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Service for Complex Autism and Associated Neurodevelopmental Disorders (SCAAND)

How our service can help you

SCAAND is a Tier 4 NHS England funded specialist service for children and young people with autism and complex mental health difficulties. SCAAND is a multi-disciplinary service providing assessment and intervention/management of complex neurodevelopmental presentations. The SCAAND service draws on expertise from a number of health disciplines and education.

  • Service Type: Child and Adolescent Mental Health Services (National and Specialist) Service Borough Covers: National (Child and Adolescent services) Treatment type: Outpatient
  • Contact the service

    Site Location: Maudsley Hospital Email: SCAANDService@slam.nhs.uk Fax Number: 020 3228 2570, 020 3228 2535, or 020 3228 2547
  • Address: Michael Rutter Centre
    Maudsley Hospital
    De Crespigny Park,
    London,
    SE5 8AZ
  • Business Hours/Visiting Hours: Monday to Friday, 9am to 5pm
  • Other essential information

  • Conditions: Autism, aspergers, learning difficulties, intellectual difficulties, neurodevelopmental disorders, complex mental health

More Info

The term ‘complex autism’ refers to children and young people with established or possible ASD who present with co-occurring neurodevelopmental and/or mental health (for example, emotional and behavioural) disorders. They may also have difficult early histories and ongoing social circumstances or accompanying physical health and genetic disorders that present additional assessment and management challenges.

Assessment work includes opinions on ASD and/or additional diagnoses. Management work undertaken by SCAAND can involve a range of modalities including psychological therapies for children/young people and their parents, medication, occupational therapy, speech and language therapy and advice on education.

The multi-disciplinary professionals work closely together to ensure that the needs of the child and their family are assessed and managed in a comprehensive manner. Service development and delivery are undertaken in close partnership with children and young people, their families and colleagues from community services, including community and mental health services, paediatrics, social care and education.

The SCAAND service is commissioned by NHS England and it is a requirement that all referrals have been through a local assessment/care pathway for ASD before referrals can be accepted.

As a specialist Tier 4 CAMHS service, SCAAND also aims to share knowledge and expertise via teaching, training and other methods of sharing information, such as resources for families and professionals.

If this was not what you were looking for:

The SCAAND services see young people who have, or might have, neurodevelopmental disorders like autism, attention deficit hyperactivity disorder or learning disability with additional mental health or behaviour problems, as well as young people with psychological problems associated with head injury, functional conditions or genetic conditions. Our teams work together and refer between services as necessary.

Interventions

Diagnostic and standardised assessments of social communication alongside co-morbid conditions:

  • Psychiatric formulation and diagnosis
  • Cognitive and neuropsychological assessment
  • Functional assessment of behaviour problems
  • Motor, sensory and adaptive skills assessment
  • Social communication and language assessment
  • Physical examination with an emphasis on neurological examination

Individually tailored care planning and interventions from a multi-disciplinary team:

  • Psychoeducation for parents and the young person
  • Behavioural management
  • Medication management and advice in collaboration with local prescriber
  • Evidence based psychological therapies, such as cognitive behavioural therapy (CBT), adapted for neurodevelopmental differences
  • Recommendations and interventions based on sensory integration theory
  • Specialised speech and language intervention
  • Educational advice and consultation
  • Individualised emotional literacy
  • Care planning and liaison with local services

Eligibility criteria

Eligibility

  • Children and young people below 18 years of age who have been referred by local consultant child and adolescent psychiatrist or paediatrician or team member
  • Evaluated by local child and adolescent mental health services (CAMHS) or child health service responsible for local assessment and care pathway for autism spectrum disorders (ASD) and felt to need an expert service for assessment and/or management of ASD or associated neurodevelopmental or mental health problems
  • Referral questions may include uncertainty about an ASD diagnosis; uncertainty about additional complex neurodisability, mental health/psychiatric or behavioural disorders; and seeking management/treatment assistance and advice for complex cases that are managed by local CAMHS

Exclusion

  • Children and young people who have not received a diagnostic assessment involving a local ASD diagnostic care pathway as recommended by NICE guidelines
  • Child or young person or parent self-referral or primary care referral without the knowledge and agreement of local CAMHS or child health service
  • Child and family not known to their local Tier 3 CAMHS or child health services
  • 18 years or older (or unable to be seen until 18 years or older)
  • Inpatient assessment and management is not provided by this service

Outcomes

Our outcomes include:

  • Better understanding of diagnoses, transdiagnostic traits and behaviours
  • Reduced challenging behaviours including aggression, self-harm or inappropriate behaviours
  • Greater parental confident in behaviour support and strategy use
  • Better emotional literacy and regulation skills, leading to fewer emotional outbursts
  • Improved understanding of sensory processing behaviours and needs
  • Better participation at a developmentally appropriate level (in education or the community)
  • Increased functioning where feasible including optimised academic attainment and adaptive skills
  • Improved wellbeing and quality of life

Care Options

Care option: Outpatient assessment

A full multidisciplinary assessment to address the specific referral question. This may include diagnostic assessments, assessments of mental state or assessments to inform intervention planning. Typical components of these comprehensive assessments include:

  • Thorough review of previous reports 
  • Psychiatric history with parents/carers
  • Standardised assessments with the young person
  • Physical examination
  • Mental state assessment
  • Analysis of questionnaires
  • A face-to-face feedback of the assessment results with the family and, optionally with the young person
  • A comprehensive report summarising the above in detail

Care option: Outpatient Treatment

All forms of multidisciplinary treatments are funded in the same manner, in units of up to one hour per professional.

Care option: Consultation

Consultation is offered as for complex case discussions between professionals. This will be the referring team and senior member of SCAAND.

Our experts

Prof Emily Simonoff, Professor of Child and Adolescent Psychiatry - read more

Dr Iris Rathwell, Consultant Psychiatrist - read more

Prof Tony Charman, Honorary Consultant Clinical Psychologist - read more

Dr Sarah H Bernard, Consultant Psychiatrist Child and Adolescent Intellectual Disability - read more

Dr Nicoletta Adamo, Consultant Child and Adolescent Psychiatrist - read more

Dr Kevin Tierney, Principal Clinical Psychologist - read more

Dr Matthew Hollocks, Clinical Psychologist - read more

Tina Bang-Andersen, Specialist Occupational Therapist - read more

Dr Laura Wilby, NAS Specialist Autism Education Lead - read more

Dr Sarah Thompson, Principal Clinical Psychologist - read more

Dr Jennifer Breen, Clinical Psychologist - read more

Dr Josephine Church, Clinical Psychologist - read more

Natasa Momcilovic, Clinical Behaviour Therapist - read more

Gillian Davies, Specialist Speech and Language Therapist - read more

Dr Sarah Carman, Principal Clinical Psychologist - read more

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