Practice Guidelines

Management of autism in children and young people: summary of NICE and SCIE guidance

BMJ 2013; 347 doi: (Published 28 August 2013) Cite this as: BMJ 2013;347:f4865
  1. Tim Kendall, director, consultant psychiatrist and medical director, professor123,
  2. Odette Megnin-Viggars, systematic reviewer1,
  3. Nick Gould, consultant, emeritus professor, professor456,
  4. Clare Taylor, senior editor1,
  5. Lucy R Burt, research assistant1,
  6. Gillian Baird, consultant paediatrician, professor of paediatric neurodisability7
  7. on behalf of the Guideline Development Group
  1. 1National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London E1 8AA, UK
  2. 2Sheffield Health and Social Care NHS Foundation Trust, Sheffield S10 3TH, UK
  3. 3University College London (Clinical, Educational and Health Psychology), London WC1E 7HB, UK
  4. 4Social Care Institute for Excellence, London SW1Y 5BH, UK
  5. 5Department of Social and Policy Sciences, University of Bath, Bath BA2 7AY, UK
  6. 6School of Human Services and Social Work, Griffith University, QLD 4131, Australia
  7. 7Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, King’s College London, London WC2R 2LS, UK
  1. Correspondence to: T Kendall tim2.kendall{at}

Autism occurs in approximately 1% of children and young people,1 though the diagnosis is made less commonly in girls2 and anyone with severe intellectual disability.1 It is one of the most important causes of lifelong disability, with support and lost productivity costs estimated at more than £28bn (€32bn, $43bn) annually in the UK.3 Individual presentations vary widely, as do associated functional impairments, but the core features of autism are persistent impairment in reciprocal social interaction and social communication and restricted, repetitive patterns of behaviour, interests, or activities. These features occur whether or not the individual has an intellectual disability and are typically present in early childhood, though they may be masked by parental support or compensations. Intellectual disability, language impairment, academic deficits, and movement disorders are common,4 and mental and behavioural disorders are found in up to 70%.5 The presence of all these factors, as well as sensory sensitivities, constipation, sleep and eating problems, and behaviour that challenges, add considerably to the impact on the child or young person, their family, and professionals in health and social care and education.

This article summarises the most recent joint recommendations from the National Institute for Health and Care Excellence (NICE) and the Social Care Institute for Excellence (SCIE) on managing autism in children and young people.6


NICE recommendations are based on systematic reviews of the 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.

Access to health and social care services

  • Ensure that all children and young people with autism have full access to health and social care services, including mental health services, regardless of their intellectual ability or …

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