Ms Sonia Magaharan:

In response to the question on the integration of services, we have actually set up a system where we meet every six weeks with our ASD service to discuss our joint cases. As I said in my submission, there is a high comorbidity for ADHD and ASD and I think we need to look at integration. The Chairman makes a valid point on integration. I actually think some of these services should be joined up. We have a a paediatrician from the North who is coming on Friday to speak to our team. In the United Kingdom, some 50% of ADHD cases are seen by the paediatrics service. They are treated, diagnosed, and managed by paediatrics, whereas in the Republic of Ireland, it is all managed by the child and adolescent mental health service. We need to look at other ways of providing services, such as neurodevelopmental teams, where we can deal with ASD and CAMHS. We need paediatric staff on those teams, because these children often have other conditions as well. We need a wraparound service. Currently what is happening is that children may be coming to CAMHS for ADHD, they are sent down the road for ASD and then in the meantime they may be referred on to the paediatric service for certain screeners. I have a child who has been waiting 18 months currently for an endocrine screener before we can actually treat the child. Our hands are tied. We cannot do an intervention because we do not know what else is going on for him. We need to do things differently and integration is really important.