Presenting Symptoms of Undiagnosed Autism Spectrum Disorder Among Young Boys and Girls in Community CAMHS Between 2018–2019

[摘要] Aims. Though Autism Spectrum Disorder (ASD) is a commonchildhood neurodevelopmental disorders, the literature on presentation of undiagnosed ASD in Consultant Child andAdolescent Mental Health Services, (CAMHS) is scarce. Theaim of the study was to look at symptoms at presentationamong boys and girls in CAMHS, compare the symptom profilebetween the two genders, establish the main referral and assessment pathways and interventions employed after diagnosis Methods. This was a retrospective review of patients’ files referredto ASD Walsall CAHMS Clinic conducted in February 2021. Arandom sample size of 44 boys and girls equally distributedfrom the ASD database was selected randomly from the completed ASD assessment list, the equal distribution between genders was intentional. We looked at presenting symptomsreported on the referral letters, assessments in CAMHS, andinterventions outlined from ASD outcome letters of all subjectswith completed ASD assessment, in age groups 7–18 years.Results. Across genders, most patients presented in the teenageyears with common age of presentation seen at ages 15 and 17,both at 15.9% and mean age being 13 years. Ninety-five percentof patients were in school at the time of referral. Only 4.5% ofpatient were referred through crisis and the rest through localGP. A variety of presenting symptoms were seen, with the majority of the patients presenting with social and communication difficulties (77.3%), under /overreaction to sensory stimuli (63.6%)and anxiety (61.4%). 9.1% of patients had a family history ofASD. 100% of assessments included ADOS, SALT and neurodevelopmental assessment. 77.3% of patients were referred to support groups like living with ASD parent support groups. Alongwith CAMHS, education (97.7%) was the main agency involvedin the care of these patients. In 44.2% of patients, EHCP wasrequested or already in place. The in between gender comparisonalso showed that although most symptoms were similar in bothgroups, some such as self-harm were higher among girls(27.3%) as compared to boys (13.6%) as well as obsessional symptoms which were more common in boys (63.3%) as compared togirls (27.3%).Conclusion. Undiagnosed ASD presents with a wide variety ofsymptoms amongst boys and girls. Previous UK studies haveshown an earlier presentation of ASD and which is contrary toour findings demonstrating a much later presentation.Therefore, we recommend referrers to be aware of the varied presentations and have a lower threshold for referral to secondaryservices to aid quicker ASD diagnosis and management.

[学科分类] 计算机科学（综合）