Elizabeth Usher Memorial Lecture: Rethinking the clinical pathway for autism spectrum disorder and challenging the status quo

Abstract

Autism spectrum disorder (ASD) is typically diagnosed between 2 and 5 years of age, which is currently thought to be the earliest that the behavioural symptoms are able to be identified without ambiguity. A significant problem with this relatively “late” age of diagnosis is that by the time a child has been identified and diagnosed with ASD, many of the best opportunities for therapies to capitalise upon brain plasticity very early in development are not realised. This paper provides an overview of the benefits and drawbacks of the current clinical pathway that places primacy on a diagnostic assessment for triggering the commencement of therapy. The paper then presents an alternative clinical pathway – the identification and provision of therapy to infants at risk of ASD – and provides a critical review of current evidence supporting this model. The aim of the paper is to outline a vision for the future of early identification and intervention of individuals with ASD, and the research goals that need to be addressed to achieve this vision.

Keywords:

• Autism spectrum disorders
• clinical pathway
• early intensive behavioural intervention

Acknowledgements

Andrew Whitehouse is supported by a Senior Research Fellowship from the National Health and Medical Research Council (APP1077966).

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.