SLPCohortFrontiers in rehabilitation sciences2023

An observational study of individual child journeys through autism diagnostic pathways, and associated costs, in the UK National Health Service.

Ian Male, William Farr, Stephen Bremner and 6 others

PMID 37350848

WHAT IT FOUND

Children in the UK NHS took an average of 375 days to receive an autism diagnosis, involving 11.5 hours of professional time.

Costs averaged £846 per child. Tertiary centres and children with multiple co-occurring conditions required significantly more time and resources.

Key findings

01The mean time across the four assessment stages to diagnosis was 375 days, with considerable variability between services.

02The mean total professional time spent per child was 11.50 hours, with costs averaging £846 per child.

03Children with autism and multiple co-occurring conditions had 117 days added to their assessment time compared to other diagnoses.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

Data was collected retrospectively from case notes, which may underestimate total costs because informal contacts like phone calls for parent support were not recorded. There was variability in data recording quality between sites, including differences in terminology used for assessment stages. A formal sample size calculation was not performed, so the statistical tests were exploratory. The study did not assess the quality of the diagnostic assessments provided by the teams.

Declared interests

The project was funded by the Paul Polani Award, 2016, from the British Academy of Childhood Disability/Royal College of Paediatrics and Child Health.

The easy way to misread this

Do not assume these costs and times reflect the full resource burden. The study explicitly states that informal contacts, such as phone calls and support activities, were not included in the data, so the reported £846 cost and 11.5 hours represent a minimum estimate.

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