Autism Diagnostic Service (LADS)

We have produced a number of videos to help individuals develop their understanding of autism.  There is an additional film available for healthcare professionals, particularly GPs available upon request.

Referral appropriateness

Referrals are screened on a weekly basis to check for quality, suitability and completeness in order to ensure resources are dedicated towards providing care to those who need it most. If the information provided does not meet minimum standards, or the referral is deemed inappropriate, a service rejection letter will be issued within 10 days advising of the next appropriate course of action.

To reduce the likelihood of a referral being declined, please ensure they are submitted using the Leeds Autism Diagnostic Service referral form and follow the criteria available in the Referral information for professionals or Self-referral sections of this page.

Due to the high number of referrals the service receives, a waiting list is currently in operation. All service users will be informed they have been placed on the waiting list and will be contacted when an initial assessment appointment can be made.

Initial assessment appointment

Once a referral has been accepted into the service, the referred person will receive a letter instructing them to telephone the service to book an initial assessment appointment. If the appointment is not made in fourteen days the service user will be discharged.

The team will require access to available health reports from paediatrics and child and adolescent mental health services.  School reports and medical reports would also significantly support the appointment. All the information required will be listed in the appointment letter.

The purpose of this initial assessment is to gather relevant background information and start the autism assessment. The appointment will last approximately 45 minutes and will cover:

• Introducing the service user to the service and explaining the care pathway
• Registration and consent forms for the service user to complete
• Questions around their social interaction, social communication and repetitive/restrictive behaviours, and any sensory issues during childhood and teenage years, which will support a diagnostic decision
• Getting details of friends or family members (ideally a parent) who would be available to complete an Autism Diagnostic Interview (ADI). Ideally they will have known the service user since they were a child. If the service user cannot provide contacts to complete an ADI a final diagnosis may not be possible

The initial assessment appointment can have the following outcomes:

• Continue to Autism Diagnostic Interview: if the assessment and evidence available cannot inform a diagnostic decision at this stage. Further information will be required from family members and other sources. This is likely for complex cases.
• Autism diagnosed: the assessment and evidence available clearly indicates autism is present. Service users will be advised of the next steps in writing.
• Autism not determined: the assessment and evidence available indicates the service user does not have autism. The service user will be discharged and a brief verbal explanation will be provided during the appointment followed by a report in the post.

All outcomes of this initial assessment appointment will be communicated in writing to the service user.

Developmental Interview

Once the service user has provided the details of a parent or family member or friend who has known them since childhood they will be contacted by letter to telephone the service to book an Autism Diagnostic Interview (ADI) appointment. In some cases the alternative Diagnostic Interview for Social and Communication Disorders (DISCO) assessment will be used.

The interview will usually take 3 hours, but can take up to 6 hours depending on the type of assessment used.  This will be advised in the appointment letter. The questions asked will be tailored towards understanding more about the service user when they were 4-5 years of age.

If the identified contact is unable to attend an appointment, the questions can be sent by email in order to gather the required information.

If the team has not yet received available reports from paediatrics or child and adolescent mental health services, or school reports or medical reports, we ask that the identified contact bring them to the appointment.

Clinical decision

When all relevant information has been received we will contact the service user to make a clinical decision appointment. This is a final review of all the evidence gathered to make a clinical decision regarding the presence of autism.

During the appointment, in advance of any decision making, the service user may be asked to complete a series of observational assessments involving simple activities. activities. At the appointment there will be two clinicians from different disciplines who will discuss with the service user the outcome of their referral in detail.

Follow up appointments

Service users who meet the diagnostic criteria for autism will be offered the opportunity to attend a follow up appointment. This appointment will provide further information about autism and provide signposting to relevant supporting services. Service users can also request consultancy support, more information about this can be found in the consultancy section of this page.

Follow up appointments are only offered to those who receive a diagnosis of autistic spectrum disorder from the Leeds service.

We offer service users diagnosed with autism the opportunity to request a one off consultancy appointment. This option is available to all service users regardless of when or which specialist autism service provided the diagnosis.

The team will request copies of reports from previous autism diagnostic assessments and may offer a re-assessment if the current presentation suggests this might be helpful. The consultancy appointment is not part of the main care pathway, but is an option for service users who feel additional support and guidance is needed.

The consultancy appointment can be for you, your carers and other professionals. If you would like to request consultancy support, please complete either the self-referral form or healthcare professional referral form and submit to referral.lypft@nhs.net.

• Healthcare Professional – Consultancy Request Form
• Self-Referral – Consultancy Request Form

Service users will receive questionnaires to complete prior to the appointment and a copy of your diagnostic report will be requested.

To make a referral to our service please complete and return the Leeds Autism Diagnostic Service referral form to referral.lypft@nhs.net.

