Therapists: Children with disabilities being let down by 'box-ticking' assessments

Families are being 'duped' into believing they are getting a faster service but therapists say it will only lead to longer waiting lists for disability services.

The Irish Association of Speech and Language Therapists has claimed the implementation of a new approach to assessment of need has "exacerbated an already intolerable situation for the children of Ireland and their families" and should stop immediately.

TheIASLT was backed in its call by the Association of Occupational Therapists of Ireland and comes as the Psychological Society of Ireland warned that its members working in disability services could leave the sector over the implementation of the Preliminary Team Assessment, or PTA, which one psychologist said was "not worth the paper they are written on".

The professional bodies said the 90-minute PTA fell short of the standard required to deliver a proper assessment of a possible diagnosis of a child, with the chief strategy officer of the AOTI, Odhran Allen, claiming it was "the direct opposite of what is intended in the Disability Act".

The chairperson of the IASLT, Marijke Morris, said the PTA could be in breach of codes of conduct and ethics set down by the regulator of the sector, CORU.

The PSI called for the "immediate cessation" of the PTA, with a poll of members working in disability services claiming it was "not fit for purpose".

The PSi also included comments from the members it surveyed. One claimed:

It is heart-breaking for families who...are being led to believe that the PTA is a meaningful assessment of their child's needs...these ‘assessments' are not worth the paper they are written on.

Another said it was "unethical to expect clinicians to complete a 90-minute assessment and make a determination of disability", while another said "it would be impossible to say for certain whether or not the child had a disability in the allocated time frame. It is therefore of little benefit for a child or family".

One senior clinician said the PTA was "diverting valuable staff resources away from meaningful, comprehensive assessments and subsequent therapeutic interventions for vulnerable children and their families. The assessment itself will result in a worthless summary report indicating that the child will need a full and comprehensive assessment".

Others described it as "a box tick exercise" and one claimed: "It is completely unethical on every level and is basically trying to dupe parents into believing they are getting a faster service but will only lead to longer waiting lists for disability services."

It is a defensive practice for legal reasons and should be exposed as such. In short it is a disgrace.

Changes to the AON system were implemented a year ago amid chronic waiting lists and a growing number of parents bringing the HSE to court over failures to deliver the AON within the statutory timeframe. 

One psychologist said: "It is my opinion that the PTA model has been pushed through as a result of the failings of the existing system, whereby the statutory time frames for assessments and reports are not being met, and to address the mounting numbers of legal challenges and High Court actions re same."

Clinicians surveyed said the PTA was an "unnecessary exercise" that would actually add to the waiting lists in the longer term, while causing stress to professionals charged with delivering a diagnosis.

"It makes me want to leave not just the disability team, but the HSE," one said, while another claimed: "I have worked in disability services for 12 years and cannot stay if this is the future."