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Assessment in specialist services - children and young people

Quality statement

Children and young people accessing specialist services for alcohol use receive a comprehensive assessment that includes the use of validated measures.

Quality measure

Structure

a) Evidence of local arrangements to ensure that children and young people accessing specialist services for alcohol use receive a comprehensive assessment that includes the use of validated measures.

b) Evidence of local arrangements to ensure the use of a standardised comprehensive assessment form in specialist services accessed by children and young people for alcohol use.

c) Evidence of regular local audit of case files for children and young people in specialist services accessed by children and young people for alcohol use, to ensure adherence to all assessment domains.

d) Evidence of local arrangements in specialist services for effective coordination with other relevant agencies for children and young people at risk of harm from alcohol use.

Process

a) Proportion of children and young people accessing specialist services for alcohol misuse who receive a comprehensive assessment.

Numerator - the number of people in the denominator receiving a comprehensive assessment.

Denominator - the number of children and young people accessing specialist services for alcohol use.

b) Proportion of children and young people accessing specialist services for alcohol use who are assessed using appropriate and validated measures for each applicable assessment domain.

Numerator - the number of people in the denominator assessed using appropriate and validated measures for each applicable assessment domain.

Denominator - the number of children and young people accessing specialist services for alcohol use.

Description of what the quality statement means for each audience

Service providers ensure they implement validated measures for assessing children and young people who access specialist services for alcohol use and ensure that all components of a comprehensive assessment are completed for every person.

Health and social care professionals ensure they carry out a comprehensive assessment of multiple areas of need using a validated measure such as the Adolescent Diagnostic Interview (ADI) or the Teen Addiction Severity Index (T-ASI) for children and young people accessing specialist services for alcohol use.

Commissioners ensure they commission specialist services for children and young people at risk of harm from alcohol use that use validated measures for assessment and ensure that all components of a comprehensive assessment are completed for every person.

Children and young people attending specialist services for alcohol problems receive a full assessment of different areas in which they may need help.

Source clinical guideline references

NICE clinical guideline 115 recommendations 1.3.7.1, 1.3.7.2, 1.3.7.3 and 1.3.7.4 and NICE public health guidance 24 recommendation 6.

Data source

Structure

a), b), c) and d) Local data collection.

Process

Local data collection. The National Drug Treatment Monitoring System (NDTMS)collects data on young people (lower age limit 9 years old) presenting to specialist young people's drug and alcohol services; ‘triage date' is collected, which is the date that triage/initial assessment took place (this is not necessarily a comprehensive assessment). Also collects data at treatment start on the numbers of drinking days in the last 28 days (self-report) and typical numbers of numbers of units consumed in an average drinking day. Contained within NICE clinical guideline 115: audit support criterion 15.

Definitions

NICE clinical guideline 115 recommends that a comprehensive assessment for children and young people (supported if possible by additional information from a parent or carer) should assess multiple areas of need, be structured around a clinical interview using a validated clinical tool (such as the ADI or T-ASI), and cover the following areas:

  • consumption, dependence features and patterns of drinking
  • comorbid substance misuse (consumption and dependence features) and associated problems
  • mental and physical health problems
  • peer relationships and social and family functioning
  • developmental and cognitive needs, and educational attainment and attendance
  • history of abuse and trauma
  • risk to self and others
  • readiness to change and belief in the ability to change
  • obtaining consent to treatment
  • developing a care plan and risk management plan.

NICE clinical guideline 115 recommends that comprehensive assessments for children and young people are carried out in child and adolescent mental health services (CAMHS). NICE public health guidance 24 recommends that, for children aged 10-15 years, if there is a reason to believe that there is a significant risk of alcohol-related harm, referral to either CAMHS, social care or to young people's alcohol services for treatment, should be considered.

Any initial assessment of children and young people where alcohol misuse is identified as a potential problem, which may or may not form part of the comprehensive assessment, should assess:

  • the duration and severity of the alcohol misuse (the standard adult threshold on the AUDIT for referral and intervention should be lowered for young people aged 10-16 years because of the more harmful effects of a given level of alcohol consumption in this population)
  • any associated health and social problems
  • the potential need for assisted withdrawal.

NICE public health guidance 24 recommends that, for children aged 10-15 years, a detailed history of their alcohol use (for example, using the Common Assessment Framework as a guide) should be obtained. Background factors such as family problems and instances of child abuse or under-achievement at school should also be included.

Equality and diversity considerations

All assessments should be age-appropriate and accessible to children and young people with additional needs such as physical, sensory or learning disabilities, and to children and young people who do not speak or read English. Children and young people needing a comprehensive assessment should have access to an interpreter or advocate if needed.

This statement applies to people aged 10-17 years only, which is appropriate given the different needs of children and young people compared to adults who misuse alcohol.

This page was last updated: 25 August 2011

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Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.