To support you in ensuring the correct depth and quality of information is provided, you can download a referral example.

Please complete the referral form in full and include as much detail as possible. Referrals which are incomplete or contradict our referral criteria will be returned. Please submit your referral from a secure email address such as nhs.net.

Exclusion criteria where referrals will not be accepted:

1. Are below the age of 18: professionals are advised to refer service users under the age of 18 to the Child and Adolescent Mental Health Service (CAMHS).
2. Do not consent to the referral: any service user referred to LADS must fully consent to the referral. The service has experienced service users being referred without full consent e.g. when a referral is submitted by carer.
3. Are at risk of harming self or others: If a service user is currently to be at risk of self-harm or harming others the service stipulates this is addressed prior to referral. If the risk is longstanding this may require a clinical discussion prior to referral.
4. Did not experience autism features during childhood: referrals into the service will be declined if there is insufficient evidence provided that they demonstrated autistic features during childhood.
5. Substance misuse: the service stipulates anyone experiencing substance misuse problems are treated and reviewed in advance of referral into the service. This includes alcohol and drug related problems.
6. BMI less than 15: Referrals for service users who have a Body Mass Index under 15 are not accepted. A malnourished brain mimics traits of Autism and we would be unable to make an accurate diagnosis. Please re-refer when BMI is above 15.
7. Dementia diagnosis: the service will not usually accept referrals for service users who have previously received a diagnosis of dementia. Please telephone the service for a clinical discussion prior to referral.

If you would like to speak to a member of the team prior to referral or ask for advice, please email lads.lypft@nhs.net or telephone 0113 855 0712.

We recognise some of the challenges being faced by people living with diagnosed or undiagnosed autism spectrum disorder in society. Feedback from our service users showed that having to be referred through GPs or Healthcare Professionals was a barrier to accessing our service.  To address this we provide the option to self-refer.

Autism is a developmental condition and the signs and symptoms are most obvious at four to five years of age. During the assessment process it is helpful to have information available from family members. If school reports, speech and language reports or medical reports from childhood are available, this can assist in the process. If information from a family member is not available, it may not be possible to reach a conclusion.

If you would like to self refer, please submit the Leeds Autism Diagnostic Service self-referral form to referral.lypft@nhs.net

Before considering self-referral please make sure you meet the following criteria:

1. You are above the age of 18: if you are below the age of 18 you are advised to be referred to the Child and Adolescent Mental Health Service (CAMHS)
2. You consent to the referral: please ensure you are fully committed to experiencing all parts of the care pathway. Please read the care pathway section of this webpage to inform your decision
3. You are not at risk of harming self or others:please ensure you have confidence you are not at risk of self-harm or harming others prior to referral. If this is currently a problem please contact the crisis service on 0300 300 1485.
4. You experienced autistic features during childhood: be prepared to share your childhood experiences with professionals in the service. If you did not experience features of autism during childhood you should not refer
5. You do not suffer from substance misuse: please address any substance misuse problems prior to referral into the service. This includes alcohol and drug related problems
6. Your BMI must be more than 15: Referrals for service users who have a Body Mass Index under 15 are not accepted. A malnourished brain mimics traits of autism and we would be unable to make an accurate diagnosis. Please re-refer when BMI is above 15
7. You do not have a dementia diagnosis: the service will not usually accept referrals for those who have previously received a diagnosis of dementia. Please telephone the service for a discussion prior to referral.

For more information on what to expect and an explanation of the steps you will experience in the service please read the care pathway section of this webpage.

The team has the capability to train NHS and other staff including; GPs, social services staff and staff working for voluntary and private providers. We are keen to ensure stakeholders who come into contact with autism spectrum disorder have an excellent level of awareness.

If you would like to know more about the training services we can offer, please register your interest by emailing lads.lypft@nhs.net. A member of the team will get back to you.

When appropriate, service users are asked to assist us with training other professionals.

The Leeds Autistic Diagnosis team are based at the Aire Court Community Unit in Middleton.

Aire Court Community Unit
Lingwell Grove
Middleton
Leeds
LS10 4BS

How to find us by bus – this starts from the Leeds Corn Exchange bus stop

If you are experiencing any travel difficulties please contact the team by telephone 0113 8550712 who will be more than happy to support you.

Dr Alison Stansfield
Clinical Lead, Consultant Psychiatrist

Alison Stansfield undertook her basic psychiatry and part of her higher training in the psychiatry of learning disability in Cambridge before moving to Leeds in 1999 to complete her specialist training in Yorkshire. She worked as a part-time locum consultant in Barnsley for two years then moved to Leeds as a part-time community learning disability consultant in October 2007. She was appointed to a permanent post in Leeds in April 2008 and was also employed by the Yorkshire and Humber Secure Services Commissioning Team to review people with learning disabilities who required treatment in conditions of security. She completed her MD with the University of Leeds in 2007 looking at non-consensual sterilisation in England and Wales.

