Thread by @IrwinGill

A thread on the Assessment of Need: the statutory process by which children whose parents have concerns about potential disability can be assessed.

The process has recently been changed by the HSE in a manner that is frankly appalling.

Explanation: (1/n)

https://twitter.com/psychpolis/status/1350809835319791616

Parents might apply for AoN for a child due to concerns about development- in my clinic, the commonest reason is queried autism.

Previously, the AoN involved a team (usually physio, OT, SLT, psychology) assessing a child to get insight into the nature of their difficulties (2/n)

The team conducted a series of assessments, usually taking several hours each, and produced a report giving a detailed analysis of how a child is doing, what the causes of their difficulties might be, suggesting a diagnosis if appropriate, and giving advice on next steps (3/n)

Based on this, a child might be entitled to additional support in the classroom or financial supports. Medical investigations for individual diagnoses could also be arranged.

Function is more important than diagnosis, but in our system diagnoses get you support.

(4/n)

Legally, the AoN must be completed within 6 months of referral.

In many parts of the country, including Dublin, this almost never happens.

91% of children do not get their assessments on time. (5/n)

irishexaminer.com/news/arid-4018…

The HSE get sued for this. A lot.

In Jan 2020, the HSE produced a new Standard Operating Procedure for AoN.

It reduces the previous assessment involving multiple professionals to a single assessment lasting a maximum of 90 minutes, regardless of the child's needs. (6/n)

The reports will indicate if a child has a disability or not, but due to the limited scope do not allow for any insight into diagnosis or next steps.

This is left for community disability teams, whose assessments are not subject to legal time limits (so the HSE cannot be sued).

In its current form, the SOP appears designed to reduce legal liability than out of any interest in meeting the needs of children. The HSE is aware of this, having been repeatedly told so, but has persisted with it anyway. (8/n)

aoti.ie/news/Joint-Sta…

The correct course of action to tackle waiting lists is to resource disability appropriately.

Instead, the HSE have reduced the AoN to a meaningless box ticking exercise which children must go through before being moved to another waiting list with no legal time limit. (9/n)

This course of action is an open declaration of contempt for the rights of children with disabilities.

It is apparently more important that statutory obligations are "met" on paper than that children's needs are actually met in real life.

This is a State apology in waiting.

@AnneRabbitte @DonnellyStephen @rodericogorman @josephamadigan @psychpolis @GarNob #disability #earlyintervention #rehabilitation #paediatrics

@OCO_ireland