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Service for Complex Autism and Associated Neurodevelopmental Disorders (SCAAND)

How our service can help you

SCAAND (The Service for Complex Autism and Associated Neurodevelopmental Disorders, including Intellectual Disability) is a Specialist CAMHS (Tier 4 Child and Adolescent Mental Health Service) and recognised as a leading UK centre in MH care for children and young people with neurodevelopmental needs. Referrals are accepted from community clinicians only.

We provide an outpatient mental health service for young people with a wide range of neurodevelopmental, neurological and genetic conditions, and we have different clinical pathways to address different referral needs. Young people seen by SCAAND typically have not responded to community interventions or there have been challenges in understanding the reasons difficulties have developed or persisted; and this is often due to young people having varied and severe needs.  Examples of our clinical pathways include specialist opinions on differential diagnosis and support for emotional and behaviour difficulties in the context of Autism Spectrum Disorder (autism), Intellectual Disability (ID), ADHD, Language Disorder, brain injury, epilepsy. We offer specialist assessment and interventions. SCAAND consists of a multi-disciplinary team of CAMHS clinicians and an education specialist. We have close links with other teams within the Trust, King’s Health Partners and the Institute of Psychiatry Psychology and Neuroscience (IoPPN) at Kings College London, and have clinical and research expertise at an international level.

Referrals to SCAAND must be made by community CAMHS or community Paediatrics with reference to the local pathway. More specifically:

  • referrals from Paediatrics will be accepted where the appropriate local pathway sits with Paediatrics
  • where the referral question relates to a CAMHS pathway, referrals must be made by community CAMHS or paediatric referral must be made with the knowledge and agreement of local CAMHS.

  • Service Borough Covers: National (Child and Adolescent services) Treatment type: Outpatient
  • Contact the service

    Site Location: Maudsley Hospital Email: SCAANDService@slam.nhs.uk Phone Number: 07858 686540

    Note: this contact number is for new referrals. Once a referral is accepted, new details will be provided.

  • Address: Michael Rutter Centre
    Maudsley Hospital
    De Crespigny Park,
    London,
    SE5 8AZ
  • Business Hours/Visiting Hours: Monday to Friday, 9am to 5pm
  • Other essential information

  • Conditions: Autism, aspergers, learning difficulties, intellectual difficulties, neurodevelopmental disorders, complex mental health, Autism; Autism Spectrum Disorder; Autism Spectrum; ASD; autistic; Intellectual disability; neurodevelopment; neurodisability; ; learning disability; LD; ID; global developmental delay; neuro; attention deficit hyperactivity disorder; ADHD; hyperkinetic disorder; Tourette’s syndrome; conduct disorder; challenging behaviour; aggression; emotional dysregulation; sensory processing; sensory integration; neuropsychiatry; neuropsychology; behavioural problems; epilepsy; feeding; eating; sleep; neural tube defect; Prader-Willi syndrome; chromosome abnormalities; genetic disorders; brain related disorders; acquired brain injuries; ABI; conversion disorder; psychogenic seizures; non-epileptic; SCAAND; CAMHS; NDT; LDT; IDT; ARD; MHID

More info

SCAAND provides a multi-disciplinary team who work closely together to ensure that the mental health (emotional and behavioural) needs of the child and their family are assessed and managed in a comprehensive manner. Service development and delivery are undertaken in close partnership with children and young people, their families and colleagues from community services, including community mental health services, paediatrics, social care and education. Typically, young people referred to SCAAND will have already accessed care and support via the appropriate local (community CAMHS or Paediatrics) autism pathway and SCAAND will review existing information to inform our specialist assessments and care.

A comment on language:

This webpage should be a useful source of information for anyone who may come into contact with SCAAND. However, the language used to refer to autism varies from person to person. In clinical practice, we  ask service users what their preferences are. For this webpage, we use the term ‘autism’ and use person-first language (e.g. young person on the autism spectrum).

Our clinical pathways are described below.

SCAAND aims to meet the needs of young people with a range of neurodevelopmental presentations. All young people referred to SCAAND will be allocated to an appropriate assessment pathway or allocated for consultation to the professional network. Following these first contacts, if indicated, the young person and their family will be allocated to an intervention pathway. SCAAND has different funding routes, which are described under the Care Options tab.

