Journal Article

121 Flexibility is key: making autism assessments in covid times and beyond

Haden, Sarah

2023

Overview

ObjectiveFaced with surging demand and Covid restrictions, our assessment process for young children with developmental needs and possible autism required transformation. Families told us that they wanted us to minimise assessment time and have their child’s individual needs considered.MethodsOur service is commissioned to provide assessments for possible autism in children referred before the age of 5 years. Previous assessments followed a standard format for all patients. This enabled a fixed yearly number of high-quality assessments but as referrals for assessment increased, capacity was insufficient, lengthening waiting times.Using existing staff with 4 additional weekly sessions of S+LT time, we developed a multi-faceted model of assessment which defined four possible assessment pathways (see figure 1). Using a structured report form, we gathered high-quality, detailed, observations from education staff focussing on DSM V defined features of autism spectrum disorder. Remote consultations were regularly used to gather information from parents. All patients were seen for at least one in-person assessment in a clinic setting. This model enabled assessments to continue throughout periods ofCovid restrictionsData on referral numbers and assessments completed were compared between two 48-month periods: pre-covid standard model 2018–2019 and new flexible model 2021–2022.We sought qualitative feedback from the MDT.ResultsNumbers of patients added to the assessment pathway and numbers of assessment completed were recorded by year (see graph 2).In the pre-covid 2018–2019 period, atotal of 540 patients were identified as needing formal assessment for autism through the multi-disciplinary assessment process (MDA). During that time468 assessments were concluded.In the 2021–2022 period, 846 patients were identified as needing formal assessment for autism through MDA. This represents a 56% increase in demand on the service. During that time 820 assessments were concluded, a 75% increase.MDT members reported liking the flexibility, panel discussions were good learning opportunities and consultants felt empowered to shorten assessments for children with classical features. Team members felt that their contribution was highly valued. Some MDT members noted that the workload was less predictable in their weekly timetable, and pressure of demand remains high.Abstract 121 Figure 1ConclusionWe have shown that a flexible patient-centred approach to autism assessment has resulted in more assessments being completed. The model is generally perceived positively by healthcare professionals. This, combined with modest additional staff time, should meet high demand efficiently.

• Publisher: BMJ Publishing Group LTD
• Subject: Autism / Autism Spectrum Disorders / Children / COVID-19 / Individual Needs / Numbers / Patient-centered care / Patients / Pediatrics