An ounce of prevention is worth a pound of cure: Autism assessment in the UK

It has been estimated that approximately 1 in 7 individuals in the UK are neurodivergent, with diagnoses increasing year on year. ADHD, (Attention Deficit Hyperactivity Disorder), diagnoses increased 20-fold between 2000 and 2018, and Autism diagnoses almost doubled between 1998 and 2018.  The rise in numbers of individuals requiring assessments has led to lengthy waiting lists. The average wait for an autism assessment in some areas is between 3 and 4 years. 

Neurodivergence is complex, with every individual presenting differently, and there is a danger that vital information will be missed if assessments are not carried out by a multi-disciplinary team, so one of the major causes for delay is this need for a team of professionals to carry out the assessments. 

The multi-disciplinary team may include: –

1. The child’s parents as well as staff from their school to provide essential information about their behaviour over time, in different contexts, their academic performance, any personal strengths and interests and how they relate to others. 
2. An educational psychologist to assess the child’s underlying ability.
3. A paediatrician to rule out medical conditions that may be affecting the child’s behaviour.
4. A speech and language therapist to assess language and social communication skills.
5. An occupational therapist to investigate any co-ordination or sensory issues.
6. A mental health practitioner to be helpful if the child experiences emotional difficulties. 

Professionals will understand that the approach the child takes to assessment is as important as their results. Do they initiate conversation? How do they cope with challenge? Can the child sustain concentration? Can they follow instructions? Does the child understand humour? Do they react in an unexpected way to noise, light or touch? What are they distracted by?

Unfortunately, many local authorities are experiencing a shortage in the number of qualified professionals available in their area to make up these multidisciplinary teams. However, when waiting times for assessments are so long, it is useful to consider the social model of disability. This model suggests that challenges experienced by neurodiverse individuals have very little to do with the individual themselves, and more to do with society’s expectations and norms. When society is able to become more inclusive, neurodiverse individuals will be accepted, accommodations automatically made, and the number of individuals requiring assessments decline.

One opportunity for increased inclusion would be in schools. What works for neurodivergent pupils works for all pupils. Modifying the school environment and providing appropriate in-service training for staff would be a cheap and easily organised starting point. An ounce of prevention is worth a pound of cure.