A thread on the Assessment of Need: the statutory process by which children whose parents have concerns about potential disability can be assessed.

The process has recently been changed by the HSE in a manner that is frankly appalling.

Explanation: (1/n)

Parents might apply for AoN for a child due to concerns about development- in my clinic, the commonest reason is queried autism.

Previously, the AoN involved a team (usually physio, OT, SLT, psychology) assessing a child to get insight into the nature of their difficulties (2/n)
The team conducted a series of assessments, usually taking several hours each, and produced a report giving a detailed analysis of how a child is doing, what the causes of their difficulties might be, suggesting a diagnosis if appropriate, and giving advice on next steps (3/n)
Based on this, a child might be entitled to additional support in the classroom or financial supports. Medical investigations for individual diagnoses could also be arranged.

Function is more important than diagnosis, but in our system diagnoses get you support.

(4/n)
Legally, the AoN must be completed within 6 months of referral.

In many parts of the country, including Dublin, this almost never happens.

91% of children do not get their assessments on time. (5/n)

https://t.co/LQseHEWj3u
The HSE get sued for this. A lot.

In Jan 2020, the HSE produced a new Standard Operating Procedure for AoN.

It reduces the previous assessment involving multiple professionals to a single assessment lasting a maximum of 90 minutes, regardless of the child's needs. (6/n)
The reports will indicate if a child has a disability or not, but due to the limited scope do not allow for any insight into diagnosis or next steps.

This is left for community disability teams, whose assessments are not subject to legal time limits (so the HSE cannot be sued).
In its current form, the SOP appears designed to reduce legal liability than out of any interest in meeting the needs of children. The HSE is aware of this, having been repeatedly told so, but has persisted with it anyway. (8/n)

https://t.co/zp5pgO0AHV
The correct course of action to tackle waiting lists is to resource disability appropriately.

Instead, the HSE have reduced the AoN to a meaningless box ticking exercise which children must go through before being moved to another waiting list with no legal time limit. (9/n)
This course of action is an open declaration of contempt for the rights of children with disabilities.

It is apparently more important that statutory obligations are "met" on paper than that children's needs are actually met in real life.

This is a State apology in waiting.
@AnneRabbitte @DonnellyStephen @rodericogorman @josephamadigan @psychpolis @GarNob #disability #earlyintervention #rehabilitation #paediatrics
@OCO_ireland

More from For later read

Today's Twitter threads (a Twitter thread).

Inside: Planet Money on HP's myriad ripoffs; Strength in numbers; and more!

Archived at: https://t.co/esjoT3u5Gr

#Pluralistic

1/


On Feb 22, I'm delivering a keynote address for the NISO Plus conference, "The day of the comet: what trustbusting means for digital manipulation."

https://t.co/Z84xicXhGg

2/


Planet Money on HP's myriad ripoffs: Ink-stained wretches of the world, unite!

https://t.co/k5ASdVUrC2

3/


Strength in numbers: The crisis in accounting.

https://t.co/DjfAfHWpNN

4/


#15yrsago Bad Samaritan family won’t return found expensive camera https://t.co/Rn9E5R1gtV

#10yrsago What does Libyan revolution mean for https://t.co/Jz28qHVhrV? https://t.co/dN1e4MxU4r

5/
There is some valuable analysis in this report, but on the defense front this report is deeply flawed. There are other sections of value in report but, candidly, I don't think it helps us think through critical question of Taiwan defense issues in clear & well-grounded way. 1/


Normally as it might seem churlish to be so critical, but @cfr is so high-profile & the co-authors so distinguished I think it’s key to be clear. If not, people - including in Beijing - could get the wrong idea & this report could do real harm if influential on defense issues. 2/

BLUF: The defense discussion in this report does not engage at the depth needed to add to this critical debate. Accordingly conclusions in report are ill-founded - & in key parts harmful/misleading, esp that US shldnt be prepared defend Taiwan directly (alongside own efforts). 3/

The root of the problem is that report doesn't engage w the real debate on TWN defense issues or, frankly, the facts as knowable in public. Perhaps the most direct proof of this: The citations. There is nothing in the citations to @DeptofDefense China Military Power Report...4/

Nor to vast majority of leading informed sources on this like Ochmanek, the @RANDCorporation Scorecard, @CNAS, etc. This is esp salient b/c co-authors by their own admission have v little insight into contemporary military issues. & both last served in govt in Bush 43. 5/

You May Also Like

https://t.co/6cRR2B3jBE
Viruses and other pathogens are often studied as stand-alone entities, despite that, in nature, they mostly live in multispecies associations called biofilms—both externally and within the host.

https://t.co/FBfXhUrH5d


Microorganisms in biofilms are enclosed by an extracellular matrix that confers protection and improves survival. Previous studies have shown that viruses can secondarily colonize preexisting biofilms, and viral biofilms have also been described.


...we raise the perspective that CoVs can persistently infect bats due to their association with biofilm structures. This phenomenon potentially provides an optimal environment for nonpathogenic & well-adapted viruses to interact with the host, as well as for viral recombination.


Biofilms can also enhance virion viability in extracellular environments, such as on fomites and in aquatic sediments, allowing viral persistence and dissemination.