Draft autism guidance calls for services improvements

New draft guidance from the National Institute for Health and Clinical Excellence (NICE) on NHS autism services for under-18s has called for better diagnosis of the condition if it is to cope with increasing demand.

At least 1 in 100 children under the age of three years has an autism spectrum disorder (ASD) but levels of understanding among healthcare professionals vary across the UK. ASD can be difficult to correctly diagnose as there are lots of possible signs and symptoms, as well as coexisting conditions with similar features, such as intellectual disability, attention deficit hyperactivity disorder and obsessive compulsive disorder. In its draft clinical guideline NICE has called for NHS healthcare professionals to work closer together, as well as to improve how they engage with schools, social care, the voluntary sector and other key services that can offer useful insight into this condition.

Dr Fergus Macbeth, director of the Centre for Clinical Practice at NICE said: “A correct diagnosis of autism can bring a profound sense of relief to some children and young people from what can be an intense feeling of isolation from the rest of the world. It can also help them and their families or carers to get support from education, health services and voluntary organisations and make contact with others with similar experiences.” Guidelines include:

• Forming a local ASD strategy group, with representation from child health and mental health services, education, social care, the voluntary sector and parents or carers of children with ASD
• A multi-professional team should lead the referral and diagnosis of individuals with possible ASD; including a paediatrician, child and adolescent psychiatrist, speech and language therapist, clinical or educational psychologist, and an occupational therapist. The ASD team should undertake the diagnostic assessments where appropriate and advise healthcare professionals about referrals
• Every child/young person who undergoes a diagnostic assessment of ASD should have an appointed case coordinator from the ASD team who will be their single point of contact and signpost them, and their parents/carers, to appropriate services and support
• Healthcare professionals should always consider the possibility that the child/young person may have another condition with similar features to ASD. If an alternative diagnosis is suspected, they should undertake the appropriate assessments and referrals
• Following diagnosis, the ASD team should create a profile of the child/young person, detailing their strengths, skills, impairments and needs. This will support their education, communication, behavioural, emotional and family needs. With consent from the parent or carer, the profile should also be shared directly with relevant services, e.g. a school visit by a team member.

The consultation deadline is Friday, March 25. The final clinical guideline is scheduled to be published in September. Once published, the recommendations will represent best clinical practice for the NHS.