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Referral
Plymouth Autism Spectrum Service – Assessment Team (PASS-AT)
Key Messages
The Plymouth Autism Spectrum Service (PASS) offers three services:
1) diagnostic assessments for adults without Learning Difficulties
2) advice, support and signposting
3) training and consultation to professionals.
This guidance is for referrers whose patients would like an assessment of Autism Spectrum Condition from the PASS Assessment Team.
We accept referrals from clinicians (GP or other professionals) for autism assessments. We do not accept self-referrals.
We are unable to manage any mental health needs your patient may have whilst they are waiting for an Autism assessment. If you think that your patient needs support regarding their mental health, please ensure they access the appropriate services whilst waiting for an assessment.
Autism is a lifelong neurodevelopmental condition, the core features of which are persistent difficulties in social interaction and communication and the presence of stereotypic (rigid and repetitive) behaviours, resistance to change or restricted interests. The way that autism is expressed in individual people differs:
- At different stages of life,
- In response to interventions
- With the presence of coexisting conditions such as learning disabilities (also called 'intellectual disabilities').
People with Autism also commonly experience difficulty with cognitive and behavioural flexibility, altered sensory sensitivity, sensory processing difficulties and emotional regulation difficulties. The features of Autism may range from mild to severe and may fluctuate over time or in response to changes in circumstances.
Over recent years there has been increasing recognition of the needs of people with Autism Spectrum Condition (ASC). The Autism Act (2009) has laid down in statute the requirements to address these needs. More recently NICE guidance has been published for adults with ASC (NICE, 2012), outlining best practice in recognition, assessment, and management for adults with autism
The prevalence of Autism in the UK population is estimated at 157 per 10000 populations (or 1.6%) (Baron-Cohen 2009). Estimates suggest that up to 80% of those with ASC do not have learning disabilities (Elsabbagh et al. 2012). From these figures it is estimated that 2,700 people living in Plymouth have ASC.
The number of adults with a diagnosis of ASC in Plymouth is unknown but there are likely to be large numbers of people who have not yet been assessed or diagnosed.
Signs and Symptoms
Consider assessment for possible Autism when a person has:
One or more of the following:
- persistent difficulties in social interaction
- persistent difficulties in social communication
- stereotypic (rigid and repetitive) behaviours, resistance to change or restricted interests.
- problems in obtaining or sustaining employment or education
- difficulties in initiating or sustaining social relationships
- altered sensory sensitivity, sensory processing difficulties
- Emotional dysregulation
History and Examination
- Evidence of abnormalities in early development (including social interactions, social communication, lack of imaginative play, restricted, repetitive interest pattern)
- A history of a neurodevelopmental condition (including learning disabilities and attention deficit hyperactivity disorder or mental disorder
- Family history of Autism or other neurodevelopmental disorders
Differential/CoMorbid Diagnoses
- Learning Disabilities
- ADHD
- EUPD
- Depression
- If patient is presenting with acute comorbid mental health issue, follow normal referral pathway into mental health or learning disability services
- If patient is presenting with urgent social care needs, contact Adult Social Care
- PASS Assessment Team does not care co-ordinate.
- PASS Assessment Team do not offer crisis response or interventions.
Referral Criteria:
We can only accept referrals for clients who:
- Are aged 18 or over
- Are registered with a Plymouth GP
- Do not already have a diagnosis of an Autism Spectrum Condition
- Do not have a diagnosis of Learning Disability
- Where there is evidence in the referral of difference related to the autism spectrum as stated in the DSM-V
Referral Instructions:
An Autism Assessment requires 5-8 hours of a person’s time. The assessment pushes uncomfortable situations to allow assessors to see Autism. It requires people to include their family in their assessment. We need to be sure therefore that assessment is clinically warranted. We do this through the information you give us at the point of referral.
In your referral:
- Briefly outline the reasons for your referral, explaining the impact upon client’s day to day life.
- Tell us the evidence of Autism – (as best you can in the time you have with the person, consider whether there is some evidence (according to DSM-V criterion) in these three areas that warrants a referral.
- Deficits must have been present in some way since childhood.
- Deficits in Social interaction and communication
- Restricted, repetitive patterns of behaviour, interests, or activities
To prioritise your referral, we need to know: is your patient a veteran, do they have a child under 1 year old, do they require a diagnosis to access urgent mental health support or educational support, are they dependent upon drugs/alcohol? Highlight any other risks that mean we need to prioritise your referral. Please note - we are not able to manage risk while an individual is on our waiting list. If you have concerns, these should be managed by other services/professionals involved in the client’s care.
Send your referral via e-Referral Service Selection/DRSS
- Specialty: Mental Health - Adults of all ages
- Clinic Type: Not Otherwise Specified
- Service: DRSS-Western-Mental Health-Adult- Devon ICB-15N
Clinicians who do not use DRSS should refer directly sending a completed PASSAT referral form to livewell.passat@nhs.net
Referral Forms
GP Information:
For queries contact PASS-AT via email – livewell.passat@nhs.net
Patient Information: If your patient already has a diagnosis of Autism and is looking for ongoing advice and support, they can refer to PASS post diagnostic team using the referral form on our website.
Please refer to Plymouth Autism Spectrum Service web page
Patient Information:
P.A.S.S. advice service leaflet
Pathway Group:
This guideline has been signed off by the PASS-AT on behalf of NHS Devon.
Publication date: December 2021
