Assessment of autism in a survey of adults Adult Psychiatric Morbidity Survey 2007

Assessment of autism in a survey of adultsAdult Psychiatric Morbidity Survey 2007

Policy focus

More common among...• boys (4:1)• people with a learning disability

• 1% of children

What is already known?

Autism spectrum conditions

Characterised by difficulty with...• Social communication • Social interaction • Social imagination

4) A disorder that, although its presentation may change and moderate with age, has a childhood onset and is life-long

• Clinical setting• Developmental history• Involvement of parent

• Self-report screening tool?

Assessment of autism

Adult Household 1993

Institutional Residents 1994

Adult Household 2007

1993 2000 2007

Adult Household 2000

Homeless Persons 1994

Prisoners 1997

Adult Household Follow-up

2002

Children and Adolescent Follow-up

2002

Children and Adolescents 1998

Children and Adolescents 2004

Carers 2001

Looked After Children 2001

The Psychiatric Morbidity Survey Series

APMS 2007: ASD assessment phases

7,400 phase one interviewsAutism Quotient 20 (AQ20)

630 phase two clinical assessmentsAutism Diagnostic Observation Schedule (ADOS)

60 validation assessments with parents/carersDiagnostic Interview for Social and Communication

Disorders (DISCO)

Phase one AQ20 distribution (7,400 adults)

Probability of selection to phase two, by phase one AQ20 score

0

0.2

0.4

0.6

0.8

1

0 2 4 6 8 10 12 14 16 18 20

AQ score at phase one

Probability of selection to phase two

Phase two ADOS assessments (618)

• 618 ADOS assessments• 19 cases of ASD diagnosed• 5 had an AQ20 score of less than 10• Weighting corrects for sampling and non-response• Estimate 72 cases in phase one sample• 1% prevalence in adults• No association with age

Prevalence of ASD by sex

ASD by highest educational qualification

In conclusion...

• Poor screening tool• Few ASD cases diagnosed • Inclusion of people who scored low at phase one • Rates of ASD not increasing• Disadvantaged group

• Communal establishments

Acknowledgements

• NatCen• Susan Purdon, Katharine Sadler, Jenny Harris, Dhriti Jotangia

• University of Leicester• Terry Brugha, Howard Meltzer, Jane Smith

• ARU, Cambridge University • Fiona Scott

• NHS Information Centre for health and social care• Netta Hollings, Vicky Cooper, Andy Sutherland

• DH policy research Unit• Zoltan Bozoky

Thank you

www.natcen.ac.uk