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.