University of Western Australia professor Andrew Whitehouse: ‘It is highly likely that our inconsistent diagnosis standards have contributed to the growth in the numbers of kids diagnosed with autism.’
Autism diagnoses will be subject to the first nationally consistent set of standards to iron out “substantial” variability in medical approaches which has contributed to a dramatic increase in the number of people, especially children, being treated for the condition.
The number of people diagnosed with autism in Australia almost doubled between 2003 and 2006, and has doubled every three years since, to 115,000 in 2012. New data, when it is finalised, is expected to show that more than 230,000 have autism.
The $22 billion National Disability Insurance Scheme with the Co-operative Research Centre for Living with Autism — a conglomerate of institutions — commissioned a study which will inform new guidelines, led by University of Western Australia professor Andrew Whitehouse.
“It is highly likely that our inconsistent diagnosis standards have contributed to the growth in the numbers of kids diagnosed with autism,” Professor Whitehouse toldThe Australian.
“We have really strong evidence of variability in the way autism is diagnosed between clinicians, between states and between rural and metropolitan areas.
“This provides inequity — in waiting times, in the cost of the assessments — it is a huge gap in what people have access to.”
The set of behaviours that define autism are outlined in the internationally recognised Diagnostic and Statistical Manual of Mental Disorders but Professor Whitehouse said these inherently contained an “element of subjectivity”, which transferred to the way clinicians interpreted them for diagnosis..
Autism can be diagnosed in Australia using a “gold-standard” team of professionals — such as a pediatrician and psychologist — or by a single pediatrician, psychologist or psychiatrist.
“The bald fact is we do not always know what is going on around Australia,” Professor Whitehouse said.
“The variations are not just about who is doing the diagnosis, but how they are doing it.”
Research led by Professor Whitehouse earlier in the year revealed that some clinicians had admitted to diagnosing children who did not meet the criteria for autism or to using older versions of the DSM.
“We would not accept this state of affairs for any other condition and we should not accept it for autism,” he said.
The study, which will inform the first guidelines, will look at global best practice and include consultation with families and medical practitioners.
The NDIS, which will fund early intervention packages for children with developmental delays, has kept a keen eye on the space. The South Australian trial of the scheme was seriously delayed when the number of children eligible blew out by 100 per cent, almost entirely due to the number of children with autism.
Professor Whitehouse said the move to standardise diagnosis was not about “tightening the guidelines’’.
“This is about consistency, we must have consistency. We know that there are areas in Australia that can improve on this,” he said.
The Productivity Commission said it believed that a federal autism intervention program — Helping Children with Autism — was partly responsible for rising diagnosis rates.
