tay.generalcomments@nhs.scot

Intellectual Disability

  • A learning disability and an intellectual disability (ID) are the same thing.
  • This is a lifelong condition that means a young person has significantly reduced ability to understand new or complex information or to learn new skills; reduced ability to cope independently; which starts in childhood with a lasting effect on development.
  • Global Developmental Delay (GDD) is used to describe delay in development of a preschool child, when a child has not reached key milestones of development in a number of areas such as communication, motor skills, social interaction, processing information, and remembering skills.
  • If development continues to be delayed after 5 years of age, this would be suggestive of an intellectual disability.
  • Children and young people with an intellectual disability can present with any mental health problem, but their presentation will be complicated by factors such as communication difficulties and sensory sensitivities.

Who to Refer

  • We will carry out an assessment for Intellectual Disability (ID) in the following circumstances: (all of the below)
    • There is evidence of delay in the child’s early development.
    • There is evidence from education that the child/young person is significantly behind in ALL academic areas compared to same age peers (not a specific difficulty in only one area).
    • There is evidence that the young person is showing difficulties in several areas of daily living (e.g. self care) compared to same age peers.
    • The above difficulties are having a significant negative impact on the child/young person and/or their family.
    • Clarification regarding an ID would make a significant difference to the ongoing management, resources or next steps for the child/young person.
    • The child/young person is a minimum of 8 years old (this is due to the administration and reliability of the assessment tools used. For children younger than 8 years old consultation and discussion may still be useful and a referral could still be made provided the above 5 criteria are met).

  • We provide further assessment and intervention for children and young people with an existing diagnosis of Intellectual Disability (ID) in the following circumstances:
    • There are concerns that the child/young person has a further developmental disorder (see criteria for ADHD, ASD and other) and the presentation of symptoms are over and above what would be expected for the child/young person’s developmental stage.
    • There are concerns regarding the child/young person’s mental health. In the ID population this might be seen in a significant change in presentation (e.g. sleep, eating, interest in activities, communication) and/or behaviour that challenges (e.g. self injurious behaviour).
    • The child/young person’s circumstance is complex due to additional medical/developmental conditions and/or multiple other professionals/agencies involved. We may consider a consultation model in the first instance in this situation.

Who not to Refer

  • The child/young person is under 8 years old (this is due to the administration and reliability of the assessment tools used. For children younger than 8 years old consultation and discussion may still be useful and a referral could still be made provided all other are met). Consider referral to Community Child Health.
  • Referrals should ordinarily be sent through the school (see How to Refer)
  • Neurodevelopmental concerns in under 5's should be via Health Visiting/Community Child Health. 

How to Refer

  • In line with other Health Boards in Scotland, Tayside CAMHS have moved to a system whereby the majority of referrals relating to neurodevelopmental conditions 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). In the event of a GP referring, it should be sent sent via SCI Gateway/paediatrics/neurodevelopmental. 
  • If parent/carer or young person asks the GP to refer them to CAMHS with concern around intellectual disability 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 GP AND school but school only.
  • 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.
  • Please note there is no change to the process for referring to CAMHS for other mental health conditions.

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