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Summary of Clinical Practice Guideline

Royal College of Speech & Language Therapists; Department of Health; National Institute for Clinical Excellence (United Kingdom)

Royal College of Speech and Language Therapists Clinical Guidelines: 5.4 Autistic Spectrum Disorders
Taylor-Goh, S., ed. (2005).
RCSLT Clinical Guidelines. Bicester, Speechmark Publishing Ltd.

AGREE Rating: Highly Recommended

Description:
This guideline provides recommendations for assessment and treatment of preschool and school-age children with autism spectrum disorder (ASD). This guideline is intended for speech-language pathologists. Each recommendation is graded:

  • A - requires at least one randomized controlled trial,

  • B - requires at least one well-conducted clinical study, or

  • C - requires evidence from expert committee reports.

Recommendations:

Autism Spectrum Disorders
  • Assessment/Diagnosis/Screening

    • Assessment Areas

      • Cognition/Language

        • Professionals should consider the triad of social impairments and theories of each impairment during the assessment process (Level B Evidence). Specifically, consideration should be given to:

          • the individual’s ability to “direct and maintain shared attention” (Level B Evidence) (p. 36).

          • the individual’s “readiness and ability to focus and shift attention” (Level B Evidence) (p. 36).

          • qualitative aspects of social interaction skills in a variety of settings (Level B Evidence) (p. 36).

          • the individual’s use of communicative strategies (Level B Evidence) (p. 37).

          • the child’s play (Level B Evidence) (p. 37).

          • the individual’s learning potential (Level C Evidence) (p. 37).

          • possible mental health impacts (Level C Evidence)(p. 37).

  • Treatment

    • Cognition/Language

      • General Findings

        • “Early intervention is likely to be beneficial in fostering the development of communication skills in children with ASD” (Level B Evidence) (p. 38).

      • Pragmatic/Social Skills

        • General Findings -  “Approaches that focus on social functioning should be introduced as an on-going intervention strategy from early years to adulthood” (Level B Evidence) (p. 38).

      • Alternative and Augmentative Communication (AAC)

        • General Findings - “Consideration should be given to the use of alternative and augmentative communication systems (low and high technology)” (Level B Evidence) (p. 38).

  • Service Delivery

    • Provider

      • Diagnosis and management of ASD should be multidisciplinary (Level C Evidence) and professionals should work collaboratively with parents, teachers and others involved in day-to-day care of the individual to ensure consistency and increase generalization and maintenance of communication skills (Level B Evidence) (p. 35).
 
Social Communication Disorders 
  • Assessment/Diagnosis/Screening

    • Assessment Areas

      • Cognition/Language 

        • Assessment of children with autism spectrum disorder (ASD) should include"an evaluation of the individual’s ability to direct and maintain shared attention with another individual" (Level B Evidence) (p. 36). 

        • "It is essential to make a qualitative assessment of the [child with ASD's] social interaction skills. This should be carried out in a variety of social settings such as a school, nursery or day centre"(Level B Evidence) (p. 36). 

    • Assessment Instruments

      • Cognition/Language 

        • "It is essential to make a qualitative assessment of the [child with ASD's] social interaction skills. This should be carried out in a variety of social settings such as a school, nursery or day centre" (Level B Evidence) (p. 36).

  • Treatment

    • Cognition/Language

      • Pragmatic/Social Skills Treatment 

        •  “Approaches that focus on social functioning should be introduced as an on-going intervention strategy from early years to adulthood” (Level B Evidence) (p. 38). 

  • Service Delivery

    • Setting

      • "It is essential to make a qualitative assessment of the [child with ASD's] social interaction skills. This should be carried out in a variety of social settings such as a school, nursery or day centre" (Level B Evidence) (p. 36).

Keywords:
Autism Spectrum Disorders

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