National guideline to improve diagnostic practices for Australians on the autism spectrum

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Australia’s first National Guideline for the assessment and diagnosis of autism was released on 16 October 2018. The Guideline was developed and published by the Autism CRC with the financial support of the National Disability Insurance Agency (NDIA). The Autism CRC is a national cooperative research centre focused on autism across the lifespan, from diagnosis and the early years, through the school years and into adult life.

To date, the processes for the clinical assessment and diagnosis of autism have varied considerably across Australia. The Guideline aims to create greater consistency in autism assessment and diagnostic practices across the country to ensure that all individuals and their families can receive optimal clinical care.

The Guideline has been developed through a comprehensive research process and in close consultation with the clinical, autistic and broader autism communities," said Professor Andrew Whitehouse, Chief Research Officer, Autism CRC.

The recommendations of the Guideline have been approved by the National Health and Medical Research Council (NHMRC), which demonstrates that they are of high quality, based on best available scientific evidence and developed to rigorous standards. NHMRC approved guidelines are recognised in Australia and internationally as representing current medical knowledge and best practice health care.

"Work will now be undertaken to ensure this Guideline is adopted and implemented by clinicians and services across Australia who are involved in autism assessment and diagnosis. This will ensure everyone can receive the best evidenced diagnostic practices, regardless of their age or location, and can make informed decisions about next steps,” said Andrew.

Andrew said that while diagnosis is an important step to help families identify the presence of a given health or medical condition, it is critical to understand not just the presence or absence of clinical diagnoses, but also the individual's unique strengths and support needs.

"For this reason, the Guideline emphasises the importance of a comprehensive needs assessment, recommending this takes place at the earliest possible stage. A comprehensive needs assessment, including an assessment of functioning and medical evaluation, allows the individual and their family to be linked to the appropriate supports," he said.

Autism diagnosis is challenging. With no established biological marker for all individuals on the autism spectrum, diagnosis is not a straightforward task: diagnosis is based on clinical judgement of behavioural presentation; there is variability in autism symptoms, together with considerable behavioural overlap with other developmental conditions; and clinicians have varying levels of skill and experience.

Further complicating diagnosis, there is considerable variance in diagnostic practices across and within Australian states and territories. A review of diagnostic practices in Australia conducted by Autism CRC concluded that these variances likely contribute to the inconsistent provision and availability of public services and support for autistic individuals and their families.

The Guideline outlines processes for both diagnostic decision-making and the comprehensive assessment of individual support needs. It includes a step-by-step, best-practice process for conducting an autism assessment and is supported by case studies and templates.

To obtain a copy of the National Guideline go to https://www.autismcrc.com.au/knowledge-centre/resource/national-guideline

The Neurodevelopmental and Behavioural Paediatric Society of Australasia (NBPSA) has welcomed the new Guideline. Associate Professor Gehan Roberts, President of the NBPSA, said:

“To maximise the effectiveness of the Guideline it will now be important that clinicians have the right level of knowledge and understanding for implementation, and agreement is reached on the criteria for access to support services being used by NDIS planners and by funders across health, education and disability services.”

The National Rural Health Alliance is an Autism CRC Participant.

 

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