Recognising and diagnosing autism in children and young people: summary of NICE guidance

Autism affects children, young people, and adults and describes qualitative difference and impairments in reciprocal social interaction and communication behaviours combined with a restricted range of interests and rigid or repetitive behaviours. Autism is diagnosed when features meet the criteria defined in the ICD-10 (international classification of diseases, 10th revision)1 and the DSM-IV-TR (diagnostic and statistical manual of mental disorders, fourth edition, revised)2 for “pervasive developmental disorder” and have a considerable impact on function. Core autism behaviours are typically present in early childhood, but are not always apparent until the circumstances of the child or young person change—for example, when the child goes to nursery or primary school or moves to secondary school. Autism is also associated with several coexisting conditions including neurodevelopmental, medical, and mental health problems. Autism was once thought to be an uncommon developmental disorder, but recent studies have reported increased prevalence and the condition is now thought to occur in at least 1% of children.3 4 5 This has increased demand for diagnostic services for children and young people of all ages in the health service. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on how to recognise and diagnose autism in children and young people up to the age of 19 years.6 This summary focuses on recommendations for the non-specialist on how to recognise the condition and when to refer to a specialist autism team.