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Tier 4 Assessment

Tier 4 Assessment. Neurodevelopment Day 27 th March 2012. ASD Diagnosis. Changing thresholds Increasing demands on health services Specialist v Generalist. NICE guidelines. Intent = Needs of child & family driven As locally available as possible (with necessary expertise)

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Tier 4 Assessment

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  1. Tier 4 Assessment Neurodevelopment Day 27th March 2012

  2. ASD Diagnosis • Changing thresholds • Increasing demands on health services • Specialist v Generalist

  3. NICE guidelines • Intent = Needs of child & family driven • As locally available as possible (with necessary expertise) • Process = Multi agency, Needs driven, timely and proportionate • Agreed with family

  4. A Suggested Model

  5. Primary (Tier 1) Services role • For under 5s, all children will have had SOGS and referrals will be made to the CDT team. • For over 5s who are referred to CAMHS or Paediatricians, specialist Educational support information will be obtained before the child is discussed at CDT.

  6. Primary Services • For over 5s from problematic families/with a history of difficulties or behavioural problems, the referrer will be expected to have had behavioural intervention. • IEP cycles will be expected to have been completed with measurable targets agreed with parents. • A cognitive assessment from Education will also be required.

  7. Specialist Tier 2/3 Services • Same team of professionals for all ages Assessments required may include: • Paediatric assessment • Speech and Language Therapy assessment • Detailed developmental history • OT assessment • Educational Psychology assessment • CAMHS assessment

  8. Specialist Services • Tasks allocated through multi disciplinary meeting – e.g. the current CDT meeting with the added input from CAMHS. From this meeting an assessment plan agreed for each child with key professionals identified. • Timescales agreed. • Communication with the child’s family would be the responsibility of a lead professional identified at the initial CDT meeting. The family would be advised of the agreed assessment plan and time limits for their child’s case.

  9. Specialist Services • The lead professional meets with the family after the assessment and follow up CDT meeting to discuss diagnosis, needs assessment and other services recommended. • A follow up meeting with parents (and the relevant SENCO and/or School Health Nurse ?) one week after diagnostic feedback

  10. Tertiary (Tier 4) level • Diagnostic dilemmas with concerns about co-morbidities will lead to a referral to the tertiary clinic. • This tertiary clinic will only accept referrals from the CDT team. The use of the tertiary clinic as a second opinion is available in exceptional circumstances only

  11. Team • Paediatrician • Speech and Language Therapy • Psychologist • OT • Educational Psychologist • CAMHS • CALD

  12. Tertiary level • Feedback to the family will be maintained by the lead professional identified at the original CDT

  13. Considerations • Training needs (Levels 1-4?) • Tools used • Post diagnosis input • LA Children’s disability teams • Third Sector involvement

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