'Instruments are good at eliciting information; scores are very dangerous': The perspectives of clinical professionals regarding neurodevelopmental assessment.
Barry Coughlan, Matt Woolgar, Emma Jl Weisblatt and 1 others
PMID 36154304WHAT IT FOUND
Clinicians said autism and ADHD scores from standardised tools can mislead when depression, learning disability or context affects behaviour.
They combined these tools with observations, history and school reports before deciding.
Key findings
01All participants said standardised autism and ADHD assessment tools were important, but scores should be interpreted with other information rather than used alone.
02Diagnosis labels were described as carrying weight and being hard to remove, and uncertain cases could lead to pragmatic decisions about benefit and access.
03Most participants had revisited autism or ADHD diagnoses because earlier assessments were sub-optimal or because the diagnosis was no longer helpful.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The paper analysed 17 professionals, mostly psychologists, recruited by convenience and snowball sampling, so it reflects a specific group of UK clinicians rather than all therapists. It reports themes from interviews rather than measured diagnostic or patient outcomes. General practitioners were interviewed but excluded from this analysis, so primary-care perspectives are missing. Only one parent reviewed the paper, and the authors did not collect clinical hours. It focused on autism and ADHD, so it may not apply to other neurodevelopmental conditions. Eight participants worked in national specialist services, which the authors say made some topics, such as resourcing issues, less prominent.
Declared interests
The authors declared no potential conflicts of interest. Funding support was acknowledged from the National Institute for Health and Care Research School for Primary Care Research (RG94577).
The easy way to misread this
Do not conclude that standardised autism and ADHD assessments should be abandoned. The clinicians said these tools are important, but scores can mislead when depression, learning disability or context affects behaviour, so they should be combined with other information.