Global perspectives and Approaches in Diagnostics and Support of Autistic People

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Background

Global awareness of autism spectrum disorder (ASD; autism) is on the rise, and with it, so is the demand for autism diagnostic assessments. Historically, diagnostic approaches for ASD required lengthy assessments by specialist teams, although there is surprisingly little evidence to support this approach. This model has not been able to keep pace with the increased demand for assessments, leading to lengthy wait times. In addition, resource-intensive diagnostic models have limited applicability in low-income countries, where subspecialists are often in short supply. The Covid-19 pandemic further limited access to in-person assessments, creating a critical need for innovation in assessment strategies. Given all of these pressures, new approaches to ASD diagnostic assessment are urgently needed to ensure timely access to diagnosis across the globe.

The need to guarantee timely access to ASD diagnosis across the globe necessitates innovative, effective approaches to increase diagnostic capacity. Early work has emerged in this field, including approaches that engage community-based physicians, such as general pediatricians, and other health care providers. Emerging work has also attempted to harness the power of technology, including using devices that are commonly available worldwide. The Covid-19 pandemic has led to a wave of innovative approaches in autism assessment, including the development of many virtual assessment tools. While we recognize that innovative tools and strategies need to be situated within their local context, we also believe there is tremendous potential to learn from successful approaches such that they can be adapted to one’s own setting. Importantly, this includes high-income countries learning from creative approaches in low-income countries. By working together to share the best ideas from around the world, we can effect meaningful change in timely access to autism diagnosis.

We welcome articles describing and evaluating approaches to increase capacity for and access to ASD diagnostic assessments. Articles must include a description of the innovative approach, and evaluation of efficacy/effectiveness, and potential for implementation in other settings. Approaches can include training programs, expanding use of personnel/scope of practice, technology-based strategies, and others that address autism diagnosis. We also welcome articles that discuss research methods to capture data and evaluate access to ASD diagnostic assessments. While not required, we encourage authors to include descriptions of how relevant stakeholders were included in the work, including autistic people and their families.

Melanie Penner has consulted with Addis & Associates, who were contracted on behalf of Roche.
Kristin Sohl has provided research support to Cognoa and Autism Navigator and has been on the Clinical Advisory Board for Quadrant Biosciences.
Jessica Brian has no competing interests to declare.

Keywords: Autism, Neurodevelopmental Disorders, Diagnosis, Global health Health Systems, Health Services Research

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