6697 Diagnosis of ASD in a South London paediatric population

Objectives Background: Autism Spectrum Disorders (ASD) are a range of neurodevelopmental conditions affecting social communication and feature repetitive or stereotypical behaviours. Early diagnosis of ASD allows for earlier intervention and treatment which are proven effective.1 ASD can be reliably diagnosed at 24 months, however in practice, the median age of diagnosis is: between four and six years.2 A diagnosis of ASD is often perceived as necessary for families to access help. As paediatricians, questions arise about reasons for the rise in ASD. Objectives: To review the diagnostic trends at one Child Development Centre in South London. The results will be used to identify risks, streamline services, inform commissioning and provide evidence-based answers for local families and agencies. Methods Methods: Retrospective review of locally held electronic databases to identify reasons for trends in ASD diagnosis. Results Results: Over the past 15 years, the diagnosis rate of ASD in our clinic has increased from 44% to 67%. The rate of 67% has held since 2014. Recent figures in 2022, show an increase in the number of children assessed (799) and diagnosed (533) with ASD. 2018: 0.5% of the Southwark child population (65 037) was referred to ARD clinic n=356; diagnostic rate 65% (clinic incidence rate: 0.4%) 2022; 1.4% of the Southwark child population (57,194) was referred to ARD clinic n= 799; diagnostic rate 67% (clinic incidence rate:0.9%). Conclusion Conclusion: Research suggested that the diagnostic rate of autism spectrum disorder using DSM 5 would likely be lower than the previous diagnostic criteria.3 Our local data fits with the national picture4 of increased prevalence. We propose that this absolute increase is driven by increased recognition of needs and aim to identify the reasons for this trend. Limitation: The data for 2020 and 2021 is not fully reconciled following the impact of COVID-19 restrictions on services. It is important to note that apart from the recommended 3-month closure of services in 2020; the local ARD clinic continued to run during this time. References Lord C. Follow-up of two-year-olds referred for possible Autism. J Child Psychol Psychiatry Internet 1995 Nov 1;36(8):1365–82. Available from: https://doi.org/10.1111/j.1469-7610.1995.tb01669.x. Shattuck PT, Durkin M, Maenner M, Newschaffer C, Mandell DS, Wiggins L, et al. Timing of identification among children with an autism spectrum disorder: findings from a population-based surveillance study. J Am Acad Child Adolesc Psychiatry Internet 2009 May 1;48(5):474–83. Available from: https://doi.org/10.1097/CHI.0b013e31819b3848. Maenner MJ, Rice CE, Arneson CL, Cunniff C, Schieve LA, Carpenter LA, Van Naarden Braun K, Kirby RS, Bakian AV, Durkin MS. Potential impact of DSM-5 criteria on autism spectrum disorder prevalence estimates. JAMA Psychiatry 2014 Mar;71(3):292–300. doi: 10.1001/jamapsychiatry.2013.3893. PMID: 24452504; PMCID: PMC4041577. Russell G, Stapley S, Newlove-Delgado T, Salmon A, White R, Warren F, Pearson A, Ford T. Time trends in autism diagnosis over 20 years: a UK population-based cohort study. J Child Psychol Psychiatr 2022;63:674–682. https://doi.org/10.1111/jcpp.13505.