Advice and resources : Request for Help process guidance for professionals

Regular movement breaks and/or ‘brain breaks’ 

Adjust seating plan, for example sitting near the teacher/away from distractions 

Use of fidget toys 

Give regular prompts and reminders 

Adapt instructions – short and specific, written instructions, repeat as needed 

Break work down into small chunks 

Give regular positive encouragement 

Allow use of noise cancelling headphones or earphones if desired 

Give opportunities to stand up or walk around classroom in a non-disruptive way for example giving out books/sharpening pencils 

If possible do not remove breaks as a punishment or way to make up for missed work 

Use of a system such as zones of regulation or the traffic light system 

Allow extra time to complete work or process information 

Frequent check-ins or 1:1 mentoring/keyworker  

Access to a quiet space when needed 

Regular and effective home-school communication e.g. communication book or weekly communication sheet 

Ignore minor behaviour if possible, especially if it seems unintentional (eg shouting out) or is unlikely to reoccur  

Offer a break or redirection if they appear dysregulated 

Regular movement breaks and/or ‘brain breaks’ eg by providing time out card 

Adjust seating plan, for example sitting near the teacher/away from distractions 

Use of fidget toys 

Give regular prompts and reminders 

Adapt instructions – short and specific, written instructions, repeat as needed 

Break work down into small chunks 

Give regular positive encouragement 

Allow use of noise cancelling headphones or earphones if desired 

If possible do not remove breaks as a punishment or way to make up for missed work 

Allow extra time to complete work or process information 

Frequent check-ins or 1:1 mentoring/keyworker  

Identify safe person for them to talk to/go to when needed 

Access to a quiet space when needed 

Provide spare equipment if forgotten rather than issuing detentions 

Regular and effective home-school communication e.g. identified member of staff to liaise with parent on a regular basis 

Ignore minor behaviour if possible, especially if it seems unintentional (eg shouting out) or is unlikely to reoccur 

Provide copies of notes rather than expecting them to copy notes from the board in a limited time 

Access to a quiet space when needed 

Use of noise cancelling earphones or ear defenders if desired 

Adjustments to uniform to meet sensory needs 

Flexibility to seating plan, for example child may wish to be seated near the door or the teacher, or away from distractions 

Give advance notice of any changes where possible 

Use of visual timetable so they can understand the plan for the day 

Regular 1:1 time with a keyworker or mentor, or when they appear frustrated or struggling  

Use of fidget toys for sensory seeking needs 

Adapt instructions – short and specific, written instructions, repeat as needed 

Break work down into small chunks 

Flexibility around group work  

Provide a safe quiet space to utilise at break or lunchtime  

Allow extra time to complete work or process information 

Flexibility around homework when child struggles with home/school separation 

Regular and effective home-school communication eg communication book or weekly communication sheet 

Use of a system such as zones of regulation or the traffic light system 

Offer a break or redirection if they appear dysregulated 

Support for coping with emotions such as ELSA 

Use of visual aids to support understanding of expectations, boundaries, daily activities etc 

Identify child’s specific triggers and strategies to limit these (eg adjustments around assemblies, PE, off timetable days such as sports days) 

Provide a ‘time out’ card to leave classroom when needed 

Access to a quiet space at break or lunchtimes 

Use of noise cancelling earphones or ear defenders if desired 

Adjustments to uniform to meet sensory needs 

Flexibility to seating plan, for example young person may wish to be seated near the door or the teacher, or away from distractions 

Give advance notice of any changes where possible 

Regular 1:1 time with a keyworker or mentor 

Identify a safe person for them to talk to/go to when needed 

Use of fidget toys for sensory seeking needs 

Adapt instructions – short and specific, written instructions, repeat as needed 

Break work down into small chunks 

Flexibility around group work  

Allow extra time to complete work or process information 

Flexibility around homework when child struggles with home/school separation 

Regular and effective home-school communication eg identified member of staff to liaise with parent on a regular basis 

