No exclusions – developing an autism diagnostic service for adults irrespective of intellectual ability

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Abstract

Purpose – Autism is a spectrum condition, yet many autism services limit access based on IQ score. The Department of Health 2009 enabled enthusiastic clinicians in Leeds with a strong interest in autism to apply for funding to develop an all IQ adult autism diagnostic service and here we present the experience. The paper aims to discuss this issue. Design/methodology/approach – The process of establishing and then expanding the service is described. Details of the diagnostic pathway and tools used are provided. Findings – The number of referrals was higher than expected – a baseline of 20 per year rose to 150 per year as soon as the service opened. Other unexpected findings include relatively low diagnosis rates (32 per cent), high rates of past trauma and patient dissatisfaction when a diagnosis of autism is not given. Originality/value – To date, the service has assessed 517 patients, and plans are underway to collaborate with the local adult ADHD team to form a unified adult neurodevelopmental disorders service.

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The Diagnostic Interview for Social and Communication Disorders: background, inter-rater reliability and clinical use

Lorna Wing, Susan R Leekam, Sarah J. Libby … (2002)

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The Adult Asperger Assessment (AAA): a diagnostic method.

J. E. M. Robinson, Sally Wheelwright, M. Gail Woodbury … (2005)

At the present time there are a large number of adults who have suspected Asperger syndrome (AS). In this paper we describe a new instrument, the Adult Asperger Assessment (AAA), developed in our clinic for adults with AS. The need for a new instrument relevant to the diagnosis of AS in adulthood arises because existing instruments are designed for use with children. Properties of the AAA include (1) being electronic, data-based, and computer-scorable; (2) linking with two screening instruments [the Autism Spectrum Quotient (AQ) and the Empathy Quotient (EQ)]; and (3) employing a more stringent set of diagnostic criteria than DSM-IV, in order to avoid false positives. The AAA is described, and its use with a series of n = 42 clinic-patients is reported. Thirty-seven of these (88%) met DSM-IV criteria, but only 34 of these (80%) met AAA criteria. The AAA is therefore more conservative than DSM-IV.