Early years: children up to 4 years
Last updated 20 December 2023
1. Support and assessment
If you think your child may be autistic, you can contact:
- your Health Visitor
- staff at your child’s nursery
- your Speech and Language Therapist if your child is already known
Your first point of contact should be your Health Visitor or SENCO at nursery. They are able to gather information from you and can help you to consider whether your child is showing behaviours or development that may indicate neurodiversity. Your health visitor and nursery should also share information.
If it's agreed that further assessment or support may be beneficial, your health visitor or nursery will complete a developmental needs form with you. The form will be sent to the Child Development Unit (CDU) at Stepping Hill Hospital.
The CDU team meet monthly to look at new referrals and decide which services would be most helpful for you and your child. This may include a:
- Consultant Paediatrician. Consultant Paediatricians are doctors who are highly specialised in child development. The paediatrician will ask you about your child’s birth, development and any concerns that you may have
- Speech and Language Therapist. They use a play-based approach to make sessions as fun and relaxed as possible. Speech and Language Therapists assess and treat a range of needs including:
- difficulties with social interaction
- significant developmental differences in understanding spoken language
- using spoken language
- children with feeding and swallowing difficulties
- Portage. Portage is an educational service for early years children with SEND and their families. Portage intervention staff work with children and families within the home and group settings to support and enhance the development of play, communication and learning
A SEND consultant for the Early Years Improvement Team may also see your child in nursery. They can support the staff by offering guidance, support and ideas that will enable them to support your child’s development and meet their needs.
If your child is showing differences in their physical development or needs specialist equipment, they may also be seen by a Physiotherapist and/or Occupational Therapist at CDU.
Initial appointment and support
If it's agreed that further assessment is needed, your child will be seen by a Consultant Paediatrician and a Speech and Language Therapist. At your initial appointment, you'll be able to discuss your child’s development and share any concerns you may have. The Consultant Paediatrician will ask you some questions about your child’s development so far and spend some time interacting with your child. The Speech and Language Therapist will ask for more information about how your child communicates and interacts with you and others, and assess your child’s communication skills through play. They will then explain any support or interventions they feel would be beneficial and will plan to monitor your child’s progress over a period of time.
The CDU team meet monthly and will provide updates on their involvement with the rest of the team.
As well as support from the CDU service, your Health Visitor can offer support via groups and/or direct support from early years workers. Their aim will be to support you in supporting your child. Each of these professionals form part of the Start Well Team and are sometimes referred to as the Team Around the Early Years. They can remain involved with your family and child until your child moves on to school.
Receiving a diagnosis
Not all children referred to CDU have autism. If appropriate, a diagnosis of autism will be confirmed by your child’s Consultant Paediatrician before they start school. A diagnosis would not usually be confirmed until the year before your child starts school.
Before confirming a diagnosis of autism, the Consultant Paediatrician will consider:
- developmental history
- observations made during clinic appointments
- feedback from your child’s Speech and Language Therapist
- nursery feedback and/or observations from professionals in nursery
They may also use some additional formal assessments, such as:
- Autism Screen Questionnaire (ASQ), which is a short questionnaire completed with parents/caregivers
- Autism Diagnostic Interview (ADI-R), which is a parental/caregiver interview
- Autism Diagnostic Observation Schedule (ADOS), which is a structured play-based assessment