Southport inquiry hears of delays in attacker’s autism diagnosis

An autism assessment for Southport attacker Axel Rudakubana was delayed by eight months despite a teacher contacting the service to call for help with his diagnosis, a public inquiry has heard.

Giving evidence to the Southport Inquiry on Tuesday, Lynsey Boggan, clinical lead of neurodevelopmental services at Alder Hey Children’s NHS Foundation Trust, said there was a 45-week wait for an appointment for Rudakubana after he was referred to the community paediatric service for an autism diagnosis in November 2019.

The inquiry, sitting at Liverpool Town Hall, heard the average waiting time for an appointment was 11 weeks.

An email from Joanne Hodson, deputy head teacher of the Acorns School, sent to the community paediatric service on November 22 2019 said: “I really need some help with a referral for a young man who is presenting to us as ASD.”

She explained the incident where Rudakubana told Childline he had been taking a knife to the Range High School, Formby, which led to him being expelled.

She said: “I asked him about the incident at his admissions meeting and he was monotone, emotionless and very matter of fact about his intentions.”

She said they had “serious safeguarding concerns” and Rudakubana was fixating on another student in his class whom he said was bullying him, although staff had seen no evidence of that.

She added: “During his ICT lesson Axel was searching school shootings in America. Dad was informed of this but then rang back and said it was untrue.”

On December 3 2019 Ms Hodson emailed the service again to “advise of further developments and concerns”.

She outlined a number of incidents, including him asking a teacher for a picture of a severed head and speaking about people getting murdered.

Ms Boggan, who was not working for Alder Hey at the time, said she had not been able to find any records of a response to the school.

Nicholas Moss KC, counsel to the inquiry, said: “Would you agree that it’s concerning that there is no such record of any response?”

Ms Boggan said: “Yes, I would.”

She agreed she would have expected the emails to trigger a prioritisation of Rudakubana’s case, but said at the time there was not a process for expediting cases.

She agreed that the fact an appointment for an autism assessment was not offered until July the next year was a “marked shortcoming”.

At a multi-disciplinary panel meeting on December 30 2020 Rudakubana was diagnosed as autistic and it was recommended he was assessed for ADHD, the inquiry heard.

Minutes from the meeting, shown on screen, recorded his behaviour had changed on transition to high school and he had highly fixated interests.

Ms Boggan said she took part in a video call with Rudakubana and his father in which his diagnosis was explained to him.

She said: “I was aware that there were some incidents where he had harmed other people and I think that was why we went around it so sensitively in terms of how we delivered the news.”

The inquiry heard an assessment by the forensic child and adolescent mental health service (FCAMHS), which works with young people with high-risk behaviour, was not done because they were awaiting the result of the autism referral.

But Ms Boggan said letters from FCAMHS were not put onto the record so the autism service was unaware of them.

She said she would have expected CAMHS to re-refer him to the forensic service after his diagnosis.

The inquiry is due to hear more evidence from mental health services on Tuesday.