Examples of presenting difficulties for young people seen in SCAAND:

  • lack of diagnostic certainty (whether the young person has autism or a co-occurring condition) despite the local assessment pathway being accessed
  • Very withdrawn and isolated young people on the autism spectrum
  • Severely distressed young people with neurodevelopmental difficulties
  • Aggressive or self injurious behaviours in young people with intellectual disability
  • Young people out of education due to mental health (emotions or behaviour)
  • Anxiety and selective mutism
  • All young people with Prader-Willi Syndrome in the UK
  • Young people with neurodevelopmental diagnosis and additional symptoms that cannot eb explained by a physical condition (e.g. non-epileptic seizures)
  • Cognitive, emotional or behavioural difficulties in the context of neurological conditions

This section outlines some of the main assessment and intervention pathways.

 

ASSESSMENT PATHWAYS

  • Specialist Multi-Disciplinary Assessment: SCAAND provides tailored assessments from our multi-disciplinary teams to address referrals about diagnostic uncertainty and differential diagnosis as well as co-occurring conditions. Examples include assessment of social communication where clinicians remain unclear if the young person has autism after initial assessment (for example due to emotional or behavioural difficulties, disruption to care in early life, selective mutism); assessment of co-occurring conditions in young people with recognised Intellectual Disabilities, or where neurodevelopmental symptoms or impairments are less obvious (for example in girls and young women, or in non-verbal young people)
  • Second Opinion Assessment: Where local professionals feel that a routine second opinion neurodevelopmental assessment is indicated (for example due to subtle symptoms or impairments being increasingly apparent over time), we offer a streamlined second opinion pathway to re-assess neurodevelopmental diagnoses (including autism, ADHD, Intellectual Disability)
  • Prader-Willi Service (PWS) assessment: This service provides multi-disciplinary assessment for young people with confirmed diagnosis of PWS of all cognitive abilities and behavioural or mental health problems associated with PWS, including autism, ADHD, anxiety, psychosis and hyperphagia.
  • Sensory Assessment & Recommendations: There is an increasing focus on the importance of the sensory differences and experience of autistic young people, and SCAAND has a team of occupational therapists trained in sensory integration, who are able to complete sensory and motor assessments with young people and their families, with the aim of developing a set of recommendations. Sensory Assessments are increasingly recommended by CETR (Care Education and Treatment Reviews) for autistic young people, and this is one trigger for a referral to our Sensory Assessment pathway.
  • Assessment of Mental Capacity and Competence: SCAAND offers assessment of mental capacity and competency of young people with intellectual disability.

 

CONSULTATION TO PROFESSIONALS

  • Consultation to Professionals: Where young people have identified needs and there is an existing professional network in place, SCAAND can offer a consultation to professionals to support local care planning and decision making, as well as to consider whether further specialist intervention directly from SCAAND is indicated.
  • Consultation may be provided as a one-off contact, or when indicated as appropriate, the assessment or intervention pathways may be activated within SCAAND

 

INTERVENTION PATHWAYS

  • Specialist Multi-disciplinary Intervention: MDT interventions are available from Psychiatry (e.g. medication), Psychology and behaviour support (e.g. adapted Cognitive Behaviour Therapy, parent/carer consultations on behaviour management), Occupational Therapy (e.g. intervention to increase participation and meaningful occupation, sensory informed interventions), Speech and Language Therapy (selective mutism intervention, emotional literacy skills), Intellectual Disability Nursing and Education (advice and support). Young people seen in SCAAND may be considered for group interventions for young people and parents. Please see the Interventions tab for more detail.
  • Psychoeducation Group for Girls with Autism: This includes a group for young people and a parallel parent group is facilitated alongside the Girls’ Group to enhance parental understanding of autism in their girls. Referrals are accepted from SLAM Boroughs (Croydon, Lambeth, Lewisham, Southwark) and other National Specialist CAMHS teams for a psychoeducation group focusing on specific information about autism in girls.

 

If this was not what you were looking for:

This page relates to the outpatient service to for young people who have varied and multiple difficulties in the context of neurodevelopmental conditions across England.

We work closed with the AID-IIT service, who provide intensive and outreach support for young people (resident in Greater London) at imminent risk of CAMHS inpatient admission: Autism and Intellectual Disability – Intensive Intervention Team (AID-IIT)

Interventions

What we offer: Assessments and/or interventions offered will vary depending on the clinical pathway the young person is seen under (please see details under ‘More Info’).
Detailed understanding and formulation of difficulties, including:
  • Psychiatric formulation and diagnosis
  • Cognitive and neuropsychological assessment
  • Functional assessment of behaviour problems
  • Motor, sensory and adaptive skills assessment
  • Social communication and language assessment
  • Physical examination with an emphasis on neurological examination
  • Psychoeducation for parents and the young person, including individualised psychoeducation and specialist groups (such as the Autism Girls Group, )
  • Psychoeducation for other parts of the professional network, including teachers and community CAMHS clinicians

 

