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Practitioner Survey

This research will investigate current diagnostic practices amongst health care professionals who are involved in the early assessment and diagnosis of young children with Autistic Spectrum Disorders (ASD). It is hoped that this research will help to facilitate earlier identification and diagnosis of ASD, and in doing so, allow for earlier entry into intervention programs and improve developmental outcomes for children with ASD. Please note: Autistic Spectrum Disorders (ASD) include Autistic Disorder, Asperger’s Syndrome, Pervasive Developmental Disorders – Not otherwise Specified Your participation in completing this anonymous questionnaire is voluntary. Completion of this anonymous questionnaire is accepted as an indication of your consent to participate in this project.

1. What is your profession? Please select one ... Paediatrician Psychiatrist Educational and Developmental Psychologist Clinical Psychologist General Psychologist Occupational Therapist Speech Pathologist 2. How many years have you been practicing? Please select one ... 0-4 years 5-9 years 10-14 years 15-19 years 20+ years 3. What best describes your type of practice? Please select one ... Private Public combined 4. What best describes your practice setting? Please select one ... Large City Provincial city Rural/Remote 5. What is your practice location? Please select one ... Queensland Victoria New South Wales Western Australia Tasmania South Australia New Zealand Other 6. Have you undergone additional training or professional development specific to the assessment and diagnosis of young children with ASD? Yes No 7. On average, how many children are you referred for assessment/diagnosis of ASD? Please select one ... 1 per month 2-3 per month 1 per week 2-3 per week week >3 per week 8. What is the age range of children you see for assessment/diagnosis of ASD? (please check all that apply) 0-3 years 3-5 years 5-8 years 8-12years 12-17years 17 years+ 9. What age range of children are you predominately referred for further assessment/diagnosis of ASD? Please select one ... <12 months 12 - 18months 19-24 months 25 – 30 months 31-36 months >37 months 10. What is the average time it takes for you to complete the assessment? Please select one ... 1 hour <4 hours <6 hours <10 hours >10 hours 11. Do you find that you require more time to diagnose ASD than other Developmental Delays and difficulties? Yes No 12. Do you have children on a wait list? Yes No 13. What is the average length of time children are on the wait list? Please select one ... Does not apply <1 week < 2 weeks < 1 month > 1 month 14. Do you follow a standardised protocol of assessment? Yes No 15. Which best describes your protocol of assessment? Developed your own protocol Follow the protocol outlined in the National Autism Plan for Children 16. What methods do you usually use when diagnosing ASD? (Please tick all that apply) Non standardised structured/unstructured interview Standardised structured interview (e.g. Autism Diagnostic Interview-Revised - ADI-R). Non standardised clinical observations across 1 session Non standardised clinical observations across 2 or more sessions Standardised observational method (e.g. Autism Diagnostic Observation Schedule - ADOS or Childhood Autism Rating Scale -CARS) Clinical judgment DSM-IV-TR diagnostic criteria Referral for Multidisciplinary assessment reports (e.g. Psychologist, Speech Pathologist, Occupational Therapist) Standardised Autism Specific parent/teacher questionnaires (e.g. Australian Asperger’s Scale, Gilliam Asperger’s Disorder Scale - GADS, Gilliam Autism Rating Scale - GARS) Observational /descriptive information from teachers/day care professionals Cognitive assessment Communication, speech and language assessment Please specify measures used:   17. Which are you most likely to use when making a diagnosis? (please tick all that apply) Clinical judgment Clinical observations Parent report Standardised Structured interview Standardized observational measure DSM-IV-TR Diagnostic Criteria Other   18. Please choose one from the following   Often Sometimes Occasionally Not at all Have you had to change the diagnosis prescribed to a child earlier on in the course of their development to ASD? Have you had to change the diagnosis prescribed to a child earlier on in the course of their development from ASD to a different diagnosis Have you adopted the ‘watch and wait’ strategy for diagnosis (i.e. holding off on a formal diagnosis and diagnosing later on in the course of development because it is unclear if the child has ASD)? Have you ever had a child who does not meet DSM-IV-TR criteria for ASD but your clinical judgment would say otherwise? if this happens, would you diagnose this child with ASD? Have you ever had a child who does meet DSM-IV-TR criteria for ASD but your clinical judgment would say otherwise? In this instance, would you diagnose this child with ASD? Do you feel confident in your training/expertise to correctly detect and diagnose ASD? 19. If you have had to change the diagnosis prescribed to a child earlier on in the course of their development to ASD what was the initial diagnosis most likely to be? Speech and Langauge Impairment Global Developmental Delay Intellectual Impairment ADHD Sensory Prcocessing Disorder Other:   20. If you have had to change the diagnosis prescribed to a child earlier on in the course of their development from ASD to a different diagnosis what was the secondary diagnosis most likely to be? Speech and Language Impairment Global Developmental Delay Intellectual Impairment ADHD Sensory Processing Disorder Other:   21. Please choose the number on the scale that best describes your level of agreement   Disagree Neutral Agree Diagnosis of children under age 2 is difficult I am more confident in prescribing a definitive diagnosis of ASD to children over 3 years of age DSM-IV-TR diagnostic criteria are useful in diagnosing ASD in children under 3 years of age DSM-IV-TR diagnostic criteria are applicable to children under 3 years of age There are reliable screeners/early detection tools to identify children with possible ASD under age 2 Screening for ASD should become standard practice It would be beneficial if a screening/early detection tool was available that could be used by GP’s and early educators to detect children who may warrant further investigation of ASD Assessment measures need to be quick to administer to reduce time demands on health practitioners Assessment measures need to be quick to administer to reduce financial demands on families In clear-cut cases, I would be more likely to diagnose ASD without using any standardized measures. Observational measures can be more reliable than retrospective parent report It is often difficult to discriminate children with a specific language disorder from children with ASD Diagnosing ASD based on the presence of ASD specific symptomology would help make a definitive diagnosis Diagnosing ASD based on the earliest presenting symptomology (primary deficits) would improve the age of diagnosis Diagnostic criteria and measures that rely on identifying secondary deficits associated with ASD (i.e. those deficits that occur later on in the course of development and that cannot be assessed early on in life e.g. delays in language) would delay diagnosis. There is a need for an observational measure that is inexpensive, quick to administer and that detects ASD based on the presence of primary deficits that are specific to ASD