《自闭症评估国家指南》：家庭需要了解的内容

Australia has a national autism assessment guideline that describes how autism assessments should be carried out. It was first published in 2018 and updated in 2023.

Knowing what the guideline says can help you understand the process, choose a provider and ask the right questions. This article explains the main points for parents, carers and adults who are thinking about an assessment, in plain English.

What the guideline is

The full name is the National Guideline for the assessment and diagnosis of autism in Australia. It was developed by Autism CRC, a national research centre, and first launched in 2018 as the first unified approach to autism assessment in Australia.

A second edition was released in 2023. Autism CRC reports that the chief executive of the National Health and Medical Research Council (NHMRC) approved all 66 recommendations on 8 December 2023. NHMRC approval means the guideline met national standards for developing health guidelines.

Why a national guideline matters

Before 2018, there was no single national approach. That meant the steps in an assessment could differ a lot depending on where you lived and which service you saw. A shared guideline gives families a clearer idea of what a thorough assessment should include, wherever they are in Australia.

The guideline is written for practitioners who carry out autism assessments. It was shaped by research, clinical practice, and the views and preferences of the autistic and autism communities. Autism CRC also provides plain-language information for parents, carers and adults.

What changed in 2023

The guideline introduction lists several changes from the first edition:

• Language. The guideline now uses identity-first language (autistic person), based on the preferences of the autistic and autism communities.
• Method. It follows GRADE, an international standard for developing guidelines, with a more concise set of recommendations.
• New topics. New recommendations were added, including on neurodiversity-affirming practice.
• New terms. “Single Clinician Diagnostic Evaluation” is now called “Lead Practitioner Diagnostic Evaluation”. This reflects that one practitioner leads, while drawing on information from all relevant sources.

The guiding principles

According to Autism CRC’s plain language summary, practitioners should make sure assessment is individualised, evidence-based, strengths-focused, culturally affirming and neurodiversity-affirming. They should work in partnership with the person being assessed.

In practice, this means:

• the assessment looks at strengths as well as challenges
• your family’s culture, language and values are respected
• autism is understood as a difference in how people experience the world
• you are kept informed and involved in decisions

Autism CRC’s information for parents and caregivers puts it simply: you are always in control of what happens in an assessment that involves your child and family.

评估流程

Starting early

The summary says practitioners should discuss referral for assessment as soon as a need is identified. In other words, families should not be told to simply wait and see.

Comprehensive needs assessment

This part aims to understand the person as a whole. It has two components:

• Assessment of functioning. A detailed look at abilities, strengths and support needs across thinking skills, speech and language, daily living, friendships and school or work.
• Medical evaluation. A physical examination and any needed tests, to check for medical causes of the person’s differences.

Diagnostic evaluation

When autism characteristics are present, practitioners use extra tools, such as questionnaires, interviews and play-based or conversation-based assessment, to decide whether a diagnosis of autism fits.

Raising Children Network explains the two ways this can happen:

• Lead practitioner: suited to situations where autism characteristics are clear and another explanation is very unlikely. A specialist medical practitioner or psychologist leads and makes the final decision.
• Consensus team: recommended when signs are less clear, or when something else, such as a language disorder or anxiety, might explain them. A team of professionals works together.

What can vary and what cannot

Autism CRC notes that some parts of an assessment are flexible, such as how appointments are timed and how many practitioners are involved. Some parts may happen by telehealth, but assessments must include in-person consultation.

Other parts are fixed. Every assessment must include all the components above, involve practitioners with the right qualifications, and consider all possible explanations. This last step is called differential diagnosis.

评估后

The guideline says findings should be discussed with the person and family. Autism CRC’s information for families says you should receive a written report that is explained to you, and to your child if appropriate, in a meeting.

The outcome can vary. Autism CRC notes it is common for an assessment that considers autism not to result in an autism diagnosis. Either way, the report should describe strengths and support needs and suggest next steps.

Importantly, the guideline says people should be referred to supports whenever needed and wanted, at any point in the process. Support does not have to wait until an assessment is finished.

Preparing and choosing a provider

What to gather

Because the guideline looks at the whole person, practitioners will want information from several sources. It helps to gather:

• reports from any past assessments, such as speech pathology, occupational therapy or paediatric letters
• childcare, school or work reports
• notes with examples of strengths and challenges at home and in the community
• details of any health conditions, hearing or vision checks, and medicines

For adults, information about early childhood from a parent or older relative can be helpful, but an assessment can still go ahead without it.

Questions to ask a provider

The guideline can help you compare services. You might ask:

• Does your assessment follow the National Guideline?
• Will you assess everyday functioning and strengths, as well as autism characteristics?
• How will medical causes be checked, and do I need to see a GP or paediatrician for that part?
• Will one practitioner lead, or will a team be involved? How do you decide?
• Which parts happen in person, and which can happen by telehealth?
• Will we get a written report and a feedback meeting?

There are no wrong questions. A good provider will be happy to explain their process.

Invictus Health 能提供哪些帮助

Our psychologists and neuropsychologists provide autism assessments for children, teenagers and adults. If you are also wondering about ADHD, our ADHD and autism assessments page explains the options. You can self-refer for most assessments.

For step-by-step detail, read our guides to autism assessment for children and autism in adults. If you need evidence for the NDIS, see NDIS assessments and reports. Fees are listed on our 费用和返利 页面。.

This article is general information only. Please speak with a qualified health professional about your own situation.