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Autism services need to improve

Draft guidance calls for improvements to NHS autism services for under-18s
WebMD UK Health News
Medically Reviewed by Dr Rob Hicks

28th January 2011 -- The NHS needs to improve how it diagnoses autism in children and teenagers if it?s to cope with the increasing demand on services says NICE.

In draft clinical guidelines, the National Institute for Health and Clinical Excellence (NICE) calls for healthcare professionals in the NHS to work closer together, as well as to improve how they engage with schools, social care, the voluntary sector and other key services which can offer useful insight into the condition. The aim is to ensure that children and teenagers with possible autism spectrum disorder (ASD), as well as their parents or carers, receive the appropriate care and support they need.

At least one in 100 children under the age of three years has an ASD. However, NICE says levels of understanding among healthcare professionals vary greatly 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.

Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE says in a statement: ?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.?

Autism spectrum disorders

Autism spectrum disorders (ASDs) are a range of related developmental disorders that begin in childhood and persist through adulthood.

Symptoms can include difficulties with social interactions, impaired language and communication skills and unusual patterns of thought and physical behaviour.

The term spectrum is used because ASD symptoms can vary from child to child and from mild to severe.

Draft guidelines

Dr MacBeth says: ?Our draft recommendations outline the best ways that healthcare professionals can recognise the possible signs and symptoms of autism spectrum disorders in children and young people, when they should consider referring them to a specialist team, and how they should then be diagnosed.?

In its draft clinical guideline, NICE advises that:

  • A local ASD strategy group should be formed, 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, a child and adolescent psychiatrist, a speech and language therapist, a 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 or young person who is to undergo 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 or 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, eg. a school visit by a team member.

Dr Macbeth added: ?We are inviting anyone who has experience with autism, including healthcare professionals, charities and members of the public, to comment on our draft recommendations via one of our registered stakeholders. In particular, we are very keen to hear from young people or carers of young people to get their thoughts on how our draft recommendations could affect them. This is so that we can ensure the final version of our clinical guideline is of greatest benefit to the NHS and importantly to those who live with this condition.?

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