Autism is sometimes called ASD (Autism Spectrum Disorder). It may also be referred to as ASC (Autism Spectrum Condition).

Children with Autism have difficulties with their:

• Communication and their social interaction and may only have interest in a very few activities and toys, so it can be very difficult to get them to show interest in other things.
   
• Sensory difficulties such as reactions to sounds, lights, foods and textures are often also a problem for the child with Autism and they may display unusual movements with their hands or their whole bodies.
   
• Children with Autism may have obsessions with routines, activities or objects.

If you are worried that your child may have Autism you can speak to one of the professionals who is already involved. This could be a Health Visitor, Paediatrician, Speech and Language Therapist or setting professional. You can also go to your GP. They may support you to get a referral to the Special Needs Early Years’ Service and to a Consultant Paediatrician.

Your child may already have been referred to Special Needs Early Years and may already have seen a Paediatrician. If this is the case, they will talk to you about your concerns.

In this case it is important that everyone involved with your child meets with you to discuss your child’s needs and to decide on the best ways to support them.

A number of professionals can make a referral to The Under Five Autism Panel. These are:

• Paediatricians
• Educational Psychologists
• Clinical Psychologists
• Special Needs Early Years Specialist Teachers and Specialist High Level Teaching Assistants
• Speech and Language Therapists

The panel does not accept direct referrals from parents/carers or school settings, but referrers always work very closely with you and only make referrals with your full consent.

When a referral is made it MUST include information about your child’s needs from at least 2 supporting teams. This makes sure that a lot of information about your child’s needs is already gathered. You will also be asked for your thoughts and feelings as well as to give written consent. Without this the referral for assessment for Autism will not take place.

It is important to know that Parents/Carers can also withdraw this consent at any time to stop the Autism assessment.

Referral checklist:

• Your child has been seen by at least 2 professionals who have written reports which indicate possible Autism
• Your child has been assessed and is supported by the Special Needs Early Years Service
• A referral form has been completed and signed by you the Parent/Carer

When your child is going through an assessment it can be a very worrying time. The priority is to provide support not only for your child but also for you as parents and carers.

You and your child will be supported through regular Team Around the Child meetings. These will help to prioritise plans and strategies to support your child at whatever stage in the assessment process they are at.

• The referral form is completed and signed by parents/carers and sent to the Autism Panel, along with two reports from professionals which describe your child’s difficulties
   
• First Panel date:
  • When the referral is accepted, a Keyworker is assigned. It will be the job of this person to keep you informed of every stage in the process and to answer any worries or concerns you may have
     
  • Any further assessments required are identified and decisions are made about when and by whom these will be done
     
  • This initial panel is the date the process will start and a date is set for a decision to be made. This will generally be within 4 months, although occasionally a little less or a little more
     
  • A letter is sent to Parents and Carers explaining everything that has happened, clearly explaining what assessments will take place and the date on which a decision will be made
     
  • Your Keyworker will contact you and make arrangements to meet with you in person
     
• Professionals will see your child and you. This is to gain as much information as possible so that the Panel can make a decision
   
• Panel Decision Meeting. All evidence is presented to the panel by representatives of the multi-Agency Teams so that a decision can be made  
   
• Decision is shared. Your Keyworker will come and visit you in person at a time convenient to you, but wherever possible on the same day as the Panel happens, to tell you what the decision is
   
• Written Confirmation of Outcome. Parents/Carers will have a written copy of the decision sent to their home address.

Will my child be upset or distressed by the assessment?

All information gathered will be done so in a very child friendly way and any appointments will be made to suit you. At no point will your child be expected to undergo anything that they find uncomfortable or upsetting.

This varies from child to child. The panel will have decided how much information has already been gathered and what else is needed. Your Keyworker will be able to inform you fully about this, but please be assured that all assessments for Autism are based on observations, discussions with Parents/Carers and professionals as well as through play based direct work with children.

All children will be seen by the Special Needs Early Years Service for an additional assessment called the CARS (Childhood Autism Rating Scale).

Some children may be invited to attend for an ADOS (Autism Diagnostic Observation Schedule).

CARS – Childhood Autism Rating Scale

This is a tool that provides more information about your child’s strengths and needs and gives an indication as to whether your child should receive a diagnosis.

It is an assessment that practitioners from the Special Needs Early Years Service use and it has two versions:

• Parents and Carers version. This records all parents/carers thoughts and observations
   
• Professional Version. This is completed by a member of the Special Needs Early Years Service Team through observations which take place in a range of environments. Each area of difficulty is given a score of between 1 and 4. The total score gives a further indication of whether a diagnosis is appropriate.

Outcomes are carefully monitored by a Special Needs Early Years Service Specialist Teacher who is responsible for ensuring that the assessment is completed accurately.

