Multidisciplinary Assessments - can anyone talk me through this?

[bamboobuddha]

Just spotted thread in SEN topic re-directing traffic here, so re-posting in the hope of getting some replies .

Some background: DS is 3.7yo. We had concerns about delayed speech from the age of 2. This led to speech therapist assessment, then paediatrician assessment because of broader developmental concerns. Following multiple appointments, assessments and bouts of speech therapy, the paediatrician put DS on the "Social Communication Pathway" last summer as he turned 3. We were told this would culminate in a full assessment by a number of health professionals, and take on board input from his new pre-school teacher. This took place in January, but in the form of a panel assessment without us or DS being present - it was basically a review of all the previous reports on DS, plus a new report from his teacher.

They wrote to us shortly after to tell us that the diagnosis was still not clear.They said that normally they would offer DS an additional "multidisciplinary assessment", but as we were shortly moving overseas, they recommended we follow this up in our new setting. We've called repeatedly to ask for the paediatrician to call us back to give us more information on what was discussed, the sorts of diagnoses they were considering and what a multi-disciplinary assessment would involve, but have heard nothing so far. Very frustrating, and it feels that after a long process in the UK, we now have to start from scratch again overseas, without really knowing what we should be asking for.

Could anyone who has been through a "multi-disciplinary assessment" with a child of a similar age let me know what this might involve? Would it be a one-off appointment with a panel of health professionals (speech therapist / paediatrician / occupational health therapist?), or a series of separate appointments over a number of months, or just an appointment with a paediatrician?

The UK paediatrician at no time mentioned possible diagnoses, but reading between the lines I have assumed that we're looking at whether DS has ASD or sensory processing disorder (presumably at the mild end of the spectrum if they couldn't take a clear diagnosis).

Thanks for any help you can give - getting information out of the system has been a disheartening process .

[bamboobuddha]

Thanks yippee and BackforGood - that's really helpful. From the sound of it, we'v already been through one multi-disciplinary assessment over the course of the last year. So it sounds as though a further assessment would be more of the same - i.e. different appointments with a range of health professionals.

We're in a complicated situation, as our health insurer is trying to get us to travel back to the UK for "the assessment" (we're still covered for NHS treatment) rather than be assessed in our new home overseas. But I'm convinced they've misunderstood the nature of the assessment (i.e. that it's a series of appointments with a number of health professionals over a period of months) and have mistakingly assumed it's one-off appointment. We're on the over side of the world now, so would much rather try to manage this in our new home than flog backwards and forwards to the UK on lengthy flights with a turbulent 3 year old!

I will keep trying to contact our original paediatrician to see if I can get the bottom line from her. But it's really helpful to have a sense of what we could normally expect.

[BackforGood]

OK. For pre-schoolers here, they are referred to the CDC and (if they make it past the first triage by Paediatricians on a rota), the child and parents have an initial appt. during which the Paed can look at information from the referrer, meet the child, take birth history / milestones history / and all information from the parents, then they decide (if trying to decide if a child has autism or not - obvs different pathway if those needs are different) to refer to the Social, Communication and Interaction multi-disciplinary assessment team.

If they don't think that's where they need to go, they also have the option of seeing them again in 3 or 6 months and taking more report, and then taking another look. Or could refer to SaLT, or could discharge, I suppose.

1 or 2 of the team (Might be a specialist Nursery nurse and a speech therapist, or might be a specialist teacher) then do a home visit, to see how the child is in an environment they are going to be a lot more comfortable in, than the original Dr's office. They used to also do a visit to Nursery but, more often than not, this is a phone call these days, possibly with the exception of if they are getting different messages from parents and nursery in which case they might come and observe them in both home and Nursery.

They then get invited to 3 sessions in a Nursery at the CDC, along with 3 or 4 other dc being assessed and the adults in the room all have their own specialisms - so, teacher, nursery nurse, OT, SaLT, for example, and they work with the child and talk with the parent / carer over those 3 sessions. Obviously they are doing assessments, and observations, but in an environment where the child thinks they are there to play.

They then meet back with the Paed to report back on each child going through the assessment, and the Paed follows their recommendations / findings, and then invites the parents back in for the diagnosis meeting.

[yippeekiyay2]

Hi in my area it is called the multi agency assessment team (MAAT) and for ASD assessment this consists of the paediatrician, speech and language therapist and ed psych. They all complete their individual assessments, which takes forever - we started the process with dd nearly a year ago and the end is still not in sight - then meet together to discuss dx. They also take on board info from education setting and any specialists involved. It's my understanding that for private dx and in some other areas less professionals would be involved tho. Hth X

[bamboobuddha]

Aah - I thought this might be the case. We've just moved overseas, and trying to get a sense of what would normally happen in the UK so we have a basic standard to compare to. So would still be very useful to hear how this works in your area.

[BackforGood]

I can tell you what happens in my local CDCs, but I'm aware this procedure is different in different areas of the country, so I don't know how much help it would be for you to know that in one area X happens, but in your area Y happens ?