Planned new autism assessments could “harm children” while lengthening waiting lists for child and adolescent mental health (Camhs) services, advocacy groups say.Neurodiversity Ireland, ADHD Ireland and the autism charity AsIAm have added their voices to concerns raised by the College of Psychiatrists of Ireland which said it “could not endorse” the Health Service Executive’s (HSE) new autism protocol. The college said it had “significant concerns” about the planned autism assessment and intervention pathway protocol announced last week by the HSE and three Ministers including Minister for Health Jennifer Carroll MacNeill.The protocol, which the HSE hopes with tackle long waiting list for the statutory assessment of needs (AON), is likely to come into force in mid-2027. Planning for its implementation will begin in the autumn. It will introduce a three-tiered approach to assessing for autism. Unlike the AON which is a statutory right under the 2005 Disability Act conducted by multidisciplinary disability teams, the protocol will see assessments offered across HSE services including Camhs, public health nurses and local primary care teams. [ Psychiatrists’ body ‘cannot endorse’ new State autism protocolOpens in new window ]Legislation states a child has a right to a completed AON within six months of a valid application. Current waiting times, however, are up to 27 months, forcing many parents who can afford it to get private assessments.A HSE explanatory note on the protocol says: “It is anticipated that the successful implementation of [the protocol] will help to reduce demand for AON.”It says: “Tier 1 autism assessment is the default assessment for relatively clear presentations of autism” to be “typically completed in less than 10 hours” including assessment, report and feedback time.Tier 2 will be an “extended assessment ... where the presentation of autism is less clear” while tier 3 will involve “continuing assessment ... for the most complex and unclear presentations”. Concerns centre on Tier 1 which campaigners fear represents a move away from the detailed examination of the person’s social, linguistic, educational, sensory, and occupational support needs. Trish Byrne, the college’s chair of its faculty of child and adolescent psychiatry, said the protocol was an attempt to “spread the load of an overwhelmed system into other systems that are already also overloaded”. “The crux of the issue is that HSE disability services are not resourced adequately to meet the needs,” said Byrne.Nessa Hill, chief executive of Neurodiversity Ireland, described the new scheme as “a waiting-list initiative”. “It is not an initiative to improve services and supports for children and their families.”Dr Sonia Morris, clinical psychologist and director at ADHD Ireland, said: “Harm happens when there are inadequate assessments. Without a minimum standard of assessment harm can be done to children.”The bulk of Camhs’s work currently was assessing for ADHD, she said. Waiting lists for this were likely to “spiral” if Camhs clinicians were to take on autism assessments. Adam Harris, chief executive of AsIAm said the protocol was “a new way of working” but would “not in and of itself address anything in waiting times or waiting lists for services”. “This in no way should be seen as an alternative to the AON,” said Harris and called for measures to ensure “autistic people do not fall between stools” after an protocol assessment. A HSE spokeswoman said the executive had had “positive engagement” with the charities. Implementation planning is due to start in the third quarter of this year, and will include training needs analysis and the identification of clinical and governance requirements.“The resourcing concerns raised ... will be addressed by the recruitment of in-reach teams in the health regions,” said the spokeswoman.“These teams will work to upskill autism assessment competency and confidence across all community teams to ensure inclusive practice, access and sustainability when supporting autistic people.”