The Assessment of Need (also known as AON) was established under the Disability Act, 2005. An Assessment of Need is an assessment carried out by the HSE for children or young people with a disability (autism is classified as a disability). If your child has a disability or you think they may have a disability, you can apply for an Assessment of Need. In recent times the AON has been a source of legal wrangling.
In 2020 a new system was introduced called the Standard Operations Procedure under the AON Guidelines, which introduced the Preliminary Team Assessment. The Preliminary Team Assessment evidenced the presence of a disability but did not provide any formal diagnosis. This then had a knock-on effect on families seeking to access autism specific supports (e.g., an autism class). The High Court has since stated that this new procedure introduced in 2020 was unlawful and not in keeping with the Disability Act, 2005 because it did not meet the standards to provide a diagnostic assessment.
Under the Act a child/young person should receive (i) a full and complete assessment of their needs and (ii) a service statement stipulating the services required to address the needs identified in the assessment. You can apply for an Assessment of Need here: Disability Assessment – HSE.ie
After you send in your application, you will get a letter from the HSE confirming they have received your application and the date when the assessment will start. The HSE must send you this letter within 14 days of your application. If the Assessment Officer is satisfied that your child needs an assessment, they must arrange this referral within 3 months 11 of receiving your completed application. Once this referral is made there will be a further 3 months to assess your child and complete the Assessment Report this is legally mandated under the Disability Act 2005, please see section 14(1) of this Act for more information on this.
You will get a Service Statement if your child is deemed to have a disability. A Service Statement lists the services the HSE proposes to provide to meet your child’s needs and the timeframe in which those services should be provided. It is prepared by a Liaison Officer and must be completed within one month of the assessment report being completed. By law, the HSE must provide the services named in the Service Statement. The Service Statement must be clear and easily understood.
If you do have any questions on the AON process, our Information Line Team would be happy to speak through these with you.
If your child has gone through the HSE Assessment of Need process and is deemed to have a disability, you will get a Service Statement. A Service Statement lists the services the HSE proposes to provide to meet your child’s needs and the timeframe in which those services should be provided. It is prepared by a Liaison Officer and must be completed within one month of the assessment report being completed. By law, the HSE must provide the services named in the Service Statement. The Service Statement must be clear and easily understood.
If your Service Statement is not completed or provided for within the statutory timelines, you can make a complaint within 3 months of the date on which you became aware of the cause of the complaint. In the first instance, you can contact your Liaison Officer. If you are still not happy and wish to escalate your complaint, you can contact the Disability Complaints Officer. You can ask the Assessment Officer or Liaison Officer for a form to complete. This form also lists the grounds on which you can make a complaint. The form, when completed, needs to be returned to the Complaints Officer. The Complaints Officer is an independent body. This means that the Complaints Officer will look at your complaint objectively and fairly. You can also contact the Complaints Officer directly on 045 880 400 or by e-mail to [email protected] If you are unhappy with the findings and recommendations of the Complaints Officer, you can appeal to the Disability Appeals Officer. If 12 the HSE has not acted on the recommendations of the Complaints Officer, you can appeal to the Disability Appeals Officer or you can go to the Circuit Court to seek an enforcement order.
If you do have any questions on the service statement process, our Information Line Team would be happy to speak through these with you.
If your child has a difficulty or difference in one area (e.g., a speech delay), it is likely a referral to Disability Services will result in you being seen by, or on the waiting list for, Primary Care. However, if your child requires specialist services delivered by more than one professional together as part of a team, they will be seen by the Children’s Disability Network Team (CDNT). The CDNT provides specialist support for children who have a disability and complex health needs associated with their disability. If your child is assessed by the CDNT, it is likely they will be seen by the occupational therapist and/or speech and language therapist in the first instance. The therapists will likely want to observe your child playing. This is so they can gain insight into a wide range of your child’s skills and preferences.
The therapists will also want to have a discussion with you to gain your perspective on your child’s developmental history, their strengths and interests, and the past and current barriers to your child’s participation at home and in school. Based on these observations and discussions, the team psychologist, alongside the occupational therapist and/or speech and language therapist, may decide to proceed with a standardised diagnostic tool for autism, such as the ADOS.
