What you can expect
Helping you to understand Neurodevelopment and our referral pathway.
If you’re concerned about your child’s development, your child’s educational environment—be it nursery, school, or college—is the first place to seek advice and support. Talk to the Additional Learning Needs Co-ordinator (ALNCo) about your concerns. Educational settings have a responsibility to support all children, even if the differences aren’t immediately apparent.
Early support can make a significant difference, and your child’s school will be guided by the Additional Learning Needs and Educational Tribunal (Wales) Act 2018, which mandates that reasonable adjustments are made to provide the right support. Importantly, your child doesn’t need a formal diagnosis to receive specialized support at school. Sometimes, all it takes is understanding and a little extra help for a child to thrive in their learning journey without a formal diagnosis.
A diagnosis of ASD is recognised as a lifelong condition. This means that this is a condition which will continue into adulthood, however this does not always mean that a person will need the same level of support. Each child diagnosed with ASD will have their own unique strengths and challenges. This means the impact of the diagnosis is different for every family. Many children as they move into adulthood will develop ways to manage challenges and grow their strengths, this can be with ongoing care and support or in some cases with no support, depending on their individual needs. A person’s needs can change overtime with age, development, life experiences and circumstances, sometimes needs can increase during adolescence and/or in adulthood.
Through our service we will build a profile of your child or young person’s individual needs, looking at both their strengths and challenges. We will complete a report following a full assessment. The report will include any diagnosis or formulation of the presentation. This report will be fully explained to you during your post-assessment feedback appointment.
During this appointment we will explain:
- What autism is, and how it may affect the child or young person
- The contents of the profile
- Provide a written report of the assessment
- Provide information and access to support resources such as books, DVDs, useful websites and local services
- Take parental consent to share information with GP and other appropriate professionals (e.g. education, social care)
A child with ADHD will have differences in brain activity ADHD which can cause challenges in attention, self-control and the ability to sit still. ADHD is a condition where a child or young person has difficulty concentrating and focusing, hyperactivity and/or impulsivity that are high for their age, and impact on their day-to-day life. The child or young person may not have all three of these aspects of ADHD and how severe each aspect is will vary between individuals, not all children and young people with poor attention will have ADHD.
Attention deficit hyperactivity disorder (ADHD) can be a lifelong condition. Your child might start to experience symptoms in childhood and find that they continue into their teenage years and as an adult. Some children may not experience this continuation into adulthood. There is some evidence that suggests this could be due to brain development or the due to the child developing strategies and abilities to manage their condition.
The right diagnosis and support is essential for children and young people with ADHD, as it supports the child/young person and their family to understand their unique strengths and challenges and allows for the right support to be put in place.
Through our service you we will build a profile for the child or young person individual needs, looking at both their strengths and challenges and will complete a report following a full assessment, outlining any diagnosis. This report will be fully explained to you during your post-assessment feedback appointment. During this appointment we will explain:
- What ADHD is, and how it may affect the child or young person
- The contents of the profile
- Provide a written report of the assessment
- Provide information and access to support resources such as books, DVDs, useful websites and local services
- Consider medication options and whether these are right for your child. – Making an additional appointment where appropriate
- Take parental consent to share information with GP and other appropriate professionals (e.g. education, social care)
In the Cardiff and Vale Service we aim to meet the identified needs of children and young people, irrespective of diagnosis by using the profiling tool which is completed in collaboration with families and schools with support when needed from the neurodiversity 0-19 service.
There is no reason why a diagnosis should be ignored simply because it was obtained privately. However, private assessment processes and diagnoses should meet the same standards as those expected of the NHS.
If an assessment completed by a privately funded provider or practitioner complies with National Institute of Clinical Excellence (NICE) guidelines, then it should be considered equivalent to an NHS assessment and should be treated as such. NICE guidelines can be found here:
- Autism spectrum disorder in under 19s: recognition, referral and diagnosis
- Attention deficit hyperactivity disorder: diagnosis and management
It is important to note that not all assessments carried out privately meet the above criteria. Please check before proceeding with any private assessment that it will meet the necessary standards:
Autism assessments must be conducted by a multidisciplinary team of appropriately trained and qualified clinicians. In practice, this means that at least two clinicians from different professional backgrounds must be directly involved in the assessment. This may be a Practitioner Psychologist (Clinical or Educational), Paediatrician, Psychiatrist, Speech and Language Therapist, or Occupational Therapist, appropriately trained nurse.
Whilst it is often beneficial for ADHD assessments to be conducted by a multidisciplinary team, this is not essential as one appropriately trained and qualified clinician is considered sufficient for the diagnosis of ADHD.
The clinician(s) involved in an Autism or ADHD assessment must be registered with an appropriate professional body (e.g. Health and Care Professions Council (HCPC) or General Medical Council (GMC), Nursing and Midwifery Council (NMC)).
All Autism and ADHD assessments must gather a comprehensive history of general development. This must have included gathering information about biological, social, environmental and psychological factors that might have impacted the young person’s development.
All Autism and ADHD assessments must have gathered information from multiple sources about a young person’s possible areas of difference across their life span. This should involve in-depth discussions with the young person if they are able to engage in these conversations, in addition to their parent carer and others who know the young person well (e.g., teachers, practitioners from other settings, other key people in the young person’s life).
All Autism and ADHD assessments must have involved at least some interactional and/or observational assessment with the young person directly. Whilst this can in some circumstances be via online video assessment, information from other sources must be sufficient to compensate for this.
Any appropriate alternative or additional explanations for a young person’s experiences or areas of difference have been adequately considered and assessed. This might include considering whether a young person’s needs are better understood in terms of other diagnoses.
It might also include considering whether a young person’s experiences may be better understood as a response to difficult or traumatic life events, a mental health concern, relational or attachment-based concerns, or developmental trauma. It is important to remember that young people with needs relating to these areas can appear similar to those who are Autistic or have ADHD.
In recent years, the demand for assessments for children and young people who are suspected of having ADHD and/or Autism has dramatically increased across the Wales. Therefore, the number of requests the Cardiff and Vale Neurodevelopmental Service receives every day has significantly increased. We are working hard to increase capacity in our team to process these requests.
Children and young people do not require a diagnosis to receive support at school. If a child or young person has a need in school, they are entitled to receive support to meet that need.
Discharge – As a specialist assessment service, it is our usual practice following our assessment to discharge the child and family back to the referrer to manage the child’s care locally, providing them with support and advice.
Review – in some cases where diagnostic uncertainty remains a review at a later date may be offered to monitor progress as the child matures.
Cardiff and Vale University Health Board’s Keeping Me Well website has information about what Occupational Therapy for Children and Young People have to offer. Please visit ‘videos and resources‘ where there is a parent workshop to watch on understanding sensory processing. If you have utilised all resources online and still have occupational or sensory concerns you can request access to direct Occupational Therapy input using our ‘request for assistance page’