New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Appendices
Practice questions and topics were defined and
a systematic, hierarchical search of medical,
psychological and social science databases
was performed in July 2004. Further searches
were also performed by accessing relevant
organisations and internet websites for policy
and position papers, textbooks, reports and
guidelines. The identified literature was
appraised using the New Zealand Guideline
Group process. Qualitative research was
appraised using the CASP (critical appraisal
skill programme) tool. Evidence tables were
constructed with levels of evidence for each
study. The evidence tables and practice
questions are available separately, published on
www.moh.govt.nz/autismspectrumdisorder. This
team consulted an advisory group on a regular
basis during the development of the sections.
Date range for inclusion of studies
For all workstreams, systematic searching was
performed until 2004. Papers published after
the completion of searching and, in some cases
before the search dates, were suggested by
members of all workstreams and incorporated in
the text and evidence tables, where appropriate.
In future updates of the guideline, systematic
searching will commence in 2004 to ensure a
systematic evaluation of all the literature is
achieved.
Mäori and Pacific perspectives
The process underlying the chapters on Mäori
and Pacific perspectives is described within
these chapters.
Consultation
An open consultation process was undertaken
requesting input from stakeholders and other
interested individuals and groups, both within
New Zealand and overseas. Parallel review of
the draft ASD Guideline was also undertaken
by a number of experts in ASD nominated by
the workstream leaders. Feedback was sought
on identification of gaps in the content, links
between evidence and recommendations and
suggestions on presentation. The workstream
leaders considered all the feedback and
made amendments supported by additional
references, where appropriate.
CAVEAT:
As a result of feedback received during
consultation, an additional independent
review of applied behaviour analysis (ABA)
is currently being undertaken. The purpose
of the review is to critically appraise
published research about ABA interventions
in relation to outcomes for people with
autism spectrum disorder (ASD).
The current sections of the New Zealand
ASD Guideline which relate to ABA will
be neither reviewed nor amended until
the independent review is completed.
The recommendations and evidence from
the review will be considered by the
ASD Living Guideline Working Group
using publicly available criteria that will
be applied to all proposed changes to
the Living Guideline (see page 16 for an
explanation of the Living Guideline).
Evidence tables
The evidence tables that support this guideline
can be accessed on www.moh.govt.nz/
autismspectrumdisorder. No evidence tables
were provided for the assessment and diagnosis
of children as this section of the guideline was
an adaptation of the NAPC UK Guideline.
The evidence tables for the remainder of the
guideline are in two separate formats. Evidence
tables assessing the benefits and harms of
medications follow a strictly quantitative
format, based on study design. This format was
considered unsuitable to describe the evidence
for all other sections of the guideline which
include expert opinion and qualitative evidence
as well as quantitative studies. All other
evidence tables have a broader, more general
format to deal with the variety of evidence that
has been gathered.
Grading
Each of the recommendations in this guideline
is followed by a ‘strength of evidence ‘ grading,
designated by the letters ‘A’, ‘B’, ‘C’, ‘I’ or ‘’
immediately after the recommendation. These
strength of evidence gradings indicate the
amount, general quality and clinical applicability
(to the guideline topic or question) of scientific
evidence used as the basis for each guideline
recommendation.
Appendices
New Zealand Autism Spectrum Disorder Guideline 269