Individually tailored care planning and interventions from a multi-disciplinary team:

  • Evidence based psychological therapies, such as cognitive behavioural therapy (CBT), adapted for the specific neurodevelopmental profile of the young person
  • Functional assessment of challenging behaviours and intervention plans
  • Behavioural management (e.g. carer-led behaviour change interventions)
  • Medication management and advice in collaboration with local prescriber
  • Recommendations and interventions based on sensory integration theory
  • Specialised speech and language intervention
  • Educational advice and consultation
  • Individualised emotional literacy and emotional regulation skills training
  • Family work adapted for young people with neurodevelopmental differences or intellectual disability
  • advise about risk management
  • transitional planning in collaboration with local services
  • Care planning and liaison with local services; including attending relevant network meetings (where indicated)

Eligibility criteria

General Eligibility Criteria

  • Children and young people below 18 years of age
  • Referral from a community clinician in the relevant local pathway. Typically, this would be a CAMHS professional for most assessment and intervention requests but may be a Community Paediatrician when the associated pathway is within Paediatrics.
  • Evaluated by the appropriate community assessment or care pathway and felt to need an expert service for assessment and/or management of mental health problems (emotional or behavioural) in the context of neurodevelopmental diagnoses
  • Young people must remain open to their community team (typically CAMHS) throughout the involvement of SCAAND
    • Where a referral has been made by Community Paediatrics, Paediatrics must remain involved and be willing to refer to the community CAMHS service if needs are identified that would require this
  • It is advised that all referrals are made with the knowledge and agreement of community CAMHS, given that SCAAND is a specialist child and adolescent mental health service.

Specific Eligibility Criteria

  • NHS-England Complex Autism services: the young person has already accessed the appropriate local autism assessment or intervention pathway, and the referral question relates to clinical complexity (e.g. lack of improvement despite interventions or challenges for professionals in formulating the difficulties).
  • Any referrals not meeting the above NHS-E criteria will be considered on a CCG funding route
     

We do not accept referrals in the following situations (Exclusion):

  • Primary care (GP) referral
  • Self-referral from a young person or parent/carer
  • Children and young people have not accessed the appropriate local pathway
  • The young person is not currently open to their community Tier 3 CAMHS or child health services
  • The young person is 18 years or older (or the initial assessment would not be completed before their 18th birthday)
  • The request is for direct inpatient assessment and management for young people at risk of admission, or who have been admitted to inpatient units

Outcomes

Our outcomes include:

  • To reduce specific, impairing mental health symptoms including ADHD, anxiety and depression symptoms where these are present
  • Reduced challenging behaviours including aggression, self-harm or inappropriate behaviours
  • To help facilitate development of strategies and environmental adaptations to support the child in different aspects of their life, such as school and leisure activities
  • To develop a holistic formulation of the young person’s strengths and difficulties
  • Better understanding (for the young person, carers and network) of diagnoses, transdiagnostic traits and behaviours
  • Greater parental confidence in behaviour support and strategy use
  • Better emotional literacy and regulation skills, leading to fewer emotional outbursts
  • Improved understanding of sensory processing behaviours and needs
  • Better participation at a developmentally appropriate level (in education or the community)
  • To help optimise the young person’s ability to communicate or be understood by others
  • To improve a young person’s ability to understand and manage social situations
  • Increased functioning where feasible including optimised academic attainment and adaptive skills
  • Improved wellbeing and quality of life for the young person and/or the family

Care Options

As SCAAND provides specialist CAMHS input for a wide range of neurodevelopmental and neurological conditions, we have a number of different funding routes and care options.

NHS England Funding Route (funded provided by national body)

This funding route is available to young people with a Complex Autism presentation, and is used when the General Eligibility criteria are met and the young person has already accessed the appropriate local Autism assessment or intervention pathway, and the referral question relates to clinical complexity (e.g. lack of improvement despite interventions or challenges for professionals in formulating the difficulties).

Care option: Outpatient assessment (NHS-E funded)
Unit: 1 assessment + up to 3 additional contacts (for care planning, management or extended assessment)
Description: Assessment: A full multidisciplinary assessment to address the specific referral question. This may include diagnostic assessments, assessments of mental state or assessments to inform intervention planning. Typical components of these comprehensive assessments include: 

  • Thorough review of previous reports 
  • Developmental and Psychiatric history with parents/carers
  • Standardised assessments with the young person
  • Physical examination
  • Mental state assessment 
  • Analysis of questionnaires
  • A comprehensive report summarising the above in detail 
  • The follow up contacts may include:

  • A direct feedback appointment with the family (and young person where appropriate) to which the referrer is invited. This includes feedback of the findings and outcome, as well as initial psychoeducation about the formulation
  • An additional extended interview or specific assessment
  • A school observation

