O’Murchú highlights issues with autism assesment diagnosis

ISSueS with assessments for autism diagnoses were raised at the Oireachtas Autism Committee by Dundalk TD Ruairí Ó Murchú where he questioned what the perfect system of assessment would look like.

A panel of experts were before the committee last week including senior clinical psychologist Dr Louise Higgins from the Psychological Society of Ireland.

The Sinn Féin deputy questioned how the HSe autism assessments are needed because schools and other services need them and ‘therefore, there is not a family that does not want it done’.

He said: ‘We all know what the law states in relation to it. The preliminary team assessment, PTA, was entered into and it did not cut the mustard at all’.

He questioned the average time of 37 hours needed for the PTAs and wondered ‘what the perfect system of assessment should look like’.

Deputy Ó Murchú also asked about therapies and the lack of OTs, SLTs and psychologists coming on stream. He said that while the government says workforce planning is kicking in, ‘even if that is the case, we are looking at four or five years where we do not have the capacity’ and asked whether it would be good to have therapists working in schools.

He also raised the issue of children with an autism diagnosis, who are also experiencing mental health issues such as anxiety and who are sent to the CAMHS only to be told they don’t fit the criteria for their help.

In response, Dr Higgins said: ‘Since we know autism is a spectrum that is present at all ages, all cognitive abilities and language abilities and with co-occurring conditions, and because of the level of diversity within the autism spectrum, we are clear it is not a one-size-fitsall approach for assessment, but also for supports.

‘However, there are key components to an assessment. It is not a one-size-fits-all approach. The preliminary team assessment had very few of those good key elements.

‘There was no use of standardised measures so it was effectively a screening assessment that could not have met the criteria of doing what we know is best practice around giving a clear comprehensive assessment, identifying a child’s difficulties and differences, and planning out the supports.

Dr Higgins also said that the Disability Act needs to be reviewed and added: ‘We argue that assessment is an important part of understand- ing an individual’s needs and identifying the appropriate supports. PTAs are suspended, thankfully, but we are trying to get back to where we were.

‘Assessments need to happen and we would want to be consulted so we do not have another situation of things having to be redone, wasting resources and children’s and families’ time. That is probably the most important thing we have to say around assessments’.

She agreed with Deputy Ó Murchú about supports for autistic children and teenagers who also have anxiety and other conditions.

She said: ‘Some will need the support of a CDNT and some of CAMHS, and some may need a combination of those.

‘There is an agreement in principle and a policy around shared care in the HSe but it often is not implemented or there is huge variation in its implementation. That needs to be in place because there are children and adolescents who will need both services’.

Deputy Ó Murchú wanted to know what can be done in interim. He asked Dr Higgins: ‘When can we have a straight conversation with parents on what we can offer them that is not absolutely failing their kids, which it is at this point in time?

Dr Higgins said: ‘The key issue is not to compromise and result in bad practice, which is what PTAs were.

‘We would be in agreement that if families apply for an AON under the Disability Act, they should get it done in a comprehensive way in line with best practice and intervention and supports should be individualised for the young person’.

Another expert, Association of Occupational Therapists of Ireland, AOTI, chief executive officer, Odhrán Allen, said: ‘A forum should be created to include those responsible for design, operations and budgets, representatives of the professional bodies and clinicians who are on the ground. Why do we not create such a forum sooner rather than later?’