Autism Spectrum Disorder and Attention Deficit Spectrum Disorder Pathway Analysis: a Local Study

Authors: Dr. Bertha Grech, Dr. Lorraine Azzopardi & Dr. Nigel Camilleri

Background: Autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD) are neurodevelopmental disorders, ranging in severity and characterised by early onset of delay and deviance in the development of social interaction, and verbal and nonverbal communication. Guidelines for referral and diagnosis have been established to ensure such patients are offered treatment to help minimize the symptoms and maximize abilities. The aim of this study was to analyse the waiting time for patients to have the pathway initiated and duration for its completion.

Method: Data from 176 cases referred to Child and Young People’s Services clinic for ASD or ADHD pathway in 2017 was collected. Details about the patient’s age, gender, diagnosis, source of referral, waiting time for initial review, assessment tools used, time taken for pathway to be complete, treatment initiation and side effects encountered were documented.

Results: Of 51 ASD referrals, 5.9% had undergone the entire diagnostic pathway whilst 35.5% of 93 ADHD referrals had finished such workup. 1 female patient was seen for every 5 males. The average patient age was 7 years, with referrals ranging from 3 years to 18 years of age. The average waiting time for initial contact was 7 months for both ASD and ADHD. The average duration for the pathway to be complete was 11 months for ASD and 10 months for ADHD.

Conclusions: International guidelines state that initial contact from time of referral should be less than 3 months. 31.4% of ASD and 25.8% of ADHD cases met these criteria. Clinics would benefit from increase in allocation of resource to ensure more timely diagnosis for better management of these young adults and their families.