1. Caroline Cantan National Programme Co-ordinator
Specialist Supports
Caroline Cantan
National Programme Co-ordinator

2. Guidance on Specialist Supports
Group bringing expertise in different fields
Research and consultation
Issued July 2015
Revised January 2016 with three amendments

3. Disability Network Teams
National Policy on Access to Services for Children & Young People with Disability & Developmental Delay
Primary
Care
Teams
Primary Care Services
Children’s
Disability Network Teams
Child with non-complex needs
Specialist support as needed by Primary Care and Children’s Disability Network Teams
Child with complex needs
Direct individual assessment and short term intervention
Support and consultation
Transfer between services if and when child’s needs change
Children with disability or developmental delay and their families

4. Children’s specialist supports
To provide highly specialised expertise to support CDNT for small number of children with exceptional needs
Network team would not have critical number of children requiring this service to develop/maintain expertise
Network teams and Primary Care will remain main service provider
Should be clearly demonstrable that these needs cannot be met solely by Primary Care or Network team

5. Children’s specialist supports cont.
Needs-led rather than determined according to diagnosis
Function based pathways which require high level of expertise
Specific skills not available at Network level e.g. clinical engineer

6. Children’s specialist supports cont.
Role in development and promotion of specialist skills in team members
Disseminate knowledge through consultation and training
Direct assessment and intervention on a short term basis when needed
Maintain high level of knowledge and skill
In a position to lead research

7. Children’s specialist supports cont.
Required for a small number of children with exceptional needs in the following groups:
Children with Autism and/or ID and/or other developmental difficulties
Children with a physical disability
Children with a visual impairment
Children with a hearing impairment

8. Children with ID/ASD/other developmental difficulties
Extreme difficulties and exceptionally complex needs
Co-morbid disorders including mental health
Behaviours which are significant risk of harm to self or others
See Guidance for fuller description

9. Children with physical disability
Estimate 0.5% child population or 14% of children attending CDNT (3.5%)
Including:-
Management of posture
Management of tone
Casting
Hip and spinal surveillance
FEDS
Specialised seating
See Guidance for fuller description

10. Children with visual impairment
Estimate 0.2% population have VI
Multi disabled and vision impaired
Awareness of vision impairment especially with children with severe/profound ID
Specialised assessment where complexity
Assistive technology
CDNTs and PC links with specialist advice and supports

11. Children with hearing impairment
Estimate prevalence 3-4 per 1000 at school entry age
40% have additional disability
Specialist assessment where complexity
CDNTs and PC links with specialist advice and supports – visiting teachers, National Cochlear Implant Programme

12. Staff considerations Development of special interests and expertise
Continuity, succession planning
Support and mentoring
Need for good relationship between network and specialist
communication
where opinions differ
acknowledge Network level skills

13. Models of service delivery
Designated member of the Children’s Disability Network Teams
Where specialist input is required from a specific discipline, support may be provided at local/regional level by a clinician who is a member of a CDNT with particular skills and experience, working in collaboration with the other members of the teams.

14. Models of service delivery
Designated members of CDNTs working together Where a team approach is required, specialist supports provided at local/regional level by designated members of CDNTs with particular specialist skills and experience, working together as a team at designated times

15. Models of service delivery
Clinicians or teams on a CHO, regional or national basis Delivered as locally as possible for the child and family, with CDNT or PC team attending alongside the children and families with whom they work. In some cases, specialist supports will of necessity be centre or hospital based

16. Staff assignment
In most cases staff providing specialist support will also be working on a CDNT with all children with complex needs, so that their wider skills and experience are maintained
Consider need for succession planning and avoid expertise being invested in only one clinician

17. Determining local needs for specialist supports
On what geographic basis (local health office, regional or national) should this service be delivered?
How many children would need the service on this geographic basis?
Frequency of clinics, consultations etc.
Determine skills and WTEs required

18. Determining local needs for specialist services cont.
Mapping of existing expertise in the area
Decisions on how best to use these resources
Assignment of staff
Accommodation and equipment required
Establishing pathways and processes