Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Should we be accepting self-referrals for Autism assessments?

Should we be accepting self-referrals for Autism assessments? The Leeds Autism Diagnostic Service (LADS) is an all IQ service accepting professional and self-referrals, from age 18, for diagnostic assessment. LADS is unusual compared to other diagnostic services in England, in that it accepts self-referrals. The purpose of this paper is to compare diagnostic outcome between self-referrals and other referral sources.Design/methodology/approachThis is a service evaluation of all 692 referrals for diagnostic assessment into LADS, over a three year period, from 2016 to 2018. The diagnostic outcomes were compared between self-referrals and other referral sources. Secondary analysis looked at age and gender differences between these groups.FindingsThere were 98 self-referrals over three years with autism diagnosed in 65 per cent. In total, 594 other referrals were received during this time period, with autism diagnosed in 44 per cent. This showed a significant difference of 21 per cent with 95% confidence intervals of 10–31 per cent (p=0.0001) using a n−1 χ2 test. In total, 59 per cent of self-referrals were from patients identifying as female, which compared to 35 per cent identifying as female from other referrals. This was a difference of 24 per cent with 95% confidence interval of 14–34 per cent (p<0.0001) on the n−1 χ2 test.Research limitations/implicationsFactors which may influence the ability to generalise from these results are: that LADS covers a large mainly urban and suburban area with a range of ethnic and socioeconomic diversity; that LADS is an all IQ service unlike some other autism diagnostic services; historical and service-related factors unique to Leeds may be dissimilar to other locations. It was beyond the scope of this evaluation to perform a qualitative analysis to compare the referral sources, but this may be an area for further study.Practical implicationsThis evaluation supports the use of a self-referral route for adult autism diagnostic services on a local level and may support its use more widely in other services.Social implicationsThis evaluation, in demonstrating proportionately significantly higher autism diagnosis from self-referrals is likely to be reducing the work load of professionals who would normally make referrals. Alternatively, it may be capturing a subgroup of the autism population who would not otherwise have sought diagnosis. In either scenario, it supports and is consistent with a patient centred approach to accessing appropriate diagnostic services.Originality/valueThe authors are not aware that any previous evaluation of this nature has been conducted and feel this evaluation supports the use of a self-referral pathway in adult autism diagnostic services. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Advances in Autism Emerald Publishing

Should we be accepting self-referrals for Autism assessments?

Whitney, Daniel; Stansfield, Alison Jane
Advances in Autism , Volume 6 (2): 7 – Apr 21, 2020
Download PDF
7 pages

Loading next page...
 
/lp/emerald-publishing/should-we-be-accepting-self-referrals-for-autism-assessments-9TRd9RZR8a
Publisher
Emerald Publishing
Copyright
© Emerald Publishing Limited
ISSN
2056-3868
DOI
10.1108/aia-09-2019-0027
Publisher site
See Article on Publisher Site

Abstract

The Leeds Autism Diagnostic Service (LADS) is an all IQ service accepting professional and self-referrals, from age 18, for diagnostic assessment. LADS is unusual compared to other diagnostic services in England, in that it accepts self-referrals. The purpose of this paper is to compare diagnostic outcome between self-referrals and other referral sources.Design/methodology/approachThis is a service evaluation of all 692 referrals for diagnostic assessment into LADS, over a three year period, from 2016 to 2018. The diagnostic outcomes were compared between self-referrals and other referral sources. Secondary analysis looked at age and gender differences between these groups.FindingsThere were 98 self-referrals over three years with autism diagnosed in 65 per cent. In total, 594 other referrals were received during this time period, with autism diagnosed in 44 per cent. This showed a significant difference of 21 per cent with 95% confidence intervals of 10–31 per cent (p=0.0001) using a n−1 χ2 test. In total, 59 per cent of self-referrals were from patients identifying as female, which compared to 35 per cent identifying as female from other referrals. This was a difference of 24 per cent with 95% confidence interval of 14–34 per cent (p<0.0001) on the n−1 χ2 test.Research limitations/implicationsFactors which may influence the ability to generalise from these results are: that LADS covers a large mainly urban and suburban area with a range of ethnic and socioeconomic diversity; that LADS is an all IQ service unlike some other autism diagnostic services; historical and service-related factors unique to Leeds may be dissimilar to other locations. It was beyond the scope of this evaluation to perform a qualitative analysis to compare the referral sources, but this may be an area for further study.Practical implicationsThis evaluation supports the use of a self-referral route for adult autism diagnostic services on a local level and may support its use more widely in other services.Social implicationsThis evaluation, in demonstrating proportionately significantly higher autism diagnosis from self-referrals is likely to be reducing the work load of professionals who would normally make referrals. Alternatively, it may be capturing a subgroup of the autism population who would not otherwise have sought diagnosis. In either scenario, it supports and is consistent with a patient centred approach to accessing appropriate diagnostic services.Originality/valueThe authors are not aware that any previous evaluation of this nature has been conducted and feel this evaluation supports the use of a self-referral pathway in adult autism diagnostic services.

Journal

Advances in Autism – Emerald Publishing

Published: Apr 21, 2020

Keywords: Autism; Diagnosis; Intellectual disability; Professional referrals; Self-referral

References

  • Patient self-assessment of nasal fractures and self-referral to an ear, nose, and throat department: a prospective study”
    Baring, D.E.C.; Bowyer, D.J.; Adamson, R.
  • Associations between self-referral and health behavior responses to genetic risk information
    Christensen, K.D.; Roberts, J.S.; Zikmund-Fisher, B.J.; Kardia, S.L.R.; McBride, C.M.; Linnenbringer, E.; Green, R.C.
  • Improving access to care by allowing self-referral to a hepatitis C clinic
    Doucette, K.; Robson, V.; Shafran, S.; Kunimoto, D.
  • ‘Brain screen’: a self-referral, screening program for strokes, falls and dementia risk factors
    Giladi, N.; Mordechovich, M.; Gruendlinger, L.; Shabtai, H.; Merims, D.; Naor, S.; Baltadzhieva, R.; Hausdorff, J.M.; Gur, A.Y.; Bornstein, N.M.
  • Breast cancer early diagnosis experience in Florence: can a self referral policy achieve the results of service screening?
    Giorgi, D.; Paci, E.; Zappa, M.; Del Turco, M.R.
  • Self-referral to a falls prevention service in London, England-does it work?
    Hall, J.; Battarbee, G.; Rossouw, C.; Hanley, E.; Buttery, A.; Hopper, A.; Ingram, C.
  • A service evaluation of self-referral to military mental health teams
    Kennedy, I.; Whybrow, D.; Jones, N.; Sharpley, J.; Greenbery, N.
  • Is physiotherapy self-referral with telephone triage viable, cost-effective and beneficial to musculoskeletal outpatients in a primary care setting?
    Mallet, R.; Bakker, E.; Burton, M.
  • Self-referral of symptoms (SOS) follow-up system of appointments for patients with uncertain diagnoses in rheumatology out-patients
    Pace, A.V.; Dowson, C.M.; Dawes, P.T.
  • The Autism diagnosis crisis
  • The Autism Act 10 years on (17 January 2019)
  • Self-referral to DESMOND, an audit of uptake compared to conventional referral
    Tinson, C.L.
  • Self referral to physiotherapy for back pain reduces pressure on GP appointments
    Torjesen, I.