Information for Referrers

The following advice is adapted from NICE Guideline CG142: Autism in adults: diagnosis and management [Link: http://www.nice.org.uk/guidance/cg142]

 

Should adults be referred for diagnostic assessment?

 

Health and social outcomes are often poor for people with ASD. Diagnostic assessment may improve quality of life and result in more efficient use of health resource. For this reason, a diagnostic assessment should be offered

 

What signs should prompt a referral from primary care for an ASD assessment?

Autistic spectrum disorder should be considered in an adult if at least one from each of the two following lists:

One or more of the following:

  • Persistent difficulties in social interaction
  • Persistent difficulties in social communication
  • Stereotypic (rigid and repetitive) behaviours, resistance to change or restricted interests

And

One or more of the following:

  • Problems in obtaining or sustaining employment or education
  • Difficulties in initiating or sustaining social relationships
  • Previous or current contact with mental health or learning disability services
  • A history of a neurodevelopmental condition (including learning disabilities and attention deficit hyperactivity disorder) or mental disorder.

 

A list of signs of ASD in adults can be found at the bottom of this page.

 

Using assessment tools to help make a referral decision

For individuals with no learning disability or mild learning disability an AQ10 screening questionnaire should be completed, if the person scores 6 or more on the AQ10, a referral for diagnostic assessment should be offered.

 

[Note: False negative scores can occur with the AQ10, particularly when interviewing a person who lacks insight into their condition. If the person scores below 6 but a false negative result is suspected, a referral for diagnostic assessment should be offered.]

 

For individuals with a moderate or severe learning disability, a referral for diagnostic assessment should be offered if two or more of the following are present.

  • difficulties in reciprocal social interaction including:
    • limited interaction with others (for example, being aloof, indifferent or unusual)
    • interaction to fulfil needs only
    • interaction that is naive or one-sided
  • lack of responsiveness to others
  • little or no change in behaviour in response to different social situations
  • limited social demonstration of empathy
  • rigid routines and resistance to change
  • marked repetitive activities (for example, rocking and hand or finger flapping), especially when under stress or expressing emotion.

 

What information should be included in a referral?

When referring for ASD assessment, include the following information:

  • signs and/or symptoms
  • developmental/childhood history (if known)
  • relevant medical history and investigations
  • information from previous assessments
  • score from AQ10 (if used)

DOWNLOADS AND RESOURCES