Recommendations for diagnosing autism (ASD) are not being followed for all children, with paediatricians reporting they are unable to access the services they need to meet recommended practice, a study by the Murdoch Childrens Research Institute has found.
The study found that while paediatricians used diagnostic classification systems to formulate the diagnosis for autism- cognitive, developmental and speech pathology assessments were not used by all paediatricians and genetic and audiology assessments are not always ordered.
The survey involved 124 paediatricians who commonly saw children with ASD from both metropolitan and regional areas.
Most paediatricians spend considerable time making a diagnosis of ASD, with 84% reporting more than one session was needed, but they did not always have all the assessment information available at the time of diagnosis. There were a number of reasons given by paediatricians as to why tests weren’t ordered including out of pocket costs for assessment, lack of local services and long waiting lists.
Speech pathologist and researcher, Amanda Brignell says paediatricians have a vital role in the diagnosis and management of children with ASD.
“A major barrier to paediatricians diagnosing ASD is limited timely access to the recommended assessment services. This lack of access needs to be addressed not only to optimise accurate diagnosis of ASD, but also to enable identification of individual children’s strengths and assist planning for the provision of the best possible services for all children.”
Professor Katrina Williams said best clinical practice for accurately assessing ASD in childhood involves a full developmental history, physical examination of the child, evidence from teacher or childcare reports regarding behaviour, assessment of speech and language abilities, assessment of general development and exclusion of other causes such as hearing and genetic testing.
“There are barriers to paediatricians accessing all the assessments they need. This means they do not have important information about each child’s abilities, which is needed for diagnosis and also for providing information relevant to intervention and future planning,” Professor Williams said.
In the study most children assessed for a diagnosis of ASD were preschool age (63%), with a smaller proportion being aged less than two years (7%), attending primary school (25%) and attending secondary school (5%).
(Source: Murdoch Childrens Research Hospital)