Decision Report 201401014

Summary

Miss C complained to us that the time taken by the board to begin an assessment of her son for possible autistic spectrum disorder (ASD) was not reasonable.

Miss C told us that she had raised concerns about her son's development and behaviour with his nursery teacher and her health visitor, and, in particular, her concerns that her son may have ASD. Various referrals for her son to be assessed were then made to the board's community child health services. Miss C considered there was an unreasonable delay by the board in carrying out these assessments.

We took independent advice from our adviser, an experienced paediatrician who specialises in autism and communication disorders, who told us that the community paediatrician involved in assessing Miss C's son and the other professionals involved including speech and language therapy and occupational therapy had provided continued, frequent and supportive contact with Miss C. However, our adviser considered the wait Miss C had for her son's first developmental assessment, a period of ten months, was excessive. Furthermore, our adviser was of the view that it would have been appropriate to consider ASD as a potential diagnosis and to have referred Miss C's son immediately to the board's Autistic Spectrum Community Assessment (the ASCA pathway) at that time.

However, the ASCA pathway was not initiated for four months and, thereafter, Miss C waited another seven months for a diagnostic discussion about her son with the community paediatrician followed by a further lengthy wait for a specialist ASD assessment with the Fife Autism Spectrum Team (FAST), which the adviser considered was unreasonable, particularly in a pre-school child. The adviser also considered that, as a process, the ASCA pathway did not address sufficiently promptly the question of a diagnosis and did not appear sufficiently collaborative with Miss C and her partner as parents.

Although the adviser could not fault the community paediatrician's care of Miss C's son, he was of the view that a multi-disciplinary assessment at an earlier stage would have been helpful, possibly saved time and meant that Miss C and her family would have been better satisfied with the process and the outcome.

In light of the advice we received, we found there was unreasonable delay in the assessment of Miss C's son and, therefore, we upheld the complaint.

Recommendations

We recommended that the board:

• apologise to Miss C for the unreasonable delays identified in this investigation;
• provide evidence of the action taken to address waiting times for assessment and diagnosis for children and young people with suspected ASD; and
• ensure that the comments of our adviser, including the ASCA process, are shared with the relevant staff for consideration.