June 5, 2009

comments on National Audit Office report on autism

The comprehensive report covers a broad range of topics relating to autism in adults, including knowledge and awareness of the condition in public services and access to, and effectiveness of, services for adults with autism.

Prof Anthony Bailey, Professor of Psychiatry, University of Oxford, said:

“The NAO report on services for adults with ASD provides hard data to support what families and professionals have long known: that adults with ASD are poorly served by central and local government services. With masterly understatement, the report highlights the savings to the UK if between 4 and 8% of adults with ASD received a correct diagnosis and appropriate intervention. It is hard to think of another handicapping disorder for which such very low rates of diagnosis would be considered acceptable.

“The challenge now for Central Government and local services is to translate the NAO recommendations into practice: short term spending to achieve long term savings and improved quality of life is a difficult message to sell when the public finances are under such intense pressure. And as the NHS, Social Services and the Department of Works and Pensions struggle to implement efficiency savings the unmet needs of adults with ASD will not be addressed unless there is consistent pressure from families and parent led organizations.”

Prof Simon Baron-Cohen, Professor of Developmental Psychopathology, University of Cambridge, said:

“The NAO Report on adults with autism spectrum conditions is very welcome because this is a sector of the population who are currently very poorly served. It is sadly still all too familiar that adults with suspected Asperger Syndrome struggle to even obtain a diagnosis, and even once they have one they are often left isolated, unemployed, lonely, and at risk of developing potentially preventable secondary depression. The NAO Report concludes that there is scope for improvement, which is a remarkable understatement given many individuals’ experience. The hope is that this report will lead to a step change in how we meet the needs of this invisible group in our society.”

Pat Abbott, Clinical Manager, Autism Diagnostic Research Centre (ADRC Southampton Ltd.), said:

“We welcome the NAO report as a major step forward for everyone affected by Autism. We believe that there are a number of key issues that need to be recognised:

•,The widespread incidence of adults with autism – of the £28 billion spent per annum on autism, £25 billion relates to 400,000 adults believed to have the condition. Much of this expenditure is in dealing with crises, admission to hospital etc. (Knapp et al., 20072)
•,That most adults with autism do not have a diagnosis and have not had access to interventions that could improve their quality of life whilst at the same time reduce the overall cost to the public purse.
•,The need for a better understanding about the condition among all organisations that offer services to this group of people
•,The need for an effective diagnosis for adults
•,That people with autism merit appropriate support even if they do not have a secondary condition such as a learning disability or a mental health problem, as many do not.
•,The need for recommendations and action to enable individuals, based on their own strengths and weaknesses, and a move away from a ‘one size fits all’ approach.

“In particular we applaud the report’s conclusions that there is:
•,A need to recognise the numbers affected
•,At present a major lack of diagnosis or effective intervention
•,A need for specialist services including clinics that can provide the quality of individual diagnosis and assessment to enable those affected by this condition life productive lives and deliver economic and social benefits to society as a whole. This at the same time freeing up resources that otherwise would be consumed in dealing with social casualties
•,A need for local authorities and services providers to develop fully integrated services.

“Finally, and very importantly, there is now the opportunity to increase the social and economic benefits suggested in the NAO analysis by identifying and helping a higher proportion of the population affected by autism.”

ADRC Southampton is a specialist diagnostic service for adults suspected of having an Autism Spectrum Disorder, owned by the University of Southampton.