Social communication

Social communication is a term used to describe a child’s ability to understand and interpret social rules, cues and interactions including use of eye contact, gestures, facial expressions to enable them to communicate with others effectively. This also includes a child’s ability to regulate their emotion, making and sustaining friendships and understanding humour and non-literal language.

Autism is a type of social communication difference. Autism is a lifelong developmental disability which affects how people communicate and interact with the world. Children, young people and adults can be diagnosed as Autistic.

Autistic people have differences in the way that they communicate and interact with other people as well as differences in how they process the world around them.

Not all children with social communication differences will be diagnosed as Autistic as there is clear specific diagnostic criteria that needs to be met in order to reach this diagnosis.

Our team sits under the Indigo Pathway and includes Paediatricians, Speech and Language Therapists and Occupational Therapists who specialise in assessing children with social communication difficulties. We work closely with our therapy colleagues, emotional wellbeing team and school nursing.

Early Years (for children not yet in school)

If you or nursery have concerns around your child’s social communication, they may suggest a referral for specialist assessment of their social communication skills. Your child will usually be referred to a speech and language therapist to assess their overall language and communication needs first. Once they have been assessed, the therapist may suggest a referral to the Indigo Pathway.

School Years (up to age 11 years)

You can discuss concerns regarding social communication with your child’s school or therapist. If your child is supported by a Speech and Language Therapist and they recognise differences in your child’s social communication skills, they may suggest a referral to the social communication pathway for assessment.

If school recognise differences in your child’s social communication, they will discuss this with you and ask for consent for a referral to the indigo pathway via school nursing. The school nursing team may contact you to discuss your concerns and either make a referral or signpost you to the appropriate support.

After completing a referral, your child’s referral will be triaged and you will be asked for additional information and questionnaires. If we do not receive this information back, your child’s referral will be discharged and we will require a new referral.

• Family Developmental History (parents only)
• Social Communication Observation Profile (parents and education setting)
• Sensory Profile (parents and education setting)

Following review of this information, if we feel that your child does require specialist assessment of their social communication, they will be accepted to the social communication waiting list for an assessment.

Please note that we do not offer “emergency assessments”.

Please note that children can be referred into the Indigo Neurodiversity Pathway up until their 11th birthday. From their 11th birthday, children should be referred for assessment through The Neurodevelopmental and Learning Disabilities Service (NLDS) provided though NELFT. https://www.nelft.nhs.uk/services-kent-medway/

Assessment:

Children will be seen for a specialist assessment by a multi-disciplinary team which will consist of a Paediatrician, a Speech and Language Therapist (SLT) and/or Occupational Therapist (OT). Your child may be seen by a combination of professionals together or may sometimes be seen in separate appointments.

The assessment will involve the Paediatrician talking to the parent/ carer about your child’s

• early developmental history
• current concerns
• strengths and differences that your child experiences
• current development
• progress in nursery/ school

If any other professionals are currently or have previously been supporting your child please bring copies of any reports with you to the assessment appointment. (This can include Educational Psychology, Speech and Language Therapy and Occupational Therapy)

Whilst you are talking to the paediatrician, your child will spend some time with the therapist(s). Usually, one will interact with your child, and one will observe. Depending on your child’s age and language level this may include

• playing with toys
• looking at books
• engaging in conversation with the therapist

The purpose of this session is to assess how your child communicates, interacts with others and plays with toys with a particular focus on the differences that may be associated with Autism.

Following this, the professionals will ask you to wait in the waiting room and discuss and compare their findings of assessment. The professionals will then give you feedback from the assessment. The assessment may be conclusive however in some situations, the team may require additional information to come to a diagnostic outcome.

The assessment outcomes could be

• Your child may meet criteria for a diagnosis.
• Your child may not meet criteria for a diagnosis.
• Professionals may need to seek additional information to either confirm or exclude a diagnosis- this may mean that the team require more time to gain additional information however this will be explained to you on the day.

If your child has already been seen by a Speech and Language Therapist and/or an Occupational Therapist, they may be seen in a Paediatrician only appointment where the Paediatrician will collate all information to come to a diagnostic outcome considering all the available information.

Following your appointment, you will be sent a full report of your child’s assessment with a diagnosis if appropriate. The report will include recommendations and strategies that nursery/ school and home can use to support your child.

Nursery/ School can use this report to update relevant paperwork with your child’s needs/ relevant diagnosis.

If your child receives a diagnosis of Autism, you will be provided information regarding the EarlyBird (up to age 5years) and EarlyBird Plus (4-9year olds) Programmes. This is a programme that is optional to attend.

Some children may benefit from follow up with our Psychosocial Team if there is a specific identified area of support required. This will be discussed with you in your appointment if appropriate.

We also offer Coffee Afternoons for families who have a child with a diagnosis of Autism. Dates and topics are advertised on our MCH Facebook page

• National Autistic Society 
• Puzzles
• Club Ausome
• Autistic Girls Network
• Young Minds
• MENCAP
• Medway SENDIAS
• EarlyBird Plus – A4 leaflet

All referral forms should be completed and forwarded to medch.childrenscommunity@nhs.net

Contact us on 0300 123 3444 if you have any questions.

School health – referral form