If your child already has an Autism diagnosis, they may receive what is often described by healthcare professionals as ‘intervention’ by the CDNT or Primary Care Team. This may involve them being seen by the psychologist, speech and language therapist, occupational therapist and/or physiotherapist. The format of this support may be individual, group or consultative. Currently, we are aware there are significant waiting lists impacting families nationally.
If your child has a Service Statement, the provision, and timeline of said revision, should reflect the Service Statement.
As a parent/guardian, you can self-refer your child to the Children’s Disability Services regardless if they have a Service Statement or a diagnosed disability. You do this by completing the electronic forms housed on the HSE Children’s Disability Services webpage: Referrals to a children’s disability network team – HSE.ie The team will review the forms you submit and based on this information will contact you regarding next steps.
Relevant community care services may include public health nurse (PHN), home help, personal assistance, psychological services, speech and language therapy, occupational therapy, social work services, physiotherapy, daycare and respite.
You can find what disability services are available in your county here: Disability services in your county – HSE.ie Currently, we are aware there are significant waiting lists impacting families nationally.
CAMHS is a HSE service that provides assessment and treatment for young people and their families who are experiencing mental health difficulties. The term ‘CAMHS’ is usually applied very specifically to services that provide specialist mental health treatment and care to young people up to 18 years of age through a multidisciplinary team. To access a CAMHS service you need to be referred by your GP. The GP should have a copy of the referral form, but you can also access it here:
Community CAMHS referral form (docx)
It is often reported that Autistic children can have difficulty accessing CAMHS as it can be viewed that the difficulties the child is experiencing are in line with an Autism diagnosis, and thus better understood by Children’s Disability Services. However, Autism is not a mental health condition. A child can be Autistic and have mental health difficulties, and a child can be Autistic and not have mental health difficulties – much like a non-Autistic child.
Mental Health Ireland have put together a helpful webpage explaining how Adult Mental Health Services in Ireland work: Mental Health Services – Mental Health Ireland
It is often reported that Autistic adults can have difficulty accessing Adult Mental Health Services as it can be viewed that the difficulties the adult is experiencing are in line with an Autism diagnosis, and thus better understood by Adult Disability Services. However, Autism is not a mental health condition. An adult can be Autistic and have mental health difficulties, and an adult can be Autistic and not have mental health difficulties – much like a non-Autistic adult.
Regarding Autism assessment, many families and adults face anxiety regarding selecting a reputable private assessor. This anxiety can be compounded by the fact there is currently no regulation of psychologists in Ireland. This makes it frighteningly easy for an individual who has not completed the full psychologist training to present as one. If you are considering a private psychologist to complete the assessment, check the Psychological Society of Ireland (PSI) website to see if they hold Chartered Membership. If you are concerned that the psychologist you are considering does not hold Chartered Membership, ask them for their 2023 PSI Chartered Membership certificate.
It is critically important to research the professional in advance of the assessment. Any chartered psychologist will be more than happy to clarify their credentials and qualifications to you and will understand why you need to request this information.
Once you have confirmed this, you should also consider whether the professional is neuroaffirmative. When you look on their website, is the language they use neurodiversity affirmative (exploring neuro differences, highlighting strengths and areas of support) or medicalised (referring to autism as autism spectrum disorder, focusing on difficulties and impairments)? It is hugely important that you or your child’s experience of the assessment does not reinforce any negative stereotypes they hold of themselves, and instead empowers and supports them. Additionally, a diagnostic report should not leave you or your child feeling it was a confirmation of ‘deficit’. Instead, it should accurately capture a person’s experience of the world, their strengths, and where they need more support.
You or your child may not only be seeking private support with regards assessment. You may be seeking private occupational therapy, speech and language therapy, psychology, counselling or physiotherapists. You can contact the Information Line Team to be signposted to reputable professionals.
Currently, if a carer would like to request respite, they need to contact HSE Disability Services directly. For adults, contact: Contact: Disability Services – HSE.ie
