The Fylde Coast - School Age Neurodevelopment Pathway

The Neurodevelopment Pathway team is made up of Paediatric Consultants, School staff,
SENCO’s, Speech and Language Therapists, the pathway Clinical Nurse Lead, Psychologist
and the pathway admin team and navigators. The views of both parent/carers and staff
from school are important in helping to understand the needs of your child. Once all of the
information is available, professionals will come together and meet to discuss and identify your child's needs.

Your child has been referred because you and a professional from health or education have
noticed that your child has persistent difficulties affecting their everyday life in a number of
different settings. You might have raised these concerns initially, or school may have spoken
with you about their observations. All children must be referred by a professional to the
Neurodevelopment Pathway, this might be a paediatrician, child and adolescent psychiatrist,
SENCO, educational psychologist, clinical psychologist, speech therapist, school nurse,
CAMHS practitioner or GP.
The professional who wishes to make a referral will ask for your consent to do so. They
will also ask for your consent to allow information to be shared between other services, for
example different health services and school. We also get consent to inform the SEND team
and educational psychology for Blackpool.

On some occasions the referral is not accepted; in these cases the person who has made
the referral is notified about this and the reason why it has not been accepted. They will then
contact you to let you know.

The pathway is a need’s (or problem) led integrated, multi-agency pathway for children
and young people who are causing parental and professional concern and who require
multiagency, specialist consideration of their neurodevelopment needs
Once accepted onto the ND Pathway there are four main stages along your journey, although
the assessment may be stopped at any point along this journey should the Pathway Team
receive enough information to make a decision:
Phase 1 - Understanding the Need
Phase 2 - Seeing the Paediatrician
Phase 3 - Further information
Phase 4 - The Multi-Agency Needs Led
Parent / carers will receive information & support throughout the journey.

The pathway journey is always focussed on the needs of the child or young person. It is
possible that at any point it will be identified that the best way to support the needs is outside
of the pathway, based on the evidence gathered. As such, not all children will complete all four
stages. It is also possible that the pathway may be paused if other priorities, and problems are
identified and need addressing. For example, mental health or wellbeing needs or educational
changes (such as a new school placement).

The first phase of the pathway is to begin understanding your child’s needs. The pathway
Clinical Nurse Lead will contact you by telephone to explain the pathway process, answer
any of your questions and identify what initial support could be offered to your child and your
family. Information will then be gathered from yourself and from professionals.
Information from home - A questionnaire will be sent to you to complete detailing your
observations of your child’s strengths and difficulties when they are at home. You are also
asked about previous problems, any assessments your child may have had and early
development. Finally, there are some screening tools that are checklists recognised across the
country as useful in gathering specific information. Please let the Clinical Nurse Lead know if
you need help to complete these forms.
Information from school - A similar questionnaire will be sent to your child’s school to get
a better understanding of their strengths and difficulties whilst in a school setting. They will
also detail any academic (key stage) results and may include formal information regarding
education.
They will also be asked to complete recognised National screening tools in order to help the
team understand your child’s needs.
SENCO - specific information will also be gained from the school SENCO detailing their
observations of your child’s strengths and difficulties. Evidence of any approach/adjustments
already made by the school (referred to as the graduated approach) would also be included.
Other relevant information It is possible that your child may have already been seen by other professionals prior to
entering the neurodevelopment pathway. Reports from speech and language therapists,
educational specialists, occupational therapists, CAHMS and mental health professionals or
previous medical consultations will all be gathered to allow a complete picture of their needs.
 

Once all the initial evidence has been gathered, the neurodevelopment team combine this
with a full history from your child’s hospital and community records and arrange for you to see
a paediatric consultant who has expertise in assessing neurodevelopment needs. They will
review all the evidence prior to meeting you.
In this meeting, they will ask about your concerns, try and explore gaps in the information
gathered or clarify key points. They will also assess your child’s neurodevelopment skills
through interaction and conversation or sometimes ask the parent/carers questions.
At the end of this consultation, it is possible that sufficient evidence would have been
gathered to identify a best way forward to meet your child’s needs and in discussion with the
Paediatrician you will exit the pathway at this point. If this happens the team will also contact
you after your appointment to discuss what support may be available to help and support you
and your child; this could be from the NHS or one of our Partner services.

