Neurodevelopmental Diagnostic Assessment

We recognise that individuals, families and professionals may prefer different language when describing a child or young person's experiences, strengths and areas where support may be helpful. Within the Salford Neurodevelopmental Approach, we aim to take a strengths-based and neuroaffirming approach, recognising and valuing each child's unique profile of abilities, interests and ways of experiencing the world.

However, during some parts of the assessment process, we may use terms such as 'needs' or 'difficulties'. This is because neurodevelopmental diagnostic assessments are guided by specific clinical criteria, which require us to understand not only a child's strengths but also the areas where they may experience challenges or require additional support.

The use of this language is not intended to define the child or young person, but rather to help us gain a complete understanding of their profile and identify the support, adjustments and resources that may enable them to thrive.

Neurodevelopmental assessments aim to build a comprehensive understanding of a child or young person's strengths, differences and support needs. As part of the assessment, we explore areas such as social communication, interaction, attention and concentration, alongside the child's interests, abilities and positive qualities. We consider whether any differences in these areas may be creating barriers in everyday life or whether additional support, understanding or adjustments may be helpful. This information helps us determine whether the child's experiences align with recognised diagnostic criteria, while maintaining a focus on identifying the support and opportunities that will enable them to flourish.

A neurodevelopmental diagnosis can help children, young people and families better understand their strengths, differences and support needs. The assessment considers whether a child's experiences fit recognised diagnostic criteria and can provide a helpful framework for understanding how they experience the world.

Support should be based on a child or young person's needs, not on whether they have a diagnosis. In Salford, support and appropriate adjustments can and should be accessed as soon as a need is identified. A diagnosis does not automatically lead to additional services, but it may help to inform a shared understanding of a child's strengths and areas where support may be helpful.

Referrals to the neurodevelopmental pathway are usually made when there are questions about a child or young person's social communication, interaction, attention or activity levels. As part of the assessment, we consider whether their experiences are consistent with recognised autism and/or ADHD diagnostic criteria.

Children and young people may also have strengths, differences or support needs in other areas, such as learning, motor skills, speech, language and communication. Where these needs are identified, support can often be accessed through the most appropriate specialist service alongside, or independently of, the neurodevelopmental assessment process.

Before requesting a neurodevelopmental assessment, it is important to consider why an assessment is being sought and what information it may provide for the child or young person and their family.

Please consider the following:

• Parent/carer choice: Families may have different views about seeking a diagnostic assessment. While professionals may notice characteristics associated with neurodevelopmental differences, the decision to pursue an assessment should be made in partnership with the parent/carer and, where appropriate, the young person.

• The child or young person's views: Young people, particularly those of secondary school age, should be involved in decisions about assessment. Their views and consent should be sought wherever possible and respected.

• Support should not wait: Children and young people should have access to appropriate support and reasonable adjustments as soon as needs are identified. It is helpful to consider what support has already been provided and its impact before making a referral.

• Provide clear examples: Referrals are most helpful when they describe a child's strengths and areas where support may be needed, using real-life examples of what has been observed. The referral form will guide you on the information required.

• Impact on everyday life: Assessments consider whether a child's experiences are having a meaningful impact on their day-to-day life across settings such as home, education and relationships. Including examples of this impact helps provide a clearer picture of their needs.

For information about inclusive support and reasonable adjustments, please refer to the Supporting SEND young people page.

Requests for a neurodevelopmental assessment are most helpful when they are completed by people who know the child or young person well. This is often a joint process involving parents/carers and professionals from the child's educational setting, allowing a fuller picture of the child's strengths, experiences and support needs to be shared.

While GPs play an important role in a child's overall healthcare, they may not have regular opportunities to observe how a child functions across their daily environments. Information from those who see the child or young person more frequently, such as family members and education staff, is therefore often the most helpful when considering whether a neurodevelopmental assessment may be appropriate.   

It is common for children and young people to show different strengths, behaviours and support needs in different environments. There can be many reasons for this, and these differences are an important part of understanding a child's individual profile.

When completing a referral, examples from both home and educational settings can help the team understand the child's experiences more fully. Even if concerns are not seen in every environment, it is helpful to share both areas of strength and any areas where additional support may be beneficial.

If there are different views or limited evidence available, parents/carers may find it helpful to:

• Seek advice from universal services, such as the 0-19 Service or Early Help.

• Discuss concerns with professionals already involved with their child, such as a Speech and Language Therapist, Portage Worker or Early Help Practitioner.

• Contact SIASS (Salford Information Advice Support Service Facebook page) for information and guidance about support available to children and young people.

We encourage parents/carers and educational settings to work together wherever possible, sharing observations and agreeing on approaches that support the child or young person's needs and wellbeing.

What age can a child be referred to the Neurodevelopmental Assessment Pathway?

Children can be referred to explore differences in social communication and interaction from two years six months of age. Before this age, a period of support and intervention is usually recommended, in line with national guidance.

