4.2 Identification of autism
In Scotland, there is currently a move towards assessing and diagnosing autism as part of a range of neurodevelopmental conditions. We recognise that autistic young people can have other co-occurring difficulties that also need to be recognised, especially if they are to understand their own strengths and difficulties. Currently, a diagnosis of autism is given through the local health authority (NHS) but across Scotland there are a range of pathways and professionals involved. The Diagnostic and Statistical Manual (DSM-5) and the International Statistical Classification of Diseases and Related Health Problems (ICD) are used by clinicians to identify autism. In 2013, DSM-5 redefined autism. The terms ‘Autistic Disorder’, ‘Asperger’s Disorder’ and ‘PDD-NOS’ were replaced by the diagnosis of Autism Spectrum Disorder. The ICD is the diagnostic classification standard for all clinical and research purposes used to identify autism and this version of the manual.
- Further information about DSM-5 can be found on the National Autistic Society website [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] .
- Further information about ICD can be found on the World Health Organisation website.
Early identification of autism
Early identification of autism can be helpful as it can allow professionals to understand and respond to the child or young person’s unique pattern of strengths and difficulties, and thus allow the learner to flourish. Health professionals and education partners should therefore be aware of the possibility of autism when they notice a pattern of features in the areas of:
‘social interaction and play, speech, language and communication difficulties and behaviour’.
In early years and childcare settings and in schools, assessment involves the gathering of information about the learner’s strengths and difficulties and will include a wellbeing assessment. In collaboration with parents and the learner, a profile of the learner is established; this may result in a request for further assessment by speech and language therapy services and potentially educational psychology services.
If the information gathered indicates that the learner may be autistic, a request for assistance can be made to the local specialist autism or neurodevelopmental diagnostic team. For a range of reasons, some parents decide that they do not wish to move to formal identification. This does not stop the team around the child planning to support and meet the needs of that child or young person.
Good practice for the identification of autism
Good practice in terms of identification of autism involves the gathering of information by a multi-disciplinary team with the relevant skills and experience. Information should include the child or young person’s strengths and difficulties, and a diagnostic assessment based on the current version of DSM-5 or ICD.
‘Specialist assessment should involve a history-taking element, a clinical observation/assessment element, and the obtaining of wider contextual and functional information.’
The team uses this information to decide if the child or young person fits the criteria for autism. A report is usually compiled based on the gathered information and post-diagnostic support is normally offered to the family.
4.1 Assessing and monitoring