Aims To measure local autism diagnostic assessment pathway against NICE guideline for recognition, referral and diagnosis of children and young people on the autistic spectrum (2011).
Methods Retrospective analysis of summary reports of the children being assessed for diagnosis of Autism between January–December 2011.
Reports were audited against NICE guideline criteria:
Criteria 1 – the autism diagnostic assessment should be started within 3 months of the referral to the autism team
Criteria 2 – Every diagnostic assessment should include parental concerns, detailed developmental and medical history
Criteria 3 – Detailed General physical examination
Criteria 4 – Provision of written reports to parents/carers and children (if appropriate)
Criteria 5 – Information should be shared with GP
Criteria 6 – Follow-up appointment for children and young people with a diagnosis of autism within 6 weeks of the end of the autism assessment for further discussion
82 patients were assessed between January–December 2011
76 out of 82 patients had assessments completed
33 out of 76 were diagnosed with Autistic Spectrum Disorders
Assessments were carried out between 4 months to 12 months after the referral
Detailed neurodevelopmental history was taken during the assessment in all children (100%)
70% (53 out of 76) of children has had general physical examination
100% of the children had a detailed written report which was explained to the parents and a copy was sent to their GPs
There is no local provision for follow up service by the Autism team.
Conclusions 43% of the children referred had a diagnosis of Autistic Spectrum Disorders. Majority of the referrals (70%) came from Paediatricians.
Assessments were delayed up to a year as a result of high numbers of referrals due to increase awareness in Autistic Spectrum Disorder.
We proposed the following local implementations.
Education and training to junior doctors by regular teaching sessions
Local referral pathway to involve initial assessment by community paediatrician, use of standard screening tools and standard referral letter.