National Centre for High Functioning Autism

Great Ormond Street Hospital

Main information

Type of service: Diagnostic services

Website: http://www.gosh.nhs.uk/medical-conditions/clinical-specialties/child-and-adolescent-mental-health-services-camhs-information-for-parents-and-visitors/services/national-centre-for-high-functioning-autism/

This is a 'Tier 4 referral' national service at Great Ormond Street Hospital (GOSH) for children with a suspected autistim spectrum disorder. Children are seen in the Social Communication Disorders Clinic, which is managed by Professor David Skuse.

The clinic focuses mainly on the assessment of complex cases of suspected autism or Asperger syndrome in children of normal-range or high intelligence. The aims of the service are to determine the diagnosis (if any), and to make recommendations for treatment.

At present this National Clinic has limited follow-up and treatment facilities. However, we will make recommendations regarding appropriate strategies regarding treatment and further management (eg educational facilities) to local Child and Adolescent Community Mental Health Services (CAMHS) or other local specialist services, after our assessment is complete. .

A child can be referred by a member of the child's local medical team, for instance, a consultant paediatrician, child psychiatrist or other medical specialist.

If the referring professional is not from within the local Child and Adolescent Mental Health (CAMHS) team, we will need to establish which local CAMHS team (or, alternatively, community or other paediatric team) will be responsible for the child's ongoing care after our assessment.

Until the local team has been identified, they have approved the referral to our team, and they have also accepted responsibility for ongoing treatment after our assessment, then we cannot accept the referral. All referrals require the local CAMHS (or equivalent) team's agreement prior to assessment.

If a family has recently moved to the UK, and they have an existing opinion from an overseas specialist, we may accept the referral provided appropriate local specialist services have agreed to take responsibility for the child's ongoing treatment after our assessment has been completed .

Families occasionally approach their family doctor (GP) to seek referral for a second opinion regarding their child's disorder, which has already been diagnosed locally. We do accept referrals from family doctors but only if they are for a second opinion and we have the local CAMHS (or equivalent) team's agreement.

We cannot accept referrals from family doctors if the child has not already been assessed by local services (i. for a first opinion on a suspected case of an autistic spectrum disorder).

It is important, in order to maintain continuity of care, that all referrals for second opinion should come with the agreement of the local service that provided the initial opinion. That service will be responsible for the child's ongoing treatment. In practice, few local services refuse to give agreement for a second opinion.

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Assessment procedure: The assessment draws information gained from - Parents, via an initial telephone consultation, the completion on several questionnaires and the completion of the 3Di interview - Schools, via completion of questionnaires and school visit - Child, via the completion of ADOS and cognitive assessment. Feedback is given in a consultation appointment with all professionals who have seen the child. The child’s school may also be invited to part of the feedback appointment. .

Follow up service: Consultation Service – Local health professionals – providing management advice and service recommendations. Particularly: Advice for children with behavioural problems; Supporting children with co-morbid disorders e.g. anxiety, depression, panic attacks; Support in helping families to apply effective individualised ASD strategies.

Multi-disciplinary assessment: Yes, professions involved: Clinical psychology, psychiatry, paediatrics, speech and language therapy.