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'Referral advice' recommendation details

Autism in children and young people

Guidance ID NICE 'referral advice' recommendation 'Referral advice' category
CG128 Refer children younger than 3 years to the autism team if there is regression in language or social skills. Time frame Not Specified
CG128 Refer first to a paediatrician or paediatric neurologist (who can refer to the autism team if necessary) children and young people: -older than 3 years with regression in language -of any age with regression in motor skills. Time frame Not Specified
CG128 Consider referring children and young people to the autism team if you are concerned about possible autism on the basis of reported or observed signs and/or symptoms. Take account of: -the severity and duration of the signs and/or symptoms -the extent to which the signs and/or symptoms are present across different settings (for example, home and school) -the impact of the signs and/or symptoms on the child or young person and on their family -the level of parental or carer concern and, if appropriate, the concerns of the child or young person -factors associated with an increased prevalence of autism -the likelihood of an alternative diagnosis. Time frame Not Specified
CG128 If you have concerns about development or behaviour but are not sure whether the signs and/or symptoms suggest autism, consider: -consulting a member of the autism team who can provide advice to help you decide if a referral to the autism team is necessary -referring to another service. That service can then refer to the autism team if necessary. Time frame Not Specified
CG128 If you do not think concerns are sufficient to prompt a referral, consider a period of watchful waiting. If you remain concerned about autism, reconsider your referral decision. Time frame Not Specified
CG128 If the parents or carers or if appropriate, the child or young person, prefer not to be referred to the autism team, consider a period of watchful waiting. If you remain concerned about autism, reconsider referral. Time frame Not Specified
CG128 Be aware that some children and young people will have features of behaviour that are seen in the autism spectrum but do not reach the ICD-10 or DSM-IV diagnostic criteria for definitive diagnosis. Based on their profile, consider referring to appropriate services. Time frame Not Specified
CG128 If the outcome of the autism diagnostic assessment clearly indicates that the child or young person does not have autism, consider referring them to appropriate services based on their profile. Time frame Not Specified
CG128 Consider whether the child or young person may have any of the following as a coexisting condition, and if suspected carry out appropriate assessments and referrals: -Mental and behaviour problems and disorders: -ADHD -anxiety disorders and phobias -mood disorders -oppositional defiant behaviour -tics or Tourette syndrome -OCD -self-injurious behaviour. -Neurodevelopmental problems and disorders: -global delay or intellectual disability -motor coordination problems or DCD -academic learning problems, for example in literacy or numeracy -speech and language disorder. -Medical or genetic problems and disorders: -epilepsy and epileptic encephalopathy -chromosome disorders -genetic abnormalities, including fragile X -tuberous sclerosis -muscular dystrophy -neurofibromatosis. -Functional problems and disorders: -feeding problems, including restricted diets -urinary incontinence or enuresis -constipation, altered bowel habit, faecal incontinence or encopresis -sleep disturbances -vision or hearing impairment. Time frame Not Specified
CG128 If any of the following apply after assessment, consider obtaining a second opinion (including referral to a specialised tertiary autism team if necessary): -continued uncertainty about the diagnosis -disagreement about the diagnosis within the autism team -disagreement with parents or carers or, if appropriate, the child or young person, about the diagnosis -a lack of local access to particular skills and competencies needed to reach a diagnosis in a child or young person who has a complex coexisting condition, such as a severe sensory or motor impairment or mental health problem -a lack of response as expected to any therapeutic interventions provided to the child or young person. Time frame Not Specified

This page was last updated: 22 August 2012

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.