Towards system redesign: An exploratory analysis of neurodivergent traits in a childhood population referred for autism assessment

Lang, J., Wylie, G., Haig, C. , Gillberg, C. and Minnis, H. (2024) Towards system redesign: An exploratory analysis of neurodivergent traits in a childhood population referred for autism assessment. PLoS ONE, 19(1), e0296077. (doi: 10.1371/journal.pone.0296077) (PMID:38198484) (PMCID:PMC10781046)

Abstract

Background: Children’s health services in many countries are moving from single condition diagnostic silo assessments to considering neurodevelopment in a more holistic sense. There has been increasing recognition of the importance of clinical overlap and co-occurrence of different neurotypes when assessing neurodivergent children. Using a cross-sectional service evaluation design, we investigated the overlap of neurodivergences in a cohort of children referred for autism assessment, focusing on motor, learning, and attention/activity level domains. We aimed to determine what proportion of children in a cohort referred for an autism assessment showed traits of additional neurodivergences, and what proportion were further investigated. Methods: We evaluated anonymised medical records of children aged between two and 17 years referred for autism assessment. We used validated questionnaires to assess for neurodivergent traits. A weighted scoring system was developed to determine traits in each neurodevelopmental domain and a score above the median was considered to indicate a neurodivergent trait. Evidence of further investigations were recorded. We then examined the relationships between autism traits and traits of additional neurodivergence. Results: 114 participants were included for evaluation. 62.3% (n = 71) had completed questionnaires for analysis. Of these, 71.8% (n = 51) scored greater than the median for at least one additional neurotype, indicating the presence of other neurodivergent traits, and 88.7% (n = 64) attracted a diagnosis of autism. Only 26.3% of children with evidence of additional neurotypes were further investigated beyond their autism assessment. Conclusions: Our results demonstrate the extensive overlap between additional neurodivergent traits in a population of children referred with suspected autism and show that only a small proportion were further investigated. The use of standardised questionnaires to uncover additional neurodivergences may have utility in improving the holistic nature of neurodevelopmental assessments.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Minnis, Professor Helen and Haig, Dr Caroline and Gillberg, Professor Christopher and Lang, Dr Jason

Creator Roles

Lang, J.: Conceptualization, Data curation, Methodology, Supervision, Writing – original draft, Writing – review and editing
Haig, C.: Data curation, Validation, Writing – review and editing
Gillberg, C.: Supervision, Writing – review and editing
Minnis, H.: Supervision, Writing – review and editing

• Authors: Lang, J., Wylie, G., Haig, C., Gillberg, C., and Minnis, H.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: PLoS ONE
• Publisher: Public Library of Science
• ISSN: 1932-6203
• ISSN (Online): 1932-6203
• Copyright Holders: Copyright © 2024 Lang et al.
• First Published: First published in PLoS ONE 19(1):e0296077
• Publisher Policy: Reproduced under a Creative Commons license