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Abstract
Diagnostic assessment of possible Autistic Spectrum Disorder requires multidisciplinary assessment incorporating information from various settings, including psychometric assessment of the child. The Pirate Adventure Autism Assessment software includes a number of psychometric tests adapted into a pirate adventure storyline. Early experience, presented here, suggests the tool is a useful adjunct to parental history and school questionnaire obtained at initial clinic, in determining the need for the child to proceed to a full, time consuming, expensive, diagnostic assessment.
Keywords: Autism, clinical assessment tool
Introduction
Autistic Spectrum Disorders (ASD) affect at least 1.1% of the population (1, 2) and could even be twice this figure allowing for possible under-representation in females. Affected children, or adults, would be expected to have difficulties in social interaction and communication particularly with their peer group, and repetitive and sensory behaviours, often described as "social communication difficulties." These difficulties can vary from a child with no speech who has minimal interaction with his peers, to a child who may be desperate to make friends but lacks the understanding as to how to do so, alongside obsessive interests.
In the absence of a diagnostic test, such as X-ray or blood test, a multidisciplinary assessment process is recommended in the UK and elsewhere (3, 4). This requires information being gathered from various places including home and educational settings, as well as observation and testing for evidence of autistic behaviours and/or patterns of thinking (5). A number of tools have been developed to aid this process including formal structured history tools such as the Autism Diagnostic Interview (ADI-R) and the Diagnostic Interview for Social Communication Disorders (DISCO), and observational tools such as the Autism Diagnostic Observation Schedule (ADOS) and the NEuroPSYchological developmental assessment (NEPSY). However, NICE recognises: "no single tool alone seems to have adequate sensitivity and specificity for diagnosis of autism" (6).
Current interactive methods including software tools such as 'Autism and Beyond' do not fulfil clinical need (7) and formal tools such as ADOS (8), and Autism Spectrum Disorder Observation for Children (9) take over an hour to complete. The multidisciplinary process takes a long time. Our own study of practice in UK based Child Development Centres suggests this takes around 13 hours of professional time to complete, costing around ?800...