Offer a break or redirection if they appear dysregulated 

Support for coping with emotions such as ELSA or counselling  

Identify young person’s specific triggers and strategies to limit these (eg adjustments around assemblies, PE, off timetable days such as sports day)

Child is aged 2 years 6 months to 4 years 11 months and registered with a Berkshire GP 

Child presents with features highly suggestive of autism 

Social communication differences are clearly out of line with overall developmental level 

Concerns/differences have been present for six months or longer 

Concerns/differences are seen across different settings 

There is clear and informed consent from parents or carers

Appropriate developmental checks have been carried out with the Health Visiting team, a support plan has been put in place and implemented 

Parents or carers have accessed support/training from the relevant autism support service and implemented recommendations at home.   

If the child is in an early years/educational setting: a SENCO-led support plan needs to have been in place and fully implemented for at least six months/two terms (eg a minimum of two ‘assess, plan, do, review’ cycles) 

 If there are concerns regarding the child’s speech and language development (eg language delay): support/advice needs to have been sought from the Speech & Language Therapy service.  

This can be accessed by calling their Early Years enquiries line on 0118 9043700 between 9am-3.30pm on Tuesdays and Thursdays.

If there are behavioural/emotional concerns: advice has been sought from Health Visiting Team and support/recommendations have been implemented for at least six months  

If supported by the development officers/early years team/educational psychologist: all support/recommendations must have been implemented and evaluated for at least six months 

Vision and hearing checks have been carried out where these are needed 

Child/young person is aged 5 years to 17 years 5 months and registered with a Berkshire GP 

Child/young person presents with features highly suggestive of autism 

If child/young person has a learning disability, social communication differences are clearly out of line with overall developmental level 

Concerns/differences have been present since early childhood 

Concerns/differences are seen across different settings 

There is clear and informed consent from parents or carers or the young person themselves if over 14 years of age (where appropriate)  

Parents/carers have accessed support/training from the relevant autism support service and implemented recommendations at home.

If the child or young person is in an educational setting: a SENCO-led support plan needs to have been in place, fully implemented and reviewed for at least six months/two terms (eg a minimum of two ‘assess, plan, do, review’ cycles)

If there are concerns regarding the child or young person’s cognitive ability or ability to access the curriculum: advice needs to be sought from the educational psychologist via the school SENCO (NB this is advice only and may or may not result in direct input)  

If seen by an educational psychologist: all support/recommendations must have been implemented and evaluated for at least six months 

 If there are concerns regarding the child or young person’s speech and language development (eg language delay): support/advice needs to have been sought from the Speech & Language Therapy service.   

If the child or young person has a moderate/severe learning disability and there are significant concerns regarding mental health and/or behaviours that challenge/behaviours of distress: consultation with or referral to the CAMHS Learning Disability Team needs to have taken place (consultation will include advice as to whether a referral to CAMHS LD should be made).  

Tel: 0118 9046660 
Email: CAMHSLearningDisabilityTeam@berkshire.nhs.uk 

If there are significant concerns about the child or young person’s mental health: the young person and/or family must have been referred for or accessed support. The best way to support will depend on the type of concerns.

Child or young person is aged 6-17 and registered with a Berkshire GP 

Child or young person presents with symptoms highly suggestive of ADHD 

If child or young person has a learning disability: concentration, activity levels & impulsivity are clearly out of line with overall developmental level 

Symptoms have been present since before the age of 12 and lasted six months or longer  

Symptoms are seen across at least two different settings 

The difficulties have a significant impact on the young person  

There is clear and informed consent from parents/carers or the young person themselves if over 14 years of age (where appropriate) 

The young person does not have current and significant drug issues due to the potential risks. We recommend substance misuse is supported and addressed first.

Parents/carers have accessed support/training from the relevant ADHD support service and implemented recommendations at home.

