The Umbrella Pathway-Autism Assessment

In 2013 The American Psychiatric Association changed the term autism to autism
spectrum disorder. ASD is now an umbrella term that covers the different levels of
autism.

The Umbrella Pathway is a diagnostic pathway that provides assessment and

diagnosis of children and young people who present with neuro-developmental
disorders due to Autism Spectrum Conditions. It is a multi-professional team that
consists of Community Paediatricians, Clinical Psychologists, Speech and Language
Therapists, Occupational Therapists and Specialist Autism/Complex Communication
Needs Teachers. Some or all of these professionals may be involved in each
assessment process.

The purpose of the Umbrella Pathway is to assess whether a child or young person
has Autism or not. Part of the assessment process through the multi-professional
team is to signpost to other appropriate services for help and support both during the
assessment and following the assessment.

The Umbrella Pathway is an assessment and diagnostic pathway which assesses children and
young people for Autism Spectrum Disorder (ASD).  
. 
Autism is a lifelong developmental disability that affects how people perceive the world and
interact with others.  Autistic people see, hear and feel the world differently to other people. 
All autistic people share certain difficulties but being autistic will affect them in different
ways.
The Umbrella Pathway Team includes; Community Paediatricians, Speech and
Language Therapists, Occupational Therapists, Specialist Autism/CCN Teachers and Clinical
Psychologists.
The signs of autism vary from one person to another but may include any of the
following:
 Difficulties with social communication & interaction
 Restrictive and repetitive behaviours & since early childhood
 Disturbance of daily functions due to the above
 Other difficulties such as sensory processing and co-ordination difficulties
 Difficulties in learning, information processing and other behaviours may be apparent

Referral criteria
For a referral to be considered evidence will be required of significant difficulties, impacting
on the child/young person’s daily life, across the 4 areas of their development associated with
ASD:
 Social emotional reciprocity
 Non-verbal communicative behaviours
 Developing and maintaining relationships
 Restricted patterns of behaviour

In addition to identifying these difficulties, it is essential that there is evidence of what

interventions have been tried in order to meet the child/ young person’s needs. This is
known as the Graduated Response. More information about this can be found in
the Worcestershire Local Offer and Graduated Response.
 SEN Support in Mainstream Settings The Graduated Response - Herefordshire &
Worcestershire SENDIASS  [Opens in a new Window]
 Understanding the Graduated Response video - Herefordshire & Worcestershire
SENDIASS  [Open in a new Window]
 Umbrella Pathway Referral Form 
 Assess Plan Do Review Cycles Graduated Response
 Brain in Hand - Digital tools for 14-18 year old autistic young people in Herefordshire
and Worcestershire

Referral

Guidance notes on completing the referral form

The referral form requires very detailed information and is best given to parents to complete
in partnership with the child/young person’s school/educational setting, or professionals
working closely with the child overtime on a regular basis.
It is not unusual for children to present differently at home and at school and it is important
that we know about these differences. If a child is not experiencing as many difficulties in the
setting/school as at home we would like school and parents to meet and monitor the
difficulties over 2 terms so that the referral is supported with information that documents and
helps us understand these differences.
The information sent to us will be considered by our multi disciplinary team usually on a
weekly basis Further information or clarification may be requested at that stage. When the
information has been considered we will inform parents, referrers and professionals involved
of our recommendations.
A re-referral of children previously assessed by the Service cannot be accepted within an 18
month period and there will need to be evidence of significant changes in the child’s
presentation since the previous assessment was carried out before a re-referral can be
accepted.
We require a wide range of detailed information to decide if this is the most appropriate
service for a child or young person. The information provided forms part of the child/young
person’s assessment if they are accepted onto the pathway.
The Umbrella Referral consists of the following 4 parts and all of these need to be completed
in full before the referral can be considered:
1. Umbrella Pathway referral form  
2. Age appropriate consent form
3. Questionnaire completed by parent
4. Questionnaire completed by Educational setting (as long as the child/young person is
attending one)

Guidance for referrers

The referral must include evidence that an Early Help or graduated approach response has
been considered and implemented over time in relation to the presenting difficulties and the
needs of the child, rather than an assumption that ASD is the cause.
 Referrals from School, school nurse,  or GP   should demonstrate:
 a graduated approach response from school with evidence of ‘Assess, Plan, Do,
Review’ cycles.  This must be in place and evidenced over a minimum of 6 months or
2 terms for all school aged children.  Insert link for graduated response form.
OR
 a supporting report from a professional such as the Complex Communication Needs
(CCN) team,  Educational Psychology (EP),  Speech and Language Therapy (SALT),
or Occupational Therapy Team (OT) that focuses on key areas as detailed above.
School referrals should be completed and signed by the school ASD Lead or SENCo. If
parents feel that they need support to complete their forms we advise them to seek support
from school. If no problems are being seen in school we will still require the school view.
 Referrals from Paediatricians and Child and Adolescent Mental Health Service
(CAMHS) should be accompanied by a neurodevelopmental history that makes
reference to the key areas above
 Referrals from Speech and Language Therapists and Occupational
Therapists should be accompanied by a report and information relating to all of
the key areas detailed above.
 Referrals from Family Support Workers should be accompanied by details of
involvement and concerns that relate to the key areas detailed above.
Parents/carers and professionals need to work in partnership to complete the referral form so
that we understand how the child/young person presents at home and at school.

Assessment process

The assessment process in total can take around 12 months to complete. If there is any delay
in this we will do our best to keep families informed with reasons why.
 Once all the information has been collected from all of the assessments, the needs of
each child/young person is discussed by the appropriate team of professionals. A
decision is made whether individual children/young people meet criteria for a
diagnosis on the autism spectrum.
 Parents are informed of the outcome as soon as possible after the decision.
  A written report is completed and shared with the parents/carers/ young person and
also the referring professional.  Recommendations will be offered for the child/young
person and family following the conclusion of the assessment .
 For nursery and school-age children confirmation of the diagnosis will be provided
for their educational setting with consent from parent.

Special Educational Needs and Disability (SEND)

All children should have access to the right services, at the right time, to make sure they can
reach their full potential. We work together with other agencies to ensure that the right
professionals are involved at the right time to meet the needs of you and your child. Find out
more about how we support children and young people with Special Educational Needs and
Disability (SEND)