Services To Support You & Your Family

Pre 5 Years Assessment Team

This is a multidisciplinary assessment team assessing children under 5 years old for autism. On this page you will find information about the referral process, who is in the team and what to expect before, during and after an assessment.

Autism is a neurodevelopmental condition which affects how people communicate and how they experience the world around them, meaning that autistic people can interact and interpret the world in unique ways compared to neurotypical people.

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Books can be a powerful way to help children and young people understand neurodivergence and feel represented. There are lots of themed book suggestions, including:

Visit our useful resources page or explore the Just One Norfolk ND Library for more information about autism, ADHD and neurodevelopmental support.

How Do I Refer?

All children under the age of five will need to be seen by our Community Paediatrics Team first. If appropriate, your child's paediatrician will then refer you to the Neurodevelopmental Service for further assessment. This is to ensure a thorough medical assessment is completed and available to NDS staff when they meet with you.

A referral to the Community Paediatrics Team can be made by your child's GP, Health Visitor, Speech and Language Therapist, or School Nurse.

These are the things we look at when considering whether to accept a referral:

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:
- differences within social interaction and communication, such as differences in reciprocity, initiation, and response to interactions
- differences with relationships, including friendships
- differences in the use of non-verbal communication such as facial expressions, gestures, eye contact
- preference for routines and focused interests
- repetitive behaviours, such as language or movements
- sensory differences
Read more about signs of autism in children.
Norfolk is working towards a needs-led approach, rather than one based solely on diagnosis. If you've been accepted for a neurodevelopmental assessment, that's enough to request reasonable adjustments in your education setting.

For support while your child waits for assessment, your can view our useful resources or visit the Just One Norfolk ND Digital Library.

Visit the ND Digital Library.
Who has parental responsibility?

Mother: automatic

Father: if married to the mother either when baby is born or since

Unmarried father: if name appears on birth certificate (since 1/12/03) or legally acquired

Young person: if over the age of 16 years*

Others: if parental responsibility is legally acquired

Parental Responsibility Agreement: signed, properly witnessed and sent for registration to Principal Registry or the Family Division (High Court)

Residence Order: granted by the court

*Please note that young people under the age of 16 can give or refuse consent for assessment if considered competent to do so by clinicians with the Neurodevelopmental Service.

What to Expect at an Assessment

What Happens?

We are trialling one-day assessment clinics to explore more efficient ways of assessing children and young people referred to our Pre-5 service for autism assessment.

Families of children selected for the pilot will be contacted directly and supported throughout the process. These clinics will run on a trial basis, and the results will be evaluated to determine whether this approach could support a new assessment process.

Those not included in the pilot will remain on the existing Pre-5 assessment pathway and do not need to take any further action.

Testing this new approach with small groups will help us improve the assessment process for all families. Find updates about our transformation project. We also welcome your feedback.

To help us maintain a fair and accessible service, it is important that parents/carers notify the NDS of the following:
- changes to contact details, such as address and/or phone number
- changes to living arrangements and carer/parent contact details
- whether the child/young person has been assessed, or is on a waiting list to be assessed, by another provider
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 child 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.

View location and travel information to find more information about the clinics in which we carry out assessments, including travel and parking information.

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.

Assessments

Below are some of the assessments your child may need. Your child may only need one or two of these assessments. Some children will need several.

A variety of other types of assessment may be carried out, so please contact us on 01553 668712 or email us at nds@nchc.nhs.uk for more information.

It is essential that all appointments are attended. Please be aware that if you and your child fail to attend one appointment, you will be contacted to confirm whether you wish to continue with the referral. If two scheduled appointments are missed or cancelled with less than 24 hours notice, your child will be discharged from our service and your GP/health professional will be informed.

After Assessment

The NDS is a diagnostic assessment-only service. Following a diagnosis, you will be provided with a pack containing information about autism, as well as information about the additional resources and support services available.

NDS clinicians also support the delivery of 'Puffins', a 4-week information group coordinated by Family Action and designed for caregivers of autistic children and young people. Read more about Puffins Autism Programme.

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.

Who is in the Team?

Annabelle Gage

Speech and Language Therapist

"I enjoy riding my horse in the forest, looking after my many animals, country music and collecting cowboy boots."

Becky Whitby

Speech and Language Therapist

"I'm Rebecca/Becky, I love animals and travelling to new places."

Charlotte Slater

Speech and Language Therapist
"I love being on the beach with my children having fun, or at home with my cat!"

Heather Westley

Speech and Language Therapist

"I'm Heather and I like dogs and walking in the woods."

Jo Chapman

Speech and Language Therapist

"I'm Jo and I love anything to do with musical theatre and Salsa dancing in my spare time!"

Katherine Baxter

Speech and Language Therapist

"I love clear blue skies, long dog walks on the Norfolk coast and spending time with my children."

Natalie Mackintosh

Speech and Language Therapist

"I'm Natalie and I like bright sunny days and shoe shopping."
Bobbi-Jane Holden

Administration Assistant

"My name is Bobbi, I like walking my dog and going to the gym. I absolutely love the beach and a good sunset."

Emma Mutton

Administration Assistant

"I'm Emma, I love long country and beach walks and exploring new places and holidays, my 2 cats and a really good slice of cake and a cup of fresh coffee."

Louise Stevens

NDS Navigator

"I'm Louise and I like reading new books, looking after my garden and spending time with my family."

Lisa Hart

NDS Coordinator

"I'm Lisa, I like baking and sightseeing."