If the child or young person is in an educational setting: a SENCO-led support plan needs to have been in place and fully implemented for at least six months/two (eg a minimum of two ‘assess, plan, do, review’ cycles) 

If there are concerns regarding the child/young person’s cognitive ability or ability to access the curriculum: advice needs to be sought from the educational psychologist via the school SENCO (NB this is advice only and may or may not result in direct input) 

If seen by an educational psychologist: all support/recommendations must have been implemented and evaluated for at least six months 

If the child or young person has a moderate/severe learning disability and there are significant concerns regarding mental health and/or behaviours that challenge/behaviour of distress: consultation with or referral to the CAMHS Learning Disability Team needs to have taken place (consultation will include advice as to whether a referral to CAMHS Learning Disability Team should be made).  

Tel: 0118 9046660  Email: CAMHSLearningDisabilityTeam@berkshire.nhs.uk 

If there are significant concerns about the child or young person’s mental health: the young person and/or family must have been referred for or accessed support. The best way to support will depend on the type of concerns

Child or young person is aged 6 to 17 years old and registered with a Berkshire GP 

The difficulties have a significant impact on the child or young person  

There is clear and informed consent from parents/carers or the young person themselves if over 14 years of age (where appropriate) 

The young person does not have current and significant drug issues due to the potential risks. We recommend substance misuse is supported and addressed first.

Parents/carers have accessed support/training from the relevant ADHD support service and implemented recommendations at home.   

For further information about support, please click on this link: https://www.parentingspecialchildren.co.uk/courses/adhd-courses-and-workshops-for-parentscarers/ on behalf of Gems (East Berkshire) & Autism Berkshire (West Berkshire) 

 If the child or young person is in an educational setting: a SENCO-led support plan needs to have been in place and fully implemented for at least six months/two (eg a minimum of two ‘assess, plan, do, review’ cycles) 

If there are concerns regarding the child or young person’s cognitive ability or ability to access the curriculum: advice needs to be sought from the educational psychologist via the school SENCO (NB this is advice only and may or may not result in direct input) 

If seen by an educational psychologist: all support/recommendations must have been implemented and evaluated for at least six months 

If the child or young person has a moderate/severe learning disability and there are significant concerns regarding mental health and/or behaviours that challenge/behaviour of distress: consultation with or referral to the CAMHS Learning Disability Team needs to have taken place (consultation will include advice as to whether a referral to CAMHS Learning Disability Team should be made). 

Tel: 0118 9046660 Email: CAMHSLearningDisabilityTeam@berkshire.nhs.uk 

If there are significant concerns about the child or young person’s mental health: the young person and/or family must have been referred for or accessed support. The best way to support will depend on the type of concerns 

Working in partnership with the school (or other involved professional) means that they can support the use of IT systems. Where there is no one available to support the young person, bespoke support can be provided by the service. 

Arrange to meet the parent/carer and explain your concern. Discuss with them how the school can support the child and what support is available to the family. Make sure an effective support plan is in place (this should be based on identified need and does not require referral/assessment/diagnosis). Arrange to meet regularly to evaluate the child's progress.

If you feel the child needs a specific provision or service that can ONLY be accessed with a specific diagnosis, please share this with the family.

This can often happen and it may be for a number of different reasons. A young person may work very hard to manage the school day, although this may not be apparent in the school setting. This may only be seen at home where the young person may, for example, have meltdowns or shutdowns. The effort to manage the school day can leave young people exhausted and with no energy or coping resources left by the time they get home. This can particularly affect young people who mask or camouflage, and work very hard to fit in. 

While the distress may only be seen at home, the underlying triggers or reasons are often things that happen at school. It is very important to understand that, although a child may appear to cope at school, they may be feeling very stressed and distressed, even if they do not show this at school. Talking to the young person and their family will usually provide important information about sources of stress at school and ideas about what support can be put in place to reduce this.  

If there is someone in school that knows the child or young person, we still ask them to work with the family as they will have important information including why the young person is not in the school setting. Where a child or young person is not known to school staff, then generally another professional who has direct knowledge of the young person will partner with the family. 

