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Table 3 Key characteristics of guidelines

From: Clinical practice guidelines for diagnosis of autism spectrum disorder in adults and children in the UK: a narrative review

Title Year Author(s) Publisher/Journal Geographical remit Target audience Age range Range of diagnoses covered Diagnostic criteria referred to Age at which symptoms are recognised
DIAGNOSTIC CRITERIA
The ICD-10 Classification of Mental and Behavioural Disorders: clinical descriptions and diagnostic guidelines [32] 1993 N/A World Health Organisation International Clinical, educational and service use All ages Pervasive development disorders N/A Before age of 3 years (childhood autism); after age 3 (atypical autism).
Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) [33] 2013 N/A American Psychiatric Association International Clinicians, students, practitioners, researchers All ages Autism Spectrum Disorder N/A During 2nd year of life (12–24 months) or earlier than 12 months if developmental delays are severe
NATIONAL CLINICAL GUIDELINES
NICE Autism in under 19 s: recognition, referral and diagnosis (NICE CG128) [39] 2011 National Collaborating Centre for Women’s and Children’s Health National Institute for Health and Care Excellence (NICE) England and Wales Healthcare professionals From birth up to 19 years Pervasive developmental disorder (PDD) ICD-10 or DSM-IV May be uncertainty before 24 months, or with developmental age of less than 18 months
Six Steps of Autism Care for children and young people in Northern Ireland (RASDN) [44] 2011 Regional Autistic Disorder Network for Northern Ireland Health and Social Care Board Northern Ireland Health care and education professionals, parents, carers, service users and providers. Up to the age of 18 years Autism spectrum disorder ICD-10, DSM-IV, NICE, SIGN, NZ Guidelines, NHS Map of Medicine Pre-school. Language delay by the age of two years.
Autism Spectrum Disorder in adults: diagnosis and management (NICE CG142) [9] 2012 National Collaborating Centre for Mental Health National Institute for Health and Care Excellence (NICE) England and Wales Health and social care providers and commissioners Adults aged 18 and over Autism spectrum disorders N/S
*ICD-10 specified in full version of CG142 [62]
N/A
Autism Adult Care Pathway (RASDN) [54] 2013 Regional Autistic Spectrum Disorder Network Health and Social Care Board Northern Ireland Professionals, adults and families Adults from age 18 Autism spectrum disorders DSM-5 and ICD-10, NICE guidance CG142. N/S
Assessment, diagnosis and interventions for autism spectrum disorders: A national clinical guideline (SIGN 145) [10] 2016 N/A Scottish Intercollegiate Guidelines Network Scotland Healthcare professionals Whole age range Autism spectrum disorder ICD-10 and DSM-5 Autism can be reliably diagnosed between the ages of 2–3.
GUIDELINES FROM PROFESSIONAL BODIES
RCSLT (Royal College of Speech and Language Therapists Clinical Guidelines (Autism) [41]a 2005 N/A Royal College of Speech and Language Therapists UK Speech and language therapists Children and adults Autism spectrum disorder ICIDH-2 (for general clinical assessment) N/S
Good practice in the management of autism (including Asperger syndrome) in adults (RCPych CR191) [11] 2014 Royal College of Psychiatrists Royal College of Psychiatrists UK Psychiatrists working with adults of at least normal intellectual ability Adults from age 18 Autism ICD-10, DSM-5, NICE, 2012. N/S
Autism Spectrum Disorders: Guidance for Psychologists (BPS) [40]b 2016 Stuart-Hamilton, Dillenburger, Hood & Austin British Psychological Society UK Psychologists All ages Autism Spectrum Disorder ICD-10 and DSM-5, NICE, 2011. Both diagnostic manuals consider ASD indicators to be present by the age of 36 months although some children can be identified under the age of 24 months.
BMJ Best Practice online resource [43] 2017 Parr &Woodbury-Smith British Medical Journal Outside US and Canada Medical Practitioners All ages Autism Spectrum Disorder DSM-IV, DSM-5 & ICD-10. NICE, SIGN, AACAP, AAP, NZ ASD guideline, AAN More than 80% of children with ASD show clear behavioural signs by the age of 24 months, some indicators in 12–18 months
JOURNAL ARTICLES
Diagnosis and management of autism in childhood [47] 2011 Blenner, Reddy & Augustyn British Medical Journal N/S General clinicians Children Autism Spectrum Disorder DSM-IV TR or ICD-10 N/S
Diagnosis and assessment in autism spectrum disorders [48] 2012 Carpenter Advances in Mental Health and Intellectual disabilities N/S Those designing and providing diagnostic services All ages Autism Spectrum Disorder DSM-IV TR or ICD-10. Gillberg’s for AS. There are others but few use them (Kopra et al., 2008; Chiappedi et al., 2010). N/S
Autism spectrum disorder in adults: clinical features and the role of the psychiatrist [49] 2013 Garland, O’Rourke & Robertson Advances in Psychiatric Treatment UK Psychiatrists Adults Autism Spectrum Disorders ICD-10 and DSM-5, NICE To satisfy ICD-10 criteria for childhood autism, impairments must manifest before the age of 3 years
Recognising, referring and diagnosing autism [45] 2012 Howlett & Richman Every Child Journal England and Wales Professionals working with children and young people Children and young people Autism NICE The core autism behaviours are typically present in early childhood; but features can appear different with age or change with circumstances
Autism [50] 2013 Lai, Lombardo & Baron-Cohen The Lancet N/S N/S All ages Autism or the autism spectrum DSM-5, ICD-10 N/S
Autism [51] 2009 Levy, Mandell & Schultz The Lancet N/S N/S N/S but primarily talks about children Autism Spectrum Disorder DSM-IV and ICD-10 Parents often aware from age 18 months, a diagnosis is often not made until 2 years after the initial expression of parental concern.
Autism spectrum disorder: diagnosis and management [53] 2009 O’Hare Archives of Disease in Childhood: Education and Practice Edition N/S but relates primarily to SIGN guidelines Paediatricians Children and young people Autism Spectrum Disorder ICD-10 and DSM-IV, SIGN N/S
Recognition, referral, diagnosis, and management of adults with autism: summary of NICE guidance [58] 2012 Pilling, Baron-Cohen, Megnin-Viggars, Lee & Taylor British Medical Journal England and Wales N/S Adults Autism N/S N/S
Autism Spectrum Disorders in childhood: a clinical update [46] 2011 Reynolds Community Practitioner UK Community practitioners Children Autism Spectrum Disorder ICD-10, DSM-IV N/S
The NICE guideline on recognition, referral, diagnosis and management of adults on the autism spectrum [52] 2014 Wilson, Roberts, Gillan, Ohlsen, Robertson & Zinkstok Advances in Mental Health and Intellectual Disabilities England and Wales Health care professionals, service managers, service users, practitioners All adults Autism spectrum disorder N/S N/S
  1. aPre 2009 but constitutes current guideline in use from RCSLT
  2. bCurrently under review but represents the most recent published guideline from BPS