Table 3 Key characteristics of guidelines
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 |