Assessment of autism in a survey of adults Adult Psychiatric Morbidity Survey 2007
Policy focus
More common among... boys (4:1) people with a learning disability 1% of children What is already known?
Autism spectrum conditions Characterised by difficulty with... Social communication Social interaction Social imagination
4) A disorder that, although its presentation may change and moderate with age, has a childhood onset and is life-long Clinical setting Developmental history Involvement of parent Self-report screening tool? Assessment of autism
Adult Household 1993 Institutional Residents 1994 Adult Household Adult Household 2000 Homeless Persons 1994 Prisoners 1997 Adult Household Follow-up 2002 Children and Adolescent Follow-up 2002 Children and Adolescents 1998 Children and Adolescents 2004 Carers 2001 Looked After Children 2001 The Psychiatric Morbidity Survey Series
APMS 2007: ASD assessment phases 7,400 phase one interviews Autism Quotient 20 (AQ20) 630 phase two clinical assessments Autism Diagnostic Observation Schedule (ADOS) 60 validation assessments with parents/carers Diagnostic Interview for Social and Communication Disorders (DISCO)
Phase one AQ20 distribution (7,400 adults)
Probability of selection to phase two, by phase one AQ20 score AQ score at phase one Probability of selection to phase two
Phase two ADOS assessments (618) 618 ADOS assessments 19 cases of ASD diagnosed 5 had an AQ20 score of less than 10 Weighting corrects for sampling and non-response Estimate 72 cases in phase one sample 1% prevalence in adults No association with age
Prevalence of ASD by sex
ASD by highest educational qualification
In conclusion... Poor screening tool Few ASD cases diagnosed Inclusion of people who scored low at phase one Rates of ASD not increasing Disadvantaged group Communal establishments
Acknowledgements NatCen Susan Purdon, Katharine Sadler, Jenny Harris, Dhriti Jotangia University of Leicester Terry Brugha, Howard Meltzer, Jane Smith ARU, Cambridge University Fiona Scott NHS Information Centre for health and social care Netta Hollings, Vicky Cooper, Andy Sutherland DH policy research Unit Zoltan Bozoky
Thank you