Autism Spectrum Disorders
Assessment/Diagnosis/Screening

General Findings

External Scientific Evidence

Evidence-Based Practice Guidelines

National Collaborating Centre for Women's and Children's Health; National Institute for Health and Clinical Excellence   Autism: Recognition, Referral and Diagnosis of Children and Young People on the Autism Spectrum National Institute for Health and Clinical Excellence. (2011). London (UK): National Institute for Health and Clinical Excellence (NICE), 296 pages.   Added: April 2012

 

Description

This guideline provides recommendations for assessment of autism spectrum disorders in children and young people. The target audience is professionals who work in or use the National Health Service in England and Wales. 

 

Recommendations

• "The autism team should either have the skills (or have access to professionals that have the skills) needed to carry out an autism diagnostic assessment, for children and young people with special circumstances including: coexisting conditions such as severe visual and hearing impairments, motor disorders including cerebral palsy, severe intellectual disability, complex language disorders or complex mental health disorders, and looked-after children and young people" (p. 15).
• “When considering the possibility of autism, be aware that autism may be missed in children or young people with an intellectual disability or who are verbally unable” (p. 17).
• “Do not rule out autism because of good eye contact, smiling and showing affection to family members [or because of] reported pretend play or normal language milestones” (p. 18).
• Refer children younger than 3 years to the autism team and carry out an autism diagnostic assessment if there is regression in language or social skills (pp. 19, 22).
• “Refer first to a paediatrician or paediatric neurologist (who can refer to the autism team if necessary) children and young people older than 3 years with regression in language [or a child or young person of] any age who presents with regression in motor skills” (p. 19).
• Multiple areas should be assessed and information gathered during an autism diagnostic assessment such as the “assessment (through interaction with and observation of the child or young person) of social and communication skills and behaviours, focusing on features consistent with ICD-10 or DSM-IV criteria (consider using an autism-specific tool to gather this information)” (p. 25).
• “Consider the following differential diagnoses for autism and whether specific assessments are needed to help interpret the autism history and observations: neurodevelopmental disorders (e.g., specific language delay or disorder), mental and behavioural disorders (e.g., attention deficit hyperactivity disorder), conditions in which there is developmental regression (e.g., Rett syndrome), and other conditions (e.g., severe hearing impairment)” (p. 26).
• “Consider which assessments are needed to construct a profile for each child or young person, for example:  intellectual ability and learning style; speech, language, and communication; and socialisation skills” (p. 27).
• “Be aware that in some children and young people there may be uncertainty about the diagnosis of autism, particularly in cases where “children or young people [present] with a complex coexisting mental health disorder (e.g., conduct disorder), sensory impairment (e.g., hearing or visual impairment), or a motor disorder (e.g., cerebral palsy)” (p. 28).
• “Consider whether the child or young person may have any of the following as a coexisting condition, and if suspected carry out appropriate assessments and referrals: mental and behavioural problems and disorders (e.g., mood disorders), neurodevelopmental problems and disorders (e.g., speech and language disorder), medical or genetic problems and disorders (e.g., tuberous sclerosis), and functional problems and disorders (e.g., feeding problems, including restricted diets)” (p. 29).
• “Be aware that in children and young people with communication difficulties it may be difficult to recognize functional problems or mental health problems” (p. 30).

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American Speech-Language-Hearing Association    Guidelines for Speech-Language Pathologists in Diagnosis, Assessment, and Treatment of Autism Spectrum Disorders across the Life Span Wetherby, A., Diehl, S., et al. (2006). Rockville (MD): American Speech-Language-Hearing Association, 46 pages.  Added: July 2011

 

Description

This guideline provides recommendations for screening, diagnosis, assessment and treatment of children and adults with autism spectrum disorder (ASD). The target audience of this guideline is speech-language pathologists. 

 

Recommendations

SLPs are involved in the screening and early identification of children at risk for ASD and must make appropriate referrals to professionals for diagnosis and treatment needs.As mandated by the IDEA (2004), SLPs should determine eligibility for services on an individualized basis, as opposed to using a priori criteria. SLPs in public school settings must determine service eligibility as a team and eligibility should be based on clinical judgment and observational measures (p. 15). 

 

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Evidence-Based Systematic Reviews

No evidence-based systematic reviews were found.