New way of conducting autism assessments for children

The Oxford Community Paediatric Service, part of the Oxford Children's Hospital at Oxford University Hospitals (OUH), has launched a new way of providing assessments to children who have a variety of complex and developmental needs.

Young children (aged under 5) who have concerning developmental progress with possible autism are referred to the service usually by their health visitor or GP.

The previous process involved having an initial in-person assessment within outpatient services. If autism was suspected, they would be added to a waiting list for several additional assessments during a Multidisciplinary Assessment week (MDA), a process principally developed for children with complex physical and learning disabilities or genetic syndromes.

During an MDA week, the child and family would have to travel to and from the hospital several times during the week before a final diagnosis was confirmed. This way of working enabled a limited number of children to be assessed, and as autism awareness and referrals increased, so did waiting lists.

However, with the onset of COVID-19 in March 2020, the service adopted a more flexible approach following the initial in person clinic appointment by focusing more on panel MDAs where individual cases were discussed by a team of experienced professionals, using clinic findings together with information collected from sources such as education settings, healthcare professionals who had seen the child in the community, and telemedicine consultations with team members.

Targeted additional standardised observational assessment tools were only used when there was a lack of clarity over a diagnosis. This has helped the team to make the diagnostic process quicker and has reduced the number of times children had to be physically present in the hospital.

In 2022, more than 500 children had completed their assessments compared to around 225 per year pre-2020.

This new way of working means children with the most straightforward or typical presentation of autism spectrum disorder have avoided additional assessments and can be diagnosed without delay.

Sarah Haden, Consultant and Clinical Lead for Community Paediatrics at Oxford University Hospitals, said: "Every child with autism is an individual, and we decided to take a flexible approach to assessment based on the patient in front of us. This has enabled us to complete assessments for many children much more quickly and efficiently. The whole team are rightly proud of this achievement."

Sara Randall, Chief Operating Officer at Oxford University Hospitals, said: "I would like to thank the entire team that have made this innovative change."

Pictured: Members of the OUH Oxford Paediatric Service