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Original research
Systematic approach to school-based assessments for autism spectrum disorders to reduce inequalities: a feasibility study in 10 primary schools
  1. Barry Wright1,2,
  2. Kalliopi Konstantopoulou3,
  3. Kuldeep Sohal4,
  4. Brian Kelly4,
  5. Geoff Morgan5,
  6. Cathy Hulin4,
  7. Sara Mansoor6,
  8. Mark Mon-Williams4,7,8,9
  1. 1Hull York medical School and Department of Health Sciences, University of York, York, UK
  2. 2Leeds and York Partnership NHS Foundation Trust, Leeds, UK
  3. 3Child and Adolescent Psychiatry, Leeds Community Healthcare NHS Trust, Leeds, UK
  4. 4Born in Bradford Research Team, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
  5. 5Educational Psychology Team, City of Bradford, Metropolitan District Council, Bradford, UK
  6. 6Child and Adolescent Psychiatry, Bradford District Care NHS Foundation Trust, Saltaire, Bradford, UK
  7. 7Department of Psychology, University of Leeds, Leeds, UK
  8. 8Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, West Yorkshire, UK
  9. 9National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Lærerskoleveien, Norway
  1. Correspondence to Dr Kalliopi Konstantopoulou; artekon84{at}gmail.com

Abstract

Objectives This was a pilot study to explore whether the Early Years Foundation Stage Profile (EYFSP) carried out by UK teachers within the ‘reception’ year, combined with the Social Communication Questionnaire (SCQ), can lead to early identification of children with autism spectrum disorders (ASD) and early access to intervention and can reduce inequity in access to assessment and intervention.

Design Pragmatic prospective cohort.

Setting Ten primary schools from the SHINE project in Bradford.

Participants 587 pupils from 10 schools who transitioned from reception to year 1 in July 2017 and had the EYFSP completed were included in the final study.

Interventions The assessment involved a multidisciplinary team of three staff who completed Autism Diagnostic Interview–Revised, Autism Diagnostic Observation Schedule Version 2, classroom observations with an ASD checklist, a teacher-based ASD questionnaire and a final consensus meeting.

Primary outcome measure National Institute for Health and Care Excellence guideline-compliant clinical diagnosis of ASD.

Secondary outcome measures Age of diagnosis, demographic data and feasibility parameters.

Results Children with low scores on the EYFSP were more likely to score above the SCQ threshold of 12, indicating potential autism (50% compared with 19% of children with high scores on the EYFSP (p<0.001)). All children scoring above the SCQ threshold received a full autism assessment; children who scored low on the EYFSP were more likely to be diagnosed with autism (and other developmental issues) compared with those who did not.

Conclusions We identified nine new children with a diagnosis of ASD, all from ethnic minorities, suggesting that this process may be addressing the inequalities in early diagnosis found in previous studies. All children who scored above the SCQ threshold required support (ie, had a neurodevelopmental disorder), indicating the EYFSP questionnaire captured ‘at-risk’ children.

  • community child health
  • child & adolescent psychiatry
  • developmental neurology & neurodisability
  • Autism Spectrum Disorders
  • Inequalities
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Footnotes

  • Contributors BW conceived the presented idea, and contributed to the design and delivery of the project and the writing of the manuscript. KK contributed to the design, delivery, data collection and the writing of the manuscript. KS contributed to the design of the project and agreed with the manuscript’s results and conclusions. BK contributed to the design of the project, completed the statistical analysis of the project and contributed to the writing of the manuscript. GM contributed to the design and delivery of the project and agreed with the manuscript’s results and conclusions. CH contributed to the design, overall organisation, data collection and writing of the manuscript. SM contributed to the design and delivery of the project. MM-W contributed to the design of the project and agreed with the manuscript’s results and conclusions.

  • Funding The work was conducted within infrastructure provided by the Centre for Applied Education Research (www.caer.org.uk), and funded by the Department for Education through the Bradford Opportunity Area. The views expressed are those of the author(s), and not necessarily those of the National Health System (NHS), the Bradford Local Authority or the Department for Education.M. Mon-Williams was supported by a Fellowship from the Alan Turing Institute. The work was conducted within infrastructure provided by the Centre for Applied Education Research (funded by the Department for Education through the Bradford Opportunity Area) and ActEarly: a City Collaboratory approach to early promotion of good health and wellbeing funded by the Medical Research Council (grant reference MR/S037527/). M. Mon-Williams involvement was supported by the National Institute for Health Research Yorkshire and Humber ARC (reference: NIHR20016). The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Departments of Health and Social Care or Education.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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