Autistic Spectrum Disorder

Children with ASD (or who require assessment) will likely present with significant and pervasive difficulties in social interaction and understanding, social communication, inflexibility of thinking and repetitive behaviours/interests.
These difficulties must be viewed within the context of a child’s circumstances.
Children and young people with ASD may present with increased worries and at times may show challenging behaviours throughout their development.
If a mental health disorder is not the cause, the child/YP is often best supported by those who know them best e.g. parents, family members and teaching staff. It is helpful to remind those involved, to review any ASD informed parenting, self-coping and teaching support strategies which were previously helpful, particularly at times of transition and change.
When the child/young person has an existing diagnosis of ASD you may wish to direct them to the resources below. Families can access the local groups/services via these national sites.

Who to Refer

Families with children who display difficulties in these categories should have already received significant advice and intervention from other professionals such as paediatricians, health visitors, social workers and educational support services before specialist referral is made.
Evidence of the following issues impacting significantly on everyday functioning would support a referral for an ASD assessment:
- Significant delay in acquiring appropriate communication and social skills
- Significant difficulties with the child’s peer relationships in normal settings
- Unusual or very fixed interests and bizarre or unusual behaviours impacting on function
- Marked preference for detailed routine and difficulties in adapting to everyday change
- Difficulties must be significantly impacting on functioning at home or school
We also see children and young people who have an existing diagnosis of ASD and require assessment or treatment for mental health disorders such as depression, anxiety, ADHD, OCD. (Please refer via CAMHS mental health pathway rather than neurodevelopmental).

In line with other Health Boards in Scotland, the majority of referrals should be made by the child/young person’s school. This is because education holds the detailed information we require to make a fully informed decision.
There are exceptions to this (when the child/young person is home schooled, when they have not attended school for a significant length of time, or they are known to community paediatrics and they wish to refer). Any such GP Referrals would be made via SCI Gateway/Paediatrics/Neurodevelopmental.
If parent/carer or young person asks the GP to refer them to CAMHS with concern around ADHD, ASD and/or cognitive function) please ask the parent/carer or young person to speak with school about making a referral. If the GP makes a referral for a child who attends an education provision it is likely that the referral will not be accepted with the suggestion the parent/carer speak with child/young person’s school about making a referral.
We do not require referral from both GP AND school but school only.
Pre-school children should be referred initially to Health Visitor/Community Paediatrics.
Following review of referrals to the neurodevelopmental pathway the neurodevelopmental referral management group will copy parent/carers into their response to referrer (when a referral is not accepted) or will send a standard acceptance letter, therefore directly informing parent/carer of their decision.