Screening for Autism Spectrum Condition Through Inner City Homeless Services in the Republic of Ireland.
A M Boilson, A Churchard, M Connolly and 2 others
PMID 35948814WHAT IT FOUND
Keyworkers screening homeless adults in Dublin found 3% had likely autism and 9% had possible traits, much higher than the general population.
These clients faced more self-neglect and medication non-adherence. Screening by staff observation is not a diagnosis, but it highlights a critical gap in recognizing autism in homeless services.
Key findings
01Screening of 106 homeless clients identified 3% with present autistic traits and 9% with possibly present traits.
02Clients with present or possibly present autistic traits were at significantly higher risk of self-neglect, poor medication adherence, and non-attendance at medical appointments.
03The DATHI tool is a research screening instrument based on keyworker observation and is explicitly not recommended as a clinical assessment tool.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The screening tool (DATHI) has not been compared against a gold standard multi-disciplinary clinical assessment. Data relied entirely on keyworker proxy reports rather than direct client interviews or observations by clinicians. The sample size was small (106 clients) and restricted to one service provider in Dublin, limiting generalizability. Keyworkers' knowledge of autism varied, and they had no formal clinical training in diagnosis, potentially leading to misclassification of other conditions. The study could not determine if the identified traits were due to autism, trauma, or other neurodevelopmental conditions.
Declared interests
Funding was provided by the National Disability Authority and Dublin City University. The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the 3% and 9% figures as confirmed diagnoses. These are screening estimates based on keyworker observation using a tool not validated against clinical assessment. The 'possibly present' category includes individuals with other conditions like psychosis or ADHD, so these numbers indicate a need for further professional evaluation, not a final conclusion of autism.