Evaluation of Context-Specific Early Identification of Autism Models Involving Multiple Stakeholders: Examples From Three Areas of England

Purpose Demand for autism assessment has increased substantially in recent years, while diagnostic capacity has not kept pace. As a result, alternative approaches to early screening and support for children with social communication difficulties are required. Method We conducted a convergent mixed-methods multiple case study evaluating three locally developed, school-based early identification models for autism in England. The models were responsive to local priorities and involved collaboration between education and health professionals, schools, families and children. Quantitative referral and diagnostic outcome data were analysed alongside qualitative data from focus groups and interviews with education and health professionals. Results Across the three cases, stakeholders perceived the models positively, particularly in relation to improved inter-professional collaboration, earlier access to support, and professional learning within schools, although concerns were raised in one area regarding potential over-identification. Involvement of school staff was viewed as essential, enhancing understanding of autism and confidence in working with families. Follow-up interviews demonstrated sustained commitment to, and further development of, the models despite the absence of continued funding. Conclusion Overall, findings highlight the importance of locally responsive early identification systems that are not solely diagnosis-focused, alongside ongoing challenges relating to inconsistent assessment frameworks and long-term sustainability.