Time to act on autism diagnosis deficiencies, say experts

Professor Robyn Young, a specialist autism researcher at Flinders University in Adelaide, South Australia, says insufficient time and money lays at the root of the problem. 

“I doubt that thorough testing is seen as financially viable. To undertake a thorough assessment, you really need at least three hours – and for adults who may have trauma or comorbidities, it is even harder,” says Professor Young.

“The National Disability Insurance Scheme (NDIS) is putting restrictions on who they will accept diagnoses from, and in some incidences, even though psychologists have undertaken approved diagnostic training through Autism SA, they are asking for the diagnosis to be endorsed by a clinical psychologist – of whom there are shortages with expertise in this field.

“Few psychiatrists and paediatricians have the capacity to do the diagnoses privately.”

A strong advocate for the importance of accurate diagnoses, in recent papers Professor Young has examined the importance of this diagnosis in understanding a person’s behaviour, particularly in the forensic setting.

Professor Young’s latest publication focuses on the effectiveness of autism diagnosis for children.

While numerous screening instruments have been developed for children under 3 years of age, Flinders researchers have evaluated Level 2 screeners that aim to distinguish children with signs of autism from those with other developmental problems.

Their investigation found limitations to the current Level 2 screeners, including inadequate sample sizes, reliability issues, and limited involvement of independent researchers. 

They also identified a lack of comparative test evaluations under standardised conditions, hindering interpretation of differences in discriminative performance across the screening instruments.

“We need to be more unified in our approach to screening for autism,” says Professor Young.

“We need to understand how it presents and how presentation may vary with development, and we need to understand the constraints placed upon people that either prevent or enable diagnoses and intervention.”

Professor Young adds that identifying behaviours and their impact early on can lead to more efficient intervention. 

“Not only will this enable people to get adequate support, it may prevent older people seeking diagnoses who have experienced a life of misdiagnoses and confusion.”

The paper – Autism Screening in Early Childhood: Discriminating Autism From Other Developmental Concerns, by Neil Brewer, Robyn Young and Carmen Lucas – has been published in Frontiers in Neurology. You can read it here.