Autism diagnosis in south London

There has been a bit of a stir in the media about autism diagnosis being restricted in south London. Headlines range from saying that autism diagnosis will be radically reduced (BBC) to implying that there will be no autism diagnosis there at all any more (Wimbledon Guardian).

No more autism diagnosis? Something doesn't sound quite right here. So with a bit of help I did a little (very little) digging and actually read the relevant part of the report they're referring to, and I have to disagree with the newspapers' interpretation. I found that the situation is, at least, sensationalised. I am disappointed with the BBC for misrepresenting it and with the National Autistic Society (NAS) for apparently buying into it.

In the areas they’re talking about, diagnosis of neurodevelopmental conditions (autism, ADHD, Tourette’s, etc.) in children is done by a specific team within Child and Adolescent Mental Health Services (CAMHS). Despite attempts to improve the service, it is overburdened and waiting lists remain at about 10 months, which they consider to be too long. So the proposal is that referral to this team in the mental health service be restricted to children with evidence of a mental health problem. Those who don't have such a problem should be dealt with in other ways, which this specialist service says is up to the local Clinical Commissioning Groups (CCGs) to figure out.

Considering many autistic people and their families are adamant about making the distinction between autism and mental health problems, this should make intuitive sense. As long as these uncomplicated autistic children are not being denied diagnosis, I don't see the problem. It's obvious why people see a problem when the media make out like leaving them undiagnosed is exactly the plan. But that's not how I read it.

Information at this point is limited. No one actually has a plan yet. CAMHS has made the first move in saying that their service is not the right place for autistic children without mental health problems. It is now up to others to figure out what to do about them, to ensure that they continue to receive services.

Something I should make clear here, because people don't often enough, is that diagnosis is not required for education, social care or benefits. In some cases it makes these easier, but it is not required.

I know children who are very complicated and need a mental health approach to their diagnosis (and treatment), and I know others who are straightforward where sending them to a mental health team would make no sense at all.

Part of the reason for the long waiting lists is that paediatricians and other health care professionals are so afraid of autism - and thus, of making a mistake in an autism diagnosis - that they resist diagnosing even very straightforward kids for an unreasonably long time. Not all of them need a long and intensive multi-disciplinary team approach. Sometimes they have a family and developmental history that makes autism so clear a health care assistant could diagnose it. There is no need to keep these children under review for years, blocking access to more kids who need it.