ADOS – Autism Diagnostic Observation Schedule

This is a play-based assessment which is completed in a one to one situation with your child. Parents and carers stay with their child throughout this. During the play activities, observations take place and are recorded. These are arranged to give a final score, and this gives extra information about whether a child has Autism or not.  

The ADOS is a specialised assessment tool and is only carried out by a small team of fully trained and experienced professionals.

How is the decision made?

• At least one week before the Panel, all information is gathered and arranged into a pack. This is shared securely and electronically with panel members so that they can review all information fully prior to the panel day.
• On the day itself individual children are discussed one at a time and specialists who make up the Panel outline children’s needs related to the criteria for Autism, based on assessments from their own teams.
• Difficulties are checked along the criteria and the panel members each then express their decision. A clear majority is needed to either give or reject a diagnosis.
• Occasionally there will be a situation where there needs to be some further information obtained. This may be because it is a borderline decision or very occasionally some evidence has been delayed. In either case a decision will be deferred, and another date arranged straight away.
• If the decision is “Not Autism”, then the Panel will look at the possibilities of any other explanations for your child’s difficulties and may suggest further assessments.

Support for you and your child

• The focus is very much on your child and their needs, but it is also on how to support you as parents, carers and families in understanding your child’s needs and developing strategies to help them.
   
• All parents/carers of children who have had a diagnosis of Autism made by the Under Five Panel are invited to attend Parents’/Carers’ Autism Awareness Training. These consist of 3 morning sessions and take place at least once per term.
   
• There is also a Support Group for Parents of Children with ASD coffee morning, inspired, set up and run by parents and carers of children who have been diagnosed with Autism which takes place every other month. At each session there is a visiting professional speaker invited to share information and knowledge.

Support for settings and schools

When a child is attending a nursery or school, the Special Needs Early Years Service offer training on Autism Awareness and specialist strategies to these individual settings to be delivered as soon as possible after the diagnosis has been made.

Support will continue for your child and further assessments may have been arranged by the Autism Panel. Your Keyworker will inform you of exactly what will happen next.

The Team around the Child approach is a model used for children with complex needs who require complex services. 

The joining up of services requires a change in systems and a move away from traditional medical and social models of care to family centred support.  This is based upon models of good practice in which the family’s needs, interests and motivations are placed at the centre. Aims are prioritised and co-ordinated to avoid overload and emotional and physical demands.

Each TAC will be individual to each child and family and the members of the team will vary in each instance.

Through selecting a keyworker families should expect co-ordinated support and appointments, joint planning and assessment and a single point of contact to support them through the system.

What happens

• Children will be identified through the multi-agency referral panel; at this point the child’s Consultant Paediatrician will be contacted for them to discuss with the family the TAC approach.
   
• If families, feel this approach is right for them they will be asked to give a first and second preference of a keyworker from those professionals who work with them on a regular basis.
   
• The Early Support administrator will then contact the named keyworker to establish if they themselves feel comfortable with being a keyworker.

The keyworker who is already known to the family will then make contact to discuss:

• Who should be members of the team including extended family members
   
• Record other professionals who do not see the family so frequently but provide vital support  
   
• Who information can be shared with
   
• Looking at unmet needs
   
• The venue for TAC meetings
   
• Frequency and length of meetings
   
• Needs of child and siblings during TAC meetings
   
• The keyworker will arrange a TAC meeting at the venue agreed with the family. If meetings are to be held at the Child Development Clinics, keyworkers must ask the administrator to book a room and check availability. Keyworkers will need to arrange their own administration.
   
• The make–up of the TAC team will alter as different professionals’ involvement changes and the needs of the individual child. These changes should be discussed at TAC meetings so that a smooth transition takes place and families have prior knowledge of the change.
   
• When a situation occurs for the keyworker to change this should be negotiated by the keyworker with the family. The family will once again be asked for their preference of keyworker; this should be discussed with the Early Support Co-ordinator. The transition period may take several months, and key workers are asked to be flexible at this point.
   
• When the number of people involved with the child starts to reduce and if for several reviews there is less than three professionals involved on a regular basis, it will be appropriate to discontinue TAC meetings. At this stage this would be a positive step forward, however the keyworker should remain in that role to co-ordinate support for the family until a time were the family no longer require support. At this point a lead professional may be identified.

The training programme is for parents of children newly diagnosed with autism.

Over 3 sessions Special Needs Early Years Service and Broadmeadow Special School will talk about why your child may do certain things and how they perceive the world. They will also discuss some useful strategies to help you to support your child.

To join and find out about upcoming dates and venue for the programme please visit Special Needs Early Year service. 

There are parent/carer support groups that offer Coffee mornings, to find out more visit SEND Early Identification Support Services.

• Debra.Baker@wolverhampton.gov.uk 
• Amelia.Jackson@wolverhampton.gov.uk     
• 01902 558406
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