Pre 5 Years Assessment Team

When we are considering if an assessment of possible autism is required, we are looking for further information within the following areas at home and school which cannot be explained by other needs:

For more information about what autism can look like, click here.

Before the referral, we request that the following questionnaires are filled in by parents and school as part of the assessment process. Help can be requested to fill in questionnaires by emailing nds@nchc.hs.uk

1a. Early Years Observation Questionnaire
If your child is in nursery, an Early Years Observation Questionnaire can be completed by your child's early years setting (nursery/pre-school).  

OR

1b. Teacher Observation Questionnaire (TOQ)
If your child is in school, a TOQ can be completed by your child's class teacher or SENDCo. 

2. Parent Observation Questionnaire (POQ)
To completed by a child's parent/caregiver. 

* If your is home-schooled or out of school, detailed information from parents (plus any other information from other professionals relating to neurodevelopmental difficulties/differences) will be considered.

As part of the assessment, members of the team will spend time with you discussing your child's early life and development. This may be a questionnaire, clinic appointment, a home visit or a video call.

It may be helpful for you to gather or prepare information in advance of this appointment. This may include information about your child's milestones, early development and life events.

We have clinics in the Children's Centre at Norwich Community Hospital (NCH), Thorpe Health Centre, West Pottergate Medical Practice, and St James Clinic in King's Lynn.

You can find more information about the clinics in which we carry out assessments, including travel and parking information, on our location and travel information page.

Team members will spend time observing and getting to know your child to learn about their strengths and needs. This may include assessments in clinic, at home or in school.

Appointments will be child friendly, and we will work as flexibly as possible around you and your family.

Every child will be discussed at a multi-professional panel meeting throughout their assessment. 

All observations are made in line with the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) and diagnostic discussions are based on these criteria. The decision is a team decision and is not made by one profession alone.

When a diagnostic decision has been reached by the team, you will be offered a feedback appointment with a member of the NDS team. You will receive written information including NDS reports following the feedback meeting.

Autism assessment guide for young people

Cognitive assessment guide for young people

Occupational Therapy assessment guide for young people

NDS clinicians also support the delivery of 'Puffins', a 4-week information group coordinated by Family Action and designed for caregivers of autistic children/young people. For more information about Puffins, please click here.

If a diagnosis is not given, the NDS will feedback the reasons and factors that have influenced this decision. You will still be provided with the assessment reports and a summary explaining the non-diagnosis. We are currently developing an information pack for young people who have not received a diagnosis. 

For children under 5 years, the overall assessment period could take around three years.

If you are not happy with the waiting time for your child's assessment, you can use the NHS Choice Framework ('Right to Choose') to choose another  healthcare provider to carry out the assessment.

We would ask that you let the Neurodevelopmental Service know that you/your child has received a diagnosis once the assessment has taken place so we can take you off our waiting list. There is no need to have an NHS assessment once you have had a private assessment, as a private diagnosis is recognised the same as an NHS one, provided it meets the same criteria.

Advice about choosing a private provider and the criteria to consider is available here.

A diagnosis of ADHD can be considered in young children but would not usually be confirmed until a child is at least 6 years of age and is settled in school. This is because it is common for children to be highly active, especially at younger ages. 

There have been lots of questions and discussion regarding Pathological Demand Avoidance (PDA). PDA does not appear as a separate diagnostic condition in nationally or internationally recognised diagnostic manuals such as DSM-5 or ICD-10. This has meant that children and young people have not received a separate "diagnosis" of PDA and in the past, it may have felt that PDA was not recognised or understood.

Professionals in Norfolk recognise and understand that there are a group of autistic children and young people who present with a demand avoidant profile, and we understand this within the umbrella term of autism spectrum disorder. We may use language such as "autism spectrum disorder with a demand avoidant profile".

We understand each individual child's unique way of seeing the world.

Sensory Processing Disorder (SPD) is not included in the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5). Sensory differences are considered a symptom rather than a diagnosis. The Royal College of Occupational Therapy do not therefore, support the use of SPD as a diagnostic label.

Within the Neurodevelopmental Service, assessment for sensory processing differences may be considered as part of a diagnostic assessment for autism spectrum disorder (ASD or Autism) or attention deficit hyperactivity disorder (ADHD).

All our assessments are child focused and adapted to individual needs. Just seeing your child in their own environment can often give us a lot of information which adds to our assessment.

A diagnostic decision comprises many parts and is not just based on one assessment alone. If your child does not engage for one part of the assessment, we can still use information from other sources such as questionnaires and nursery/school observations.

We can provide your child with support prior to the appointment if this would be helpful, for example by sending a photo of the clinician they are seeing or of the room they will be going into. We can also send a letter to your child to explain the tasks that they will be doing.

Please contact us on 01553 668712 or by emailing nds@nchc.nhs.uk to talk through any worries that you have.

You will receive a written report regarding each assessment that the Neurodevelopmental Service has carried out at the end of your child's assessment regarding the diagnostic decision.

The reason we send reports together at the end of the process is that each report is a small part of the bigger picture. It is only when all reports are viewed that the whole picture can be seen, and a final diagnostic decision can be reached.

The criteria for an assessment with the Neurodevelopmental Service to be expedited are:

• Looked After Children (this is a child or young person that might be looked after with their parents' consent or by a court order. They might live with foster carers, in a children's home, with family members or connected people (such as friends or neighbours) or sometimes even with their birth parents).
• If the assessment process has started with an NHS Trust in a different area - including military families - you will be added to the waiting list with your original referral date.

Unfortunately, we are not able to speed up assessments for any other children.

The Neurodevelopmental Service is an assessment-only team. Receiving a diagnosis of a neurodevelopmental disorder does not resolve any difficulties/differences that your child/young person may be experiencing and therefore alternative support needs to be explored regardless of whether a diagnosis is given.

Norfolk is working towards a needs-led culture rather than a diagnosis-led culture. Just being accepted for a neurodevelopmental assessment is sufficient to request reasonable adjustments within your education setting.

Please visit our useful resources page or the Just One Norfolk ND Digital Library for information about other services that can be accessed for support.

You do not need to have a formal diagnosis when applying for an EHCP. To apply for an EHCP, your child will need to have identified additional needs (please see the Norfolk SENDIASS website for more information).

A child can be on a waiting list or may not even be referred into the service before an application for an EHCP is made. Some young people start their assessment having already received an EHCP.

A diagnosis also does not necessarily mean that a young person will need an EHCP.

If your appointment with the team is within school hours, you should speak to your child's headteacher so they can authorise your child/young person's absence. Norfolk County Council recommend that you try to minimise disruption to your child's/young person's school day if possible. Norfolk County Council provide further information about absences from school for medical appointments.

Please do let us know if you move out of Norfolk. If you move area before your child's assessment has started you will be transferred to the team responsible for neurodevelopmental assessments in your new area. Some teams will honour the original referral date, but other teams will not.