The role of a clinical nurse specialist in the care pathway of children referred for an autism assessment

Abstract

The Covid-19 pandemic has led to an increase in demand for assessment for children with suspected autism spectrum disorder (ASD), with waiting times in the UK varying from 1–3 years. This article outlines a project to introduce a neurodevelopment clinical nurse specialist (CNS) to a care pathway for assessment in response to this need. The role included undertaking assessments in a clinical setting and providing early intervention support to children and their families. The clinics targeted the 0–5 age group, streamlining the ASD diagnostic pathway, offering a differential pathway to other specialist services in neurodevelopment. A service audit showed that around 60% of children identified by a CNS went on to receive a diagnosis of ASD in comparison to paediatricians, who were able to identify 80% of patients. A total of 70% of children were discharged by the CNS, with the remaining 30% needing a follow-up or a differential diagnosis and/or consideration of other investigations. It is concluded that health visiting teams would benefit from the clinical expertise of a CNS to build on evidence-based practice in this specialist area. This model should be a national standard to reduce health inequalities and provide a solution to the skills gap in health visiting.