Recognising and diagnosing autism in children and young people: summary of NICE guidanceBMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d6360 (Published 21 October 2011) Cite this as: BMJ 2011;343:d6360
- Gillian Baird, consultant paediatrician1, professor of paediatric neurodisability 1,
- Hannah Rose Douglas2,
- associate director,
- M Stephen Murphy, clinical codirector2
- 1Newcomen Centre, Guy’s Hospital, London SE1 9RT, UK
- 2National Collaborating Centre for Women’s and Children’s Health, Kings Court, London W1T 2QA
- Correspondence to: G Baird
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.
NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets.
Recognition of autism
Whenever concerns are raised by parents or …