Disabilities Assessments

89. Deputy Tony McCormack asked the Minister for Children, Disability and Equality if she is satisfied with the robustness, consistency and appropriateness of the assessment processes used currently and historically in diagnosing disabilities and developmental conditions in children; and whether these processes have been reviewed to ensure that diagnoses are based solely on appropriate clinical criteria and the individual needs of the child. [66524/26]

I ask the Minister of State if she is satisfied with the robustness, consistency and appropriateness of the assessment processes used currently and historically to diagnose disabilities and developmental conditions in children. Have these processes been reviewed to ensure that diagnoses are solely based on appropriate clinical criteria and the individual needs of the child?

I thank the Deputy. The Government has always recognised the importance of ensuring that assessment and diagnostic processes for children with disabilities are clinically appropriate, evidence-based and respond to the individual needs of the child. It is important to note that a diagnosis is not required for access to children’s disability services. That includes primary care, children’s disability network teams, CDNTs, and child and adolescent mental health services, CAMHS. Under the HSE national policy on access to services for children and young people with disability and developmental delay, access to services is determined by the child’s needs rather than diagnosis. The Government remains committed to ensuring that children receive the right supports based on their assessed needs and it is working on a suite of legislation and operational reforms to improve delivery of children’s disability services. Clinical judgment is central to determining the type, scope and nature of a clinical assessment. These decisions are informed by the child’s developmental history, age, presenting needs, family context, the specific question being considered or the purpose of the assessment. A clinical assessment may be undertaken for a range of purposes and may comprise formal or informal methods, depending on the circumstances. Clinical assessment and diagnostic practice are underpinned by national and international evidence, professional standards and established clinical governance arrangements. These include professional regulation, continuing professional development, clinical supervision and quality assurance processes, which support safe, consistent and evidence-informed decision-making across services. A diagnosis is the process of identifying and determining the nature of a disease or disorder by its signs and symptoms through the use of assessment techniques such as tests, examinations and other available evidence. These diagnoses are informed by internationally recognised diagnostic classification systems alongside professional standards and evidence-based clinical practice. These frameworks support consistency and allow for clinical judgment.

I thank the Minister for that update. Will she talk a little more about the AON process and what the Department is doing to streamline that? Families are locked in a cycle of waiting. They are waiting for assessment and waiting for reports. It has proven for many years to be a blocker to things like educational places. I appreciate that is interdepartmental work between the Minister of State’s Department and education, but will she give me an update?

The Deputy is right. Many families are waiting too long for assessments of need for their children and it is not good enough. What got us here are increased demand, changing demographics and more awareness. All of those are good things but they have contributed to a quadrupling of assessments of need received since 2019. The reality is that the service has not kept pace. Ultimately, parents do not want to know why; they want to know what we are doing about it. The only way to fix it is to change things and that means reform. We are making three significant reforms. One is from a legislative perspective, one is from a policy perspective and one is from a budgetary perspective. We are updating the assessment of need legislation section of the Act to make it more efficient and effective, and most importantly to give a standardised approach so no matter where you are in the country you will get the same approach from a policy perspective. There are a number of changes the HSE is beginning to roll out. Single point of access is one. That relates to ensuring there is no wrong door. The autism protocol and pathways are another.

I welcome the changes coming under the Disability (Amendment) Bill 2026 and the Minister of State's and the Minister's continued commitment to maintaining the statutory entitlement to the AON. That remains there, but it is proving to be a blocker. I ask the Minister of State to continue her point and to speak more about the single point of access. How does that work practically? Is it through a GP or is it through any healthcare professional? How can we ensure that all those healthcare practitioners are informed?

The policy changes coming in include the introduction of the autism pathway and protocol, which will be there specifically for children presenting as potentially autistic. That will be a help in that regard. The single point of access, which the Deputy asked about, is the HSE initiative to ensure there will be no wrong door. I often meet with families who say their child was on a waiting list for a long time. They got to the top of the waiting list and were told they were in the wrong queue. That should not happen, cannot happen and will not happen. Going forward that is what the HSE's single point of access will be about. That will be for the whole of the health service, including CDNTs, CAMHS and primary care. The third element we are introducing is budgetary reform. We are investing in this section. We are building capacity. We are investing in our CDNTs. For example, this year we will have 150 additional posts in our CDNTs. We have secured a budget for another 150 posts next year. We have also introduced funding for a targeted wait list initiative, which supplements the work ongoing within our CDNTs by outsourcing to private providers. To be frank, the legislation, policy changes and budgetary changes are important and are all going to have an impact, but they will not have an impact overnight. I know that is frustrating for families to hear, but we need to make these changes because we need to make it easier and better for families to access these services.