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Specialist Assessments

Specialist assessments can be undertaken including:
• Expert Opinions for:
o Family court proceedings
o Mental capacity
o Civil court proceedings
o Mental health tribunals
o Forensic matters, including pre-sentencing
o Pre-proceedings assessments for Children’s Services, in respect of children and parents
o Employment and employer’s duty of care
o Education tribunals

All these assessments are provided on an individualised basis and will be designed in conjunction with the commissioner to ensure that the assessment addresses the specific concerns and instructions of the referrer.

Inclusion Criteria:
• Aged from 7-75 years; we would expect their consent to the assessment unless they have been identified as lacking the capacity to do so and a best interest decision has been made on their behalf.
• A formal assessment for ASD has been completed, where diagnostic clarification or a second opinion is required.
• The ENC will consider offering assessments for individuals who have been refused access to the local ASD assessment pathway, where there is evidence to indicate the presence of significant social communication difficulties.

Exclusion Criteria:
• Individuals with profound learning disabilities
• Presence of an acute psychiatric disorder or difficulty requiring urgent assessment or treatment, unless under local psychiatric care for risk management and/or undergoing medical treatment.

Referrals should include:
• Clear instructions regarding the work to be undertaken
• Summary of current situation, background and nature of the concerns
• Copies of previous diagnostic assessments, diagnostic and community therapy reports.
Providing the above information will help referrals to be processed in a timely fashion. Failure to provide the evidence above will delay the referral or we may be unable to accept the referral at this time.

What we offer
We undertake a variety of individualised assessments, depending on the needs of the individual, their family circumstances and the tasks.
When the referral has been accepted and before the assessment
We will request disclosure of documentation which allows our MDT to decide on the most appropriate approach to the assessment process.
This should include:
• Relevant health records and records of the involvement of other agencies who have supported the individual and their family.
• Records from school, education providers, care services and any other appropriate services that have been involved with the individual.
• We may send the individual and/or their family a selection of questionnaires to complete and return to the clinic before the first meeting.

This enables us to gain important background information and develop a detailed chronology, which is required in order for the MDT to make appropriate decisions about the most appropriate the assessment process. This allows the ENC to develop an accurate costing for the assessment that is required. Once this has been agreed in writing by the funders the team will proceed with the process.

The Assessment Process
Telephone consultations with the referrer and, if appropriate, with the family will be undertaken by a member of the clinical team to ensure that the arrangements for the clinical assessment are understood and to identify particular concerns and needs.
The aim of this consultation is to gain an understanding of the individual’s current presentation and to identify hopes and goals for the assessment. It is also an opportunity for the referrer to ask about how the assessment process works, who is involved and how long it is likely to take before the assessment is completed. We will also ask for information to help us offer an assessment that is tailored to
the needs of the individual.

The assessments are undertaken by a team of two or three members of the team; one of our consultants will always led the team. The team members are individually selected to best meet the outcomes required for the assessment. We prefer to undertake assessments in settings that are familiar to the individuals and we want to ensure that the settings we use are comfortable for those contributing to the assessment. This will often mean that we will take our assessment team to the local area, seeing the child at home or in school; however, we can also offer assessments at the Elizabeth Newson Centre. The assessment process is an interactive one; we plan this carefully in advance and have clear aims and objectives for the assessment to ensure we can provide answers to the particular questions and issues we have been asked to assess. We work hard to have meaningful and effective interactions with the person concerned. However, we will alter and change our plans as the assessment progresses, both to respond to any difficulties that occur and to help us understand problems and difficulties if these are not apparent. The core aims of the assessment our to understand how the person interacts, engages and responds to members of the team, their personal and family history and their current functioning at home, across other parts of their lives, including in the community.

Detailed chronology and developmental and personal history
Prior to the assessment, chronology and developmental history are prepared based on the information provided and this is discussed and supplemented during the assessment. This always involves the use of use of semi-structured interview schedules that have been developed by the centre and may also involve the use of formal tools, such as the Autism Diagnostic Interview or the DISCO. This will be supplemented by more general and wider ranging personal and family history, considering family life, education, employment and relationships. If possible, this audio data is recorded to improve analysis.

Observational Assessment
Some form of playful activity based session is always used, if possible observed by members of the family and/or other members of the assessment team. If appropriate, this session may use formal assessment processes, such as the ADOS. Wherever possible and unobtrusive, the audio and video of these sessions are recorded to improve analysis of this data.
Cognitive, Communication and Functional Profile
The assessment will involve evaluation of cognitive and functional skills and may include formal or informal assessment according to previous assessments, current presentation and needs.

Further assessments
We may carry out visits to the home and/or other settings, as agreed at the beginning of the assessment process, in order to observe the person in more familiar environments.

The Report
A detailed report is provided which will include a summary of the assessment process and findings, conclusion, with a diagnostic opinion and recommendations. The centre uses recognised diagnostic criteria, in accordance with best practice. Currently, we use both the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, DSM–5and the 11th revision of the International Classification of Diseases, ICD-11 when providing our diagnostic opinions. These reports also contain detailed recommendations and guidance for the individual, their family and the services supporting them. The centre will complete these reports within a timescale agreed with those commissioning the assessment and always within 10 weeks of the assessment.

Follow up
After the assessment, the ENC can provide consultation to local teams and services if this is commissioned. The aim of this would be to ensure the successful handover to local service providers.