JCPSLP Vol 22 No 1 2020
Table 1. Participant assessments, waiting times and diagnoses (Retrospective cohort)
Participant
Age at DPOP (months)
SLP assessment completed
Waiting time for public SLP (months)
School observation completed
Waiting time for diagnosis (months)
Diagnosis
1
53
Private
No
7
DLD
2
73
No
No
6
Behaviour
3
54
Public
7
No
9
ASD
4
69
Public
7
No
5
ASD
5
58
Public
2
Yes
13
ASD
6
49
Public
3
Yes
5
DLD
7
81
No
Yes
6
ASD
8
59
No
Yes
3
WNL
9
58
Public
8
No
5
ASD
10
59
Private
No
2
ASD
11
49
No
No
3
ASD
12
80
No
Yes
3
WNL
13
51
Public
8
Yes
8
Behaviour
14
68
No
Yes
18
ASD
15
48
No
Yes
6
WNL
16
61
Public
7
No
8
ASD
17
55
No
No
3
ASD
18
60
No
Yes
2
Behaviour
19
52
Private
No
7
ASD
20
61
No
No
3
ASD
ASD: autism spectrum disorder; WNL: within normal limits; DLD: developmental language disorder Waiting time for diagnosis calculated from time of medical evaluation at Developmental Paediatric Outpatient (DPOP) Clinic
assessment, 60% (n = 12) of children received an ASD diagnosis, with the remaining 40% being diagnosed with language disorder (n = 2), behaviour difficulties (n = 3) or no developmental disorder (n = 3). The average waiting time to diagnosis, taken from the time of the DPOP (medical evaluation) appointment to the Tumbatin multidisciplinary team assessment (consensus team diagnostic evaluation), was 6.1 months (SD 3.9). Two participants (10%) required multiple multidisciplinary team assessments prior to an ASD diagnosis. Retrospective data is summarised in Table 1. Prospective study All 15 participants attended the speech-language pathology assessment of functioning following the medical evaluation in the DPOP Clinic. The mean wait from DPOP to speech- language pathology was 2.6 weeks (SD 1.8). The 15 participants were categorised into three groups – ASD, Behaviour, and WNL, as previously mentioned. The accuracy of this group allocation was analysed following the Tumbatin multidisciplinary team assessment (consensus team diagnostic evaluation). Fourteen of the 15 participants went on to receive a formal diagnosis. Of these 14 participants there was 100% consensus with their suspected diagnosis based on medical evaluation and SLP assessment (Table 2). The data shows that the suspected
diagnosis following medical evaluation and a speech- language pathology assessment of functioning was accurate for all children who received a diagnosis at a later point. One participant received an ASD diagnosis following an assessment with a private paediatrician. Another participant, who presented as within normal limits during their speech-language pathology assessment and preschool observation, did not attend any further appointments. For the 13 participants who did attend the Tumbatin multidisciplinary assessment, the mean waiting time taken from the time of the DPOP appointment was 4.5 (SD 1.9) months. Although not the focus of this study, the formal language and social communication assessment results provide interesting, complementary information. As expected, all children scored within the average range or above on the core language assessment. The results of the CCC- 2 need to be interpreted according the combination of scores. According to the CCC-2, a child with ASD would present with a general communication composite (GCC) of less than 55 and a negative social interaction deviance composite (SIDC). The children in the ASD category in this study scored a mean GCC of 58.0 and a SIDC score of –12.7. One child with ASD scored a positive SIDC.
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JCPSLP Volume 22, Number 1 2020
www.speechpathologyaustralia.org.au
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