What is Autistic Spectrum Disorder (ASD)?
ASD is strongly associated with a number of coexisting conditions that may significantly impact on the wellbeing of the person and their families, partners, and/or carer.
Autism is a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience.
The issues and co-existing conditions of ASD can lead to certain complications. When considering referral, it is important to bear these in mind, as appropriate support/management can help individuals lead more fulfilling lives.
Diagnosing ASD
However, preliminary assessment is performed using Autism-Spectrum Quotient – 10 items (AQ-10) questionnaire in appropriate situations to determine if history suggestive of ASD and, therefore, if referral warranted.
AQ-10 scores ≥6, or autism is suspected based on clinical judgement → consider referral to secondary services if patient requesting assessment and diagnosis.
Penrose Health Action Plan
⚠️ Safety netting
Always review any safeguarding concerns (see Adult Safeguarding).
If there is a change in status, then discuss with senior (GP or clinical meeting) and/or safeguarding lead.
Secondary and External services may be better placed to help/support patients than we are.
- Secondary services offer psychological treatments (e.g., interpersonal/psychodynamic therapies, CBT)
- External services in the community offer many options for social and psychological help through relationships with the wider service network (e.g. Social Prescriber, Befriender, Care Coordinator, Therapist, Lifestyle Coach, etc.)
We do not provide any form of psychotherapy within our surgeries.
Patient Journey - Determining Schedule of Reviews
Click toggle for a schematic of the action plan/treatment policy for all Penrose Health Surgeries, or follow the guidance below.
Suspected ASD → assess using appropriate screening tools and full patient history, including:
- childhood symptoms
- current vocational or social impairment
Refer to secondary services if history suggestive of ASD and patient requesting full assessment and diagnosis. (Not all patients require a formal diagnosis to understand how to live with/manage their condition.)
Perform thorough assessment for any concurrent diagnosis (e.g. Depression or Anxiety). If assessment/history is suggestive → rebook and follow that pathway.
- Once depression/anxiety treated → Consider re-doing assessment and/or referral to ASD secondary care service.
No other concurrent diagnosis, but patient struggling with self care → rebook for single appointment in 6 weeks.
If patient has no active issues and just awaiting diagnosis/shared care agreement → liaise with other services as necessary but conclude routine MHN appointments.
- If a patient is actively managed by another mental health provider → liaise with services as required and conclude routine MHN appointments.
- If rejected by secondary services and patient is at high risk → review again in <1-2 weeks.
If patient has no other concurrent diagnosis, but is struggling with self care → focus of this appointment should be how to manage ASD and signposting to services.
Routinely review the ASD patient in primary care (as well as their family, partners, and/or carers), using clinical judgement on a case by case basis, to ensure that they are coping well and receiving appropriate support.
Referring/Signposting Onward
Below are some services to which you can signpost/refer patients. More services can be found on the Penrose Portal in Mental Health Services Database.
'Access to Work' Government Scheme (for access to software, equipment etc.)