Joint care pathways for Autism Spectrum Disorder Carolyn Brown, Area Depute Principal Psychologist, Fife Council Psychological Service Wendy Simpson, Public Health Scientist, NHS Fife

What key purposes should care pathways serve? To deliver an efficient, multi-professional, multi-agency service that is truly integrated and collaborative To establish a clear, consistent and transparent referral route to multi-agency assessment, diagnosis and intervention To be accessible, predictable and understandable to parents

What outcomes should they achieve? Reduced waiting and referral times for diagnosis Optimal use of current resources Parental experience of a streamlined, transparent system of diagnosis linked to appropriate intervention, planning and implementation Reduction in duplication of assessment/diagnosis tasks carried out by the professionals involved with the individual Assessment and diagnosis carried out in the child’s learning contexts and contexts which are familiar to the child Jointly planned and agreed interventions

What might a care pathway look like? Stage 1: Recognition of difficulties Stage 2: General assessments Stage 3: ASD Specific Assessments Stage 4: Tertiary services Diagnosis uncertain Second opinion Complex cases

Reported benefits of model (Staff and parents) Shorter waiting times and opportunity for earlier diagnosis Natural environment for most of the assessment process Lack of disruption to the child Large range and richness of assessments provided Multi-agency group decision process Increased knowledge about ASD amongst frontline staff Useful information for referral to FAST (Fife Autism Spectrum Team) Better links to support and intervention for the child and family

Pitfalls/worth thinking about Setting up school meetings could be difficult Uncertainty about how to run meetings Some staff unclear about what we mean by assessment How should parents be informed of outcome of assessment?

Clashes of professional cultures/understanding respective professional roles Expectations of professionals Administration and coordination issues Communication within and between services Who owns the process?

What do you need? Senior management support across services A strategic vision Administrative coordination Good communications Guidelines – how to do manual How meetings should operate, who’s responsible for what etc Protocols Commitment and ideas on the ground Compromise