Diagnosis of autismBMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7433.226 (Published 22 January 2004) Cite this as: BMJ 2004;328:226
Adequate funding is needed for assessment services
- Iain McClure, consultant child and adolescent psychiatrist (, )
- Haider Mamdani, consultant community paediatrician,
- Roslyn McCaughey, senior speech and language therapist
EDITOR—In their clinical review of the diagnosis of autism Baird et al highlight the need for a multiagency process of assessment and supportive intervention to be made available to all children presenting with concerning symptoms, in accordance with the recommendations of recent national reviews.1–3 One important additional reason for such provision, which their review does not emphasise, is that well coordinated, multiagency assessment teams for autism spectrum disorders have a better chance of accurately not giving a diagnosis of it.
Our multiagency assessment service for autism spectrum disorders has seen 57 patients in the past two years. We request baseline speech and language therapy and (where applicable) educational psychology assessments on the likelihood of autism spectrum disorder in all cases before patients are seen by our team, so as to ensure best use of clinical resources. Despite this approach only 26 patients (46%) deemed to be likely cases of autism spectrum disorder received a positive diagnosis. This is not due to overzealous interpretation of ICD-10 diagnostic criteria (which are increasingly recognised as being in urgent need of review), as we tend, if anything, to err in favour of diagnosis, even if ICD-10 (or DSM-IV) criteria, are not strictly fulfilled.
Relevant agencies must receive adequate funding for implementing the national autism plan for children.3 This is to benefit not only the children and their families who are struggling with the often devastating impact of this disorder but also the depressingly high number of children whom, we suspect, will be wrongly, or inaccurately, given diagnoses, if assessment services for autism spectrum disorders do not improve.
Competing interests None declared.
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