Umbrella Pathway. assessment and diagnosis for children and young people who may have signs consistent with the autism spectrum
About the service
The umbrella pathway is an assessment and diagnostic pathway which assesses children and young people for Autism Spectrum Disorder (ASD). Autism is the name for a range of conditions that affect a person’s social interaction, communication and imagination. Autism is a lifelong developmental disability that affects how people perceive the world and interact with others. Autistic people see, hear and feel the world differently to other people. All autistic people share certain difficulties but being autistic will affect them in different ways.
The Umbrella Pathway Team includes; Community Paediatricians, Speech and Language Therapists, Occupational Therapists, Specialist Autism/CCN Teachers and Clinical Psychologists.
The signs of autism vary from one person to another but may include any of the following:
• Difficulties with social communication
• Difficulties with social interaction
• Restrictive and repetitive behaviours
• Repetitive activities and interests since early childhood
• Disturbance of daily functions due to the above
• Other difficulties such as sensory processing and co-ordination difficulties
• Difficulties in learning, information processing and other behaviours may be apparent
How to refer
Service referral criteria are in place to ensure that this service works with the child/young people and their families who need and will benefit from further highly specialist assessment.
The service accepts referrals only for children/young people up to the age of 18 and who have a Worcestershire GP. Written consent from parents/carers (or young people aged 16 and over) must be obtained and provided with the referral documents.
For a referral to be considered evidence will be required of significant difficulties, impacting on the child/young person’s daily life, across the 4 areas of their development associated with ASD:
• Social emotional reciprocity
• Non-verbal communicative behaviours
• Developing and maintaining relationships
• Restricted patterns of behaviour
In addition to identifying these difficulties it is essential that there is evidence of what interventions have been tried in order to meet the child/ young person’s needs. This is known as the Graduated Response. More information about this can be found in the Worcestershire Local Offer and Graduated Response
Guidance notes on completing the referral form
The referral form requires very detailed information and is best given to parents to complete in partnership with the child/young person’s school/educational setting, or professionals working closely with the child over time on a regular basis.
It is not unusual for children to present differently at home and at school and it is important that we know about these differences. If a child is not experiencing as many difficulties in the setting/school as at home we would like school and parents to meet and monitor the difficulties over 2 terms so that the referral is supported with information that documents and helps us understand these differences.
The information sent to us will be considered by our multi disciplinary team usually on a weekly basis Further information or clarification may be requested at that stage. When the information has been considered we will inform parents, referrers and professionals involved of our recommendations.
A re-referral of children previously assessed by the Service cannot be accepted within an 18 month period and there will need to be evidence of significant changes in the child’s presentation since the previous assessment was carried out before a re-referral can be accepted.
We require a wide range of detailed information to decide if this is the most appropriate service for a child or young person. The information provided forms part of the child/young person’s assessment if they are accepted onto the pathway.
The Umbrella Referral consists of the following 4 parts and all of these need to be completed in full before the referral can be considered:
1. Umbrella Pathway referral form
2. Age appropriate consent form
3. Questionnaire completed by parent
4. Questionnaire completed by Educational setting (as long as the child/young person is attending one)
Guidance for referrers
The referral must include evidence that an Early Help or graduated approach response has been considered and implemented over time in relation to the presenting difficulties and the needs of the child, rather than an assumption that ASD is the cause.
- Referrals from School, school nurse, or GP should demonstrate:
- a graduated approach response from school with evidence of ‘Assess, Plan, Do, Review’ cycles. This must be in place and evidenced over a minimum of 6 months or 2 terms for all school aged children. Insert link for graduated response form.
- a supporting report from a professional such as the Complex Communication Needs (CCN) team, Educational Psychology (EP), Speech and Language Therapy (SALT), or Occupational Therapy Team (OT) that focuses on key areas as detailed above.
School referrals should be completed and signed by the school ASD Lead or SENCo. If parents feel that they need support to complete their forms we advise them to seek support from school. If no problems are being seen in school we will still require the school view.
- Referrals from Paediatricians and Child and Adolescent Mental Health Service (CAMHS) should be accompanied by a neurodevelopmental history that makes reference to the key areas above
- Referrals from Speech and Language Therapists and Occupational Therapists should be accompanied by a report and information relating to all of the key areas detailed above.
- Referrals from Family Support Workers should be accompanied by details of involvement and concerns that relate to the key areas detailed above.
Parents/carers and professionals need to work in partnership to complete the referral form so that we understand how the child/young person presents at home and at school.
The assessment process in total can take around 12 months to complete. If there is any delay in this we will do our best to keep families informed with reasons why.
- Once all the information has been collected from all of the assessments, the needs of each child/young person is discussed by the appropriate team of professionals. A decision is made whether individual children/young people meet criteria for a diagnosis on the autism spectrum.
- Parents are informed of the outcome as soon as possible after the decision.
- A written report is completed and shared with the parents/carers/ young person and also the referring professional. Recommendations will be offered for the child/young person and family following the conclusion of the assessment .
- For nursery and school-age children confirmation of the diagnosis will be provided for their educational setting with consent from parent.