The diagnostic pathways for children up to the age of 18
A guide for parent/carers in Bromley
This page was last updated 16.12.2020
If you feel that your child may be displaying social communication difficulties indicating that they may be on the Autistic Spectrum, an assessment can help to better understand their needs and may lead to a diagnosis.
We understand that the diagnostic assessment process can sometimes feel confusing – this guide has been developed to help you navigate the system and to explain the different ways in which children and young people can be referred for a diagnostic assessment in Bromley.
Early Years Referral Pathway
For early years, meetings between parents/carers and professionals will be held to discuss the child’s development. This will be an opportunity to talk about the child’s likes and dislikes, behaviour, communication skills and social skills. Parents can raise any concerns and discuss what the next steps could be. There are also a number of options across Education, Health, Social Care and Voluntary Services for seeking more support and views on how to proceed if you feel your child has Social Communication Difficulties.
If concerns continue, referrals can be made with parent’s consent, or by the parents themselves to relevant specialist education, health or voluntary sector. Referrals must include information from a preschool setting where appropriate. Parents can refer to services such as those on the list below:
- Bromley Early Years SEN Advisory Team
- Speech and Language Therapy (SLT)
- Bromley Children's Project (BCP)
- Community Paediatrician (referrals via Health Visitor, GP or Speech and Language Therapist)
- Bromley MENCAP, supporting families
- CASPA - activities and support for children and families
- IASS - Information Advice and Support Service
If the difficulties are persisting, professionals can refer the child to Community Paediatricians who will meet with the child and their parents to determine if they should be put forward for a multi-disciplinary meeting (Complex Communication Diagnostic Service, CCDS) to discuss whether they should be assessed for Autistic Spectrum Disorder(ASD).
School Age Referral Pathway
For school age children who may have social communication needs/difficulties, the Inclusion Lead or SENCO at the education setting will be advised to use the toolkit available on Bromley Education Matters (bottom of the page):
It is suggested schools complete the Social Communication Toolkit in the first instance to help them identify the difficulties the child is showing and what support the child needs.The toolkit’s documents are designed to be used flexibly. If there are social communication concerns in school, the school may want to seek the advice of the Education Psychologist, Inclusion Support Advisory Team (ISAT) or a Behaviour Support Service.
Parents have to give their consent before the SENCO/Inclusion Lead can refer the child on to services. The SENCO or Inclusion Lead will ensure that sufficient evidence is gathered to consider other possible barriers to learning and special educational needs, before it can be progressed to the Community Paediatrician.
If the difficulties are persisting, the SENCO/Inclusion Lead can refer the child to Community Paediatricians who will meet with the child and parents to determine if they should be put forward for a multi-disciplinary meeting, CCDS (Complex Communication Diagnostic Service), to discuss whether they should be assessed for ASD.
Occasionally, children who are already receiving support within specialist community Child & Adolescent Mental Health Services (CAMHS, Oxleas NHS Foundation Trust) may be referred for a diagnostic assessment within CAMHS itself. The CAMHS clinician involved in a child’s care will make a referral in these instances, in discussion with the child and family.
Clinicians from CAMHS may also be involved in the diagnostic assessment process for a child referred to the multi-disciplinary CCDS assessment pathway where this is clinically indicated.
If you have concerns regarding a child’s mental health or emotional wellbeing, then a referral should be made to the Single Point of Access, hosted by Bromley Y, for all referrals to mental health and emotional wellbeing services in Bromley. Referrals to Bromley Y may be received from any child, young person or family/carer (self-referral), or agency involved in working with children and young people, including primary care (GPs), social care, education, acute and community paediatricians and voluntary sector organisations.
If the child is known to CAMHS, the relevant professionals would complete the assessment and may also discuss with Community Paediatricians.
The multi-disciplinary meeting (CCDS)
After a Community Paediatrician has referred the child to the multi-disciplinary meeting, CCDS (Complex Communication Diagnostic Service), there are two possible outcomes:
- The referral does not have enough evidence included for the professionals to make an informed decision, or it is decided that the child would require further observation before they can be referred again.
OR
- The referral is agreed and the ASD assessment will be initiated.
My child has been referred to an assessment for ASD... what happens now?
The assessment may take place over more than one session and include at least one of the following:
- A diagnostic interview with the parent
- Observation of the child - this is often a direct assessment activity with the child/young person
Once the assessment has been completed...
Parent/carer/family/young person will be sent a letter to invite them to a face to face feedback meeting with the assessment team. The education setting can also be included at this meeting, subject to parental preference.
The purpose of this meeting is to explain the assessment findings and to discuss any ASD diagnosis with the parent/carer/family and child/young person. This meeting is a great opportunity for parent/carer/family/young person to comment on the findings and ask questions. Furthermore, support options and an action plan will be developed and provided to parents at this time.
The written CCDS report will be circulated by post to the parents and education setting up to 6 weeks after the feedback meeting.
What happens after the diagnosis and feedback meeting?
After a diagnosis has been made and a support plan agreed, the child will be discharged by Community Paediatrics and CCDS service and referred to additional support available where appropriate (please see Local Offer).
The Bromley Local Offer sets out information on local services and support available for families including children and young people aged 0-25 years with special educational needs and disabilities.