2026-06-23

1. Deputy Ruairí Ó Murchú asked the Minister for Children, Disability and Equality to provide an update on the progress of the establishment of the new autism assessment service; and if she will make a statement on the matter. [47690/26]

I ask the Minister of State to provide an update on the progress of the establishment of a new autism assessment service. We all know about the issue that exists. We are talking about more than 20,000 on the assessment of need waiting lists, many of them over the six months in which that should be provided legally. There are a huge number of parents out there who can get neither an assessment nor the therapies their child requires. We really need to solve this for the parents out there.

I thank the Deputy for this question. On 26 May, the Minister for Children, Disability and Equality, Deputy Foley and I, along with the Minister for Health, Deputy Carroll MacNeill, and the HSE were pleased to launch the new autism assessment and intervention pathway protocol - the autism protocol. The new protocol represents an important step in ensuring that children and adults have access to appropriate and timely autism assessment processes. The new protocol will, for the very first time, provide a standardised assessment process across children's disability network teams, primary care and mental health services. Evidence tells us that some presentations of autism are easier to identify than others. Informed by this evidence, the HSE has designed a protocol that will introduce a three-tiered approach to autism assessment. It will match the intensity of assessment to the complexity of the presentation, as decided by the assessing clinicians. It is a pathway designed specifically for autism assessment, and this includes differential assessment and diagnosis, as required, as well as the development of a formulation to provide clearer understanding of the person's lived experience and the services and supports they may require. The autism protocol has been developed over a period of five years, with input from people with lived experience, civil society and all clinical disciplines involved in assessments as well as managers and service leaders across disability, primary care and mental health services. To support the implementation of this, my Department secured funding in this year's budget for the development of inreach teams. These will consist of a psychologist, a speech and language therapist, an occupational therapist and a case worker. These teams will work with the health areas to support and to build capacity within community services, including mental health and primary care teams as well as our CDNTs. Implementation planning for the protocol within the regions will commence in quarter 3 of this year and will include relative briefing and training within the regional healthcare areas. We are providing training in the meantime, until that point.

I ask the Minister of State to give the exact timelines when she gets an opportunity again-----

Sure. I understand.

-----because, obviously, it is vital that we see this. It is also a matter of knowing how these assessments will be made. Some have said they would be worried about how the assessment officer or whoever makes the clinical determination. It is about ensuring that there would be a sufficient amount of clinical backup. We all accept that if we were starting again, we would have to look at a different system as regards assessment of need and how therapies are provided. I have always had a worry about how we will try to ensure we have enough of a workforce as regards therapists, whether we are talking about the inreach teams, CDNTs or primary care. In addition, I ask the Minister of State to give the up-to-date figure for the assessment-of-need waiting list and how she sees this impacting that.

To be clear on the timelines, since the Deputy specifically asked, this is now launched. It will be rolled out in quarter 3 of this year. Right now, we are working with teams across the country to upskill and to train them on this new system of autism protocol and pathways. It is expected that when it is fully rolled out, each of the 20 integrated health areas will have one established inreach team. This year we will recruit 11 inreach teams. The final design and respective roles of the teams are being finalised. Recruitment for those inreach teams will commence in quarter 3 and quarter 4 of this year and they will be, as the Deputy referred to them in his remarks, the backup for the system. While it is not possible to quantify the exact impact at this stage in terms of assessments, it is anticipated that the successful implementation of the autism protocol will help to reduce demand for assessment of need, which the Deputy also mentioned. It will do that through the provision of a more direct and a clearer path to autism assessment for children and their families. To be clear, however, this does not in any way impact anybody's statutory right to an assessment of need. It is just a clearer access pathway through existing services such as primary care, our children's disability network teams and CAMHS, should people with an appropriate route to an assessment require one.

I understand that your right to an assessment of need remains, but the fact is that these are attempts to reduce the waiting list. We all know that what parents want to see is a better form or means of assessment and provision of therapies. We need to ensure we have a proper framework that works. I will ask again about an aspect of this matter that I have asked about in a further question which I imagine will not get answered tonight. At this point in time, what are the numbers for the assessment of need waiting list and, as I said, specifically the number that is above the six months that are legally required to provide that service for families? We all know the issues that exist out there. The problem is that parents and children are really suffering from the fact that we have not put a proper framework in place to provide the therapies and the constant assessment, which is the best means of doing this, to provide something that works.

I agree with much of what the Deputy says. This is an attempt to provide alternative means for assessments. There will be three tiers in this autism assessment and intervention pathway protocol. Tier 1 is for an assessment with clear presentations of autism, tier 2 is a more detailed assessment for unclear causes using structured tools and input from multiple professionals, and tier 3 is an assessment for more complex presentations involving additional specialists and further reports. I know the Deputy has a further parliamentary question. I think it is No. 19. The updated figure we have is that there are 21,782 applications overdue for completion. That was as at the end of March. The figures we have are on a quarterly basis, so that is the most up-to-date figure we have this quarter.