From 2010 to 2013 she was the Associate Medical Director for Learning Disabilities but relinquished the post to concentrate on her role as Clinical Lead for the Leeds Autism Diagnostic Service (LADS) after successfully submitting business cases which resulted in permanent funding.  She has co-authored 4 recent publications describing the service development of LADS in Advances in Autism.

She also co-authored “A Clinician’s Brief Guide to the Mental Capacity Act” published June 2013 (2nd edition 2015) and is currently contributing to a book about autism for the BMA.

Dr Conor Davidson
Consultant Psychiatrist

Dr Conor Davidson qualified as a consultant psychiatrist in 2012.  He works two days a week in the Leeds Autism Diagnostic Service, and three days a week as a general adult psychiatrist in York.  His particular clinical interest is the comorbidity of autism and psychiatric disorders.  He has published several papers on autism including on Asperger syndrome and First Episode Psychosis.  In April 2017, Conor was appointed trust wide autism lead for Tees, Esk and Wear Valley Foundation Trust.    Unfortunately for him, Conor is a lifelong Leeds United supporter.

Dr Alwyn Kam
Specialty Doctor

Dr Alwyn Kam graduated from Manchester University with a degree in Biochemistry. He continued his education by studying Medicine and after qualifying, spent time working as a doctor in Australia for two years. He is a Specialty Doctor with the Leeds Autism Diagnostic Service (LADS) for two and half days in a week and Psychiatry of Learning Disability for two and a half days. He has maintained a keen interest in autism and other neurodevelopmental conditions.

Sarah Beswick
Clinical Team Manager

As team manager of the Leeds Autism Diagnostic Service, Sarah aims to make sure all people accessing the service have the best possible experience.

To ensure this, service users are asked for feedback at every stage of the pathway and this is regularly collected and utilised in service improvement work. Sarah uses her clinical and managerial experience to support the team so that they can deliver a clinical service with high standards in safety and clinical excellence.

Joanne Field
Occupational Therapist

Joanne works as an Occupational Therapist for the Leeds Autism Diagnostic Service and Leeds Adult ADHD (Attention Deficit Hyperactivity Disorder) Service. Joanne brings a wealth of experience to the team having worked in the organisation for 13 years in various teams. Joanne qualified as an Occupational Health Therapist in 2005.

Joanne supports our service users given a diagnosis of autism by providing specialist advice around reasonable adjustments required in the workplace.

Janet Tsiga
Autism Nurse

Janet qualified as a Learning Disability Nurse at Bradford University in 2004. She was seconded into a 12 month project for the Leeds Clinical Commissioning Groups to pilot a project of facilitating quality and improving the uptake of annual health checks for adults with Learning Disabilities.  Shortly after she was involved with two other nurses in a two year CQUIN within the 3 CCG areas of Leeds to continue implementing the pilot work.

She currently works as an Autism Nurse within the Leeds Diagnostic Service as part of the Multi-Disciplinary Team utilising specialist assessments. She is also part of the team providing autism awareness training to other professionals, carers and students within the LYPFT.

Vicky Straker
Autism Nurse

Vicky is a specialist autism Nurse who has worked with the Leeds Autism Diagnostic service for 1 year. Vicky qualified as a registered Nurse for Learning Disabilities 14 years ago and has worked in Leeds and York Partnership NHS Foundation Trust in various positions.

Vicky is very passionate about providing service users with high quality care & takes a keen interest in ensuring the pathway remains efficient & a fulfilling experience for service users.

Emma Jackson
Neurodevelopment Service Team Co-ordinator

Emma has worked in the NHS for 10 years. Prior to coming into the Leeds Autism Diagnostic Service Emma was employed by Mid Yorkshire Hospitals NHS Trust in the Community Administration Team. Emma started working for LADS in 2017 as the Team Coordinator. Emma’s main responsibility in the service is to ensure healthcare professionals are supported adequately to perform their roles.

Michaela Craggs
Service Support Secretary

Michaela has worked with the Leeds Autism Diagnostic Service since inception of the service in 2013.

More information on autism can be found by visiting the sites below:

• autism.org.uk
• nice.org.uk

Research papers

You can also download research papers authored by members of the Leeds Autism Diagnostic Service:

• Are we good and are we safe? Measuring quality and assessing risk in an adult autism diagnostic service
• How useful are the Adult Asperger Assessment and AQ-10 within an adult clinical population of all intellectual abilities
• No exclusions – developing an autism diagnostic service for adults irrespective of intellectual ability
• What is the association between ADI-R scores and final diagnosis of autism in an all IQ adult autism diagnostic service