The Paediatrician may feel that further information and multi-agency information is needed to
better understand the difficulties that your child is experiencing. They could therefore refer for
support or information from others, including:
• Speech & Language Therapist
A speech & language therapist with neurodevelopment expertise. They will assess your
child’s social communication strengths and difficulties. As this needs a child to interact, it
is possible this could take more than one appointment or even in some cases need to be
tried in different locations. It is always individualised to achieve the information needed to
better understand the needs of your child.
• Other specialities that may need to be involved
CAMHS, clinical psychologists, educational psychologist, and specialist teaching services
are some of the range of services that may be asked to provide information to the multiagency
needs led discussion meeting.
 

The multi-agency needs led discussion meeting will occur once all the relevant multi-agency
information is complete. This meeting involves at least the following groups:
• A paediatrician with expertise in neurodevelopment
• A speech and language therapist with expertise in neurodevelopment
• An educator with understanding of special educational need (this could be a specialist
teacher or your school SENCO)
• The Neurodevelopment team staff, including clinical lead nurse and administrative teams
Additionally, any and all relevant professionals are invited to give their own information,
including:
• Any school staff best placed to present and discuss the information
• CAHMS practitioners
• An educational psychologist or clinical psychologists
They will discuss this information, identify your child’s strengths and difficulties. They will
also work together to try and produce a clear plan as to how your child’s needs may be best
supported moving forward.
It is also common that collectively they will agree on other actions or evidence that needs to
be collected to better support and understand your child’s needs. This would be arranged and
your child then brought back to panel at a later date.
The professional group may also find significant evidence of a neurodevelopment condition
and then apply a nationally recognised diagnostic tool to assess the evidence against.
One example would be the Diagnostic Service Manual (DSM, current version V) criteria for
assessing children for Autism. This can then allow clarification as to whether your child meets
the criteria for diagnosis or whether they do not.
In all cases, your child’s needs are at the centre of the discussions. An agreement on the
best ways to support these needs is important, regardless as to whether a child is assessed
as having a neurodevelopment permanent diagnosis or not. Suitable support from a range of
organisations will be considered.
 

At whatever point on the pathway, outcomes can be clarified. A further meeting will be
arranged with the consultant to discuss this. At this appointment the Consultant will go through
the information, talk about your child’s strengths and difficulties, and tell you the outcomes and
plan.
On the occasions when it is decided to wait for a set period of time and then review your child
again, this will be discussed with you. This could be because the information they currently
have isn’t conclusive and the group feel that a period of waiting and a further review is
required before a final decision is made on both understanding the needs and what methods
are best to meet them.
The Clinical Nurse Lead will also contact you after your appointment to discuss what support
may be available to help you, in order for you to help and support your child; this could be
from the NHS or one of our Partner services. This support would be available for you with or
without a diagnosis – it is recognised by the pathway team that whilst a diagnosis may not
always be made, to have progressed along the pathway is evident that there are some needs
and support your child and family will need.
 

Triage

• Referral received - accepted or rejected
• Families notified if accepted and Clinical Lead Nurse will telephone
• Professional that referred notified if rejected with rationale, information and support

Phase 1

• Information requested from home, SENCO, school & other specialties already involved with your child.
• Once all received combined with any NHS hospital & community history

Phase 2

• Appointment with the Paediatrician
• Sufficient evidence may support an exit of the pathway at this point.

Phase 3

• Other professional may be asked to see your child and provide further information

Phase 4

• Multi - Agency needs led group comes together to discuss all of the information
• A decision will be made how all agencies can work together to better support
  your child
• A plan will be made to demonstrate show this will happen

Outcomes - all phases

• Further appointment with the Paediatrician to go through the decision making
  and plan from the multi -agency needs led discussion meeting
• Clinical Nurse Lead will contact you to further explore ways to help you to
  support your child

Support - all Phases

• Local Offer
• Contact the Pathway Team
• Signposting to help and support services within the NHS and our Partners

Throughout the Neurodevelopment Pathway process, you may have questions about how
your child will be supported before, during and after the pathway. It is important to recognise
that the pathway itself does not specifically offer any therapies or treatments. Rather, it allows
complex needs to be considered by multiple agencies working together. As such, it is almost
certain that most children referred will already have support occurring from agencies through
education or the community.
Every Local Authority has a ‘Local Offer’. This is information of every service and organisation
that can support children with Special Educational Needs and Disabilities (SEND) and their
families.
If you live in Fylde or Wyre search for the ‘Local Offer’ at www.lancashire.gov.uk
If you live in Blackpool search for the ‘Local Offer’ at Blackpool local offer - FYi Directory