Huge rise in referrals of Clare children with additional needs

THE referral rate of additional needs children to the Clare Children’s Disability Network Team (CDNT) has soared on average by 18% year on year, over the past four years, shocking new figures have revealed.

The Mid-West Community Healthcare has acknowledged the introduction of Covid-19 related public health guidelines in March 2020 has also had a significant impact on the waiting times for all services and supports with Clare CDNT, given that services were paused in the most part for several months.

This has particularly affected the waiting times for Autism Spectrum Disorder (ASD) assessments.

In total, 92 Clare children are waiting on average 9.3 months for an initial contact with the CDNT; 80 are waiting for an (Individual Family Support Plan) following initial contact; 2,190 specified needs have been identified for families to help achieve identified goals, such as training programme on toilet training and provision of equipment, provision of resources, while 138 children are waiting for an ASD assessment.

The average waiting time for an ASD assessment is 15 months.

These figures were released in response to a Dáil question tabled by Deputy Michael McNamara following a query from a constituent.

Deputy McNamara said Clare children with additional needs were adversely impacted by Covid-19 restrictions, which are now being exacerbated by very long waiting times for services.
In view of claims leaked last week that certain sections of the mental health service and other parts of the HSE didn’t want money and didn’t want to spend it, Deputy McNamara said the long waiting times were difficult to understand.

He said there is an issue surrounding the lack of qualified clinical consultant psychiatrists, psychologists throughout the service for a long number of years, which hasn’t been addressed by the HSE.

“Any child that is awaiting a referral has a particular need to be addressed. These children and their families have experienced a very difficult two years because of Covid-19 restrictions.

“The long waiting times are compounding what was a very difficult time. My criticism is not of those who provide the service, it is the HSE who inadequately funds the service.”

Deputy McNamara called on the national HSE allocate additional funding to try and substantially reduce the current backlog.

Initial contact has been defined as a meeting, which includes providing an orientation to the service; profiling parental priorities for their child/family; achieving a better
understanding of a child’s needs; based on parental priorities and informed by observations, developing some agreed initial goals; providing guidance on strategies specific to the
agreed initial goals that parents can use immediately and facilitating completion of initial IFSP.

An IFSP sets out the goals for the child and how the family and team are going to work towards them.

All supports offered by the team will relate to the plan and the agreed goals, which should be regularly explained to the family. The plan includes the child’s concerns and priorities,
the family’s concerns and priorities, goals agreed, how the child, the family, the team and others will work towards these goals, how achievement of the goals will be measured and the time frame for achievement of goals.

The Mid-West Community Healthcare pointed out a particular difficulty with ASD assessments has been that some of the standardised clinical assessments, previously used by the team had not been validated with the use of PPE.

As a result new assessment tools had to be adopted, which required a period of orientation and training and the sourcing of new assessment materials.

In addition to this, where a school or preschool visit was deemed necessary as part of the ASD assessment, as they were closed for several months the assessment process was further delayed.

When they reopened, the schools were adhering to strict restrictions which made observations of social interactions and communication difficult at times. Due to high levels of Covid-19 circulating, cancelled appointments at short notice due to ‘close contacts’ or confirmed cases of Covid-19 also extended the assessment process in some cases.

“All of these issues have had a negative impact on the waiting lists overall. The CDNT continue to monitor the waiting times, and continues to seek additional resources accordingly.

Measures have been taken to address these impacts including:
All staff on the Clare CDNT were provided with laptops to allow for telehealth appointments and to allow for remote working where public health guidelines restricted the number of clients and staff in the Clare Children’s Services building.

In March 2021, the team received approval for an additional 0.6WTE clinical psychologist for nine months.

Increased funding of two posts vital in many assessment processes

Provision of backfill for maternity leave where it arose

Backfill of the Children’s Disability Network Manager post when vacant due to maternity leave and secondment.”

Funding for the outsourcing of a number of assessments was provided through pay savings.

The HSE has recently provided additional resources to the Mid-West Community Disability Network Teams to specifically address the ASD assessment waiting time.