Early Developmental Assessment

Children identified in infancy as likely to require additional support in school for health/education needs are referred to the Earlylinks (Shropshire) or First Steps (Telford) pathway by health professionals.:

We are proposing some changes to this pathway in Shropshire. The plan is for children accepted onto this pathway to be offered

• Structured parent sessions every six months up to the age of 2:03-2:06 where parents/carers have time to discuss their child’s development and any areas of concern face-face by phone or online. Onward referrals can be made to other agencies as appropriate at these times.
• When Covid-19 restrictions allow blocks of group sessions, run at the child development centre until the age of 2:03-2:06,
• For those families who cannot access the face-face group sessions, regular bi-monthly phone, clinic or home visit contact is made by a Nursery Nurse and /or health professional.
• At the age of 2:03-2:06 a multidisciplinary assessment where the child’s strengths and weaknesses are identified through assessment by an Educational Psychologist, Specialist Nursery Nurse and Speech and Language Therapist supported by the child’s Paediatrician. All professionals working with the child, their parent/carer, a representative from the local education authority SEND team, and if they are attending, their early years setting are invited to attend a meeting [face-face or online] to discuss the findings and plan for future support/needs in their preferred educational placement.
• A multidisciplinary report written by health professionals involved with the child following this meeting and the parents/carers informed of the next steps for all agencies involved. The child will then move from the Earlylinks pathway onto other health agency pathways as appropriate.

Autism diagnosis

In Shropshire, Telford and Wrekin, assessment for possible Autism Spectrum Disorder in younger children has been completed wherever possible as part of a wider developmental assessment in the CDCs based at Monkmoor Campus, Shrewsbury and Stepping Stones Centre, Telford.

Children with developmental concerns are referred to the Community Paediatric Service by a health professional who has worked with the family and child. The Community Paediatrician’s role is to see if there is a medical cause for any developmental problems.

The Paediatrician meets the child and family to understand the concerns and also gather information about the child from other professionals involved in the child’s care; such as Speech and language Therapy, Health Visiting and any Early Years setting.  A developmental screening tool called the Schedule of Growing Skills (SOGS) assessment is completed by one of our Specialist Nursey Nurses. If the Paediatrician’s wider assessment highlights concerns about possible Autism and the child was less than 5 years when they were referred to the Paediatrician then a referral can be made to the Child Development Centre.

The CDC assessment has always aimed to be a holistic assessment of the child’s individual strengths and difficulties. If evidence gathered fulfils criteria for Autism, a diagnosis will be given. However, we also work with children who have profiles that don’t include Autism.

Before Covid, Multi-disciplinary assessment (MDA) was carried out at the CDC over a series of appointments and included both group and 1:1 observations and assessments. The Communication and Interaction (C and I) pathway, primarily for young children thought to have autism, usually included an element of trialling different intervention approaches with children and families. The standard MDA pathway provided assessment for children with a range of difficulties, including possible ASD.

Due to Covid restrictions both assessment pathways have recently included a combination of information gathering, virtual/remote elements, a 1:1 session in the CDC playroom observed by a team of practitioners and a setting visit if required. It is hoped to develop the assessment sessions into distinct pathways again as soon as possible following the easing of social distancing and other infection prevention control restrictions

In addition over the last 12 to 18 months we have been working really hard across Health and Local Authority teams to develop our pathways for Autism assessment in those children who have started in Reception at school but were still less than 5 years when they were first referred to the Paediatrician. These assessments are undertaken in the home and school setting rather than in the CDC playroom, although COVID restrictions have meant including some virtual elements in the model. As with all the assessments undertaken through the CDC there is involvement from parents, schools, specialist nursery nurses/play therapists and therapy services as well as the Local Authority SEND team.

We are currently working with PACC, PODS, the Local Authorities and our children and young people to develop a visual representation of the Autism pathways in the CDC. We will display this artwork on our new social media sites and the Local Offer when it is ready.

Jill Boland, Jane Ball, Speech and Language Therapists
Dr Helen Unsworth, Consultant Paediatrician
Alison Parkinson, Clinical Services manager and Children’s Allied Health Professions Lead

For further information please visit the Child Development Centres website.

If you have any queries please contact the Child Development Centre on either 01743 730012 (Shropshire) or 01952 567300 (Telford).