Appraisal of a Proforma for Initial ASD (Autistic spectrum disorder) Diagnostic Assessment, to Contribute to Design of a Long Term Cohort Study of Children with Possible Autistic Spectrum Disorder
Rosie Ives*, Ian Male**
Brighton and Sussex Medical School, UK *, Brighton and Sussex Medical School, UK **
Background
Autistic spectrum disorder (ASD) is characterised by a triad of impairments in communication, social interaction and flexible imaginative functions. Presently only having IQ below 70 and/or not speaking by the age of 5 are conclusively is known to be associated with poorer long term outcomes. By piloting an ASD proforma this study aims to help initiate a long term cohort study to try and determine other factors that can predict prognosis.

Methods
The prototype proforma was used in clinical practice by five health care professionals. A standardised questionnaire was then used to record the proformas ease of use and any suggested improvements. Returned proformas were analysed to see if there was any significant differences between the DSM-IV scores given by paediatricians compared to other healthcare professionals or the number of diagnoses indicated by the DSM-IV criteria compared to that of the DSM-V criteria.

Results
The difference between the paediatricians and other healthcare professionals DSM-IV scores was not quite statistically significant (p-value =0.083) but there was a trend for the paediatricians to give higher scores. All the health professionals felt the DSM-IV criteria needed to be scored separately for the school and the parent's history. The health professionals also agreed that they would not include the new DSM-V criteria on the proforma because they felt it was not user friendly but there was no significant difference in the number of diagnoses it indicated.

Conclusion
The current study was successful at determining alterations that should be made to the proforma. DSM-IV and DSM-V criteria are to be removed and replaced with the ICD-10 criteria which will be used separately for the school and parents? history. Further research is needed to determine the remainder of the logistics for the future cohort study before it can be commenced.
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