Care option:  Consultation to Professionals (NHS-E funded)
Unit: Per discipline, per contact
Description: Consultation is offered to the professional network for case discussions where young people present with severe and varied difficulties which are not improving with local care plan implementation. Typical components of these consultations to professionals include: 

  • Thorough review of previous reports provided with the referral
  • Discussion of the current difficulties and care plan
  • Recommendations about future care plans
  • A report summarising the above

Care option: Outpatient Treatment (NHS-E funded)
Unit: Per discipline, per contact
Description: All forms of multidisciplinary treatments are funded in the same manner, in units of up to one hour per professional.

CCG Funding Route (funding provided by community services)

This funding route is available to young people who do not meet criteria for the Complex Autism (NHS-E) finding route as described above. This includes young people referred for Intellectual Disability or other neurodevelopmental needs without an Autism Diagnosis.

Care option: Outpatient assessment (CCG route)
Unit: 1 assessment + up to 3 follow up contacts
Description: Assessment: A full multidisciplinary assessment to address the specific referral question. This may include diagnostic assessments, assessments of mental state or assessments to inform intervention planning. Typical components of these comprehensive assessments include: 

  • Thorough review of previous reports 
  • Developmental and Psychiatric history with parents/carers
  • Standardised assessments with the young person
  • Physical examination
  • Mental state assessment 
  • Analysis of questionnaires
  • A comprehensive report summarising the above in detail 

The follow up contacts may include:

  • A direct feedback appointment with the family (and young person where appropriate) to which the referrer is invited. This includes feedback of the findings and outcome, as well as initial psychoeducation about the formulation
  • An additional extended interview or specific assessment
  • A school or home observation
     

Care option: Outpatient Treatment (CCG funded)
Unit: Per discipline, per contact
Description: All forms of multidisciplinary treatments are funded in the same manner, in units of up to one hour per professional. This includes consultation to professionals.

Our experts

Psychiatry

Prof Emily Simonoff, Professor of Child and Adolescent Psychiatry - read more

Dr Sarah H Bernard, Consultant Psychiatrist Child and Adolescent Intellectual Disability - read more

Dr Eleni Paliokosta, Consultant Child and Adolescent Psychiatrist - read more

Dr Elaine Chung, Consultant Child and Adolescent Psychiatrist

Dr Nicoletta Adamo, Consultant Child and Adolescent Psychiatrist - read more

Dr Kenneth Lee, Consultant Child and Adolescent Psychiatrist

Psychology and Behaviour Therapy

Prof Tony Charman, Honorary Consultant Clinical Psychologist - read more 

Dr Kevin Tierney, Consultant Clinical Psychologist - read more

Dr Sarah Thompson, Principal Clinical Psychologist - read more

Dr Sarah Carman, Principal Clinical Psychologist - read more

Dr Matthew Hollocks, Senior Lecturer/Clinical Psychologist - read more

Dr Jennifer Breen, Clinical Psychologist - read more

Natasa Momcilovic, Clinical Behaviour Therapist - read more

Dr Rachel Kent, Highly Specialist Clinical Psychologist - read more

Dr Nikolaos Sarras, Clinical Psychologist

Dr Julia Cook, Senior Lecturer/Clinical Psychologist read more

Dr Kirstie Stanworth, Clinical Psychologist

Dr Sophie Robbins, Clinical Psychologist 

Dr Jeidi Lee, Clinical Psychologist 

Occupational Therapy:

Tina Bang-Andersen, Specialist Occupational Therapist - read more

Abi Hooper, Occupational Therapist – read more

Speech and Language Therapy: 

Gillian Davies, CAMHS Practitioner / Specialist Speech and Language Therapist - read more

Charlie Hollins, Specialist Speech and Language Therapist - read more

Nursing: 

Brodie Heath, Clinical Nurse Specialist / Learning Disabilities Nurse

Educational Specialist: 

Dr Laura Wilby, NAS Specialist Autism Education Lead - read more

Teaching and Training

SCAAND is able to offer bespoke training at a cost. This includes both general training sessions and bespoke training packages. Please contact the service coordinators by emailing SCAANDservice@slam.nhs.uk

Recent examples of training provided by SCAAND including:

  • The Mental Health of Intellectual Disability team has provided Master Classes and half day training sessions aimed at parents/carers and other professionals
  • Contributions to Train-the-trainers national programme to improve knowledge of Autism among CAMHS inpatient staff
  • Training to the South London Partnership Crisis Line staff on a range of topics including communicating with and responding to distress in young people with autism.
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