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Integrated Neurodevelopmental Team (INDT) – ASD Service

The Integrated Neurodevelopmental Team (IND) provides a specialist assessment service for children and young people in Greenwich with difficulties around social skills.

Contents

  1. How to get an assessment
  2. Pre-assessment – What is ASD and what Communication you should expect
  3. What to Expect During the Assessment and How to Prepare for it
  4. Post-Assessment – what communication to expect and next steps
  5. Support Services for children and parents
  6. How to explain ASD to my child 

How to get an assessment:

Referrals to the Integrated Neurodevelopmental Team are currently accepted from Paediatricians, CAMHS and Speech and Language Therapists where sufficient concern to proceed for assessment has been identified. This is provided the child has a Greenwich GP and 17 years or under with parental consent. Children aged over 16 years will need to consent to the referral.

Pre-Assessment

Information on ASD for Parents and Children

a. What is autism?

Autism Spectrum Disorder (ASD) impacts on how an individual interacts with the world around them. Children with autism spectrum disorder usually experience differences in three main areas: social interaction, social communication and imagination and cognitive flexibility. Each of these diagnostic features can be present in different forms and varying degrees.

The reason that this is called a spectrum disorder is that there is a wide variability in how individuals present.

What communication you should expect from the service pre-assessment?

  • A notification that the referral has been accepted onto the Integrated Neurodevelopmental (IND) Team and your child has been placed on the waitlist for an appointment. Please note that until you receive this letter, your child is not yet on the waitlist for an ASD Assessment.
  • Your child will then be sent an appointment letter and email which will have the details for your upcoming appointments. The emails you receive for these appointments will have a Microsoft Teams link that will be sued to access the appointment on the day of the assessments.
  • In preparation for your assessment – if possible, use a larger tablet or Laptop for the play-based/ observational interview-based assessment

What to Expect During the Assessment and How to Prepare for it:

How is Autism Spectrum Disorder (ASD) diagnosed?

There is no biological marker for Autism and therefore it cannot be diagnosed by a medical test, such as a brain scan or blood test.

The diagnosis of ASD is made by professionals who have expertise in the assessment and diagnosis of ASD. This is usually a Community Paediatrician, Speech and Language Therapist, Clinical Psychologist or Psychiatrist.

Assessments are multi-disciplinary in that more than one of these professionals would be involved in an ASD assessment. An ASD assessment has to follow the guidelines set out by NICE (National Institute for Clinical Excellence).

NICE Guidelines

A diagnostic assessment for children and young people includes the following elements:

  • A detailed interview with parents / carers that focuses on social communication, interaction, and rigid / repetitive / sensory behaviour.
  • Observations of the young person. This often, but not always, includes a standardised measure known as an Autism Diagnostic Observation Schedule (ADOS)
  • Information from school /nursery or College

All information that is gathered during an assessment is then reviewed alongside the diagnostic criteria outlined in DSM V or ICD 10 to see if your child meets the diagnostic threshold.

We offer appointments depending on your child’s needs and how much information has already been collected. If some of the above has already been completed when the referral was made, then your child may be offered only one appointment. Appointments range from 90 minutes to 120 minutes.

Developmental History

Your child does not need to be present for this but if they are 16 or over, they will need to give their consent for this to take place.

Observational Assessments:

Under 5’s

For children under 5 years of age or with limited expressive language, the assessment is play based.

The assessment will consist of 4 parts

  • Free Play: we want to see what our child does on there own and what toys they like to play with
  • Play with you: we want to see you and your child playing together
  • Blowing bubbles; we want to see your child in play with a highly motivating toy and how they let you know they want the activity to continue
  • People games (e.g., singing songs); we want to see your child in play with no toys

Over 5’s

For children over 5 years of age the assessment is conversation based. We will ask your child about their interests, friendships, and feelings. We will ask them to complete some activities such as looking at a book, picture, and/or cartoons.

For young people over 16 years, we will ask about plans for the future.

What to Expect Post-Assessment:

What communication to expect post-assessment

  • After we conclude our assessment, we will endeavour to give you feedback on the same day. This is possible in most case this is possible however in a minority of the cases we might to gather additional information.
  • Feedback for the assessment will include a decision about your child receiving an ASD diagnosis.
  • We will also give information about the next step. This involves sending a letter that confirms/does not the diagnosis (immediately) and a report (within six weeks after the final part of the assessment) about the diagnosis.
  • For children who do receive a diagnosis we will also send an information pack which contains basic information about ASD alongside some useful links related to ASD services. We will also make a referral to an outreach service which helps children and parents better understand their child’s difficulties related to the diagnosis (psychoeducation).
  • For older adolescents (e.g., 16 over) it is important that they have consented to the assessment and that they receive some direct feedback from the examiner.
  • For children and families who receive a diagnosis It is not uncommon to have only few questions at this stage although later they might have many more. It is often the case that parents and young people require time to understand and come to terms with a diagnosis.
  • After the feedback appointment we will discharge the child from the service unless there are other concerns for which there is an assessment underway e.g., ADHD.

Support Services for children and parents

School age children:

  • SENCO: every school has a Special Educational Needs Coordinator to manage support of students with additional needs.
  • ASD outreach is a local authority team in Greenwich. After a diagnosis they’ll contact you and a specialist teacher or SLT with visit the child in school to see how they are getting on. They’ll recommend strategies to manage some of the ASD related needs.
  • Occupational Therapy can help children manage their sensory needs.
  • Speech and Language Therapy can help children develop their social communication and language.
  • SENDIAS offers support to families to enable them to make informed decisions about children’s educational needs.

Outside school:

  • National Autistic Society (NAS) has a Greenwich branch. They run activities for families and children and young people.
  • Youth Action Diversity Trust runs Autism social clubs in Bexley.
  • Greenwich Toy and Leisure Library Association runs stay and play sessions for children up to 5yrs.
  • The local offer lists the services for residents of Greenwich with additional needs.
  • Community Paediatrics can provide advise and support about medical issues such as sleep or co-occurring neuordevel9pmetranl conditions.
  • NEMFLA is a project with provides free advice and support to Black and Ethnic Minority families living with ASD.

How to explain ASD to my child

Understanding ASD can be complex. You might find the following websites helpful for explaining autism to your child and to other family members.

  • Helping my child to understand ASD

Making sense of your autism diagnosis | Ambitious about Autism – Young People on the Spectrum explaining their experiences of ASD.

Parents and carers (autism.org.uk)

Talking to your child about autism – CBeebies – BBC

  • How to understand my ASD (for older children/adolescents)

Making sense of your autism diagnosis | Ambitious about Autism (videos from teenagers talking about their diagnosis)

Community (autism.org.uk)

Family relationships – a guide for siblings of autistic people (autism.org.uk)

Please note: Oxleas NHS Foundation Trust is not responsible for the content of external websites. The above links should not be understood to be an endorsement for those websites, the site owners, or their products/services.