New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Part 1: Diagnosis and initial assessment of ASD
child. In areas with large child populations, an
Autism Spectrum Disorder coordinator may be
appointed to assist the developmental services
coordinator in this task (Good Practice Point
1.2.11).
• Contact details for the local developmental
services coordinator and ASD coordinator
should be widely disseminated to all
potential referrers.
• The coordinator will also be responsible for
collecting data and providing information
to the Ministry of Health and District Health
Boards for policy and planning purposes.
Data to be collected include:
– parental report of age of first
developmental concerns
– age at referral to the coordinator or to
another professional service
– duration of waiting time for
multidisciplinary assessment
– outcome of assessment
– time until specified services and supports
are in place for the child.
• Outcome data could include:
– diagnosis of autism or Asperger syndrome
by DSM-IV or ICD-10 criteria
– autism spectrum disorder diagnosis, or
other diagnosis
– presence of co-morbid conditions
– level of verbal and non-verbal
developmental function.
NOTE: It is not intended that an ASD or
developmental disorder register be established,
rather that the efficiency of service provision and
service gaps be identified by data collection.
4. Multidisciplinary assessment
A multidisciplinary specialist assessment
team involves a group of professionals
working collaboratively to assess the child.
This team usually includes at least two or
three members drawn from the following
professions: paediatricians, child and
adolescent psychiatrists, clinical or educational
psychologists, speech-language therapists and
occupational therapists.
The preferred model of assessment process
is a concurrent assessment by a collaborating
team. If this is not feasible, the process could
involve sequential assessments by individual
professionals who then share their findings
with one another. Each professional provides
insights from his/her area of expertise which
are then integrated and synthesised through
an interactive group process. This approach
will lead to more robust diagnosis, more
accurate planning of future services and
supports, and will reduce repetition and
redundancy. Where a paediatrician or child
and adolescent psychiatrist is not present at the
multidisciplinary assessment, a separate medical
assessment, including physical examination, is
required by one of these professionals.
Specialist assessment teams are
multidisciplinary, and may be multiagency
(team members employed by different health
and education providers such as Ministry
of Education, Special Education, Child
Development teams, Child Adolescent and
Family Mental Health Service) or provided
within one agency. Multiagency teams are
preferred to prevent the child and family having
to undergo repeated assessments and to ensure
timely access to all the services needed by the
child and family.
Occasionally, the local multidisciplinary
specialist assessment team will be unable to
make a diagnosis. This may occur where the
clinical features are atypical or complex. In this
situation, local clinicians should be able to access
assessment at a tertiary centre. It is envisaged
that there should be a network of tertiary
centres, with such assessments being available in
main centres (Good Practice Point 1.2.12).
The NAPC Guideline has defined the following
essential components of specialist team
assessment. These have been adapted for
New Zealand.
Part 1
New Zealand Autism Spectrum Disorder Guideline 47