Improving Efficiency and Quality of the Children's ASD Diagnostic Pathway: Lessons Learned from Practice.
Marion Rutherford, Morag Burns, Duncan Gray and 5 others
PMID 29189916WHAT IT FOUND
A single evidence-based pathway with multi-disciplinary triage significantly cut waits for children's autism assessment.
Referral to diagnosis dropped from 26.4 weeks in 2015 to 17.5 weeks in 2016. Referral demand was also found to be more than double previous estimates.
Key findings
01The average wait from referral to shared diagnosis significantly reduced from 26.4 weeks in 2015 to 17.5 weeks in 2016.
02Systematic data collection revealed actual referral rates (711 per year) were more than double previous estimates (340 per year).
03Multi-disciplinary triage allocated 11.3% of referrals to an abbreviated pathway, bypassing specialist teams for straightforward cases.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was a before-and-after service evaluation without a control group, so other factors could have contributed to the reduced waiting times. Data collection was inconsistent at baseline, with four of seven teams unable to record waiting times accurately. 453 of the 711 referrals were still undergoing assessment when the data was analysed, so waiting times reflect only completed cases. The study did not independently verify the accuracy of diagnoses made via the abbreviated pathway. Gender data was missing for most referrals, and ethnicity was not recorded.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the reduction in waiting times as proof that the pathway alone caused the improvement. This was a before-and-after study without a control group, and the authors note that staff awareness and other concurrent service changes may have contributed to the result.