G629(P) Pilot study of neurodevelopmental diagnostic clinic model in school-aged children, for whom there is diagnostic uncertainty regarding the presence of autistic spectrum disorder
Austreng, Lucy McAuley, Charlotte Thurston, Victoria de Gressi, Susanna
Austreng, Lucy
McAuley, Charlotte
Thurston, Victoria
de Gressi, Susanna
Date
2020-10-25
Journal Title
Subject
Type
Conference Abstract
Collections
Abstract
Background Locally, neurodevelopmental assessment of primary school aged children with social and communication difficulties involves collation of reports from the educational setting, then assessment by a paediatrician. Often, no formal diagnostic tool or face-to-face multi-professional assessment is carried out. For some children, this model of working can lead to a delay in conclusions due to complexities with that child. This pilot was a model for multi-professional working between a paediatrician and clinical psychologist using structured assessments for a group of children that presented diagnostic challenge.
Aims To pilot a neurodevelopmental clinical model of joint working between a paediatrician and psychologist. To collect data regarding clinician and patient experience, time from initial referral to diagnosis and identify the advantages and pitfalls of this method of working. To provide information for the MDT reviewing the pathway for Autistic Spectrum Disorder (ASD) diagnosis.
Method Cases were selected by the paediatrician. Data collected included demographics, presenting problems, time from referral to receiving a final diagnosis, diagnostic outcome and experience feedback questionnaires. Diagnostic Interview for Social and Communication Disorders (DISCO) and Autism Diagnostic Observation Schedule (ADOS) assessments were carried out.
Results Thirteen children were enrolled in the pilot from 2017 to 2019 with a median age of nine years, four months. Eleven participants were male. Five of the children were given a final diagnosis of ASD. Other children received a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) or other cognitive or attachment difficulties. Six families completed feedback questionnaires. Most parents felt that the process helped their understanding of their child. Follow-up support was identified as an area for improvement. The clinicians found the process helpful, particularly with patients for whom there was disparity of opinion about that child.
Conclusion This model demonstrated positive patient experience, increased diagnostic accuracy and clinicians reported improved job satisfaction. It is likely to shorten initial referral to diagnosis time and offer a model of working that is closer to NICE guidance. Cost implications would need to be considered. Should this model of working be commissioned, areas for improvement would include follow up after diagnosis, and the robustness of the administration around the clinic.
Citation
Austreng, L., McAuley, C., Thurston, V., & de Gressi, S. (2020). G629 (P) Pilot study of neurodevelopmental diagnostic clinic model in school-aged children, for whom there is diagnostic uncertainty regarding the presence of autistic spectrum disorder. Archives of Diseases in Childhood. A226.
Usage rights
Free access to article on publisher's webpage. Click DOI.