Neuro Developmental conditions
Information for referrers for the diagnosis and assessment of Neuro developmental conditions such as Autism and ADHD
Diagnosis of Autism and ADHD
Community Paediatrics is the local specialist service for the assessment and diagnosis of primary school age children with Neuro developmental and the medical assessment of those with significant learning difficulties.
Referral is made through a detailed school assessment requested by the early help hub and not through General practice
CAMHS is the specialist service for intervention and management of clinically confirmed ADHD and autism and will accept referrals from Community paediatrics or those with diagnoses made elsewhere.
Children 0-5 years- Referral is through the EARLY HELP HUB to Community Paediatrics
Referral process for primary school age children-
- Referral in Cambridgeshire requires detailed information across school and social functioning.
- School completes the following assessments and will submit them directly
- GP referrals can only be accepted via the school SENCO.
- Involvement from the school SENCO
- A completed referral form.A completed Early Help hub assessment
- Evidence of the school using a graduated response, and following a clear cycle of
“Assess, Plan, Do, Review” with outcome measures of appropriate strategies and interventions used.
- Detailed and relevant records of the impact of response to training.
- Parental consent to share the information
- Additional information may be requested
Community paediatricians do not offer cognitive assessments on school age children. The nature and extent of a child’s learning needs and appropriate investigation of any specific learning difficulties would already have been undertaken by the school. If the school needs advice on this, they should contact the Specialist Teaching Team.
Community paediatrics will provide a medical assessment for children identified in school age as having a significant learning difficulty which necessitates an EHCP to exclude a medical or genetic diagnosis.
Childhood sensory issues: a referral to occupational therapy may be indicated if there are significant sensory issues.
Behavioural issues occurring at home only:
Parents should be directed to behavioural support either within the school based services or via locality teams – this will require a Early help hub referral.
Behavioural concerns only in the school setting:
This is managed in school following a clear cycle of “Assess, Plan, Do, Review”.
If concerns persist, then the school should discuss with a member of the SEND Specialist Service (e.g. Specialist Teacher or Educational Psychologist).
The presenting behaviour should be considered in terms of that child’s developmental level.
Speech and language difficulties
Children under the age of 5 years
- Children presenting with significant delays or difficulties with speech and language may be seen in a speech and language therapy drop-in session and do not require a formal referral: details can be found on the speech and language therapy website: www.slc.cambridgeshire.nhs.uk/
Children aged 5 and over
- Where concerns are primarily about speech and language development, the SENCO should discuss the referral with the local speech and language therapist who covers that school or call 01223 884494 for further information. All referrals must be discussed with parents and accompanied by the speech and language descriptors.
Social Communication difficulties
Children aged 5 and over –
- Where concerns are about social communication, follow the advice given above and refer to Community Paediatrics if appropriate. If a speech and language assessment might be helpful, say this on the Early Help hub referral and this will be discussed at the joint referral meeting.
Re-referrals for speech and language therapy: please discuss with the local speech and language therapist who covers the school.
Motor planning difficulties
- A number of children will be identified as having fine motor skills and motor planning issues out of keeping with their developmental level.
- These children can be referred to occupational therapy for assessment and management.
- Prior to referral it is expected that schools enrol children in any motor groups within school before referral.
- The exceptions to this would be progressive or asymmetric difficulties which would be seen separately.
- A referral would require a Motor ABC before an appointment would be considered. Children identified with motor planning difficulties are offered advice and strategies for the difficulties that they experience. We would consider them to have a Developmental Coordination Disorder of which Dyspraxia (motor planning and coordination difficulties) is part of.
Ongoing urinary incontinence/ toileting issues should be referred initially to the 0-19 Nursing service through the single point of access.
For all Health Visiting and School Nurse enquiries, please call the 0-19 duty desk number which is 0300 029 5050.
Cognitive assessments and Dyslexia
Educational Psychologist/Specialist Teachers may undertake some form of cognitive assessment in conjunction with the school if this is considered appropriate;
Please see Cambridgeshire’s Dyslexia Guidance (2012) and other information on Dyslexia on the Local Offer website below.
It is not the role of the community paediatrics or CAMHS.
www.cambridgeshire.gov.uk/SEND (this is the Local Offer website address)
Referrals with supporting information should be sent to:-
Cambridge North, South, City and Ely, based at The Peacock Centre, Cambridge:
Tel: 01223 218072
Huntingdon and Fenland, based at the Oak Tree Centre, Huntingdon:
Tel: 01480 418600