Team Composition & Competencies
The following advice is adapted from NICE Guideline CG128, Autism in under 19s: recognition, referral and diagnosis. [http://www.nice.org.uk/guidance/cg128/chapter/1-recommendations]
The team should take action to reduce inequalities in recognition, referral and diagnosis for those with good verbal ability and average or above average intellectual ability, females, those with a dual language and those in the criminal justice system.
Assessment should include “development of a profile of the child’s or young person’s strengths, skills, impairments and needs” that can be used to create a needs-based management plan, taking into account family and educational context. This requires a multidisciplinary team which has the skills to undertake the assessments necessary for profiling.
The core team membership should include a:
- paediatrician and/or child and adolescent psychiatrist
- speech and language therapist
- clinical and/or educational psychologist
And either include or have regular access to the following professionals if they are not already in the team:
- paediatrician or paediatric neurologist
- child and adolescent psychiatrist
- educational psychologist
- clinical psychologist
- occupational therapist
Members of the autism team will be clinicians who may have other roles and be members of other teams in child health, child and adolescent mental health services (CAMHS) and or education and social care, but membership of the autism team should be a dedicated role for this group of professionals.
Not all professionals in the autism team need to be involved in the diagnostic process for every child or young person but a single practitioner is not well placed to undertake a full diagnostic assessment.
A very experienced healthcare professional could undertake some aspects of the assessment single-handedly (such as ADI/ADI-R and ADOS). However, a wider range of expertise is required to undertake the other aspects of assessments in order to develop a comprehensive profile of the child or young person.
The autism team should have the skills and competencies to:
- carry out an autism diagnostic assessment
- communicate with children and young people with suspected or known autism, and with their parents and carers, and sensitively share the diagnosis with them
The autism team should either have the skills (or have access to professionals that have the skills) needed to carry out an autism diagnostic assessment, for children and young people with special circumstances including:
- coexisting conditions such as severe visual and hearing impairments, motor disorders including cerebral palsy, severe intellectual disability, complex language disorders or complex mental health disorders
- looked-after children and young people