None listed
Conditions
Brief summary
The assessment of Autism Spectrum Disorder (ASD) in children takes into account the perspectives of many professionals across the education, health and community sectors. Within Queensland Health, Allied Health Professionals (such as Psychologists, Speech Pathologists and Occupational Therapists) work with medical specialists for children (also known as Paediatricians) in the assessment of ASD. However, there is variability in the clinical care pathways available in the assessment of ASD. This includes the order and timing of allied health assessments in relation to Paediatrician appointments. At some facilities, children are seen by allied health professionals first before seeing a Paediatrician. While in other facilities, the opposite occurs where children are seen by a Paediatrician first, then are later seen by allied health professionals. Both clinical care pathways for the assessment of ASD are safe and appropriate. However, we do not know which clinical pathway results in more efficient and satisfying care for children and their families. Understanding which clinical care pathway is more efficient and satisfying for families will help inform which clinical care pathway is offered more consistently across Queensland. This will ensure children have access to early intervention as soon as possible and avoid any delays. In this study, we are aiming to determine whether first contact with a Paediatrician or Allied Health Professional results in more efficient and satisfying care for children and their families. We hypothesize that an allied health first-contact model of care reduces service healthcare costs and results in comparable patient quality of life and satisfaction with care, when compared to a traditional medical first-contact model of care for the assessment of ASD in children.
Interventions
Intervention group: Allied health first contact model. Children will be receive assessments from a team of allied health professionals before seeing a Paediatrician for confirmation of the presence/absence of an ASD diagnosis.
Assessments may include one or more of the following: Child Behaviour Checklist (Parent-Reported), Child Behaviour Checklist (Teacher-Reported, where possible). Vineland Adaptive Behaviour Scale, Ages and Stages Questionnaire, Pragmatics Profile for Everyday Communicatio
Intervention group: Allied health first contact model. Children will be receive assessments from a team of allied health professionals before seeing a Paediatrician for confirmation of the presence/absence of an ASD diagnosis. Assessments may include one or more of the following: Child Behaviour Checklist (Parent-Reported), Child Behaviour Checklist (Teacher-Reported, where possible). Vineland Adaptive Behaviour Scale, Ages and Stages Questionnaire, Pragmatics Profile for Everyday Communication, Childhood Autism Rating Scale, Autism Diagnostic Observation Scale (version 2), Sensory Profile 2, Clinical Evaluation of Language Fundamentals (5th Edition), Clinical Evaluation of Language Fundamentals (Preschool, 2nd Edition), Wechsler Preschool and Primary Scale of Intelligence (4th Edition), Wechsler Intelligence Scale for Children (5th Edition), Social Communication Questionnaire (SCQ). The type and number of assessments completed will be based on clinician judgement based on the clinical presentation of each participant. Assessments may be 1:1 face to face standardised assessments and/or involve semi-structured interviews either face to face, over the phone or via telehealth. Assessment sessions are typically scheduled for 60 minutes and frequency of assessment sessions will be at least one or more weeks apart, dependent on clinician, participant and caregiver availability. After the allied health assessments are completed, the Paediatrician appointment will be scheduled at the next available clinical slot, as determined by the children's outpatient clinic coordinator. Scheduling of the Paediatrician appointment will vary between facilities and are contingent on existing organisational priorities for urgent versus non-urgent care. Timing of the Paediatrician appointment, however, will always follow on from the completion of Allied Health appointments. Paediatricians will diagnose the presence/absence of ASD according to the DSM-V criteria with all relevant information collected at the time of face to face or telehealth consultation with the participant and/or caregiver. The Research Officer will be responsible for the adherence of Allied Health versus Paediatrician appointment ordering throughout the trial via hospital based appointment systems. It is estimated that each participant will require multiple appointments with the Allied Health team for the completion of relevant assessments, ranging between 2 to 12 one hour long appointments.
Sponsors
Dr Thuy Frakking
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Diagnosis
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
0 to 16 Years
Healthy volunteers
No
Inclusion criteria
• Referred for cognitive, behavioural, learning or developmental assessment; and • Triaging team determine assessment of ASD is warranted as part of differential diagnosis.
Exclusion criteria
• Children with >2 allied health assessments completed in past 12 months • Children in out of home care • Previous diagnosis of ASD • Acute functional deterioration requiring medical review
Outcome results
None listed