National Institute for Health and Clinical Excellence (NICE)
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Set up "autism teams" to improve services for under-18s, says NICE

Local autism teams should be set up across the country to improve the diagnosis and assessment of children and young people with autism, says NICE.

At least 1 in 100 children under the age of three years has an autism spectrum disorder (ASD). This rising prevalence has increased demand for diagnostic services for children and young people of all ages in the health service.

However, levels of understanding among healthcare professionals vary greatly across the UK.

Making a diagnosis of autism can be difficult as there are lots of possible signs and symptoms, as well as coexisting conditions with similar features, such as intellectual disability, attention deficit hyperactivity disorder and obsessive compulsive disorder.

It is estimated that around 70 per cent of people who have autism will have a co-existing condition.

Guidance published today by NICE recommends that local multidisciplinary autism teams are set up to support healthcare professionals and enable them to work together with schools, social care, the voluntary sector and other key services which can offer useful insight into this condition.

This is to ensure that children and teenagers with possible ASD, as well as their parents or carers, receive the appropriate care and support they need.

Autism teams should lead on the referral and diagnosis of individuals with possible ASD, and should include a paediatrician, a child and adolescent psychiatrist, a speech and language therapist, a clinical or educational psychologist, and an occupational therapist.

The autism teams should undertake diagnostic assessments where appropriate, and advise healthcare professionals about referrals.

Every autism diagnostic assessment should include an assessment of social and communication skills and behaviours through interaction with and observation of the child or young person, and consideration of any coexisting conditions.

A profile of the child's or young person's strengths, skills, impairments and needs should be developed during their assessment. With consent, this profile can be shared with those involved in the child's education to help ensure the assessment will contribute to the child or young person's individual education plan and needs-based management plan.

Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE said: "A correct diagnosis of autism can bring a profound sense of relief to some children and young people from what can be an intense feeling of isolation from the rest of the world.

“It can also help them and their families or carers to get support from education, health services and voluntary organisations and make contact with others with similar experiences.”

Gillian Baird, Consultant Paediatrician, Guy's and St Thomas' NHS Foundation Trust, London and Chair of the Guideline Development Group said: "While the NHS is responsible for diagnosing autism, all services that support the wellbeing of children and young people, including education and the voluntary sector, can play a crucial role in recognising the possible signs and symptoms of autism.

“The NHS-led multi-agency strategy groups recommended in the NICE guideline will hopefully lead to more joined up working between these key services through training, integrated assessment and increased parent/carer partnership."

This is the first of three NICE guidelines to focus on this condition. NICE will be publishing further guidance on the management of autism in children and young people, and on autism in adults.

To help put this guidance into practice, NICE has produced a range of support tools, including signs and symptoms tables for children of preschool age, primary school age and secondary school age.

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