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Diagnostic labelling of autism spectrum disorders in NSW

  1. Katrina Williams1,3,*,
  2. Marshall Tuck2,
  3. Megan Helmer1,
  4. Lawrence Bartak4,
  5. Craig Mellis1,3,
  6. Jennifer K Peat1,3,
  7. the Autism Spectrum Disorder Steering Group1

Article first published online: 10 OCT 2007

DOI: 10.1111/j.1440-1754.2007.01232.x

Issue

Journal of Paediatrics and Child Health

Journal of Paediatrics and Child Health

Volume 44, Issue 3, pages 108–113, March 2008

Additional Information

How to Cite

Williams, K., Tuck, M., Helmer, M., Bartak, L., Mellis, C., Peat, J. K. and the Autism Spectrum Disorder Steering Group (2008), Diagnostic labelling of autism spectrum disorders in NSW. Journal of Paediatrics and Child Health, 44: 108–113. doi: 10.1111/j.1440-1754.2007.01232.x

Author Information

  1. 1

    Clinical Epidemiology Unit,

  2. 2

    Department of Psychological Medicine, The Children's Hospital at Westmead, Westmead,

  3. 3

    University of Sydney, Sydney, New South Wales, and

  4. 4

    Faculty of Education, Monash University, Melbourne, Victoria, Australia

*Dr Katrina Williams, Sydney Children's Community Health Centre, Cnr Barker and Avoca Streets, Randwick, NSW 2031, Australia. Fax: +61 9382 8188; email: katrina.williams@sesiahs.health.nsw.gov.au

Publication History

  1. Issue published online: 10 OCT 2007
  2. Article first published online: 10 OCT 2007
  3. Accepted for publication 26 June 2007.

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Keywords:

  • Asperger syndrome;
  • autistic disorder;
  • pervasive developmental disorder;
  • diagnosis

Aim:  To describe the use of diagnostic labels by clinicians for children with autism spectrum disorders (ASD) and calculate the label-specific and overall agreement between diagnostic labels and Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV) diagnoses provided by the same clinician.

Methods:  State-wide active surveillance was used to ascertain children newly recognised with one or more DSM-IV criteria for autistic disorder aged 0–15 years (incident cases) in New South Wales (NSW) between July 1999 and December 2000. Clinicians were asked to supply a diagnostic label and then complete DSM-IV criteria for each child reported.

Results:  Questionnaires with diagnostic label and DSM-IV criteria were returned for 348 children. The agreement between labels used and diagnosis based on DSM-IV classification system was the highest for autism (97%) and lower for labels of Asperger disorder, pervasive developmental disorder – not otherwise specified or atypical autism (27%). Kappa overall agreement was 0.31. Level of agreement between label and DSM-IV diagnosis was similar for questionnaires completed by multidisciplinary teams, psychiatrists, paediatricians and psychologists working as part of a team.

Conclusion:  A lack of agreement between the diagnostic labelling used by clinicians and diagnosis based on DSM-IV criteria indicates a lack of consistency in diagnostic communication that is necessary to provide best clinical care, appropriate services and relevant information to parents and carers.

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