Section 3: Know how autism is diagnosed
Q6: Outline the current guidelines for the diagnosis of autism in the UK. (3.1)
There is no cure for autism, and the cause of it – regardless of the theories – is completely unknown. This can cause difficulties when diagnosing autism and specialists rely on characteristics to identify someone with autism and someone without. There are steps put in place to ensure diagnosis is correct, these are:
- If someone feels as if they are autistic, they can gain general advice from their General Practitioner (GP), or if they’re under age, their social worker, carer or parent may seek advice and guidance.
- If the GP is concerned enough about the patient, they will refer them onto a specialist, who can be a psychologist or a psychiatrist.
- If the patient is still in full-time education, they will be given an educational psychologist who will set out tests to check for autism characteristics.
- If all professionals agree that autism is apparent, the diagnosis will be made.
Although, it can usually be diagnosed within four steps, it is still a complex diagnostic process, led by a clinician, that can need the assistance of the individual’s – if necessary – teachers or care workers. In most cases, the characteristics will show quite quickly and children are most likely to get diagnosed, however, some people live into adulthood undiagnosed and may seek diagnosis. It can become increasingly difficult for diagnosis as a child ages to adulthood due to where characteristics should have been noticeable in childhood and it can be difficult for clinicians to be sure of the symptoms being related to autism and not another condition. In some cases, they will ask family – ideally immediate – to relay information from the individual’s childhood to see if characteristics were present in childhood. There are a variety of different processes to ensure a correct and fair diagnosis is made, one created by the National Institute for Care and Excellence and one provided in the Autism Act 2009. The National Institute for Care and Excellence ensures that an establishment of generic principles and care is provided, as well as recognition and making sure there is a referral and diagnosis and management and support. The Autism Act 2009 ensures provisions of:
- Arrangements for the diagnosis of autism and the identification of adults with ASC;
- Assessment and planning for services to meet needs, including planning for the transition from childhood to adulthood;
- Training for service providers;
- Local arrangements for the leadership of the process.
Q7: Describe the difficulties surrounding the diagnosis of autism in relation to: (3.2)
a) Formal diagnosis
It is important that all individuals who suspect they have autism get a formal diagnosis. It can sometimes be difficult due to characteristics, age and other factors as autism spectrum disorders vary from person to person. Some of the most recent theorists argue that spectrum disorders are just more defined versions of traits that are commonly seen in neurotypicals. If an individual shows characteristics based in the ‘triad of impairments’ it can be easier to diagnose. In milder cases of autism, which include HFA and Asperger’s syndrome, characteristics can be misinterpreted and can be diagnosed as a mental health disorder or just as part of the individuals personality. As explained before, there are quite a few factors that make diagnosis difficult and it is known that four times more boys get diagnosed than girls, based off of the Office of National Statistics October 2016 research. There can be many reasons for this, e.g. characteristics may be easier to hide due to wanting to better fit in or they may just have better social skills to begin with. A child may not get diagnosed due to parental pressure, as parents may be unsure or want their child to be diagnosed due to outdated theories. There is also the funding element in which the NHS do not receive funding for adult diagnosis whereas for
young children they do. An increase in diagnosis is apparent which can be due to improved recognition and detection of characteristics, changes in study methodology, increase in available diagnostic services, increased awareness among professionals and parents as well as a growing acceptance that autism can coexist with a range of other conditions and a widening of the diagnostic criteria.
After diagnosis is reached, there are financial aids put into place for those with autism. Some can receive support in the form of social security benefits and social care. Parents, guardians and carers can also obtain an Education, Health and Care plan for a child which can enable schools and colleges to apply for funding; which allows schools and colleges to hire specific teaching assistants, arrange visits from Speech and Language therapists as well as source extra equipment.
b) The range of different diagnoses on the spectrum
Currently, there are only three known types of autism, which are severe autism, high-functioning autism and Asperger’s syndrome. However, there are also a variety of different characteristics that someone with ASC may experience, making it harder to diagnose, such as:
- Sensory Processing Disorder
- Attention Deficit Hyperactivity Disorder
- Obsessive Compulsive Disorder
Q8: Give reasons why people may be reluctant to seek a diagnosis. (3.3)
Seeking a diagnosis can be something that some individuals or parents may not want to do. There are a few reasons why some may not want to have their child diagnosed or be diagnosed themselves and it can cause issues for the person suspected of having autism. Some reasons why someone may not choose diagnosis could be due to concerns of being labelled and not want to be known as needing additional support and needs; a diagnosis may make them feel like a lesser person or ‘odd’ in
comparison, causing anxiety if labelled. It may be unsuitable due to an educational placement, and parents may want to still enrol their child into a ‘mainstream’ school. It can also be a highly emotional issue, usually caused by outdated views of autism, such as feeling intense guilt, anxiety and confusion, based on Kanner’s theory from the 1940s.
Q9: Explain why it is important for individuals to have a formal diagnosis. (3.4)
Just like any ongoing condition, autism is important to be diagnosed as soon as characteristics start to show. Those who are not diagnosed will miss out on the support and advice they may need to help them to cope with their diagnosis. Similar to a physical condition, such as diabetes, and due to its permanence, there will need to be encouragement of using self-management strategies and support mechanisms available through different social services. They can also receive appropriate responses from others, including patience, empathy and the ability to understand difficulties they are facing, such as toilet training problems, communication methods, and appropriate educational settings to allow them to develop.
Q10: State the prevalence of autism in the UK. (3.5)
They can also receive appropriate responses from others, including patience, empathy and the ability to understand difficulties they are facing, such as toilet training problems, communication methods, and appropriate educational settings to allow them to develop. Over the last four decades, prevalence has increased since the 1980s. However, why this has occurred can be disputed: currently, we are unsure if the increase in common autism diagnoses is based on prevalence or due to the change in the way we diagnose. There has been evidence that shows a 2:1 to 16:1 ratio in men diagnoses to women, based off of studies and anecdotal evidence which has led to the suggestion of characteristics being presented differently in men and women. The difference in social and communication between men and women suggests that diagnosis may need to be done in a different way to men and women, perhaps starting with asking different questions to get diagnosis.