Evidence map›Paper›PMID 38897620›Full record

ArticleBMJ paediatrics open2024

A national research survey of childhood autism assessment services in the UK: empirical evidence of diagnostic practice, challenges and improvement opportunities.

Jeremy Parr, Sarah Wigham, William Farr, Ian Male, Lucy Isard, Rhianna Lees, Venkat Reddy, Gráinne Saunders, Victoria Grahame

Abstract read
In one paragraph

Article in BMJ paediatrics open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jeremy ParrPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK jeremy.parr@ncl.ac.uk.
Sarah WighamPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID http://orcid.org/0000-0002-7722-9108
William FarrSussex Community NHS Foundation Trust, West Sussex, UK.
Ian MaleSussex Community NHS Foundation Trust, West Sussex, UK.ORCID http://orcid.org/0000-0001-5426-6646
Lucy IsardPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Rhianna LeesPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Venkat ReddyCambridgeshire and Peterborough NHS Foundation Trust, Peterborough, UK.
Gráinne SaundersTrainer for NHS health system Expert Parent Programme, Sussex, UK, Sussex, UK.
Victoria GrahameCumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe UK National Health Service (NHS) Long Term Plan aims to reduce waiting times for childhood autism diagnostic assessment and improve parent and child satisfaction. This empirical research investigated current childhood diagnostic practice provision, and changes made by teams to address challenges faced.

methodsData were collected using an online semi-structured research questionnaire. UK childhood autism diagnostic assessment services (for children aged 1-18 years) were invited to participate through multidisciplinary clinical networks, special interest groups and professionals mailing lists. The study was on the National Institute for Health Research Clinical Research Network portfolio.

results128 clinicians from diverse NHS services responded including: 10 (8%) integrated services, 46 (36%) Child and Adolescent Mental Health Services (CAMHS) and 72 (56%) paediatric services. A minority of services (23, 17.9%) reported always meeting the National Institute for Health and Care Excellence guidance for assessment. Referrals rose 115% between 2015 and 2019. Clinicians described increased child and family complexity compared with previously; children had more co-occurring physical, mental health and neurodevelopmental conditions and there were more frequent family health problems and safeguarding concerns. Most services (97, 75.8%) reported recent funding stayed constant/decreased. Incomplete multidisciplinary teams (MDTs) were frequently reported; a minority of services reported increased availability of professionals, and some experienced reductions in key professionals. Many teams were unable to undertake assessments or make recommendations for associated neurodevelopmental and co-existing conditions. Teams described improvement strategies implemented (eg, adapting professionals' roles, supporting parents).

conclusionsMost UK autism paediatric and CAMHS diagnostic teams experience significant challenges affecting the assessment of children with possible autism, and recommendations regarding treatment/intervention. Where CAMHS or paediatric services work in isolation, there are often competency gaps in MDTs and ability to deliver full neurodevelopmental and mental health assessments. Teams identified service improvement strategies; however, investment in MDT expertise is required to enable services to implement changes to meet the needs of children and families.

Indexed as

Autistic DisorderAdolescentChildChild Health ServicesChild, PreschoolFemaleHealth Care SurveysHumansInfantMaleReferral and ConsultationState MedicineSurveys and QuestionnairesUnited Kingdomautismchild psychiatrydata collectionhealth services research

Identifiers

PMID38897620
PMCPMC11191818

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.