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      The assessment of autism spectrum disorders in adults

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          Abstract

          Purpose

          – The purpose of this paper is to explore and highlight the main elements of an autism spectrum disorder assessment in adults. It features significant challenges for the clinical teams responsible to undertake the assessment. This paper aims to explain the importance of the wider needs assessment in accordance to the Autism Act and Autism Strategy.

          Design/methodology/approach

          – The paper describes the main symptom domains for an ASD diagnosis, according to the two basic diagnostic manuals. It provides compendious summary of the available diagnostic tools and the significant comorbidities people with ASD present with including other neurodevelopmental disorders, mental or physical health problems, challenging behaviour and risk issues.

          Findings

          – The paper proposes that all National Health System professionals should be able to recognise possible signs of ASD and accordingly refer individuals for a comprehensive assessment to secondary services. It highlights the importance of a wider needs assessment as part of a broader approach to addressing the needs of those with suspected ASD.

          Practical implications

          – The paper aims to improve the gaps which remain in the referral and diagnostic process of people affected by ASD.

          Social implications

          – Through a comprehensive assessment the paper aims to improve the educational, social and personal functioning of people with ASD as well as the quality of life of their parents and carers.

          Originality/value

          – The paper assembles a wide range of relevant considerations in regards to potential ASD in one place, and can be used to inform a comprehensive understanding of the assessment/diagnosis process.

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          Most cited references21

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          Pervasive developmental disorders in preschool children.

          Prevalence rates of autism-spectrum disorders are uncertain, and speculation that their incidence is increasing continues to cause concern. To estimate the prevalence of pervasive developmental disorders (PDDs) in a geographically defined population of preschool children. Survey conducted July 1998 to June 1999 in Staffordshire, England. The area's 15 500 children aged 2.5 to 6.5 years were screened for developmental problems. Children with symptoms suggestive of a PDD were intensively assessed by a multidisciplinary team, which conducted standardized diagnostic interviews and administered psychometric tests. Prevalence estimates for subtypes of PDDs. A total of 97 children (79.4% male) were confirmed to have a PDD. The prevalence of PDDs was estimated to be 62.6 (95% confidence interval, 50.8-76.3) per 10 000 children. Prevalences were 16.8 per 10 000 for autistic disorder and 45.8 per 10 000 for other PDDs. The mean age at diagnosis was 41 months, and 81% were originally referred by health visitors (nurse specialists). Of the 97 children with a PDD, 25.8% had some degree of mental retardation and 9.3% had an associated medical condition. Our results suggest that rates of PDD are higher than previously reported. Methodological limitations in existing epidemiological investigations preclude interpretation of recent high rates as indicative of increased incidence of these disorders although this hypothesis requires further rigorous testing. Attention is nevertheless drawn to the important needs of a substantial minority of preschool children.
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            The Diagnostic Interview for Social and Communication Disorders: background, inter-rater reliability and clinical use

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              • Article: not found

              Autism and Asperger syndrome: coexistence with other clinical disorders.

              : To provide a clinically useful analysis of the extent to which autism and Asperger syndrome coexist with other disorders. Selective review of the literature detailing data pertaining to symptoms and disorders sometimes encountered in connection with autism or Asperger syndrome. A large number of medical conditions, psychiatric disorders and behavioural and motor dyscontrol symptoms are associated with autism and Asperger syndrome. Comorbidity is to be expected in autism spectrum disorders -directly or indirectly. Comorbid conditions may be markers for underlying pathophysiology and suggest a more varied treatment approach. There is a great need for in-depth research into this area, meaning that the exclusion criteria of current diagnostic manuals, i.e. those that rule out a diagnosis of autism in some disorders, and a diagnosis of certain other disorders in autism may have to be revised.
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                Author and article information

                Contributors
                Journal
                AIA
                10.1108/AIA
                Advances in Autism
                Emerald Publishing
                2056-3868
                4 January 2016
                4 January 2016
                : 2
                : 1
                : 31-40
                Affiliations
                Department of Behavioural and Developmental Psychiatry, Clinical Academic Group, Adult ADHD Service, South London and Maudsley NHS Foundation Trust, Maudsley Hospital , London, UK
                Department of Behavioural and Developmental Psychiatry, Clinical Academic Group, Adult ADHD Service, South London and Maudsley NHS Foundation Trust, Maudsley Hospital , London, UK
                The Institute of Psychiatry, Psychology and Neuroscience, Forensic and Neurodevelopmental Sciences, Kings College, London, London, UK
                Article
                AIA-09-2015-0017.pdf
                10.1108/AIA-09-2015-0017
                c073b7ec-e1e3-49e0-928f-9331dbd68447
                © Emerald Group Publishing Limited
                History
                Categories
                Articles
                General review
                Health & social care
                Learning & intellectual disabilities
                Custom metadata
                yes
                yes
                JOURNAL
                included

                Health & Social care
                Assessment,Comorbidity,Adults,Autism spectrum disorder,Complex needs
                Health & Social care
                Assessment, Comorbidity, Adults, Autism spectrum disorder, Complex needs

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