Thread by @DrGirishPsych

Lifespan Services for Learning Disability and Autism: From #Concept2Construct (thread)
@YorksHumbODN Steering group decided in its last meeting to move #LifespanServices 4 Learning Disability/ Autism frm a concept 2 exploring it as a construct (noun).
lexico.com/en/definition/… 1/11

The @YorksHumbODN consists of a range of stakeholders who provide ‘Thought Leadership’. As such, its findings could be considered to be reflective of its stakeholders and further stakeholders are always welcome.
#LifespanServices is significant for a number of reasons. 2/11

Current services are based on historical notions of ‘child/ adolescent’ and ‘adult’ services defined by *chronological* age. Yet, chronological age is a poor indicator of emotional maturity/maturity of executive function. 3/11

Transitions between these services are problematic with particular gaps around neurodevelopmental conditions (e.g. autism/ learning disability / ADHD) (Hill et al 2019 - paywall). Adults with ASD get misdx with Personality Disorders with poor outcomes 4/11 tinyurl.com/so442c4

The ‘concept’ of #LifespanServices presumes that service users wouldn’t move *between* services but *through* them i.e services will mould accdg to SU needs.
There are some obvious advantages for LD +/- Autism.
1.Both are #Lifespan conditions that become visible in childhood 5/11

and last throughout life
2.Both are disabling because of #environmental factors not the conditions per se
3. There is variable awareness of the conditions across child and adult services 6/11

4.Autism, where it runs in families, ought to be understood through the lens of #IntrafamilialCommunication. Child(ren) and parent(s) being diagnosed and supported in different services doesn’t help. 7/11

https://twitter.com/AutieAk/status/1081558157527314433

5.There are HUGE gaps in both services with variable thresholds 4 each leaving service users/carers bewildered, frustrated and exhausted.
6.Exacerbations of beh that challenges leads to ⬆️ restrictions through inpatient admissions which r traumatising and worsen the problem 8/11

(There are quite a few more, but I'll pause for now).
I am certain there are disadvantages too, but those who talk of disadvantages are actually speaking about *obstacles* due to the current nature of service provision. That said, I'm keen to hear of the disadvantages too. 9/11

What next?
At the @YorksHumbODN Task and Finish group, we would welcome wider inputs into our report hence this thread. We would be happy to come over and talk to your group(s) including service users/commissioners/providers in Y&H. Humber's invite is accepted 🙂 10/11

We recognise that there is no ‘single’ right solution to everyone/everywhere.
Any service should aim reduce #IntergenerationalAdversity through realisation of #HumanPotential.
(Tx to @NHSSheffieldCCG where some of my ideas evolved)
Also join the conv at linkedin.com/pulse/lifespan…
11

Important publication. 18 to 24 age group has <50% health checks. Parents often complain of a cliff edge at age 18. No equivalent to the paediatric neurologist who had oversight when under age 18. #LifespanServices for #lifespanConditions? digital.nhs.uk/data-and-infor…