s difficulties meeting the threshold of level 3 or above on all four areas of ‘Social Communication’, ‘Social Interaction’, ‘Flexibility of Thought’ and ‘Sensory’
Referrals to the Community Paediatric Service should be sent to:
Community Paediatrics, Specialist Children’s Health Services, CNWL-MK, Hospital Campus, Eaglestone, Milton Keynes, MK6 5NG, Tel: 01908 724800 Email:
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