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What you can expect
Making a referral
If you have identified a child or young person you are supporting may be experiencing some challenges with their development you can make a referral to the Neurodevelopment Service Single Point of Access.
Referrals can be made to the neurodevelopmental single point of access, where we accept referrals from schools, nurseries, clinical professionals from the UHB and GPs. The parents of children and young people who are electively home educated are also able to make referrals to the service.
The service covers all areas of Cardiff and the Vale of Glamorgan and is based at the Children’s Centre, St David’s Hospital, and Llandough Children Centre, Llandough Hospital.
What is needed to make a referral?
Children and young people should have access to support prior to a referral being made. Support is important to ensure the child/young person’s individual needs are met. Providing support also offers evaluation of whether interventions have helped the child and determines what further support is needed.
The child/young person MUST present with both social communication and interaction difficulties AND restricted repetitive patterns of behaviour, interests or activities to enable a diagnosis. The young person is struggling with everyday functioning difficulties not better explained by learning difficulties or any significant trauma the child may have experienced. The complexity and persistence of any difficulties observed for over a period of six month or two school terms.
How the child/young person’s day to day functioning has been impacted on across all environments should be emphasized in the referral. Examples must be included of behaviours observed that cause concern.
Education, Social Services and Council Staff
forms to be completed by appropriate member of staff (ALNCo, class teacher, pastoral staff etc.):
- ND Service Referral Form
- SNAP Teacher Questionnaire
- School Report Form
- Checklist for Social Communication Difficulties
Parent/Carer Questionnaires to be completed by Parent/Carer:
- Developmental History Form
- SNAP Parent Questionnaire
- Parent Carer Questionnaire
- Checklist for Social Communication Difficulties
All the above forms must be completed and returned to Childrensspoa.Cav@wales.nhs.uk
Please return all the forms in a single email to avoid delay in triaging the referral.
General Practitioner
Referrals to the ND Service will be made through WAP/WCCG
Parent/Carer will be sent parent questionnaires and school questionnaires. Parents will be asked to liaise with school to complete the school questionnaires.
- Developmental History Form
- SNAP Parent Questionnaire
- Parent Carer Questionnaire
- Checklist for Social Communication Difficulties
- SNAP Teacher Questionnaire
- School Report Form
When all questionnaires are returned the referral will be triaged.
Health Visitors and other Health Board staff
Referrals to the ND Team should be made internally through PARIS.
Parents/Carers will receive parent and school questionnaires and must liaise with the school to complete them.
Home-Schooled Children/Young People
Forms to be completed by Parents/Carers:
- ND Service Referral Form
- Development History Form
- SNAP Parent Questionnaire
- Parent Carer Questionnaire
- Checklist for Social Communication Difficulties
Children and Young People Already on the ND Waiting List
Parents/carers will be contacted to complete the relevant questionnaires and liaise with schools to ensure the school questionnaires are completed.
Signs must be persistent across multiple settings
Impulsivity
- Challenges with taking turns and queuing
- Excitable and sudden actions such as darting into the road without thinking about safety
- Appear reckless to others
- Challenges in sitting still and fidgets when sitting
Impact on functioning
- Difficulty in keeping friends as gets annoyed easily
- Impacts on learning
- Often argues with adults which impacts on relationships
- Risk of injury
- Often angry
- At risk of antisocial behaviour
Hyperactivity
- Excessive talking
- Challenges remaining seated where it is expected such as mealtimes, classroom and carpet time
- Noisy with a loud tone of voice
- Needs excessive exercise
Inventiveness
- Challenges in paying attention and completing tasks
- Short attention span compared to others of the same developmental age
- Challenges in organisation and planning of tasks
- Forgetfulness
- Challenges in finishing tasks that need sustained attention
- Being easily distracted
Sensory seeking behaviour
- Sensory seeking behaviours such as sniffing or licking objects and dislike of certain noises and texture
- Parent may raise concerns regarding developmental delay
- Girls tend to mask, look more in depth in the function of their social relationships
Restrictive and repetitive behaviour
- Unusual interests and obsessions
- Rigidity and inflexible and prefer to follow set routines
- Unstructured situations may challenge
- Prefer the same activities
- Prefer similar foods each mealtime
Social communication
- Difficulty in communicating with others, limited conversation and answers
- Tone of speech appears flat or monotonous
- Perceived as blunt with inappropriate or insensitive communication
- Limited facial gestures, poor eye contact and reduced gestures such as pointing
- Literal understanding of jokes or sarcasm
- May prefer adult company
- Challenges in participating in group activities
- Struggle to make friends
- Talk in detail about they preferred interest
- Struggle with the concept of a two-way conversation
Special schools will be able to complete a ND focused form for those children and young people who present with Neurodevelopmental traits. This will:
- facilitate the completion of a multidisciplinary ND assessment avoiding delays and repeated unnecessary involvement of specific professional expertise
- provide a thorough understanding of the individual child’s needs and differences in complexities or differential diagnosis.
- be time effective at all the steps in the child’s care
Professionals will be able to book a slot in one of the Consolidation and Interpretation of Findings (CIF) meetings if they need an MDT case discussion.
What happens once a referral is made?
The online referral form is completed by a professional and it includes a range of mandatory fields that focus on the strengths and needs of the child/young person. Referrals cannot be submitted without the mandatory fields being completed.
On receipt of the fully completed referral form, you will receive a receive acknowledgement via email. The neurodevelopmental single point of access will screen these to determine whether a neurodevelopmental assessment is appropriate.
When a referral is made, this does not mean it has been accepted. The neurodevelopmental team will triage the referrers information to consider if the assessment pathway should be followed. All requests are considered on an individual basis alongside the inclusion criteria.
What decisions are possible at triage
The request is accepted to the neurodevelopmental pathway, the child/young person will then be placed on the waiting list for an appointment.
The request is accepted although further information may be needed for further observations or information gathering to understand the difficulties. A decision will then be made to determine whether an assessment is needed.
It may be that an assessment is not needed at this time, and we will offer advice on what recommendations we feel are suitable in this instance.
There is insufficient information, the referrer will be contacted, and advice given on what information is needed.