Short Screening Measures for Child Autism and AD/HD

Abstract

The U.K.’s National Health Service has a large and growing problem with overdiagnosis of Autism and AD/HD in primary school children (1) Background:  General medical practitioners in the U.K. currently undertake the identification and screening of children suspected of having Autism or Attention Deficit/Hyperactivity Disorder, but the recommended screening questionnaires contain far too many extraneous symptoms and are likely to lead to overdiagnosis of the two disorders.  The objective of this article is to provide two brief and conservative core symptom-based questionnaires that GPs can use to diagnose Autism and AD/HD.  (2) Methods:  Expert review of the DSM-IV and revised DSM-5 criteria for childhood Autism and AD/HD together with NHS-recommended diagnostic questionnaires.  Preparation of a core symptoms-based Child Autism Questionnaire and Child AD/HD Questionnaire for use by GPs to diagnose these two disorders in children without referral to a pediatrician or psychiatrist. (3) Results:  The GPs firstly must conduct a comprehensive physical examination of the child to ensure that the child has no uncorrected hearing or eyesight problems or dyslexia.  The GP should also order an IQ test from a qualified psychologist to assess the child’s mental capacity.  GPs can then use the Child Autism Questionnaire or the Child AD/HD Questionnaire, as appropriate, to interview the child’s parent or guardian, have the child observed by a nurse in the case of suspected Autism or obtain a report from the child’s primary teacher in the case of suspected AD/HD, then make a clear recommendation to the NHS as to whether the child qualifies for in-home support or in-school support. (4) Conclusion:  Accurate screening by GPs will go a long way toward eliminating overdiagnosis of childhood autism and AD/HD at low cost to the NHS and to parents.