Autism in Children and Young People

This is really not a very helpful guideline. Really the message for us is that if parents / school or you have a real concern that a child may have an Autism Spectrum Disorder, refer on for assessment.

Don’t dismiss the possibility of a problem if they have features such as good eye contact, smiling, showing affection, reported pretend play or normal language. Also don’t rely on a negative score on a diagnostic test. Still consider the diagnosis if a previous assessment showed that there was no autism, if new features have appeared. You should also not dismiss the diagnosis if the child’s difficulties resolve after initial interventions.

On a more helpful note, they list associated features that can be found at each age of presentation (from pre-school to adult). These are worth referring to if you have someone with a behavioural problem.

Referral

  • Children over 3 with suggested features and regression should be referred first to paeds to exclude other conditions.
  • Other children in whom the diagnosis is considered, should be referred to the ‘autism team’ (in Portsmouth this is currently led by the community paeds I believe).

My own comments

I try not to put too much of my own interpretation onto things, but I think that this is a really unhelpful guideline. I think the message that I’m getting is that it can be really difficult to diagnose an Autism Spectrum Disorder and that people with mild problems can easily be missed. The full guideline goes to some length to explain that even people with mild problems can be helped by understanding the condition that they have. It also explains that parents can be helped too by understanding the condition. They also say that sometimes a ‘label’ can be a helpful thing. I guess that a full discussion with the parents about what they actual want (a ‘label’,’ just to be able to manage’ or both) may help to decide on when referral is appropriate and when trying other local resources first may be appropriate. I would appreciate comments!

Louise Hudman

I'm a freelance GP locum in Winchester & Southampton.

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