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NICE guidelines: 3 months for assessment from referral

8 replies

purplemurple · 31/10/2011 09:37

Could someone please clarify this for me as I am confused or just thick :)

In the NICE guidelines it states that from the point of referral for suspected ASD the assessment should be done within 3 months.

DS was referred in May 2010 and has been assessed by Physio, OT, EP, SALT and has been seen by the paed three times. The school have completed the questionnaires supporting possible ASD. The paed has reported that a dx is likely and most probably be AS.

The ASD team have discussed him in their meetings but referral to CAMHS for ADOS was only made in July with a waiting list of approx 12 - 18 mths.

So my question is: as he has been assessed by the above already does this cover the 3 mth referral despite the fact that by the time he has ADOS it could be 33 mths since referral.

In other posts I see that it is the norm to be waiting years for assessment so I am a tad confused. Can I push for out of area assesment on the NHS?, was hoping to go private but money is so tight £600 would leave us really skint and I would rather spend that kind of money on 1-1 swimming lessons for ds etc.

I haven't put a claim in for DLA yet but I am contemplating it.

OP posts:
coff33pot · 31/10/2011 13:06

Funnily enough I have been reading through all the new nice guidelines. Mainly because I want a second opinion due to the fact there are no written reports for them to base their complex dx on and not AS/ASD

These are new and were only out in september I believe. Why not try phoning camhs and have it out with them quoting the new guideline? saying as you have said here he has all the other necessary reports done so can I now expect a date in the NEARER future for the ADOS?

chocjunkie · 31/10/2011 13:09

purpe, do you have a link?

ThePumpkinofDoomandTotalCha0s · 31/10/2011 13:49

suspect they will claim that the 3 months is until initial assessment, rather than the full multidisciplinary/ados procedure, but give it a go anyway. I would put in the claim for DLA asap anyway regardless of where you are in the dx process, as it sounds like the relevant specialists are aware of him.

Triggles · 31/10/2011 17:02

My impression is that it's 3 months for them to be seen for initial assessment to get the ball rolling. You don't need a dx for DLA, only care needs.

AgnesDiPesto · 31/10/2011 19:06

I think most Trusts are nowhere near being able to meet NICE guidelines yet, however 33 months is excessive - you could go back to your GP and ask for an out of area referral somewhere with a shorter waiting list. Also hassle your MP. here Trusts are refusing to fund out of area but local campaign groups are putting pressure on. Joining together with others in same boat and trying to get publicity can help

Triggles · 31/10/2011 21:44

purple - in all honesty, I'm puzzled. You've had the initial assessment (as in meeting with paed and going over history and getting feedback), right? They've said it most likely IS ASD. Yes you will be waiting for awhile for the CAMHS referral, but in the meantime, you should still be able to access support based on what feedback you've gotten so far. Are you looking for an absolute diagnosis or simply speeding up of the assessment process? I'm not trying to be snarky or anything, simply asking.

purplemurple · 01/11/2011 11:01

Thanks for your question Triggles, it actually gave me a lot to think about. The honest answer is, I am not sure why a dx is so important to me although I feel like we are in limbo.

Although the last report from the paed indicates that an AS dx is likely, they were the third paed that we have seen as all the paeds for the area have left, I think he was a locum??. The second paed stated "A child like M may not get a dx" I am not very confident when dealing with proffs so stupidly didn't ask for clarification. He is very passive in school and causing no problems, he does have meltdowns but they are aimed at himself (very self critical) so I presumed that was what she meant. He does fit the triad of impairment and is the typical "litlle proffesor". All the reports point to ASD but the EP for example spoke about not labelling children, Until we get the dx I am not counting my chickens.

School are supportive to the point of agreeing that something is wrong but other than an IEP and weekly social skills he isn't given any support. He is very anxious about school (and most other things).Until Y1 I was carrying him in kicking and screaming. He lives in fear of doing something wrong in school or doing his work wrong and is constantly scared. I worry that if he continues to be so scared he will become a school refuser.

He doesn't have a single friend, wonders around on his own, doesn't speak at all unless asked a direct question. He has been bullied on a number of occasions by older children. Recommendations made by the EP such as a sensory break haven't been implemented. He can cope most of the time but when it is wet play for example he cannot cope with the noise levels. I am going to mention this at parents evening. He struggles to eat his lunch because of the smells and sights of the dc eating and went through a spell of vomiting at lunch. This seems to have eased but he hardly eats anything "as he loses his appetite"

Physio won't dx dyspraxia until he has ADOS and have now discharged him as he could stand on one leg for 7 secs (wobbling) as opposed to 2 secs. OT only assessed sensory needs, he scored highly but again not a dx of SPD as they don't dx that?? Nobody has looked at his fine motor skills, he cannot fasten buttons, zips or indeed get dressed independently, wipe his bottom. His hand aches when he writes and now he has moved up to the juniors and the quantity of work has increased this is becoming a problem.

I just feel lost, it isn't a problem to manage his behaviour but that isn't helping him, it is like grounhog day. He says the same things day in day out. I am naughty, I am sorry, you hate me, I am stupid and cries. I can console him and calm him down but i can't get him to see that he isn't naughty and he hasn't done anything to say sorry about. It most probably sounds daft, but he can cry and say these things 50+ times a day and it can be quite wearing to be constantly reassuring and consoing him and is not doing anything for his self esteem.

I read on here about ABA and retained reflexes and i don't know if should I be doing these things with him. I know from reading other peoples experiences that a dx doesn't magically get help and support, so in short I don't know why I feel like a dx is so important.

Sorry for the looooooooonnnnnnnnnnnnnnnggggggggggg post :)

OP posts:
Triggles · 01/11/2011 12:38

purple - obviously we all are different, and have different concerns, but I would say that at this point the diagnosis is secondary and getting the school to recognise and support his needs is the much more urgent priority.

Who are you dealing with at the school? Is it the senco? Who is putting together the IEP, and are they having regular reviews? are you attending the review and putting in your comments? It sounds like the school is not implementing the things that are needed to support your child, which means you may have to force the issue by getting a statement. You can apply for this yourself, and many on the board have done just that.

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