Six months will give enough time to implement and evaluate a robust support plan based on the child or young person ’s needs. Some children or young people may not need a formal assessment after this, as their needs will now have been met. 

We ask you to work in partnership with the parents and carers. Information needs to be gathered by looking back over a minimum period of two terms or six months. This is so we can fully understand the child/young person’s needs, the strategies put in place and the impact these strategies have had.  This is referred to as a ‘graduated response’ to meet a child/young person’s needs. 

The updates to the process are intended to reflect the graduated response and ordinarily available provision and what is already happening in schools. Our assumption is that where there are concerns sufficient enough to warrant referral for a specialist assessment, these will also be triggering a support plan in school.  

All children/young people will need a fully completed form and supporting evidence before we can accept for assessment as it is the only way to gather the depth of information required. We cannot properly triage the referral and make decisions we have all the information required. 

We would like to reassure you that the additional information forms have been designed to reduce the burden for those completing them when compared to the previous process. For example the combined autism and ADHD form replaces a total of 9 separate questionnaires previously sent out to families and schools. The forms have been designed to streamline the process, reduce duplication and the reliance on referrers providing a great deal of narrative text or description. Very similar additional information forms have been in place in Oxford for over a year and in Buckinghamshire for several months and are working well. 

By making the forms available to download and asking for the form and support plan to be uploaded with the referral form, we are eliminating delays and issues with sending and receiving documentation that has held the process up for many families. We are already seeing that triage under the updated process is taking much less time to complete.

Yes, we will collect feedback from families and schools with every referral to help us evaluate, refine and improve the process. We want to make sure the system adapts to meet the needs of children and young people effectively. 

This is the support in place that is above and beyond what would be typical to support a child/young person at this stage of development. A support plan is expected to include areas of need we would typically associate with possible autism and/or possible ADHD. For example for possible autism this would include needs with communication and social interaction, flexibility of thought and behaviour and sensory needs (three key areas of difference).  

When completing a referral we ask for you to demonstrate that a ‘graduated response’ has been put in place for at least six months or two terms prior to referral. This includes any support that has been offered at home, in school or by other services involved. It can include strategies that parents have introduced at home as well as strategies recommended or put in place by professionals.

When we look at the process overall (in terms of referrals that are not accepted and referrals for children who do not go on to get a diagnosis) it is clear that there are  children and young people whose needs can be met without referral for a specialist assessment. It is also very important that we do not add children to a long waiting list without knowing that they have support in place.  For ADHD we have always asked that support is in place first (previously for 10 weeks) and a copy of the school support plan is provided.  

We are providing detailed guidance on our website and will be available to answer any questions. We encourage families and schools to spend some time on the website reviewing all of the information as this is likely to answer their questions. If not they can contact us for advice. 

CYP Autism and ADHD triage team
CYPADHDandAutismTriage@berkshire.nhs.uk 
0118 9046620

There is a range of resources and free training to help schools with supporting children and young people. This includes:  

• Psychological Perspectives in Education and Primary Care  or PPEPCare Training: Flexible and free training for EYS/schools delivered by Berkshire Healthcare, with a total of 17 modules covering autism, ADHD and a wide range of common concerns and mental health difficulties   

• Our advice pages and workshops

• What does inclusivity in schools look like? 

• NHSE info re Children and Young People including PINS: A national pilot coordinated by the Department for Education, Department of Health and Social Care, NHS England. Currently in primary schools in Reading, Bracknell, Royal Borough of Windsor and Maidenhead. The pilot will focus on early support and intervention for neurodivergent children in the mainstream primary setting. It will achieve this by bringing together health, the local parent carer forum, the local authority, and education staff to help shape whole school SEND provision , provide early interventions at a school level , upskill school staff, and support strengthening of partnerships between schools and parent carers.  

• LEANS Learning about Neurodiversity at Schools 

• Belonging in School  A guide to developing an inclusion policy for schools  

• Person Centred profiling tool from Bracknell Forest