Profile of children diagnosed with autistic spectrum disorder managed at a tertiary child development unit

Lian WB, Ho S
Correspondence: Dr Lian Wee Bin, lian.wee.bin@sgh.com.sg

ABSTRACT
Introduction There has been a rising trend in childhood developmental and behavioural disorders (CDABD). This study reports the profile of children with autistic spectrum disorders (ASD) initially referred for evaluation of CDABD.
Methods The CDABD database prospectively collected data of all consenting children referred in 2003 to the then Child Development Unit at KK Women’s and Children’s Hospital. All received medical consultation, followed by further assessments and intervention. Patients were tracked for one year.
Results Among 542 referred children, 32% (n = 170) received a diagnosis of ASD one year after the first consultation. Most were male, with a male to female ratio of 4.5:1. The median age at the first consultation was 41 (19,109) months. The main presenting concern was a delay in the development of speech and language skills in 78% of the children. A significant number had behavioural (63%) and social interaction (34%) issues. Criteria for the diagnosis of ASD according to the Diagnostic Statistical Manual IV-Revised were fulfilled in almost 90%. With the remaining refusing or deferring evaluation, only 74% received a psychological assessment. ASD was assessed to be severe or moderate in 86% of the children. Three-quarters remained on follow-up one year after the first consultation. The majority were referred for either centre- or school-based intervention programmes, with 70% assessed to have improved at the one-year mark.
Conclusion This is the first presentation of local data that aids programme planning and resource allocation. Children with ASD have varied outcomes. It is important to identify and intervene early in order to optimise development and functionality.

Keywords: autistic spectrum disorder, childhood development, childhood developmental and behavioural disorders, speech and language delay, social interaction
Singapore Med J 2012; 53(12): 794–800