Always take parents’ or carers’ concerns and, if appropriate, the child’s or young person’s concerns, about behaviour or development seriously, even if these are not shared by others. Yes When considering the possibility of autism and whether to refer a child or young person to the autism team, be critical about your professional competence and seek advice from a colleague if in doubt about the next step. Yes To help identify the signs and symptoms of possible autism, use tables 1–3 (see appendix C). Do not rule out autism if the exact features described in the tables are not evident; they should be used for guidance, but do not include all possible manifestations of autism. Yes When considering the possibility of autism, be aware that: • signs and symptoms should be seen in the context of the child’s or young person’s overall development • signs and symptoms will not always have been recognised by parents, carers, children or young people themselves or by other professionals • when older children or young people present for the first time with possible autism, signs or symptoms may have previously been masked by the child or young person’s coping mechanisms and/or a supportive environment • it is necessary to take account of cultural variation, but do not assume that language delay is accounted for because English is not the family’s first language or by early hearing difficulties • autism may be missed in children or young people with an intellectual disability • autism may be missed in children or young people who are verbally able • autism may be under-diagnosed in girls • important information about early development may not be readily available for some children and young people, for example looked-after children and those in the criminal justice system • signs and symptoms may not be accounted for by disruptive home experiences or parental or carer mental or physical illness. Yes DISCO training conducted. Greenvale – secondary severe school. When considering the possibility of autism, ask about the child or young person's use and understanding of their first language. Yes
Be that in some children and young people there may be uncertainty about the diagnosis of autism, particularly in: • children younger than 24 months • children or young people with a developmental age of less than 18 months • children or young people for whom there is a lack of available information about their early life (for example some looked-after or adopted children) • older teenagers • children or young people with a complex coexisting mental health disorder (for example ADHD, conduct disorder, a possible attachment disorder), sensory impairment (for example severe hearing or visual impairment), or a motor disorder such as cerebral palsy. Yes Be aware that some children and young people will have features of behaviour that are seen in the autism spectrum but do not reach the ICD-10 or DSM-IV diagnostic criteria for definitive diagnosis. Based on their profile, consider referring to appropriate services. Yes If the outcome of the autism diagnostic assessment clearly indicates that the child or young person does not have autism, consider referring them to appropriate services based on their profile. Yes
With parental or carer consent and, if appropriate, the consent of the child or young person, share information with key professionals involved in the child’s or young person’s care, including those in education and social care. Yes Parents/Carers have 2/52 to review/ check the report before sent out to other parties. With parental or carer consent and, if appropriate, the consent of the child or young person, make the profile available to professionals in education (for example, through a school visit by a member of the autism team) and, if appropriate, social care. This is so it can contribute to the child or young person's individual education plan and needs-based management plan. Yes Always to education, if appropriate to social care. For children and young people with a diagnosis of autism, offer a follow-up appointment with an appropriate member of the autism team within 6 weeks of the end of the autism assessment for further discussion (for example about the conclusions of the assessment and the implications for the child or young person). No Variable – but 6-8 weeks at earliest. Often later. For children and young people with a diagnosis of autism, discuss with parents or carers the risk of autism occurring in siblings and future children. Yes 1.9 Information and support for families and carers Provide individual information on support available locally for parents, carers, children and young people with autism, according to the family’s needs. This may include: • contact details for: - local and national support organisations (who may provide, for example, an opportunity to meet other families with experience of autism, or information about specific courses for parents and carers and/or young people) - organisations that can provide advice on welfare benefits - organisations that can provide information on educational support and social care • information to help prepare for the future, for example transition to adult services. Yes