Policy Analysis and Evaluation of National Clinician-reported Practices for the Diagnosis of Autism Spectrum Disorder

Abstract

Timely autism spectrum disorder (ASD) diagnosis is critical to access early intervention. The objectives of this thesis were to 1) conduct a systematic review of ASD diagnosis guidance documents; 2) conduct a policy scan of Canadian and UK policies for ASD diagnosis; 3) describe Canadian ASD diagnostic practices through a national survey of paediatricians; and 4) identify determinants of wait times for ASD diagnosis. The systematic review and policy scan showed varying recommendations for ASD diagnosis. The 91 survey respondents described divergent ASD diagnostic assessment practices. Duration of the assessment was a determinant of wait time for the first visit of the assessment and total wait time. The mean adjusted wait time from referral to communication of the diagnosis was 254 days (95% confidence interval 214, 302). ASD diagnostic guidance and practices vary widely. Efficient assessment practices are a key element of reducing wait times and facilitating access to intervention.