Referrals to explore attention, concentration and activity differences (ADHD) can be made from six years of age. It is expected that appropriate support strategies have been tried first.

Important: If a child under two years six months is experiencing a continued loss of previously acquired developmental skills, a direct referral to the Community Paediatric Service should be made.

What is considered during triage?

When a referral is received, the triage team considers whether a neurodevelopmental assessment is likely to be helpful. The team looks at information about the child or young person's:

• Social communication and interaction

• Attention, concentration and activity levels

• Everyday functioning, including learning, independence, participation and wellbeing

The team uses recognised clinical criteria to guide decision-making and looks for evidence that any differences are having a meaningful impact on day-to-day life.

The team may also consider additional factors such as:

• Mental health and emotional wellbeing

• Challenges within education or attendance at school

• Family or placement stability

• Involvement from specialist services

• Speech, language and communication needs

• Whether ADHD medication may be considered as part of future support

The most helpful referrals provide clear examples of the child's strengths, experiences and support needs, along with information about how these affect everyday life across different settings.

There is no perfect way to complete a referral. The most helpful referrals provide a clear picture of the child or young person's individual strengths, experiences and support needs.

The referral form is designed to gather information from the people who know the child best and includes their views and experiences. Specific, real-life examples are particularly valuable, as they help the triage team understand the child's day-to-day experiences and any support that has been helpful.

Referrals do not need to be lengthy. Clear summaries, short descriptions and bullet points can often be the most effective way to share information. The key is to provide meaningful examples that help bring the child's unique profile to life.

Approved AI tools may be useful in assisting with structuring information or improving grammar and readability. AI, however, provides generic statements. They often do not provide a personal description of the individuals strengths and areas of need. As we learn more about AI we are beginning to understand that it may:

• Over-pathologise behaviours

• Misinterpret cultural communication differences

• Reinforce stereotypes

• Produce gender-biased descriptions

We have recently seen an increase in the use of AI in neurodevelopmental assessment requests. Its use makes it difficult to determine whether a neurodevelopmental assessment is required or not. Referrals are often returned as a result. The new referral form has been structured to make providing the information as simple as possible.

Yes. Children and young people should receive support as soon as a need is identified and should not have to wait for an assessment or diagnosis.

When making a referral, it is helpful to include information about any targeted support that has been provided, what was tried, and how the child or young person responded. This helps the triage team understand their needs and the support that may be helpful going forward.

Quality First Teaching, reasonable adjustments and other ordinarily available inclusive support are expected as part of everyday practice. Referrals should focus on any additional targeted support or interventions that have been put in place beyond these universal approaches.

Yes you can. We do ask referrers to carefully consider the reasons for making the request and whether a pathway the child/young person is currently accessing is meeting their needs. For example, pathways such as EHCP and Child in Need pathways will mean a range of professionals are currently involved. Consideration should be given to why there is a need for a neurodevelopmental assessment and the level of evidence the referrer or multi-professional team has indicating there is a need for a further assessment.  

The triage team consider each case on an individual basis. In some instances, referrers may be signposted to another pathway if this seems more appropriate at that point in time. This does not mean future referrals will not be accepted, it may be another process needs to be completed prior to a request for a neurodevelopmental assessment. This is so a clear understanding of the circumstances, what a child/young person may need and why the professionals feel a neurodevelopmental assessment is required is obtained.    

If a neurodevelopmental assessment is recommended, parents and carers can attend an Understanding the Diagnostic Assessment Process session (if they have not already done so). Please go to the overview of support offer page for further information. This session explains what to expect and provides information about the assessment process.

The text below outlines the main stages of the assessment process. While there are some key steps that most families will follow, the assessment may look slightly different for each child or young person to reflect their individual strengths, experiences and support needs.

Triage and outcome decision

• Referrals are considered by senior clinicians

• The information is considered in line with nationally recognised criteria

• A decision is made whether a child or young person requires a neurodevelopmental assessment

• An outcome email is sent within seven days of the referral being received.

First appointment

• Families are invited to ‘Understanding the Assessment Pathway’ session

• An appointment is sent to the family by the relevant service

• In the first appointment the clinician will review your child’s development, complete any assessments

• A plan will be agreed on the next steps

Evidence gathering

• Further assessments may be required e.g. your child may need to see a Speech and Language Therapist or specialist nurse as part of the assessment

• A visit to your child’s setting may need to be completed

MDT diagnostic panel

• Once all the evidence is gathered the clinician will discuss the MDT panel

• The clinician will present the evidence that they have

• The panel will then decide whether this evidence meets the clinical threshold for a diagnosis to be given

• The clinician will inform you of the outcome of this discussion and whether a diagnosis has been given or not

Post diagnosis

• The clinician will offer you a follow up appointment so you can ask any questions

• During this appointment you will be signposted to other support

• The assessment process is completed